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27 APRIL 2001
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practice

Resistance

Hugh McIntyre

Bessie is a fourteen year old brought into our Centre. She was labelled as a girl displaying: inappropriate sexual behaviour, severe parent-child conflict, and extreme defiance oppositional behaviour. She was verbally abusive, involved with the Justice System, a 'runner', and attended school irregularly. She was non-verbal with therapists, had violent episodes hurting others, and was non-compliant with authority figures. The plan was to have Bessie remain with us until 'the system' could find a place in a secure treatment centre out of the province.

When Bessie arrived her behaviour soon matched the profile we read. Bessie became labelled as non-compliant, uncontrollable and a threat towards others and therefore needed a secure treatment environment. She assumed that we really didn’t want her and she certainly made it clear to us that she didn’t want to be here with us. Her behaviour pushed our buttons and initially we got locked into this mode of reacting rather than trying to understand the dynamics of Bessie’s behaviour and our own behaviour. Most of us also became influenced by the profile that the clinical social workers and psychologists presented. The clinical social workers were not able to identify what Bessie was defending by her resistant behaviour and because Bessie refused to talk about herself to these therapists they were unable to diagnose whether Bessie’s defences were automatic responses to certain triggers. The therapist took the approach of preparing the written reports to advocate to their administrators and legal system that movement to a facility out of the province was the only option for this young lady. These clinical therapists expected that we would house this troubled youth, keep her safe and respond to her basic needs until transfer occurred. Anyone in this situation understands that waiting approval for transfer to another province takes months of negotiations. The therapists were unable to reach her and they certainly indicated to us that they had no expectations that we Child and Youth Care workers could possibly make a difference – other than to keep Bessie safe.

During the first month, life with Bessie was like being on a roller coaster. Lots of ups and downs, fast and furious moments filled with cries of anguish and destructive outbursts with many AWOLs. What was consistent was a black leather jacket (two to three sizes too big) that she wore constantly. When she arrived she also had a hunting knife that was taken away from her. This caused tremendous pain for Bessie but she could only display her pain by physical outbursts and abusive language. During the “back shift” when you checked in on her during the night the jacket was either under her pillow or she had it over her shoulders or tucked under her arms like a child would hold a doll. This was eventually noted and reported to her clinical therapists. Bessie would never comment as to why the jacket was important. This just gave the therapist more ammunition to present on Bessie's resistant behaviour. Many mornings Bessie would wake up demanding to see that her hunting knife was still in the locked filing cabinet in our office. This behaviour was also noted and, again, Bessie would never share the importance of this knife.

Bessie and I had moments of connection during this first month, where we would embrace a situation with a smile, a nod or a hand movement. Sometimes we watched television together and during those rare occasions we would exchange comments about a commercial or certain type of music. I felt comfortable hanging out with Bessie during these moments and I believe Bessie felt somewhat comfortable in my presence as well.

It wasn’t until a particular 7 am – 7 pm shift one Saturday during October that our connection extended beyond a few moments. That day Bessie spent most of her day in and out of her bedroom. I made an effort to include her in our activities but she was content simply to make an appearance every now and then. For lunch Bessie and I prepared the meal. I was in a rather 'silly mood' and the two of us laughed uncontrollably while we were making a “devil's omelette" for lunch. I had no idea what was happening inside Bessie's head that day. I was simply content that the shift was going well and we were having a blast with our nonsensical ways.

During shift change another young lady who lived in our Centre approached me and said that Bessie wanted to talk to me. I went to Bessie's room and I could tell that she had been crying. The other young lady who came to get me was also in the room. These two girls often ran from the home together and did have a close friendship. It was the other girl that said: “Bessie wants you to take her to her brother's grave”.

The shift was over and my wife was expecting me home any time. 7:30 pm in October in the Maritimes means that it's pitch dark outside. From this perspective it's late, and no time for visiting graveyards with two teenage girls! What to do? This was the first time Bessie had asked for anything. This was the first time she risked asking for something, and risked being rejected. Was I prepared to walk with Bessie through this request? I knew I had to and that I would. After explaining to her that I was prepared to see what I could do, I first had to call my wife and then discuss the situation with the other workers. I was in a situation where I was the supervisor and had some additional 'authority' to intervene. Not all the workers were receptive to Bessie's request and some later questioned my motives in entertaining it.

Once everything was settled, Bessie, her friend and I took a twenty-minute car drive to the graveyard. It being so dark I had no idea where to go once reaching the graveyard. Bessie and her friend gave me the directions and it soon became clear to me that these ladies had been here before. It was agreed that Bessie and her friend would go over to the grave and that I was to remain by the car. My role for that evening was strictly their chauffeur. It became apparent to me that Bessie didn't want to talk when she got back into the car. She couldn't look directly at me and kept her teary eyed face down. The friend did the talking saying: “At least we didn't have to run from the home to night." We all went out for coffee and engaged in 'small chat' for the rest of the evening. I interpreted Bessie’s behaviour to mean that she didn't want me to get any closer that night.

Two weeks went by and then one afternoon Bessie asked me if the two of us could go back to the graveyard. I was prepared to stay by the car while she went over to the grave. This time she invited me to the grave. Nothing was said, we simply shared this experience in silence. When we got back to the car Bessie asked if I would take a different route back. I felt that she had a mission and that when she wanted to share she would. I had no idea why we were taking this route although I became curious when she asked if we could stop in front of an abandoned farmhouse. I knew it was important to her but that I had to respect her space and privacy. From her quietness and her being in deep thought I knew it wasn't the time for questions, so I simply told Bessie to let me know when it was time to move on.

The incident was later recorded and eventually passed on to Bessie's therapist. The therapist thought that Bessie was manipulating the situation with me and that I should be asking more questions. All I could see was that Bessie and I were experiencing something meaningful, that I was beginning to understand some of what she was going through and that my role was simply to listen to her silence and behaviour at this point. All I knew was that I had to be with Bessie at that moment.

For the next couple weeks we continued to visit the grave and each time we stopped in front of that abandoned farmhouse. While driving back to the Centre on one of these outings Bessie told me that the jacket she wears belonged to her brother. The brother in that grave. Through uncontrollable tears and a painful deep down cry that seemed to come from her innermost being she told me that the farmhouse was where she and her brother lived before he killed himself.

When I described this cry to the therapist I was told that it was a 'primal scream' as if that made a difference to understanding the pain of this young lady! I felt the hurt and agony from her cry. I didn't have to question it and I didn't have to name it; I simply felt every ounce of that pain.

Bessie continued her defiant behaviour towards the other staff, especially when she was questioned as to why she wanted to go to a graveyard or why the knife was so important. One day she took a chair and threw it against the door of the therapist's office. Sometimes Bessie would stay in her room all day or she would simply refuse to get up in the morning for school.

Workers would get frustrated by this type of behaviour and always wanted to question her about this. Everyone seemed to get stuck on the behaviour and found it difficult to understand that it was simply the tip of Bessie's iceberg. Workers were even overlooking the fact that AWOLs were almost non-existent now, and still wanted to zero in on her defiant mannerisms. I was beginning to think that the resistance was Bessie's way of defending herself against the terrible pain she was experiencing.

I was having a difficult time with the therapist because I was told that I needed to question Bessie. In my manner I thought I was simply assessing the situation so I could better intervene. When I shared that with the therapist I was clearly told that Bessie was already assessed and that our role in the Centre was to keep Bessie and others safe until movement to a secure treatment centre took place and that I should be coming up with more effective strategies in dealing with her defiant ways. I would respond to the therapist by saying “I'm being present to Bessie". The therapist didn't have a clue what I meant so I explained that through my empathy I was able to join with Bessie. The two of us had different jargon to express the same dynamics. When I used her jargon of empathy and joining, she seemed to buy into our 'academic' discussions about Bessie but still wanted us to question Bessie's motives. I had a difficult time with this. I wanted to say to this therapist, “If we're only keeping her safe until transfer occurs there is no need to question.” But I knew that if I said that to this particular therapist I would only be hindering the process.

I knew I needed to continue to work with the therapist if I wanted to make a difference in Bessie's life. The therapist had the power to influence the type of service Bessie would receive. I was experiencing the administrative pressure to conform to the therapists' viewpoints but deep down I believed that Bessie would only open up when she was good and ready to do so and that the 'gem' I and other Child and Youth Care workers had was our ability to 'hang out' with Bessie. I wasn't prepared to jeopardize my relationship with the therapist for fear that my own 'resistance' would only negatively influence any hope of being able to connect with Bessie.

On a particular night late in October while I was working the back shift, Bessie came down into the kitchen asking me for some hot chocolate. Normally this is not permitted. Do I accommodate Bessie's request or do I follow policy? Every instinct in me told me that Bessie wanted to talk, that this was the time and the opening was here and now. Whoever said nothing happens on back shift!!

She told me she had two brothers. In a span of two months she lost her two brothers, was removed from her mother's care and her grandfather disowned her. One brother was working around a fish-grinding machine and fell in and was instantly killed.

The other brother placed his leather jacket and hunting knife under Bessie's pillow one day before going to school. On the way to school this brother said to Bessie “Good-bye I'll see you much later". Bessie recalls that she was surprised by that remark but never thought any thing else about it during the day. When she got home from school he was hanging from a rafter in their barn. Both boys and their grandfather had previously 'done something' to Bessie and she had previously threatened them saying she was going to tell their mother. Shortly after the threat both boys died and the grandfather left the area. Bessie believed that she murdered both of her brothers and was responsible for her grandfather's disappearance.

The CAS was called in and Bessie was further interviewed as to what her brothers and grandfather “did to her". The therapists attempted to push Bessie to be cooperative with CAS but she wasn't prepared to share that with anyone at that time.

As time progressed Bessie would often volunteer to do certain things in the centre. At other times we would simply go on long walks and share our silence. A special Plexiglas case was made with a safety lock and the hunting knife was placed inside with a plaque attached stating Bessie's brother's name and date of death. With special permission we were able to mount this glass case on the wall in our office, which was in clear view from the office door. Bessie's behaviour soon changed from a non-verbal bully to a noticeably aggressive but verbal individual. Throughout this new phase, unbeknown to any one of us she was also writing poetry.

She never opened up to her therapist and the bureaucratic system was still processing the necessary paperwork for the transfer to another facility. Time was running out. Even though progress was made and Bessie was demonstrating less and less destructive behaviour, the therapists and other clinical social workers were pursuing the transfer. They spent considerable energies in advocating with the decision-makers to make this transfer happen. One day on a walk with Bessie she gave me a poem entitled “The Black Future". It described in detail how she resented the repeated questions from her social workers and how no one took the time to understand her, except a special someone who stood by the grave. The time came to fight for Bessie's right to stay with us instead of having her shipped to another location.

How do you tell a person with their doctorate in psychology that their plan to ship Bessie to a secure treatment centre was all wrong? How do you convince the sponsoring agency to support Bessie's stay with us? How do we get what we think is right while maintaining a workable relationship with the therapist? How do we show progress to a therapist who evidently wanted to be the one 'to save' Bessie?

The key was in Bessie's writings. She clearly made it known that she was not prepared to enter 'therapy' at this time of her life. She was prepared to allow us to 'hang out' with her. We could now be with Bessie while she participated in her daily life events. We could now facilitate activities that would assist Bessie in working through her pain. Yes she had 'blow ups' but nothing compared to what she had done in the past. Movement was occurring, and it was imperative that the therapists and clinical social workers saw this.

With Bessie's permission “The Black Future" was shared with the therapist. This poem clearly illustrated that she had an unconscious need to have her internal picture of her world confirmed by acting out in ways that would provoke the social workers to respond to her in the way that she perceived her brothers and grandfather were responding to her. She felt loss and abandonment by her brothers and grandfather and so she provoked behaviour so the social workers would also abandon her. The poem clearly illustrated this saying “nobody's dumping me – I'll dump you first." This being a classic example of children's feelings in group home settings, the therapist was able to see it for what it was and did not internalize it to be her fault. Bessie's own writings became our strategy in being able to keep her at our place. The writings illustrated that she was voluntarily stating her willingness to remain in this setting. The incident reports had decreased considerably and we had no 'runs' from the house for over a month.

It became clear to the therapist that Bessie could benefit from our open setting. The therapist was eventually able to see that being with Bessie in the moment was working. Bessie was now beginning to talk about the feelings she was defending, rather than acting them out. We were eventually able to demonstrate that our 'therapeutic environment' was what Bessie needed and she would only see it as another rejection if we pursued transfer at this time.

We continued through many different phases of resistance through the year-and-a-half Bessie remained with us. There was a time when she needed to be hospitalized, and there was a time when her mother re-entered her life that the “old Bessie" surfaced. Overall, though, Bessie became more and more responsive to verbal direction and limits. She was eventually able to talk out rather than act out her feelings of depression and anger. Being particularly gifted in writing, Bessie often used that medium as a calmer when upset or depressed.

* * *

Resistance affects everyone in a system in which it occurs. The resistance needs to be analyzed and then we need to do something about it. However any actions by professionals to force the resident to deal with it without first establishing a meaningful connection, will drive the resident away, as was seen with Bessie. Through the youth care approach of being there and “hanging out”, Bessie was eventually able to look at her pain, her anger and confusion. On the other hand if I, as the worker, had not analyzed my own resistance I would have continued to deal with the therapist, co-workers and Bessie’s resistance with my own resistance. Resistance work can have both negative and positive connotations. It all depends on how we choose to work with it.

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