Listen to thisI don’t think it’s revolutionary to say here that healthy human relationships are a foundation for healthy human development. In fact, I’ll let someone else say it because they do a much nicer job of it than I ever could. “From the days of Freud and the subsequent waves of ‘dynamic’ and ‘attachment’ theorists, through to contemporary trauma-based perspectives, the nature of a child’s close relational connections has been understood to play a central role in their physical, social, emotional and cognitive development” (Bath, 2021, pg 4).
If this is true, which I would venture to assert that you, the reader, believes, as I do, that it is; then we are both deeply aware of the importance of the relationships we build with the young people we work with. As Perry (2019) says about those who have experienced developmental trauma in the context of past relationships, they have a template for what a relationship is in their mind. Often, that template is one of danger, mistrust, abuse, or neglect. With all of this in mind, it becomes obvious that a large part of our role in intervention with the young people and families we support is rewriting these templates. Our role is to build relationships.
While it is important when engaging in relationship to understand that it is not something we have, something we, as the CYC-P, are the sole arbiter and judge of. We share it with others, we share the responsibility of defining it together, building the rituals and rhythms together. But, as Freeman, Fulcher, Garfat & Gharabaghi (2018) discuss, there is an aspect of relationship that we, as the practitioner, need to hold responsibility for, and it is the bedrock on which any relationship is founded. Connection.
If the young people we find ourselves working with are coming to us with, as Perry suggests, templates of relationship as harmful, then they will likely behave in ways that we interpret as resistant to it (I think we’ve all been told to ‘fuck off’ in practice, not exactly an indicator of openness to engagement). This is where, I think, there becomes a clear line in the sand between personal and professional relationships in the CYC context.
We have all been conditioned to view and engage in relationships in certain ways throughout our lives. In almost all cases, the relationships we create in our personal lives are conditional. That is there are expectations we have, and when these expectations are not met, we disengage from relationship. We expect mutual respect, a certain give and take, perhaps there is an expectation that from time to time, one person in a relationship can fully depend on the other (Holloway, 2021). We create these conditions to protect Self. In personal relationships, these conditions are healthy and support our own social and emotional well-being. But as practitioners, we must suspend these conditions, and, in a lot of ways, work in a way that is in complete opposition to the way we have been socialized to conceive of a relationship. We cannot put the onus to connect on young people. If they are engaging in a way that aligns with their perspective of relationship, they may never feel safe to connect without us taking it on. We must, as Holloway (2021) asserts, make our relationships with them unconditional.
“It is unacceptable to blame the ‘other’ when they are nonresponsive; it is the practitioner’s obligation to work towards making the connection (Freeman, Fulcher, Garfat, Gharabaghi, 2018).”
The story that follows is about one practitioner's attempt to hang in and take ownership of his connection with a particular young person. As you will see, he works to remove the conditions from his relationship with her and tries to support her to redraft the template of relationships with adult men she carries around wherever she goes.
Collarbone
“You still smell like piss, dude,” Mark, my supervisor remarked from behind his desk with smirk as I dropped into the chair across from him.
I returned his smirk, but, admittedly, without the gusto I typically did when joking back and forth with him. “Yeah,” I said weakly, “changing my clothes wasn’t enough to shake it, I guess.”
Mark must have noticed my lack of enthusiasm because the smirk left his face quickly. “Sorry, Francis. Probably not that best way to start a debrief.” He fidgeted with the report I had dropped on his desk before sitting down. “You good?”
“Yeah, yeah,” I brushed off what I interpreted as his guilt. “Don’t stress on it. Not like you threw urine-soaked clothes in my face.” I grinned now with a bit more authenticity.
Mark smiled wider, and let his eyes fall onto the first page of the incident report. “Let’s have a look here.” He began to read.
After about thirty seconds, he looked up. “So, looks like it started with administering afternoon meds,” he said.
“Yup,” I agreed, “that kicked off the dysregulation for sure.” I leaned forward as Mark turned the page and pointed to the Antecedents section. “I did write about here, what went down this morning. Ophelia was not happy that I was the one who came into her room when she woke up and called for staff. She refused to take her medication from me this morning, and I had to switch off with Janessa.” Janessa was my shift partner, and the other full-time staff I worked most of my shifts with.
“Good call on that switch off,” Mark told me as his eyes moved back and forth over that section of the report. “Why no switch off for the afternoon meds?”
Some people might have got defensive at the question, and even though I had only been a full-time employee for a month or so now, I knew Mark was just asking for more context. “Janessa was with Ivan doing his room clean, and Jackson was with the other kids playing a game of Catan in the dining room. I thought the other kids deserved the engagement they were getting. Especially Ivan. I think sometimes he misses out on 1-1 because he can regulate himself better than some of the other kids. I actually wrote that in there if you keep reading that section.”
Mark looked back down at the report. “There it is,” he confirmed. “I know you’ve been a trigger for Phee since you got here, and I know we’ve been using the change-of-face intervention effectively with her, but I still think your decision makes sense.”
I snorted. “The outcome wasn’t great, though.” I held my forearm to my nose and took a sniff, tried to figure out the main source of the stink that I’d suddenly become aware of again.
“Yeah, well,” Mark conceded, “bad things happen to good people every day. Let’s keep going here.” He returned his eyes to the report and was quiet for another 30 seconds or so. “Alright, so you were playing video games with Ophelia and Spring.”
“Yup. Begrudgingly on Phee’s part.”
Mark kept reading. “Then you went to get their meds,” he stated.
“Yup. We’d finished a round of Mario Kart, and it was a good natural break in the action.”
“Right. And then you brought them down...” Mark trailed off to continue reading.
I interjected and recalled what had happened. “I came back down, and, honestly, I should have known something was coming. They were both so agreeable to pause the game and get their meds. Anyway, I handed them each their med cup at the same time, and then it just happened so quick.”
Mark was reading along with me and said, “then they switched med cups, and ran into the bathroom.”
“Yeah,” I said.
“Spring didn’t stay in too long though, eh?” Mark asked, his eyes still on the report.
“Nope she came out pretty quick, but she’d already taken Ophelia’s medication. I was by the door when she slid out, but Phee slammed it behind her and locked herself in. Spring ran out of the basement....”
Mark cut in. “Yeah, she came right up here and knocked on my door. She was quite proud of herself.”
“Anyway,” I said, “I stayed outside the bathroom door, told Phee I was worried, and that taking medicine her doctor didn’t prescribe could be dangerous, told her I wanted to come in and make sure she was alright.”
Mark was still reading. “Looks like she wasn’t too receptive to your concern.”
“She was not,” I said. “Told me to get the fuck away, and that I better not fucking come in there. Screamed she was naked, and she didn’t want any pervert around her, called me a pedophile.”
Mark looked up now. “How’d you do with that? The ‘pervert’ and ‘pedo’ stuff does always get to me a little bit.”
I shrugged. “Yeah, it’s not great, but honestly, I was too worried about her taking the wrong medication to worry about the name calling.”
Mark smiled. “Hopefully she’ll hear that concern someday.”
“Maybe,” I said. “Not today though.”
“So, you just sat outside the bathroom then?”
“Yup,” I said, “figured it would be riskier to try and barge in, than to give her space to regulate. The main concern, I figured, was that she had the wrong medication in her, and I could call 811 to get a better idea of that risk before I decided one way or the other.”
“So, you called 811 right then and there?” Mark flipped through the pages and scanned the report.
“I was going to call 811 right then and there...”
“Ah,” Mark cut in, “I see, you were interrupted.”
“Yup,” I sighed. “I heard this sound, like she was pouring water on the ground. I thought maybe she was trying to trash the bathroom by dumping water from the sink onto the floor.”
Mark winced. “It wasn’t water though.”
“Nope,” I confirmed. “It was not water.”
Mark looked back at the report.
“So, she wasn’t lying about being naked,” I continued. “The door flew open, and there was Phee, no clothes on, but her sopping wet pants were in her in her hand. I didn’t really register what was going on, but once she chucked them into my face, and they fell onto my lap, the smell helped me figure it out real quick.”
“Jesus, man,” Mark ended, dropping the report on the desk.
“Yeah,” I said.
“So,” Mark started, “here’s where I ask: would you do anything differently next time?”
I thought for a second. “Probably not,” I said, before correcting myself, “that’s not true, I would have done something other than hand them both of their meds at the same time on the couch down there.”
“Take them up to the office with you to administer?”
“Yeah,” I admitted, then continued, “but as far as holding to me administering, I’d do that again.
Mark adjusted in his seat but didn’t say anything.
“I mean,” I went on, “I do think me giving the meds was the trigger. She doesn’t like it when I am the one doing things with her, it was probably giving her a sense of control to do what she did. And in her mind, it might make me think twice about holding the limit that I’m giving meds next time.”
“Fair,” Mark agreed. “I gotta say, Francis, not many folks could be needs-focused right now.”
I shrugged. “But would I do anything different next time? Probably not. The other kids needed the attention they were getting, and I’ve gotta keep hanging in with Phee.”
“Agree,” Mark stated. “Alright, final thing. The meds,” Mark looked back at the report.
“Yup. Called 811. They said Vyvanse and Ritalin treat similar symptoms. The doses were about the same. Not ideal, but aside from monitoring for anything concerning, they don’t need to come in, and normal activity should be fine.”
“And there’s all that documented. Nurse’s name. Good stuff.” He signed the report and let it close in front of him. “So, how’re you doing then?”
“Well,” I admitted, “I don’t smell great.”
Mark guffawed and leaned back in his chair. “You know what I mean, Francis.”
“I’m good,” I said. And I really was. “We’ve all read her case history. She’s got good reason not to trust men, especially new men, in her life. It’s not really about me.”
“Sure,” Mark said. “But still...”
“Yeah. But still, it’s not pleasant getting an armful of piss-soaked clothes in the face.”
“What do you need right now?” Mark looked at his watch. He was cutting to the chase. “There’s still 6 hours until 9 o’clock. We can talk to the team, get you more task focused for the rest of shift to give you a bit of a break. Laundry. Supper. That kind of thing.”
I waved off the suggestion. “I’m good, Mark. Really. Jackson got that butter chicken started, and I don’t know what to do with it anyway. We’re all packed and set to head to the pool in about an hour.”
“Phee’s going?” He asked.
“She is,” I confirmed. “And Spring, and Naomi as well. Janessa and I are going to take them.”
Mark bent his head forward and stared at me.
“It’s good, Mark. Really. It’ll take more than a little urine to dampen my spirits.”
Mark shrugged. “If you’re sure,” he said.
“I could use one thing though,” I told him, thinking about the staff bathroom.
“Let me have it.”
“The change of clothes didn’t really cut it. Can you cover me on the floor for 30 minutes or so while I grab a shower in the staff bathroom? It’s like you said when we started: I do still smell like piss.”
“How do the kids put it?” Mark asked, grinning at me. “Say less.” And he pushed himself out of his chair.
***
“You don’t have to get in today, Francis. We should be fine,” Janessa assured me.
I tied up the draw string on my swimsuit as we walked toward the edge of the pool. Phee, Spring and Naomi were already in the pool and splashing around, doing their cheerleading routines they loved to practice in the safety of the water. “Yeah, yeah.” I told her. “I know. But y’all can’t get rid of me that easy.”
“Have it your way,” Janessa said.
“They’ll likely tell me to beat it anyway. Worst case, I’ll just swim some-”
“Francis is not doing routines with us, Janessa! Fuck, off, Francis!”
“Laps.” I finished my sentence. “Phee, you can just tell me you don’t want me to play. I can hear you without the f-bombs.”
Phee glared at me. “Fine,” she grumbled. “Stay away from us.”
“Progress,” I chuckled to Janessa. “I’ll be in the lane next to you guys. Maybe they’ll want me to join in, eventually.”
And so, I swam, back and forth. I kept a slow pace and focused on my breathing. The girls were leaping into the pool one lane over, practicing their toe touches, and other cheerleading moves I didn’t know the name of. I alternated between breaststroke and front crawl, between quick pace and a slower one. I was just starting to enjoy the fact I had a nice little opportunity to focus on my own needs, when I heard a bit of commotion coming from the next lane.
“No, Spring! You need to lock your knees once you're on my shoulders so you can balance! Janessa, come here. Let me get on your shoulders so I can show her!” Ophelia had taken on the role of coach and was trying to get Spring to stand up on her shoulders.
“I can’t get you on my shoulders, Phee. You’re too big.”
“Are you calling me fucking fat?!”
“No,” Janessa told her, “I’m calling me weak. And we are in a public space, Phee. There are other kids around, younger kids. If we can’t be here without swearing, we will have to leave early.”
Phee huffed in response and turned away from Janessa. We made eye contact. I looked away and went to continue swimming.
“Francis!” Ophelia exclaimed. “Come here. I want to stand on your shoulders and show Spring something!”
I stopped. This was a new one. Invited to play. “I think you wanted to ask me a question, but it didn’t really sound like one,” I said back, still holding expectations around healthy communication.
Ophelia rolled her eyes. “Can you come here?” she groaned.
I ducked below the water and swam under the plastic rope dividing my lane from where the girls were playing. I came up next to Ophelia. “What do I do,” I asked her.
“Go under the water,” she directed me. “Get on your knees so that I can get my feet on your shoulders. Then, just stand up.”
I did what I was told. I ducked down, got to my knees, and when I felt Phelia’s feet on my shoulders I stood up slowly. Ophelia was crouched down when I first came up. She had a hand on my head to balance and was wobbling all over the place.
“Hold my legs!” she shouted at me.
I grabbed her legs just under her kneecap.
“Not there!” she yelled at me. “Closer to my ankles!”
I slid my hands down and held tight just above her ankles.
“OK, Spring. Now watch!” She straightened her legs, locking her knees and threw her hands above her head in a ‘Y’ shape. Spring and Naomi clapped and cheered. I held Ophelia for a few more seconds.
“How do you get down?” Spring asked.
“Like this!” Ophelia exclaimed. She bent her knees slightly. “Let go on three, Francis! One, two THREE!” She sprung herself off my shoulders and I felt a twinge of pain in my collarbone. She straightened in the air and flopped into the water flat on her back.
Spring and Naomi clapped and cheered again. Janessa was laughing. I rubbed my collarbone. “Again!” Ophelia said when she came up for air.
Janessa had noticed me rubbing my shoulder. “I think that’s enough, Phee, Francis’ shoulder is hurting a bit.”
It was my collarbone, and it was hurting a bit. But not enough to get in the way of this opportunity. “It’s good,” I told Janessa. “Let’s go, Phee. I’ll duck down again.” And Ophelia swam back over to me while I ducked back under onto my knees, and she stood on my shoulders for the second time. Ophelia forgot about wanting Spring to stand on her shoulders, she asked again and again for me to hold her on mine while she toe-touched, pike-jumped (I was learning the names now) and twisted off. It wasn’t long before the other girls asked about the waterslide. But Ophelia didn’t want to follow them. On we went for another 10 minutes or so, each jump grinding my whole shoulder now, no matter how I tried to adjust it.
After one jump, Phelia said, “you’re shoulder really does hurt. We don’t have to keep going.” She looked around me. “I’m going to go on the water slides.”
“Sounds good,” I said. “I’ll finish my laps.” I turned back to duck under the rope, and into the lane.
“You’re coming,” Ophelia stated plainly before I was totally submerged.
I turned around and asked, “was that a question?”
She just rolled her eyes and groaned before turning and swimming away, leaving, quite literally in her wake, an opportunity to join her.
References
Bath, H. (2021). Relational healing for relational trauma: Is there anything new the neuroscience can tell us? In Modlin, H., Freeman, J., Gaitens, C. & Garfat, T. (eds.), Relational child and youth care in action (pp. 4-16). The CYC-Net Press.
Freeman, J., Fulcher, L., Garfat, T., Gharabaghi, K. (2018). Characteristics of a relational child and youth care approach revisited. CYC-Online, No. 236, pp 7-49.
Holloway, H. (2021). Conditioning for an unconditional relational approach. In Modlin, H., Freeman, J., Gaitens, C. & Garfat, T. (eds.), Relational child and youth care in action (pp. 92-100). The CYC-Net Press.
Perry, B. & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a child psychiatrist’s notebook (2nd ed.). Basic Books.
