Listen to thisI want to briefly outline some of the ideas behind the work conducted by my colleague, Karsten Hundeide, and me through a Norwegian-based NGO called International Child Development Programmes (ICDP). Some of the ideas are included in a book we are writing entitled Human Care for Very Vulnerable Young Children.
There are many forms of human care, most basic being the care that is provided by parenting adults and older children in a loving way to infants and small children. Both the care of children by care-givers and practised forms of care, such as provided in our programmes, can be distorted when the empathic foundation of human relationships is not recognised, or when it is obstructed, fails or is lost.
Empathy with the child by the care-giver is regarded as a key element of care and stimulation of young children. When empathy is weak or absent from a care-giving relationship, the child may be seen as bad, abnormal, neurologically impaired, weak, possessed by demons, and may therefore be ignored, neglected or abused.
Empathic care by care-givers may be obstructed or blocked by a number of factors, including when the children in their care have no special identity for them, as occurs in orphanages; when there is brutalisation due to inter-group hatred and violence; when there is family conflict involving alcohol and drug abuse; and when the child triggers negative images in the care-giver.
Conditions associated with decreased empathy for others, amongst both care-givers in relation to children, and amongst people doing care-work, are:
Demoralisation and depression, associated with fatigue and a turning-inwards, decreased attention and responsiveness to others.
Preconceptions and simplifications that reduce other people to a single dimension represented by a category, such as poor, AIDS orphan, OVC, street child, handicapped, and so on. These assumptions block our openness to hearing and understanding them.
Separation and estrangement: As children in orphanages are separated and estranged from care-givers who come to work for their duty hours, so we are often separated and estranged from the people we attempt to help. This makes it difficult for us to identify with them and their daily concerns and experience, their hopes and fears.
Negative conceptualisations of others: Children with disabilities, people who look different from ourselves, someone who reminds us of a person we don’t like, can all be thought of in negative ways which reduce our capacity for empathic identification with them.
Stigmatisation, rejection and abuse: In extreme cases, negative conceptualisations of others can lead to the feeling that that the person or group is morally inferior, non-human and deserving of abuse, which seems to justify neglectful and abusive behaviour.
Confusion and paralysis. The distress of others may arouse such strong emotions in us that we are confused and paralysed, stripped of our capacity to respond with care and assistance.
Compassion fatigue has been called “the cost of caring”. People doing care-work often suffer compassion fatigue which, if not addressed, reduces our interest in others and our capacity to empathise with and assist children and care-givers experiencing difficulties.
Various degrees of empathy can be visualised as zones of intimacy that include ourselves and those nearest and dearest to us in the inner zone, becoming weaker in the outer zones towards those with less direct relationship to us. At the extreme, people may be excluded from our zone of intimacy, and this leads to and justifies making a child sleep outside, feeding them scraps, forcing them to do heavy and damaging work, having sex with them, and the like.
The deepest goal of all psychosocial interventions is to try and bring the outsider “in from the cold”, and include them in our zone of intimacy so that we can identify empathically with them. Seeing the child as a fellow human being, with the same needs for security, love, approval, and respect as we have is the first step towards humanisation and inclusion. When care-givers respond to children empathically, a deeper and more sustainable basis for care is possible.
The essential ingredients of human care can be obscured by the technology of the interventions, which, if not adjusted by the perspective of human care, can become ends in themselves. Examples of these technologies include counselling, memory books and memory boxes, toy-making and provision, social activities for children, grief work, and so on. Many of the technologies, in themselves, are not sustainable in conditions that cause distress to children and their care-givers. It is frequently necessary to find opportunities that do, or can, occur in the everyday lives of the children we want to help, and that can be encouraged and extended to provide benefits to children.
Here is an example: A health worker instructs a mother to add oil to her child's porridge to increase its energy content, and to feed the child several times in a day. This is good advice, but the health worker must not forget that one of the most important things she does when she advises the mother about her child's nutrition, is to help to keep the child's wellbeing at the forefront of the mother’s attention and effort. She can do this by commenting favourably on the mothers effort to bring the child to the clinic. When the mother does have resources, not only will she know what to feed her child, but she will want to expend what resources she has on her young child's nutrition and care.
When we try and tell care-givers what to do, when, how, and with what materials in order to improve their children's development, we are in danger of being irrelevant to their life circumstances and their cultural priorities, and we are also likely to undermine their self-esteem and competence. However, when we sensitise, build and strengthen care-givers” capacity for human care and their awareness of children's needs, we reinforce their competencies and promote the type of care-giving relationships that must sustain and support children long after we have left.
This feature: Richter, L. (2006). Empathic care at the heart of psychosocial support. Children First, 10, 64. pp. 24-25.
