For the past four years I have worked twenty hours per week at Project Rain-bow, a transitional, residential facility for women and children. When families enter (many times after living on the street or in poorly staffed shelters), they often feel angry, invisible, and powerless. These fragmented families present not only as disconnected from their extended families and communities but also as shattered within themselves. Project Rainbow provides a safe environment that helps families begin to experience a sense of control and relative calm in their external world.
As the only clinician in my agency with psychoanalytic training, I was faced with the challenge of bringing my knowledge of the complexity of the child's inner world to the staff and residents without alienating them.
One approach was to offer a psychoanalytically informed child development course. The administration showed its support by requiring every employee to participate, from maintenance workers to day care workers to fellow clinicians with advanced degrees. In this way everyone interacting with families could gain some understanding of appropriate expectations, given the child's developmental level.
One of my most valuable contributions is in helping the staff to understand how unconscious affects and conflicts can be expressed in symptoms and disturbing behaviors. For example, head banging was considered a normal and acceptable behavior I had to be sensitive to this phenomenon because children of day care teachers presented with this symptom. It became personal and painful when teachers realized it was not a normal developmental behavior Once staff members feel empathy for their clients, they are better able to begin to grasp their countertransferences and to grapple with their own histories as old wounds are reopened. As staff members relate their internal experiences to those of our homeless families, the gulf of difference begins to close. They realize that their inner lives are similar to those of their clients.
Another very well received program is a course for moms and their children. This course is divided into two components: (2) a lecture/discussion interwoven with a family photo album made by the mothers and (2) an interactive hour with the mothers and their children.
Each week I take photographs of the mothers with their children. Each mother is asked to write a memory, a hope, a wish, or a worry about her child. These writings have been beautiful, warm, and caring—breathtaking in their hopefulness for the future and painfully torturous in the suffering portrayed. There have been terrible moments when a mother can't think of one positive thing to write about her child or can't remember one activity she enjoyed with her child. At these intense moments of shame and humiliation the women surround each other and attempt to provide hope to the one who feels there is none.
The group quickly becomes cohesive, and I become the much longed-for “mother.” This mother-transference is palpable as the women seek physical proximity to me and try to please me. We celebrate the last session with a dinner that I cook for them. As the women begin to feel nurtured and psychologically held by me, they are more able to feel empathy for their children. Exploring and verbalizing their inner lives helps them to view their children as having inner lives that are separate. This group provides the structure and consistency of a caring, loving, listening environment that for many of these families has been completely absent from their lives. As the women gain trust in me, they make use of me as both a transferential object and a new developmental object. At the conclusion of the course, many of the mothers ask to come back for the next program session. Several have entered individual therapy within our clinical department.
Perhaps most valuable to me as a fledgling psychoanalyst was the opportunity to conduct analysis with a three-year-old homeless child. Much of our work in the analysis fell outside the domain of the treatment room. I was quickly confronted with the necessity of redefining the analytic frame. I first met with this tiny, anaclitically depressed child as we sat together on the floor of her daycare room. She was selectively mute and had stopped eating. But I perceived a desire in her to connect. I attempted to form a relationship with her by gently putting words to her silent affects.
At the end of our first week she gestured to be carried to my office, and when it was time to end she had a violent tantrum. She threw herself backward, hitting the floor hard, her body heaving in silent sobs. Within a month she spoke—in a whisper, but her speech was clear and she spoke in full sentences. She was gaining weight.
It was now time to bring the mother-child dyad together. The mother of my patient was unable to bring her child to my office for her appointments. The mother's inner life, as well as her outer circumstances, was often in a state of chaos. A naked child often greeted me at her door, or the mother would open the door clothed only in her underwear. I often met with mother and daughter in their one-room unit with the TV blaring. Eventually the mother began attending sessions and was able to respond to her daughter with loving affection and a newfound understanding of her child's emotional needs.
This case presented multiple dilemmas. My training provided me with the foundation to begin the work; theory gave me background and substance; but it was within supervision that I learned the most. Week after week my super-visor from my institute helped me to conceptualize the work, redefine the goals, and bring together the mother-child dyad.
My psychoanalytic training has helped me to understand the profound effects of trauma and deprivation on the inner worlds of mothers and their children and has guided my efforts to provide a safe holding environment for the work of learning, feeling, and healing. I am eternally grateful to all the women and children from Project Rainbow. They have guided me and given me the courage to sit with them and feel the most profound sadness and the most unmanageable rage, to tolerate terrible humiliation and shame, to ultimately bear the unbearable. These gracious, fragile families have taught me how to be with another person in her deepest sadness and most hostile anger, whether on a pullout bed in a homeless shelter, walking on an inner city street, or sitting in a beautifully furnished office.
Ann G. Smolen, M.S.S., L.S.W., is currently a second-year candidate in the child and adult programs at the Psychoanalytic Center of Philadelphia. She was a fellow of the American Psychoanalytic Association in 2001-02 and has won national and local awards for her clinical work with homeless children.