In the best of circumstances one cannot talk naturally to a listener who makes no response. And these were not the best of circumstances. We were conscious that we were not ourselves. With our children, sick and well, we were firm and confident because we knew that our confidence was their security. Not here, though. Here we were on trial. Nothing had to be said about parental responsibility for infantile psychosis. I record it to the Institute’s credit that nothing was said. But the thought hung heavy. I tried to bring it out into the open. I imagined they knew of the paper I have quoted at such length earlier in this chapter; timidly I mentioned it. At least we could find out where we were. The response was admirably controlled. ‘You’ve read that, have you?’ was all the social worker said.
One could not talk naturally, yet so much depended on what the silent listener would think. In the absence of feedback, I tried to talk in the way that would be most helpful to Elly — to play it their way, insofar as I could figure it out, to be reasonable and obedient, to make sure that in the limited time available they got the information they needed.
My family, my pregnancy, Elly’s whole life — how could I get it all in? I began to take out the material I had brought — the photographs that showed the progress of the condition from babyhood, the notebooks recording skills, vocabulary, the games we played, their purposes and their results. ‘I began keeping these as soon as we suspected… they’re quite detailed. they tell about the work I do with Elly… if you could look them over you could ask me questions and we could go on from there. .
But of course the words trailed weakly off. It was not their practice… I put my records away.
Obediently, I talked. I have a good memory, I am experienced in the stages of child development, and Elly’s growth had engaged all my attention. I tried to cram in all the interviewer could have read in the notebooks, afraid some significant fact would be left out. I began at the beginning — the unexpected pregnancy, the depression, everything they might be expected to find usable. It was not for me to impose my standards of relevance on the material. It took me time really to take in the ground rules; I thought they wanted me to be informative and I kept trying to make it personal, trying — it was one of their words — to relate. It’s not normal for me to talk very long without some stab at a joke. Jokes relieve tension, they help make strangers friends. The social worker received my jokes with Oriental calm — the same calm with which she received everything I said, whether I told of anxiety, satisfaction, or pain. Only once did I jolt her. In describing Elly, I happened to use the word ‘autistic’. Instantly, sharply, she asked, ‘Where did you get that word?’ ‘Dr Blank,’ I said, ‘you know, the referring physician.’ ‘We don’t use that word here,’ said the social worker.
In another room, my husband was also trying to convey helpful, relevant information. Like me, he asked questions at first. There were so many mysteries about Elly. These people had seen so many children, they could tell us so much. But every question was courteously fielded; we would be able to ask that at the final interview. We stopped asking questions almost as soon as we stopped making jokes.
They were now ready to see Elly. Since it was not until late in her third interview that she was ready to remain alone with the psychiatrist, I was able to watch him with her. His behaviour was communicative if he was not. I watched him operate with clay, lollipops, the dollhouse. Elly took up the pieces of doll furniture one by one and methodically impressed a leg or an edge into the clay. She picked up the little toilet. I felt the quality of his attention sharpen, but she merely used it, like the other pieces, to imprint the clay. The psychiatrist spoke little; when he did, it was a gentle, reiterated, positive statement: ‘Clay [lollipops/puzzles/dollhouses] can be fun.’ I understood, I thought, why he said that, though I could not ask him. One day, perhaps, Elly would be able to take that meaning in.
I learned from his cautious, indirect approaches; I learned more from observing Elly among other strange children in the diagnostic nursery school. There was a huge mirror on the wall. I thought I guessed why, and made a note to get Elly a mirror on our return. I was fascinated by the IQ test. The tester did not quite manage to conceal her surprise when this uncomprehending child, who had no conception what the verbal part of the test was about and fretted because she could not pull the objects she was supposed to identify off the cards to which they were attached, still strung the beads, stacked the blocks in order of size, and slapped the stars and crescents of the twelve-piece formboard into place as rapidly as an adult. This was progress. At the hospital it had been impossible to test her at all. And I enjoyed the session with the neurologist; it was like being back among human beings again. She answered questions, we joked, laughed. I suppose she, a physician, had not been trained in the couchside manner. It was all right for her to relate.
So it was over. On the whole we had been impressed, especially by their skill with Elly, who at the end of her final session with the psychiatrist had gravely tried to follow him upstairs. I was not reassured when the very last day the social worker could still ask me ‘Does she ever smile?’ But that was my fault. I knew that their gentle caution had missed Elly’s gay side; I had wanted desperately for them to see us romping together, to watch her delight in ‘this little piggy’, her laughter when her father threw her into the air. Every day I had determined to ask if they would watch us play. One day I even came in an old pair of pants; in our gayest game, I would lie on my back and lift her with my feet, high into the air. But they never learned the reason for my odd costume; I played no games with Elly there. Surrounded by that cool detachment, I just couldn’t. So we took Elly home, there to wait for them to schedule the climactic final interview when all their observations would be synthesized and presented to us and where at last we could ask questions.
We waited. Again we watched every mail. (Every month counts.) We waited one and a half months. Finally the notification came and we travelled back to the city to hear the verdict.
This is what they had to say about Elly. It is not a summary of what they said. It is all they said, although the psychiatrist, a hesitant, rather inarticulate elderly man, took considerably more time to say it than it takes to write it here:
1. Elly needed psychotherapy.
2. She had performed above her age-level on the part of the IQ test she could do, and it was their belief that she had no mental deficiency.
3. ‘She has many fears.’
That is what they had made of all that information. We had been afraid we would not be able to tell them enough about Elly. Our fears were groundless. They were based on a misunderstanding of the purpose of the interviews. We had thought, naively, that these were a means of conveying information about Elly from us to the psychiatric team to aid in diagnosis. But since no use was made of the information, their actual purpose must have been something else. Those trained in psychology will perhaps know what it was. I can only conjecture. Perhaps it was to get us to reveal ourselves as people and parents. Perhaps not. For nothing was said about that either, for good or ill.
Of course we asked questions. We had been told we could. But no question we could think of could get the psychiatrist to add anything to those statements. He did not say she was like any child he had seen before. He did not say she was unlike any child he had seen before. We had hoped he would speak from his vast experience of abnormal children, but when we asked about other children at the Institute he suggested, vaguely, that every child was different. . He would give the condition no name, suggest not even a possible range of prognoses. I asked if there was any reading I could do. Case histories? I had got some ideas from them already. Hesitant before, he was suddenly firm. Case histories would be bad for us. I tried again. I had been impressed by the nursery school. There were, perhaps, books on nursery-school techniques for disturbed children? ‘Disturbed children? It was hard. . very hard… in fact it was very hard even to bring up normal children,’ said the psychiatrist to the mother of four.