11. Professionals as Human Beings
I have jumped ahead of my story. Let me erase the glimpse just given, to return to four-year-old Elly, just arrived in England. That Elly was not the child I have just described enjoying my renditions of comparative church architecture. That Elly had shown a capacity for seeing pictures only for the past six months. She was not yet able to ask even the crudest question or respond to the crudest answer. She had just recovered from the severest illness of her life and it had left her narrowed and subdued. It was this child that, as soon as we were settled, we made arrangements to take to the Hampstead Clinic.
We had planned to do this even before we left. Dr Blank had written Miss Freud the day after we spoke with him. That had been a major reason for my anxiety when I found the Institute had not made out its report; I knew we would need it in England, and soon. My letter of appeal to the Institute’s director reflected the desperation and pressure of the last days before departure. I remained shrewd enough, however, to make it clear that we wanted the record, not for Dr Blank or for our small-town clinic, but for Anna Freud.
An answer arrived by return mail; the silent psychiatrist himself wrote it. He quite understood my anxiety; he had delayed the report because he wanted to write it himself; he would make sure it went out promptly. I was past charity. I reflected that there was hierarchy in this profession as in others. The great provincial archdiocese need not exert itself for the little country parish — but now we were going to Rome. After six months I could still recall the reverential tone in which the Institute psychiatrist had spoken of the Hampstead Clinic.
And Rome it was. No footsore pilgrim was ever welcomed in the holy city with warmer hospitality or more healing kindness than we experienced at Hampstead. Dr Blank had said that whatever our language was, Anna Freud would speak it. As things turned out, we did not see Anna Freud. We did not have to. What happened was something more remarkable still; her spirit so permeated her clinic that everybody spoke our language. The building was little different from what we knew already; clinics for disturbed children seem to run to shabby, ageing houses with many rooms. The examining team was the same — social worker, psychiatrist, and testing psychologist. As far as I know, their theoretical presuppositions were not markedly different. I even recognized the puzzles that Elly worked for the intelligence test — the same old-fashioned browns and pinks, the same nineteen-twentyish dress. Yet all was different. The chill, noncommittal professionalism that we had found in America was missing here.
We could have guessed from the ease with which we made our appointments. The Clinic seemed to find no particular difficulty in answering letters. That was professionalism, in its proper place. For the rest, from the time we walked in the door of Number 21 Maresfield Gardens, we were treated, not like sick children, but like adults, human beings, and friends. Perhaps, as truly practised, this is professionalism too.
What should one say further about anything so natural? Why should it be worthy of mention that the psychiatrist and social worker talked to us together as well as separately, that they asked questions and answered them, that they discussed with us matters of theory and nomenclature? We conversed with sensitive and intelligent people on matters of mutual interest. They picked up cues from our voices and manner and allowed us to do the same from theirs. We smiled and joked, although all concerned were aware that our errand was not funny. With everyone there we experienced that delicate progress of mutual adjustment which we call communication and which is one of the great pleasures. In our own land we had been treated by strangers as strangers, and strangers we had remained. We were not strangers here.
The psychologist laughed with me as we watched Elly solve the now familiar puzzles. We went rapidly through the rest; they had the Institute’s report and they had obviously read it, and the medical history as well. The social worker asked if I had any photographs of Elly. I had not; remembering the Institute, I had left them in America. Encouraged, I mentioned my notebooks. Certainly, of course they would want to read them. I sent for the photographs and turned the notebooks over. When we came again a week later they knew what was in them.
I had determined that I could not repeat my mistake of eight months ago; whatever it cost me, I would make sure they saw me play with Elly. It cost me nothing; playfulness was easy here. The social worker was interested in our play; she had read my records. Knowing that, I could elaborate on episodes I had only sketched. I described for her, much as I have described them in Chapter 4, the slow stages in teaching Elly to turn on a tap. This is the sort of thing, I suggested, that you can help me with. I will not forget her reply. ‘I think,’ she said, ‘that we will be able to learn from you.’
I could scarcely believe I had heard it. But it must have been so, for after more conversation about particulars came something for which I was even less prepared. ‘I suppose you’ve often been told,’ she said, ‘that this is a very interesting case.’ Often? Interesting? No one had told us anything, least of all that. I felt better at once; if one’s troubles are heavy it helps that someone finds them interesting. But I had not heard it all. What was unusual about the case — the words dropped into my mind like balm — was the persistence and energy shown by the parents. Regressions had been kept temporary. ‘A massive regression now appears unlikely.’
I did not, I think, begin to shake. Kanner’s control stood me in good stead, though my skin seemed a frail integument just able to impart its usual definition to the trembling chaos of animal gratitude within. One is less vulnerable to pain than to understanding and kindness. One develops defences against slights or insensitivity; against kindness, none. When one has been long in such straits, one has a terrible greed for kindness. Before one feels real pain one may think — I thought — that one would want people not to notice, to aid one in the attempt to carry on — business here as usual. It is not so. Business may seem as usual but it is not. What one wants is that people should know that. What one wants is sympathy, understanding, not tacit but openly given. What one wants is love.
Too much to ask? It is surprising how freely it is given in some quarters while in others it is not given at all. I remember, I think, from those years everyone — everyone — who was kind to me. I should, for I lived on kindness, I consumed it like fuel. I remember the friend, herself a trained social worker, who telephoned me after a visit to her house where Elly, only two, had misbehaved and been disciplined and then loved, merely to tell me ‘how beautifully you handled that child’. I remember, from the chill months in England the loud-voiced checker in the local Co-op who called me ‘ducks’ and understood when Elly screamed because she couldn’t touch the candy, who asked after her when I left her at home, and who went out of her way to say how much she had improved. I remember the man who, when I apologized for some embarrassing caper of Elly’s with a muffled not a normal child’, smiled and replied, ‘Well, I’m not normal myself. My honour roll is long — too long for inclusion here. The list of those who have helped us contains the names of amateurs and professionals. What they have given us may have seemed to differ on its surface; at bottom, it has not differed at all. The measure of my gratitude is greater to those whose kindness, because institutionalized, has been more prolonged. But it does not differ in kind.