View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by LSE Theses Online INVISIBLE WOUNDS: A GENEALOGY OF EMOTIONAL ABUSE AND OTHER PSYCHIC HARMS INTRODUCTORY CHAPTER This dissertation is about how the concept of harm, damage or wound is applied as a metaphor to a site often called the self or the soul. This is the social space of the individual subject, which is, paradoxically, placed by our language and culture in a person’s interior – a place where we are all said to be vulnerable and endangered by a potentially hostile environment. The thesis consists of a series of studies which are designed to show how the concept of harm to an inner life emerges from different discursive contexts, and how it does so in distinctly variable versions: psychological, emotional, neurological or social, in more or less stable hybrid forms. Using primary sources which are mostly documentary, supported by some interviews, the studies range from a look at the psychiatric history of post traumatic stress disorder (PTSD) and at the story of its rewriting in English tort law; the recent reprised popularity of attachment theory and its marriage to neurology and a look at the career of the concept of the emotional abuse of children as a social problem category in the legal/administrative processes of Child Protection. These are introduced by a first chapter which concentrates on the metaphoric content of invisible wounds or psychic trauma 11 and the way it produces particular forms of the self. The studies which follow this are clustered around the literature and practices of the psychiatric, psychological, psycho-analytic, social work and legal professions, in order to show how the work of these professionals makes the concept of a psychic injury visible, discussible, treatable, administrable and justiciable. Through their efforts, it is argued, the concept moves from being a metaphor, hooked onto the palpable reality of a physical wound, to acquire a ‘facticity’ of its own; it becomes a reality through its achieved status as a social problem category and an ever present risk to self and self regulation at the turn of the 21st century. I. JOURNEY INTO THE INTERIOR Starting Out The roundabout ways in which I approached this subject and its title were, indeed, something of a journey. When I started this project in 1999, I was well acquainted with severe psychological problems, and their variable descriptions and treatment modalities, having worked for some years, over the 1980s, as a single-handed social worker, family therapist and professional systems consultant in a psychiatric unit for adolescents, in a large National Health Service teaching hospital. But, in the early 1990s, I changed jobs to work as a Research Officer on an ESRC funded study, Social Workers Attitudes to Risk in Child Protection and I was keen to ground my thesis in the knowledge I had gained here. I wanted particularly to look in detail at the risk assessment process for Local Authority Child Protection case conferences and the way social workers and assessors of paedophiles accomplished the task of applying the rigid, technical categories of risk management to the indeterminate, turbulent and morally ambiguous world of their clients. From there, I became increasingly interested in what I thought was, at the turn of the new century, the smallest category of child abuse, the one least applied to children in the Child Protection 12 registration process,1 certainly the one least talked or written about: emotional abuse – a vague puzzling idea and one which would take most work and ingenuity to dress up in the calculus of risk. What was it that was ‘at risk’ and what would count as evidence in the administrative and legal processing of cases where this cruelty was suspected? My curiosity about this concept and its application was enhanced by two events. The first occurred when I began to investigate the meagre literature in this area and discovered that there was a copy of the first US book on the subject by John Garbarino and colleagues (Garbarino et al, 1986a) in the University Science Library – where else? I found it there wedged between two other books. On the left was a large medical tome on the physical abuse of children, a photographic compendium of injuries on small, fragile bodies, images which were powerful and quite pornographic in their raw, red detail; on the right was one of the first volumes published on the sexual abuse of children, which consisted in chapters of compelling oral testimony by adult survivors, transcribed into the written word. I was struck by the force and the directness of their visual and oral communication and by the contrasting invisibility and silence of the problem I was interested in. The ‘injury’ caused by this abuse could not be seen and nor could the inchoate experience of a small child, who had known no other life, be put into words. How could the intermittently cruel behaviour of parents be observed without continual access to the private world of the family? To be made public and visible, this was an injury which would need a subtle form of policing and the mediation of a certain sort of professional knowledge. It required some convincing theory or stockpile of lay wisdom, which could relate, by inference, observable behavioural signs to an invisible mental state and some causal parental actions or poor familial relationship. It was hardly surprising that the emotional abuse of children had never become the subject of a political and media campaign in the US and the UK, in the way that child physical abuse, in 1 In fact, according to the Department of Health (DOH) figures for registrations of child abuse by category in 1999, not published until 2000, the figure for emotional abuse just overtook the numbers registered for sexual abuse. 13 the form of baby battery and child sexual abuse, had done in the 1960s and the 1970s-80s respectively. It lay in a hidden territory, which, as in Foucault’s version of the psychoanalytic confessional, could only be known or explored through the arcane knowledge of experts. And who were these experts? This question triggered the second event: a memory, this time, of a session of an International Society for the Prevention of Child Abuse and Neglect (ISPCAN) European Congress in Oslo in 1995, where a social work academic from Northern Ireland gave a paper on the urgent necessity of finding a definition that would distinguish between the emotional and the psychological abuse of children. I was surprised by a paper on this little- discussed form of child abuse, surprised that what was problematised here was the classification of this particular form of deviancy, rather than the behaviour it purported to describe. I was even more struck by the vigorous way in which some of the leading players in the Child Protection field entered into the consequent discussion of taxonomy. I later realised that, at that point, the paper’s author had published the only UK monograph on the subject, but that these other experts were about to enter the field. Compared to other social problem categories, the terrain of emotional abuse was as yet unoccupied and I was witnessing my colleagues laying claim to a new strip or two. It may seem cynical to go from an initial interest in a social problem category straight to the politics of its inception, promotion and public recognition, rather than to the causes, manifestations and consequences of the problem itself – the distress and difficulty located in the child and family. But I had trained in and practiced a therapy which, whilst it acknowledged and worked with distress in all its forms, intervened with clients at a cognitive rather than an emotional level. It was primarily interested in how the client construed the problem, in the belief that any such construction, be it lay, psychiatric, psychological or social, could be superseded by an infinite number of re-descriptions. It was the helpfulness of this framing to the client, rather than its approximation to any 14 objective state of the world, which was of ultimate importance. With such a relativist approach to my work (with all its much criticised drawbacks in terms of lack of a moral marker), I was also sensitive to the constant negotiation and renegotiation of the nature of child and family problems in the eclectic, multi- professional field of child welfare. Here, child psychiatrists, psychologists and psycho-analysts rubbed shoulders with teachers, social workers and lawyers. They met in clinics, courts and case conferences, where difficulties for children and their families were constantly being rewritten in the light of different professional rationalities and organisational imperatives – most especially those entailed by scarce resources. I was aware, of course, that these professional rewritings were not infinite. Apart from the limitations imposed by institutional structure, professional rationalities depended on a limited set of knowledges, which crossed institutional and professional boundaries and were found in multi-professional training manuals, journals, literature on sale at conferences and publishers’ lists. The items of this repertoire were often mixed up with each other even in the language and practices of one individual, let alone in those of one profession or institution. On the whole, day to day practice and decision making in this area seemed like a thoroughly commonsense affair, in which particular pieces of technical talk were adopted for rhetorical purposes – to prove a point or assert a professional identity. Nevertheless, several broad discourses could be identified in everyday professional practices in the area of emotional abuse and in the academic and professional literature.