Our Profession


The first children

In January of 1958 the first children arrived in Thistletown Hospital. The staff had only recently been collected together and had had about three months of training and visiting other institutions to try and prepare them for this great day. Upon opening its doors, Thistletown Hospital received all kinds of children, not just emotionally disturbed ones. There were schizophrenic children, brain damaged children, developmentally delayed children, very aggressive children, children with physical limitations such as deafness, and a child who was impacted by meningitis. They were lumped together, all requiring treatment, with a staff who had very little knowledge of how to provide it.

Immediately upon the arrival of the children, the destruction began. The children literally took the place apart. All of the windows were smashed, all the mattresses were set on fire, many of the doors were ripped off: chaos reigned.

At first, the child care workers tried to simply control the child through love and relationships. The psychiatrists provided treatment by giving different forms of individual psychotherapy to the children.

From the beginning, for child care workers, the name of the game was survival; 'survival treatment'. More than one remembers their first day working with children being punctuated by being physically attacked for, as far as they were concerned, no reason at all. Nora Lillie, another of the original child care workers, remembers a little girl who, on that day, pulled out Nora's hair, scratched her face, sat on her and had to be pried off by a couple of male staff. Arthur Bickerton remembered.

One month after I'd come to Thistletown and some seven or eight months after the children had first arrived, I was asked to take two boys for the occupational therapy period as the therapist, Mary Tweedy, had to go to a meeting. I took them into a room that was full of paint cans and brushes and wood, and clay and plaster of paris, all kinds of things. The room was completely cluttered with all this stuff. I had said I didn't know anything about art and, certainly didn't know how to conduct an occupational therapy session. The boys, by the way, were quite crafty and they knew how to manipulate in order to do their own thing. I asked them, 'What would you like to do?' Their reply was, 'You just stay over there, we've got something planned'. They then proceeded to practically destroy the room. Now I had been locked in the room with the two boys and Mary had said 'They'll be O.K., and I'll come back when the session is over and let you out'. So there I was, locked in this room with the two boys destroying the place. I couldn't get out; there was no telephone; there was no point in screaming out the window because that wouldn't have meant anything in those days; there was paint all over me, all over the ceiling, all over the floor; it was absolute chaos and all I could really do was to protect myself. I am sure that if there had been matches in the room they would have set fire to it and me! At the end of an eternity Mary returned, took one look at the room and fell apart. I said to myself, obviously this was not the way to conduct a session, but perhaps it was 'good' experience for me!

In spite of all the trouble, or perhaps because of it, there was a tremendous feeling of spirit among the student child care workers. They depended upon each other in order to survive the day. A strong rapport was absolutely essential. Everyone helped each other because everybody knew that an hour later you could be the one that needed the help. To have survived a day, despite the turmoil, blows and the kicks was an accomplishment. At that time, a child care worker could be really proud and could have a very satisfying feeling, if he had made it throughout the day, was still walking, and, in the face of the most aggressive, hostile act, was still able to give tender loving care. In the very beginning, this was the major treatment philosophy of Lawson and Rich. Staff were to care for the children and love them, even though they were battered and torn by them. It was important to prove to the children no matter how they behaved, that they were loved and cared for. Lawson described those early years this way.

Theoretically and ideologically, we didn't know where we stood. At that time the bible of everybody in this thing was Bettelheim, and we used Bettelheim and that's about all the theoretical ammunition that we had to work with. Behavior modification was a dirty word around Toronto at that time. Nobody, at least in our group, had ever heard of Adlerian psychology or people like Dreikers. Glasser was still somebody way out on the West Coast that nobody had heard of so we were pretty stuck with the Bettleheim approach. Well, it took us some time to find out it didn't work. What we were trying to do was to set up a system; some kind of community here which would not be authoritarian, because we felt that the authoritarian settings in which these children had been committed, had done more harm than good: a system where they would have a certain amount of liberty, a certain amount of freedom, where the controls would be only those essential controls which were necessary to protect their health, and where we, because we were loving people, would be able to establish good relationships with them, and, using what particular skills we had in recreation and arts and crafts and personal relationships and so on, create a therapeutic environment. Well, I was at Thistletown for two and a half years before I moved out to B.C. During that time we began to create something like a therapeutic milieu but it was far from the sort of thing we had been aiming at. During this time, I think it is fair to say we were constantly at war with the children. We were constantly trying to find some kind of controls which would be appropriate, which would be meaningful to them, that wouldn't consist of the locked doors and the barred windows which were the feature of the Thistletown operation at the time. These were simply challenges to the kids, they solved nothing. And, before I left, I think we were moving in that direction. We were moving in getting rid of some of the Bettleheim notions which were found to be inappropriate. We were be-ginning to think more in terms of a realistic therapeutic milieu, of some kind of controls which did make sense to the children.

Probably, a saving grace for this hectic situation was that student child care workers worked three days a week on the ward and then had two days which they spent in lectures, discussions, and all kinds of different educational activities. This was the time for discussing the milieu. It was a strange experience for them as they could barely see how what they were learning in the lectures had to do with what was happening in the wards. Often they didn't want to learn what their instructors wanted to teach. What they wanted to learn was how to defend themselves. Several remember thinking to themselves

Don't you realize that I could get killed down there and here you are talking to me about personality and dynamics! What I want to learn is karate!

Through these discussions the staff, students and their teachers developed some concepts for how to set up the milieu and how to handle the children with whom they were working. As the Bettleheim approach wasn't working for them, they had to come up with a theoretical basis for some other way of handling the children. After repeated experiments in giving children freedom and responsibility failed, Lawson and a lot of child care workers came to realize that children need to be limited. What they were trying was not only hard on the building, it was hard on the staff and it was hard on the children. Lon realized that the Hospital would have to have a structure that the child could understand and it had to be enforced firmly without any provocation but in as an accepting a way as possible. This struggle occupied Lon and the child care workers for the most of the first two years. Within those first two years though, those on the front line learned a great deal about what would work with the children and changes were made. As well as limits, there was more emphasis on milieu therapy and less on psychiatric analysis of the child. There was a beginning of understanding that the child care worker needed to have a good relationship with the parents as well as with the child.