Transforming Despair to Hope: how to help traumatised children. Legacy interview
It’s not an exaggeration to say that Dilys Daws’ contribution to the field of child mental health and child psychotherapy has been immense. Spanning over five decades, her career as a Child & Adolescent Psychotherapist is notable in many respects as a clinician and shaping public opinion and government policy about the importance of infant mental health.
In the 1980’s Dilys began speaking to the public and government about the work of child psychotherapists with their patients, raising awareness of the profession and the difficulties babies and parents experience in a way that had never been done before.
Her books, such as Through the Night, which focus on the difficulties infants and parents experience , have become classics for therapists and new parents alike. Their popularity is perhaps due to the fact that they are based on fifty years of careful observation of babies and their families, many of them spent in the same baby clinic.
Dilys Daws’ writings and activities in promoting child psychotherapy are significant. In 1996 she set up the Association for Infant Mental Health UK, an interdisciplinary, not-for-profit organization, promoting understanding about infant mental health: https://aimh.uk
It is Dilys’ ability to influence government policy and collaborate with different child professions, as well as her extraordinary clinical work which is really quite remarkable which mark her out as one of the most important child psychotherapists of her generation. Because since 1976, Dilys has been transforming the lives of children and parents in what might be to some an unconventional setting for psychotherapeutic work. Each week she has been going to the James Wigg GP Practice, in Kentish Town, London to stand by the weighing scales, observing what takes place as parents bring in their babies to be checked. In this interview with Jane O’Rourke, hear Dilys discuss:
|3’00||Parent-infant work in the community setting of a baby clinic|
|5’00||The importance of child therapists being brave in their clinical work|
|7’40||How experiencing difficulty herself, as a young mother, led Dilys to work in a baby clinic|
|13’05||How Dilys broke the taboo of child psychotherapists speaking to the media about child mental health in the early 1980’s|
|13’55||The importance of acknowledging the emotional turmoil which having a new baby can provoke in parents.|
|17’00||The discoveries parents can make by observing their babies|
|18’00||The importance of helping new fathers who are struggling|
|21’13||Ghosts in the nursery: connections between a baby’s problems and their parents’ childhood traumas|
|24’25||The taboos of breastfeeding, such as the sensuality of it|
|30’00||A child psychotherapist’s advice for others after nearly 60 years of clinical work|
Dilys co-founded the Child Psychotherapy Trust in 1989 and had a significant role in developing awareness of child psychotherapy in the UK among the public and the government. Following this, the training for child psychotherapy was negotiated by the Association for Child Psychotherapy within the NHS. It was during this time under her tenure in the early 1990’s, that she encouraged fellow child psychotherapists to speak to the media about child mental health and the difficulties their patients were experiencing – and perhaps broke a taboo that had existed until then.
In 1979 she wrote what was to become a classic for professionals and new parents called Through the Night. This was recently updated with the help of Sarah Sutton in 2020 and is now published as Parent-Infant Psychotherapy for Sleep Problems: Through the Night. Finding your Way with Your Baby, written in 2015 with Alexandra de Rementeria, won the British Medical Association Prize for best popular medicine book.
These books are clearly psychoanalytically informed, sharing some key theories with parents to help them better understand their babies, as well as themselves, during what can be a tumultuous period of time. Perhaps what distinguishes them both from other parenting books, is Dilys’ encouragement to parents to acknowledge the negative as well as positive feelings aroused in them by their babies.
In 1985, the Child Guidance Training Centre, where she worked, merged with the Tavistock Clinic. Dilys and colleague Juliet Hopkins [watch Juliet’s interview with MINDinMIND here] joined the Infant Mental Health Workshop at the Tavistock Clinic in London and later led it. It was one of the first forums in the UK where parent-infant psychotherapy could be thought about in-depth and has become central to the training of child psychotherapists at the Tavistock.
‘Dilys Daws has quietly been a unique pioneer in child psychotherapy, so often ahead of her time, spearheading new developments, in particular in Infant Mental Health, as well as politically fighting for child psychotherapy. Her calm exterior hides an incisive mind, passionate heart and a determination to ensure the right thing gets done. Child psychotherapy would not be the same without her.’ Graham Music, Child & Adolescent Psychotherapist
‘Dilys has been an inspiration to me in her steadfast commitment to the wellbeing of babies and their parents, and her support for practitioners who work with them. I just love Dilys’ humility alongside her wisdom and courage in speaking out loud on issues of importance. And with it all, she brings a little smile and chuckle. Thank you, Dilys.’ Tessa Baradon, Child & Adolescent Psychotherapist
‘Dilys and I entered the infancy world running a course on infant mental health at the Tavistock clinic at a time when few people took much interest in babies. She has a way of communicating her knowledge and understanding that is not threatening to other professionals whose work with infants has been helped enormously by her. One of her greatest strengths is her patience. She does not need to have an immediate understanding; she has the capacity to wait and not to have to look for an end in her work which I greatly admire as colleague and friend.’ Juliet Hopkins, Child & Adolescent Psychotherapist
Interview recorded November 2018
AIMH is an interdisciplinary, not-for-profit organization, promoting understanding about infant mental health, ie how well a child develops socially and emotionally from birth to three.
AiMH’s primary function is to support the UK community of infant mental health (IMH) practitioners to come together and learn from each other, and to contribute to the raising of standards of IMH practice.
AiMH UK Hubs provide members with the opportunity to share knowledge and skills with their local multi-disciplinary network of IMH practitioners. Online and face-to-face, the Hubs offer CPD events, share resources, and enable practitioners to engage in discussion on local issues, including using the AiMH UK website forums.
03’00 : Why does Dilys Daws stand by the baby weighing scales in the James Wigg baby clinic in Kentish Town, North London?
My first paper was in fact Standing Next to the Weighing Scales 1985 Standing by weighing scales is a useful place to be – I am visible to the doctors, health visitors and noticing me helps them to notice which parents might need help with the emotions of being a new parent.
I don’t see patients on the spot but I’m there for referrals to see them later. Careful observation of parents means you can see a lot of the relationship between parents and infants in things like dressing and undressing, how they put them on weighing scales and I can point it out to the Health visitors.
04’39 : Being an outsider in organisations
It is difficult– I told Sebastian Kraemer that you need to have a thick skin to come into organisations and do quite difficult work on the inside.
05’30 : The importance of child therapists being bold in our clinical work.
I have deliberately encouraged other child professionals to be braver in their work. I have particularly helped other professionals not to immediately react to the problems that parents bring but to wait and ask them to tell them more about it. This provides a thinking space.
06’35 : How has Dilys helped families?
They have come with problems about excessive crying, feeding, sleeping and bonding. It’s parents who haven’t been able to use the ordinary good advice from clinic staff, who refer them on to Dilys.
07’40 : Why did Dilys Daws work at a baby clinic?
It was something very personal – I was experiencing difficulties in my first marriage and with feeding my second baby and getting help for that inspired me to work in a baby clinic. Parents often don’t need much help – just a bit of understanding can help them sort out the problems.
09’20 : Dilys’s role models.
I had a particularly good mother and tried to be as good as her. My GP father’s work was exciting, and he also did a psychiatric training with a lot of psychoanalysis which meant Freud was on the dining table growing up and influenced me. Previous experience at the Institute of Community Studies in Bethnal Green was useful. This is where you find star people such as influential sociologists like Peter Townsend, Peter Maris, Peter Wilmott run by Michael Young. This was good training and helped me to think of the context [of babies being a part of a family and a family being a part of wider society].
13’05 – 13’48 : Why did Dilys Daws decide to break the taboo of child psychotherapists speaking to the media about child mental health?
The media don’t know what you don’t tell them, and we had a lot of knowledge we were circulating in our profession and weren’t telling people outside – particularly politicians and civil servants. They were delighted to hear about it.
13’55 – 14’53 : The importance of acknowledging the emotional turmoil that having a new baby can provoke in parents.
Negative emotions are just as important as positive ones and just as universal. You miss out the meaning of relationships if you don’t acknowledge the conflicts. Things get repressed and a dimension of relationships doesn’t happen.
15’00 – 15’40 : Importance of psychoanalysis to Dilys’s thinking.
The unconscious and importance of early experience and relationships are for the rest of one’s life
15’40 – 16’57 : Relevance of psychoanalytic ideas for parents to know about – such as Too Good Mothering (See Juliet Hopkins discuss this idea on MINDinMIND here) and Good Enough Mother (Winnicott)
17’00 – 17’43 : The discoveries parents can make by observing their babies Babies are trying to communicate – it’s preverbal but you can see it if you look.
17’50 : Value of not knowing and bearing with difficulty.
18’19 – 20’09 : Importance of including fathers in Parent Infant work and creating a ‘triangulation’.
Where there are two parents, the creativeness of having two different points of view of the baby helps the baby as long as they aren’t hostile. It is important for babies and parents to have different views. Daniel Stern’s work shows that a baby realises around 12 months of age that there are other minds. Parents need to respect that babies have a different mind and views on things.
Single parents need to have different people around for the baby as well as for themselves.
20’10 : Challenges new fathers have when they have a baby.
Sometimes fathers cope by working longer hours or going out to do something else. They go to a job where they might be more respected.
21’13 – 24’23 : Ghosts in the nursery: connections between baby’s problems and parents’ early trauma.
Dilys discusses this in her paper, ‘The perils of intimacy: Closeness and distance in feeding and weaning’ (1997) .
Two kinds of feeding difficulties – feeding too much and too little are often connected with early difficulties of the parents. A child fed too little sometimes has a parent who has been neglected and wasn’t fed enough and doesn’t have the resources for their baby. They need more support to be looked after and nourished by a professional which they can then pass on to their baby. Feeding too much – those parents have often suffered a separation or loss themselves and they feel they are neglecting their baby if they stop or say no. Helping them make the connection themselves often changes the behaviour without them having to decide to do so.
As described by Selma Fraiberg’s ‘Ghosts in the nursery’ – it can really impair relationships if parents aren’t helped. Just telling the story is sometimes all that’s needed. It’s surprising how little help is necessary often.
How do you approach parent’s early traumas?
By asking ‘how was it for you?’. Sometimes even in a first session they can trust you enough to tell you. It helps them to remember consciously to tell the story to themselves sometimes for the first time.
24’25 – 26’20 : Controversies and taboos of breastfeeding.
It’s a very sensual activity and some people feel afraid of it because of that. Sometimes not wanting to let the baby latch on because of difficulties managing closeness of the baby. John Bowlby first spoke about the importance of baby being close when feeding, which leads to love.
26’20 : Earliest intervention to help with difficulties such as feeding.
Dilys set up the Association for Infant Mental Health which draws in the professions helping babies at earliest stages [such as early feeding].
27’10 : Importance of connecting with the wider professional network, spreading ideas to help them extend their work.
28’00 : Dilys involved in getting funding for child psychotherapist training from NHS in the 1980s.
I managed to help the NHS to understand that Child Psychotherapists needed funding like doctors.
29’00 : Under-funding of child mental health services and children not being offered treatment when they should be, at an earlier stage which is more effective.
30’00 – 30’42 : After 60 years of clinical work what would Dilys most like to pass on to others working with children?
Always think of children within the family context. Never see a child for psychotherapy without someone seeing the family as well. You don’t get very far helping a child to change without supporting the parents.
Parent-Infant Psychotherapy for Sleep Problems: Through the Night Daws, D. with Sutton, S. (2020). Routledge.
Finding your way with your baby: The emotional life of parents and babies Daws, D. and De Rementeria, A. (2015). Routledge.
Reflecting on reality: Psychotherapists at work in primary care Launer, J., Blake, S., & Daws, D. (Eds.). (2005). Tavistock clinic series. Karnac Books.
Through the night: Helping parents and sleepless infants Daws, D. (1989). Free Association Books.