Date added: 12/02/22

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PUNISHMENTS & REWARDS – CONSEQUENCES & DISCIPLINE (In Work with Children and Young People who have Suffered Trauma and other Adversities)

This article aims to provide some food (not necessarily a carrot!) for thought on this interesting and complex subject. It is also based upon a significant amount of experience and research. The subject is at the centre of our lives - from our experiences of parenting, education, work and society. It is especially fundamental to those of us who work with people who have difficulties in managing themselves and staying within the boundaries of ‘acceptable’ behaviour. It is of such importance and continually challenging. It is one of those subjects that is helpful to regularly reflect on, however many years we may have been working on it. 

When I was aged 11, my best friend suffered the loss of his mother after a long and awful illness. I don’t think he had a day off school during that time or any counselling, etc. He had a lively and mischievous character - delinquent on a small scale. Referring to the work of the Austrian psychoanalyst and educator, August Aichorn, famous for his pioneering work with juvenile delinquents in the 1920s, Brett Kahr (2020, p.47) states,

Aichhorn argued that such profound losses will have contributed to the development of this young person’s criminal activities in later years and, moreover, that the acts of delinquency may even have prevented him from a deep melancholia. 

It seemed wrong to me that my friend would be frequently punished for minor delinquencies. In the 1970s the cane was often used in our school. Twelve years later, in 1985, I began work at the Cotswold Community, a therapeutic community in England for ‘emotionally disturbed’ boys. A few decades earlier these boys would have been classified as ‘juvenile delinquents’.  The Community started in 1967. It was described by Eric Miller (1989, p.28) who became an organizational consultant to the community as an, “… experimental process of transforming an approved school into a therapeutic community.” Approved schools were like borstals or reform schools. This ‘experiment’ was set up by the British Government to find an effective treatment for such disadvantaged children, who had suffered serious levels of adversity. By the end of the 1980s, Miller (ibid) referred to research on the outcomes.

In fact, when the experiment started, 80% of the boys leaving the approved school re-offended within three years; ten years later, the proportion dropped to 20%.

Summarizing the approach, Whitwell (1986) refers to an inspection report by the Department of Health and Social Services, 

At the Cotswold Community there is no use of sanctions and privileges in producing “good” behaviour. The therapeutic relationship is used to explain to the child why he should behave in a certain way and patiently gaining his cooperation. There are also strong verbal commands, but these are not limited to rewards for complying or punishments for not doing so. There is, needless to say, no corporal punishment. This approach does mean that the sanctioning of behaviour is not uniform, but individual boys and adults do seem to understand why this is so. From observation it would seem that this approach has paid good dividends. Acting out behaviour is seen for what it is and with the more integrated children the absence of an aggressive subculture with its veneer of bullying, bravado, illicit smoking and gratuitous swearing, was particularly refreshing to encounter.

This article will explore some of the issues involved in how we respond to troublesome behaviour. 

Pain-Based Behaviour 
Traumatized children’s difficult behaviour is often referred to as ‘acting out’.  The term acting out implies the question - what is being acted out? Anglin (2002) prefers to use the term ‘pain-based behaviour’ to describe ‘acting out’ and the internalizing processes such as depression which are often the result of triggering this internalised pain.  This helps to shift our focus towards the meaning beneath the behaviour.  Since the beginning of the last century, Freud and others understood the link between childhood trauma and anti-social and criminal behaviour. Brett Kahr (2020, p.40) in his book, Dangerous Lunatics: Trauma, Criminality, and Forensic Psychotherapy states,

Across the decades, Freud came to anticipate many of the foundational principles of modem forensic psychoanalysis and forensic psychotherapy namely, the widespread propensity for violent fantasies and, moreover, the potential for those subjected to abuse and trauma to become more likely to enact their hateful thoughts and emotions. 

Similarly, referring to the work of John Bowlby, Kahr (p.56) claims, “Bowlby (1944a, 1944b, 1945-1946, 1946) will best be remembered for his landmark writings about forty-four juvenile thieves who endured profound separation and loss during their early childhood, which Bowlby came to regard as an important aetiological factor”.  Referring to a speech by a British magistrate, Claud Mullins, in 1943, Kahr (p.140) highlights the importance of understanding the meaning beneath behaviour.

”I think we must, for the first few minutes, concentrate on the causes of crime, because you cannot treat people successfully if you do not know what has caused the state which you are trying to cure; and the weakness up to now of penological reform effort has been that it has been rather blind to the causes of crime.” (Mullins, 1943, p.141) 

Mullins then enumerated what he and his contemporaries in the 1940s considered to be the principal causes of crime, namely, inheritance (i.e., one’s genetic vulnerability), poverty, the endocrine glands, as well as lack of parental love, parental separation and divorce, illegitimacy and, also, something that Mullins (p.143) referred to as “psychological trauma”. 

The work involved with traumatized children can be extremely challenging. As well as being faced with the child’s pain, it may resonate with our history in a way that can lead to powerful feelings and at times overwhelming emotions.  Therefore, there must be a high level of training and support available to those carrying out this skilled and sensitive work. Support can be as simple as feeling connected with others and having help available. As Perry and Szalavitz (2010, p.310) say about being a parent,   

The bottom line is that an isolated mother is a distressed mother. She will be less capable of caring for her infant.

Core elements of a helpful response to the child’s behaviour are,
•    believing and validating the child’s experience
•    tolerating the child’s affect 
•    managing our own emotions

Responses to Behaviour
In a sense, two basic responses underpin approaches to behaviour. The psychotherapist Adam Phillips (2013) explains using a simple everyday context. 

When your child zooms round the house saying he’s a superhero you can either remind him that he’s actually a little boy, or you can indicate one way or another that you’re impressed. When your child falls over you can get cross with her for not looking where she’s going, or you can comfort her in an affectionate way.

One response assumes a likeness between you and the child, the other asserts a difference, an innate superiority; one has to do with solidarity, the other is punishing. It is the difference between wanting to be right – wanting to win an argument – and wanting to be kind. Or between two types of authority. One is in essence humiliating and breeds resentment, one is reassuring and makes a bond.

These responses have something in common with what the developmental psychologist, Angela Duckworth (2006, p.211) refers to as demanding and supportive approaches. Demanding includes setting expectations and consistent boundaries and holding responsible. Supportive includes warmth and nurture, showing empathy and encouragement. Referring to much research Duckworth claims that the combination of being demanding and supportive is the most effective approach. This tends to get the best outcomes in helping children develop, as well as adults. Macdonald and Millen (2012) point out that demanding and supportive can be thought of as authoritative rather than punitive.

Authoritative parents set clear standards for conduct and use disciplinary methods that are supportive rather than punitive. This encourages children to be self-regulated and cooperative (Darling, 1999).

Hannon et al. (2010) also conclude that,

Empirical studies show that children who were raised by authoritative parents consistently had better social skills, a stronger sense of agency, and were more cognitively advanced.

In work with traumatized children, Stien and Kendall (2004, p.152) concur, 

Thus, empathic limit setting requires a two part statement.  In the first part, convey an understanding of the child’s feelings to show you are on her side.  In the second part, make sure to state the boundary that the child has crossed (Chu, 1998).

As Phillips suggests we can either get alongside the child or we can emphasize the power difference between us - who is big and who is small. The first response creates a sense of being together while the second separates and puts the child in his place. Sometimes the child may need to be clear of the distinction between the adult and child. This can help create a feeling of safety. But we should observe ourselves and wonder if this is our intention or if something less helpful is getting enacted. For example, as Phillips discusses, have the parents used the child’s relative smallness to make themselves seem big? In other words, are we acting in the interests of the child or at his expense? He suggests that when this happens it is not usually because parents are ‘bad’ people but more often because they are re-enacting experiences from their childhood. It can be argued that the language we use, such as punishments and rewards, support and empathy, consequences and discipline reflect the position we take to whatever is happening. 

Punishments and Rewards 
Traumatized children are often used to being punished and for reasons they cannot understand. Often a child’s difficult behaviour is the result of frustration and her efforts to manage this. Phillips (2013) explains the irony of responding punitively in these situations.

Every child feels punished by being frustrated, and is then sometimes punished on top of that for his response to being frustrated.

Many times, traumatized children will have been punished and treated harshly, in an arbitrary fashion based on the mood of the adult rather than on the child’s behaviour. For children who have hyper-aroused stress response systems, punishments are often likely to make matters worse.  By increasing stress levels and re-enforcing a negative view of the world as a hostile and unforgiving place.  We need to model qualities that challenge the child’s negative view of the world, or, as John Bowlby (1969, 1973) described, the child’s internal working model. Perry and Szalavitz (2006, p.243) point out,

Punishment can’t create or model those qualities.  Although we do need to set limits, if we want our children to behave well, we have to treat them well.  A child raised with love wants to make those around him happy because he sees his happiness makes them happy too; he doesn’t simply comply to avoid punishment.

Perry and Szalavitz (2010, p.313) expand upon the negative effects of a punitive approach,

Research shows that children who receive corporal punishment are more aggressive, more likely to be anti-social as teenagers, and may even have lower IQs than those who are not physically disciplined. Ninety percent of the research on spanking shows negative effects.   

This evidence is strongly confirmed by Heilmann et al. (2021). A meta-analysis of 69 studies, looking at the effects of physical punishment found no evidence that physical punishment is good for children. All the evidence indicates that it is harmful to children’s well-being and development. And the more frequent the punishment the worse are the outcomes. Referring to the study, University of Texas (2021) state, 

A conclusive narrative review has found physical punishment of children is not effective in preventing child behavior problems or promoting positive outcomes and instead predicts increases in behavior problems and other poor outcomes over time. The study by an international group of scientists including a researcher from The University of Texas at Austin was published today in The Lancet.

The ‘carrot and stick’ approach certainly does not work with young people who have suffered complex childhood trauma.  Just as punishment is ineffective so is a system based on rewards. Both are an attempt to manipulate the child into being compliant and behaving ‘well’. The key issue here is manipulation. By putting the focus on either gaining a reward or avoiding the pain of punishment there is a risk of further reinforcing the child’s defences and lack of concern for others. A child whose development has been disrupted by trauma and who feels little concern towards others will be helped better by first of all experiencing care and love from others. Then through the development of a meaningful relationship, the child begins to care about not hurting a valued ‘other’. Donald Winnicott (1963) referred to this as the ‘development of the capacity of concern’. It is one of the fundamental developmental achievements.  Commission for Children and Young People (2012, p.12) explain why behaviourist approaches that rely on systems of reward and punishment tend to be ineffectual.  

Behaviourist techniques may achieve a degree of change in children’s behaviours but without engaging with the underlying emotional content of the behaviour, these changes will not ultimately correspond to transformations in the child’s internal working models or assist them to achieve psychological healing (Forbes and Post, 2007). Forbes and Post maintain that these techniques inadvertently convey to children that the feelings behind their behaviour are not valid or intelligible.

Perry and Szalavitz, (2006, p.244) make a similar point. 

Traumatized children tend to have overactive responses and, as we’ve seen, these can make them aggressive, impulsive, and needy.  These children are difficult, they are easy to upset and hard to calm, they may overreact to the slightest novelty or change and they often don’t know how to think before they act.  Before they can make any kind of lasting change at all in their behavior, they need to feel safe and loved.  Unfortunately, however, many of the treatment programs and other interventions aimed at them get it backwards: they take a punitive approach and hope to lure children into good behavior by restoring love and safety only if the children first start acting “better.”  While such approaches may temporarily threaten children into doing what adults want, they can’t provide the long-term, internal motivation that will ultimately help them control themselves better and become more loving towards others.

A punitive approach runs the risk of being unhelpful for two clear reasons. Firstly, the child’s behaviour that leads to punishment is often the result of frustration. So, as Phillips has said, the frustrated child is being punished for being frustrated. Frustration and punishment can both feel humiliating to him. He feels humiliated by his inability to do or manage something. Punishment for this failing further adds to the humiliation.  Phillips’s (2013) article on tantrums, The Magical Act of a Desperate Person, refers to tantrums as the ‘primal scene of frustration’ for both the child and adult. He suggests what the adult might helpfully do.

Once again, broadly speaking, the child can be punished, penalized, made to sit on the naughty step. Or the parent can stay with the child with a view to containing him: stopping him harming himself, stopping him doing too much damage, but not trying to stop him having the tantrum – which of course involves a belief that the tantrum will end.

Secondly, the punitive response may be perceived by the child as one of adult frustration. Phillips argues that punishment can be a kind of adult tantrum. For example, I can think of the absurdity of shouting at a child to stop shouting. The adult may be giving the message that ‘my tantrum is more powerful than yours, but tantrums are all we have got’ (Phillips, 2013).  It doesn’t offer the child a more helpful way of dealing with frustration. It may even reinforce the child’s view that frustration cannot be managed. It is as if the frustration cannot be transformed into anything more useful and has to be acted out. Phillips highlights the irony of this,

The punitive parent is giving the child what we have learned to call a double message: he is being told by someone who is enraged by their frustration that he should not be enraged by his frustration.

When adults set children boundaries, it is a natural part of child development for them to be tested. Phillips (2009) captures this need well with the title of his paper, In Praise of Difficult Children. As he says,

You find out what the rules are made of by trying to break them.

This puts adults in a paradoxical position, as Phillips (ibid) explains, 

The upshot of all this is that adults who look after adolescents have both to want them to behave badly, and to try and stop them; and to be able to do this the adults have to enjoy having truant minds themselves. They have to believe that truancy is good and that the rules are good.

We have to respect both the child’s need to develop and push boundaries and the need for rules. Rules and boundaries help children learn the limits of reality. Children’s development is achieved by the balance of pleasure and the pain imposed by reality. The maturing child learns to manage her impulses and desires to conform with external reality. She cannot have what she wants and do what she likes all the time. This is challenging to the child and the steady authoritative stance by his parents and others is usually enough to facilitate her development. Just saying no can feel punishing to the child. As children mature, they need greater space to be autonomous and to make their own choices. Deciding how much space is appropriate is based upon the child’s ability to manage herself appropriately in the context. This acts as an incentive to her so that she can enjoy his autonomy and be part of a social group.  

Children are most motivated by feeling they are doing something because they want to do it, rather than because they are being manipulated into doing it.  Alfie Kohn (1993) in his aptly titled book, ‘Punished by Rewards: The Trouble with Gold Stars, Incentive Plans, A's, Praise, and Other Bribes’, has referred to numerous studies where systems of punishment and reward, or even just reward have reduced motivation and performance.  For example, children given a sweet as a reward for doing well in a test did worse in the next test compared to those who weren’t given a sweet. The mere suggestion that the child has an extrinsic motive other than the intrinsic value in the subject can reduce their interest. Summarizing the key message of his book Kohn (1994) says, 

We can never meet our long-term goals by doing things to students, only by working with them. Rewards, like punishments, are ways of doing things to people. And to that extent they can never help them to take responsibility for their own behavior, to develop a sense of themselves as caring people, to work as creatively as they can or become excited learners for the rest of their lives. Rewards, like punishments, actively undermine those goals.

This doesn’t mean that adults should not be clear and firm about their expectations of the child’s behaviour, but within that, the child needs space to work things out for herself. Neither does it mean that adults should not be encouraging and supportive. Caregivers and other adults who are warm and provide clear and consistent expectations for children’s behaviour also encourage early conscience development (Eisenberg and Murphy, 1995; Kochanska, 1991, 1993, 1995).  Pro-social role modelling plays a crucial role in showing the child morally responsible behaviour. 

Porges (2017, p.221) explains why punishments and rewards are especially problematic where children’s development has been affected by trauma.

In addition, the child’s nervous system might not be sufficiently developed to regulate in a complex setting. So rather than incorporating an understanding of how the nervous system regulates behavioral state, we try to use laws of learning by ramping up the motivation through punishment or reward to change behavior when perhaps the neural mechanisms are not sufficiently developed or atypical. Thus, these strategies are, at best, inefficient.

As said, it is helpful to have clear expectations about what behaviour is acceptable and what is not.  When a child crosses a line, we can help them think about it and find ways in which things could be put right.  Making reparation for something hurtful or damaging that they have done, provides them with the vital developmental experience of contributing and making it right (Dockar-Drysdale, 1953, Winnicott, 1963). And this should be done at a level the child is capable of and that is meaningful to them.

Many traumatized children believe that the mistakes they make, or their negative behaviour has catastrophic and long-lasting consequences.  They have learnt this through experience. A small misdemeanour may have resulted in a severely punitive or abusive response from a caregiver.   In some cases, difficult behaviour may have been followed by a major change such as being taken into care. The child often believes he or she is ‘bad’ and responsible for whatever happens.  

The capacity to make reparation rather than be punished also requires that the child has a degree of empathy and concern for others.  For children who are so emotionally underdeveloped, it may take considerable time before they can do this.  To show concern and care for others, first, they need to experience being cared for.  We can also encourage the development of empathy by discussing with the child, her behaviour and how it might make others feel.  Perry and Szalavitz (2010, p.313) suggest,  

To encourage empathy, discipline by reasoning, perspective taking, consistency of appropriate consequences, and above all, love.

They continue (p.314),  

If you teach children to behave by using reason, they are likelier to be reasonable.

Dockar-Drysdale (1953, p.7) argued in her paper, ‘Some Aspects of Damage and Restitution’, that a punitive approach may even damage the child’s potential to develop a capacity of concern towards others.  

I suggest that punishment not only anticipates but hampers and probably blocks the natural process of restitution, thereby preventing the further process by which the child may direct into constructive channels the hostile feelings which have led to guilt and the need for making restitution. 

Traumatized children are familiar with being punished, humiliated, and hurt.  Punishing such a child is likely to trigger his memory of these experiences, causing him to feel angry and resentful towards whoever is punishing him. The skilled worker needs to adopt a non-judgemental approach. This is more focused on working with pro-social behaviour modification, rather than blaming the person.  This has been called, “challenging the behaviour, not the person” (Barton, Gonzalez, and Tomlinson, 2012). It is more helpful to give the message that it is the behaviour that we find unacceptable rather than the person. 

It is crucial that we pay attention to the needs of anyone who suffers because of an anti-social act. For example, a child who has a valued possession stolen and damaged. Or a group of children who have to endure damage inflicted to the home. Winnicott (1961, p.175) argues,

It is quite possible for an individual offender to be forgiven and yet for there to be a reservoir of revenge and also of fear which we cannot afford to neglect; we cannot think only in terms of treating individual criminals, forgetting that society has been wounded and also needs treatment.   

While Winnicott is talking about criminals and society the same principle applies to children in residential care and other settings. If we neglect the hurt inflicted on a child and a group a climate of fear and retaliation will develop. It can also be helpful for children to see that all the attention is not given to the child who has been antisocial. If he or she is not capable of reparation, he or she can be managed safely, and the other children can be given the opportunity to communicate their feelings. 

Consequences of Behaviour – Positive and Negative
However, children must be helped to understand that there can be positive and negative consequences of their behaviour.  We need to help them understand the positive consequences, as much, if not more than the negative consequences.  This is because these children know only too well that they can do hurtful and destructive things, but they often have no idea that they can do things that give pleasure and make others feel good.  They often feel that they are insignificant to others and the only way they can have an impact and be of any significance is by being challenging.  As Perry (2016) has said, we need to help children feel the intrinsic value in relationships. 

Reward and punishment systems often undermine the idea that a child may be interested in what another thinks or feels about him or her. The key to healthy growth is not based on fear or material gain, but on developing a sense of care and concern towards others within meaningful relationships.   Referring to the kind of points systems, sometimes used to induce children to change their behaviour, Perry (2016) argued that ironically, they often miss the point. This is especially so in work with children and young people who are not emotionally regulated. Instead, he claimed that,

Positive human interactions are the most positive reward we can experience.

Natural Consequences
Sometimes we do need to help a child understand the negative consequences of their behaviour and to do something, if possible, to put it right. The more natural or ‘logical’ the consequence is to the behaviour the more likely it is to make sense to the child.  For example, if the child has damaged something in the home, helping to fix it is more relevant than having to go to bed early.  Helping to fix something that has been broken can be understood as a natural consequence. However, Kohn (1995) warns us how easy it is for the use of consequences to slide into a disguised form of punishment.

A number of people seem to think if we call it "consequences" or insert the modifier "logical," then it's okay. "Logical consequences" is an example of what I call "punishment lite," a kinder, gentler way of doing things to children instead of working with them.

However, used helpfully, consequences rather than punishment can be seen as a form of discipline, showing and teaching children how to behave, by providing a climate of mutual respect, where problems are seen as opportunities for learning and growth.  Children are supported to learn from their mistakes through natural and logical consequences. Self-discipline is more likely to grow out of this. Redshaw et al. (2012, p.44) outline the differences between discipline and punishment.

Qualities of Discipline
•    To teach
•    A climate of mutual respect
•    Problems are opportunities
•    Preventative planning - a proactive focus on preventing problems
•    Natural/logical consequences, discussed with children
•    Reasons for standards
•    Demands responsibility
•    Teaches caring values, control by inner values
•    Adults as coaches and mentors

According to Laursen (2003), one of the primary goals of discipline is to:
… provide a safe and consistent environment where children can learn reasonable rules, limits, and consequences, as well as the reasons for them... 

Qualities of Punishment
•    To inflict pain, penalise, cause loss, suffering, to treat in a harsh manner
•    Must respect those in power
•    Problems require punishment
•    Reactive response
•    Arbitrary consequences
•    Do it because I said so
•    Demands obedience
•    Teaches rule compliance
•    Adults as rulers
•    Controlled by external enforcement

We can probably never be sure that an element of a punitive response does not slip into natural consequences and discipline. These situations and relationships between children and adults are emotional by nature. Reflecting on what has happened, by oneself, with other adults, and with the children will provide a protective factor. We must also hold onto the belief that difficulties can be worked through, and small reactions to the child are not disastrous. Only when the reactions become frequent and normalized within the system serious difficulties are likely to occur. For example, where corporal punishment is common within a family or school and rationalized as teaching children right from wrong. This is especially harmful when it is reactive, severe, and based on the mood of the adult at any given moment. 

At least if punishment was based on a set of rules and was carried out consistently the child might have perceived the system to be fair and not so personal, i.e., everyone got punished in the same way for that behaviour and not just me.  This doesn’t mean anything is achieved by punishment just that it might be less harmful. There is also a big difference for a child who sometimes feels harshly treated within the context of a loving, caring environment compared with one who is in a neglectful and/or abusive environment.  

Meaning Beneath Behaviour
To return to the point made at the beginning about pain-based behaviour. Before we can decide whether we use any of the above approaches, punishments, rewards, consequences or discipline it seems essential that we have some understanding of potential meaning connected to the behaviour. We would have no difficulty in the most obvious cases. For example, punishing someone for not being able to do something outside of their capacity. Such as punishing someone for having a disability or an infant for not tidying her room. Or for behaving in a typical age-appropriate way, such as an infant crying. However, we know that babies, people with disabilities, people with mental health difficulties, the elderly have been and can be treated punitively. 

In other situations, the behaviour may be more difficult to understand. But if we don’t have any idea about the possible reason for it, we may make no difference in improving the situation and may make matters worse. During the last century, great progress has been made in recognizing that difficult behaviour may be connected to many different factors and extremely difficult behaviour can be ‘treated’ by responding to the root cause or need beneath it. I will give some reasons why this kind of thinking is vitally important.

1. Anti-social Behaviour and Child Development                                                               At certain stages of development difficult behaviour may just be part of the person’s development process. A degree of acting out delinquently may be a way of managing difficult feelings and conflict and moving through a stage of development. For example, adolescence is well known for being a time when young people come into conflict with parents and society. Adolescent behaviour can be a way of feeling real and potent, during a time of underlying fear and feeling out of control. It is a time of major change, physically and emotionally, from being a child to an adult. Winnicott (1963) refers to adolescence as the ‘doldrums’. Adolescence is a process of separation from parental figures and one where young people are forming their identity. Commonly, adolescents might form groups that have a challenging anti-authority attitude. There may be group as well as individual delinquency. This does not mean that there doesn’t need to be rules and boundaries, but there may also be no need to be too concerned.  Winnicott (1963, p.132) says, 

It does not mean that we grown-ups have to be saying: ‘Look at these dear little adolescents having their adolescence; we must put up with everything and let our windows get broken.’ This is not the point. The point is that we are challenged and we meet the challenge as part of the function of adult living. But we meet that challenge rather than set out to cure what is essentially healthy.

2. Anti-social Behaviour as a Sign of Hope                 If  the behaviour seems more concerning it may be an attempt to draw attention to a need. As Winnicott (1956, p.309) said the delinquent behaviour or anti-social tendency may be a sign of hope. 

The antisocial tendency implies hope.  Lack of hope is the basic feature of the deprived child who, of course, is not all the time being antisocial.  In the period of hope, the child manifests an antisocial tendency.  The understanding that the antisocial tendency is an expression of hope is vital in the treatment of children who show the antisocial tendency.  Over and over again one sees the moment wasted, or withered, because of mismanagement or intolerance.  This is another way of saying that the treatment of the antisocial tendency is not psychoanalysis but management, a going to meet and match the moment of hope.

As Winnicott points out there may be a therapeutic opportunity being presented by the behaviour. If there is a reaction rather than a thoughtful response to the behaviour, the opportunity is likely to be missed. This concept was groundbreaking and one that was central to the work of the therapeutic community I began in. Winnicott was a paediatrician and psychoanalyst. His prolific work had a major influence on approaches to parenting and therapeutic work with young people. He also gave talks to prison warders and wrote about residential care. Kahr (2020, p.57-58) captures the essence of the concept. 

Winnicott best encapsulated his ideas on the early roots of delinquency in a landmark essay, “The Anti-social Tendency“, in which he described the case of “John”, a young boy who stole from shops compulsively. Although most psychoanalysts in the mid-twentieth century insisted upon working with their patients on a five-times-weekly basis, Winnicott knew that this would not be possible for many families, or, even, necessary; hence, he helped John by talking at length to the boy’s mother. With tremendous compassion and insight, Winnicott (1956, p.307) told the mother, “Why not tell him that you know that when he steals, he is not wanting the things that he steals but he is looking for something that he has a right to: that he is making a claim on his mother and father because he feels deprived of their love.” The mother did, indeed, follow Winnicott’s recommendation; and, rather than simply punishing John as most parents of that era would have done, she engaged the boy in conversation and discovered that he believed that his parents did not love him. Such a frank and touching discussion between a mother and child eventually proved most therapeutic, so much so that, in later years, Winnicott (1968) came to regard juvenile delinquency as a hopeful cry for help. 

Example 1: For over 35 years I have seen the benefits of Winnicott’s concept applied in practice. Recently, one provider of a residential care service that I consult with told me about one of their girls, Anna, who is 10 years old. Anna lives with a group of 9 girls with 5 other groups of similar size in the same large building.  The senior staff member, Debby, told me that Anna had started to frequently get up in the night, leave her group, and go to one of the night staff. The staff were concerned about this and wondered what could be done. Maybe Anna was frightened on her own in her room? In exploring this with Debby, we paid attention to the pattern of Anna’s behaviour. Did it happen on certain evenings of the week? What did she do when she got up and left her group living space? There were different night staff working on different evenings. Anna did not have any explanation as to why she was doing this. Debby noticed that she only got up when one of the night staff was working, Rachel. 

Rachel usually placed a lit lamp from Anna's room, on the floor, so that the nightlight would be less bright. This lamp was left on because Anna was afraid of the dark. So, even though Anna could not see Rachel, she knew it was her on duty as she was the only one who did this. Thinking about why Anna would go to Rachel, it became clear that Rachel was especially nurturing and maternal in her personality. This could be seen in the thoughtfulness of placing the lamp on the floor. Anna’s early childhood was one where she had some positive experiences but also significant neglect. It seemed a reasonable hypothesis that Anna was seeking some individual nurturing attention from Rachel. Debby decided to explore this further with the two care workers in Anna’s group. They were both convinced she did it out of fear, as it happened in the past. Later on, exploring it with Rachel, she confirmed that Anna did not seem frightened or complicated in her mood when she came to her in the night. She described they would calmly walk to her bed; she would tuck her in and stay with her for a bit. It wouldn’t take long for her to fall asleep again until morning. They then wondered if instead of fear she was getting from Rachel something she needed. So, the care workers started paying more attention to Anna and help make her bedtime a more nurturing experience with some 1-1 attention. They started to do this, and Anna more or less immediately stopped getting up in the night and slept better.  This is a simple example of thinking about behaviour as giving a clue and opportunity to meet a need. Unfortunately, it is also possible that a child who regularly behaves like Anna could be responded to in a controlling way mainly to stop the behaviour. Her behaviour shows the resilience and hopefulness of a deprived child to find a way of getting what she needs.

Example 2: This example is from a paper by John Whitwell (1998), 

“An example of reality confrontation: 
At the end of the session, we spent time with Stephen, who we knew had stolen a large quantity of Lego. In many ways, it was an arduous process, with one step forward and one back. After three-quarters of an hour, he acknowledged that he may have taken one piece by mistake. After one and a half hours he acknowledged that maybe it was a few more and we could go to his room and after three hours a pile of Lego was able to be returned. This piece of work was only possible through the three of us working together. It enabled different aspects, feelings, thoughts to be voiced and held by different people at different times, i.e., someone holding the empathy, someone the depression, someone the anger etc., and created something which was eventually sufficiently containing and challenging to enable Stephen to be able to put something right in a context where there was no blame or devastating consequences. It was a moving experience and something significant had taken place for Stephen and our relationship with him.

I have already said that unintegrated children do not need permissiveness. Their lack of personal boundaries requires an emphasis on clear external boundaries. However, control, sanctions, punishment are not words that sit easily in a therapeutic environment.”

Example 3: This example is from my work at the Cotswold Community.

“Robert’s first two years of life were characterized by an absent father and traumatic separations from his mother, in a generally chaotic and unreliable environment.  His development from then on had been fraught with difficulty.  At the time of referral, Robert was described as uncontrollable and unable to take responsibility for his actions.  His anti-social behaviour included stealing, destructiveness (vandalism), stealing cars and running off.  A few months into his placement, we noticed several yoghurts hidden in his room and empty cartons lying on the ground outside his bedroom window.  He was taking yoghurts from the fridge in the night, eating them and then throwing the cartons out of his window.  As Robert was normally very adept at stealing and hiding things, it seemed odd at first, that he was making little attempt to conceal these cartons.  Having discussed this with Robert’s carer, Terry, we decided that this might be a ‘sign of hope’, that Robert was looking for us to provide him with an experience, symbolizing the provision he lost in early infancy and to help fill some of the gaps left by that.  Dockar-Drysdale (1961, p.63) described the significance of this provision and how it may be provided, throughout her writing and terms the provision ‘adaptation to individual need’.  She compared this to the way a mother responds to her infant’s ‘spontaneous gestures’, as described by Winnicott.

Rather than confront him, Terry simply asked Robert if he liked yoghurts, to which Robert smiled, looking rather embarrassed and said yes.  Terry asked him if he would like to be provided with yoghurt as a special thing (adaptation) at bedtime, just before settling down.  Robert replied with enthusiasm that he would. This then became a reliable provision from Terry for Robert, on the same evenings every week for over a year.  Robert kept the empty cartons and eventually had a stack several feet high.  McMahon (1995), referring to the same case, pointed out that the yoghurt cartons may have represented the emotional experience that Robert now had stored up inside him.  Certainly, at those times Robert received his yoghurts from Terry, he seemed to feel very much like a small child enjoying a meaningful feeding experience.  As this provision was important to Robert, representing early ‘primary experience’ of which he was then deprived, it needed to be reliable.  His carer Terry would never be asked to do anything else at those times and his time with Robert would be protected, ensuring the provision would not be disrupted.” (Barton, Gonzalez, and Tomlinson, 2012, p.95-96).

In all of these examples, the key aspect of the response is to think about what is happening and if possible, to understand the cause of the behaviour. When something seems to work, and a change takes place in the child we cannot be sure exactly what has caused it. It may be that we got the hypothesis correct, or the child simply responded to being thought about, being paid attention. So just as a punishment is a simple method of dishing out the same to everyone, we need to work at remembering each child and situation is unique. When we feel we have succeeded in one situation there is always the risk that we try to fit following situations that seem similar into the same formulation (Aichorn, 1925, p.37). This may cause us to overlook information and not pay attention as we have already jumped to our conclusion. Aichorn (p.39) summarizes these points well,

If the physician limits himself to clearing up symptoms, he does not necessarily cure the disease. The possibility of a new illness may remain; new symptoms may replace the old. In the re-education of the delinquent, we have an analogous situation. Our task is to remove the cause rather than eliminate the overt behaviour … what parents undertake by way of correction or punishment serves only to suppress the dissocial behaviour. If this behaviour disappears, the problem is considered solved. However, the disappearance of a symptom does not indicate a cure.  

Aichorn (p.41) goes on to claim, 

Without discovery of the deep underlying causes of delinquency, any cure is accidental. 

3. Punishment and Depencency                                                                                          A person can develop a dependency on being punished. This could be because it has become familiar. It could also be because the person has begun to derive pleasure from being punished. This is one way that masochism develops. The person has no control over being hurt, so one form of control can be to turn pain into pleasure. This also takes the power away from the punisher or abuser. I can remember one 8-year-old boy I worked with asking me and others to hit him. He wanted to be hit and found it extremely difficult when we refused. In effect, he was asking to be ‘punished’ in a way that was familiar to him. Any punishment he received would only re-enforce his pattern. Punishment also helped him avoid what was far more difficult for him – thinking and talking.

4. Reality Blindness and the Gaining of Insight                                                            Often difficult children and criminal adults have no insight and little control into why they do what they do. Fritz Redl used the term “reality blindness”. Not only does the child deny that he has done some delinquent or aggressive act, he does not know that he has done it. Such a young person tends to live entirely in the present, with no past to regret and no future to consider (Whitwell, 1989). Without working on improving this, change is unlikely. The patterns may even be reinforced. In his research on criminal behaviour, Kahr (2020, p.49) has this to say on the importance of insight.

Based upon the observation that most, if not all, offender patients have little or no insight into why they had perpetrated crimes, Franz Alexander and Hugo Staub argued that investigators must strive to uncover the hidden motivations of violence. They also lambasted the traditional prescription of punishment as “psychologisch unsinnig” (Alexander and Staub, 1929, p.76), namely, “psychologically nonsensical”. Indeed, these forward-thinking investigators even hypothesised that the prospect of punishment might arouse some of the more masochistic offenders and could, therefore, encourage criminality. 

Whitwell (2018, p.20) explains the connection between the non-punitive approach and the development of insight.

The Cotswold Community did not have a system of punishments and rewards to control children because having children ‘under control’ was not our primary task. As therapists, we were more interested in the meaning of behaviour rather than simply controlling it. If a child behaved in an anti-social way we wanted to know why and, ultimately, we wanted the child to understand why, because a gain in insight by the child would lead to a change in behaviour. For instance, if one understands why one is driven to steal, it is no longer possible to steal with impunity. We were not interested in children behaving well while residing in the Community and then falling apart once they’d left.

Referring to the visionary work of Eileen Vizard, Kahr (2020, p.89) confirms the value of this approach.  

… I certainly came to appreciate that psychotherapy does, in fact, reduce the likelihood of reoffending quite considerably, especially after the young patients have had an opportunity to verbalise their early traumatic experiences and to obtain both catharsis and insight.  

The Challenges of Being Non-Punitive
Adopting a non-punitive response is not easy however much we might be convinced of the rationality. One of the reasons is that children and adults will tend to push boundaries. This is a natural process needed by the child to know where the boundaries are and to feel safe. When one is in the position of being the ‘boundary setter’ this is often challenging, whether as a parent, a manager at work, or in therapeutic work. Often people also need to know that they are safe from harsh, punitive reactions. So, as well as being implicitly asked to make a boundary clear the process can often also feel provocative and testing. Nothing can be more so than in the work with children who have suffered complex trauma, including abuse and neglect. These children need safety and clear boundaries, but also to be understood and cared for. Paradoxically, they may try and provoke hurtful reactions to feel in control rather than be taken by surprise. Talking of her work as a consultant at the Cotswold Community, Dockar-Drysdale (1953, p.3) says,

Many of the children who come to us are punishment-seeking, and, in consequence, self-destructive. 

When children are seeking punishment, they will most likely persist in a manner that pushes us to our limits. Certainly, we will have to tolerate strong reactions within ourselves, including punitive feelings. This can be very troubling for people who see themselves as caring and loving. Bruno Bettleheim who ran a residential treatment centre in Chicago (1974) claimed, 

It isn’t so much the patient’s actions or feelings against which the staff need to protect themselves, but mainly their own. 

Having such feelings can be a natural response. It is the effort to be in touch with these feelings, to manage them and not act out, that is a meaningful demonstration of care. Understanding and holding onto this perspective needs support.  Helpful support includes the opportunity to reflect with a skilled supervisor, consultant or manager, and also in teams, as well as training. Without effective support, many workers will be unable to survive these challenges. They may leave or become ill. They become highly defended, insensitive, or reactive. Unfortunately, many instances of abuse have probably been related to difficulties in this area. Dockar-Drysdale (1969, p.58) said that punishment is often this kind of acting out. She also makes the connection (1968, p.10), between, stress, support and acting out.

I would suppose that systems of discipline in a place have a connection with the stress level which can be tolerated by the staff: the lower the level of stress toleration, the harsher the discipline. Organized and consistent (or rigid) methods of punishment, for example, tend to bypass conscious stress in the person who inflicts the punishment. Where there is ‘punishment made to fit the crime’ stress can easily be denied in a place ... 

A person imposing disciplinary measures, however, often acts under considerable and complex stress of which he may not be aware. Both punisher and punished can be involved in a kind of unconscious excitement, which can result in a pairing set-up, and this may perpetuate a pathological punishing/punished pattern. 

Her observation of this mutual unconscious excitement is important. Sapolsky (2017, p.66) refers to neuroscientific research that has shown how punishment can release the pleasure related chemical dopamine in the brain. As a result, Sapolsky (ibid) says, “Punishing norm violations is satisfying”. This adds to the challenge of being non-punitive. We have to work against what can be a biological pull to punish.  

As well as dealing with our punitive tendencies we must also contend with a child’s attempt to pull us into the role of punisher. Greene (2020) explains this well in her article reporting on what has happened to some of the Romanian Orphans who were removed 30 years ago. Many of these orphans suffered terrible deprivation and abuse. Referring to the experience of one of the adults she interviewed, Izidor, she says,

Unable to process his family’s affection, he just wanted to know where he stood. It was simpler in the orphanage, where either you were being beaten or you weren’t. 

Izidor himself, says, “I responded better to being smacked around.” He found it easier to be punished than to think or talk. It is misguided to think that most rule breakers, especially when habitual and criminal are likely to suffer pain as a result of punishment. Sapolsky (p.182-183) referring to research on children between two and ten years old confirms this point.

Crucially, the behaviour of future sociopaths seems impervious to negative feedback. As we noted, high pain thresholds in sociopaths helps explain their lack of empathy – it’s hard to feel someone else’s pain when you can’t feel your own. It also helps explain the imperviousness to negative feedback – why change your behavior if pain doesn’t register?

It seems clear that punishment does not work in changing the child in any positive way. It might even gratify the child or cause excitement. However, holding a non-punitive approach requires our thinking, executive function to be working well.  We know this is less likely when we are under high stress. It can be argued that in society, there is also a correlation between stress and punishment. The higher the stress in the population the more it may feel necessary that people who break the rules are punished. Punishing offenders may provide a kind of cathartic relief for non-offenders.  Sapolsky (p.635) argues that research has shown that where a system of punishment that requires an investment of time and money is established, pro-social behaviour can be improved in society. This is an argument that punishment may serve a useful purpose as a protective factor. However, for the punished the outcomes are universally poor. Kahr (2020) refers to international research that shows high rates of recidivism for released prisoners, in being reconvicted and imprisoned. On a societal level, Kahr argues that the punitive approach is neglectful. Law-abiding citizens are left at risk of the further crimes that unrehabilitated criminals will commit. This is even more so in the case of children who have profound difficulties due to their childhood experiences. We can either help them to recover and develop and go on to make a positive contribution to society or waste the opportunity and face the risk of the children becoming a burden to society, with great suffering to themselves and potentially others. 

The Need for Safety
Sapolsky makes the important point that one reason for imposing restrictions such as imprisonment on criminals is to make others safe. Incarceration can be considered a protective factor. In the same way, restrictions may need to be placed on children for the protection and well-being of others. For example, there may be a plan to take a group of children in a care home out to the cinema. One child may be behaving in an unsafe manner. The staff may decide to exclude this child from the outing as it might not be safe, or it might spoil the event for the other children. The child may complain that this is a punishment and genuinely feel that it is. This is one of the challenges of confronting a child with reality. For example, “no you can’t have any more”, or “that behaviour is not good, I won’t allow you to do that”. To the child, this may feel equally punitive to being hit, or any other act that by nature is meant to inflict pain. The point of punishment is to cause pain as a deterrent, whereas the point of facing the child with reality is, firstly, to make a boundary and expectation clear. Secondly, it is hoped that the child will gain insight. If that happens without too much pain everyone is happy. Whereas there is nothing that annoys a punisher more than the offender laughing or smirking at the punishment. This is a defiance of the intended pain. We are probably familiar with terms like, ‘you can wipe that smile off your face’, or ‘don’t you dare be so disrespectful’, or, to find another punishment added on top of the first. The responses of the child may challenge and cause doubt in the adult making the decision. He or she may even be accused of being abusive. The adult will have to consider if she is making the right decision for the right reason. As well as being punitive there is also the risk of colluding with the child due to fear of potential reactions.  

Where children are managed very closely due to their immaturity and the risks involved this can feel like a strict environment. This is especially when there is a significant gap between a child’s chronological age and his level of emotional maturity. It will need to be clear what the rules and boundaries are. Winnicott (1950, p.157) explains,

It must be remembered that even in very strictest communities, as long as there is consistency and fairness the children can discover humanity among themselves, and they can even come to value the strictness because of the fact that it implies stability … if the strict setting is the basis, then it is disturbing to the children if this strict setting has exceptions and loopholes. If there has to be a strict setting, then let it be consistent, reliable and fair, so that it can have positive value.

The ‘strict’ or firm and containing environment helps the child manage his primitive impulses and potentially develop concern towards others. Restrictions made on the grounds of protecting others and the child can be done without the intent to punish. Empathy can even be had towards the excluded child. Therefore, even though the action taken can feel punitive it may be necessary and can be carried out with compassion. Being non-punitive does not mean having a lack of consequences, it simply means acting towards the ‘rule breaker’ in a manner that maintains values, such as, dignity and compassion. This does not mean being permissive or not holding boundaries and expectations firmly. It is vitally important that children know that whatever destructive feelings and impulses they have will not be allowed to hurt others or themselves or destroy the good things they value in the home. 

Whenever a child does cause harm, they also need to know that the transgression is taken seriously. All children in a group will notice whatever responses are made towards others. Their feeling of safety will strengthen as they see protective but non-punitive responses being taken by the adults. Depending on the culture of the group, the size of it, etc. there may need to be some fair, reasonable and consistent consequences to help contain feelings of anger and retaliation. Winnicott argued that legal systems serve a purpose to reduce the public’s need to directly retaliate to unlawful behaviour. In this sense, a system of legal punishment can be seen to reduce aggression in society. Not as a deterrent but as a way of channelling and managing anger towards the perpetrator. Winnicott (1946, p.98) says,

Crime produces public revenge feelings. Public revenge would add up to a dangerous thing were it not for the law and those who implement it. First and foremost in court work, the magistrate gives expression to public revenge feelings, and only by doing so can the foundation be laid for a humane treatment of the offender. 

All these challenges require significant resourcing if we are to contend with the internal and external pressures to punish. On a societal level in response to adult criminals, this is an uphill task. The public may need to feel that justice is being done, and criminals are not getting away with it, too much. This feeling is likely to be stronger when living conditions in society are challenged. Emotional energy is mainly focused on survival and the needs of criminals are not high on the agenda. A punitive focus on criminals can even create a feeling of being at least better off than someone else.

However, in treatment centres aiming to help prevent children from becoming adult criminals, and other negative outcomes, punishment tends to not serve a useful purpose. Whenever punitive responses become the norm, the approach is sliding off task and most likely there is a lack of support being offered to counteract the inevitable punitive tendencies. This may be one reason why there is a move away from group care in many countries. The feelings of everyone in the group, including the revengeful kind of feelings that Winnicott referred to are difficult to manage. However, the cost of isolating children from their peers does not help with vital learning about reality which is a necessary part of their treatment. Positive peer culture (Bath, 2003) can help improve sociability. It can be especially helpful for children and young people who tend to act out selfishly.  Positive peer pressure can help children be accountable to commitments made to others.  The ability to develop healthy peer relationships has been identified as a key factor in the achievement of good outcomes in the long-term (Shonkoff and Phillips, 2000, p.165). Aichorn (1925, p.205) argued that, 

During the course of his training, the delinquent must learn that the amount of pleasure obtained from social conformity is greater than the sum of small pleasures derived from dissocial acts even when the accompanying discomfort of conformity is taken into account. 

Positive peer relationships can be a spur to development and also helps create the sense of normalcy that is so important.  

The Need to Manage Ourselves
In work with traumatized children (as in parenting) and other relationships, there can sometimes be a sense of being at a loss of what to do. When this is mixed with strong emotions, such as anger, anxiety, and fear, there can be a reaction to do something and feel in control. For many reasons, including our own childhood experiences, we may feel justified in punishing the child. We may feel that we have to do something to create a positive change. The concept of punishment and reward can be seductive in these moments. Taking a punitive action may provide some relief to the adult, and give an impression of making a difference, however short-lived. 

Therefore, as well as considering the child-centred matters discussed in this article, we also need to ensure there are ways for the adults involved to process their feelings, feel supported, and be able to take a step back. Working on the issues involved is not something we are likely to feel we have ever mastered.  There are many complexities involved, including how we manage ourselves. If we are working with children who have suffered complex trauma we will often be tested to the limit of our capacities. As in the children’s histories, the most punitive and unhelpful responses are likely to occur when adults are at the ‘end of their tether’. Or as Phillips (2013) says,

People punish other people when they don’t know what to do with them. 

Conversely, Dockar-Drysdale (1990, p.127) believed that with support and a good level of attunement most violent incidents are potentially avoidable. 

One could start by saying that the management of violence is its prevention.  By this statement, I mean that, since all acting out is a breakdown in communication, it is our responsibility to keep in communication with the children in our care.

Or as Farragher and Yanosy (2005, p.101) said, “Our job is to help put feelings into words rather than act them out.” The quality of emotional holding will have a direct impact on the feelings of safety for children.   As a child begins to feel safe and develop emotionally, he will become more able to manage his feelings. An effective treatment environment must maintain open communication. This means that adults can reflect on their part in relationships with children. As Dockar-Drysdale suggests, when it comes to difficult behaviour, anticipation is the best form of prevention. This means understanding a child’s needs and how we might influence her positively or negatively. Naturally, at times, the difficulty in this can make us feel inadequate, unsure of ourselves, and feeling as if the child is inflicting pain upon us. Unless we can acknowledge and think about these feelings it might feel as if we should punish the child. In her paper, The Management of Violence in Disturbed Children, Dockar-Drysdale (1971, p.125) says,

Punishment is often a rationalization of violence-grown-ups can act out, denying the real causes within themselves which lead to their violent actions. 

In our work with children and young people, especially when they have suffered significant adversities, we must hold onto the fact that systems of punishment are generally not effective. For the sake of the young people, whose lives are dependent on what we do, we need to persevere with the belief and hope that they can recover - that their lives can be positive for themselves and society. To achieve this, we must keep our attention on the need to offer the necessary conditions of support and training to sustain an effective approach in our work. So that the punitive tendencies do not take over, with the costly consequences that have been so well documented throughout the last 100 and more years (Kahr, 2020). This is challenging and hard work that we can never be certain we have got right. We have to continually reflect on children’s behaviour, their needs and our responses. 

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