Hurts to Care

by Nancy Macguire

I used to belong to a club. A rather small and selective club of people who work with abused and neglected children placed outside their homes. We were even more exclusive because we worked with the “tough kids” or the “deep-end kids.” These are the children whose lives became tragedies at very young ages. These are the kids involved when you hear about prostitution rings of 8- and 9-year-olds and families with generations ravaged by poverty, drugs and violence. These are also kids who have no home, no family with the resources to care for a child who needs to heal so many wounds.

So we created homes and healing environments. The children lived in the community and went to public school. They also came to therapy and had "individual service plan" meetings, where people talked about a child learning to cook, playing in intramural sports and visiting a sister who is in foster care. We cared for the children in every aspect of their lives. And it took a team to do that, including a director, clinical director, therapist, education coordinator, recreation coordinator and, most important, the staff, who spend eight, 10 or 12 hours at a time in a home with five or six children. The children lived in a home that was theirs, where they could become attached to a place, a program, a staff member and therapist.

What happens when you join this club is that you fall in love with it. You become an advocate, mentor and teacher. You want good things for these children. You want them to be safe, to heal and grow. You want them to connect with family, or you protect them from family members who have proven to be abusive. You listen to their pain, feel their anxiety and watch with a mother's pleasure as a malnourished 12-year-old suddenly grows four inches. You weep as they can't help but sabotage their own lives, remembering that they are still better off for having had a safe place for at least a while.

You learn a secret language of abbreviations such as DHS, CBH, ISP, PTSD and ODD. You tell stories of triumph and loss. You pass on with joy the story of a child, now 23 and attending college. You marvel with colleagues at the wisdom found in a 14-year-old announcing that she is not visiting the home she desperately wants to return to until her mother stops being abused by her boyfriend.

So I used to belong to this club. I turned in my membership. Burnout, you ask? No, not burnout. These children live in a system that grinds away slowly. It is a system without enough resources that exists in a larger system that does not really care about abused kids, especially poor minority kids. That is not enough to say I can't do this any more. Indeed the challenges of the system only created a greater desire to advocate for a child and for change.

So what had me walk away from work I love? Probably when I found myself without the resources to provide the children with the primary thing they need: relationships. These are children who have lost many people in their lives. They are described as having "disrupted relationships" -- meaning that the adults who were supposed to love and care for them were unable to do so. We know from research that children who are resilient in the face of enormous challenges are the children who have at least one meaningful relationship with an adult. These so-called tough kids are not the most resilient. They have significant trouble attending school, living in society and making friends. There are children who need to be attached to someone. This does not mean being shuffled on to the next foster home, or living with 14 other children in a group home. They need to live in a home that is theirs, where there are rules, consequences and safety. The program needs to have the resources to focus not on how to control a child's behavior, but on how do I have a relationship with this child. This requires resources in time and energy for training staff, responding to emergencies, and creating an environment where staff is not burned out and looking to move on.

Because change is slow, maybe even a generation away, ending a seemingly endless litany of tragedy can take a lifetime. So if there are not the resources for long-term healing relationships, then the next generation is not even being helped. That is when I realized how much it can hurt to care. That is when I realized that, if I continued to work in a place that was unable to provide homes, not housing, not institutions, then I became a part of the problem. That very thought created the path to my exit. I cannot do harm.

So I turned in my membership -- well, mostly. I'm still working with kids. I'm not a creating a safe home. I am creating a safe space where healing can occur, slowly and for both of us.

Nancy Maguire is a clinical psychologist practicing in Philadelphia and New Jersey. If you would like to respond to this Slant or have one of your own (850 words), contact Howard Altman, City Paper interim editor, 123 Chestnut St., third floor, Phila., PA 19106 or e-mail altman@citypaper.net.