Weaving the Cradle by Monika Celebi

Author:Monika Celebi
Language: eng
Format: epub
Publisher: Singing Dragon
Published: 2017-03-30T04:00:00+00:00

CHAPTER 11

When the Bough Breaks

The Lighthouse Programme

Gerry Byrne and Gabrielle Lees

The Lighthouse© MBT-Parenting Programme is a mentalization-based group treatment (MBT) for parents where there are significant safeguarding concerns. Their children may be at high risk of abuse or re-abuse, on child protection plans, involved with family courts or already placed in the care of the Local Authority. Although the groups usually take place without any children present, this chapter will consider how the presence of a baby, in utero and/or in person can impact on the group dynamics, the other parents and the facilitators.

The Lighthouse model has been developed in collaboration with the Anna Freud Centre, and adapted to incorporate therapeutic methods and skills from mentalization-based treatment, developed by Anthony Bateman and Peter Fonagy (Bateman and Fonagy 2008).

CONTEXT

The Lighthouse Programme is delivered by the National Health Service (NHS) in a specialist child and adolescent mental health service (CAMHS). The aim of the service is to offer intervention to parents and their children to break the cycle of repeated abuse and/or neglect and trans-generational cycles of attachment difficulties and lifelong psychological difficulties. It includes psycho-education, group therapy and individual treatment. The Lighthouse© MBT-Parenting Programme has been developed specifically to promote mentalizing (the ability to imagine, to perceive and to interpret other people’s behaviour in terms of deliberate mental states, such as feelings and intentions [Stolk et al. 2007]) in parents whose children have been identified as in danger of, or have already experienced, emotional and physical maltreatment, abuse and neglect. The programme aims to improve parental functioning and strengthen the parent-child relationship. This is achieved by educating parents to mentalize, think about feelings and intentions, their own and their child’s, to help them understand the child’s mind, enhance their sensitivity and empathy, and improve attunement to their baby. This offers greater opportunity for developing a more ‘secure’ attachment and reducing the likelihood of abuse in the future. In our experience, it is failures in a parent’s mentalizing capacity, usually in moments of high stress, such as hearing a baby cry inconsolably, that can result in serious physical or psychological harm to the baby.

The parents we work with have almost always been traumatized by their experiences in childhood, and their histories of neglect, physical, sexual and/or emotional abuse often result in serious personality problems, mental health difficulties or substance abuse. A number of parents attending the programme have lost children to care recently, some have their children currently in foster care and others may lose care of their baby or children during the treatment period. Many groups contain at least one pregnant mother and sometimes the baby, once born, attends with the mother for the remaining weeks.

In her paper ‘Ghosts in the nursery’, Selma Fraiberg (Fraiberg, Adelson and Shapiro 1975) describes a young mother who is apparently deaf to her baby’s cries. She concludes that the mother’s cries went unheard when she was a baby herself. Parents we work with show numerous blind spots to their children’s communications and so struggle to hold their children in mind and respond to them sensitively and appropriately.

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