All children in the course of growing up encounter minor stresses: accidents and illnesses, the birth of a new baby, a move of house or school, and the inevitable demands of increasing maturity and self control. Most children react to these stresses with temporary behaviour disorders, such as nightmares, bed wetting, temper tantrums or excessive fears. Serious difficulties arise only when the stresses are overwhelming or when the adults are too occupied to attend to the child’s signals of distress. Skilled psychological help then is needed although the reactions of a child are “normal” in the sense that any child under these conditions would react similarly. Help for children under stress fulfils a double purpose, the relief of present anxieties and the prevention of personality defects in later.
Disturbed behaviour arousing anger in other people may be the first indication that a child is struggling with an emotional problem. Before proceeding to curing remedies it is important to know what usual causes of stress in children are. Mostly problems stem out when there is a conflict between inner wishes on the one hand and the external world on the other or between inner urges and one’s own conscience.
We cannot neglect the harmful effects of bereavement. It has grim impressions more often due to its long term social consequences and emotional reactions of the surviving parent than to the impact of the death itself upon the child. Further there is much evidence that the children from disrupted families have more behaviour disturbances than children whose homes are intact. Families incomplete because of illegitimacy and those broken by divorce are different from families disrupted by death, in that the remaining parents tend to be censured by their own families and by society in general. A leading cause of stress in children is a neurotic family. A marriage in which the unresolved childhood conflicts of both parents are repeatedly enacted is the basis of the neurotic family. Though outwardly a family may appear perfectly stable and united but there are repeated violent quarrels and even temporary separations. Children belonging to such families are characterised by frustration and discontent.
We have discussed how the disruption of family structure can increase a child’s difficulties in adapting to the family life. But there is a second series of reasons those of the outside world. More important are the demands made on a child to confirm standards of achievement and social behavior. Failure in the outer world is accompanied by loss of self-esteem and has profound effects on personality developments. Despite of the disorders induced by adverse family interaction social and cultural differences between the sub-groups of society may cause anxiety and makes it difficult for a child to concentrate on his performance.
To curb the growing rate of stress in children it is necessary to take some measures. Preventive psychiatry, like preventive medicine, focuses not on the individual patient nor even on the individual family but on wider social groups. The behaviour disorders of childhood, the neurotic illness of later life, antisocial personality distortion that interfere with work, with animate relationships such as marriage and parenthood, all these are psychiatric disturbances which theoretically at least are preventable.
In considering what society can do to prevent and ameliorate such psychiatric disorders it is important to know that it is caused by two sets of circumstances: experiences of overwhelming anxieties and experiences of inadequate socialisation often associated with parental and cultural deprivation. The field is still wide open for exploration. Housing policies, reforms in education, the administration of National Health Service and changes in our legal system are all social processes likely to affect mental health. There is room for more experimental investigations of the effects of proposed policy changes before they are implemented on a nation- wide basis.
Society takes responsibility for a considerable part of child rearing. The experiences provided for children in schools are in large measure under public control. Through the training of teachers and the organisation of schools and classrooms, society has a chance to improve and modify the major part of the environment of children. The expectations are that schools should not only compensate children for cultural deficiencies in their own homes but should in addition provide an environment in which generally acceptable social standards can be acquired, especially by children from disorganised in which these standards are lacking. But to transmit social standards it requires techniques quite different from traditional teaching methods. Social behavior can be modified if a teacher deliberately conducts the interactions in the classrooms in such a way to foster satisfaction rather than frustration. The prevailing environment should have co-operation, efficiency, cohesion, trust and mutual identification.
Another solution which is quite practical is to provide an expert advice for each newly wedded couple. By means of regular discussions and proper training the problems can be overcome. Usually our curriculum is deficient in inculcating an awareness of minor psychological problems and their solutions. Petty differences are aggravated resulting into the destruction of the domestic bliss. Any therapeutic help given to adults has indirect beneficial effects on children although this has not been substantiated because of the difficulty of long term follow up studies, the hope is that if we can make specific improvements in the environment of our children this will also contribute to their mental health as adults.