4.3 Case Study: Anna, aged 5

Understanding Anna’s background

Anna’s mother, Nina, was one of 7 children who had been in and out of care due to her mother’s mental illness and family neglect. Nina’s mother suffered from depression for which she had often been in hospital and Nina experienced a number of different carers as she grew up, as her father had been in and out of work and unable to care for his children. The family had been known to Social Services throughout Nina’s childhood and social workers were now involved with the next generation as Nina and her siblings had their own children.

At 23, she met Sam whom she thought cared for her and made her feel special. However, when Nina became pregnant he was not supportive as he knew that she would have less time for him and babies were a drain on time and money. Nina wanted to be a better mother than her own mother and found Sam’s mixed feelings about the pregnancy unsettling. There were rows and Nina became preoccupied with her own anger and anxiety as the pregnancy progressed.

Anna’s birth

Anna was born into an uncertain world where her parents were preoccupied with their own needs and unable to be emotionally available to focus on her. Nina wanted to be a good mother and had high expectations that Anna would love her too and fill the emptiness she sometimes felt. There were times when Anna cried that Nina could comfort her and other times, when Nina was preoccupied or angry and Nina would shout at her to be quiet. If Anna was not easily comforted, Nina experienced Anna as critical of her care and on occasions Nina ignored the baby to manage these feelings. Anna learned that she could sometimes be comforted by her mother but, at other times, she would be ignored or even responded to with anger.

Nina became pregnant again and her relationship with Sam grew worse and he would often leave after angry rows. Without support Nina’s mental health deteriorated and caused great concern for the social workers involved in trying to support her. Nina became withdrawn and was hospitalised after a suicide attempt when Anna was 18 months old. Anna had a period in care until her mother was able to care for her again.

Anna’s foster mother experienced Anna as an unhappy toddler who constantly demanded attention. However, if given attention Anna wasn’t satisfied and seemed to resist comfort and continued to complain. It was as if negative attention was as confirming to Anna as positive attention if it kept her carer focused on her. Anna had learned that making a fuss maximised opportunities to feel cared for, even if sometimes the attention was irritable and negative. Anna fears that if she stopped making demands then her carer will lose interest, so it is best to keep whining for attention.

Anna’s foster carer understood that Anna’s demanding behaviour was a response to the anxious feelings that she had not been helped to manage in the past. Such behaviour prevented Anna from developing confidence and enjoying her play as her anxious feelings constantly preoccupied her. Anna was just beginning to learn that her foster carer could be sensitive, when her mother Nina became well enough to care for her again. Anna was 2 years old when her younger sister Keira was born. Again Nina became overwhelmed and both children went into foster care. The foster mother who had cared for Nina with such sensitivity was not able to take both children. Therefore Anna and her baby sister were placed together in another foster home.

Sadly, a pattern of care was evolving similar to the care Nina received as a young child and as Nina’s mental health deteriorated she could not parent Anna. Attempts were made to find the girls a permanent home with the families of Nina’s siblings, but because there were concerns about the quality of care offered by Nina’s wider family the court agreed that Anna and her sister needed an adoptive family. Anna was 4 years old and had experienced several placements in her young life.