Therapy saved a refugee child. Fifty years on, he’s leading a mental health revolution

In 1967, a young Hungarian refugee sent to live in Britain planned on ending his life. “At 16 I was a very depressed adolescent, I had suicidal ideation, I had suicidal plans,” Peter Fonagy recalls. “If I was assessing myself now I would be very worried about me, because I knew exactly how I was going to do it. The reason is not that subtle or surprising: I was a Hungarian boy, who had landed in England and was not able to speak English.”

Lodging with a family in Kew Gardens, west London, the young Fonagy did not want to eat, or leave his room. He hated talking to people and was struggling academically. “I was massively inhibited. I was at a secondary modern school with kids who failed the 11-plus whose main interest was football.”

Fortunately, a neighbour recognised that Fonagy was in trouble and the boy, who would go on to become one of the most high-profile child psychologists of his generation, was sent to the Anna Freud National Centre For Children and Families in Hampstead, north London, for help.

Freud, the daughter of Sigmund Freud, the father of psychoanalysis, established the centre having fled Austria as a young child with her family before the war. Initially it helped children displaced by the blitz and those who had returned from concentration camps. Today, as one of the leading charities in its field, it continues to work with children affected by trauma, including those who have suffered abuse or been affected by major incidents such as the Grenfell fire.

“The therapist who saw me could see beyond the struggles and see another person, see they had certain competencies and capacities, and that, if you removed some of the inhibitions, the self-defeating behaviours, and got access to my more positive side then I could do quite well,” Fonagy remembers.

He recounts how, as a 17-year-old, he once pulled up to a therapy session in a battered old Ford Anglia that was his pride and joy. Inside he babbled to his therapist about his love of the car. “She got up, walked to the window, looked out and said ‘Peter that is a wonderful car’. Recognising my pride in it, seeing that what I needed was someone else appreciating my excitement, that really establishes trust with a patient, that makes them a legitimate source of advice, that’s someone you will take seriously.”

It is a telling anecdote. Earning the trust of children is crucial, Fonagy argues. “Kids come to me in a state of hyper-vigilance about relationships because of what’s happened to them. They don’t trust anyone, they don’t trust what I say, they don’t trust any knowledge I have to give them.”

Sometimes, though, it is not a professional counsellor that a child needs, Fonagy argues. “After a crisis like the Manchester bombing or London Bridge, the worst thing you can do is parachute a bunch of mental-health professionals in there to try and talk to young people about what had happened. It does harm, it prevents the person from coming to a natural accommodation.”

Rather, in this context, it is the relationship a child has with others – friends, family, teachers – that is crucial. “I’m fond of saying that adversity turns into trauma when you experience your mind as being alone. If you have good relationships they actually help you assimilate that experience.”

In a remarkable personal journey, Fonagy, 66, is now the centre’s chief executive and will this week preside over the official launch of its new campus in King’s Cross, a move that has seen it wave goodbye to its historic Hampstead location and its deep association with psychoanalysis.

Today, psychoanalysis will be just one discipline used at the new centre, at the heart of which will be a school for pupils excluded from mainstream education so, as Fonagy puts it, “we can’t avoid the meaning of what we are trying to do.”

Bringing together three former sites, it will carry out some of the largest ever randomised controlled trials on mental health and will house experts in neuroscience, mental health, social care and education as it seeks to improve global understanding of child development.

Its opening comes at a time when concerns about child mental health are paramount. One in eight five- to 19-year-olds in England – some 1.25 million children – now have at least one mental disorder. And while society – thanks, in part, to frank admissions from politicians and celebrities – recognises the problem, Fonagy says much remains unknown about who will be affected and why.

One fruitful area of study, Fonagy believes, is the role culture plays in the formation of the self. “In our society, particularly among kids from middle-class backgrounds, parents prioritise the development of the self, but other non-western societies prioritise the development of understanding others.”

But this carries risks. “In the west kids feel they are the king, the centre of everything.” This may make them less resilient to knock-backs. “It could account for some of the high prevalence of depression and anxiety that is definitely higher in our society than others.” Ultimately, though, there is no magic bullet. Fonagy argues that society needs to accepts mental health issues are an inevitable consequence of being human. “I think it is due to excessive imagination. Zebras don’t get ulcers, they live in a very stressful environment but they don’t get ulcers. Human beings get ulcers because they imagine all the terrible things that could happen.”

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How parents can help

Read with your child
‘A strong, lasting bond between families and children is founded on shared interests, excitement, and wonder – all of which can be achieved by reading for pleasure to explore new worlds and concepts that fire their imaginations.Children have a multitude of developmental needs that can all be served simultaneously by reading together with parents or carers they love and trust. The long-term cognitive and emotional benefits are clear – reading together promotes optimal interpersonal, developmental and educational functioning in later life.’

Be humble
‘Humility as a parent is as important to one’s child as to any other human. Parents should be authoritative, as they are older and wiser, but no one is infallible so being able to admit mistakes is important.’

Don’t be afraid to say ‘no’
‘Words like “no, don’t do that” can be the best possible intervention, except when they trigger misbehaviour and a parent must use alternative strategies.’

Talk about mental health
‘Most young people navigate their way through adolescence. But for a small number, problems can become persistent and threaten the connection between parent and child. Talking early on, before problems become too ingrained, almost always helps.’

Supervision is key
‘Parental supervision is incredibly important. If a child is not supervised, he or she is much more likely to go off the rails.’


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