The central phenomenon: Not feeling safe enough to go to school

5.2.1.1 The fundamental need to feel safe

The importance of feeling safe as a precursor to being able to attend to other, higher-order needs, such as engaging with education, immediately chimes with Abraham Maslow’s well-known concept of a hierarchy of needs in human motivation (Maslow, 1943). Maslow’s theory sets out how basic, fundamental needs of physiology and safety must first be met before a person can start to consider higher order needs, such as those of esteem or self-actualisation. Many of the CYP being supported by the coaches in this study were simply perceived to be prioritising lower order needs in the hierarchy over attending school; a typical human reaction to difficult environmental circumstances.

Figure 5.1: Maslow’s hierarchy of needs

Key Factor 1: PSNA is felt to be ‘red flag’ and occurs when a CYP feels unsafe.

It is one of many associated signs that the wellbeing and physical and mental health of the CYP is suffering.

5.2.1.2 The role of secure attachments

Associations to attachment theory are also evident. The theory of attachment, as developed by John Bowlby, asserted that a main caregiver and an infant develop a close bond that is necessary for both the physical and psychic survival of the child (Bowlby, 1958). Central components of this bond are caregiver sensitivity and responsiveness, which directly affect the quality of the attachment formed and subsequently the personality development and emotional regulation of the child (Ainsworth, 1969).

Attachment relationships provide protection from fear and harm and a safe, “secure base” from which the developing child can confidently explore the world (Ainsworth, 1969; Ainsworth and Bowlby, 1991). Attachment theory sets out that a sufficiently attuned relationship leads to a healthy or secure attachment style. Insecure

attachment styles result from inadequate or inconsistent caretaking, where the main caregiver has not been adequately responsive, affectionate or sensitive to the child.

(Ainsworth, Blehar, Waters, & Wall, 1978).

This resonates powerfully with the theory generated from this study. CYP not feeling safe enough to leave the family home to attend school regularly is an echo of

proximity-seeking behaviour, especially where the school environment appears not to be problematic. Two of the main causal factors, an insecure home base and

diminished parental capacity, if they have persisted long term, may have acted to inhibit the formation of a secure attachment bond. In accordance with attachment theory, an insecure attachment style might lead to a child seeking increased proximity

to a parent, as well as increased sensitivity to anxiety about their well-being. It might therefore act to prevent CYP from feeling able to venture confidently away from the home for long enough periods necessary to maintain satisfactory attendance at school.

This links fittingly with CYP described as having separation anxiety, one way of categorising PSNA that was outlined in chapter 2.0.

One of the coaches described the effect of home-related anxieties constantly drawing the CYP back to the home as, like “an elastic… band”. Ongoing and legitimate fears about the safety and well-being of a parent would act to exacerbate this; certainly, a feature of the lives of many of the CYP described in this study. Attachment theory might also help to explain why the incidence of relapse seemed to be so high, as well as why many of the CYP were so difficult to support back to full attendance. Even where the difficulties at home had been historic, the effects appeared to be much longer lasting, continuing over time to impact CYP significantly. Perhaps seeking proximity to a parent had become a default behaviour, triggered by a variety of environmental stressors.

5.2.1.3 Associated psychological conditions

If CYP were not having their fundamental needs of safety adequately met, it would follow that PSNA would not be the only sign. PSNA was indeed found, in this study, to be part of a spectrum of psychological conditions, in particular those under the category of mental illness. The link between PSNA and poor mental wellbeing also bears out in the wider literature. One example is a longitudinal study by Attwood and Croll (2015), which looked at the link between truancy from school in England and

mental well-being. They found that truancy, even at low levels, was associated with feelings of distress and inability to cope with everyday life. Indeed, a clear link has been drawn in the majority of the literature, between PSNA and disorders of mental health, such as anxiety, depression, separation anxiety, “emotional disturbance”, psychosomatic illness and social phobia (Chen et al., 2016; Christogiorgos &

Giannakopoulos, 2014; Doobay, 2008; Ek & Eriksson, 2013; Gren-Landell et al, 2015; Honjo et al, 2001; Lingenfelter & Hartung, 2015).

Environmental exposure, for example to childhood trauma, has also been found to significantly impact upon the symptoms of mental disorders, in line with growing evidence for “the conceptualization of psychopathology as a contextually sensitive network of mutually interacting symptoms” (Guloksuz et al, 2016, p. 8).PSNA and mental illness appear from this perspective to be interrelated symptoms of

environmental stressors, rather than isolated, organic conditions. Put another way, with the home circumstances of some CYP, coaches were “not surprised” at their PSNA, perceived not as a disorder but as a “coping mechanism” [FG1:123]. Given a similar context, several coaches felt that they would struggle too.

“I’d be curled up under my duvet, ignoring the world…” [John, FG1:127]

5.2.2 The Causal Conditions: Factors causing CYP to feel not safe enough to go to