Articles

Pat Schroeder’s endorsement of Rage Reduction Therapy: The Cult of the Celebrity Strikes Again

We all know that misguided celebrities, such as Jenny McCarthy, Oprah, Prince Charles, and Arianna Huffington, pose considerable public health threats. Few know that arguably the most vile form of quackery has been getting the thumbs up from a celebrity hailing from the most rarified heights of power and influence — Representative Patricia Schroeder (D-CO, 1973-1997).

The practice I’m referring to is “Rage Reduction.” This practice, popular for decades in adoption and foster care circles, claims to help children develop the capacity to love and become attached to their new caregivers. Practitioners believe these children suffer from “Attachment Disorder” because of early abuse and neglect. Typical of quackery, this unrecognized diagnosis consists of an absurdly long catch-all list of signs used to ensnare any child. (Even good behavior is interpreted as sneaky manipulation of parents.)

In a Rage Reduction therapy session, a child is restrained by a therapist – usually a licensed psychologist or social worker – plus one or more assistants. The therapist “activates” a child by yelling, belittling, threatening, relentlessly tickling, bouncing the child’s head, covering his mouth, and painfully knuckling the child’s rib cage and sternum. Such sessions typically go on for two or more hours, until the child is exhausted from struggling and becomes, as one psychologist observed, “a whimpering little puddle.” Children, even teenagers, are then swaddled and given a baby bottle by their adopted mother for “bonding time.”

The rationale for Rage Reduction consists of several thoroughly discredited notions: the need to regress children back to infancy so that “repressed” memories of abuse can be recovered and repressed “infantile anger” can be drained out through “catharsis.”

There is no reliable evidence that indicates that Rage Reduction would be anything but harmful. To critics, Rage Reduction is indistinguishable from literal torture, i.e. the infliction of severe pain or suffering, whether physical or mental, for a purpose. The purpose here is apparently not the creation of loving relationships, but rather grinding down children until they are grateful and unquestioningly obedient. Think “Stepford Children.”

In one particularly brutal form of Rage Reduction called “Compression Therapy,” therapists claim to provoke repressed memories of rape by lying on top of the child and licking the child’s face. Along with violating just about every ethical code in the mental health book, Compression Therapy puts much pressure on the child’s abdomen, making breathing difficult. At least two children have died from suffocation in Rage Reduction sessions; and survivors tell of “seeing stars,” and even of passing out during therapy.

Many criminal child abuse and death cases have been linked to Rage Reduction and its harsh parenting methods. For those with a strong stomach, there is a blogsite that has published several survivor accounts.

Rage Reduction got its start in Colorado back in the 1970s, when psychologist Robert Zaslow came to the state claiming he could cure blindness. Zaslow had served as consultant on Elvis Presley’s last movie, A Change of Habit (1969). In this film, “Dr.” Elvis cures a girl of autism in just one Rage Reduction session.

When Rage Reduction failed to cure blindness, or autism off screen, Colorado followers of Zaslow turned to treating “attachment breaks” in children. The practice really took off in the late 1980s when adoptions from Eastern Europe opened up – and when Rage Reduction got a big celebrity bump from none other than US Representative Patricia Schroeder.

Schroeder was the long-time Democrat Congresswoman representing the Denver area who took a stab at the presidency in 1988. Chairing the US House Select Committee on Children, Youth and Families, Schroeder billed herself as “Friend of the Family.”

At the peak of her influence, Schroeder also wrote the foreword for a book promoting Rage Reduction entitled High Risk: Children Without A Conscience by Ken Magid and Carole McKelvey (Bantam, 1987). Today, after one author has surrendered her therapy license (the other is dead), this book is still in print.

High Risk

US News & World Report later took note of Schroeder’s “promotion” of High Risk:

High Risk has a foreword by former Colorado Rep. Pat Schroeder, who thanks the authors for their “gift” at a time when inadequate day care, rising divorce rates, and teen pregnancy threaten to inflate the numbers of unattached kids.

A Dead Child, A Troubling Defense” by Miriam Horn)

Shortly after High Risk was published, HBO aired a documentary about a child being treated by Magid. This film, Child of Rage, was followed up with an HBO drama by the same name. Both films, like the book, portrayed “unattached” children as murderous psychopaths, a danger to parents and society at large. This sensationalism fueled Rage Reduction ascendancy into a fad therapy, with cult-like followings all over the country, and in Britain and Australia, as well. Without Schroeder’s endorsement, Rage Reduction might have otherwise died a quick death — from lack of research, from moral outrage, and from compassion for children.

Today, High Risk is considered by critics to be the worst book of its kind. If a therapist recommends High Risk, you’ve pretty much got him pegged as an adherent of coercive restraint therapies. No one else would likely want to be associated with it.

High Risk contains one photo that nearly says it all. It is a photo of psychiatrist Foster Cline, MD knuckling the sternum of a young boy.

image-1

The caption says:

Dr. Foster Cline illustrates how a Rage Reduction Therapy session is conducted….Cline stimulates subject toward rage reaction. Child is being held by “holders.” …[the] child screams how much he hates the therapist.

When a boy with a bruised chest escaped Cline’s center a few years later, Cline was ordered by the Colorado Board of Medical Examiners to stop using Rage Reduction. Cline opted to leave the state instead.

This extreme treatment, which High Risk likens to an “exorcism,” is justified by demonizing children with “Attachment Disorder.” The same US New & World Report article explains:

A cartoon in the book Schroeder promotes depicts a spectrum of well-being: from the securely attached like “Mother Teresa,” illustrated with a haloed saint holding a cross, to the severely unattached like “Charles Manson,” depicted as a horned devil holding a bloody knife. Paula Pickle says of the kids her center [Attachment Center at Evergreen, Colorado] treats that “there often doesn’t seem to be a heart or soul.” [Thais] Tepper [of Parents' Network for the Post-Institutionalized Child] explains in chilling terms the effort by Russian orphanages to get rid of their most troubled charges: “Who are you going to send abroad, the healthy kids or the little minions of Satan?”

image-2
image-3

The banality of this diagram is almost unworthy of being pseudoscience. It’s not junk science. It’s just plain junk. (But do note, Ms Schroeder, where “Some Politicians” rank on this scale.)

High Risk does dabbles in other pseudoscience, as well, e.g.:

What Ted Bundy’s Handwriting Reveals..His manipulative tendencies are indicated by the “hooks” in some of his “c’s.”

Rage Reduction, repackaged with the less explicit name of “Attachment Therapy,” flourished through the 1990s. A welter of child welfare workers, CASA volunteers, judges, and adoptive/foster parents were sucked into the pseudoscientific solutions offered by Attachment Therapy.

With Schroeder’s imprimatur firmly in place, government agencies at federal, state and local levels funneled money into Attachment Therapy, paying for treatment and to house children in special “therapeutic foster homes” versed in Attachment Therapy’s uber harsh parenting methods, aka Nancy Thomas parenting.

(Nancy Thomas, a Colorado layperson trained by Foster Cline to be a “co-therapist” in Rage Reduction, will be keynoting at an adoption training conference in Tennessee Nov 5, 2010, for which social workers can receive continuing education credits. The sponsoring organization of this conference, which receives funding from the Tennessee Department of Children’s Services, advertises that Thomas’ “work was highlighted in an HBO special in 1990 titled, ‘Child of Rage.’”)

In Iowa, Vermont, Colorado, Virginia, New Hampshire, Utah, and Georgia, public funding paid for training therapists in Attachment Therapy. Adoption Subsidy Funding for “special needs children” could pay for any treatment parents wanted, evidence-based or not, including Attachment Therapy.

By 2002, numerous high-profile deaths and child abuse prosecutions resulted in growing professional condemnation of Attachment Therapy. It was at this time that I wrote Schroeder, on behalf of Advocates for Children in Therapy, (ACT) fully expecting she would retract her support.

When Schroeder did not respond, ACT picketed a pricey speaking event in Denver where Schroeder had been chosen to speak because of her “compassion.” Hoping the protest got Schroeder’s attention, I wrote her again:

You obviously did the authors of High Risk (still in print) an enormous favor by writing a foreword, in effect helping to legitimize the message of their book by lending them your well known name and your reputation as a humanitarian. That is viewed by the public as an endorsement of what is said in the book. Do you presently stand by your decision to have written the foreword for the book High Risk?

This time Schroeder responded, albeit briefly:

I am not a doctor and can’t endorse.

When I pressed the issue, she responded:

Writing a foreword and endorsing a medical authority are two different things. I believe books are to stir thoughts, debate, ideas, etc. The more the better. Different theories on everything are detailed in books. That is the best way to vet them.

With such a rationale, it is unclear whether there would be any book Schroeder wouldn’t write a foreword for. Schroeder’s response prompted Wallace Sampson, MD, to comment:

A book is not for discussion or debating. That is what journals are for.

Some years later, when the American Professional Society on the Abuse of Children released its “Task Force Report on Attachment Therapy” (in the journal Child Maltreatment Feb 2006) denouncing Attachment Therapy, its parenting methods and the Attachment Disorder diagnosis, I again wrote Schroeder, hoping that some high level dissing of the practice might make her reconsider her position. She didn’t respond.

Some suggest that Schroeder might not have been aware of High Risk’s contents, and that she is now taking the politically expedient route, hoping the whole issue goes away with time. But while Schroeder has been evasive, she is clearly not regretting her promotion of High Risk. If she was duped, why not jump ship while the jumping is good? While High Risk allowed her to pontificate about her own agenda in the foreword, I have a hard time coming to any other conclusion than that Schroeder may actually approve of this “therapy.” Would someone with presidential aspirations write a foreword for just any book?

At any rate, I think we can assume that Schroeder will not be asking Bantam to remove her foreword from future editions of High Risk, nor will she be calling for legislation that requires federal funding only go to providing evidence-based therapies for adopted children — or any of a dozen other things to help save children from Attachment Therapy.

Schroeder has good reasons to believe her endorsement of Rage Reduction will not tarnish her reputation. She continues to be feted as one of America’s great humanists. Last year, no less than the Center for Inquiry honored her at their 2009 World Congress and highlighted her participation in their Travel Club Adventure Caribbean cruise. CFI officials were not only unconcerned by Schroeder’s association with Attachment Therapy, but accused critics of “nastiness” towards a “defender of good science.”

But it gets worse.

Irony of ironies, Schroeder is now scheduled to keynote for that bastion of evidence-based medicine: The Joint Colloquium of the Cochrane and Campbell Collaborations in Keystone, Colorado, on October 18, 2010.

(As keynoter, Schroeder is billed as the leader of a “multi-year study for the Institute on Civil Society.” But according to ICS, this study produced “no formal document” or publication.)

Last March, I gave a heads up to colloquium organizer Robert Dellavalle, MD, about Schroeder’s unrepentant support of Attachment Therapy. When this yielded no response, I did a broad-spectrum emailing to Cochrane and Campbell officials about this brewing scandal, which prompted Dellavalle to respond:

The leadership discussions so far have noted that invitations to speak at the Colloquium do not constitute an endorsement of any views of the speakers positions past or present. And the topic of your concern is not the topic of Ms. Schroeder’s talk at the meeting.

On learning the title of Schroeder’s keynote is: “Can we keep this Democracy going?” I responded:

We fail to see how this topic is not relevant to the rights of children to be free from actual torture (using the definition of the UN Convention on Torture).

In the same way that world seemed upside down when Bill Maher received the Richard Dawkins Award for scientific integrity, so now do things seem topsy-turvy with CFI and the Cochrane/Campbell Collaborations honoring Schroeder as a defender of science and ethics. This is, alas, not the most shining hour for these otherwise esteemed organizations. Once again, the cult of celebrity scores a bullseye.

See childrenintherapy.org for more information on Attachment Therapy.

See childrenintherapy.org/practitioners for claims made by Attachment Therapy practitioners and proponents.

Linda Rosa, RN, works in home health care in Colorado. She has written about pseudoscientific practices in nursing, such as Therapeutic Touch, and works with Advocates for Children in Therapy to oppose unvalidated and abusive psychotherapy. She currently is Executive Director for the Institute for Science in Medicine.

Posted in: Science and Medicine

Leave a Comment (51) ↓

51 thoughts on “Pat Schroeder’s endorsement of Rage Reduction Therapy: The Cult of the Celebrity Strikes Again

  1. skepgal says:

    Wow… I’m shocked, horrified and saddened to hear about this. As a trainee clinical psychologist I really cringe when i read the word ‘psychologist’ in articles like this – I so desperately want my chosen profession to be free of things like this!

  2. Jann Bellamy says:

    A very interesting and disturbing post. Linda is to be commended for her relentless advocacy on behalf of children being abused by “attachment therapy.” This post is also another example of toothless state regulatory oversight of the health professions.

  3. windriven says:

    This is simply insane. This isn’t an issue of pseudo-science. It is the loathsome crime of child abuse. Schroeder’s argument that “Writing a foreword and endorsing a medical authority are two different things,” is simply inane. She has aided and abetted child abuse IMHO. Worse, she has taken no action to withdraw her imprimatur which can only be read as a continuing endorsement of child abuse.

    The Center for Inquiry is way off base having her as keynote speaker. How is this different from first rank journals and medical schools dabbling in woo? One either walks the principled path or one doesn’t.

  4. DrMonicaP says:

    As we all know, it is typical of politicians not to want to admit when they have made mistakes, but if Ms. Schroeder wishes to move from the world of politics to the scientific community it is time she learns to do so. Scientists respect people who, when recognizing they have made a serious mistake, publicly own up to it but what the scientific community should not respect is a person who refuses to admit that she has made a serious error. Given all the skeptical and scientific organizations that have recently provided her with a venue, it is high time she be held accountable for this and I applaud Linda Rosa and Science Based Medicine blog for calling her on the carpet.

    What say you, Ms. Schroeder? I hope anyone attending the Cochrane conference asks her about this.

  5. Thanks so much for this topic. As the parent of two children who joined our family through adoption, I have heard about “attachment disorder” and the problems with attachment therapy.

    I have to admit that the whole attachment therapy movement has really under minded my trust in therapists and psychologists dealing with children. So many of the books that I’ve read and the information that you see online makes me think that many (or some, I don’t have a statistic) view adoptive children in a skewed and unscientific way. They see that the child is adopted and immediately focus on disorders that they view as related to adoption (predominately attachment issues and PTSD).

    I know of at least one case where a psychologist missed symptoms of mild autism/asperger syndrome and diagnosed attachment disorder. Luckily the parents sought a second opinion. I would like to remind therapist that adoptive children also have the same risk factors of common childhood developmental or psychiatric issues as children who join their family through birth. Can we treat the whole child?

    I’d also like to point out the proponents of attachment disorder are supported by the press and other media who’s fascination with the sensational lead them to focus on the stories of adoptive children who have significant emotional problems. I am reasonably tired of meeting people who, upon learning that my daughter was adopted from a former soviet country, immediately seem to equate her with every adoption horror story they’ve seen in the news. (bit of a rant there, sorry.)

    These broad diagnoses (driven more my expanding market share than science) also does a dis-service to the occasional child who does actually have reactive attachment disorder or PTSD, by under minding trust in the diagnoses and making ethical treatment more difficult to find.

  6. huh, strange, I’m not aware of anything I did that made my text bold.

  7. DrMonicaP says:

    I tried to post a comment earlier that does not seem to have gone through even though later comments than mine have been approved and posted. Moderator, was this a technical problem or did I in some way unintentionally violate your policy? It didn’t seem to me that my comments were any stronger than a number of the others you posted, so if there is some kind of technical glitch, please let me know and I will re-send.

  8. LovleAnjel says:

    My brother worked as an aide to a family with an autistic child when I was in jr high. I remember him explaining attachment therapy (which the parents tried and then gave up on because it did nothing). They abused the child (I remember something about forcing him into a corner and pushing him into walls), wrapped him tightly in a blanket and forcing him to eat from a baby bottle (the kid was 10). I thought that had to be something crazy from the 30s or 40s, it sounded too much like The Snake Pit.

    That is truly bizarre that people in modern developed countries in the 21st century buy into this crap.

  9. DrMonicaP says:

    Here is a link to a video that demonstrates this so-called “therapy”. This is a training video from the Attachment Center at Evergreen, run at the time by Foster Cline, the person featured in the High Risk Children without a Conscience book. See:

    http://childrenintherapy.org/2010/10/08/attachment-therapy-training-tape-by-neil-feinberg/

  10. windriven says:

    @DrMonicaP

    I don’t know exactly what the ‘triggers’ are for moderation. Suffice it to say that they aren’t easily deduced. Sometimes I post comments that I’m sure will trigger moderation and they sail right through. Other times perfectly innocuous comments get trapped.

    But the important thing is that the comments always (in my experience) get posted eventually. SBM is extraordinarily broad-minded in allowing even nonsensical posts to appear. Compare and contrast with the woo sites where any comment that fails to march in lock step quickly disappears.

  11. superdave says:

    I think including links is what generally causes the moderation, though there might be some kind of whitelist for “acceptable” sites, cause sometimes my comments with links seem to go through right away.

  12. daedalus2u says:

    This isn’t treatment, it is torture. Aren’t there professional guidelines that make it unethical for psychologists to participate in torture?

    http://seminal.firedoglake.com/diary/48108

    But when psychologists are unbonded and unattached to their victims, why would the psychologists not treat them as criminals and sadists to be tortured?

    Don’t they understand projection? Don’t they recognize Munchausen Syndrome by Proxy?

    Torture of children this way is a crime. Psychologists in many jurisdictions are mandated reporters, that is if they even suspect that child abuse is going on they must report it.

  13. dedicated lurker says:

    I will emphasise that nothing can prepare you for reading High Risk. It’s a train wreck of pseudoscience (and almost all the references are from Foster Cline or Connell Watkins, some even as “personal communications.”) When I was done with it, I was horrified, but not in the way the authors wanted me to be.

  14. Zetetic says:

    Concerning the question about how people fall into this abdominal practice… Does anyone else see the connection with those who easily accept severe corporal punishment as a norm for disciplining children?

  15. DrMonicaP says:

    @Zetetic, I think part of the way people rationalize this is by demonizing the child, calling the child a budding sociopath. Parents are frightened into thinking that if they don’t do what these attachment therapists recommend, their kids will grow up to be serial killers, criminals, sociopaths, etc, but this is all without scientific basis, of course.

    These types of brutal treatments have been happening for longer than most people realize. Here is what the famous grandfather of modern Hypnosis, Milton Erickson, who is highly revered by many psychotherapists recommended in a 1962 publication:

    http://anticultcontroversies.blogspot.com/2009/05/dark-side-of-milton-erickson.html

  16. Here’s another syndrome to mention. Stockholm syndrome. Isn’t it likely that any improvement in a child’s behavior that is observed after this abusive treatment is more related to that then any actual improvement in attachment?

    I do think it’s important to note, though, to folks not familiar with toddler or older child adoption that some of these recommendation are deceptive to adoptive parents because they have a grain of truth to them (they are the killer mutant plant based on that grain).

    For instance it is not uncommon for an internationally adopted child to be somewhat delayed in self feeding, drinking or other self-care. Also some children regress (eating, potty, other milestones) under the stress of joining a new family, environment, etc. For younger children*, the standard adoption social worker advice I’ve heard is not to push the self-care issues. That feeding a newly adopted child or bottle feeding the child at bed time* can give a feeling of closeness that encourages attachment. That it’s okay to let the child “be a baby” for a while.

    This is contrary to the common advise that family member or friends not family with adoption might give. They might push to cutting off feeding help or bottle feeding to encourage the child to act “age appropriate”.

    The tact recommended by our social worker is to allow the child to take over feeding tasks as they are able and when they seek to. There is no attempt to force the child to regress or maintain a regressed state.

    I believe that’s just one example of how this SCAM uses real therapeutic information, but distorts it into something harmful. For a parent it can sometimes be difficult to sort the good from the bad. For instance, when a child tantrums in an aggressive way, is out of control, won’t sit in a time out what do you do? Hold the child, which can be a form of restraint or shut them in a save room, which can be a form of isolation. Difficult questions like this enable unethical therapists to lure in parents seeking help.

    Of course, as has been pointed out, this kind of SCAM also offers an endorsement to parents or foster parents who seek to demonize or use their children for whatever reason.

    *I’m not talking ten year olds. Don’t know the advice there.
    *No letting them take the bottle to bed, unless it’s water. Bad for the teeth.

  17. “family member or friends not family with adoption might give” Should be “family members or friends not familiar with adoption”

  18. “For instance it is not uncommon for an internationally adopted child to be somewhat delayed in self feeding, drinking or other self-care”

    I should add, these not uncommon developmental delay (often referred to as institutional delays) are temporary. Most internationally adopted children who are otherwise healthy show very fast developmental catch-up over the course of a few months to a year.

  19. daedalus2u says:

    This kind of “treatment” is much more likely to cause adult criminal behavior than prevent it.

    Virtually every serial killer was abused as a child. Not all abused children become serial killers, but virtually every serial killer was abused as a child.

    Of course if you are growing up in a world where you need to be abusive to get ahead or to survive, better to learn how to be abusive (and enjoy it) at an early age. What better way to teach that important life lesson than for care givers to be abusive? But then you create a world where a certain amount of abusive behavior is necessary, to “be competitive”.

  20. Linda Rosa says:

    daedalus2u wrote:

    “Aren’t there professional guidelines that make it unethical for psychologists to participate in torture?”

    I suspect professional organizations never anticipated this level of abuse in a therapeutic setting. But Attachment Therapy has (very) gradually led all national mental health professional organizations (except for the marriage & family therapists) to ban the use of physical restraint as therapy, with surprising opposition.

    In reaction to this, Attachment Therapists recently started to claim that Holding Therapy was now “gentle and nurturing,” and that the child WANTED to be in the therapist’s’ lap, where mere “closeness” would cause the “Attachment Disordered” child to go into a rage reaction.

    Attachment Therapists also felt justified in claiming they are no longer restraining children if they don’t restraint the child with their hands, although one arm of the child is pinned behind the therapist’s back while an assistant “holds hands” with the child’s other arm.

    Because of the prevalence and dangerous nature of Attachment Therapy, APSAC convened a task force on this practice. Their 2006 report, adopted by the APA, is the strongest professional denouncement we activists have to work with:

    http://works.bepress.com/cgi/viewcontent.cgi?article=1002&context=thomaslyon

    The APSAC report cuts through all this nonsense about what is and is not physical restraint, claiming even psychologically-enforced restraint is taboo.

    I also think that Attachment Therapy has other features, such sado-sexual abuse, that violate professional ethics, as well.

    All in all, Attachment Therapy seems a prime example of how bizarre and abusive a “therapy” can become when it is not restrained by scientific inquiry.

  21. Linda Rosa says:

    Zetetic wrote:

    “Concerning the question about how people fall into this abdominal practice… Does anyone else see the connection with those who easily accept severe corporal punishment as a norm for disciplining children?”

    Yes. Working the last ten years to oppose Attachment Therapy and corporal punishment in schools has driven home the lesson that we live in a country that is much more tolerant of child abuse than other societies.

    Thirty grand for an adoption, and you get the child of your dreams? Parents may start to think drastic measures are called for. People may go into adoption with unrealistic fantasies. Waving around a few poorly-done in-house studies that show Attachment Therapy has great success rate, Attachment Therapists claim to fulfill those fantasies. And if therapy fails, the therapists in turn help parents put all responsibility on the children for adoption disruptions and out-of-home placements.

  22. Firstly “People may go into adoption with unrealistic fantasies.”

    Sure, In my experience most all parents (biological and adoptive) go into parenting with unrealistic expectations. Most all of both groups get over the shock of reality without turning to abuse or falling into the trap of predatory and abusive therapists. A small percentage of both biological and adoptive parents do not.

    Also, adoptions have a wide range of cost. From very inexpensive foster care adoptions that may be three or four thousand dollars and include state subsidy for child medical expenses on up to around $30,000-$40,000 (including travel expenses). In the U.S. IVF is around $15,000 an attempt (with a 15% to 50% success rate) often not covered by insurance. I don’t know many adoptive parents who think the price of adopting their child buys them the child of their dreams*. I find that statement a bit disrespectful. Obviously going into an adoption with an attitude like that would be a serious red flag.

    Secondly – Thanks for the APSAC report link. Very good reading. A good common sense guide for understanding some effective things a therapist might suggest as well as negatives to look for that should tell you “run away.”

    *My children are not the children of my dreams. They just happen to be two of the three best things that ever happened to me. Funny how that works out.

  23. Linda Rosa says:

    Point taken on the “dreams,” though it is not unusual to hear adoptive parents say they are jealous of those who are capable of making kids from scratch. So perhaps there is the perception that they have it a lot harder, and therefore expect more in return. Could that be a possibility?

    There does appear to be a rescue element to some foreign adoptions, where parents may expect the child to be especially grateful for the material comforts afforded them.

    Parents of foreign adoptees might, in part, be more vulnerable to Attachment Therapy because many of its practitioners considers “lack of eye contact” to be a major sign of “Attachment Disorder.” (This may stem from the first days of Attachment Therapy when it was first used as a cure for autism.) This fails to take into consideration that many foreign orphans do not look directly at the face of adults out of respect.

  24. Linda Rosa
    “Point taken on the “dreams,” though it is not unusual to hear adoptive parents say they are jealous of those who are capable of making kids from scratch. So perhaps there is the perception that they have it a lot harder, and therefore expect more in return. Could that be a possibility?”

    Yes, I’m sure that is possible for individual parents adoptive or biological to have the perception that their parenting experience is harder, etc. I believe that would fall under “unrealistic expectations” that could be trigger for pursuit of a unpoven diagnostics, medical care, abuse.

    I wonder, why assume such a strong correlation to the adoption experience? It’s clear from reading other articles in this blog that some parents (biological or adoptive) pursue treatments for illnesses (real or mistaken) that are unproven, unethical and sometime result in harm or death. Look-up Chelation therapy.

    There is a mental tendency to group people by their differences then attempt to correlate any problems to that difference. You see a person with blue skin. You hear they have cancer. There is a tendency for you to try to correlate the blue skin to the cancer. I believe this is one of those fallacies or logical errors that is talked about so often on this site. Sadly, I don’t know what it’s called.

    One sees an adoptive child with some behavior problem and has a tendency to try to correlate the behavior problem to the adoption. But that is a cognitive bias. The behavior problem may be related to the adoption, a trauma, a developmental or medical condition, a cultural difference, personality conflicts within the family, parental mishandling, etc or any combination some or all.

    The same goes for the adoptive parents. A problem with their parenting decisions is not necessarily related to adoption. To assume that it is may miss the diagnoses entirely, which undermines helping the parent make better decision and helping the child to have a better life.

    Lastly, I find that kind of bias leads to a belief that the adoptive family relationship is somehow more inherently pathological and leads to a one dimensional view of both parents and children. As far as I know statistic don’t bear that out.

    Sorry to be so critical. I am in complete agreement on your concerns with unethical attachment therapies. I’m am grateful for your work in getting the word out. But, I also feel an obligation to offer my perspective on the matter, due to my experience as an adoptive parent and being part of the adoption community.

  25. DrMonicaP says:

    @Michele. I think you and Linda might agree on more than you think. The point is that adoptees are being pathologized, told they have a disorder for which there is no sound basis. It’s a marketing issue. AT is targeting adopted children and making up unvalidated symptom checklists that are not bona fide disorders. Linda, as I understand her, gave the lack of eye contact as an example of how this is pathologized. This gets interpreted as a disorder when it might not necessarily be the case. It could be a cultural difference since in many cultures, children learn not to make eye contact with someone in authority and so lack of eye contact has nothing to do with a disorder and everything to do with culture.

    Another common error mental clinicians who lack a sound scientific background make is that they assume that the people they see who are coming to them because they have a problem, are representative of the population of adoptees as a whole. Such clinicians never see people who may well be in the majority who have no serious problems and have no need to seek their help. At least some of the people who come for help may actually have serious problems (although the way the ATers assess and diagnose them is often without scientific basis), but may not be representative of the population as a whole who the clinician never sees.

    However, that being said, it is also the case that marketing tactics of ATers might lead people to think they have a problem when they don’t, which then becomes a self-fulfilling prophecy. There are websites where people planning to adopt are told from the very beginning to expect to have problems and to arrange in advance for AT interventions. If a child is constantly treated as damaged goods from day one and every little thing the child done is treated as pathology, that child may well begin to act that way.

  26. DrMonicaP – Yes I do think that Linda Rosa and I agree on more of the issues than not. I am only questioning whether her statements regarding adoptive parents motives (quotes below) are actually an evidence based analysis of causes and risk factors in parents seeking treatment for children that end up consenting to unethical or unproven techniques?

    “though it is not unusual to hear adoptive parents say they are jealous of those who are capable of making kids from scratch. So perhaps there is the perception that they have it a lot harder, and therefore expect more in return. Could that be a possibility?”

    “Thirty grand for an adoption, and you get the child of your dreams? Parents may start to think drastic measures are called for.”

    They sound more like anecdotal conjecture to me. I don’t see the constructive value of such observations.

    I’m good with the eye contact, ethnic customs statement. Although I would note that cultural explanations can cut both ways. I had two early intervention specialists suggest to me that my son’s severe speech delay (caused by cleft lip and palate) “could be a cultural thing, because the Chinese are quiet”. So clearly it’s all a balancing act, but sure, quite plausible.

  27. tcw says:

    Maybe I missed it, but doesn’t “attachment disorder” exist as a legitimate diagnosis?
    There are so many oddballs waiting to prey on parents anxiety about their children. I looked at picture above and thought, why can’t they just take the boy fishing or something?

    And does anyone know what happened to the kids from the 80′s who underwent this? Any prospective studies?

  28. DrMonicaP says:

    @TCW. The legitimate diagnosis, in terms of it being in the DSM is Reactive Attachment Disorder (RAD), which is different from what the so-called “attachment therapists” consider to be “attachment disorder”. They throw in all kinds of symptoms that have nothing to do with the DSM definition of RAD and there is no real evidence that attachment problems are the cause, for example, of behavior problems. They also frequently use assessment tools that have poor reliability and validity. Here is a podcast where a psychologist explains the differences and discusses empirically supported treatments people can use for serious behavior problems:

    http://behaviortherapist.podbean.com/2010/08/31/reactive-attachment-disorder/

    I don’t know of any prospective studies that followed the kids through to adulthood, but there are some people coming forward as adults, who feel they were damaged from AT. Based on what they describe, such a study would never be approved by a human subjects committee. See:

    http://stopchildtorture.org/

    Some people have criticized me for referring people to these because they are are anecdotal, but that is reversal of the burden of proof, something AT folks seem to like to do. When no evidence exists in the first place to support the safety and efficacy of an intervention, the burden of proof is on the claimants to show it is safe, not on critics to show it is not safe. If there is any indication of harm being done, even anecdotal evidence, the salient ethical principle is to first, do no harm.

  29. Regarding Reactive Attachment Disorder vs Attachment Disorder

    As DrMonicaP said, The dsm-iv-tr has a very distinct description of RAD. http://www.behavenet.com/capsules/disorders/reactatt.htm if you’re not a pod cast type.

    Attachment Disorder Advocates do not have a criteria for diagnoses that I’ve seen. But they do have a very extensive list of symptoms,

    examples: http://www.attach.org/whatisattachment.htm
    http://www.attachmenttherapy.com/childsymptom.htm

    These cover many things that a child can typically do to annoy or concern a parent. AND for an extra added bonus, they add common symptoms for other pediatric issues like ADHD, LD ASD, Speech Delays and Articulation Errors, Depression, etc. But wait! now, for a limited time only*, They’ll include a list of traits commonly exhibited by children coming from orphanages.

    For instance “abnormal eating patterns”. Gorging and the opposite, oral defensiveness are not uncommon in internationally adopted children. In all the accounts I’ve heard, the gorging (although disconcerting for parents) is followed by a large growth spurt or healthy weight/muscle gain and levels off. Oral defensiveness (child can’t tolerate a normal range of textures or temperatures) is something I’ve heard as well. I’ve never seen any evidence this is related to attachment. It’s more likely to be related to feeding practices in an orphanage, a medical condition or a developmental condition.

    Really this is a text-book case of SCAM using a catch all diagnostic to ensnare as many customers as possible*. Sadly many of the people who repeat these “symptoms” on adoption sites don’t even realize the flaws, they are innocently (I believe) propagating a dangerous myth.

    *To be updated to include any children coming from new Hague Convention countries.

    **One site I read a few years ago even suggested that a negative attitude about the pregnancy or the fetus during pregnancy could lead to attachment disorder… So you see, it’s not just for adopted or foster kids anymore.

  30. I said that gorging or oral defensiveness where not uncommon in internationally adopted children. To have said “more common in internationally adopted children than the general population of children.” or some such would have been more accurate.

  31. tcw says:

    michelleinmichigan and Dr Monica: Thanks, I learned something. You shouldn’t and wouldn’t need a scientific study to accuse someone of a crime, just an anecdote, that is another reason why DrMonica’s links are valid.

  32. Calli Arcale says:

    It distresses me to no end that *despite* all the deaths, this junk “therapy” goes on. Then again, it seems there is no limit to what some parents will do to try to make their children right. The hell of it is, they mean well. The cannibals who kill and eat tribesmen who they believe to have been possessed by demonic spirits mean well. The road to hell is paved with good intentions . . . .

    I think it’s been said that more evil can be done with good intentions than with bad ones, because when your intentions are good, you try harder and are less willing to surrender. Imagine women in Cameroon ironing their daughters’ breasts; they know it hurts (it was done to them), but they believe it will protect them from being raped, so they make the daughters endure it. Parents will torment their children if they think it is for their own good. They do not see it as torture if it is for a good end. The people who promote this horrific therapy to the parents of children who are already suffering should be not only stripped of their licenses but have criminal charges laid upon them. Never mind the standard of care; this would be criminal if anyone else did it.

  33. Calli Arcale – I agree with you on the road to good intentions*. And often actions that we would consider cruel in one situation are considered acceptable or required in another. ex: Surgeries for malformations, chemo-therapy, organ transplants. There is definitely a pain/true benefit equation.

    I would also add another element. The relationship between parent and therapist or doctor has an inherent power imbalance. In many cases the therapist or doctor holds the power of authority in the room. The Stanley Milgram experiments show how shockingly individuals can follow the harmful directions of an authority figure. Of course, these experience are with stranger victims, and we are talking about a parent/child relationship, but I still think that the situational power imbalance can bring about compliance in parents who would not be otherwise inclined.

    What are the parents resources in weighing the decisions of appropriate treatment? How are they prepared to deal with the power imbalances inherent in a theraputic relationship? As the parent of a child with special needs. I would say, sometimes the resources and preparations are inadequate. The books on specials needs I’ve read sometimes mention questioning your doctor (seldom therapist) but I’ve never seen the power imbalance mentioned. I’ve never seen an indepth discussion of the ethics in selecting treatments outside of the rather obvious weighing risks in surgery.

    In relationship to this I would note, Doctor and Therapist Organizations have experts and panels that they can task with considering the ethical implications of various therapies and strategies. Who does a parent have? Their parents, their friends, sometimes an online group, googleU. I don’t think that’s always adequate or constructive. They can all help or acerbate the problem.

    One good thing is most parents instinctive defense of their child. Anecdote – Our son’s first early intervention therapist was poor at handling my son. She tended to be too demanding and impatient. She would grab his hand and direct it somewhere in an overly abrupt way. I have seldom felt the level of fury that I felt at this woman (way out of proportion to her actual actions or my son’s reaction to her actions). That kind of instinctive anger is a good bolster when confronting an authority figure that is in the wrong. (It’s not great if you are wrong and the authority is right, oh well.)

    Considering that, I wonder if poor attachment is not actually part of the issue in some cases. Not the child’s attachment to the parent, but the parent’s attachment to the child. In a insecure attachment, demonizing the child would weaken attachment further. This is speculation, I think daedalus2u has discussed a similar thought with his “changeling” theory of parents who pursue unsafe therapies for their children with autism. I don’t know the current literature on the topic.

    *This comment is referring to parents of children with special needs or real behavior or emotional problems. It’s clear to me that these abusive “therapies”/therapists would also attract parents who are basically maladjusted or predatory.

  34. Calli Arcale says:

    I would also add another element. The relationship between parent and therapist or doctor has an inherent power imbalance.

    That is an excellent point. I think a lot of parents (and I’m definitely one of them) are very anxious to know that they are parenting their children *right*, and that society approve of their parenting.

    My youngest daughter has this thing she does when she’s really upset and/or not getting her way. She’ll ask for me, then I’ll pick her up, she’ll cuddle in, and say, “I want mommy.” No matter how close she is to me, even if she’s clutching me with all her might (and she’s got a lot of upper body strength for her age), she’ll keep saying “I want mommy!” When this happens in public, I always have this nagging worry that people will think I’m not her mother and have abducted her or something. But she’s three; I don’t think she quite understands how it comes across, and I think she’s using the phrase more as a shorthand for some emotion that she’s having trouble expressing.

    You want your choices as a parent to be validated, and you dread being told that you’ve screwed up. This does make some parents vulnerable in that sort of a relationship.

  35. Linda Rosa says:

    Regarding the allure of Attachment Therapy, it might be more useful for me to suggest following the money. There is funding available for adopted children with “special needs.” My understanding is that much of this money is discretionary,* with the parents allowed to pick the therapy they think most appropriate. Some parents claim that their insurance has paid for Attachment Therapy, while others have sued adoption agencies for reimbursement, claiming they were not advised in advance of the child’s severe condition, i.e. “Attachment Disorder.”

    In some criminal child abuse cases, we have seen examples of “mega families” with large numbers of adopted children diagnosed with “Attachment Disorder.” These families brought in a significant income from government agencies.

    (*Once considered as the state most generous with funding for Attachment Therapy, Ohio no longer allows funding for “special need” adoption to go to Attachment Therapy.)

    micheleinmichigan mentions the claim that negativity during pregnancy affects attachment:

    I see it mostly used as something to blame on the birthmother. The claims about this get pretty wild. Several Attachment Therapists claim that “Attachment Disorder” can even begin at conception as when, for example, the “defenseless” ovum is traumatically attacked by a “drunken” sperm. One leading spokesman claims that prior to pregnancy ova are already “bonded” to the unique “vibrations” of women. (That’s a concept so weird that it makes it hard to construct a sentence about it.)

    The fetus is also given credit with understanding language and telepathy. An example given by Nancy Thomas is that the fetus knows when mom is even thinking about having a cigarette, and in anticipation of the pain the nicotine will cause, the fetus clamps down on his umbilical cord to cut off circulation. Honestly, I couldn’t make up stuff like this.

    Someone wondered if the problem might be the lack of attachment on the parents’ side. That’s a question that people who observe Attachment Therapy often ask. (It has also been suggested that the therapists seem to display the problematic behaviors they attribute to “Attachment Disordered” children.)

    Here’s an example of parents following their Russian adoptees with a camera, characterizing their children’s distress as a “meltdown,” and airing the film on national TV. I’d be interested in knowing how this strikes you:

    ABC’s 20/20,”The Toughest Call” (2008)
    http://abcnews.go.com/video/playerIndex?id=6356996

    This program features Ranch for Kids in Montana, a bootcamp-like facility that promotes Attachment Therapy. ABC’s Nicole Gallagher, Director of News Practices, wrote me that ABC consulted with an expert on “Reactive Attachment Disorder,” psychologist Gregory Keck, on this story before paying for the family’s travel expenses to Montana. Keck is a prominent figure in Attachment Therapy (http://childrenintherapy.org/practitioners/gregory-keck/).

  36. Linda Rosa, Firstly, regarding the money. Govenment paying for ineffective and dangerous treatment is a complaint seen here on SBM too often. I’m glad that it’s being talked about and discontinued in some states.

    Regarding your video – I couldn’t watch the whole thing. Firstly, this is one of these “scary adoption stories” that the news programs love. It’s very hard to get the actual facts, because it’s clear that it has been edited to fit the expected storyline.

    I’ll tell you my gut reaction. These parents “ain’t go no sand*.”

    Since these kind of stories have been highlighted in the news at least since the Romanian adoption surge, it’s reasonable hard to believe that this couple didn’t have adequate opportunity to learn that adopting any older child from an orphanage is not an easy placement. That they should sit their butts down and read up on the reality of the situation.

    I was a bit stunned that the parents videotaped a child’s emotional upset a week after they came home. Grieving is a very real part of adoption. If your niece had moved to your home due to the death of her parents, would you video tape her inconsolable day the next week? Weird.

    Also regarding the boys multiple diagnoses, RAD, autism, pica, schizophrenia, Tourettes….really? Major red flag for diagnostic hoarders.

    The diagnostic criteria for RAD states.

    “B. The disturbance in Criterion A is not accounted for solely by developmental delay (as in Mental Retardation) and does not meet criteria for a Pervasive Developmental Disorder.”

    Doesn’t that alone raise questions?

    But, I can not emphasis this enough. ALL older child adoptions are special needs adoptions. They require study of the issues and an understanding that added time and effort will be required to support the child. This is not to say that they are not rewarding and children do recover from difficult experiences. They are resilient, but you have to be prepared to accept a “new normal”, be patient, be resilient yourself.

    I’m linking to an interview on attaching on adoption. If someone wants an approach that is more realistic and constructive, non coercive, then the abusive therapy described, this link may get them started. http://www.comeunity.com/adoption/special_needs/gray-interview.html

    *guts, grit, courage under pressure.

  37. Linda Rosa, your link on Keck seems to be broken.

  38. jre says:

    Probably more than any other event, it was the death of 10-year old Candace Newmaker in April 2000 that brought public attention (and a good deal of outrage) to coercive restraint therapies:

    Candace stated several times during the session that she was dying, to which Ponder responded, “You want to die? OK, then die. Go ahead, die right now”. Twenty minutes into the session, Candace had vomited and excreted inside of the sheet; she was nonetheless kept restrained.
    Forty minutes into the session, Jeane asked Candace “Baby, do you want to be born?” Candace faintly responded “no”; this would ultimately be her last word.

    This took place at an office in Evergreen, Colorado, just a few miles from Pat Schroeder’s erstwhile congressional district, and only three years after she left office. Schroeder certainly knows about the danger of these therapies, and has no excuse for endorsing them.

  39. Joe says:

    micheleinmichigan on 13 Oct 2010 at 10:32 am wrote “Linda Rosa, your link on Keck seems to be broken.”

    http://childrenintherapy.org/practitioners/gregory-keck/

    It was embedded too close to the surrounding characters.

  40. Thanks Joe, I did not realize that Keck was one of the author of Parenting the Hurt Child, a book that I have seen recommended on international adoption boards. I did pick that book up in the store a few times, but reading parts of it, I felt they construed the intent of a child who may be struggling with attachment, sensory, anxiety or other issues too negatively.

  41. Linda Rosa says:

    Advocates for Children in Therapy (once again) has a YouTube collection of clips from Attachment Therapy training tapes, news programs, etc.:

    http://www.youtube.com/user/ACTonlinevideos#p/u

    These don’t have captions yet, so let me know if you have any questions about them.

    To JRE:

    Psychologist Jean Mercer, Larry Sarner and myself published a book about the death of Candace Newmaker and what the three-week trial of the therapists (and the 11 hours of video-taped therapy) revealed about Attachment Therapy:

    “Attachment Therapy on Trial: The Torture and Death of Candace Newmaker” (Praeger 2003)

  42. Linda Rosa says:

    Advocates for Children in Therapy has just posted a YouTube collection of clips from Attachment Therapy training tapes, news programs, etc.:

    http://www.youtube.com/user/ACTonlinevideos#p/u

    To JRE: There is a book written about this case:

    “Attachment Therapy on Trial: The Torture and Death of Candace Newmaker” (Praeger 2003) by psychologist Jean Mercer, Larry Sarner and me.

    Part of our research was attending the three-week trial of Attachment Therapists Connell Watkins and Julie Ponder. The jury was shown 11 hours of Candace being subjected to various styles of Attachment Therapy (e.g. Holding Therapy and Compression Therapy), including the last, fatal session, which Waktins said was supposed to be an “easy day.” The judge sequestered this video, but Watkins’ Holding Therapy methods closely resemble those demonstrated in the Feinberg tape mentioned above.

  43. Linda Rosa says:

    Here is a clip of the Rage Reduction session from Elvis Presley’s “Change of Habit,” with Mary Tyler Moore, where Elvis cures autism:

    http://www.youtube.com/watch?v=HgxFbh80KyA&feature=related

    Some think that this child, while being restrained, does not appear to be acting but is in real distress.

  44. daedalus2u says:

    One of the big issues in diagnosing attachment disorders is that it takes two individuals for attachment to happen. It is not possible to determine which of those individuals requires “treatment” for “attachment” to happen.

    http://daedalus2u.blogspot.com/2010/03/physiology-behind-xenophobia.html

    Children of a different ethnic and social background are very likely to be more difficult for an adult of a dissimilar background to attach to.

    I think the difficulty in attaching is real, but may reside in the adult and not in the child. I think that similar things sometimes happens to parents of autistic children and children can be significantly maltreated as a result.

    Torture and high stress treatments like this are not going to result in normal healthy attachment. They might induce Stockholm Syndrome, but that is a pathological attachment. It would also likely induce PTSD.

  45. Dr Benway says:

    I took the Universal Studios tour and know all about “movie magic,” so Imma not read much into to kid’s behavior in *Change of Habit.*

    I will say this though: Elvis was pretty friggin hot in 1969.

    The hotness caused me to click on the YouTubes with the musical bits –i.e., when he sings “Change of Habit,” and “Have a Happy.”

    That was a mistake. I now have the diabeetus. *sad face*

    Don’t understand? Listen to this.

  46. Daedalus2u “Children of a different ethnic and social background are very likely to be more difficult for an adult of a dissimilar background to attach to. ”

    Who says? daedalus2u please read some actual research on adoption and international adoption. You can not build a theory for typical attachment patterns by focusing on case studies of attachment failure. You must look at the big picture, which includes successful attachment in the vast majority of interracial or international adoption. I have never seen any evidence that different ethnic or social background result in below average attachment or below average mental health outcomes.

    This link primarily deals with trans-racial foster care adoption, but I believe it’s a good place to start for people interested in general considerations for trans-racial adoption.

    http://www.adoptioninstitute.org/research/2008_05_mepa.php

    “Research on transracial adoption has progressed over the past 35 years in methodological rigor and complexity. Overall, the current body of research on this issue supports three key conclusions:

    1. Transracial adoption in itself does not produce psychological or social maladjustment problems in children.

    2. Transracially adopted children and their families face a range of challenges, and the manner in which parents handle them facilitates or hinders children’s development.

    3. Children in foster care come to adoption with many risk factors that pose challenges for healthy development. For these children, research points to the importance of adoptive placements with families who can address their individual issues and maximize their opportunity to develop to their fullest potential.”

    My experience as an international adoptive parent and from socializing with and corresponding with adoptive families, which is pretty extensive considering that not only do I belong to several international adoptive family groups, but I am also a adoptive sibling who belongs to an extended family where 1/2 of the cousins* and/or nieces and nephews joined the family through adoption, has not indicated to me that differing ethnicity or differing backgrounds is any indicator for attachment.

    I believe you are unintentionally engaging in a common misconception similar to the “child of your own” mythology that so many individuals without personal experience in adoption believe.

  47. Dr Benway – I believe you may be a Shaolin monk of pointedly tangential comments. I would ask if I could learn at your feet, but I am frightened that you would hit me with your teaching stick.

  48. Dr Benway says:

    Sorry, michele. Sometimes I’m in a hurry and I’m not clear.

    I was responding to Linda Rosa’s link above, to Elvis Presley’s performance in *Change of Habit*. It’s a flashback to a particular southern California musical genre involving paisleys and lots of positive energy.

    Perhaps this will help.

  49. Well that reduced my rage.

  50. Dr Benway says:

    Rage? Oh yeah, back on topic after mah psychedelic tangent (just say no-to-drugs, kids).

    The attachment therapy shtick plays right into the story-telling bias of the human brain. It’s just another version of the caterpillar-into-butterfly trope: a lonely protagonist with a broken heart meets and is transformed by a wise healer, in three acts. The dramatic breakthrough arrives at the end of Act 2, just when everyone was about to give up hope. Maybe the healer played a little rough, but that’s because he cared MOAR.

    Lasting, useful developmental progress is usually gradual.

  51. Linda Rosa says:

    Speaking of movies, a wretched book (The Boarder, by Jane Ryan) about an “attachment disordered” boy and the pastor’s family that was supposedly terrorized by him, based on a true story, is being made in Ravenna, Nebraska, with community involvement (bake sales, pot lucks, amateur acting, etc). It’s disheartening to see such a concentrated effort in promoting Attachment Therapy beliefs. And with no Elvis or MTM, I doubt the movie will have any saving grace at all.

    http://theindependent.com/articles/2010/10/12/news/local/doc4cb3e4b1099a6744966585.txt

    A note about that scene in “Change of Habit”: not surprisingly, one Elvis historian claims that the child playing the autistic girl became “very, very upset” during the Rage Reduction scene. Mary Tyler Moore demanded the filming stop and “stormed off the set.” Moore, in her autobiography, when she commented about this scene, only said that she thought Elvis was trying to be a gentle with the girl. It seems to me that he was trying to do a mild version of Rage Reduction.

Comments are closed.