Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Tuesday, October 19, 2010

Things Attachment Therapists Want Adoptive Parents to Think

A very sensible, well-educated, and dear friend of mine and her husband adopted a little boy from another country some years ago. He did not come to them straight from his birth mother, but was with a foster family until he was about ten months old. The new family settled down quite quickly, and the boy has developed nicely in every way. They’ve followed everyone’s directions about his transition, kept a life book for him, and stayed in communication with the foster family.

I was surprised a few months ago when the mother, whom I’ll call Mary because that isn’t her name, told me she was concerned that the little boy was experiencing grief for his birth mother. I asked why she thought that, and she said she had been reading that all adoptees have this problem. She also described conversations in which he had expressed concern for what had happened to his birth mother and why it was that she couldn’t take care of him. But it seemed to me that he expressed a lot of concern about many people, animals, bugs, and caterpillars, and that he didn’t seem especially preoccupied with the birth mother-- nor did he seem greatly worried about the foster family to whom he had had some chance to attach.

Recently I had a chance to visit Mary and her husband and son and to see once again what a great job they’re all doing. And Mary solved a puzzle for me by showing me the book that had caused her concern: Sherrie Eldridge’s Twenty things adopted kids wish their adoptive parents knew. In my opinion, this book would be better titled “A bunch of things attachment therapists wish adoptive parents believed”, because people who hold the beliefs Eldridge proposes would be very likely to accept both the theory and the practice of attachment therapy. As neither attachment therapy practice nor its underlying theory have any support in conventional mental health information, it is not surprising that Eldridge’s “things” are also unsupported claims. It would be excellent if adoptive parents knew about these issues, but they need that information in order to avoid inappropriate choices, not so they can follow Eldridge’s advice.

Let me comment on a few of Eldridge’s twenty things. First, we see that Eldridge is a proponent of the “primal wound” theory, claiming that all adopted children are suffering from the grief of separation from the birth mother, and need treatment that focuses on that loss. However, all the facts about early development and infants’ emotional attachment tell us that babies adopted into a stable family in the first months of life show no sign of distress or grief over the separation from the birth mother. Babies’ attachment to adults takes time to develop, and it’s based on a history of social interactions and emotional maturation, not on prenatal experience or genetic relationships. The birth mother may miss and grieve over her lost baby, but the baby does not respond in the same way, as he or she is physically, mentally, and emotionally very different from any adult. Relationship or mood difficulties in adoptive families benefit from pretty much the same kinds of treatment that would help non-adoptive families. Where a different focus is needed, it may involve the needs of the adoptive parents rather than the children, because a history of infertility or loss of children can cast a long shadow on a family.

A second point is that Eldridge proposes that young babies exist in a form of shared identity with the mother, a state described as symbiosis by Margaret Mahler and others, years ago. Eldridge does not refer to Mahler, and appears to have picked up this idea from Henry Cloud and John Townsend’s 1992 book Boundaries, from which she also took some of Mahler’s language (like the term “rapprochement”). The idea of symbiosis suggests that separation would be traumatic. There are some problems for this argument, though. One was that even Mahler did not propose that symbiosis was in place at birth, so it becomes irrelevant to early separation from the birth mother. Second, much of what we now know about communication between mothers and babies tells us that even the very young have some capacity for intersubjectivity, or knowing that another person is not the same as the self. I’ve recently come across people commenting on blogs who say that “it’s accepted” that babies identify self and mother as the same, but, as I just argued, that acceptance, if it ever existed, is certainly no longer the case, and for that reason it is not “accepted” that early separations are traumatic.

I’ll just add one more item to my list. Eldridge gives the standard checklist for identifying children with attachment problems--- the checklist seen on many an attachment therapy website, the one that suggests that disobedience, lying, preoccupation with blood and gore, and so on, are indications of the need for attachment therapy. This simply is not the case, for two basic reasons. Those behaviors have nothing to do with Reactive Attachment Disorder, and may or may not have to do with other mental health problems. In addition, whatever the family’s problems may or may not be, treatment that focuses on infant attachment alone could not solve the problems mentioned.

A look through Eldridge’s bibliography shows that at least half of the sources she cites are attachment therapists. There are several citations to Foster Cline, who is [in]famous for his claim that “all bonds are trauma bonds” and that a child’s emotional engagement with his adoptive family must involve traumatic experience. It’s clear that, without referring to holding therapy or related practices, Eldridge produced a book that reflects the attachment therapy “party line” as it existed in 1999 when the book appeared.

If Eldridge’s material seems to speak to your condition, use it as you find appropriate. Strange things can help people, I know. But please don’t accept all her statements without careful examination, and don’t assume that there must be problems with your child for which there is no visible evidence.

8 comments:

  1. Eldridge is also a rejected adoptee (her birthmother did not want to meet her) and Fundamentalist Born-Again Christian. This is all in her writings. She suggests that other adoptees who were rejected when they searched remember that God is their father and loves them and will never reject them no matter what. Also many referrences to giving your life over to Jesus. This advice does not work if one is not religious or not Christian. I am not surprised she is a proponent of attachment therapy, and almost everyone who does the speaking circuit in adoption reform is a true believer in Primal Wound Theory. You know what happens to those who dare to doubt.

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  2. I suppose one reason there's no counter-PW talk is because most conventionally-trained professionals have never heard of it. But how to approach this? Any ideas? I wonder if there's a Wikipedia article about it-- but of course they get on your case about POV.

    I don't mind catching flak if there are any suggestions about how to enter this fray.

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  3. I have found your clear statements about infant and child development helpful to me in explaining why primal wound theory is doubtful. I am not a professional but pretty well-read on science subjects in general, which made me question that a newborn had the cognition to be forever harmed shortly after birth simply by transfer to another loving caregiver who is not the biological mother. But I do not have your knowledge of child development or the latest writings in the mainstream of that field to back up my skepticism, so just having you explain and reference some of this clarified my thinking and arguments against PW as anything but a metaphor for the grief in adoption for many adoptees.

    If you could stand it, it might be good to get your ideas out there in the newsletters of some reform groups like AAC and CUB, and perhaps to speak at some of their conferences. I know they would be open to your critique of attachment therapy, and you might be able to sneak in some stuff about PW.

    It may also be helpful to make some of your professional colleagues aware that PW and related beliefs are out there so that they could challenge them.

    Thanks for taking an interest in this issue. It is frustrating to be the lone skeptical voice in a sea of true believers.

    maryanne

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    1. Dear Maryanne,

      I am another member of your league. When I first read The Primal Wound, I was so worried that I started thinking of my child as a wounded person who would always live grieving... I decided to carefully observe him, we went to family therapy, and truly... my loved child does want to know things about adoption,but does not seem to have any "archaic" memory that prevents him from feeling identified and loved.

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  4. Those are really good ideas. I confess that although I knew what PW was, I had no idea until recently that it was playing such an important role in people's thinking about adoption. I'm looking into the newsletters of the groups you mentioned. I think speakers at their conferences are probably invited, so I'll try to introduce myself by newsletter articles as a beginning.

    I have been trying to educate other professionals about some of these belief systems, but I have to say it's uphill work. On the whole, people want to hear about what's good to do and don't seem to understand that the beliefs of their clients help determine what works. Also, I find a deep divide between those interested in adoption and those interested in infant and child mental health-- they simply don't talk to each other. In my own state,I've managed to get some discussion of foster care among infant mental health people, but that's about all.

    Anyway, it's good to know that you're splashing about in this sea too!

    Best regards,
    Jean

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  5. The only thing on wikipedia I could find was a very short article on the book "The Primal Wound".

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  6. I saw that Wikpedia article too, and when I read the Talk part I realized I didn't feel ready to meet the onslaught of argument that would follow if I tried to add to it. What's more, what I would say would be judged OR, as practically nobody has bothered to contradict the PW belief in print.

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  7. I have been reading about these so called attachment-therapy theories and have been driven to comment. I believe a lot of it seems to be uninformed people preying on the insecurities of parents (especially adoptive ones) First and foremost ANY child needs to feel LOVED and SAFE and SECURE in order to be able to develop the ability to form meaningful relationships and secondly these techniques grossly impinge on what I believe should be basic human rights. I acknowledge that there are families dealing with severely challenging children and that it can be enormously overwhelming but surely compassion and support would seem a more appropriate action. A lot of the behaviours described used to "diagnose" this disorder seem more in line with a natural response to being exposed to a tumultuous or dangerous environment when you are vulnerable and powerless...who wouldn't act out.
    I also believe the whole biological mother bonding thing is way over stated and that bonding occurs through repeated positive interactions with a trusted person. The fact is that many mothers feel ambivalent towards their newborns and love develops over time. Conversely a baby learns through experience that he/she had someone who will love them, care for them and protect them (Whilst the RAD therapy seems to teach them the exact opposite).
    I know there are people who believe these intrinsic bonds exist but I strongly disagree as I feel it sets up negative expectations for adoptees and their families. I myself was adopted from a foreign country at almost 3 from an overcrowded and appalling orphanage yet I developed a loving relationship with my (adoptive) mother and have a close extended family. I always knew I was adopted yet never experienced issues of identity or bereavement. I am happily married with a child and a career and have not become a serial killer or even a minor felon.
    It is easy to get a distorted view on the outcomes for adopted children as you only tend to hear the negative or fraught cases. You don't hear the many stories about perfectly happy and content adoptees because they are too busy getting on with their lives and it doesn't grab as much attention in the headlines. Also you have to bear in mind that there are also many cases of children from stable biological families that have severe behavioural issues too! So love and nurture your children and be guided by your heart.

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