Concerned About Unconventional Mental Health Interventions?

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

Wednesday, August 31, 2011

An Open Letter to Nancy Verrier

Dear Nancy:

As you probably know, some of your strong supporters are very mad at me for contradicting the idea that adoptees suffer from a lasting emotional trauma that you have called the Primal Wound. I’m told by people who know you that you are a sensible and friendly person and a supportive, helpful therapist. I wonder whether you might be willing to answer some questions for me. They are more challenging questions than I suppose you often get, but I am asking them in a genuine spirit of inquiry after reading some of your work. I am curious about unconventional theories and have been working on a book that examines some of the ideas shared by such theories and the therapies that are associated with them, and that work is the source of some of my questions. In addition, I believe that better understanding of these issues could facilitate mutual understanding between the “pro-PW” and “anti” groups.

1. Why do you accept and use the idea of cellular consciousness or memory? I’m sure you know that conventional views attribute consciousness and memory to the functioning of cells of the nervous system and not to other types of cells. Are there aspects of memory that you feel are better explained by cellular memory than by the conventional perspective?


2. Do you think personality development can be explained in terms of natural, material events, or would you say that some non-material/spiritual factors are needed for an explanation?


3. It seems that different adoptees have different feelings about their adoptions. What do you think are the factors that lead them to have one opinion or another?


4. What are some examples of what you call biological mirroring, ways people look or behave that you say have special meaning for biologically-related children? What are your reasons for thinking they have special meaning?


5. You have been involved for some time with the organization APPPAH, which in turn has connections with primal therapy and other “primal” ideas. I assume that this connection
is why you chose the term Primal Wound. Do you share beliefs with Arthur Janov and earlier contributors like Frank Lake and Francis Mott? Do you consider their LSD and “breathwork” experiences to give an accurate depiction of the experiences of an unborn baby?

6. Do you recommend that adoptees use any of the “primal” or “rebirthing”therapies to help with distress that they consider a result of adoption? Would you say there are other treatments that are helpful?



I think the answers to some of these questions might help explain the very intense commitment of some adoptees to the Primal Wound concept. It’s possible that the attractiveness of this idea to its proponents may have to do with a broader set of beliefs, not just with the single idea-- that discussions of this issue are culture wars in miniature. If that’s the case, discussing the “real problem” might be the beginning of a way for well-intentioned people concerned about adoption to come together for good purposes rather than attacking and blaming each other.


I hope you will take the time to answer at least some of my questions, not necessarily all at once. I would be grateful for your help on this, and I believe readers of this blog would also appreciate it.

Yours sincerely.
Jean Mercer


[9/1/2011 Nancy Verrier has kindly responded that she will be answering these questions in the near future. ]



Monday, August 29, 2011

Examining Unconventional Theories: More on the "Primal Wound"


Like many other unorthodox belief systems, Nancy Verrier’s “Primal Wound” theory just keeps on keeping on in spite of clear evidence that it can’t be correct. For those who are just coming in, the Primal Wound idea is the entirely speculative notion that babies adopted in the first days or weeks of life are deeply troubled by separation from the birth mother, and that this disturbance causes psychological difficulties that continue to be experienced right into adulthood.

An interview with Verrier at http://blog.adoptionmosaic.org/interview-with-nancy-verrier/ shows a continuing emphasis on some easily refutable points.

The first of these is the assumption that infants are psychologically more vulnerable in the period soon after birth than they are later. This belief depends on a logical fallacy; it’s based on the idea that if childhood is a vulnerable period, and people in later life are less psychologically vulnerable, then earlier and earlier developmental periods are times of greater and greater vulnerability. In fact, though, both physical and psychological vulnerability have schedules in which a somewhat later period is more sensitive than the earliest time. As an example, the probability of birth defects from exposure to rubella is much less right after conception than it is 6 weeks later.

Critical periods in development, when normal events are more easily disturbed by trauma or disease, are different for different aspects of developmental change. Emotional attachment to a caregiver has not developed at birth and is not apparent until 6 months or so later. Think about this a bit-- what has there been for the baby to attach to, before birth? In the interview with Verrier, she says the baby knows nothing but that mother. In fact, though, the baby knows nothing but the inside of that mother, not the outside.

Are we to assume that newborn babies are grieving for the taste of the amniotic fluid and for the sound of the mother’s stomach rumbling, not to mention other less socially-acceptable noises? If not, what are we to think they miss? Is it the “psychological connection” mentioned by Verrier, which she says is not severed with the umbilical cord? What was that connection? Are we actually talking about a telepathic communication between mother and baby, as posited by the ‘50s psychoanalyst Nandor Fodor? If so, why doesn’t such a connection continue after birth-- is it somehow dependent on physical transmission through the cord? There seems to be quite a confusion of material and non-material events here.

Verrier argues that babies remember not only birth but prenatal events back to conception because of cellular consciousness. This idea, that experiences are imprinted on cells and need not be represented in the nervous system, has been popular among Scientologists for many decades (see Janet Reitman’s recent history of Scientology). It has also much been much favored among advocates of Janov’s primal therapy, including the Australian physician Graham Farrant, who believed that there were memories from the egg and sperm stages too (see http://primals./org/articles/farrant3.html). There is certainly no evidence that this type of memory exists or that either subjective experience or recall can occur without the functioning of high levels of the nervous system; this also applies, by the way, to the “body memory” idea much discussed by Bessell van der Kolk. Once again, this belief seems to involve a confusion between functions of cells and some posited non-material component of the personality.

Now let’s consider Verrier’s idea of “biological mirroring”, which seems to be the experience of observing others who share some of one’s genetically-determined behavior traits. I wonder whether Verrier is aware that human infants don’t even recognize themselves in the mirror until 15-18 months of age? How are they then to compare their own more subtle behavior characteristics with those of others until a much more advanced age? And when they do notice differences, what does this mean--- would we see psychological problems caused by being the only girl in a large family of boys, or the blue-eyed child of heterozygous brown-eyed parents? As for genetically-determined behavior traits, I would be at a loss to name even one that is obvious and is inherited according to a dominant-recessive pattern (we can’t expect tongue-rolling or tasting certain chemicals to be easily observed). Instead, behavior traits like temperament are determined by combinations of genes and environment. The big similarities in behavior of some separated twins, so much emphasized by the media, need to be considered in the context of other separated pairs who have little in common. Before arguing for the positive impact of “biological mirroring”, Verrier needs to present evidence that children in families where there are strong resemblances are somehow psychologically healthier than those in families where the roll of the genetic dice has produced varying temperaments and appearances.

The Sunday New York Times (Aug. 28, 2011) this week carried an obituary whose details reminded me strongly of Verrier’s claims. This was the obituary of Budd Hopkins, an abstract expressionist painter-- and, more to the point, the instigator of the “alien-abduction movement”. According to the Times, “Many who shared their stories with Mr. Hopkins had no conscious memory of their abductions at first. But they had lived for years, he said, with the nagging feeling that somewhere, something in their lives had gone horribly wrong….. by his reckoning, 1 in 50 Americans has been abducted by an alien and simply does not know it.” Here is a theory of emotional discomfort that is as much supported by evidence as the theory of the Primal Wound. Is there the slightest reason why anyone should accept either of these ideas?




Tuesday, August 23, 2011

A Russian Adoptee, Child Abuse, RAD, and MAD

In an all too common scenario, the Alaskan adoptive mother of a Russian child is on trial for child abuse, and her defense argues that the child is so awful that it was suitable to punish him by putting hot sauce in his mouth and by forcing him into a cold shower. (See http://articles.ktuu.com/2011-08-19/hot-sauce_29907825 and http://www.ktuu.com/news/ktuu-jessica-beagley-child-abuse-trial-closing-statements-082211,0,2078692.story for information about this.) Jessica Beagley’s actions toward her adopted son might never have been detected, or if detected might not have “made news”, except for the fact that she wrote to “Dr. Phil” and made a tape for the show, describing her anger and frustration and the use of worrisome disciplinary methods.

During Beagley’s child abuse trial, her attorney argued that she had done nothing wrong. Her family therapist, Chantal Cohen, and others stated that the 7-year-old was difficult because he suffered from Reactive Attachment Disorder as a result of his early life in a Russian orphanage. Cohen stated that such children can be “sweethearts at school and monsters at home.” Other testimony said that children with Reactive Attachment Disorder “are uncontrollable and don’t show empathy”. Cohen also testified that the children “intuitively find the one button that’s intolerable to you and then they smack it really hard.”

This all seems pretty inconsistent; how can a person without empathy, the capacity to know what others feel, also have a capacity to figure out what someone else’s concerns are? But, be that inconsistency as it may, there’s a much bigger issue to consider about these statements regarding Reactive Attachment Disorder. My question is, what did Chantal Cohen and others think they were talking about when they referred to Reactive Attachment Disorder? The characteristics they referred to and attributed to Beagley’s adopted 7-year-old form no part of Reactive Attachment Disorder as it is defined by the official source, the Diagnostic and Statistical Manual of the American Psychiatric Association (often called just DSM).

Here is how DSM describes the characteristics of Reactive Attachment Disorder (code 313.89):

Markedly disturbed and developmentally inappropriate social relatedness in most contexts [not just at home-- J.M.], as evidenced by either (1) or (2):

Persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions [again, not just at home-- J.M.], as manifest by excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses…
Diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (e.g., excessive familiarity with relative strangers…).
[The DSM description goes on to cite other points that are irrelevant here but can easily be found by interested readers. ]

There is nothing in this description about being a “monster at home”, about lacking empathy, or about intuitively finding and pushing a parent’s most sensitive button. What, then, is Chantal Cohen talking about? Chances are that she misunderstands Reactive Attachment Disorder because she has been “trained” in an alternative view, put about by quasi-professional family therapists and life coaches, that describes either Reactive Attachment Disorder or something called just “Attachment Disorder” in a way completely different from the DSM description. They sometimes call it RAD, sometimes AD; I’d like to call it MAD for Misunderstood Attachment Disorder (and because it makes me mad to see this deception practiced).

Here are the characteristics of this MAD/RAD as stated at http://www.attachment.org/pages_what_is_rad.php:


Superficially engaging and charming.
Lack of eye contact on parent’s terms [this does not seem to preclude the existence of normal eye contact most of the time-- J.M.]
Indiscriminately affectionate with strangers.
Not affectionate on parent’s terms (not cuddly).
Destructive to self, others, and material things (accident prone).
Cruelty to animals.
Lying about the obvious (crazy lying).
Stealing.
No impulse controls (frequently acts hyperactive).
Learning lags.
Lack of cause and effect thinking.
Lack of conscience.
Abnormal eating patterns.
Poor peer relationships.
Preoccupation with fire.
Preoccupation with blood and gore.
Persistent nonsense questions and chatter.
Inappropriately demanding and clingy.
Abnormal speech patterns.
Triangulation of adults [might be difficult to do without empathy-- J.M.].
False allegations of abuse.
Presumptive entitlement issues.
Parents appear hostile and angry.

This list is on a web site belonging to Nancy Thomas, a foster parent and advocate of Holding Therapy, as well as in print and Internet publications by similar authors. In no case is evidence provided that such a group of characteristics is in any way associated with emotional attachment of children to caregivers, or that these characteristics tend to be shared in the form of an identifiable syndrome. Only two of these characteristics (“indiscriminately affectionate with strangers” and “inappropriately demanding and clinging”) overlap conceptually with the description of Reactive Attachment Disorder in DSM.

It appears that Jessica Beagley’s defense is arguing that she has been abusive in the course of her well-intentioned efforts to deal with a child with Reactive Attachment Disorder. However, nothing reported about the testimony suggests that the child has been professionally diagnosed with Reactive Attachment Disorder as it is properly defined. On the contrary, the testimony suggests that the witnesses wish to use the established term Reactive Attachment Disorder as a way of normalizing their unconventional diagnosis, the MAD/RAD concept. Assigning a child to the MAD/RAD category, with the characteristics listed above, enables the defense to argue that the child is lying and making false allegations of abuse, that the mother’s hostility toward him is in response to his personality disorder, and that the mother’s escalation of unacceptable punishments was entirely an effort to control the uncontrollable.

The RAD defense is regrettably becoming more common as a way to extricate abusive, even homicidal, parents from legal difficulties. In the Salvetti case which I discussed some months ago on this blog, the defense argued that another Russian adoptee had refused to eat until his weight dropped noticeably, rather than having his food limited by his parents as a disciplinary measure. The Salvetti defense stressed the idea that as a RAD sufferer, the boy was a persistent liar.

Prosecutors and judges need to be aware of the real and the false Reactive Attachment Disorder descriptions so they can respond appropriately when the RAD defense is mounted during child abuse trials. It’s time to stop the repetition of this scenario, with its tendency not only to do injustice, but to spread disinformation and encourage mistreatment of adopted children.

P.S. Aug.24-- Jessica Beagley has been found guilty, and SLATE, in commenting on this, has invented something called Radical Attachment Disorder!


Monday, August 22, 2011

When Will My Baby Understand....?

Concerned parents (and what other kind is there, really?) pore over lists of developmental milestones, checking out the average age for the first independent step, first word, and so on. Even more important-- but much harder to establish-- would be developmental milestones for ways of understanding and communicating with other people.

As it happens, an American developmental psychologist who has contributed much to our understanding of infant understanding, Michael Tomasello, has just received the 2011 Wiley-Blackwell/British Academy prize for contributions to psychology. I’ve been going through some of his research articles (kindly posted for free by Wiley-Blackwell), and I put together some “milestones” that I think will be of interest to parents. Some of these developmental achievements may seem pretty ordinary at a casual glance, but if you think it over you’ll see that they’re very significant steps in understanding other people.

12-month-olds:

How do 12-month-olds understand pointing? Do they just look where you point, as they look where you look, or do they understand that a pointing person means to communicate some information? When an adult pointed at a hidden toy, 12-month-olds could usually find the toy. Those who had understood the pointing could also point correctly themselves when an adult asked them where a toy was. This suggests that 12-month-olds know that a gesture like pointing means that another person knows something and wants them to know it too.
[Behne, T., Liszkowski, U., Carpenter, M., & Tomasello, M. (2011). Twelve-month-olds’ comprehension and production of pointin. British Journal of Developmental Psychology, 29, 1-17.]

Do 12-month-olds point just because they are interested in a toy or an entertaining sight? No, they point for various reasons. One is to call a person’s attention to something she does not know about or isn’t looking at; one is to share a positive or negative attitude about things they are both looking at; and one is in reference to things that are mentioned but are not there--- for example, a puppet that is no longer in a window the baby can see. These different purposes seem to be related to the 12-month-old’s developing understanding of other people’s mental states.
[Liszowski, U., Carpenter, M., & Tomasello, M. (2007). Pointing out new news, old news, and absent referents at 12 months of age. Developmental Science, 10, F1-F7.]

14-month-olds:

Do 14-month-olds just remember things like toys, or do they pay attention to the toy experiences they have shared with other people? In this study an adult and a baby played with three toys. The adult acted excited and encouraged the baby to be excited about one toy but was bland about the others. Later, the baby was shown all three toys on a tray, and the adult excitedly said “give it to me!” (leaving it unclear which toy was meant). 14-month-olds most often chose the toy they had been excited about--- but they did not make the same choice if they had only watched the adult acting excited without being involved. The babies could use the past history of playing together to figure out which toy the adult meant.
[Moll, H., Richter, N., Carpenter, M., & Tomasello,M. (2008). Fourteen-month-olds know what “we” have shared in a special way. Infancy, 13, 90-101.)

Do 14-month-olds understand when someone else is having trouble, and do they want to help? In one study, an adult pretended not to be able to reach a dropped clothespin. 14-month-olds spontaneously tried to help. When the adult was struggling with a more complicated task like opening a box, though, 14-month-olds did not always try to help. The toddlers could understand that the adult had a problem, and wanted to help, but they could apparently also figure out whether they could do the task or not.
[Warneken, F., & Tomasello, M. (2009). The roots of human altruism. British Journal of Psychology, 100, 455-471.]

18-month-olds:

Will 18-month-olds work hard to give help when they see it’s needed? When older toddlers saw an adult “struggling” to reach a dropped object, 18-month-olds would walk around obstacles to help, and they did this without being rewarded. They not only understood what another person might want, but they were eager to help and would do something difficult for them to manage while they were still amateur walkers.
[Warneken & Tomasello, above]

Do 18-month-olds understand that different people can know and mean different things, even if they say or do the same things? In one study, when 18-month-olds played with a toy one way with the first adult and another way with a second adult, they started the first activity when the first adult pointed at the toy, and the second activity when the second adult pointed at the toy.
[Liebal, K., Behne, T., Carpenter, M., & Tomasello,M. (2009). Infants use shared experience to interpret pointing gestures. Developmental Science, 12, 264-271.]

20-month-0lds:

Will 20-month-olds put helping someone above their immediate play interests? In one study, 20-month-olds would stop playing and leave an attractive group of toys to help someone who seemed to be having trouble. They would not only do this without reward-- if they were rewarded they became less likely to help on another occasion! Their understanding of the need for help and their motivation to help were both apparently very high.
[Warneken & Tomasello, above.]

Can 20-month-olds use other information to figure out the meaning of words they don’t know? In one study, 20-22-month-olds were shown pictures of puppets doing odd things that were described with nonsense words like “tamming”. If they were shown a picture and just told “this is tamming”, they did not seem to learn the meaning of the word. But if they were helped to practice by seeing pictures and hearing about one thing doing something to another thing, they were later able to use that kind of information to choose the right meaning for a word. If they saw a picture of a frog “tamming” a monkey, and heard it described with a complete transitive sentence, they would later look toward the correct picture -- for example, they would look at a frog doing something to a monkey, not at a picture of a monkey doing something to a frog. They used the relationship between the two animals to help decide what the unknown word probably meant; they did not need to be “taught” every word.
[Dittmar, M., Abbot-Smith, K., Lieven, E., & Tomasello, M. (2008). Young German children's early syntactic competence: A preferential looking study. Developmental Science, 11, 575-582.]

24-month-olds:

Children of 24 months know that if someone leaves the room before an event occurs, that person does not know about the event. But in one study, when an adult stayed in the room but could not see a new object because of a barrier that was above her eye level, 24-month-olds did not act as if the adult knew more about the hidden object than about two other objects she had seen. Just being together when the child saw the object was a factor that confused the children about what the adult might know—suggesting that for all the social and cognitive skills described here, there was still a lot of development ahead.

[Moll, H., Carpenter, M., & Tomasello, M. (2011). Social engagement leads 2-year-olds to overestimate others’ knowledge. Infancy, 16, 248-265.]

36-month-olds:

Do three-year-olds understand enough about what others can see or hear to be able to be “sneaky” in disobedience? Even though this might be something we don’t want them to do, we have to give credit for understanding to anyone who is able to manage this task. In one study, 3-year-olds were told not to peek in a box that had a very nice toy in it, and told they could play with it when the adult said it was all right. They were more likely to peek when they could tell that the adult could not see what they were doing. Given a box with two doors, one decorated with bells and one that would not make noise, they chose the silent door to peek through. To manage this “sneakiness”, they had to be able to think about what the adult could see or hear and whether they could do what they wanted to without being “caught”. (This is one of many cases in child development where being “bad” is evidence of good development.)

[Melis, A.P., Call, J., & Tomasello, M. (2010). 36-month-olds conceal visual and auditory information from others. Developmental Science, 13, 479-489.]

Can 3-year-olds really pretend, by playing that an object is one thing at one time, another thing at another time? In one study, they were able to switch back and forth from one pretend identity of an object to another and could talk about whether a wooden block “was a car” or “was an apple” at different times. This advance in pretend play may be associated with the earlier understanding that different people may mean the same thing by different gestures.
[Wyman, E., Rakoczy, H., & Tomasello, M. (2009). Young children understand multiple pretend identities in their object play. British Journal of Developmental Psychology, 27, 385-404.]

Do 3-year-olds mind if bad things are done to other people? Does their earlier “helping” tendency extend to social problems? In one study, each child and each of two hand puppets made a picture or a paper sculpture. One hand puppet “left”. For half of the children, the remaining hand puppet then destroyed the other one’s work; for the other half, the puppet destroyed some extra materials that had not been used. The children seeing the departed puppet’s work destroyed were more likely to protest, tell the puppet not to do that, and tattle on the destructive puppet; they also comforted or helped the second puppet on its return. The children’s concern extended to situations where another person was hurt, even though the child had no problems of his or her own. “Tattling” in this situation seemed to be a natural part of the child’s attempt to help.
[Vaish, A., Missana, M., & Tomasello, M. (2011). Three-year-old children intervene in third-party moral transgressions. British Journal of Developmental Psychology, 29, 124-130.]

Tomasello’s work shows that young children already know a lot about how to learn from other people and how to communicate with and act toward them. But what if your child can’t do all these things at the “right age”? Should you be worried? Parents usually ARE worried, but there are a lot of reasons not to panic here. One is that even in these studies there were some children of a given age who did not manage to do the task. They may have been having a bad day, or maybe the successful children were having good days. (Some of the children didn’t complete the tasks at all.) Also, the researchers did not just march up to each child and try to get him or her to do a task. They spent a long time with “warm-up” tasks and with getting the child ready. In addition, they were in a specially-designed lab, without a lot of familiar objects and people to distract the child from the job at hand. You may try this at home-- but results will vary!

Saturday, August 20, 2011

Holding Therapy in the UK

For an audio account of his experiences by a young man who when in his early teens was given holding therapy in a well-known UK residential treatment center, go to http://anyachaika.wordpress.com/2011/07/29/first-audio-account-of-holding-therapy.

Those who think this method is "nurturing" may have their minds changed by listening to this disturbing account.

Friday, August 19, 2011

Back to School, Maybe for the First Time

I recently participated in a very pleasant interview/discussion with a representative of the organization care.com. We talked about issues belonging to this time of year (August), especially “back to school” events. Because my interviewer has a four-month-old, we also discussed entry into day care. You can see a version of the discussion at http://www.care.com/child-care-back-to-school-troubles-p1017-98420002.html, but here are some other thoughts about these issues..

Not all children are concerned about staring back to school. Older kids may be bored with summer and ready for a change, especially if they are returning to a familiar school with familiar classmates. But younger ones may have some anxiety about the whole thing--- after three months of vacation they may not remember all the details they once knew well-- and are especially likely to feel worried if they are going to a new school, with a new teacher and new classmates.

Whether or not children express concern about starting school, it’s probably a good idea to make sure that their last week or two out of school is a calm, undemanding period. Unless there’s absolutely no choice, this is not the time to take an elaborate and fatiguing family vacation. Traveling with children is hard on the whole family, as we can see when everyone gets home and younger children demand even more attention than usual of their exhausted parents. Although a vacation trip may end with wonderful memories and a sense of family solidarity, it’s also a time of stress when new experiences demand extra consideration of each other’s needs if “meltdowns” (of parent or child!) are to be avoided.

Don’t forget that even a trip of a week in length really takes two weeks when you count planning, packing, unpacking, and catching up afterward, and those are two weeks when young children experience unpredictable events that are inconsistent with their usual lives. Yes, those are valuable experiences, and we want children to learn that things aren’t just the same all the time; however, it’s probably better for children not to have those experiences just when they are about to enter a new situation that will not become completely familiar to them for a couple of weeks.

Most children of school age are only a little anxious about school and adapt readily and quickly. Entry of younger children, toddlers, and infants into out-of-home child care is not such a simple matter, and how complicated it is depends on the child’s age and temperament. This matter is confusing to parents because it contradicts the usual rule that children get better at doing things as they get older. In the case of starting and attending child care happily, we see instead that babies under about 6 months of age are generally comfortable with non-parent care (always assuming that it is of good quality, of course), but that starting at some point in the second half of the first year, the great majority of babies will express distress at out-of-home care and will take some time to adapt to it. Preschoolers of 3 or more will probably show some reluctance to go into a new situation, but their developing language skills help them understand that a familiar caregiver will be back to get them, and that this will occur at a predictable time (“after juice” or “after circle time”, for instance).

This relationship between age and adaptability to child care does complicate life. Many parents are reluctant to use out-of-home care in the early months because of a realistic concern about infectious disease, or about the amount of attention a young baby needs, or about continuing to breastfeed. The parents may at that point also have access to continuing maternity leave that gives them the option of caring for their baby at home. Although the baby at this point may be able to adapt very easily to out-of-home care, there are many reasons not to use child care at that point.

A few months later, in the second half of the first year, parents may have weaned the baby from the breast, may feel he or she needs less individual attention, and perhaps have become more accustomed to common childhood illnesses. Maternity or paternity leave has probably run out in the U.S. (if indeed they had such a luxury). There are growing reasons for out-of-home care. But, whoops! The baby has developed to the point of feeling quite anxious about strange people and places. Adapting to care outside the home is a lot more difficult than it used to be.

What to do at this point? Are there ways the parents can ease their baby’s transition and make the family arrangements they need without excessive stress on anyone? Yes, most babies can be guided into greater comfort with a strange care situation, and the key word here is “gradualness.” Perhaps a few people have learned to swim by being thrown into water over their heads, but more have been frightened badly-- and the same thing is true of babies having new experiences. A gentle introduction fine-tuned by observation of the baby’s reactions is the best way to achieve a happy acceptance of any new situation.

Ideally, a baby should be introduced to a new care arrangement by short visits with a parent, leading after a few days to a short period there without the parent, and gradually increasing to the desired amount of care time. (A child care center that will not cooperate in this or that does not want the parent to stay is not a place you want to leave your child, by the way.) Ideally, also, the baby will have an assigned caregiver, and at least at the beginning will be cared for by that person most or all of the time, rather than having to deal with “floating” staff who work with any baby who seems to need attention. In addition, the ideal arrangement will involve careful attention to transitions, having a staff member greet the child and engage with her when she enters, and say goodbye as child and parent leave. Child care centers that are accredited by the National Association for the Education of Young Children are well aware of these points.

Real life is not ideal, of course. What if things just don’t, or can’t, work out this way? Let me give just one hint about what a parent can do: Don’t Sneak Out. Don’t ever sneak out. Tiptoeing away is easier on parents than hearing babies cry, but it’s very important for a baby to learn that a parent will not go away without making it clear that this is about to happen. Otherwise, anxiety may be constant that at any moment Mom or Dad could be gone, and when the baby feels this, it’s much harder to play and learn, or even to get used to day care.



Sunday, August 14, 2011

More on the Russia-US Adoption Treaty

When I commented a few weeks ago on the need for the conditions of foreign-adopted children to receive independent monitoring, rather than monitoring by the placing agency, a number of readers stated their agreement. I want to point out to you a way to bring your opinion on this to the attention of the State Department.

I've received a response from Sarah Shaffer of the Office of Children's Issues (ShafferSF@state.gov). She said that the treaty itself has been signed, but she can receive comments as the agreement moves toward ratification and implementation. More information on the treaty itself is available at http://adoption.state.gov/content/pdf/FAQs_re_agreement_07_13_2011_FINAL2.pdf
and at http://www.uscis.gov/adoption
and http://adoption.state.gov.


Changes will be posted on those sites, and you can request e-mail or feed notification.

I hope readers will join me in passing on opinions to Ms. Shaffer.