Concerned About Unconventional Mental Health Interventions?

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

Friday, September 28, 2012

Attachment Therapy Makes Strange Bedfellows


A news story from Washington State raises a multitude of questions in reference to people’s beliefs about attachment. According to this story, the adoptive parents of a 15-year-old girl who had been removed from a polygamous group in Utah were advised to share a bed with her so they could “bond” (http://www.heraldnet.com/article/20120904/NEWS01/709049844#Snohomish-man-sentenced-to-6-years-for-rape-of-girl). The therapist felt the girl had “abandonment and attachment” issues and advised attachment therapy. Somewhere all these good intentions were turned into the proverbial paving stones on the way to hell, though, as the father soon turned the bed-sharing into an even more intimate connection. When the girl resisted, he threatened her with being returned to her biological family and married off polygamously. She complied while living with the adoptive parents, but filed a complaint when she went away to college.

What the father was up to was no doubt largely a matter of letting the little head do the thinking. One hopes that the adoption agency is now a little more sophisticated about some of the possibilities of this kind.

My question is, what did the therapist imagine she was doing when she gave this advice? Where did this misch-masch of ideas about attachment come from?

The therapist (so-called) told investigators that she advised “attachment therapy”.  Although there is no “official” definition of this term, it’s usually used to describe an unorthodox treatment that purports to switch an adopted child’s emotional attachment from a biological parent to and adoptive parent. According to www.attach.org, an organization that promotes the treatment, attachment therapy involves physical holding of the child by therapists and parents; past history shows that some practitioners use a coercive and painful form of holding that has caused injuries and deaths, but presumably others do not. (In neither case is there evidence that these treatments are effective approaches to emotional disturbance.)

It’s possible that the Snohomish County therapist also recommended attachment therapy when she suggested that the adoptive parents and the 15-year-old share a bed. Ordinarily, attachment therapy would not be associated with bedsharing, and for all the serious problems associated with attachment therapy, I have never heard of sexual abuse occurring in the context of that treatment.  Attachment therapists do suggest a great deal of physical contact, rocking, hugging, and so on, and push this beyond what might be developmentally appropriate because of their unconventional beliefs about emotional development, but this would not necessarily imply or lead to overt sexual activity. In any case, such practitioners tend to stress the mother’s relationship with the child much more than the father’s.

So, we have a therapist who’s talking about attachment therapy, but she seems to be recommending something unrelated, whether instead of or in addition to attachment therapy. Where did she get the bedsharing idea?

My guess is that the therapist has become intrigued with some of the beliefs often called Attachment Parenting--  beliefs originally proposed by William Sears, and stressing physical and emotional interactions between parents and children during infancy and toddlerhood. Suggestions made by Sears and others have included an emphasis on skin-to-skin contact, on long breastfeeding, and on the “family bed” shared by parents and children. Fans of Attachment Parenting hold that these activities (which are not part of the “standard culture” of the United States) are needed in order to create a strong emotional attachment of parents and children, to provide an optimal foundation for the children’s later development, and to avoid developmental problems. Proponents of Attachment Parenting don’t regard attachment as a very robust phenomenon, an opinion in which they disagree with developmental scientists.

A small number of advocates of Attachment Parenting may approve of continuing to share a bed with the older children who have slept with their parents since birth. As far as I know, however, none of these advocates, even the most enthusiastic, has proposed that an adopted adolescent be brought into the “family bed”.

That suggestion, made by the Washington State therapist, seems to have been based on a misunderstanding common among those who  practice attachment therapy or derive their understanding of attachment from a few workshops--  the supposition that events that have a particular effect in infancy and toddlerhood will have the same effect on older children or even teenagers. This idea flies in the face of the concept of developmentally appropriate practice, which stresses the differing needs and reactions of children at different stages of development.

Attachment therapists in general--  and perhaps the Washington State therapist in particular—believe that an individual who has had problems in early development (for example, in attachment) will have those problems corrected  in the present if exposed to the kinds of situations that would have produced good development if experienced in the past. This is somewhat analogous to thinking that a 16-year-old whose growth was stunted by a lack of protein during infancy can be returned to a normal growth trajectory by having the diet limited to milk for a while.  Even if bedsharing were needed for attachment in the very young (which it isn’t), this would not be evidence that adolescent attitudes and relationships can be manipulated in the same way.

The therapist in the present case seems to have made two big mistakes. The first was to assume that she could or should make a 15-year-old “attached” to adoptive parents, in the same sense that a toddler is attached to familiar caregivers. The second was to think that the methods used by advocates of Attachment Parenting could harmlessly be generalized from infants to adolescents. Unfortunately, the person most harmed by these mistakes was the girl, with the adoptive mother next in line--  and we  might think that even the father might have behaved better and not be in prison if he did not feel some sort of permission from the therapist for “bonding”.  But, there’s no law against giving bad advice, and that’s how this therapist and others get off without punishment after contributing to family train wrecks like this one.

I just have to wonder, though--  did the therapist advise skin-to-skin contact?

3 comments:

  1. Honestly, I always wonder about adoptive parents adopting older children/adolescents and expecting / trying to force “attachment” or “bonding” or “dependence” on a person who is developmentally programed (by virtue of BEING adolescent) to be asserting independence and autonomy. It seems to me to be a recipe for disaster and many a disappointment all the way around.

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  2. It's curious that the law also regards an individual as a child in almost the same ways from birth to age 18. There's something about developmental change that seems to be excessively hard for people to grasp.

    Your point is an awfully good one-- and I have to wonder also what the issues are for 2-year-olds, who are simultaneously in need of dependence and of autonomy.

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  3. That is an incredibly disgusting story, after what that poor girl was through with the FLDS then to be adopted by a pervert with a "therapist" urging him on. Agreeing with Sunday, anyone adopting an older child has to deal with them in age-appropriate manner, not try to turn back to early childhood or infancy. That is just wrong in so many ways.

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