Concerned About Unconventional Mental Health Interventions?

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

Wednesday, February 29, 2012

Who's Abusive? Comparing Step-Parents, Adoptive Parents, and Others



Warning: this is not going to be a juicy post, but dry and statistical. A commenter the other day brought up the question of whether adoptive parents or step-parents actually are more often abusive to children than biological parents, as we have been told by “Cinderella” and other stories. I went rummaging among the statistical reports and found a few answers--  although not all that I was looking for.

The U.S. Children’s Bureau publication Child Maltreatment in 2010 (http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#can) reported data from 51 states (including Puerto Rico and the District of Columbia) about substantiated cases of child abuse and neglect. The data are based on the definition used in the Child Abuse Prevention and Treatment Act Reauthorization Act of 2010: “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm”. [Interesting—I never realized before that this definition omits to mention cognitive or educational harm.] Children who are abused and neglected are most often exposed to a variety of difficulties, and it is not necessarily possible to discriminate between actions that most of us would call neglect (like poor diets) and those we’d usually call abuse (like beating with an object). This makes it hard to decide which people are abusers, but we have to recognize that the problem is a reflection of the real world conditions, not of the data collection or analysis. 

According to the Children’s Bureau report, there were 436,321  substantiated reports of child abuse and neglect in 2010. Of these, 78% focused on neglect, 17.6% on physical abuse, and 9.2% on sexual abuse. It was not clear from this report how each of these was associated with a particular group of perpetrators, but it’s important to see that specific physical abuse was relatively infrequent--- these points should be kept in mind when looking at the rest of this post.

The Children’s Bureau report noted that parents (including step-parents and adoptive parents, but not foster parents) were responsible for 81.2% of the cases in the “duplicate count” (adults who were reported more than once for mistreatment of a child). Of these cases involving parents, 0.7%  were perpetrated by adoptive parents, 84.2% by biological parents, 4.0% by step-parents, and 11.2% by parents whose relationship to the child was not recorded.

These numbers suggest that biological parents were by far the most frequent maltreaters, followed by the “unknown” group, with a much smaller frequency of mistreatment by step-parents, and the adoptive parents with a tiny proportion of cases. However, these numbers don’t tell the whole story; we need to know the proportion of each of these kinds of parents in the population, so we can look at rates of maltreatment and see whether each group accounts for more or less abuse than its occurrence in the population would predict. If there are many adoptive parents, we would expect many cases of maltreatment, and if there are very few, we would expect very few cases. (We’ll have to leave out the “unknown” group.)

A visit to the 2008 U.S. census, at www.census.gov/newsroom/releases/archives/children/cb08-30.html  shows a total of 73 million children in the United States. Of those, 61% lived with their biological mother and father, 8% with at least one step-parent (I can’t explain what this means, sorry!), and 2 % with at least one adoptive parent. The difference between this total and 100% is because I’ve omitted less frequent situations like living with grandparents or being emancipated.

If child maltreatment was not associated with the parent’s actual relationship to the child, we’d expect 61% of cases to be perpetrated by biological parents, 8% to occur when there was a step-parent in the house, and 2% to be carried out by adoptive parents. In fact, we see many more cases of maltreatment by biological parents than we’d expect, and fewer by step-parents and adoptive parents—in fact, only about half of the expected rate by the last two groups. This result is much different from what is usually reported about step-parent maltreatment, and contradicts the 1985 article that originally stated that step-children are in unusual danger of abusive treatment (Daly,M., & Wilson, M. [1985]. Child abuse and other risks of not living with both parents. Ethology and Sociobiology, Vol. 6, pp. 197-210; courses.washington.edu/evpsych/D&W-child-abuse-ESB1985.pdf).

What if we look at the 2010 report’s information about child fatalities, as opposed to non-fatal neglect and abuse? The table showing relationship of perpetrator to child does not show step-parents or adoptive parents separately, but it does show deaths due to the actions of mothers, of fathers, of mother and father, and of mother plus another or of father plus another. It also shows deaths associated with a partner of the mother or of the father. The proportion of child fatalities perpetrated by mother or father plus another, or by a partner of one of the parents, still amounts to less than 17% of the total--  but without information about the numbers of children living in each of those situations, it’s hard to interpret exactly what this signifies. A proportion of 17% is somewhat more than the 10% accounted for by the census data for step-parents and adoptive parents, but may not be excessive when we consider unmarried partners of parents too.

Have I made mistakes here? Or could it be that step-parents have been maligned or have changed since the 1980s?    

Saturday, February 25, 2012

The Hardin and Chritton Cases: Where Did These Abusive Parents Learn Their Methods?


Two recent child abuse cases--  one fatal— raise a question: was it chance that the abusive adults chose the methods they used? Were they simply repeating punishments that were generally accepted in the past? Was their bizarre and harmful behavior symptomatic of mental illness? Or are abusive actions encouraged by quasi-professional “therapists” and “parent educators”?

The fatal case, that of a 9-year-old Alabama girl, Savannah Hardin, is shown at www.dailymail.uk/news/article-2106370/Savannah-Hardin-9-run-death-lying-eating-candy.html as well as posted elsewhere. Savannah told her grandmother she had not eaten a candy bar, when she actually had done so; as punishment, she was made to run for hours, until she collapsed and later died of dehydration. One article notes that, as well as running, she was to gather wood and add it to a pile. Savannah was said to be under medical care and receiving medication for a chronic condition that was not named.

An Alabama attorney quoted in a piece at www.cbs42.com stated that “a lot of parents do this as punishment”, apparently referring to the forced running, but that they would not expect it to end in death. Older people may remember this type of punishment from their own childhoods, and those who have been associated with the military will recall similar punishments involving running or marching with full packs (and the old British expression, “no names, no pack drill).

Punishments of this kind are part of a vernacular or popular belief system about appropriate treatment of children and are more likely to be favored in rural areas or by “old-fashioned” families or individuals. However, they also form part of a popularized system associated with so-called “Attachment Therapy” or “Holding Therapy”, unconventional treatments intended to make children compliant. The system, which some call “Attachment Therapy parenting”, involves an emphasis on unquestioning and uncomplaining obedience, to be brought about through limitations of diet and tedious repetition of heavy or difficult work, or of tasks like holding objects over the head with extended arms before meals may be eaten.  This approach  has been suggested and described by the “parent educator” Nancy Thomas in a 2000 Academic Press book edited by the “attachment therapist” Terry Levy. (I would note that the techniques of holding objects over the head is not included in Thomas’s work, but has shown up in the practices of parents using similar methods.)  

Was Savannah Hardin’s grandmother, Joyce Garrard, familiar with the advice of “attachment therapists”? Was she simply repeating methods she knew from previous experience? Or was some degree of emotional disturbance responsible for her fatally-flawed judgment in this matter? It’s to be hoped that investigators and prosecutors will explore these issues thoroughly. Although Ms. Garrard’s actions are her own responsibility, if “therapists” or “parent educators” in the area are encouraging this behavior, the public needs to be informed of their involvement and its potential outcome.

The second case, non-fatal but highly injurious to the child, can be seen at http://www.channel3000.com/news/30475617/detail.html. A Madison, WI family is accused of years of maltreatment of a 15-year-old girl who was found weighing 70 pounds. Her condition requires very careful care and may end in her death. Her father, Chad Chritton, and stepmother, Melinda Drabek-Chritton, are said to have kept her in the basement of their house most of the time for the last 6 years, to have limited her diet to oatmeal and peanut butter sandwiches (as recommended by the “parent educator” Nancy Thomas), supplemented by garbage and, sometimes, her own feces, to have made her do housework in the nude, and to have failed to provide adequate sanitary facilities. Their reasons for mistreating the child are not yet clear, but they are said to have told her that she is autistic and to have claimed that she has Reactive Attachment Disorder (a claim that is, of course, a specialty of  “Attachment Therapists”). It has been suggested that this post http://groups.yahoo.com/group/HopeForADKids/message/3118 may have been written by Melinda Drabek-Chritton, and it appears that the description of the surveillance cameras is accurate. (Readers may notice that the URL above uses the term “AD” rather than “RAD”. This refers to the “Attachment Disorder” posited by “Attachment Therapists” --  sometimes used interchangeably with “Reactive Attachment Disorder” by them, but also said to have different symptoms and claimed to culminate in serial killing.)

Did the girl’s father and stepmother pick up these techniques from their own past experiences? The serious harm done to the child makes it seem unlikely that this was the case, or at least that they had ever seen such severe treatment go on for long. Is their behavior symptomatic of mental illness? This remains to be seen, of course. Have they learned to use these methods as advised by “therapists” or “parent educators”? This is a very real possibility, as a document available from the organization Adoption Resources of Wisconsin repeats misconceptions claimed as true by “Attachment Therapists”. This document does not in itself suggest maltreatment, but cites as sources and recommends materials by Nancy Thomas and by Connell Watkins, one of the therapists convicted in the 2000 suffocation death of Candace Newmaker. Such dangerous misinformation has been circulated in Wisconsin by a number of groups.

Again, it is to be hoped that investigators and prosecutors will thoroughly explore all these possibilities. If, in fact, state or local organizations are encouraging the practices and belief systems that seem to have been at work in the Wisconsin case, it is essential that families be made aware of the dangers of following this kind of advice--  advice that is protected under the First Amendment, so that punishment of the advisers is not as likely as punishment of those who followed their counsel.  




Thursday, February 16, 2012

More on Child Witches and Deliverance


I’ve been getting some interesting information on the activities of Helen Ukpabio, the “child witch” exorcist I mentioned recently, from Leo Igwe, until recently the International Humanist and Ethical Union representative for Western and Southern Africa. Leo is about to begin a three-year project to study beliefs and practices related to the idea that children can be possessed by demons and harmful to people and property . Not surprisingly, he is aware of events related to the “child witch” belief. He passed on a relevant Youtube piece, which you can see at www.barthsnotes.com/2012/02/16/houston-liberty-gospel-pastor-gives-interview/ as well as on Youtube.

The Youtube material is telephone interview conducted by Sahara TV interviewer Chika Oduah with Godwin Umotong,  pastor of the Houston church that plans to run a “mammoth deliverance” (group exorcism)  under the care of Helen Ukpabio. I found the interview somewhat difficult to understand (it has those video pauses where the sound vanishes too), but it did provide the information that the deliverance event, originally scheduled for March 14-25, has been postponed until May. Ms. Oduah asked some pointed questions about the whereabouts of the “mermaid spirits” that are named as a concern in the flyer for the planned deliverance meeting. She also pointed out that the crying in the night, feverishness, and deteriorating health --- symptoms that Helen Ukpabio says can indicate demon possession in toddlers--  could  well be symptoms of malaria. Umotong maintained that children can be initiated as witches, but denied that they could be witches from birth.

Pentecostal beliefs (as described in the work of Frank and Ida Mae Hammond and of Bill Banks) do include the idea that an individual may be demon-possessed not only from birth, but from conception. In the views of the Hammonds and of Banks, events such as conception in a spirit of lust, or the consideration of abortion by the mother or father, attract demonic entities who then “indwell” the developing child and can be expelled only through deliverance rituals. (Adopted children are especially likely to have these problems.)  Demon-possessed children may be ill-behaved and rebellious or rejecting to their parents, as well as showing learning disabilities or even physical disorders; these difficulties occur because of the demonic influences and cannot be cured except through deliverance.

The belief in demonic possession of infants and children has real dangers from the perspective of non-Pentecostals. Those committed to this world-view may avoid educational, psychological, even medical treatments that exclude demonic possession as an explanation of children’s problems. In addition, as I pointed out recently, there have been child deaths caused by deliverance rituals. The Hammonds and Banks, as well as other Pentecostal authors, assume that expulsion of demons is often accompanied by crying, screaming, and vomiting. These are all possible indications of harm being done, and if ignored may lead to greater harm or death.

 Nevertheless, the “child witch” accusations of Helen Ukpabio seem to be of a different order of magnitude than “ordinary” demon possession and deliverance beliefs. Although “witch children” may seem to overlap with the usual demon-possessed child in characteristics like stubbornness or lack of interest in school, “witch children” are also perceived as harmful to others, and even as plotting with other children and with malignant spirits to hurt people and property. The kind of harm they are thought to do may be as vague as “draining” health and happiness from adults, or  as specific as causing appliances and electronics to fail. In either case, these posited effects are common events with multiple causes, and are likely to occur from time to time in anyone’s life. If they have been blamed on a “child witch” and that child has been exorcized, it will be easy for adults to assume that further bad luck is due to the need for repeated and intensified ill-treatment of the child.

When I used to teach a course on history and systems of psychology, one theme of my course was that every religion contains within it a psychology, in the form of beliefs about the capabilities and obligations of human beings. For many people, their religious instruction or exposure is the only systematic study of psychology they will ever do--  although they may pick up various bits of information, from myths to factoids, in the course of their lives. Christian fundamentalists, including Pentecostals, use a psychology in which human beings are thought of as non-material entities temporarily inhabiting material bodies, and influenced by other non-material, supernatural entities of either a benevolent or a malevolent disposition. Although Christians reject the idea of reincarnation, they believe in the existence of individual entitities both before and after the life of the material body. These beliefs suggest that psychological events (learning, emotion, thought, affection) and related behavior are based on non-material causes and can be explained and manipulated by non-material methods. Those who share these perspectives would thus accept that demonic entities could affect both mental and physical health, and that treatment of such effects would involve getting rid of the demons. As demons or other supernatural entities are unconstrained by time or space, their effects or treatments need not resemble events in the natural world.

 Conventional psychology, on the other hand, like other modern science, assumes that psychological events emerge from events in the material body. Psychological functioning follows the laws of the natural world, so that, for example, events in the environment occurring before the development of the individual brain would not be remembered or responded to.  Neither could posited non-material events affect psychological functioning, whose basis is material phenomena that are part of the natural world.

Although Christian fundamentalists (Pentecostal or otherwise) do not necessarily accept the idea of “child witches”, their non-material psychology does offer potential support for this belief, and for the idea that tormenting such children could drive away harmful demonic entities.  Conventional psychology, which is generally accepted by atheists, agnostics, and adherents of the liberal churches, could not support these beliefs.

The contrast between these two positions is so great as to suggest a culture war, and indeed the Sahara TV interview between Chika Oduah and Godwin Umotong exemplified that contrast. It’s not a matter of Africa versus North America and Europe, but of two mutually-exclusive world-views. The rapid growth of the perspective represented by Umotong means that the clash between the two will need to be recognized in the near future. Leo Igwe’s researches in Ghana will help us understand whether the conflict can be resolved, or whether one belief system is going to prevail.

Monday, February 13, 2012

Child Witches in America, and Related Matters



A House of Commons report in 2003, the Victoria Climbie Inquiry Report (www.publications.parliament.uk/pa/cm200203/cmselect/cmhealth/570/570.pdf), told the extremely disturbing story of the long period of abuse ending in the death of Victoria Climbie, an 8-year-old Ivorian child living in London with a relative. The attacks on Victoria were related to the belief in “child witches”, children possessed by demons, and British social workers appear to have been afraid that they would be culturally insensitive if they interfered with her treatment. Victoria was not alone in suffering from accusations of demonic possession and from the treatment others deemed appropriate for her (http://news.bbc.co.uk/2/hi/uk_news/7003534.stm).

Couldn’t happen here? Maybe--  but look who’s coming to dinner in Texas: Helen Ukpabio,head of Liberty Foundation Gospel Ministries in Nigeria. Ms. Ukpabio will be performing a marathon deliverance (casting out of demons) at Liberty Gospel Church in Houston (http://libertyfoundationgospelministries.org/images/U.S..jpg). She plans to cast out demons for those who have bad dreams, are possessed by mermaid spirits, have many miscarriages, fail to achieve promotion, and so on. The flyer for this event does not state that she will perform deliverance for possessed children, but she has been quoted as saying “If a child under 2 screams in the night, cries and is always feverish with deteriorating health, he or she is a servant of Satan [i.e., possessed by demons]” (www.nytimes.com/2010/05/22/us/22beliefs.html). Ms. Ukpabio has been accused, and apparently not without reason, of encouraging and spreading the belief in child witches that led to injuries and deaths like that of Victoria Climbie.

I haven’t been able to access any of Ms.Ukpabio’s books,  but I see that Malcolm Gaskill, in Witchcraft: A Very Short Introduction, quotes her 1999 End of the Wicked as claiming that children’s souls can leave their bodies at night to attend a witches’ meeting. (Whether they follow Robert’s Rules of Order is not mentioned.) David Tonghou Ngong writes in  his recent The Holy Spirit and Salvation in African Christian Theology that Ukpabio states that the children are said to be “taken to a witches’ coven… where they are spiritually inculcated  with recalcitrant and destructive behaviors such as the ability to drain out health, happiness, and money from people; they are also made to be stubborn, to steal, to lack interest in school, to destroy electronic appliances, and so on. Thus it is that in many communities in Nigeria and the DRC, children are blamed as witches when appliances break down, when they are stubborn, or when there is sickness or poverty around them. In Nigeria, Ukpabio runs special seminars on detecting and exorcising witches, like the one she held for seven days in 2008 to a packed auditorium. Her activities foster an imagination that demonizes children [N.B., Ngong is not using this term in the Pentecostal sense of demon-possessed. J.M.] and sometimes even death. However, scholars of African Christianity hardly raise the issue” (pp. 36-37).  

Ukpabio’s views of child witches and the dangers they bring are a bit different from beliefs common in the United States. However, members of  U.S. and Canadian Pentecostal groups have for many years attributed both mental and physical illnesses of children as well as adults to demonic possession, and have suggested that healing results from expulsion of the demons by means of divine powers available to believers. This process is called “deliverance” by Pentecostals (including Ukpabio) but may also be referred to as exorcism.

Unfortunately, deliverance practices can be dangerous in themselves, as well as interfering with the use of conventional treatment for both mental and physical disorders. In one case in 2008, a 13-month-old Texas child died as a result of parental attempts at deliverance (http://www.ktbs.com/news/27447281/detail.html), and there are numerous similar cases in the United States, like that of Kairissa Mark, whom I mentioned in an earlier post.  An important point to understand about deliverance is that such rituals are not limited to “professional” deliverers like Roman Catholic or Church of England exorcists, who may have some awareness of potential harmful outcomes, but may be performed by any believer, including family members. (In fact, some authors discussing deliverance state that the father of a family is the most capable of “delivering” his wife and children.)

Ms. Ukpabio’s presence in the United States  is relevant to ongoing questions about religious exemptions from ordinary requirements for parents. A number of states continue to permit “philosophical” exemptions for parents who reject immunization of their children. Many states continue to have laws protecting Christian Scientist parents whose children die for lack of medical care. Protection of parents whose children die in the course of deliverance seems less likely, because the actions that cause death are in themselves prohibited by law--  but  it is possible that the “good intentions” of parents may minimize the crimes of which they are convicted and the penalties imposed, if prosecutors, judges, and communities sympathize with their beliefs. It’s also an issue whether some U.S. and Canadian social workers, like their British counterparts, either share deliverance beliefs or feel it is politically incorrect to oppose them. If so, how far will they go in sympathy with Ms. Ukpabio’s claims?

As I write this, I begin to ask myself, where is the State Department’s Office of Children’s Issues in this situation? Why is Ms. Ukpabio permitted to visit the United States and to speak publicly? Do we have to wait until “it happens here” (as it did in England) before we recognize the dangers to children inherent in these beliefs?  

***NOTE: a petition to deny Ms. Ukpabio entry to the U.S. can be signed at www.change.org/petitions/the-president-of-the-united-states-deny-entry-to-the-usa-for-helen-ukpabio.



   

Wednesday, February 8, 2012

Asking Questions About Spanking



Is everyone thoroughly tired of this topic? I surely am, but it keeps coming up. For example, the Canadian Medical Association Journal has just published an article summarizing some 20 years of work on spanking and its effects (see http://nospank.net/n-v16.htm--- I haven’t been able to get the original article to read, but this link will give you some access). The authors, Durant and Ensom, concluded that spanking has no positive outcomes and a number of negative ones, among which they include possible shrinkage of brain matter and declines in IQ.

And this could be true, although of course none of the studies discussed had the randomized design that allows us to understand whether one factor actually caused another.  But let me refer to another journal article that brought a high level of critical thinking to this difficult issue (Berlin,L.J., Ispa, J.M., Fine,M.A., Malone,P.S., Brooks-Gunn, J. et al. [2009]. Correlates and consequences of spanking and verbal punishment for low-income White, African American, and Mexican American toddlers. Child Development, 80, 1403-1420).

Berlin and her colleagues noted that “the extent to which the literature speaks to the effects of spanking, per se, is limited.” They pointed out that one well-known analysis combined spanking with the bare hand and hitting with an object into the category “corporal punishment”. This conflation of the two events has been common and is probably characteristic of the studies considered in the Canadian article. When spanking and hitting with an object are combined categories, no study can conclude correctly whether spanking itself has specific good or bad effects on child behavior and development.

 Berlin and the other authors also emphasized the need for the transactional perspective that is essential to modern developmental psychology, a perspective that considers the possibility that parents can influence children, that children can influence parents and evoke different parent behaviors, pr that both can happen simultaneously. In the case of spanking, this would mean that parent punishment behavior could change children’s behavior, mood, personality, etc.; that children’s characteristics could evoke particular punishment behaviors and attitudes from parents; and that these mutual influences could go on simultaneously. It would be a failure of critical thinking to focus exclusively on one factor--  for example, the effect spanking, or any other form of punishment has on the child.

A second broad concern of developmental psychologists is an ecological approach, as suggested many years ago by Uri Bronfenbrenner. Berlin and her colleagues noted the need to look at individual factors and contextual factors that may make a difference to the effects of a specific childrearing practice on child outcomes. They mentioned a particular need to consider race/ethnicity and maternal emotional warmth as factors that may influence the outcome of spanking or other punishment methods. They pointed out a number of studies showing an association between corporal punishment and aggression for White but not for African American children. According to Berlin and her colleagues, those studies suggested that spanking “ may have negative effects for White children that do not necessarily apply to racial/ethnic minority children and that parents’ emotional responsiveness can buffer or even trump the potentially negative effects of their disciplinary practices”.

Interviewing over 2,000 mothers when their children were age 1, then age 2, then age 3, Berlin and her colleagues found that boys were significantly more likely to be  reported as spanked at all three ages, and fussy children were more likely to be reported as spanked at ages 1 and 2. (It could be argued that being spanked might make children more fussy, but hardly that being spanked makes them boys.) Regrettably, the researchers did not provide the mothers with a definition of what they meant by spanking, so once again it’s possible that both spanking with the bare hand and blows with an object were being reported here.

The outcomes reported by Berlin and her co-authors are too complicated to be summarized here. But, at the risk of cherry-picking, I will point out that in fact results of spanking (whatever that meant) were different for different ethnic groups. For a more acculturated Mexican American group, for example, a high frequency of spanking at age 1 was associated with high scores on a test of development at age 2, while there was no such association for White children (I follow Berlin’s capitalization here, by the way). Spanking at age 1 or 2 did not predict child aggression at age 3. (All the effects were small in size.)

The Berlin study also included an analysis of verbal punishment and its effects. Other parental practices like time-out were not a focus of the study, nor were positive practices like reward or praise. We still lack research that gives a complete picture of parents’ disciplinary or guidance efforts, but this does not seem to prevent various commentators from drawing absolute conclusions.

A complete picture of parents’ methods would allow us to consider what parental characteristics were associated with what methods. The question may be not whether spanking causes negative or positive outcomes, but whether living with the kind of parent who does or does not spank has negative or positive outcomes.  An additional question may be whether child characteristics (like being male) are associated both with the evocation of spanking in parents and with “negative outcomes” (which may not be outcomes of experience, and may only be negative in certain contexts)  like aggressive behavior. So many aspects of early development involve transactional processes and therefore relationships--  is it really likely that the effects of spanking will be otherwise? 

Tuesday, February 7, 2012

Slapping, Teasing,and Play


An interesting story came up the other day at a discussion on childrearing sponsored by the Delaware Valley group of the World Association for Infant Mental Health. One participant told a story that’s quite relevant to some of the recent discussion on this blog of punishment as a parenting technique, modeling of aggressive behavior, and so on.

Her story was this: a young mother played roughly with her year-old son, slapping him lightly but repeatedly until he became distressed and frustrated. The mother was amused by what she was doing and by the child’s frustration and attempts to fight back. If he slapped back at her too much, though, she became infuriated and beat him. When the child got a little older, he went to live with a relative, and there he showed that he had learned that exchanging slaps was “play” and the right way to interact with older people. The relative tried to teach him not to slap, but to use some other form of physical contact like tickling or kissing, and this worked to some extent, but the toddler would still occasionally approach an adult with a slap. Within the family, people understood the background, but his behavior was not welcome in out-of-home child care and early intervention settings.

Because of the physical force involved, this sounds like an extreme case, but it’s certainly common for adults or older kids to tease young children unmercifully, to justify their actions by saying they’re “just teasing”, and to become angry and even punish the child who displays distress when teased intensely. School-age children exposed to this treatment usually learn how to evade the adult’s attention, but younger ones naturally respond to distress by approaching the people who ought to be protecting them--  the very ones who are tormenting them.  We’ve all seen this at the beach, as screaming toddlers and preschoolers are carried to be thrown into the water, or in other situations where an adult picks up a child and won’t put her down, or threatens to throw away a toy or harm a pet. These situations often conclude with some type of punishment of the child, who is then characterized as a “wimp” or a “sissy”.

Infants too are teased, although their language and cognitive development is not good enough for them to understand most threats or insulting words. Even actions that an older person might think of as potentially threatening--  like an adult pretending to drink up a baby’s bottle--  may just seem funny to the baby, who doesn’t envision a world without milk. Some play sequences seem to verge on teasing while never really getting there--  for example, holding out a toy for a baby to grasp, pulling it away, holding it out again, and repeating this several times before letting the baby take the toy. When this stops before the baby gets distressed, it’s certainly play; when it’s pressed until the baby reacts with fretting or tears, it’s turned into teasing.

Most adults who play with or mildly tease babies will stop when the game goes too far, or when the child is old enough to be disturbed and confused by the adult’s ambiguous behavior. But others, like the mother mentioned earlier, will escalate their teasing as the child gets to the toddler stage. Little boys, especially, may be encouraged to get angry and “fight” with other people, then be punished if their fighting gets too intense, or ignored if the adult is suddenly bored with the whole thing.

Why is being teased so disturbing for toddlers and preschoolers? The basic problem is that the adult’s communication is so ambiguous. If the person is friendly, why is he threatening or frightening the child? If he is hostile, why is he smiling and laughing? All of us find these mixed messages confusing and concerning, but young children have developed little skill in understanding how apparently contradictory emotions and facts can exist side by side. They have not developed much ability at what the psychologist Simon Baron-Cohen (yep, Sasha’s brother) and others call Theory of Mind--- the ability to make accurate guesses about other people’s knowledge, beliefs, and intentions.

Children under the age of three can already figure out certain things about what others know or want, but they are not clear on whether people can deliberately “trick” people or tease them by feigning a belief or intention. In a study by Vanderbilt, Liu, and Heyman (The development of distrust.[2011]. Child Development, 82,1372-1380), children watched an actor who pretended he did not know where something was and misled another person who was looking for the object. Three-year-olds trusted information from that person as much as information from an actor who helped another person. Four- and 5-year-olds trusted the “tricker” a bit less than the “helper”, but only 5-year-olds said the helping person was “nicer” than the other. This suggests that the toddler I mentioned at the beginning of this post would not have been able to interpret some of his mother’s slapping as teasing play, and other slaps as seriously meant. For him, slapping became just another mode of interacting with adults, even when they appeared not to like it (after all, his mother seemed not to like it sometimes, but then she would start it up the next time).

Why did the mother behave this way? Not surprisingly, the discussion of this point began with a suggestion that has appeared often in recent comments on this blog: that she was repeating what had been done to her when she was a child. This is certainly a possibility, and I would not want to reject it without evidence. However, I’d  like to point out that this is not the only possibility, nor is it likely that such a complex behavior would have only one cause. I would suggest also that the mother saw friends and relations “play” with their children and even with each other by pretending to fight. In addition, her slapping play may have been one of the few ways of playful interaction with a child that she was aware of. All of us initiate play with children because we enjoy the way they respond to us--  for our own fun--- and we often carry out that play in stereotyped ways like rolling a ball or playing tickling games. The issue may not be so much what the mother had done to her, but what she did NOT have done. She may have had no experience of games that limited teasing to a minimum (after all, teasing can enter any interaction, especially tickling), nor of play styles that help the excited child return to a moderate level of arousal. She may have seen other adults play in ways that brought the child to a peak of agitation, followed by the adult’s losing interest and turning away. In addition to all that, she may have valued personality characteristics that included aggressiveness and recklessness, and may have seen them as “manly”.

It might well be that we could be most helpful to this mother and child by helping the mother learn better ways to play, rather than by exploring her psychodynamics or condemning her as abusive. But, best of luck to us for getting any funding for this project nowadays!

Sunday, February 5, 2012

Puzzlement About Punishment



A kind reader called my attention to further evidence on our confused beliefs and assumptions about corporal punishment. The Toronto Globe and Mail (www.globeandmail.com/life/parenting/young-children/discipline/spanking-your-kid-does-it-help-or-hurt/article2324686/ has quoted the mayor of London, Boris Johnson, as speculating that parents feel anxious about discipline because of anti-spanking laws. He was speaking in support of other politicians’ claims that  British riots were the long-term result of lax parental discipline – an interesting counterpoint to the suggestions of some that riots and other violence result from excessive parental punishment.

According to the Globe and Mail, surveys of Canadians suggest that parents simultaneously use physical punishment and believe that it’s not a good thing to do. This would also seem to be the case in the United States, and I would guess that one of the reasons for this apparent paradox is that parents feel under social and internal pressure to Do Something, and they see physical punishment as the “gold standard” for Doing Something. Sally Provence, one of the doyennes of the early childhood movement, used to say, “Don’t just do something. Stand there and watch.” She felt it was easy to follow impulses to interfere with what a child was doing, but both harder and more constructive to observe the situation and the child.

 Parents rarely hear Provence’s maxim, though, and if they watch and reflect on what’s happening, they’re likely to have friends, neighbors, teachers, and grandparents tell them that they are lax and creating trouble. One mother was telling me a few days ago that her young daughter very occasionally talked back to her teacher, and the teacher would send home a note demanding to be told what the mother had “done about it”--   the message was that some punishment at home was required, whether physical punishment, loss of privileges, whatever. When a note describing the punishment was sent back to the school, the teacher was satisfied--  until, of course, the next time this unsolved problem became apparent.

Multiple sources tell parents to Do Something. Whatever they do, other voices will tell them it was the wrong thing--  some that physical punishment causes anger and violence, the others that lack of physical punishment causes anger and violence. And whatever capacity parents have for reflection and considering the best approach to take with their children, that capacity will be diminished by the social and emotional pressure they experience both inside and outside their families.
All that confusion is worsened by our apparent inability to even agree on the terms we use. I think I’m in line with some authors when I define spanking as one or two smacks on the bottom or legs (clothed or unclothed) with the adult’s bare and open hand. But a recent off-blog correspondent has said that she thought of “spanking” not as a smack, but “serious authoritarian whopping”. I recently read an account of a religious ritual in which a mother was told she should now spank her uncooperative child, and she said she couldn’t, she didn’t have a paddle--  so the clergyman suggested her shoe, and she used that. (What ritual?? I’ll save that for another time.) We just don’t seem to have any shared language, understood by everybody, that discriminates between a mildly painful and physically safe event at one extreme, and clobbering the child with a large object at the other extreme. When someone says “I gave him a tap”, we can’t tell whether that was a quick smack on the hand, or the belt or razor strop (if anyone besides me is old enough to remember those thick leather straps).

For anyone who wants to think seriously about physical punishment, it’s important to be aware of how punishment is differentiated from abuse for research purposes and in law. The fourth national incidence study of child maltreatment in 2010 listed specific actions that would be considered abusive; these are discussed at www.acf.hhs.gov/programs/opre/abuse_neglect/natl_incid/.

The Toronto Globe and Mail article cited earlier described a 2004 ruling of Canada’s Supreme Court about the “justification” of physical punishment (I am not sure but what this might have been better stated as “acceptability”). Here are the circumstances in which physical punishment of a child is legally acceptable under the Canadian criminal code:

The punisher is a parent, not a teacher.

The child is between 2 and 12 years of age.

The child is capable of learning from the physical punishment.

It involves “minor corrective force of a transitory and trifling nature”.

It does not involve blows with objects or blows to the head.

It is not “degrading, inhuman, or harmful” (and I would appreciate any glosses on those words that any readers can provide, because I am really unsure what would be “inhuman”.)

It is corrective rather than due to the caregiver’s “frustration, loss of temper, or abusive personality”. (This too is unclear--   does it mean that a person who is frustrated cannot also seek to correct a child’s behavior?)

The Canadian list seems to cover a number of the points that discriminate between what I call spanking and what I’d call beating. There are still some issues that I would think need to be established, though. For example, how often does such punishment occur? Is it possible for a simple spanking to move to the abuse category if it occurs ten times a day, and no other corrective measures are used?

Well, we can’t really depend on the law to answer these questions. Nor, I submit, are psychologists ready to answer almost any specific questions about the safety (in emotional terms) or effectiveness of physical punishment.  It does seem that all answers will have to come from looking at punishment in context: what happened before the punishment? What happened afterward? How are the cultural differences in attitudes toward physical punishment played out in outcomes for children of different groups? Yes, it’s complicated --  not like Doing Something. But we do seem to have made enough progress to begin to ask what the “gold standard” for discipline really is.