Concerned About Unconventional Mental Health Interventions?

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

Tuesday, March 20, 2012

Do You Have Good Things to Say About Your Childhood Experience of Attachment Therapy?


A couple of days ago, I posted some remarks about the fact that I never seem to come across positive statements about Attachment Therapy/Holding Therapy by the people who have experienced it--  except for Beth Thomas. There are lots of testimonials by parents who report great satisfaction, but when the children grow up, they don’t seem to come forward with positive comments. On the other hand, there are quite a few who have volunteered negative testimony on their experiences and outcomes.

I asked for people who have been through AT/HT to let me know if as adults they consider it to have been a good idea. One reader kindly searched for any existing testimonials, and did find  two positive comments here: http://www.deseretnews.com/user/comments/600111262/Utah-jettisons-holding-therapy.html.  But that seems to be all.

One reader argued that perhaps those who have been through AT/HT are doing very well and simply don’t want to talk about the past or have their undesirable behavior shown to strangers. That could be, of course, although confession and public display of one’s emotional problems seems to be a way of life in the U.S. today.

What I’m wondering is whether people who experienced AT/HT were ever told that that was what their treatment was. For one thing, in the past, there were various names for physically-intrusive  mental health interventions for children. One of the first practitioners called it “Z-therapy”, presumably after his own name, Zaslow. His immediate followers, like Foster Cline, called it “rage-reduction therapy” because they believed that physical discomfort could make the child so angry that his accumulated rage would drain away. The term “holding therapy” described the method used, and “attachment therapy” came into the picture as attachment theory came into fashion.

In addition to the use of different names for the treatment, another factor may apply. That is the tendency of AT/HT practitioners not to discuss the treatment with the children. Nancy Thomas, in a paper she contributed to a book edited by Terry M. Levy in 2000, advised adults not to answer children’s questions, even those that have to do with their wish to be reunited with their parents (to whom they are said not to be attached, but that’s another story)--  instead of answering, adults should say “How come you ask so many questions?” or “Why do you need to know that?” Having a monopoly on information enhances the authority and power of adults, just as physical control does, and AT/HT authors (although not conventional psychologists) have agreed that such authority is a foundation of the child’s attachment  to the parent. Parents and practitioners who took this viewpoint may have felt that it was not necessary or even suitable for children to know what their treatment was called, or any other facts about it.

Finally, it may be that people who experienced this type of treatment heard it called simply “holding”, or “holding time”, or more recently Prolonged Parent-Child Embrace. These are terms used by Martha Welch, a practitioner who used methods similar to AT/HT but came to them from a somewhat different theoretical position.

If you or someone you know recalls any of these terms used about a treatment you underwent, and if you feel that the treatment worked well, I’d like to hear about it. If you don’t remember any of these terms, see if you remember any of these factors or experiences in a childhood mental health intervention:

1.      You were adopted and were said to have either Reactive Attachment Disorder or “Attachment Disorder”, or to be at risk for developing one of those if you were not treated.

2.      Your treatment involved being physically restrained against your wishes. You may have been lying with your head and shoulders in someone’s lap and one arm behind the person, or an adult may have lain on top of you.

3.      Your treatment included being tickled or prodded uncomfortably by the therapist.

4.      Your treatment included following commands for physical movements such as kicking your feet or doing push-ups or jumping-jacks.

5.      Your treatment included being told to make sustained eye contact with your therapist.

6.      Your treatment included being told to shout that you wanted to kill your mother, or similar statements.

7.      Following a treatment session, you may have been encouraged to sit in your mother’s lap and be fed sweets by hand.

8.      You may have spent time between sessions not with your parents but in a therapeutic foster home, where you had tedious chores to do and a minimum of play or free time.

These are some basic characteristics of AT/HT, although treatments by different practitioners differed in some ways. If you or anyone you know had experiences like these in childhood, chances are that you were receiving AT/HT treatment. I’d very much appreciate hearing from you if you did have such experiences and if you thought they were an effective mental health treatment.

If you considered the experiences bad, of course it would be of interest to hear from you, too. 

Putting "Nasty Tastes" in Child's Mouth: A Charming Idea, I'm Told


Well, gentle readers (and belligerent readers too), there’s just no telling what you’ll find in your morning’s e-mail, is there? This morning I received this link: http://www.nanny.net/blog/10-nasty-tastes-sometimes-used-to-discipline-kids/  It was sent by one Debbie Denard, who said she thought my readers and I might find it “charming”.

The post is just exactly what it says. It recommends the use of lemon juice, vinegar, Tabasco sauce, soap, pepper, and other substances, inserted into a child’s mouth as punishment (not discipline) for thumbsucking, nail-biting, biting other people, and general disobedience. The author notes that some people think “hot-saucing” with Tabasco is child abuse, but she thinks it’s okay if you don’t do it “too often” or with “too much” hot sauce (appropriate frequency and amounts undefined). She also refers to the use of most of the items as addressing biting or “bad word” problems, but Tabasco as a general treatment for disobedience. She believes such treatment is a better idea than spanking.

Guess what. There are few things I find more un-charming than this kind of advice being given in cold blood and the apparent conviction that these are normal and desirable ways to treat children.

I don’t deny that people--  even those who ought to know better—use these methods. The day care center at a Pittsburgh area YMCA was investigated a few years ago because staff had punished young children by putting alum powder in their mouths (www.post-gazette.com/pg/09017/942536-455.stn). In addition to using hot sauce or similar noxious substances, others have forced children to eat or drink as a punishment for disobedience--  a box of Oreo cookies coated with hot sauce, or a large amount of water, the latter of which figured in the death of Cassandra Killpack in Utah some years ago. (Cassandra was receiving Attachment Therapy, by the way, and this method was said to have been advised by her therapist).

I do say, however, that it’s time to stop these dangerous and ineffective practices, and especially to stop suggesting them to people looking for advice on line. (Ms. Denard, I’m talking to you.)

Why stop? Why is this method worse than spanking with the bare hand, which I’ve argued is not necessarily the root of all evil?

Here are some reasons:

  1. You might be able to slip something noxious into the child’s mouth the first time without resistance, but after that it will take a fight to accomplish. That means that there are in fact two major parts to this action: the child’s fear and distress when driven to fight back against an adult attack, and the real discomfort caused by the substance. Both parties become angrier and more distressed as the struggle goes on, and as feelings run higher neither will be able to focus on what is being taught or learned. (Note the post author’s glee over the fact that putting pepper on top of lemon juice makes it very hard to get free of the pepper.) Or is the idea that one person will hold the child while the other puts the hot sauce in? Yet, you know, I’ll bet many people who do this consider themselves authoritative rather than authoritarian.
  2. Adults like a bit of hot sauce with food, and some even make it a bit of a contest who can eat the hottest food. But the fact is that a little hot sauce with food is interesting because it gives a sort of controlled burn. The undiluted sauce on a child’s tender mouth and tongue causes actual burns, which will take a while to heal. And, what would you think would be the result if a thrashing child inhaled some of this stuff? This is not just an unpleasant taste.
  3. Are bad words really so bad that pain is necessary to stop their use? And can’t you think of any other method?  Children use “bad words” as imitation of adults, because they’ve never been instructed about what words to use and when, or because they don’t have vocabularies to express themselves. You can work on all those without putting soap in their mouths.
  4. When the post author recommends “nasty tastes” for biting other people, the implication is that the children are toddlers or young preschoolers. At that age, children bite out of frustration and the lack of social skills to work out conflicts with other children. Guide them to use words and take turns, and watch carefully so you can intervene before tempers get to the biting stage; you’ll see that biting incidents diminish. If the child is older than preschool age and has some handicapping condition, the same suggestions apply. If  the child is older and has no physical handicaps, but still bites people, there may be a need for psychological or psychiatric care.
  5. The post also recommends “nasty tastes” for thumbsucking. Until the permanent teeth come in, thumbsucking is not a problem. When they do come in, and if they are being distorted by the pressure, dentists can provide a device that breaks the suction and takes the “oomph” out of thumbsucking, usually to the gratification of the child, who would like to stop.
  6. A general issue about the use of punishment is that when caregivers see that their punishment is unsuccessful in changing behavior, they often can think of nothing but how to escalate the punishment. This is highly counter-productive. For both punishments and rewards, the best learning occurs with small doses. Intense punishments cause so much anger, fear, and distress that the child’s ability to learn is lessened, and he or she remembers the bad experience--  but not the desired behavior change.
      
  7. A final point: are you going to be the person to give the child medicine? How easy do you think that will be when you’ve taught her to associate you with painful and scary attacks on her mouth?

No, charmed I’m not. And I hope that people training to be nannies are not taking this kind of advice from nanny.net.

Sunday, March 18, 2012

Attachment Therapy: Where Are the Testimonials From the Children?


It’s been a long time since I posted anything about Attachment Therapy on this blog. For those of you who don’t remember or never knew, Attachment Therapy, also known as Holding Therapy, is a physically-intrusive mental health intervention presented as a treatment for disorders of attachment. It has most often been proposed as a treatment for adopted children whose moods and behavior are difficult for the adoptive parents to accept. Although many conventional treatments can be described as “attachment-based” therapies, and most mental health interventions for children focus to some extent on relationships, Attachment Therapy/Holding Therapy (AT/HT for short, or just AT) is a term that refers to an unconventional, non-evidence-based treatment, one that belongs to the complementary-and-alternative-medicine (CAM) category.

Two colleagues and I described AT/HT in detail in our book Attachment Therapy on Trial (Mercer, Sarner, & Rosa; Praeger, 2003).  We discussed the poorly designed research that has claimed to support the effectiveness of AT/HT, as well as a number of child deaths associated with the method. We pointed out that AT/HT would probably not kill any healthy child, but that attitudes and beliefs connected with the method have led parents and therapists to push the treatment in ways that have proved fatal. Michael Shermer has referred to this very accurately as “death by theory”.

When I get into arguments on this blog--  as I did some months ago with supporters of Nancy Verrier’s supposititious “primal wound” concept—I’m usually the one arguing in favor of systematic research that can provide a reliable evidence basis, and the opponents are claiming that individual experiences are the measure of whether a concept is true or a treatment is effective. I don’t think the latter argument is true, but today I’m going to come and play on that side of the field. I want to ask people to tell me if they as children experienced AT/HT and believe that it had a positive effect on their mental health. Even if your experience was not with the bad old, intrusive, painful AT/HT, but with the “kinder and gentler” version claimed by ATTACh following the death of Candace Newmaker in 2000, I’d still like very much to hear about it if you can give a positive testimonial.

Here’s the thing: I’ve come across a number of people who have reported bad experiences with AT/HT. Some are reluctant to speak out, possibly because in the course of their long treatment they received little education and are self-conscious about telling their stories. Others simply want to forget it all and get on with their lives. One young woman spent several years contacting survivors of the treatment and posting their story on her web site; she has now dropped out of sight, but conversation with her revealed the terrible mark of her memories of her experience. Another young woman, who had managed to go on for some years without thinking about AT/HT, began to have disturbing memories after a relationship ruptured, and was eventually treated for an anxiety disorder at a University of Pennsylvania clinic. The “Invisible England” blog reports the experiences and outcome for a young British man who was subjected to AT/HT for years.

But where are the positive testimonials? On a number of web sites, including jl10ll.wordpress.com/2010/10/30/children-of-rage/, I find references to Beth Thomas, adopted daughter of Nancy Thomas, a strong proponent of AT/HT thinking, a “therapeutic foster parent”, and a parent educator who runs camps based on the AT/HT philosophy. Beth is described as having been a terrifying child, sexually vicious, cruel, and unpredictable. Now, having gone through the AT/HT program, she is a registered nurse and goes on the lecture circuit with her adoptive mother--  no longer a “child of rage”, but an “adult of admiration”. The site I just mentioned, by the way, also refers to Mary Bell, a British woman who as a young girl killed and mutilated a little boy. Maltreated by her mother from birth, Mary Bell was mistreated in the juvenile facility she was sent to and later was raped while incarcerated. She served a further sentence as an adult, during which time she read and thought deeply and expressed great remorse at her actions. Mary Bell never received AT/HT, but for some reason the site classes her together with Beth Thomas as a former “child of rage”.  

All right, suppose that all that has been written about Beth Thomas is true, and she feels she owes it all to AT/HT methods. Where, then, are the others who feel they have benefited from the AT intervention? I mean, where are the people, now adults, who as children were treated with AT/HT, and who now come forward to say it was a marvelous idea?

I don’t want to hear from the adoptive parents who think AT/HT is fine. After all, the criterion is personal experience, yes? There are plenty of adoptive parents who are ready to say the treatment is a big help. Rachel Stryker’s book The Road to Evergreen quoted a number of people who felt that the treatment had been effective even though their children were in residential care; the parents said it had helped them become a family, and they were still a family with their children elsewhere, “loving them at a distance”. The same attitude shows up at http://www.findinghopefoundation.com/blog-2, where a mother describes how she looked forward to having her adopted daughter go into respite care, and how long it’s been since the daughter lived at home--  but it’s okay, because now she Has Hope--  for what, it’s not too clear. And there are plenty more blogs where adoptive parents tell what a big help AT/HT in various forms has been to them.

It’s the positive testimonials of people treated with AT/HT methods as children that I want to see. And to help me and everybody be sure it’s really you and not your parent or therapist pretending to be you, maybe you could explain whether and where you’ve ever spoken up before--  and if you haven’t, why not.

    

Monday, March 5, 2012

Demon Attributions in the United States


In several posts about Helen Ukpabio and children’s deaths following accusations of witchcraft and demon possession, I’ve focused on beliefs that African Pentecostals encourage. Child deaths related to witchcraft and demon accusations have occurred both in Africa and among African immigrants in the United Kingdom. Using Dr. Rosalind Hackett’s work as a source, I also discussed the role that certain postulated spirits play in African Pentecostal life, and the value of such malevolent spirits in contributing to the worldview that emphasizes “spiritual warfare” between good and evil.

However, the fact that some Africans mistreat or kill children because they believe in demon possession does not mean that all non-Africans are free of this dangerous assumption. Children in the United States, too, have died during attempts to expel the demons that were thought to infest them. One recent case, discussed at http://childmyths.blogspot.com/2011/12/faith-based-child-abuse.html , involved a recently-adopted 4-year-old, Kairissa Mark, whose adoptive father referred to her as a “demon child”.

Publications about expulsion of demons are easily available through Amazon and other source. For example, “Deliverance for Children and Teens”, by Bill Banks, was published in 1985 and reissued in 2008. “A Manual for Children’s Deliverance”, by Frank and Ida Mae Hammond, originally published in 1996, was reissued in 2010. (The term “deliverance” in these titles refers to the expulsion of demons, which the authors consider to be responsible for many childhood problems both trivial and serious.) Numerous websites profess problems that occur when demons attack children--  which, it is said, they may do through no fault of the child, but because a parent or even grandparent deviated from strict rules about sexual behavior or trafficked with the occult by using a Ouija board or an “8-ball”.

A recent youtube production, http://www.youtube.com/watch?v=kIPkjOF-dCQ&feature=related, was mentioned on the “Little Prince” adoption and Reactive Attachment Disorder website, and was accompanied by enlightening comments about the role demons are thought to play in a child’s development. (Please let me point out, though, that the video and comments are now said to have been taken down by the maker, so there’s no way I can arrange for you to check my accuracy here. My thanks to Linda Rosa for pointing these out; I didn’t move quite fast enough to see the video.) Here are a couple of the comments (verbatim):

@BlessedBlessedinHim said: If that was happening to me I would get spiritual help immediately there may not be nothing wrong with your child. Demons are real, and can enter children who are not baptised, and have not made the decision to repent they are open to demonic harm. I have seen these things myself so no matter what anyone says I will never be convinced they are not real. Maybe this is real to you? This is something a doctor can’t cure your child appears normal otherwise.

@Retro80Lady30 said:  I agree. some things are caused by demons and do believe that a child can be influenced by such things.. Our son has healed immensely but it has taken years of prayers and showing unconditional love. I do not believe the whole cause of Rad is demonic influence ..oe these children are hurt, traumatized, and angry from having no control … they need healing and sometimes healing does not come instantly.. In that case God gives us what we need in order to parent and love these children..

These comments demonstrate that it would be a mistake to think of demon possession beliefs as “what people used to think in the Middle Ages” or “what some people think in Africa, not here”. People living in the United States, Canada, the United Kingdom, and no doubt elsewhere are on this very day attributing children’s behavioral, mood, and physical problems to possession by demons, and are seeking deliverance practices as cures for seizure disorders, ADHD, schizophrenia (a specialty of the Hammonds, who believed the word meant multiple personality), and, as we saw above, Reactive Attachment Disorder. Believing that deliverance can cure these problems, the adults are likely to avoid conventional medical and psychological treatments for these treatable problems.

I have had a long love affair with the First Amendment, but as time goes on my passion is turning to ambivalence. The problem is the difficulty in discriminating between the right to hold certain beliefs and the right to act on those beliefs in ways that affect other people. We tolerate  a belief in polygamy while simultaneously forbidding polygamous marriages. But it’s much harder to tolerate a belief in demonic possession of children while forbidding neglect of appropriate medical and psychological treatment, because we can’t foresee that neglect or detect it immediately. The tradition of the “family veil” prevents authorities from investigating what families do to children, unless it has become clear that a child has been harmed, and rightly so--  we would all be frightened if investigators (not necessarily knowledgeable ones) could come into our homes at a whim. Public and private schools used to provide a layer of protection for children whose parents’ beliefs were dangerous, but the rise in unsupervised homeschooling has removed that protection for many children.

Where do we go now? Is it possible to protect children from belief-based abuse and neglect, without instituting a force of Childrearing Police? When inappropriate action flows from beliefs, what ideas should we tolerate?  I can’t answer; I can only repeat that children in the United States have died from exorcism practices, and that the belief in demon possession of children is still very much with us.






Thursday, March 1, 2012

Another "Child Witch" Tragedy, and Some Explanation of Those Mermaid Spirits

**The child witch issue: If you have the stomach for it, you can see a documentary about accused African child witches at www.veoh.com/watch/v1963403396SNnb35?h1=Saving+Africa's+Witch+Children, or, if this doesn't work, Google Saving Africa's Witch Children documentary. It's tragic, pitiful, and deeply disturbing.**



Not long ago, I commented on the invitation of Liberty Gospel Church in Houston to the Nigerian Pentecostal minister Helen Ukpabio to visit and carry on a “mammoth deliverance”. Ukpabio’s history of accusing children of witchcraft and exorcising them, as well as the deaths of some children accused of being witches, would suggest that her influence is not needed in the United States. A petition at change.org is in agreement with that suggestion and asks the President to deny entry to Ukpabio. Among others, the American Professional Society on the Abuse of Children has also written to the State Department about this matter. Ukpabio’s visit to Houston has apparently been delayed, in any case.

In London, where exorcism has injured or killed other African children, a Congolese couple has just been convicted of killing the woman’s 15-year-old brother in the course of an exorcism or “deliverance” in December, 2010 (http://www.bbc.co.uk/news/uk-england-london-16444602). The boy was tortured and finally drowned as he was accused repeatedly of sorcery. The couple had previously practiced “deliverance” on a friend by making her cut her hair and fasting for three days.  Although many in the United States think of exorcism as being carried out by a clergyman, with appurtenances like holy water and a cross, in fact those Christians who accept the idea of demonic possession also generally accept that any believer can perform an exorcism. (A 1972 report of the Church of England, edited by Dom Robert Petitpierre, even said that a non-believer can do it by using the name of Jesus.) This means that it is a mistake to assume that “deliverance” practices are the work of trained and educated clergypersons who have the good of their “client” at heart; as in the London cases, these practices may be performed by those who have no understanding of physical or mental illness, or whose motives are malicious.

It’s for these reasons that people concerned about children’s welfare have asked that Helen Ukpabio be excluded from the United States.

Another aspect of Ukpabio’s “mammoth deliverance” in Houston has been puzzling to readers, and appeared so even to the Nigerian Sahara TV interviewer who discussed the Ukpabio visit with the pastor of the Houston church. This was the reference on the advertising flyer to the help Ukpabio could offer people under attack by “mermaid spirits”. The Sahara TV interviewer asked whether these were to be found in the Gulf of Mexico, while others simply said “mermaid spirits??”. An article by the religious studies scholar Rosalind Hackett, of the University of Tennessee, clarifies the “mermaid spirits” issue (web.utk.edu/~rhackett/mwucla.pdf). According to Hackett, the people of the Nigerian city of Calabar traditionally were under the protection of aquatic spirits who could give blessings, fertility, and forgiveness. These spirits preferred light colors of skin and clothing, and albino girls were sometimes sacrificed to them (similar to current practices of using albino children, or their body parts, in sorcery). Among, or perhaps ruling over, these water spirits was “Mami Wata”--  not a mermaid in the usual sense, but perhaps imaged as one because of European pictures. As Hackett says, “These stories of spirit-human relations provide insight into the contested images of water, women, and misfortune. Addressing perennial concerns about wealth and sexuality, they find new life in the worldviews of modern pentecostal Christians with their elaborate and vivid spirit [imagery]—that of a dualistic world inhabited by warring spiritual forces.”

Mami Wata may possess a person and cause mental illness, or may make women infertile. Other personal water spirits, Hackett says, may “seek out a ‘spouse’ and reward the person with worldly success but deprive them of progeny and happiness in marriage.” According to Hackett, belief in the water spirits has diminished for members of mainline churches. However,they are of great concern for Pentecostals. Hackett quotes “well-connected” Nigerian friends as claiming that “the newer churches are perpetuating, if not reviving, beliefs in aquatic spirits as sources of people’s problems, and that the appropriate spiritual remedies” are advised. Church members are made to change their names if they have a name that is associated with water spirits, and their parents are blamed for having “satanic” connections if they have used one of these names. This concern goes as far as suspicion of any church that baptizes in water that is not clear to the bottom.

Hackett raises two issues about the marine spirit beliefs: “First, the fact that these ‘marine agents’ are now able to penetrate the hallowed and presumed safe territory of the pentecostal church  generates new fears and new quests for protection. As I was told in hushed tones by one deliverance specialist, so sophisticated are some of these newer ‘manifestations’ of Mami Wata as virtuous church virgins, that they can manipulate through their… charms not just the bodies but also the minds of men. He added that this type of spirit is the most dangerous and deceitful, and attacks pastors only. [! J.M.] Second, the maintenance, if not resurgence, of Mami Wata beliefs in these new religious contexts may be linked to millenialist claims that the increase in the number of ‘Jezebels’ inviting the people of God to compromise with the world is ‘part of the operations of Satan and his demons in these last days’.”

Hackett’s description shows us how important evil spirits are to believers, and makes it plain why some “deliverers” may feel moved to go too far when they think a child is a sorcerer or demon-possessed.   My question: is Houston waiting for Helen Ukpabio to bring them news about “mermaid spirits”--  or is that belief already firmly in place?