Concerned About Unconventional Mental Health Interventions?

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

Tuesday, December 31, 2013

Adoptive Nursing, Part 2: The Dependency Question

Yesterday I discussed some issues about adoptive nursing--  breastfeeding a child who is in one’s care but who was born to a different mother. I concluded that adoptive nursing can be valuable for the health of very young babies or others who have poor immune reactions to infection, but that it is irrelevant to the social and emotional development of the child, and relevant to mothers’ emotions only in that they may expect it to influence their relationship with a child.

Today, I want to look further into advice about early emotional development as it is given by proponents of adoptive nursing like Alla Gordina and Karleen Gribble.  These authors, as well as Gordina’s colleague Ronald Federici, propose that it is essential for adopted children to experience complete dependency on their new parents. For example, Gordina says in her PowerPoint presentation (www.wiziq.com/tutorial/693267-ADAPTIVE-NURSING-APC): “Promote dependency on you providing food for your child (hand/finger feeding by caregiver even for snacks, feeding/drinking in the breastfeeding position and/or on caregiver’s lap, bottle feeding, eye contact, etc”.  She also says (without further explanation in the PPT): “Not to give such a child a sippy cup; use a bottle with the hole as large as the child needs, slowly decreasing the opening; straw cup or a regular cup can be used too”.  Bottle-feeding for all ages is encouraged.

What is the reasoning here? Why would either breastfeeding, or continued bottle-feeding of an older child, be expected to benefit the child’s emotional development? This viewpoint, shared by Gordina, Gribble, Federici, and others, seems to be part of a naïve psychology that expects imitation or re-enactment of desirable events of early life to have positive effects, as if they had  really occurred early on. This is a form of magical thinking in which symbolic actions are “mapped’ onto actual events, and the outcome of a ritual is expected to be the same as the outcome of the real occurrence. Similar thinking can be found in various alternative psychologies and psychotherapies like the screaming and convulsing of “primal therapy” and the apparently-painful infant massage done by people like William Emerson.  

Specifically, the rationale for associating breast- or bottle-feeding with attachment would seem to be the following: Young infants who are breastfed or bottle-fed  are completely dependent on their caregivers and indeed would not survive without adult care. Such infants are still completely dependent some months later, when they start to show signs of attachment behavior to their familiar caregivers. Therefore (and here’s the tricky part), the dependency must have caused the attachment--  so, if dependency can be fostered in an older child, that child will also show attachment as infants and toddlers do. In addition, if that child can be made to appear like a dependent young child  by replicating breast- or bottle-feeding or other infant care routines, he or she will actually BE dependent, and therefore (again) become attached and show this as younger children do.

When the rationale is spelled out like this, it’s clear that it resembles the thinking behind rituals like the couvade or like spitting if someone compliments your child, so evil spirits won’t get interested.

But there’s more. Looking at remarks by Karleen Gribble (https://www.breastfeeding.ans.au/bf-info/adoption), we can see another reasoning problem behind some of the claims of adoptive nursing advocates. Gribble says: “…it is important to bear in mind that the emotional and developmental ages of a child may be very different from their chronological age and that breastfeeding can help nurture the baby inside the older body” (my italics--  JM).  This view is common among “attachment therapists” and others whose work is not evidence-based, especially therapists who are focused on multiple personalities or dissociative conditions. The concept of independent entities within a personality has many sources, but the idea of the “Inner Child” was popularized in the 1970s as part of Transactional Analysis. The posited need to care for this entity goes back much further to “wild psychoanalysts” like Sandor Ferenczi. 

The belief that some “inner baby” needs to receive care suitable for an infant is an aspect of a “parts” psychology that ignores the integration of components of any person. Of course a child may  act in some ways as if he or she is younger than is chronologically the case, but this does not mean that the child has younger “parts” that need care different from what the whole child needs. To assume this ignores the whole nature of the child, and resembles thinking that a 20-year-old with an IQ of 50 would do well in a school class of 10-year-olds with IQs of 100, or that a 15-year-old who behaves “childishly” should be given a time-out.   

An adopted 5-year-old may seem emotionally “young” or “immature” when he or she has trouble resisting temptation or tolerating frustration, but that child does not have an “inner baby” who needs special care. Instead, the child is a person with many typical 5-year-old abilities who is having difficulty mastering some emotional capacities. To treat such a child like a baby (unless this is what he asks for) is to dismiss his most mature capacities as if they did not exist, and thus to remove points of pride and the senses of autonomy and initiative that are characteristic of his developmental stage. This situation is similar to one in which the 5-year-old has difficulty using speech; high-pitched, repetitious infant-directed talk is suitable and useful for an infant to hear, but however poorly the older child may speak, he is beyond the stage when infant-directed talk  will help him, and needs support that is appropriate for his entire developmental picture.

Again, I want to be clear that I am not rejecting adoptive breastfeeding, and I believe it can be very appropriate for babies with some medical conditions or with poor immune reactions. However, the social and emotional reasons claimed for it are without grounds.

One final point: Gordina’s PowerPoint gives one piece of advice which I wish could be given to all parents, adoptive or otherwise. She says, “Not to stare on your child, while he/she is eating unless you and he/she are ready to initiate the eye contact”. I’m not too sure what that last part means, or how you would know this readiness, but I’m convinced that the anxious stares of parents have exactly the opposite effect from what’s wanted. Babies don’t like blank or frightened-looking faces and are likely to avert their eyes and avoid looking at a staring adult. If you find you are staring, try “flirting” instead--  look away, glance back, look away again, and keep smiling until the baby gets interested in you. That’s how you get relationships rolling.



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