Tuesday, February 18, 2014
Deceptive Commercial Practices and Attachment Therapy
In the United States (and in most other nations), laws prohibit deceptive commercial practices. If someone who sells refrigerators tells customers that a refrigerator is larger than it really is or that it keeps food colder, it’s possible for charges to be brought against that seller. When such charges are brought, it’s usually done by an annoyed customer-- and of course when the purchased object is a refrigerator, it’s possible for the buyer to ascertain whether the volume or the temperature are what they were claimed to be.
Laws about deceptive commercial practices apply to services as well as to goods, and to services sold by non-profit groups as well as by those that operate as for-profit organizations. However, it can be a lot harder to detect whether a service is what the seller has advertised. It can take a long time to see whether a service is effective, and in many cases a purchaser might not know exactly what the service should be like.
These problems are especially relevant to the sale of psychotherapy services. Although there are effective brief therapies, it’s traditionally—and not unrealistically-- thought that psychotherapies can take a long time to “work”. It’s also the case that most psychotherapy customers have no clear idea of what a treatment should be like, except perhaps that they’ve seen movies that included psychotherapy scenes. Therapy clients may be and remain quite confused about how they should be feeling or acting, whether a treatment is ineffective or whether their case is just much less tractable than they thought. If they feel distressed by the treatment or even think the problem is getting worse, they may believe that these are normal aspects of “healing”. They will probably not be aware if they have been attracted to a treatment as a result of deceptive material about it.
It will not surprise anyone when I say that the Internet is an ideal medium for the posting of deceptive material for commercial purposes. There are hundreds of websites advertising psychotherapies in deceptive fashions—and I am not even talking about attempting to pass off testimonials as equivalent to systematic research evidence. Some of these sites include specific claims that are easily recognized as untrue by anyone with a thorough background in psychology. When recommendations for treatment are derived from such false claims, I would say that the statements amount to deceptive commercial practices.
Let me provide an object lesson by examining a single website, http://instituteforattachment.org, belonging to the Institute for Attachment and Child Development in Colorado. Here are some statements on the home page about Reactive Attachment Disorder: “Traditional therapy only feeds it.” “Love infuriates it.”
Are these statements correct? Does traditional therapy exacerbate Reactive Attachment Disorder (whatever they mean by that, but that’s a separate issue)? There is absolutely no evidence to the effect that any “traditional” therapy-- by which I presume the authors of this material mean a cognitive or behavioral therapy—causes any childhood mental health disorder to become worse. This is a claim that has been made by proponents of Attachment Therapy/Holding Therapy for two decades. It is not only without foundation, but is a profoundly ethically questionable statement for mental health professionals to make, as it intentionally deceives potential clients. To quote the National Association of Social Workers code of ethics on the principle of integrity: “Social workers behave in an ethical manner. Social workers are continually aware of the profession’s mission, values, ethical principles, and ethical standards and practice in manner consistent with them. Social workers act honestly and responsibly and promote ethical practices on the part of the organizations with which they are affiliated.” Surely it cannot be argued that anyone is behaving honestly and responsibly by making unfounded statements that serve only for their own commercial advantage.
Now, how about “Love infuriates it” (Reactive Attachment Disorder)? To begin with, this really means nothing, as “love” is an abstract noun referring to an emotion or motivation, and it’s hard to see how a psychological disorder can be “infuriated”, any more than measles can. Presumably this really means that behavior usually interpreted as loving, like kissing, hugging, mutual gaze, or gift-giving, has a different effect on some children than some caregivers would expect or like it to have, and that if such affectionate advances are pressed in spite of the child’s obvious withdrawal, the result may be an angry interaction ending in a tantrum. But that’s not what is communicated by the website’s claim, which deceptively suggests that the fact of love for a child, not a parent’s behavior, causes the child (or perhaps the disorder, in a demonic fashion?) to become furious.
I think the deceptive aspects of this website are pretty clear already, but let’s soldier on and look at some specifics at http://instituteforattachment.org/learn-about-attachment-disorder/common-questions/#1. Hmm, this is interesting, isn’t it? The home page referred repeatedly to Reactive Attachment Disorder, which is an “official” DSM disorder, although with some redefinition in DSM-5. But here we see that the discussion is of something called attachment disorder, a term that is applied here to Reactive Attachment Disorder, oppositional defiant disorder, post-traumatic stress disorder, childhood trauma, Pervasive Developmental Disorders, and “pervasive developmental delay”. These are conventionally seen as different disorders, although more than one may be a problem for a particular individual. It is deceptive to present all of these as part of the same disorder, and especially to assign a purely speculative overarching category to them without explanation.
There are quite a few other points you may notice if you look at this page. But let me go on to one of particular interest with respect to the code of ethics mentioned earlier. Scroll down to the orange headline, “I’ve sought traditional therapy in the past. It didn’t work for me. Why?” The response is this: “In traditional therapy, the client with a maladaptive upbringing usually functions more from his frontal lobe-- the part of the brain that performs abstract reasoning. For them, traditional talk therapy tends to be more of a cognitive process. Basically, they never access and deal with their limbic-based emotions. The more intelligent the client, the better they are at defending their stored up feelings of inadequacy. As a result, they tend to get frustrated by traditional therapy.” Now, this is nothing but neurotrash talk. There is no evidence that any of this is true. In addition, it exposes this approach as a “parts” therapy that views human beings as collections of unintegrated entities (curious, because I expect the practitioners call themselves “holistic”).
One more bit, then I’ll rein myself in. Below the part just mentioned, you’ll see another orange headline: “Does my child have attachment disorder?” Here we have a good many of the same-old same-old “symptoms” of attachment disorders, promulgated by AT/HT practitioners for lo, these many years. “Lacks cause and effect thinking”! Have these people ever stopped to consider what someone would be like if they actually did not have this ability, which starts to develop a few months after birth? What they actually mean is that no matter how much people have been yelling at and punishing the kid, they have been unsuccessful in changing the behavior they find a problem. It is a deceptive practice to claim that any of the “symptoms” listed here are part of an attachment disorder, much less part of PDD, especially when by doing so the authors imply that their form of treatment can ameliorate the problem.
By the way, the outfit that has posted these deceptive statements is the one that has prevented “Eve Innocenti” (see http://childmyths.blogspot.com/2012/12/the-attachment-therapist-wears-two-hats.html) from seeing her children for some years now. As the organization sells its services to the county, perhaps there is more here than simply deceptive commercial practices that could lead to charges if a victim had legal help. Many states have “false claims” acts that punish the sale to governmental agencies of substandard goods or services. But a whistle-blower needs to report what is happening. Is there one out there?