Concerned About Unconventional Mental Health Interventions?

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

Thursday, May 1, 2014

HuffPo Spreads Garbage About Reactive Attachment Disorder

The Huffington Post has once again posted a story that is startling in its inaccuracy, but perhaps not surprising in its blatant appeal to sensationalism. Like many such stories, it is about BAD CHILDREN Who Might Kill You, and although it does not specifically say you’d better attack them first, such is the implication of the story. I refer to the description of Eric Kinzel’s family at http://www.huffingtonpost.com/2014/04/23/reactive-attachment-disorder_n_5199552.html, starring that darling of Focus on the Family and the Westminster dog show, Nancy Thomas.

The HuffPo story purports to tell about two adopted children, both of whom had been badly neglected and one of whom was afflicted with a “rare disorder” associated with the absence of emotional attachment, Reactive Attachment Disorder. Local practitioners identified the disorder and told the father that without treatment the child would become a psychopath. Nancy Thomas, a “therapeutic parenting specialist” (i.e., a foster parent) later stated that the disorder came from fear of abandonment and created “destructive instincts”. The child was eventually removed from the Kinzel family.

I want to note some claims made by participants in this program and comment on each of them.

  1. Reactive Attachment Disorder is easily diagnosed by means of a checklist. On the contrary, there is no validated method for diagnosing Reactive Attachment Disorder, particularly for children past toddlerhood. (Unusual social behaviors may combine with past history to suggest this diagnosis in children who have not yet developed more mature social skills.) The checklist referenced by Nancy Thomas in the HuffPo program is in fact derived from a much older list that was supposed to identify whether children masturbated (!). It is also associated with the Randolph Attachment Disorder Questionnaire, a paper-and-pencil test (to be answered by parents, not children) devised by one Elizabeth Randolph and never subjected to the serious validation work we demand of diagnostic instruments. The criteria mentioned by Thomas are highly subjective, by the way: that the child is “charming”, “has no conscience”, and does not make eye contact “except when lying”; a parent convinced by Thomas (who is remarkably charming herself) can easily see these characteristics in almost any child.
  2. Reactive Attachment Disorder is associated with psychopathy. The claim that children diagnosed with Reactive Attachment Disorder will grow up to be psychopaths/serial killers (as exemplified by Hitler and Ted Bundy) is a commonly made by proponents of the alternative psychological theory of attachment espoused by Thomas and others. This claim is simply PFA--  Pulled From the Air. Many serial killers are known to have been neglected or abused children, but the great majority of these unfortunate children do not become psychopaths. Even if all serial killers were known to have been neglected or abused--  and this is NOT known—it would be a fallacy to state that all such children become psychopaths. (And, by the way, I am not claiming that psychopaths and serial killers are the same thing; I’m just borrowing the language of Thomas and her friends.) Incidentally, reports from the English-Romanian Adoptees study show that children who might actually have been diagnosed with Reactive Attachment Disorder as preschoolers were in fact outgoing, sociable, and popular as adolescents.
  3. Reactive Attachment Disorder is present at birth. Kinzel reported being told that “when a pregnancy is not wanted, the woman’s body puts out different chemicals than in a wanted pregnancy. And even before the baby is born they can have RAD.” Certainly the stress of an unwanted pregnancy can cause hormonal differences, but so can any other form of severe stress; is the claim that all stressed pregnancies, including those where the father is deployed with the military or where another child is seriously ill, will cause Reactive Attachment Disorder? This is difficult to fathom (and am I the only person who is reminded of that statement about women’s bodies being able to prevent pregnancy if they’re raped?). In addition, all the established information about attachment shows that attachment of a baby to a parent is not present at the time of birth, but develops gradually and is demonstrated only in the second half of the first year. No attachment, no attachment disorder, this would suggest; therefore, no Reactive Attachment Disorder at birth. To claim that an unborn or newborn baby is aware of a mother’s rejection is essentially to range oneself on the side of the Scientologists and the primal therapists, not on the side of child development research.
  4. Reactive Attachment Disorder can occur because of events after the toddler period. Kinzel also says he was told “Usually a psychopath is damaged before 3. But RAD can be at any time.” There is no question that neglect, abuse, and unpredictable living conditions or custody can distress and disturb children of any age, and adults too, for that matter. Older children who are ill-treated will be angry and depressed and may well learn by imitation to be cruel to others. However, Reactive Attachment Disorder is a disturbance of a basic social behavior that involves a preference for the company of familiar people, especially in threatening or stressful conditions. This social behavior typically changes dramatically after the preschool years, as children learn social skills and advance cognitively so that they can tell real threats from “scary” ones. Even ill-treated children continue to develop in this way. The idea that Reactive Attachment Disorder suddenly “strikes” an older child is reminiscent of Jenny McCarthy’s claim that she saw her son’s soul leave his eyes when he was vaccinated.
  5. Reactive Attachment Disorder involves failure of cause-and-effect thinking. Now, this one is a pip. I have no idea where Thomas et al picked it up, but it sure sounds scienterrific, doesn’t it? I won’t even get into the fact that cause-and-effect thinking is present  even in babies a few months old and would be necessary for the learning of language, for play even at the peek-a-boo level, and for holding a bottle (but, of course, Thomas says not to let them hold their bottles, because they might not learn that parents are the only authority and source of satisfaction). What Thomas and the gang really mean, I think, is that children who are diagnosed as having Reactive Attachment Disorder by quasi-professional therapists are usually in the office to begin with because their parents haven’t managed to get them to be obedient or compliant. This situation is described by saying that they don’t connect bad behavior with punishment because they haven’t got you-know-what. But wait! These are the same children who are falsely charming and manipulative in order to get their own way--  so don’t they understand that being charming causes the effect they want? It seems they have cause-and-effect thinking and don’t have it at the same time, depending on what they’re doing and what the alternative therapist wants to explain. (But although she doesn’t say so publicly, I have to wonder whether Thomas thinks demons make them do it.)

It was a pity, really, to put Kinzel out in the limelight like this. He was either confused by the situation, or he can’t tell the difference between “conscious” and “conscience”--  though this may be the result of being talked at, at length, about his “psychopathic” adopted child. But of course the real point of this program was to advertise Thomas and her empire of therapeutic foster care and camps. I noticed no reference to the fact that a few weeks ago the American Psychological Association cancelled the continuing professional education credits that were supposed to be earned by attendance at one of Thomas’s lectures. (I have the e-mails to show this, so there’s no point coming after me with lawyers.) Some of us are watching the titans of the RAD biz, but whether we can fight their commercial power successfully, I don’t know. HuffPo is no help--  that I do know.


25 comments:

  1. Nancy Thomas uses adopters desire to blame the children or circumstances. Child does not want to obey and love ...... and she blame the child. Ostensibly It is necessary to treat the child but the adopter is always right. I think the logic is very simple. Customer is always right. Adopter pays money mean he's always right. Money is the main reason for the reluctance to understand the child. At least it is necessary to try to keep netralitet. Tend to blame both sides and improve both sides of the conflict. We must proceed from that. Although ...... it would be more productive to use common sense adopter if it is present.

    ReplyDelete
    Replies
    1. Unfortunately,common sense is not very common!

      Delete
  2. "Usually a psychopath is damaged before 3."

    I really, really hate the word 'damaged' applied to human beings. As in damaged goods? Not only is this unscientific, but it seems to a disturbing worldview. What, either children are perfect or they are less than human? What a message for parents... Or for people who survived abuse, abandonment or deprivation and grew up into fine adults, decent and loving and all that.

    ReplyDelete
    Replies
    1. And even if they didn't grow up "fine", they have a right to be here, just like the moon and the stars.

      I believe that the real thinking behind this has to do with damnation and redemption more than with any psychological concepts.

      Delete
  3. What's even scarier is the sub-group of self-proclaimed "trauma mamas" -- adoptive moms who claim their kids have RAD based on the frankly made up lists of "symptoms" you refer to, i.e. ones that do not line up with the "official" RAD symptoms in the DSM.

    The trauma mamas ignore sane advice while adopting -- like that it's not a good idea to simultaneously adopt 5 unrelated, high-needs, special needs from Haiti, all out of birth order.

    Which is exactly what Lindsay Crappo did circa 2010:

    http://homeasoftplacetofall.blogspot.com/2012/03/evil-siamese-twins-attachment-vs-trauma.html

    Gee, I wonder why Lindsay's adopted kids are having a hard time adjusting? There aren't enough hours for her to give adequate attention to each of her NINE kids!

    In the post linked to above, Lindsay justified pulling one of her adopted kids from a special needs kindergarten taught by specially trained teachers (Master's degrees in social work + teaching credentials) because her adopted kid suckered them in to giving her extra snacks. And that RAD is somehow to blame for her kid:

    - managing to get extra snacks: My loved-from-the-second-she-was-conceived, never for a minute deprived of *anything* kid spent half of *her* kindergarten year eating a *second* breakfast at school; she figured out the Head Start kids got donuts in the classroom next door. Katie unabashedly told her teacher, once she was caught, that donuts were yummier than what she got for breakfast at home. (True -- my kids eat cereal most mornings; chocolate-frosted donuts 5 days a week is not gonna happen)

    - occasionally running away from her teachers instead of waiting politely in the pick up line. Her kid was 5 at the time. That's normal behavior.

    ReplyDelete
    Replies
    1. Points well taken! First of all, these multiple adoptions of special needs kids create "iatrogenic" or perhaps "mamagenic" problems by raising everyone's stress levels and minimizing the time and energy to give to each child. (And how this is different from an orphanage, I'd like to know...)

      Second, once people have internalized the RAD checklist, virtually every typical kid behavior gets interpreted as yet another sign of a condition that can be handled only with radical authoritarianism.

      Delete
    2. And telling them to catch her. Does she remember how fun that was when you were five?

      In elementary school I got multiple lunches because everyone knew if you didn't want something I'd eat it. And I got three meals a day and two snacks. But while my family knew I got more lunches, they didn't care.

      Delete
  4. Melanie Hollis is another deranged “trauma mama” who claims that “30-35% of children adopted from other countries… struggle with attachment issues”. She also claims that Natalie (who has FASD and was adopted from Russia as a toddler) somehow developed RAD at age 12-13 (!) based on the following “symptoms”.

    Every single symptom is pretty much what you’d expect in a kid with FASD. If you set aside #6 and #9, you’ve got a description of a typical, if somewhat highly strung, teen.

    Supposed RAD symptoms:

    "1. Wrestling with school work = Probably a learning delay
    2. Temper tantrum = She is high spirited, that's all
    3. Wanting her own way = The classic strong willed child
    4. Stubborn = Give her credit, the girl knows what she wants
    5. Obsessive Compulsive = She likes things orderly
    6. Lies = Lot's of kids tell lies, but they grow out of it
    7. Binging on food = Her body is growing
    8. No impulse control = She's just immature for her age
    9. Unusual speech patterns = Her first three years were spent in an orphanage where no one spoke to her, so I shouldn't expect too much. "

    Melanie shipped her daughter off to an unlicensed “ranch”-style boarding school on the basis of these RAD symptoms for a YEAR. TWELVE MONTHS. Horrifying.

    Why do people do this? Why the heck doesn’t somebody call CPS to report idiots who ship kids off to unlicensed ‘schools’, which have ZERO licensed healthcare providers on staff??

    Even if Natalie did have RAD (a serious mental illness), sending her to a school with no doctors/nurses/therapists, accomplishes, what, exactly? The kid is exiled to a place that CANNOT treat her mental illness!

    The part I really, really don’t get is that if Natalie, say, fell and hurt her leg and her mom took her to ANYPLACE THAT ISN’T A HOSPITAL WITH DOCTORS ON STAFF for treatment, she’d be charged with child neglect. Period. But sending a kid with a mental illness to a place with NO DOCTORS ON STAFF is somehow okay and NOT child neglect. Grr.


    http://the30dayjourneyforhope.blogspot.com/2014/05/identifying-reactive-attachment-disorder.html

    ReplyDelete
    Replies
    1. "Grrr" is so right!

      As to how people can do these things unchallenged, I suppose the real answer is that adults have rights, and on the whole children don't. Remember that the U.S. has not ratified the UN Convention on the Rights of Children. In addition, we have under common law the idea of the "family veil"-- that unless a problem is visible to an outsider, the state cannot interfere with what goes on in a family. And I freely admit that it might be just as bad to have the kind of state interference that could occur without the family veil, as the kinds of family problems that occur with it. After all, we have plenty of evidence that CPS employees may accept the whole alternative RAD theory.

      I don't know what the answer is, but we need to keep telling people the facts about child development and child mental illness. Maybe, maybe, we'll have some impact.

      Delete
    2. My understanding is that our government cannot sign on to that treaty, even if we wanted to -- because Texas barbarically subjects kids and the mentally ill to capital punishment!

      Delete
    3. As I understand it, the resistance to the UN convention also involves our practice of allowing 17-year-olds to enlist in the military.

      Delete
    4. Carlee....really? Natalie was at a licensed therapeutic boarding school,is back home, and is doing GREAT! Why do you believe remaining in a home, surrounded by what is triggering behaviors, is always the answer? Kids are not all alike, and in our case, Natalie needed (was begging for) some space. Because of people like you, who are quick to attack anything that falls outside of what you deem to be "normal", I fought Natalie on the idea of getting help (away from home) for a long time. Had I listened to HER, instead of to people like you, she would've been able to resolve her anger much sooner. She has come home with no fear...with no anger...and is excited about her life. She would tell you the time away gave her the chance to deal with her adoption/abandonment. I feel so good about our decision and would encourage adoptive parents to LISTEN to their children without thinking they've done something wrong....life is not always all about us....sometimes people just need a break! Natalie loved her time at the school, made friendships with girls who were just like her, caught up on all of her schoolwork, and learned how to care for some sweet horses. Her experience at the school built her confidence and allowed her to grow on her own terms....we spoke and wrote to one another regularly while she was there....so I felt a part of the process too. The long term, doctor driven, treatment centers were our first avenue since that is what the medical community recommends....but those places, Natalie says, did more harm than good. I'll be writing more about it all on my blog, which I know you follow, so how about giving it a chance and try to use your voice to help families like me and kiddos like Natalie instead of throwing hate and vitriol. Honestly....you are over the top!

      Delete
    5. You know, disagreeing with someone is not the same as "throwing hate and vitriol".

      If the problems you are dealing with actually have to do with attachment, as is so often claimed, it's hard to see what the rationale is for sending the child away from the existing attachment figures. On the other hand, if something happening in the home is a "trigger", there seems to be a choice between removing the child from the home, and altering the "triggering" situation, which may include highly resistant parent attitudes.
      And, of course, if there are already excessive numbers of children in the home, it may be very difficult to change problem factors.

      Whatever the case may be, the answer is in analyzing all the factors in a given child's situation. There's no one-size-fits-all here. Cheerleading for a specific method is a good way to engage a lot of readers but does not move us forward toward improved child welfare.

      If a treatment works well for one child, there is no guarantee at all that it will work for other children. In addition, the fact that someone is "better" after an experience than before does not show that the experience necessarily caused the improvement. This should be kept in mind while cheerleading.

      BTW, I always feel suspicious when someone refers to "kiddos". Is this not just the contemporary version of RADishes?

      (Kindly forgive the organization of this statement-- I'm playing Scrabble with grandchildren at the same time!)

      Delete
    6. Melanie -

      The RAD "symptoms" you describe are pretty much the symptoms of FASD - and, as Jean points out, it's hard to imagine how spending less time with her family will help Natalie "attach" to said family.

      I also find it interesting that Natalie's totally typical for a teen (and teen with FASD) behavior resulted in you kicking her out of your home for a year to a place without on-site doctors -- but when your biological son Caleb was expelled from school for bullying and repeated internet taunting/bullying/threats against other kids you let him remain at home. You defended him as a great kid, that online threats are "no biggie" -- and didn't even discipline him for his out of line and vile behavior.

      Your little biological daughter Hope -- who's like 9 years old and has Down syndrome but cannot speak? Or use a fork? Or do anything but grunt and tantrum? Who gets to live at home? Whose bad behavior and lack if basic skills that you blame on DS... despite the fact that the MANY MANY kids, the overwhelming majority of kids, with DS are able to eat with forks and write their names at age 9??

      Your biokids stay home, regardless of how atrocious their behavior is. Bad behavior you ENABLE .

      The adopted kid, Natalie? You pathologise everything she does and kicked her out -- I'm assuming it's a strategy for keeping lil adopted charlie in line too!!

      Delete
    7. Carlee, I wasn't going to publish this because it is so personal, until I saw that Melanie had invited it. However, it would be better if neither of you used the children's names.

      Delete
  5. "Incidentally, reports from the English-Romanian Adoptees study show that children who might actually have been diagnosed with Reactive Attachment Disorder as preschoolers were in fact outgoing, sociable, and popular as adolescents."

    What does that have to be with disproving a link with psychopathy? Most psychopaths are outgoing, sociable and popular too.

    I hate the myth that psychopaths are loners. There is absolutely no truth to it - in fact, psychopaths are more likely than non-psychopaths to be highly extroverted.

    ReplyDelete
    Replies
    1. Well, that's why I said "incidentally"/ But you're right, it's not particularly relevant and I was simply tucking this bit of information into a paragraph rather than discussing it on its own.
      However, most people don't get called psychopaths until they've done something rather awful, so the research probably deals only with a small set of people who did bad things and got caught-- not the ones who might deserve the label but through chance have never committed such crimes, or at least haven't been identified when they have. That would mean that it's not really known whether they are loners or not.

      Delete
    2. Actually, a lot of research nowadays is focusing on noncriminal psychopaths. They tend to be smarter and less impulsive than criminal psychopaths, but they're no less sociable.

      Delete
    3. I'm under the impression that psychopathy is still very much an evolving construct-- isn't that correct?

      Delete
  6. I've been in therapy for almost four years now due to Reactive Attachment Disorder and PTSD from childhood. The symptoms of PTSD included numbness all over and identity splits multiple times. It's my understanding the root cause for RAD is the mother not giving the child what they need, especially love and acceptance. The child/adult with RAD subconciously hates his mother for not giving him what he needed, love and acceptance, so he has rage at his mother and wants to kill her, but if he kills her he won't get what he never got from her, so he goes out and hurts other people and himself, even up to and including being a serial killer, rampage killer, or a man who kills prostitutes. The two characteristics of RAD as I understand it is the fear of being killed and eaten. For me the killed and eaten part manifested itself in my dreams of the eaten part as being consumed by a huge black wave many, many stories taller than I. I talked to a guy the other day who'd been adopted, and I asked him if he ever thought he'd be killed and eaten. His eyes lit up and he said he used to have nightmares that a wolf was tracking him in the forest, so on one side of him a wolf is stalking him and on the other side of him was a cliff. A perfect set up for being killed and eaten. My understanding is that our prisons are full of people with RAD and they go into prison where they are less safe and the attachment issues get worse so when they get out they are more hard core than when they went in. RAD produced killings usually being around age 21, according to my understanding, because up to age 21 we are in a psychological cocoon as to what the damage our mother/primary caregiver did to us. Hence many killings are done by males in their early 20s. My brother, who also suffers from RAD, when he was around 21 or 22 he was locked and loaded with a firearm and was probably thinking about killing people. Thankfully an Sheriff's Deputy caught him and returned him home. Now I've been told he drinks massive amounts of vodka to self medicate.

    ReplyDelete
    Replies
    1. Dear Mike-- I am very sorry to hear of the disturbing symptoms and behaviors you and your brother have experienced.

      However, I think it is most important for you to realize that these are not symptoms of Reactive Attachment Disorder. RAD is a disorder of childhood, and you can read about its actual symptoms at www.cebc4cw.org/search/topic-areas/dsm-5-criteria-for-reactive-attachment-disorder-rad/ . It is not possible to diagnose RAD even in school-age children, much less in adults. I am not saying that you have no troubles-- simply that RAD is not the right name for them.

      In many ways, it does not matter what you call your disorder, as the point is for you to find help in resolving it. But I am pointing to the actual characteristics of RAD for two reasons.

      First, I am very concerned that you are spreading to other people your misunderstanding about RAD as involving violence, and as a result making adoptive parents afraid that their children will be violent. This can be a self-fulfilling prophecy, as I'm sure you will understand. When people allow their children to think that there are "RAD-produced killings", it becomes more likely that children who are told they have RAD will be violent.

      My second concern is that you may have picked up your misinformation from your therapist. If so, the best thing you can possibly do is to find a new, properly trained, therapist as soon as you can. I realize that this will be difficult for you to do as you already have a long relationship with the current therapist, but please understand that a person who has so many mistaken beliefs cannot help you. You need to find a licensed clinical psychologist or psychiatrist who will be able to help you handle not only your original problems, but the mistaken beliefs that your present therapist has apparently created.

      I look forward to hearing from you that you are taking my advice seriously and will act on it, for your own benefit.

      Delete
    2. Dear Mr. Nelson -- Thank you for posting your personal experience here.

      I thought you might be interested in this essay about RAD and something that poses as RAD:

      "RAD vs AD"
      http://www.childrenintherapy.org/attachmentdisorder.html

      Delete
    3. This is an important comparison, but Mike should also be aware that the "AD" category is not supported by systematic investigation.

      Delete
  7. I think it's not a coincidence that adoptive parents are most likely to have a child with RAD. You put a traumatised child in a loving home and they can slowly unfreeze emotionally and begin to express themselves freely. Its just so unfortunate that a lot of their deep emotions are of extreme anget and pain. I think this blog post and comments are naive to the realities of RAD. These children can be violent and dangerous to other children. The experts in the field are really trying to help these parents, not just throw up their hands when their text books don't work. I don't think that children with RAD do end up as psychopaths because the abuse has been broken and they can process their trauma somewhat, as oppose to being stuck in fear and having their personalities completely split by the time they are adults.

    ReplyDelete
    Replies
    1. Let me say it once more: there is a diagnosis of Reactive Attachment Disorder, but its symptoms are nothing like the ones you describe. To keep claiming that children with RAD are violent and dangerous because of the RAD, is like insisting on calling chickenpox "measles" and treating it as if it were measles. The advantage of doing this for the "RAD experts" is that they can claim that some work they think fixes attachment is the cure for violent and dangerous behavior.

      But I am curious as to what you mean by "having their personalities completely split".

      Delete