Concerned About Unconventional Mental Health Interventions?

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

Wednesday, April 1, 2015

"Taming Tiny Tigers", by Kali Miller: A Tale Told With Trepidation

Let me note first that the trepidation I’m talking about is my own, as Kali Miller does not seem to experience any. And my trepidation is about two things--  first, whether by discussing this at all I’m simply offering some unintentional paid advertisement for a disturbing attempt at intervention, and second, how well I can untangle the ideas so well braided in a document that mingles established concepts with fantasy.

The document I’m referring to is called “Taming Tiny Tigers”, by Debra “Kali” Miller, whose psychology license revocation I described in a post a few days ago. As I noted at that time, Miller is becoming a parenting coach now that her license has been revoked for her role in the treatment that culminated in a 12-year-old’s suicide attempt. As a coach, she will still be in a position to use the advice she has given in “Taming Tiny Tigers” (http://c.ymcdn.com/sites/opa.site-ym.com/resource/resmgr/imported/E1%20Handout.pdf).

“Taming Tiny Tigers” is an excellent example of the Trojan Horse approach that brings unsubstantiated ideas into discussion under the cover of established information. For example, Miller provides some accurate (though not particularly relevant) material about brain development. She also quotes directly the diagnostic criteria for Reactive Attachment Disorder from DSM-IV; these have changed, of course, but what she uses was correct at the time “Taming Tiny Tigers” was written. She references the much-respected Dante Cicchetti in the documents bibliography. She also points out that physical and emotional abuse are not good for kids. All good stuff, right? She must know a lot about early emotional development and later mental illness--  or so you would think until you see what else is in there.

Now let’s look at what’s inside this handsome Trojan Horse (we’ll see that much of it is similar to something that’s inside real horses). I’ll just begin at the beginning and go on until I can’t stand it any more.

The first problem that comes into view is on pp. 3-4: the good old first-  and second-year bonding cycles. Once again, I will point out that these have no parallel in conventional, evidence-based views of the development of attachment. Naturally, if a baby is not fed or cared for regularly, both physical and mental development will suffer, but attachment develops as a result of pleasant social interactions with a caregiver, not because that caregiver feeds the baby. In real life, of course, chances will be great that a lot of pleasant interaction is mingled with feeding and other care routines, but it’s the interaction and not the care that brings about attachment (which, by the way, is a very robust phenomenon, and does not often fail to happen if a few adults regularly care for a baby). The “second-year attachment cycle” focuses on rage and capitulation as contributing to some unstated aspect of attachment, whereas established information focuses on sensitive, responsive parenting that helps the child tolerate the inevitable frustrations of  this period of development. A large but unstated difference between the “attachment cycle” approach and conventional thinking about early emotional development is that the “cyclists” equate toddler attachment with obedience and compliance, whereas conventional thinking focuses on attachment as a function that helps young children explore and learn. I’ve gone into some detail about this at http://thestudyofnonsense.blogspot.com/2012/08/parsing-attachment-cycle-fox-terrier-of.html.

Let’s move on to p. 7 of “Taming Tiny Tigers”, where we’re given symptoms that are supposed to let us know that a child has Reactive Attachment Disorder by looking at events that may occur before six months of age. Here we have an interesting hint that what is being talked about here is not attachment in the conventional sense at all, but something else (undefined).  It is quite remarkable to claim that a child’s recognition or nonrecognition of the mother in the first six months tells something about Reactive Attachment Disorder, as attachment is not indicated behaviorally until after that age. Be that as it may, the symptoms Miller lists are serious problems indeed, including withdrawal, difficulty with touch, poor muscle tone, delayed motor development, and decreased vocalization. Any baby showing these symptoms does need early intervention for both physical and cognitive problems, there is no question about that . However, what they do NOT need is treatment for Reactive Attachment Disorder, especially the types of treatment Miller recommends later in the document. To tell parents of developmentally delayed toddlers or preschoolers that these early symptoms showed that they had Reactive Attachment Disorder all along is in my opinion little, if at all, short of criminal.

Slogging onward, we come to pp. 11-13. Having listed the DSM-IV criteria for diagnosis of Reactive Attachment Disorder, Miller now turns right around and introduces the infamous checklists of Walter Buenning and Gregory Keck. These completely unvalidated lists include such items as poor eye contact, wanting to hold own bottle, and preferring Dad to Mom as indicating Reactive Attachment Disorder in infants and toddlers, and for older children list the usual Attachment Therapy-related group, such as being superficially charming, not making eye contact on parental terms, “crazy lying”, and abnormal speech patterns. These lists contain a number of items like lack of impulse control that are indeed of concern, but are not aspects of  attachment problems and are not likely to be treatable by the interventions Miller offers.

What are the interventions Miller recommends? On p. 15, she suggests “brain building activities” as suggested by Bruce Perry, and of course by Nancy Thomas. In typical Nancy Thomas fashion, the list of these activities is headed by the injunction that they must be led by the adult, not the child; this injunction reflects the belief that  displays of parental authority create attachment, and that a child’s obedience shows that he is attached to an adult. The activities include many that would ordinarily probably be fun for children, ping-pong, playing catch, and jumping on a trampoline. However, when these are to be done as recommended, five or six times each day, for ten minutes at a time, at the command of an adult caregiver, the “fun” aspects seem to be a good deal lessened.

To continue with the recommendations for intervention, we see on p. 14 of “Taming Tiny Tigers” a page that is startling in its simplicity. Without elaboration, and under the heading of “Therapeutic Continuum”, this page shows a line with the words “non-directive play therapy” at the left and “holding therapy” at the right. What can Miller mean? What is she recommending? She doesn’t come right out and tell, but a look at the bibliography shows publications by the heavy-duty masters of the intrusive and potentially dangerous holding therapy, Foster Cline and Martha Welch, and by Ronald Federici, who advises restraining adopted children in the dangerous prone position. And of course, it shows many publications by Nancy Thomas, the woman who recommends that foster children not be permitted to say grace at meals, “because you don’t know who they might be praying to.”

All in all, “Taming Tiny Tigers” is a pretty disconcerting package, but Miller doesn’t have to conform to any rules to be a parenting coach. What’s more, the First Amendment permits her to pass out all this disinformation. Fortunately, it also permits me and others to have our say about Miller and her “Tigers”.


  

33 comments:

  1. Jean, For me, pages 24-27 -- "Beneficial Treatment Messages" and "Beneficial Parenting Messages" are the smoking gun here. I haven't looked into the details of the method much, but if someone were to tell me that the basic concept is, "Let's create attachment via the Stockholm Syndrome," I'd be tempted to believe it.

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    1. You would be quite right to believe it. The system at work here is based largely on the declaration by Foster Cline that "all bonds are trauma bonds". That in turn is vaguely related to the claims of Robert Zaslow about the role of authority-- based loosely on John Bowlby's statement that attachment figures are usually bigger and wiser than children-- and farther back, on the psychoanalytic concept of identification with the aggressor.

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    2. I know that the training tiger is quite cruel event.
      Trainer periodically beats tiger cub tiger cub to recognize leadership and subordinate to man at an older age.
      Famous trainer VL Durov, in 1880 studied the animals' ability to understand human mental orders. Crucial in his experiments Durov gave power of the human eye. Especially strong power if the sight is directed into the eyes of an animal or, "through the eyes directly into the brain of the animal."
      But he had no tigers in his circus. Circus dynasty Durov not employ violence to animals (Only the game, tenderness and delicacy to secure reflexes). Lev Durov tried to work with the Tigers without violence, but failed. The Tigers were gentle, but refused to perform circus tricks. Also every time they attacked the back of the trainer and it was dangerous if there is no strong levers.
      I suspect that Nancy Thomas absolutely refuses to believe that the children are not wild animals.

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    3. Ah.))) I have not written. Lev Durov grandchildren now work with the Tigers but without violence. Tricks are not very vpechetlyaet but in this circus can not use violence. Therefore it is not very impressive.
      Durov's wild animal theatre for children
      https://www.youtube.com/watch?v=yjfZLSgCZeo

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    4. It's always a surprise to hear what you have to say, Mihail! Your point about Thomas's belief that children are like animals is well taken.

      But do you realize that the idea of "the power of the human eye" is one of the beliefs held by attachment therapists? Keep in mind-- light goes into the eye, nothing comes out of the eye-- even though looking at a person or an animal can be a powerful signal.

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    5. Jean, maybe you're right ..... but I've read that the trainer Durov eyes stopped enraged animals. In the theater Durov still stands stuffed bear who went berserk during a performance. Durov began to look into the eyes of a bear and brought him from the scene. Maybe it's a circus trick. But Academician Pavlov studied the methods of training Durov. They knew each other and worked together. Pavlov is the creator of the theory of higher nervous activity. I guess he had a reason to study these methods of training.

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    6. I'm sure you are right to say that gazing at a person or animal can give them a social signal and change their behavior. I only meant that this does not happen because of something that comes out of one set of eyes and goes into the other.

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    7. You're right. The teacher also tries to capture the views of all children. This helps to control discipline. But the basis of the lesson is to create interest and motivation to learn (competition, praise, evaluation ....) but the main motivation is the desire to know more. This gives an incentive to work independently and self-learning in children. This creativity and this is far and not at all like the motivation of animals (food, praise, fear of punishment ...).

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  2. Jean, I keep kicking myself that I haven't read any of Pavlov's work, because the bits and pieces I've heard imply that his work is much more subtle and interesting than most people realize. Re children as animals, we should all be careful with our metaphors! One thing I find annoying about theories of therapy is that someone will utter a tautology (children are animals, as opposed to being, say, plants or rocks) and somehow manage to draw conclusions from it. I personally have no problem with the idea that there's a gulf between theory and practice: life's like that. I just prefer my gulf's to be gulfs, and not papered over with whatever theory comes to mind. Same with eye contact. The old "forceful gaze" concept of 19th century hypnosis works pretty well, I'm told, but I'm sure it's never been studied much. The "Clever Hans" effect is always a possibility. I think I see the point with training actual tigers: putting on a good show requires that they seem angry and barely under control, and the most straightforward way is for them to be angry and barely under control! Not a concept I'd apply to children, though. Especially when working through intermediaries. God help the untrained animal trainer, and the animals.

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    1. About Pavlov: I don't think there was so much subtlety there. He collected a lot of useful information about classical conditioning, a form of learning that requires the initial existence of a reflex response (i.e., not a learned response). But then he decided that everything about human beings could be explained that way, so there must be some reflex that would be behind each kind of human behavior. How does a "reflex of slavery" grab you? His two volumes on conditioned reflexes list this and a lot of other reflexes that nobody had invented before. Pavlov was a gastroenterologist by training, and good at that-- his difficulty, and the difficulty of his followers, is that no single-factor theory is going to be adequate to explain complex behavior.

      As for the forceful gaze of hypnosis, let me point out that mesmerism originally involved touching the patient. When in Victoria's day it became a theatrical performance as well as a treatment, it was considered not at all the thing for a male hypnotist to touch a lady patient, especially in public, so the touching changed into "magic passes", and the gaze was deployed as a good way to focus the patient's attention.

      With respect to metaphors-- there is an American Professional Society on the Abuse of Children-- I propose a similar one to combat the Abuse of Analogies! This would prove beneficial to children, too.

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    2. Yup. Pavlov introduced in the scientific school, the term "reflex of slavery" but he also coined the term "freedom reflex".
      Freedom reflex is a common property, a common reaction of animals, one of the most important innate reflexes. If this reflex is absent then every obstacle in the way of animal facilitated the death of the animal. All animals are deprived of their liberty, seeking to be released, especially wild animals.
      I think that the systematic study of innate reactions animal fund will immensely contribute to the understanding of people and development of the children's personal ability to self-government.
      But understanding the innate responses of the animal does not mean to identify children with animals.

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    3. "Reflex slavish obedience" not hardly contributes to the love and affection .. A well-known fact that puppies and small dogs often fall before the big dogs in the back. It is, giving of oneself to the will of the strongest, analogue of human cast on his knees. Deliberate passive posture is weak, leading to a drop in aggressive reaction of the strongest. Weak animal has the ability to retains the ability to survive and to demonstrate humility and even love. For example a weak dog licks muzzle and tail strong dog. Weak dog or puppy show love ....... but this is a hoax and a sham if the basis of this behavior is fear of getting hurt or lose a life.

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    4. Jean, I take it for granted that researchers will extend their theories waaaaay to far, given half a chance. The thing that caught my attention about Pavlov was that he found a way of measuring response (the number of drops of saliva that fell from the dog's mouth) in an era where responses were not measurable, and he demonstrated that the response could be obtained arbitrarily through non-causal linkage (tone and feed), which demolished existing theories. In addition, he demonstrated that, if he usually used a middle-C tuning fork, a B-flat tuning fork would get a diminished response, simultaneously demonstrating that dogs have a good sense of pitch and that an imperfect stimulus gets a diminished response. Which is a very respectable body of work for its era -- and hints at more that I don't know about. Hence my regret at not having read his work.

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    5. You would probably find Pavlov's work interesting if you can get hold of it somewhere-- might even be on line. And of course he was good at measurement. But he wasn't the only one to be interested in quantitative approaches-- look at Galton and Helmholtz before him.

      Nevertheless, I have to point out that he confused definitions of reflexes in a way much more like the tautological popular discussions of the time than like any scientific approach even then. He had Hughlings Jackson and Sherrington to build on-- but actually I don't think he read English or traveled at all, so I suppose that for all practical purposes he didn't have them.

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    6. Mihail, yes, it seems to me that in many species there is an unconscious dance of dominance and submission, which typically ends in a more or less amicable equilibrium with little or no violence. If we were to speculate that this is also true of humans, and that children diagnosed with RAD do not give the "correct" dominance/submission responses, then I think what you're saying is that escalating the violence of the dominant person to force a sham submission is absurd and abusive. I agree!

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    7. Of course such "treatment" and "education" is offensive and dangerous. Even if the home country of the children living in difficult conditions in the poor house and it does not give the right to torture these children in a beautiful house in a foster family. Even if these children have problems. Some stories of children in foster families can not be completely understood. 6 children from disadvantaged families Tulumovi were surprisingly friendly and had a very warm relationship. 3 older children stayed in Russia. 3 younger children went to the United States. 3 senior now grown up, graduated college and vocational school and live normally. 3 younger children 4 months in the United States have been hard as a result of re-education and one child died. What are guilty of these children? Maybe they were mentally retarded and aggressiveness? But we know that Victor 4 years learned to read. In the six years he was a born leader among peers. Younger twins did not have backlog and develop normally. What was the reason for abuse?
      Gemini Vladimir and Yevgeny Tulimovy visited older twin brothers and sister in Russia in 2008.
      http://www.gzt-sv.ru/cont/2014/03/2014031302-300x225.jpg

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    8. I am not kidding. Dog odorless is an object of contempt among stray relatives. If the dog (even not large dog) get covered in stinking mud .... this dog becomes respected among dogs. You can check it out).
      Even large aggressive dogs have the respect and admiration of smelly dog. Let attachment therapists use this natural method to create attachments and to teach children to respect :)

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    9. I'm sure you are not kidding, Mihail, but don't forget your original idea that human beings are not animals.

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    10. Unfortunate children ........ Americans are experimenting on them ... Russian decided to send them to the Arctic with Astakhov. Children certainly stand and do not even scared. They returned from the Arctic in a good mood and with a victory. But Astakhov older and grayer over the 2 weeks of travel to the North Pole. I understand that he wanted to prove that our children are capable of great feats . but Arctic .... it's overkill.
      Return after the conquest of the North Pole.
      http://img.rg.ru/i/gallery/3d0d1de2/6_1c815724.jpg
      http://img2.ntv.ru/home/news/20140422/vvv.jpg

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    11. I don't think the inappropriate treatments children may receive in the U.S. and elsewhere are "experiments". They are mistaken choices by people committed to and alternative belief system-- people who do not feel that evidence of effectiveness is important. As for Astakhov's venture, he must have had some moments of panic and regret! But fortunately all was well in the end.

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    12. Fortunately all ended well for our expedition. Astakhov very proud of these orphans. They won adult American and Chinese explorers.
      http://www.youtube.com/watch?v=xd2GWCiegi8

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    13. Interesting .... but if the bride does not like buuschego husband? Attachments therapists will also be thinking that this bride is sick and it should be treated?
      It is not necessary to answer. Just listen to this folk song if you have time.
      http://www.youtube.com/watch?v=6xJtTGPpePw

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  3. I think it is impossible to rely on reflexes and instincts in the upbringing of children. Sensory also can not be the uniqueness of the incentive for the development and education of children. Must be an integrated approach that eliminates abuse. People can overcome their desires and act against pain or hunger. The older the child .. the more difficult to influence it via encouragements meal or corporal punishment. It is no accident in Russia, there is an ancient tradition to teach the children: "If the enemy gave you candy ... you throw and forget it."

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  4. New York Society for the Prevention of Cruelty to Children was originally the name of "American Society for the Prevention of Cruelty to Animals". They have created a society to protect animals but then realized that children no less than animals in need of protection. Already in the early 1870's eight-year girl Mary Ellen Wilson turned in a society where said to be suffering from cruelty adoptive parents. Lawyer of the Company for the court said that like animals, children need to be protected. At the trial it was proved that the girl almost daily flogged and beaten, she slept on the floor, etc.

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  6. Mihail, please see above for Robert's response to your comments.

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    1. Pavlov different from psychiatrists of the time. He does not duplicate them but suggest to a new method for studying the human psyche.
      IP Pavlov abandoned the method of subjective psychology and embarked on an objective study of psychic phenomena. He suggested to combine all the resources of human, art, religion, literature, philosophy, history of science to study human psyche. In addition, he first suggested the use for the study of natural history - science with its strictly objective methods. "It was a challenge because the English physiologist Charles Sherrington, referring to the study of mental problems, said the mental, as the final after study researches Aristotle more than 2,000 years ago. Pavlov managed through the application of universal method of natural science - the experiment .......... begin the study of higher nervous activity. But who could then assume that psychiatrists will start experimenting on children? Pavlov tormented (experimenting) only dogs. But even from -this dogs he felt remorse . He put a monument to the dog in gratitude and partial atonement.
      http://content.foto.mail.ru/mail/prinss/_blogs/i-3606.jpg

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  7. It always bothers me when people use cutsey demeaning phrases regarding children. "Tiny Tigers". . . It has a way of adding to the dehumanization of people just because they are young. Children aren't actually" tiny". Fleas and Fairies and Church Mice are "tiny". And children aren't tigers. They are human beings with the right to the full range of emotions that human beings have And most of all they aren't to be "tamed"!.

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    1. Well said-- it also reminds me of the habit, maybe not so common now as ten years ago, of calling children said to have Reactive Attachment Disorder "RADishes". As you say, these terms are dehumanizing and focus attention on some minor or even nonexistent aspect of the child, distracting from his or her full reality. This is like making the fundamental attribution error, in which everything a person does is attributed to his own basic character, rather than seen as possibly influenced by environment,past experience, etc.

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  8. Another self-proclaimed trauma mama makes stuff up about the RAD her adopted Russian girl allegedly has... a girl whom even she admits:
    (1) had zip in the way of RAD 'symptoms' until she hit puberty at 13, i.e. DSMV requires diagnosis at ages way younger than 13
    (2) has symptoms of mental illness
    (3) also has FASD (might explain some of the impulsivity, emotional lability, etc)
    (4) has been exiled to a variety of unlicensed, no-licensed-healthcare-professionals-on-staff 'crisis respite' and Montana 'ranches' for 'kids' for much of the past two or three years.

    If this kid was sent to an actual licensed healthcare provider, maybe she'd have a fighting chance at getting better. Exiling the kid to facilities where the kid will be treated with ONLY the supposed Word of Jesus... well, doesn't seem to work so well!

    http://the30dayjourneyforhope.blogspot.com/2015/04/reactive-attachment-disorder-colors-of.html

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    1. This is all so discouraging and pitiful-- and you know, very few health professionals of any type even know that it is going on.

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  9. The whole Trauma Mama Retreats motto (Beyond Trauma and Attachment Retreats, now renamed momsfindhealing.com) has a motto based on a ptsd definition that doesn't exist Complex Trauma:
    To support families who are raising children who have Complex Trauma and attachment issues by networking, offering support, and educating others.


    It's now an official non-profit, run by Diana Estulin of fromsurvivaltoserenity.com -- a self-proclaimed trauma a mama with no credentials who charged other trauma mamas money to participate in her webinars!

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    1. This is really a terrifying list you're putting together.

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