Thursday, September 3, 2015
When Nonsense Hurts: Mary Evelyn Greene's Adoption Book
With her 2013 book, When rain hurts, Mary Evelyn Greene has added yet another dramatic chapter to the ongoing trauma-mama narrative. This is certainly her privilege, and there is no doubt that her experience of adoption was a painful one in which she came up against some disturbing advice that she may have been too distraught to recognize for what it was. However, like other material in this genre, Greene’s commentary offers the potential for harm to other adoptive families as it features nonsensical explanations and interventions.
The summary of Greene’s book on Amazon contains some significant details about the story and the attitudes presented. Greene adopted a three-year-old boy (as well as another child) from a Russian orphanage. The boy, called Peter, is described as suffering from Fetal Alcohol Syndrome and as being “feral”. Greene is said in this summary to have sought “a magical path of healing and forgiveness for her son”. The summary material alone is enough to raise some concerns.
The first is the description of Peter as “feral”, suggesting that he, like “the wild boy of Aveyron” in the 19th century, may be incapable of being socialized; this terminology also calls to mind the words of Greene’s adviser Ronald Federici, as he was quoted in a Harper’s 2013 article: “the kids I see are feral as animals… I’ve dealt with four Russian kids who’ve murdered their parents…”. Readers who accept the word “feral” as being an accurate and chilling description are having their attitudes manipulated, potentially causing them to regard Russian-adopted children with expectations of seriously disturbed behavior-- and while such behavior can certainly exist, its description can become a self-fulfilling prophecy for otherwise naïve readers.
A second issue in the summary is the reference to a “magical path.” Yes, this is without a doubt just what Greene wanted—an approach that would cut straight through logic and scientific evidence to the outcome she envisaged, whether or not such an outcome was actually possible for Peter. This path was also to involve forgiveness, and while I assume this means the questionable assumption that the maltreated child is full of rage and must forgive those who harmed him in order to improve, I cannot help feeling that Greene also recognized her own need to forgive herself and the world for the position she had chosen to be in.
I mentioned a couple of paragraphs ago that Greene was advised by Ronald Federici. Federici, a self-proclaimed world expert on adoption, is the author of a self-published book, Help for the hopeless child, in which he recommends what he calls “therapeutic holding”. This technique, which Federici shares with David Ziegler, head of the Jasper Mountain, OR, residential treatment program for children, is strongly related to the “holding therapy” done by Zaslow, Cline, etc., etc. The difference between the two is that “therapeutic holding” is brought to bear when the child is already distraught, whereas “holding therapy” includes a period in which a calm child is brought to a distressed state. In his Help book, Federici recommends forcing a distressed or noncompliant child to lie prone, then holding him or her down by having the parents put their body weight across the upper back and the legs. The prone position is well known to offer unusual dangers for asphyxiation; although Federici has never changed the material in Help in response to reminders of this, he apparently did not tell Greene to restrain Peter in that way. Instead, according to Greene, he advised a variant of the use of the “prolonged parent-child embrace” form of treatment, as advocated by Martha Welch and Jirina Prekopova. In this variation, the child is initially held in what used to be called a “basket hold”, with his back against the adult’s chest and the adult’s arms around him. When the child has been quiet for three minutes, he is turned around for a face-to-face embrace (Greene does not say how long this is to last, but in Welch’s and Prekopova’s methods, it can last an hour). The problem, of course, is the same for all these techniques: the child may not quiet sufficiently until after an hour or more of physical struggle. There is no question that the experience of this lengthy restraint can give the child a clear message about the authority of the adult and place the child in a state of fearful dependency, as described by Federici in his Help book. Why it should be done is another matter, especially in the absence of any systematic data providing evidence for its effectiveness. But of course, if Greene was seeking a “magical path”, this would not have mattered to her.
Federici and Ziegler have both denied being “holding therapists”, but in Greene’s case Federici seems to have tolerated or encouraged the presence of one Suzanne d’Averna, a social worker who advised the use of a number of adjuvant treatments of the kind used by “holding therapists” for some 30 years or more. These included the use of joint compression (an alternative treatment primarily designed for autistic individuals). “strong sitting” ( immobility on command, a specialty of holding therapists who believe they are treating attachment disorders, but clearly yet another exertion of authority over the child), and “re-parenting” by means of spoon- and bottle-feeding children who are capable of and accustomed to feeding themselves. Greene attempted bottle-feeding with the school-age Peter, and when he resisted, attributed his reaction to an inability to “handle intimate, physical contact”, not to the ridiculously age-inappropriate position he was being placed in. No evidence exists to support the effectiveness of any of the interventions employed. If Greene was indeed seeking a “magical path”, she found a version of one here, as only magical thinking would lead to the idea that ritual re-enactment of infant care routines could return a child to developmental square one and then bring him back to today, with all long-term problems erased. There is potential harm in this claim for readers who believe it appropriate to adopt for their children the same “recipe” followed by Greene.
So much more could be said here, but one more point will have to do. Was Peter actually suffering from the effects of prenatal alcohol exposure? His head circumference appears to have been normal, and the major reason for speaking of him as FAS-affected seems to have been the absence of a philtrum or fetal groove in the area between the upper lip and the nose. This and some other symptoms may be shared by children with FAS and by those who have been affected by Dilantin prenatally, or those with genetic problems like Prader-Willi syndrome. Greene also discusses the possibility of mitochondrial disease. What is the issue here? It’s that Greene has somehow transformed this ambiguous situation into one that is declared to involve FAS—even the book’s subtitle says so. So we end with a sort of nonsense that is potentially harmful to readers who want to find out what happens to FAS children, how they develop, and how they should be treated, but who somehow miss the point that Peter may not after all even have been a victim of FAS. And if he was not… is it possible that his escalating problems were iatrogenic in nature? Greene’s dramatic depiction of life with Peter fails to touch on the possibility that some of his problems may have resulted from the treatment efforts described-- efforts that may in fact prove harmful to the families of the readers who are attracted to this book.