Concerned About Unconventional Mental Health Interventions?

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

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 na├»ve 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.

9 comments:

  1. Sticking the label "feral" on *any* child in our supposedly enlightened 21st century, is not only a way of getting around or ignoring the many possible reasons for the child's behaviours, but it is also dehumanizing. By suggesting that it is appropriate to "tame" the child (often by extreme and brutal means) in order for that child to be recognized as human, it gives permission to abuse.

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    1. So true-- one of the many ways in which names actually can hurt us. Also, it's a real abuse of analogy.

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  2. An Amazon review of interest:

    On the fringe of therapy and parenting
    ByRevieweron September 2, 2015
    Format: Paperback
    While the author, a lawyer, is apparently a well-educated person and voices an appreciation for science ("... sheer desperation may have driven me to try any approach that had any basis at all in logic and science”), her book is rather a testimony to the prevalence of dangerous and scientifically invalidated practices that are often inflicted on adopted children. 

Let’s examine some of the places where the author took her child into the realm of fringe nonsense:

    1.) Catharsis:

    The author takes a "cathartic journey." The notion of catharsis was thoroughly discredited back in the 1950's. Today, "catharsis as therapy” is considered to reinforce behaviors and emotions rather than lessen them, e.g. acting out rage may only make a person better at being angry.

    

It is therefore doubly disturbing to read that the author used coercive physical restraint to achieve catharsis:

    

“My tiny son's vehement reaction to these holds left me feeling like I had been thrust into the middle of a stormy exorcism. I questioned, critically, Dr. Federici's methods and second-guessed our decision to undertake such an arduous process that was exhausting and terrifying for both parent and child.... We were taking away [my son's] pain. Forcing him to exorcise the rage, confusion, and distrust in a manner that looked violent but wasn't. I consoled myself by comparing this process to watching a child get his stomach pumped in the emergency room.”

    2.) Re-parenting:

    The author went along with a therapist who gave her:

 "...instructions to nurture and treat [my son] like a baby. The idea was that he needed to experience the developmental stages he missed... I was to cradle him several times a day, rock him...sing lullabies, devise tricks to engage eye contact, even give him warm milk with a bottle while I held him in my arms... our feeding/bonding session...”



    Any modern child development textbook will tell you that you can’t redo developmental stages, and forced age regression is considered unethical and counterproductive -- a practice that kids usually find humiliating or stupid.

    Did it work for the author? She explains away the failure: 



    “[My son] could not tolerate either Pat or me trying to give him milk (including chocolate milk) from a bottle. He would squirm and giggle maniacally. Any milk that made it into his mouth would come out in a bubbling, spurting mess that would then invoke another wave of hysterical laughter. He simply couldn’t handle intimate, physical contact.”

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  3. Amazon review continued:

    3.) Primal Wound:



    The author writes: “Until we adopted, I had little experience with anger and primal wounds, scars that run so deep they travel the speeding course of the very blood that fuels our children's hearts and souls.”

    The annoying hyperbole aside, “primal wound” is mythology. There is no valid evidence to support the notion that children attach to their biological mother *in utero,* only to be devastated when separated from her at birth. There is rather plenty of research confirming that children separated at birth from their mother and adopted in the first few months of life do as well as biological children or better. Research indicates that attachment is something that happens when the child is older – around 5-7 months of age, not at birth or earlier.

    

4.) Attachment Therapy & Attachment Therapy Parenting

    
Attachment Therapy is an unvalidated fringe practice that uses coercive physical restraint and other aversives, intimidation, threats, and highly authoritarian parenting (including "re-parenting"). It is condemned by APSAC and the American Psychological Association. There are several proponents mentioned in this book, most notably Ronald Federici.

    

The author writes about being introduced to Federici: “Dr. Aronson...didn't mince words. ‘It's time to see my friend Ron Federici. He's the best, Mary....look him up on the web.’” 

I can only conclude that Ms. Greene confined her research to Federici’s own website, claiming he has: “... impressive credentials...clear[ly] this man knew his business.” Did she read his book?:

    http://www.childrenintherapy.org/proponents/federici.html



    Here’s the highly authoritarian parenting plan and approach that the author Ms Greene apparently followed without hesitation: “Day One of Behavior Intervention... ‘Welcome to Boot Camp’... we withdrew P. from preschool and jumped headfirst into the program.... I must have experienced some quasi-religious measure of ‘faith’ in Dr. Federici's methods to even contemplate doing what I did....[My son] was to stay within six feet of one of us at all times, his days and evening were scheduled in fifteen-minute increments, and all choice and free time were eliminated....confined to property...no visitors....[My son] spit, bit, screamed, vomited and scratched me to gain some distance and freedom....I was sometimes forced to implement the holds that Dr. Federici taught Pat and me in his office....I felt like we were breaking a horse....”



    From videos made of Federici employing his methods, I suspect that horses are tamed with a good deal more gentleness and patience. 


    5.) Mitochondria



    The author writes: “...Mitochondrial Depletion Syndrome, which means his mitochondiral cells functioned normally but they reproduced and replenished abnormally.”

    
Mitochondria are not “cells.” They are organelles within cells. You’d think a mother writing about her child facing this diagnosis would have learned that basic bit of information somewhere along the way.



    6.) FAS?

    

It’s hard to know what problems this child actually struggles with.
 But it does seem somewhat disingenuous to claim in the book’s title that it is about a child with FAS when he had variously “telltale signs of FAS” by one physician and “severe” FAS diagnosed by an infamous psychologist. 



    While I found this book fascinating for the amount of potentially abusive and dangerous pseudoscience it describes, it is my opinion that it has little of value to offer adoptive parents. 





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    1. Thanks, Linda, for these extremely cogent remarks!

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  4. Mary Evelyn Green writes that the 3-year-old Peter was in the orphanage accustomed to the pot, had the skills of self-service (self-eating, dressing undressing ...), he understood it and was able to talk .... But it is not like Mary Green. She allegedly wrote the boy was like a robot. She returned it to the state newborn .... and start all over again (diapers, bottle with nipple .........). She threw in the trash all the previous work of the staff of the orphanage. She pushed the boy back for 3 years instead of to stimulate its development and go ahead and catch up with their peers. But this is not the worst thing . Despite all her efforts on education of Peter .... she was forced to send him to a psychiatric hospital because he allegedly showed aggression towards other children. He accidentally threw the ball into the face of a child during a game of football ... then there was a small scuffle between boys ..... and then Greene sent Peter to a psychiatric clinic. His sister Sophia was pleased that Peter is in hospital. Allegedly, she was tired of Peter and sighed with relief. This bad relationship between brother and sister. Usually twins are going through difficult separation and bored far without each other. Something very little mercy in the education of these children even though a lot of beautiful words and lyrics.

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    1. Extremely interesting-- thanks so much-- have you added this comment as a review on Amazon?

      Unfortunately, this kind of thing is a common result of the belief that children can be taken back to earlier stages of development and brought forward again.

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  5. I read "When Rain Hurts" by Mary Evelyn Greene
    But in this book there is nothing about the treatment of Peter but only lyric debris and accusations against Russia and the orphanage. Although she could refuse, and even had an offer from the administration of the orphanage. It is impossible to separate brothers and sisters. She had two children to adopt or reject both. There was no deception. Only 6 months after the adoption has begun a significant regression of Peter. What's foster family did wrong during these 6 months? The book does not answer this question.

    "Russian Roulette: A Review of When Rain Hurts: An Adoptive Mother's Journey with Fetal Alcohol Syndrome"
    CHRISTINA GOMBAR
    November 2014
    - See more at: http://www.literarymama.com/reviews/archives/2014/11/russian-roulette-a-review-of-when-rain-hurts-an-adoptive-mothers-journey-with-fetal-alcohol-syndrome.html#sthash.xAgimZIh.dpuf
    excerpts from the article -
    "Having spent thousands of dollars and precious months filing paperwork, Greene and her husband finally took their first trip to a remote Russian outpost only to discover the boy they'd set their heart on was clearly too ill to take on. There they were introduced to a two-year-old girl, and instantly fell in love ..............
    ..................
    After six months, this boy "woke up in a primal scream" and became completely uncontrollable-defecating at will (though long toilet trained in Russia), and vomiting at every meal. His speech was primitive, he refused eye contact, and he was physically destructive. Greene says he went from being "like a cuddly toddler" to something "more like an explosive device."
    ............................................
    A doctor advised them to try "attachment coaching." They needed to treat Peter like a baby, so he could experience the developmental stages he missed in the orphanage.
    .......................................
    "At times I felt we were breaking a horse," writes Greene before she realizes: "His entire repertoire of behaviors was designed to inoculate himself against the dangers of love and intimacy. I was not breaking a horse. I was nurturing a helpless foal . "

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    1. Thank you for these comments. This situation needs much further discussion and I hope to write another post about it soon.

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