Concerned About Unconventional Mental Health Interventions?

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

Monday, September 28, 2015

You Can't Go Home Again, or Back to the Cradle Either

I recently commented on a book by one Mary Evelyn Greene (http://childmyths.blogspot.com/2015/09/when-nonsense-hurts-mary-evelyn-greenes.html). Greene described all the difficulties of her adoption of children from a Russian orphanage, emphasizing the little boy’s “feral” nature and violent aggression. Subsequently, I received the following comment on my post (the commenter gave other information as well, so interested readers may want to look back at both the comments):

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 ..............
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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 .  “


Of course, I have no idea of the accuracy of anyone’s statements here --  Greene’s description,  the comments, or the review. However, all of these involve ideas that I think require close examination.

The first of these is ideas that if a child suddenly shows difficult behaviors after a calm six months, the cause of these behaviors must have occurred in earlier life , and not be associated with any more recent experiences. This thinking involves a kind of primitive “infantile determinism” that assumes that all problems must come from an early stage of development—ignoring the reality that past and present experiences as well as maturational factors work together to determine an individual’s present characteristics. The idea that the child woke with a “primal scream” (not just a scream) indicates the assumption that traumatic experiences in very early life have been repressed and now are breaking through; the whole “primal” or “primal scream” concept (popular in the 1970s following the proposals made by Janov) focused on the experience of birth as terrible, and impossible to handle in a rational way unless re-experienced and re-processed.  Related to this belief in “primal” is the view that a child who defecates without control and vomits frequently must be doing these things as emotional acting-out and not because of physical illness. Greene seems to have further revealed her belief system by saying that Peter defecated “at will”, echoing the claim of the holding therapist Keith Reber and others that children with attachment disorders could defecate or vomit voluntarily.

The second issue that needs addressing is the recommendation for so-called “attachment coaching” and for causing Peter to “experience the developmental stages he had missed in the orphanage”. This belief has a long history  (50-100 years of it) among the wilder psychoanalysts like Ferenczi and Fromm-Reichmann, who were convinced that by acting out nurturing  events for patients, they could somehow “re-do” the patients’ early experiences, which the therapists blamed for all mental illness including schizophrenia.  This view--  which naturally appeals to the wish we all have to be able to “fix” emotional disturbances—was also encouraged by claims that hypnosis or other techniques could cause age regression (these claims were strongly contradicted by systematic investigations).

It is not plausible that existing psychological development can be undone and started over, however unsatisfactory were the conditions in which it occurred. Think of that claim and what it would mean if it were made with respect to physical development. A child may be of unusually small stature or may have an unusual pattern of bone development due to early malnutrition. Could we rationally expect a good diet in later years to “regress” the child to a state of infantile skeletal development, and to cause new growth and bone maturation that will create a more typical body? The answer is NO, of course, and I would point out that all the present emphasis on brain development as the basis of emotional development should be considered analogously; no experience can undo the existing synapses or change the history of migration of neurons to different parts of the brain, any more than diet can alter salient characteristics of bones that have already formed.

Third, let’s consider Greene’s statement that Peter’s behavior was designed “to inoculate himself against the dangers of love and intimacy”. This is one of the mantras of attachment therapy/holding therapy, and has been repeated in woozle-like fashion for many years now. No doubt this is what Greene was told before the adoption occurred, and what she heard on many occasions afterward. However, this belief is based not on evidence from child behavior, but on an analogy to the feelings of adults whose companions have chosen to leave them--  post-divorce, for example. These people are often irritable with others and may be preoccupied with the dangers of intimacy, sometimes rejecting possible new mates on the grounds that “women/men are all alike and you can’t trust them”. But is it possible for a young child to do the same?

In the 1940s, Bowlby and Spitz put great emphasis on the idea that young children separated from familiar caregivers would become depressed, eat and sleep poorly, and be unable to accept care from other adults. Bowlby’s film “Nine days in a residential nursery” showed the physical illness and emotional distress of a two-year-old left in a nursery while his mother had a baby; the child rejected his mother when she came back to pick him up. But that film showed that the child received little attention from caregivers (or from his father, who dropped in briefly every day) and was overwhelmed by other children in the nursery. Bowlby’s colleague James Robertson later showed that young children separated from familiar people but given plenty of sensitive, responsive care did not in fact seem nearly as badly affected as the child in Bowlby’s film.

The belief that adopted children intentionally reject love is one that assumes that the adopted child is adult-like in abilities and reactions—indeed, that he is more capable than an adult of controlling his own behavior. Curiously, that school of thought does not assume that nonadopted infants are rejecting love when they cry nerve-wrackingly, have tantrums, or do that trick that enables them to weigh 40 pounds extra when they do not want to be picked up.  Somehow, the adopted child is considered to do on purpose all sorts of things that in other children would be thought to be outside their control. She is also said to do these things because she does not want to be loved, on account of the losses or disappointments she has already experienced. These ideas are simply assertions, because there is no evidence to suggest that a child does not want affection, and it is more likely that he or she has no experience of the codes adults use to signal the giving or receiving of love.


I am not one to quote Freud frequently, but there was a term he used about implausible treatments of these kinds. He referred to their proponents as having a furor sanandi—a frenzied wish to heal. Unfortunately, unless that furor is turned to methods that are at least plausible, and better yet evidence-based, the wish to heal may well culminate in the fact of harm. 

14 comments:

  1. Maybe Peter has not been able to adapt to a new food? Or the body can not cope with a new infection? Is it possible to exclude it? When the child is ill can be irritated and nervous. But maybe Green saw the signs on the face of FAS child and wanted to start immediately written "treatment" of the child. It could trigger a setback. Green kosultirovalas with R.Federichi. It was already dangerous for the child and could lead to unpredictable results.
    But even if in the end Green received from the child desires the words "I love you." This incredibly high fees for the lost 3 years of life and development. The child loses almost all the chances to reduce the distance between it and the peers.

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    1. It seems to me that it is an enormously inappropriate goal to have the child say "I love you". Talk about an isolated skill! A parrot is able to do as much, but only a few parrot fanciers agree that the parrot loves the owner.

      It's the job of parents to love a young child, not the job of a child to love the parents. The child's positive feelings, wish to be near the parents, or even obedience and expressions of gratitude do not indicate a capacity for the same sort of love that adults can give. Parents' love and nurturing help a child to grow into an adult who is capable of love-- but they cannot force genuine love to appear precociously.

      So, what is the motivation for getting the child to say he loves the adoptive mother? Is it simply the fantasy and myth that little children who show dependency and need care, respond to care with genuine love? Or is it an immature need on the part of one or both adoptive parents, to "win" some struggle and to justify their existence by having a child who says "I love you"? Or, do these words suggest to the adoptive mother that the child will now sit quietly in church, never do drugs, never have premarital sex? Is it a matter of confusing attachment with compliance?

      This is all too reminiscent of the Elvis Presley movie "Change of Habit" in which he plays a holding therapist (Yes, really!). He does some holding on a nonspeaking autistic child, who then totters out to the waiting room and tells her mother in a shaky voice, "I... love... you". Implication: it's all fixed! No more autism-- it was all about not being able to love someone.

      It would be much more to the point in all these cases to show that the child was now capable of taking turns.



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  2. I totally agree with you. Every child needs love. Even if he rejects hugs and kisses ....... it does not mean that he denies love. The rejection could mean lack of confidence and it must be patiently overcome but do not try to speed up the processes of convergence with the child.
    Such a cute little boy .... He does not look like a tortured prisoner in an orphanage.

    Peter in the orphanage (Oct. 2004)
    Peter's 1st breakfast at the hotel (Moscow, Nov. 2004)
    https://whenrainhurts.files.wordpress.com/2010/02/img_2774.жп

    Peter and Sophie Hyde Park, NY, Dec. 2004
    https://whenrainhurts.files.wordpress.com/2010/02/copy-of-20050101_0065.jpg

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    1. Mary Dozier, the creator of an evidence-based program for improving secure attachment in foster children, has pointed out that foster children are often misperceived by caregivers, who do not see the children's subtle communications about social contact, or who are severely discouraged if a child pushes them away. It's possible for foster and adoptive parents to learn to "read" unusual communications from children and to provide the needed sensitive and responsive parenting-- but of course they will not manage this if they are convinced that the child is fighting against love.

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  3. "It's the job of parents to love a young child, not the job of a child to love the parents." Yes yes yes!! I am reminded of the song lyrics "I can't make you love me/if you don't/I can't make your heart feel/something it won't..." The whole point of these harmful therapies is wrong, to try to force the appearance of love from a child by force and breaking their spirit. The best this can result in is something like Stockholm Syndrome, not genuine freely given love.

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    1. It's too bad that adoption organizations can't screen out parents who are looking for a child to love them, make them look good, etc. Perhaps all parents have this fantasy to some extent, but those for whom it's a major motivation can cause all sorts of trouble.

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  4. Maybe I'm wrong .... but I have a lot of claims to the staff of the orphanage. The children in this orphanage are only 2 "entertainm Bowlby's film "Nine days in a residential nursery" was translated into Russian.
    Bloggers call this film "Horror".
    ent."
    1 . The struggle for possession of the coveted toy.
    2. The struggle for attention and affection favorite nurse.
    In addition there is one more "entertainment". It is a loud b
    All of these "entertainment is not interesting for the little John. It feels like a nobleman which police locked in the tavern with stevedores.anging on the table with a mug.
    He suffered, and not for a moment distracted from his grief. Is there no way to alleviate the suffering of this child? Is the nIf there is no desire to entertain and distract children ..... At least then it was necessary to offer John the designer "Lego" or a puzzle for his age.
    One way to distract the child:https://www.youtube.com/watch?v=qmypKyT3Snc

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    1. I absolutely agree that little John's situation was agonizing and is difficult even to watch, but please remember that this was made many years ago when young children's feelings were not considered important. One hopes that today a different situation might be seen, at least in the best of cases. For example-- John's father might have spent more time with him, or even kept him at home with a baby-sitter to help out while the father worked, but in those days no one expected fathers to care for young children.

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  5. In the film, saying that the family was experiencing financial difficulties at the time. The shelter was the only way to correct situation and create the conditions for further prosperous life of the family. Sometimes (in Russia very often) the circumstances of life are higher than our feelings. 9 days
    it is not a disaster. All are alive and the family began. But nine days of suffering this child will remain on the conscience of employees of the orphanage. John became stronger and learned to assert their rights among their peers. But he will not be the same. He has changed. But he did not become worse.

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  6. You may be right, Mikhail, but what I understood from the film in English was that the nursery was considered suitable care for a child while the mother was in the hospital for more than a week following giving birth. This kind of care was certainly customary at the time in England. My former husband was at about the age of four dropped off at a London hospital to have his tonsils taken out and picked up by his mother a week later-- no visiting, as it was thought to upset the children. He didn't speak for a year after that, but all this was considered normal practice, as was John's distress. John Bowlby's work was very important in creating understanding of the care needs of these young children.

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    1. Jean ..... 20 years ago, Russia was normal practice to send children to the cottage for the summer. Children's summer residence ... is kindergarten away from the city. Children lived there around the clock for three months. There's a lot of work carried out to improve the health of children (massage, sunbathing, nourishing diet, plenty of fruits and vitamins and so on. The first 3 days
      3 to 5-year-olds have experienced very difficult separation from their parents. It was almost impossible to reassure these children. Staff would collapse to the ground from the emotional and physical fatigue. Then everything came back to normal. Kids playing sunbathing, laughed a lot .... At the end of the summer, they came to Moscow healthy and happy. Nothing wrong with their emotional development did not occur during this period because the had a lot of fun events and entertainment for the children. 5-7-year-olds usually do not cry. They already knew that nothing bad will happen but it will be many new and interesting experiences.
      Of course there were children who difficult reacted to the separation from their parents. If on day 3 the child does not like to be included in the co-op or rising temperature .... then an employee of the child carried off to Moscow to parents. It happens very rarely. Usually these children have not had the experience of visiting a kindergarten and had a full family (mom and dad), 1-2 loving grandparents and other relatives. They are used obschatsya with adults and be in the spotlight. Such children -individualisty were very few children in the Soviet period. For 3 years I saw only two children who were not able to adapt and have been returned to the city.

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  7. After the collapse of the Soviet system .... Moscow has ceased to finance the children's country cottages. Moscow kindergartens have ceased to take the children out of town for the summer.
    St. Petersburg has not ceased to use this practice, but to make this service a fee.
    http://www.deti-club.ru/detsad/da4a

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  8. Kindergarten in the country in 1934
    http://images.myshared.ru/5/410741/slide_13.jpg
    Kindergarten in the country in 2014
    http://d103.shko.la/novosti-1/zagorodnaadacavkomarovodlavospitannikovdetskihsadovvyborgskogorajonanacalarabotu

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  9. Even if a child is sick (FAST). Why squeeze a confession of love? Really do not want to teach that child something useful. Really do not want to attach to the child's art? Adoptive parents are afraid that if the child does not say the magic words "I love you" .... he will take a knife and goes to kill? It is naive, these adoptive parents. There is no ready-made recipes and there is no miracle cure.
    sings orphanage "new family" Uzhgorod Nikolai Scriabin.
    "I was an angel, and I could fly" http://www.youtube.com/watch?v=6lDRF7XEj_M

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