Concerned About Unconventional Mental Health Interventions?

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

Saturday, December 3, 2016

The Gentrification of Martha Welch

My friend and colleague Linda Rosa recently pointed out to me a Wikipedia article about the Columbia University-associated psychiatrist Martha G. Welch. This article contains much about Welch, including her connection with the grape juice family and her current partner’s name. Her interest  in autism is mentioned, as well as various honors she has received from Columbia and biological research she is engaged in.

But… a lot was missing in this article, until I went to work and edited it by adding a paragraph that described some of Welch’s complementary-alternative approaches to treatment of autism. Indeed, the article as it stood cleaned up Welch’s professional life thoroughly and positioned her as a conventional researcher with no history of any fringe theories. I checked both the Talk and the History sections of the Wikipedia page, where you can see whether people have discussed or made changes in included material, but I did not see that material had been deleted, so I assume that the gentrified, non-comp-alt version was pretty much the way the article was originally written.

Of course, anyone who knows anything about Martha Welch knows better than to accept this tidied-up version. Here’s the reality.

Martha Welch many years ago visited Foster Cline and other proponents of Holding Therapy in Evergreen, Colorado. She was impressed with their intrusive, potentially dangerous methods of restraining children, techniques that they posited as psychotherapeutic. These methods were based on the work of Robert Zaslow, the California psychologist  who in the 1960s and ‘70s claimed that autism and other mental illnesses could be treated successfully with painful physical methods (until he lost his license for injuring an adult patient).  

Welch did not exactly follow the Evergreen methods, but she decided that something similar would be an effective treatment for autism. She speculated, like Zaslow, that autism was the result of a disorder of attachment—the child’s mother had not done the right things to create attachment. (On Welch’s behalf, I have to say that this exaggeration of the role of attachment in development was common at that time and has not completely left us). Welch considered that human attachment occurred in an exact parallel to the “imprinting” whereby a recently-hatched duckling follows a moving object and subsequently tries to stay near (and eventually mate with) similar objects. This ethological explanation was maintained despite the fact that imprinting has never really been demonstrated in any mammals, much less in human beings—but the possibility was given serious consideration by Konrad Lorenz and Nikolaas Tinbergen, the ethologists who had investigated such instinctive behaviors in birds and fish.

Welch suggested that attachment (which of course she saw as the key to autism) could be created long after the period when it normally occurs if a child was forcibly kept in close physical contact with the mother. (Sorry fathers, you did not really get much of a role in all this.) She developed a technique she called “holding time” (also the title of a book she published on the subject in the 1980s). “Holding time” was to take place every day, and required the child to be held in close physical contact with the mother for an hour or so, during which time the child would fight, scream, and struggle, but eventually would be exhausted and snuggle closer. Younger children were to be held straddling the sitting mother’s lap and pressed against her chest. If too big to be held in this way, they were to be made to lie supine on the floor while the mother lay prone on top of them, supporting herself on her elbows and looking into the child’s face while she told the child her feelings both negative and positive. Welch presented this method not only as a cure for autism but as a key to good parent-child relations for all families.

As it happened, Elisabeth Tinbergen, the wife of the ethologist and Nobel Prize winner Nikolaas Tinbergen, was a special education advocate, and she came to know Welch and to be fascinated by what she perceived as the benefits of Welch’s method for autistic children. Niko Tinbergen also took an interest and argued that human attachment paralleled imprinting and might be able to be manipulated in the same way (although they stated clearly that no empirical support had been found for this practice). The Tinbergens published a book encouraging Welch’s methods and connecting them with ethological theory; their book included a lengthy appendix by Welch and led to the publication of her own book Holding time.  Welch went to England and Germany on an extensive book tour, during which she instructed large groups of mothers of autistic children on using restraint methods with their children. (She also met Jirina Prekopova, another protegee of Tinbergen, who is still doing a similar form of holding therapy in the Czech Republic.) Welch also set up a “clinic” in Connecticut for instruction about this treatment for autism, although no research support had appeared to show that the treatment was effective.

In 2006, a new publication by Welch and colleagues appeared (you can look at the Wikipedia article now for the reference if you want it—it’s not easy to find on her own website). She changed the name of the restraint treatment to Prolonged Parent-Child Embrace therapy and now recommended it for attachment problems and oppositional behavior. A comparison of parents’ assessments of children before and after the treatment was presented was used to conclude that the treatment was effective—a move that ignored the many problems of this kind of research design, including both regression to the mean and developmental changes unrelated to the treatment.

Now, ten years later, Welch appeared in a Wikipedia article as a completely conventional psychiatrist and researcher, quite rehabilitated from her comp-alt days. Of course, I may be wrong in thinking that all the fringe stuff was left out intentionally. Perhaps Welch regrets her involvement with those unsubstantiated claims and recommendations? That would be interesting if true, and I would hope that in that case she would publish a statement about why she has changed her mind (although people who get involved  with the fringe rarely do this later on –cf. Dan Hughes). But it is probably more likely that this article’s take was mainly about burnishing the image.



2 comments:

  1. There are a couple of videos on YouTube that demonstrate the brutal Welch methods:

    https://www.youtube.com/watch?v=GPaNe0g9_-w

    https://www.youtube.com/watch?v=OdWhcyz6KbY

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