Concerned About Unconventional Mental Health Interventions?

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

Sunday, August 27, 2017

Proposing a Pattern of Child Abuse: Maltreatment Syndrome


When a number of medical or psychological symptoms tend to be seen together, that group of symptoms is referred to as a syndrome. Not every symptom that belongs to a syndrome occurs in every case, and symptoms can belong to more than one syndrome. (For instance, having a fever can be part of many medical syndromes, and being anxious can be part of more than one psychological syndrome.)  In some cases, more than one cause could create the same pattern of symptoms.

Usually when people talk about a syndrome, they are referring to the symptoms experienced by a person suffering from a problem. But it makes just as much sense in some cases to talk about a syndrome of behavior shown by people who are not experiencing, but causing, someone else’s discomfort.

I’ve referred a number of times on this blog to a pattern of behaviors of parents toward children, a pattern often described in journalists’ reports of child abuse and neglect cases. This pattern usually includes some or all of the following: keeping children isolated or secluded in a less-used part of the house like a basement or attic, removing or not supplying furniture like beds, limiting the food children are given, claiming homeschooling but in fact not providing education, limiting toilet access, and requiring tedious and unnecessary physical work or exercise. There may or may not be physical punishment, and when there is it may include or be confined to “hot-saucing” or forcing other kinds of noxious food, or forcing liquids.

I propose to call this pattern of parental behavior maltreatment syndrome. Please note that I am simply proposing the existence of this pattern as an identifiable syndrome; I am not claiming that this is a well-known term or one that can be used authoritatively or diagnostically. However, it seems to me that the pattern crops up so often that it would be fruitful to regard it as a syndrome.

 Although discussions of many syndromes include references to causes of the syndrome, in this case a specific cause may be difficult to pinpoint unless we have a good deal of detailed information about a case. However, I would suggest that there are two major causes of maltreatment syndrome. One involves learning or personal experience of some “old-fashioned” punishment methods, and implementation of those methods by parents who may be intellectually challenged or suffering from some form of mental or physical illness that limits their capacity for empathy and for recognition of consequences of their behavior. The other possible cause of maltreatment syndrome is direct instruction, through classes, reading, or personal contacts, about the parenting methods advocated by Nancy Thomas, the former dog trainer and currently self-identified trainer of foster parents. Thomas’s ideas, like those of her mentor Foster Cline in the 1990s, emphasize  goals of child obedience and complete parental authority, to be achieved by whatever means of child control are necessary. These goals are presented as essential ways to prevent a child from becoming a serial killer or a prostitute (these being seen as equally evil by Thomas and Cline).

Which cause is at work in any specific case? This is something we could only know by examining the beliefs and experiences of the maltreating parents whose children have been found to be injured or killed by elements of maltreatment syndrome. Unless law enforcement and child protective services investigate these issues, it is impossible to know why parents chose the actions they did—and it is rare for the authorities to do this kind of investigation, possibly because they see the maltreatment as a series of undesirable acts rather than as a pattern.



In this case, a Utah couple by the name of Waldmiller have been identified as maltreating their three adopted sons, ages 7 to 11. I would identify their behavior toward the children as maltreatment syndrome. The Waldmillers kept the children for as much as 13 hours a day in a room with no lights, with windows screwed shut and painted black. They bound the children with zip ties and sometimes duct-taped their mouths. If they cried when beaten, their clothes were taken away. They were given limited food and had been punished for searching for food in the dumpster of a nearby school. They were sometimes punished by being made to eat heavily- salted rice with cayenne pepper and having water limited. To complete the maltreatment syndrome picture, the boys were not given access to toilet facilities and used a heating vent instead. They were also required to do exercises like squats to earn permission to read, and reading was required for them to be permitted to eat.


The Waldmillers did not go to trial but pled guilty to reduced child abuse charges. This means that there was no opportunity for full investigation of their motives and no public discussion of the beliefs behind their actions—whether these were simply what they remembered their parents doing, or techniques they had learned through Nancy Thomas instruction. Given the expense of investigations and trials, this is a common occurrence in cases of this kind, which in turn makes a fuller understanding of maltreatment syndrome impossible.  Without a trial, there is no complete public record of the proceedings, and people concerned with the abusive pattern must rely on journalists’ reports of cases.


The lack of information about this parental behavior means that I can only suggest that the pattern be called maltreatment syndrome; I can’t say confidently that there is such a thing. I base my suggestion on years of journalists’ reports and on the reports of a small number of adults who experienced this kind of maltreatment pattern as children and are willing to talk about it. Unfortunately, not much more will be known until law enforcement and child protective services staff are aware at least of the concept of a maltreatment pattern that overlaps only slightly with other known patterns. Considering abusive acts one by one meets the requirements of the law, but misses the insights that can come from consideration of a syndrome.

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