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Concerned About Unconventional Mental Health Interventions?

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

Monday, February 19, 2018

Is Attachment Therapy "Controversial"?

A newspaper in Greeley, Colorado has once again incorrectly referred to Attachment Therapy as a “controversial” treatment. AT is not controversial, not are its associated beliefs and adjuvant treatments like Nancy Thomas parenting. They are not controversial because there is no controversy here. No one who has any understanding of child development would enter into any controversy on these ideas and practices, which are clearly wrong, unfounded, and potentially harmful. There is no need to argue the point, as would be done if something were genuinely controversial.

Attachment Therapy is an alternative psychotherapy, the parallel in the psychology world of complementary and alternative medicine (CAM). It can be identified as an alternative treatment because it is implausible, incongruent with what is known about child development, and lacking both an evidence basis and a possible mechanism by which it might work. The same points can be made about the alternative developmental theories and adjuvant treatments associated with AT. Arguments in favor of the AT principles and practices are based on a completely mistaken definition and theory of emotional attachment and use terms related to attachment in obfuscatory ways rather than for clarification.  

There are many other alternative belief systems that are completely wrong, but not controversial, because no knowledgeable person would enter into serious controversy about them. For example, the belief that the earth is flat rather than spherical, as promulgated by the Flat Earth Society (https://www.tfes.org), is wrong, but there is no controversy about it in serious circles. We do not see geographers applying for grants to demonstrate that the earth is a sphere, or writing learned books arguing on philosophical principles that the flat earth view is wrong. Like AT beliefs, the Flat Earth view is a mistaken alternative belief, but not the subject of controversy.

So, why did the Greeley newspaper say AT is controversial? One reason is that lots of other people have said this and it seems like an exciting idea. (And it would be extremely exciting if any evidence were advanced to support AT beliefs, because if they are right, that would mean that almost all established facts and principles about child development have to be abandoned!) Using the word “controversial” also lets the reporter off the hook with both AT proponents and conventional psychologists, by implying that no stand is being taken—although mentioning these ideas at all, when they are so little known in the world of professional psychology, actually is taking a stand. Describing AT as controversial and giving space to differing ideas about attachment and attachment disorders provides the pseudosymmetry, or equal weight for well- and poorly-supported ideas, that passes as “fair treatment” in present-day journalism. Using the “controversial” word  about AT also gives lots of chances to talk about horrible children and the need for adult domination, topics that are bound to attract interest.

Are there controversial ideas and treatments in psychology, as opposed to alternative psychotherapies? Yes, of course. A good example is Eye Movement Desensitization and Reprocessing (EMDR), a treatment claimed to treat anxiety and other emotional discomfort by having the patient imagine the frightening situation while moving the eyes in a pattern. There are lots of controversies here, and lots of people attempting to investigate EMDR empirically. Is EMDR effective in reducing emotional discomfort? If it is effective, what is the mechanism—do the eye movements really make any difference, or is the effective component simply exposure and desensitization as they are used by other treatments without planned eye movements? Because there is genuine controversy here, you will see many articles on these in peer-reviewed professional journals. People who know a lot about the topic disagree on EMDR and seek to test their beliefs by finding new evidence. None of this is true about AT, which is an alternative (CAM) treatment, not a subject of controversy.

If there was ever real controversy among professional psychologists over AT, it died down in 2006 when the joint task force of the American Professional Society on Abuse of Children (APSAC) and the American Psychological Association’s Division 37 rejected out of hand the use of attachment therapy, of adjuvant treatments, of the related views of attachment disorders, and of the alternative theory of child development on which all of these are based. So what keeps reporters and the public talking about these ideas? I would say that it is in part the wholehearted commitment of the public to the idea of attachment as the central theme of human life, coupled with a considerable misunderstanding of what attachment is. “Everybody knows” about attachment so it’s very comfortable for readers and viewers to encounter. Really, however, we need to keep in mind that although attachment (the actual process) is important, it’s not the only thing that’s important in development.

And, there's a difference between controversy and unsupported claims about alternative treatments.


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