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Concerned About Unconventional Mental Health Interventions?

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

Thursday, July 8, 2010

To Bed Without Supper

Being sent to bed without supper as a punishment--- this old-fashioned idea seems to have a certain charm. It’s much less violent than spanking, but still conveys a strong sense of adult authority. Doing it every now and then is not likely to do much harm to a healthy child. Nevertheless, we don’t hear of many ordinary parents using this punishment nowadays. They might deprive children of dessert, or “ground” them, or take away a toy or a week’s allowance, but meals are provided regularly, no matter what. And although those ordinary parents may get annoyed at children who won’t eat something, it’s rare for them to attempt to force eating. Withholding or forcing food or drink are not part of most families’ child-rearing or discipline methods.

Unfortunately, what I just said is true only of “ordinary” parents. The Philadelphia Inquirer this morning described the conviction of a Baltimore cult leader who had advised a mother not to give her toddler son food or drink because he was “rebellious” and did not say “Amen” after meals ( . The child died of hunger and thirst after a week of deprivation. The child’s mother, who still believes he will be resurrected, is in a residential treatment program for young women.

The conviction of the cult leader on second-degree murder and child-abuse charges may be a breakthrough in this area. People who practice as therapists or parenting coaches or educators have advised parents to limit food and have not been held liable for child injuries or deaths; it was the parents who were convicted. For example, in the death some years ago of Viktor Matthey in New Jersey (, Viktor’s adoptive parents were convicted and sent to prison for the child’s death from multiple causes. Among other things, they had “punished” Viktor by forcing him to eat a mixture of uncooked beans and barley; if he did not finish it in time, he was not allowed to drink. Did the Mattheys invent this punishment for themselves? It seems unlikely, because punishment by means of forcing or limiting food is suggested in various publications advocating unconventional child-rearing or discipline methods. But no advisors were charged in the Matthey case.

Similarly, Cassandra Killpack’s mother was convicted after she forced the 4-year-old to drink a large amount of water, causing brain swelling and the child’s death (,5143,515037467,00.html). Mrs. Killpack said that this punishment for having “sneaked” some of a sister’s fruit juice had been advised by a therapist she consulted. The therapist denied this, saying he was only there to support the parents. The therapist , who had lost his license in another state because of inappropriate practices, was not charged.

Why do I suggest that unconventional therapists advise withholding or forcing food, rather than thinking that parents invent these practices for themselves? After all, most of us are aware of the “bed without supper” tradition, and some people may convince themselves that serious deprivations are really no worse than that. But what makes me think that therapists (like that Baltiomore cult leader) may be giving this advice is that there are published materials that suggest food deprivation as part of the “treatment” for Reactive Attachment Disorder or other problems. This idea goes back to the generally-respected psychologist Milton Erickson [N.B.not Erik Erikson!) who advised a diet of cold oatmeal, and periods of physical restraint, for a disobedient boy, and noted with approval that after a time on this regimen the child trembled when his mother spoke to him ( Erickson, M.H. [1962]. The identification of a secure reality. Family Process, Vol. 1(2), pp. 294-303). The parenting “educator” or “coach” Nancy Thomas has more recently advised limiting of food to peanut butter sandwiches and milk for weeks at a time, with a more nourishing diet dependent on pleasing the parents (Thomas, N. [2000]. Parenting children with attachment disorders. In T.M. Levy [Ed.], Handbook of attachment interventions. San Diego: Academic Press). (Thomas, incidentally, claims that feeding caramels to children fosters attachment, because caramels contain milk, etc., etc.-- you fill in the rationale.) There is no evidence that such treatment is either safe or effective as a way of dealing with discipline or mental health problems, but there the advice is in print, and the First Amendment protects it.

Although I believe it would be highly appropriate to charge therapists and other advisors whose counsel encourages parents to harm children, I recognize the legal complications here. If I tell someone to shoplift, that other person has the responsibility for recognizing that the action is wrong and refraining from doing it. However, the conviction of the Baltimore cult leader suggests that authorities are beginning to see the importance of the roles played by givers of advice, whose words may encourage parents to perform acts that they would otherwise only have considered. In the Baltimore case, the judge described the cult leader as a manipulator of lost souls. Perhaps we are on the way to recognizing that such manipulators may appear in professional or quasi-professional guises, and that harmful advice from such people merits punishment as much as if they were leaders of cults.

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