Thursday, January 26, 2012
The Regression Myth versus Developmentally Appropriate Practice
A disturbing report about a family in Snohomish, WA (www.heraldnet.com/article/20120121/NEWS01/701219927) states that a college-age adopted daughter has confronted her father with accusations of sexual assault, and that investigation has shown that a “therapist” concerned with attachment issues recommended years ago that the family share a bed. The intention behind this advice was to correct the daughter’s posited problems resulting from abandonment and lack of emotional attachment.
The details of the sexual relationship were outlined in the news report, but they are not the real point of this post. My guess would be that an adoptive father who was strongly tempted to be sexual with a young girl under his care would probably find some way to do this, shared bed or no shared bed. However wrong-headed the therapist’s approach, her advice probably had little to do with the sexual misconduct, other than possibly offering an increased level of temptation.
Sorry as I am that the girl had repeated experiences of unwanted sexual approaches from one who should have protected her, what concerns me in a broader way is the belief system that made the practitioner (and note that I am not calling her a psychologist-- I doubt that she was one) think her advice was appropriate. That belief system must have included the idea that through regression a person can rework earlier experiences and resolve problems resulting from her early history, such as problems about emotional attachment to caregivers. The system is likely also to have involved the belief that regression can be brought about by behaving like a young child, or being treated like a young child. This view, which is common among advocates of rebirthing, patterning, primal therapy, and similar unconventional treatments, suggests that the cure for any problems that may date from early life is to re-enact early life events-- but, this time, make sure the experiences are right.
How does this link up with having the family share a bed? There is a popular set of beliefs (not usually necessarily associated with the idea of regression), advocated by William Sears and his family, and often called “attachment parenting”. Attachment parenting focuses on the idea that infants need intensive and extensive social and physical contact with their caregivers in order for attachment to develop. “Kangaroo care”, skin-to-skin contact, breastfeeding, and the “family bed” are all part of this approach. As a general comment, I’d say these activities are harmless but unnecessary; the development of attachment is a robust phenomenon that will occur if it’s given half a chance and does not need this kind of artificial cultivation. (By the way, if you wonder how people maintain a sex life while doing the family bed routine: some friends of mine used to give their 5-year-old a quarter to keep his little sister downstairs while Mom and Dad got it on-- necessity as the mother of invention!)
But surely the Searses do not say 15-year-old adoptees should be in the family bed? No, indeed they don’t. And this is where our so-called therapist fell prey to the regression myth. She knew that co-sleeping was supposed to encourage attachment; she knew the girl had a history of separation and loss, as well as a new relationship with adoptive parents whom she didn’t know well. If the girl would have developed an attachment to parents in her early childhood, given a chance--- and if co-sleeping was a way to develop an attachment--- and if regression through re-enactment of experiences typical of early childhood was a way to rework early personality development—voila! Put the girl in bed with the parents, she will regress to early childhood because of this experience, because she is co-sleeping she will become attached to the parents , and that attachment will dissolve any personality problems she has developed because of her lack of attachment. It’s all so simple, really.
Except…. Except that these things aren’t true. People can’t regress to earlier stages of life, although of course they can behave in immature ways and may do so particularly under emotional stress. Treating people as if they are infants or young children is a pointless “magic” ritual that cannot actually cause them to return to early development (and if it did, would you expect them to return to maturity immediately, or would they have to repeat years of normal development?). Co-sleeping is not necessary or sufficient for the development of attachment. And, an individual who is already 15 years old has a vastly different perspective on emotional attachment than an infant is capable of having; she doesn’t form attachments as an infant does, and she doesn’t show them through an infant’s attachment behavior when she does form them.
The therapist and the parents fell for some common myths about personality development. In addition, they forgot an important theme of childhood interventions for emotional, physical, or cognitive problems: treatments need to be developmentally appropriate if they’re to be effective. We feed a tiny infant milk, an older baby strained food, a five-year-old most of what adults eat. Giving the five-year-old an all-milk diet will cause malnutrition, and so will feeding the three-month-old barbecue. Treating an infant or toddler who is grieving over separation and loss may well require staying with her a lot of the time, but treating a teenager who has experienced many separations requires a much more complex treatment approach.
We can’t expect most parents to be aware of developmentally appropriate practice, but we surely should expect, even demand, that therapists working with children and families will know this concept. Regrettably, training and licensing in many related fields (like marriage and family therapy) may completely ignore this and other important ideas. We seem to have a long way to go before we can be sure that all psychological treatments are either effective or safe, let alone both. The therapist in this case made mistake after mistake because she misunderstood some basic concepts, although her mistakes may not have been the cause of the sexual mistreatment that will probably be the focus of any discussion.