Wednesday, November 14, 2012
An Open Letter to Richard Dawkins: Butterflies, Herring Gulls, and Hurricanes in Child Mental Health
Dear Professor Dawkins:
About 30 years ago, you contributed inadvertently to a mistake whose repercussions are still being felt by vulnerable and innocent people. Without wishing to blame you for an action whose consequences are not your fault, I would like to ask you to speak up in support of those of us who are working toward correction of the error.
The flapping butterfly, or perhaps herring gull, wing I refer to was your contribution to the book Autistic children: New hope for a cure, published in 1983 by Nikolaas and Elisabeth Tinbergen, with appendices by Martha Welch and Michele Zappella. In the Preface, the Tinbergens thank you for reading and critiquing Chapter 7 (“Methodological comments”). Presumably you had some idea what claims were made in the book; if you did not, I will point out now that the Tinbergens’ intention was to advocate for the use of “holding therapy” in the treatment of autistic children. Many of the book’s illustrations show children screaming and fighting against the physical restraint that is the core of “holding therapy”. In the appendices, Welch advised this form of restraint for every child every day, as well as for autistic children. Zappella claimed that he used “holding therapy” to cure not only autism but the problems of a child who had been exposed to rubella prenatally.
Today, it is clear that “holding therapy” is not only ineffective but dangerous to children, and a number of professional organizations have stated this in public resolutions. But such statements have not stopped the use of the treatment. Martha Welch, who has often referenced the Tinbergens, continues to practice in the United States. At least one British practitioner has used the method in residential treatment of foster children. The Czech practitioner Jirina Prekopova, whom the Tinbergens mention with approval, has recently returned to the Czech Republic to practice “holding therapy” after many years in Germany. Prekopova too refers to the Tinbergens’ book as the scientific basis for her methods, which apparently receive strong support from the church. If you want to hear the sound of the hurricane that has resulted from that butterfly or gull wing, go to www.youtu.be/uzQmHq-7rKM where you will hear the screams and pleas of a child being subjected to Prekovopa’s “holding therapy” methods. (I suggest that you do not play this where children or unsuspecting adults can hear it.)
The chapter on methodology that you critiqued is in no way supportive of “holding therapy”, but simply discusses the Tinbergens’ view of an appropriate, ethologically-based way of studying autism. If the book stopped at that point, there might be little need to ask you or anyone else to speak out-- but it does not stop, and the succeeding unevidentiated claims about “holding therapy” appear to the naïve reader to be logical consequences of the earlier material. This presentation has enabled practitioners of “holding therapy” like Prekopova to argue that there is a scientific basis for what they do. In point of fact, the Tinbergens’ elaborate discussion of behavior patterns provides an interesting hypothesis for the exploration of autism, but no support whatsoever for the use of “holding”. Your public statement of that fact could help to counter the present use of what is simply a complementary and alternative treatment.
In April 2013, there will be a meeting in London of what may be provisionally named an International Working Group on Abuses in Child Psychotherapy. It will be attended by interested American and British psychologists and social workers and by people from the Czech Republic who are particularly concerned about the popularity of Prekopova’s methods in several European and Latin American countries. A statement from you, making clear that you reject any scientific foundation for “holding therapy”, including the arguments presented by the Tinbergens, would be much appreciated by the members of the group and could help reduce the use of the method.
Thank you for your attention.
Jean Mercer, Ph.D.