Wednesday, March 18, 2015
The Harris Case: Attachment,Trauma, Ambiguity, and Investigation
Unless you read only the New York Times (which hasn’t mentioned a word of this), you are probably aware of the Arkansas case of Justin Harris, a state legislator, and his wife, who adopted two little girls, exorcised them, treated them with harsh “parenting” methods, and passed them along privately to another family, where one was sexually abused. The most recent discussion of this case and its background is at www.arktimes.com/arkansas/harris-therapy-controversial/Content?oid=3755237). Before writing this article, Leslie Peacock, an Arkansas Times editor, talked at length to me and to Jean Crume, a DHS social worker, as well as doing a great deal of reading and considering the testimony of the babysitter who took care of the little girls for a period while they lived with the Harrises.
When Leslie and I started our discussion, one of the first issues that came up was what some terms meant. If the Harrises were using “attachment therapy” with the girls—a method that Jean Crume says she sometimes uses—exactly what did that amount to? We looked back at the 2006 APSAC-APA Division 37 Task Force Report, and saw that in 2006 the authors had stated, “The terms attachment disorder, attachment problems, and attachment therapy, although increasingly used, have no clear, specific, or consensus definitions.” This continues to be true a decade later, and in my opinion this is the reason why conventional treatments focusing on parent-child relationships are usually called “attachment-focused” or “attachment-based” therapies, or words to that effect, rather than “attachment therapies”. For myself, I would define “attachment therapy” as a form of intervention derived from the older Holding Therapy, and popularized at the time in the early 2000s when the dangers of Holding Therapy were being publicized. I would add to this that “attachment therapy” is based on a conflation of child attachment with child obedience and compliance, and on the belief that re-enactment of posited infant experiences in later life causes a child to become emotionally attached to an adult caregiver.
I don’t know whether these would be Jean Crume’s definitions of the “attachment therapy” that she considers suitable in some cases. I do know, though, that as the Arkansas Times pursues its proposed investigation of DHS, terms must not be allowed to go undefined. “Attachment therapy” is an especially problematic term, because for many readers, “attachment” sounds good, and “therapy” must be good, so “attachment therapy” is definitely more than acceptable—even though some practices associated with that label would probably be rejected if they were called “isolation treatment” or “no-toys intervention”. The investigation of DHS must clarify this point.
But of course “attachment therapy” is not the only problem word. Jean Crume is quoted as calling Nancy Thomas methods “controversial”. What do people mean or understand to be meant when they use this word? My big old Webster’s says it means “debatable”, which seems not to be much of a description, as most things more complicated than the time of day are open to debate. It seems to me, however, that in fact the principles and practices of “attachment therapy”, including the “parenting” techniques, are not at all debatable. On the contrary, there are a large number of psychologists and other mental health professionals who would regard those beliefs and practices as totally wrong and unacceptable. Opposed to those thinkers are a small number of persons with various backgrounds who claim not only that “attachment therapy” is effective, but that conventional methods exacerbate children’s problems, and that even the most basic conventional ideas about attachment are incorrect. There is no debate here. These ideas are mutually exclusive. If the conventional attachment theory and treatment methods are right, “attachment therapy” approaches cannot be right, and vice-versa—if “attachment therapy” views are correct, 75 years of research on attachment must be overturned and forgotten. Where is the controversy? Could it be that Jean Crume and others really mean, “A lot if people don’t like these ideas, but I think they’re all right, and there’s no law against the practices unless somebody really gets hurt”? If that is not what they mean by “controversial”, I can’t guess what they might mean. But I think it would be essential for any investigation to be sure what is intended.
Toward the end of Leslie Peacock’s article (linked earlier) a DHS spokesperson says that the agency is working toward educating foster parents about trauma and its role in determining children’s later behavior. She noted the focus on a “trauma informed” approach and the intention to use Trauma Focused Cognitive Based Therapy, an evidence-based treatment for children who have been sexually abused or hurt by domestic violence. But the spokesperson goes on to say. “Training has also been provided to a number of foster parents. We think a trauma-informed approach is critically important and we’ll be working…on how we can accomplish training for all foster parents.” So, investigators-- what is going on here? TF-CBT is indeed an evidence-based method, but it is taught to and used by qualified professionals. The foster parents are not going to become psychotherapists in the professional sense. What are the foster parents being taught about trauma, about what experiences have traumatic effects, on the behavioral outcomes for children, and on what methods can be helpful? I ask this question not out of general suspiciousness, but because the term “trauma” has “crept” to a much wider meaning than it originally had, just as happened years ago with “attachment”; trauma is now sometimes used to mean practically any bad thing, just as attachment came to mean all good things when present, all bad things when absent. Just a few days ago, I published a post on this blog on the subject of an adoption agency in Ontario whose website baldly stated that all adopted children have been subjected to extensive trauma because of the separation from the birthmother, to whom, it was claimed, they had developed a powerful emotional attachment during their gestation—an idea completely at odds with established research on attachment, but certainly popular with Nancy Thomas and “attachment therapy” advocates . What are the foster parents being taught? The term “evidence-based” seems to be intended to describe their training as well as the professional training, but I don’t see how that can possibly be. Investigators need to explore this, because the attitudes and expectations of foster parents are a good deal more likely to affect children than their occasional visits to therapists.
There are a lot of questions to be asked before anyone understands exactly what has been going on in Atkansas, as well as in many other states’ human services departments.