As many readers will know, iatrogenic effects are problems caused by efforts at treatment of other problems. An obvious example would be a headache caused by a medication. It’s easy to think of examples of medical iatrogenic effects. But can the idea of iatrogenic problems also be applied to psychological or social interventions?
I am going to speculate about how iatrogenic effects of social intervention may have been part of a story that is getting a lot of play in some parts of the U.S. But before I try that, I’d better tell the story, as far as I am able to do so. Because this story involves the Arkansas Division of Child and Family Services, adoptive parents, foster parents, and children, there is a good deal of confidentiality involved, and I have no way to be sure that what has been written reflects what really happened (so be warned, I’m just reporting the news as it has been written so far).
This story involves an Arkansas legislator, Justin Harris, and his wife, Marsha Harris. The Harrises were the biological parents of three boys, but decided they wanted to adopt three young sisters, the oldest 6 years old at the time. The girls had been in foster care, two in the same foster home and the eldest in a “therapeutic” home. The Harrises did not keep the oldest girl very long and returned her to DCFS before the adoption was final. But before a year had gone by, they decided that they could not keep the other girls either. They stated that the oldest girl had threatened to kill them, that one of the younger girls had “crushed” a pet animal, and that their sons were sleeping with Mr. Harris because they were afraid of the girls. (This information comes from www.arktimes.com/ArkansasBlog/archives/2015/03/06/harris-blames-adoption-woes-on-department-of-human-services and other similar sources such as www.arktimes.com/ArkansasBlog/archives/2015/03/07/foster-family-disputes-key-staments-from-justin-harris [yes, it does say “staments”].)
According to Mr. Harris, when he told DCFS that he and his wife did not want to keep the girls, he was told, he says, that they could be charged with abandonment if they did not. The Harrises then elected the “rehoming” option (see http://childmyths.blogspot/com/2013/09/the-reuters-investigation-into-re.html). They informally transferred care of the girls to Stacey and Eric Francis. Eric Francis was the head teacher at a preschool, Growing God’s Kingdom preschool, owned by Justin Harris. The Harrises continued to receive adoption subsidy checks and say that they gave the money to the Francises. Unfortunately, this apparently satisfactory solution to the Harrises’ difficulties came to light and ended when Mr. Francis was charged with raping one of the girls.
The foster parents who had cared for the girls denied that the girls had shown disturbed behavior when with them, and stated that they had argued against adoption by the Harrises, on the grounds that a home with three older boys was not appropriate for the girls, one of whom had been molested. The director of DCFS, Cecile Blucker, is speculated to have played some role in the decision for adoption placement.
So when do we get to the iatrogenic effects part? Obviously, this is speculation, especially because there is no clear information about what happened before, during, or after the girls’ stay in the Harris household.
Harris has claimed that he and his wife were not told that the girls were disturbed (and the foster parents, who knew them well, say they were not). My speculation is that they were indeed told, not that these particular children were disturbed, but that all adopted children suffered from some form of mental illness, and that their disturbance included attacks on people and pet animals. Such beliefs are widespread on the Internet and have been encouraged by authors like Tina Traster as well as by adoption caseworkers. The web site https://dhs.arkansas.gov/dcfs/heartgallery/suggested%20reading.htm gives an extensive reading list that includes books by writers who have advocated this point of view, including Foster Cline, Terry Orlans, and Deborah Gray, so we need not look far for evidence that the Harrises may have been encouraged in this mistaken belief by the state of Arkansas itself. If the Harrises were taught to expect that adopted children would behave dangerously and aggressively, their expectations might well cause them to interpret ordinary, age-appropriate behavior as indicative of serious disturbance. Because proponents of these beliefs about adoption also claim that untreated children will grow up to be serial killers, parents exposed to such ideas may feel that they must seek whatever treatment is available rather than just riding out temporary problems. A “crushed” pet may have been killed by accident, especially if it was small, but such an event might well be seen as evidence of a serious emotional disorder (although the foster parents noted that the girls lived happily with their dog and treated it appropriately). This sequence of events, leading to mistaken beliefs on the part of adoptive parents, would be an example of iatrogenic effects caused by an intervention. In addition, we might well expect other children in the household-- and the adoptees themselves!—to pick up on these expectations and to misinterpret normal moods and behaviors.
What treatment did the Harrises seek, when convinced that some treatment was necessary? This is not clearly stated in any of the sources I have found, but one parenting technique said to have been used was a familiar one for those of us who have paid attention to Attachment Therapy. One child had all of the belongings removed from her room and was required to “earn” them back by compliant behavior. This approach is recommended by many Attachment Therapy proponents, very much including Nancy Thomas. What is the iatrogenic aspect of treatment of this kind? Well, consider what impact this assertion of adult power actually has on a child who is struggling to adjust to a new home. Thomas, Cline, and their ilk all declare that when adults assert their authority, children become emotionally attached to them, and therefore (according to those authors) become compliant-- “responsible, respectful, and fun to be around”. However, what is far more likely is that constant power displays cause fear and anger in young children, who (like adults) are therefore less capable of rational behavior, and certainly less likely to feel affectionate toward the adults. The iatrogenic effect of these mistaken treatments is to exacerbate children’s negative moods and to interfere with development of the normal goal-corrected partnership stage of attachment.
Am I saying that these things happened in the Harris household? No, of course I do not have the information I would need to reach such conclusions. I am saying, however, that I see a distinct possibility that adoptive parents who have mistaken beliefs and choose mistaken treatments may create problems in children who did not have them before. That they may have been encouraged to do this by a state agency raises important questions that I hope will be asked by someone in a position to do this.
I want to raise one other issue before closing. Let’s go back to the preschool, Growing God’s Kingdom, whose head teacher took the girls informally and raped one. The name of this school is more than suggestive of the owner Harris’s evangelical Christian beliefs, which are possibly related to approval of Attachment Therapy. But there is another issue here, and one that suggests that Harris may feel that his rules about various matters are above the law. At www.arktimes.com/ArkansasBlog/2011/11/03/complaint-religion-taught-in-lawmakers-tax-funded-daycare, we see that in 2011 Americans United for Separation of Church and State brought a complaint against Harris and Growing God’s Kingdom on the grounds that the preschool received $500,000 from Arkansas Better Chance for School Success, in spite of teacher contracts that required a love of Jesus, and a curriculum plan including a Christian curriculum and Bible time. A.U.’s letter pointed out that, constitutionally, tax money cannot go to support religious activities. Why would Harris, a state legislator presumably familiar with constitutional restrictions on legislation, receive this money illegally? Why, also, did he apparently continue to receive state money for the girls when they had been “rehomed”? Although I’ve argued that other people also bear responsibility for what happened to the girls, there seems to be an attitude here that fits right in with the Attachment Therapy approach of displaying power and authority in order to reach a goal.
3/11/15 for further information about the Harrises' beliefs about the girls' demonic possession, see www.arktimes.com/ArkansasBlog/archives/2015/03/11/casting-out-demons-the-latest-on-the-justin-harris-adoption-story. (I can't figure out why this is not creating a link here).
A lot of these unregulated homes hide under the banner of religion to do whatever they want to the children in their care. The Child Catchers really illustrates this as well as a series on Tampa teen reform homes and there was another series on Chicago reform homesReplyDelete
Our daughter is 6 next month. When she first came to live with us last June she gave our cat a "whisker trim". He is a marmalade tabby with intact claws and he just sat there and let her cut off each one. Now I am assuming that he just SAT there but I know for a fact if she was hurting him he would have clawed her severely. She very proudly showed us when my husband got home from work. we had a long conversation with her about why whiskers are important to cats and why she should never do it again and it hasn't been an issue since.
Then she was caught stealing candy from the bins intended for a school-wide gingerbread house building. Her logic was that we had purchased some of the candy and everybody was going to share the candy for the houses so why did it matter that she took a few pieces before the project? We discussed theft and didn't allow her to participate and picked her up early that day.
When she misbehaves we will send her to her room to cool down. The amount of time is totally up to her and she will put herself down for a nap. Other times she throws her toys everywhere and in the past if we are in the tv room she would throw things towards us to gain negative attention. That last bit stopped when I informed her that any more toys or books that were thrown into the hallway would be donated to charity.
Another thing she will do is that whenever she meets new people she will say outlandish things just to see how they react. She reminds me a lot of Louise from Bob's Burgers! LOL our daughter will find whatever buttons she can press and then push every single one just to see how you will react.
Lastly, she has poor impulse control and very much has an attitude that says I'm going to do what I want when I want and I don't care what you think or what happens to me. at the same time she is still a very loving and caring child and she doesn't expect anything in return when she gives out that love and care.
many would be thinking that maybe she does have an attachment disorder but the reality is that these are pretty common behaviors for children her age. Her need to test people and to be independent and in charge come completely from her genetic heritage. Both her biological mother and my husband can out stubborn cats. Her temperament is also closely related to theirs.
My biological, non-abused, non-adopted daughters BOTH stole candy -- one from a corner store, the other from a supermarket. Both got caught, were required to return the candy, apologise to the owner and were subsequently grounded. It is an age-appropriate (albeit awful and must be nipped in the bud) behavior -- and I did the same thing as a kid (and my parents subjected me to an almost identical punishment).Delete
Both girls went through looooong no-or-non-compliant-to-absolutely-everything phases that Nancy Thomas advises rehoming kids on the basis of -- behavior that's annoying as all get-out but 100% age appropriate.
My littlest is (finally, hopefully) emerging from what feels like the longest biting-other-toddlers phase ever. You do not want to know how many birthday parties, play dates, parks, etc. we've left in the past eight months. She's never been abused. She's never seen her older sister, older cousins, me or her dad bite anybody. Annoying and age-appropriate too.
Pathologizing normal kid behavior does no one any favors.
Last but not least, even if a child DOES get diagnosed with a severe mental illness... treatment can take ages. It's much more art than science to find a therapy, a medication or a mix of meds that works. Or that works for more than about four seconds. (My younger sister was diagnosed with a severe mental illness as a little girl and getting her stable, really stable, took nearly a decade -- about average for many of the early onset "frequent flyers" treated at the peds hospital that was her home away from home).
Same here-- I'm sure my grown-up sons would not care for me to tell who stole some money and fibbed about it, who dreidl-napped another kid's dreidl and concealed it, who tried at age 2 to strangle another toddler who was pestering him, etc! But now they are solid citizens and busy telling their own children not to bite, steal, lie, hit,and all that.Delete
Also,you're quite right, both diagnosis and treatment of early mental illness are real challenges and not to be accomplished with checklists and dietary limitations.
Right on the mark. The most recent report in the Arkansas Times reveals that not only did the Harrises follow the techniques promoted by Nancy Thomas, but they also believe in demonic possession.ReplyDelete
You said "there seems to be an attitude here that fits right in with the Attachment Therapy approach of displaying power and authority in order to reach a goal."
I agree. And it seems to me that people who have a deeply inculcated sense of being "special" and/or "chosen" (by God or whoever) tend to be past masters in self-justfication.
Thanks for the suggestion about demonic possession. I wondered very much about that, but didn't have any evidence to support it-- I must not have seen that most recent article yet.Delete
Through their attorney, Jennifer Wells, the Harrises completely denied all talk of demonic possession, because of course it sounds more than a little bit nutty. Wells released a statement reading,
“Exorcisms and telepathy are not part of the Harrises’ religious practice. They followed the techniques in a book called When Love Is Not Enough, a Parent’s Guide to Reactive Attachment Disorder by Nancy Thomas, who is a recognized expert on therapeutic parenting techniques.”
Amazon reviews of Thomas’s book detail some of her therapeutic advice:
“In the beginning, rewards and bonuses should be food, clothing or necessities.”
“In the beginning, your child should learn to ask for everything. They must ask to go to the bathroom, to get a drink of water, EVERYTHING. When it starts to feel like they must ask to breathe, you are on the right track.”
“The alarm on the bedroom door establishes a very clear physical limit for the child. When the alarm is working, day or night, the child can be controlled by being placed in the bedroom … There needs to be a very substantial consequence for opening the door after being told not to. In my house, for children over 5, it is 100 to 500 (depending on their age) pushups interspersed throughout the day for a number of days and no privileges until they are complete.”
Read more at http://wonkette.com/579216/ark-rep-justin-harris-had-daughters-demons-exorcised-before-rehoming-them-with-a-rapist#HDm9JD4eqJ5zqmBQ.99
Thomas certainly recognizes herself as an expert. She keeps saying so.Delete
What I want to know is, how many more adoptive parents are following this regimen in the belief that they are doing their best for their children? And how many adoption caseworkers are recommending it? Several years ago I testified at the trial of a Santa Barbara adoptive mother who had kept her kids in cages with buckets for toilets-- she said she had gotten it all out of a book by NT that her caseworker gave her. I don't think NT ever wrote exactly those suggestions, but she comes close enough for parents to think that the sky is the limit.
And when you treat traumatized kids in the exact opposite way that you should be treating them, already expecting the worst of them, their behavior only fits more and more into the picture of this adopted monster child who needs to be mistreated so they don't become a serial killer.Delete
It makes me so mad that so many people listen to this nonsense.
In Nancy Thomas's book "Dandelion on My Pillow, Butcher Knife Below," Thomas reveals her belief in satanic ritual abuse.ReplyDelete
Unfortunately for Arkansas, their DHS department on adoption has a webpage on "Suggested Reading" which includes a large percentage of books on Attachment Therapy, including one of Foster Cline's especially horrific books.
NT also says not to let foster children say grace at meals because "you don't know who they might be praying to."Delete
I encountered stuff like this a lot in the fight for our daughter. Lots of decisions based on feelings and supposed experts, not actual scientific facts.Delete