A piece in the Week in Review section of the Sunday Times today described how the writer
visited a New York post office, and looking at the rubber stamps available,
discovered one marked PRETENTIOUSLY HAZARDOUS. I can’t let this golden trouvaille go to waste. It is the
perfect category description for the whole attachment therapy-holding therapy-
Nancy Thomas parenting-industrial complex, as well as for more than a few other
treatment methods.
Some years ago, the clinical psychologist Scott
Lilienfeld introduced the term potentially harmful treatment (PHT), to describe
therapies that were already known to have caused harm to patients, or which
might logically be expected to do so. This term, of course, did not mean that
every use of a treatment would end in harm to a patient, simply that there was
a reasonable possibility that this would occur. The PHT concept stressed the
fact that despite the etymology of their name, “therapies” might actually do harm—that
safety as well as effectiveness could be issues for psychological treatments. The idea of a PHT was not obvious to a Georgia
attorney who cross-examined me in a holding therapy case; he argued that no
harm had apparently been done, until I gave him the example of running across a
busy highway and by some miracle not getting hit by a car-- he had to agree that this was a potentially
harmful act that should be prevented, even though the runner came through
unscathed this time.
The psychologist Michael Linden added to the PHT
concept by pointing out that various types of harm could be associated with
misconceived psychotherapies—for example, that the “emotional burden” of
feeling distressed during treatment was harmful and should be avoided if at all
possible.
So, why am I not content to call AT-HT-NTP
potentially harmful treatments? Why not just point out the emotional burdens
children experience when subjected to these methods? In fact, why not stick to
the term “alternative psychotherapies”, which I have used myself to designate
treatments that are without an empirical evidence basis, that are incongruent
with established information about human development, and that are potentially
harmful?
PRETENTIOUSLY HAZARDOUS treatments display problems
in addition to those just stated as they retrofit theory and diagnosis to
support treatment methods that are in fact derived from old ways of punishing children
(perhaps even from the old German “black pedagogy”). Proponents of these treatments
have spun out of straw a prosperous belief system which meets the definition of
pretentiousness given by my big old Webster’s: “making claims, explicit or
implicit, to some distinction, importance, dignity, or excellence”. The claims
include the putting forward of an unfounded “attachment cycle” theory that states
that attachment is affected by caregivers’ boundary-setting in the second year
of a child’s life (such boundary-setting is important, but is not a factor in
attachment). The “attachment cycle” concept is used to justify age-inappropriate
actions like insisting on bottle-feeding a ten-year-old or hand-feeding sweets
to a child. It is also used to justify intrusive and rigidly-controlling
actions toward children that are defined as equivalent to boundary-setting.
The “attachment cycle” concept and related adult
actions make the explicit claims to importance mentioned in the Webster’s definition of pretentiousness. But they in turn are based on
an implicit claim that is all too easily swallowed by parents and other
caregivers—in fact, that may be believed to a considerable extent by many
adults. This is the claim of recapitulation,
the repetition of earlier events, but it is not the old familiar but faulty
idea that the development of the individual repeats events in the development
of the species. This concept of recapitulation holds that it is possible to
magically cause the recapitulation of past development, and to make it come right
where it has gone wrong, simply by ritually re-enacting some past events that
might be associated with the desired developmental change. For example, if a
child is thought to have problems with attachment because she was not
sufficiently cuddled as an infant, cuddling her now, feeding her with a baby
bottle, and gazing into her eyes are thought of as ways to recapitulate and
correct her early emotional life. If a child’s problems are thought to have
come from failures of limit-setting in the second year, rituals of demanding
that the child ask for everything he needs or sit motionless for long periods
are considered to recapitulate and correct the earlier problems.
There are several problems that make such treatments
PRETENTIOUSLY HAZARDOUS. One is that it is very unlikely that attachment does
result from feeding experiences per se,
and it is particularly unlikely that ingestion of sweet things is related to
attachment in infancy. It is similarly unlikely that attachment is the aspect
of development affected by boundary-setting. But suppose for the sake of
argument we were to assume that those events did cause attachment in infancy?
Why would we think that experiences characteristic of infancy would have the
same effects on older children as they do on infants? To imagine that would be
like thinking that an all-milk diet, healthy and appropriate for young infants,
would also be suitable for older children with different nutritional needs and
growth patterns. Magical recapitulation rituals cannot return children to the
developmental needs and patterns of an earlier stage of life, and it is
pretentious to claim that they do. In fact, one might well argue that it is
fraudulent to do so.
It’s clear that AT-HT-NTP methods are PRETENTIOUS.
Need I also argue that they are HAZARDOUS? Proponents of these methods have
stated that they no longer lie down on top of children or do other things that
have caused death by asphyxia in the past, and perhaps they do not.
Nevertheless, the recent license revocation case of “Kali” Miller in Oregon has
shown the suicidal response of a boy to treatments that did not risk
suffocation but appear to have carried an unbearable emotional burden. In my
opinion, this is hazardous enough to argue against use of any such methods.
These treatments are not prohibited, in spite of all
we know about them. But there should be large PRETENTIOUSLY HAZARDOUS stamps on
all their websites.