Doulas, Shamanism, and Sham

My thanks to Yulia Massino for sending the link http://domrebenok.ru/shop/618/mezhdunarodnaya_konferentsiya_onlayn_uchastie/

where (by using Google translate) we can read about the June 2015 international midwives conference in St. Peterburg, which drew participants from the U.S., Ukraine, Russia, and other countries. This article uses the term doula in what appears to be a broader way than is usual in the U.S., where a doula is usually a “birth companion” who attends and comforts the laboring mother rather than actively focusing on the baby. We also tend to use “midwife” to describe a person trained to work with the delivery and the baby, but without the medical training of an obstetrician or a neonatologist. The Google translation as I read it seems to mix the vocabulary describing these functions.

As many readers will know, a rebound from the intense medicalization of childbirth as it took place before World War II was underway in the 1950s and increased greatly in the 1970s in the U.S. Resistance to medicalization caused some real changes, including the presence of fathers or other relatives in delivery rooms and the establishment of birthing centers that had medical services but a relaxed atmosphere where a family’s older children would be welcome. This movement, added to insurance coverage changes, led to shorter hospital stays for healthy mothers and babies. The motivation of medical facilities to please birthing families also began  not only to allow fathers or grandmothers to be present with the laboring mother, but to permit a doula who might be a friend or relation (but who might also be hired by the family) to stay with the mother and give her the help that nurses rarely have time for.  

Those of us who gave labored in isolation and gave birth while attendants shouted at us in the “old days” can appreciate the changes that have been made, and appreciate the idea of a nurturing, supportive environment during labor. Because being alone during labor is frightening for most women, having a relative or a hired companion with us seems like a wonderful idea. This swing of the pendulum to an older, less medicalized has many advantages.

BUT!

Regrettably, whatever may be the attitudes of individual doulas or  midwives, organizations of these persons have a strong tendency to pursue the opposite pole from mechanistic, objectively-evaluated medical practices. Rather than simply humanizing some unnecessarily problematic medical approaches to childbirth, and reaching some sensible central position, the organizations have often gone far from center toward New Age beliefs and practices that stress subjectivity and the supernatural. This tendency is seen in the material at the link given above. For example, one recommendation has been to keep a large pyramid over the mother’s head during labor and delivery—an idea that seems directly related to Wilhelm Reich’s “orgone box” which was claimed to keep life energies from dissipating. Similarly, it was suggested that the umbilical cord and placenta should be left attached to the baby for several days after the birth, in order to “drain” back into the child all the beneficial substances that had been taken in during gestation.

The article on the St. Petersburg conference is difficult to follow because of some of the vagaries of Google translate, so I took the opportunity to look at web sites of some U.S.participants. For example, Gail Tully at www.spinningbabies.com mentions a number of ideas that involve rituals of sympathetic magic and shamanistic approaches--  for example, visualizing the unborn baby moving into an ideal position for birth, in order to create this desired outcome. This web site makes clear the connections between organizations of midwives and doulas and the Association for Pre- and Perinatal Psychology and Health (APPPAH).

APPPAH members promulgate a variety of beliefs about embryonic and fetal life that fail to be congruent with what is known about prenatal development or with basic assumptions of developmental studies, such as the connection between consciousness or memory and considerable advancement of nervous system maturation.  APPPAH members have claimed that the unborn human being is aware of external events from the time of conception or even before (some suggesting that each human being has memories of life in sperm form and life in ovum form). These views are quite similar to those stated by L. Ron Hubbard in Dianetics and repeated in other Scientological discussion. APPPAH has also supported and repeated the views of Lloyd DeMause, the “psychohistorian”, about the psychological pain and suffering of the fetus before and during birth, and how this trauma marks each personality and distorts its development.

Not to put too fine a point on it, when I see APPPAH links, I understand that any systematic evaluation of treatment outcomes has been abandoned by the linker. It appears to me that except for the rare individual doula or midwife, these entire professions have been contaminated by an APPPAH-like perspective on reality that abandons all scientific knowledge about prenatal life and development. In addition, the commercialization of these fields has moved them from shamanism right on to sham.

What was gained by past efforts to give families more healthy choices about the conduct of childbirth has unfortunately come to offer a choice between the simply outre’ and the outrageous and dangerous. The New Thought period has been over for many decades. It’s time for reasonable people to stand up and say we want potentially harmful alternative practices to be regulated.

   

More Nancy Verrier, or, Don't Say "Ain't" When She Says "Is"

Quite some time ago, I posted here some comments about the claims made by the California MFT Nancy Verrier, to the effect that all adopted children, even those adopted on the day of birth, suffer from a “primal wound” caused by the disruption of the prenatal attachment to the mother, and experience life-long misery as a result. This belief is not congruent with anything we know about the responses of young infants to separation from familiar caregivers, nor with established information about the development of attachment. I wrote an open letter asking Nancy Verrier to explain her position and say why it should be considered plausible (http://childmyths.blogspot.com/2011/08/open-letter-to-Nancy-Verrier.html ). Verrier did not reply, unsurprisingly, but periodically I receive vituperative comments from her followers.

I recently received one of these privately rather than as a blog comment. The writer, whose name I will not mention because she did not apparently intend to make her remarks public, started   thus: “As an adopted person, a lawyer person, and a sensible person, I say this:- As long as the law is the way it is the worst case scenario is possible thus accounting for various responses but all under the rubric of the denial of our loss. What’s your investment in denying that unprocessed grief can [emotionally disturb ] a person…? And if you know [person’s name] you should recuse yourself from this discussion. Thank you.”

This relatively mild, though not very coherent, statement was followed by two others in which I was said to be “nasty nasty nasty” and [person’s name] was vilified for having adopted two children of an ethnicity different from her own.

I don’t think it will be useful to address the implied ad feminam attack (“what’s your investment…?”) as this is a common technique among proponents of alternative treatments and belief systems—rather than discussing the evidence for their viewpoint, they propose that the opponent has some pathological, malicious, or greedy reason for taking a contradictory position. The proponents don’t seem to see that this opens the possibility of questioning their own motives, but perhaps they realize that most of us who oppose them would not waste our time in that kind of discussion.

Let me just focus in on the primary point of the message I have quoted, that somehow my remarks involve “denial of our loss”. This is a frequent rejoinder from Verrier supporters, who accuse critics of claiming that they, the supporters are not unhappy.

No one, including me, has ever said that adopted individuals do not experience a sense of loss as they realize their own history. All adoptions begin with a narrative of sadness, as their stories may involve abandonment of mother and child by a biological father, poverty, the fear and shame of a young girl, the death of one or both parents, civil war, etc., etc. Although some adoptive families may experience undiluted joy and satisfaction from bringing a new child into their home, many also have a history of their own sadness because of infertility or even the deaths of children in the past. There is plenty of sadness to go around, some of it like the sadness that may be found in nonadoptive families, some of it characteristic of adoption. Whether this narrative of sadness does or does not have a life-long impact on an individual depends on factors like personality and resilience, a tendency to depression or to bipolar disorders, a culture’s perspective on the adopted individual (for example, native Hawaiian culture does not consider a person to have any connection with the birth family that did not rear her), and of course the family’s handling of the adoption as “secret” or otherwise.  

Verrier’s claim, and the claim of the Association for Pre- and Perinatal Psychology and Health (APPPAH) group that supports her, is that just as older children may suffer emotionally from separation from familiar people, even the youngest infants experience rage and grief at separation from a birth mother to whom they have developed a prenatal emotional attachment. (Such a posited attachment is explained variously as having biological/genetic causes or by prenatal telepathic communication.)

It is true that children between about 8 months and 2 1/2 years are likely to respond with deep depression and social withdrawal when separated from familiar attachment figures. With sensitive, nurturing care, over time they recover from this loss and form new attachments, but without sensitive care, or if subjected to several such losses, they may be handicapped in their emotional and social lives. Infants under perhaps 6 months of age, however, do not show concern about separation or anxiety about the approach of unfamiliar people. Their behavior does not include attachment behavior like watching or trying to stay near familiar caregivers, or like depression, feeding and sleeping difficulties, irritability, or apathy when separated abruptly and  for a long period. For these reasons, it appears implausible that early-adopted children suffer from a “primal wound” (as opposed to sadness and concern about their history) or that any grief they feel can be attributed to the loss of the birth mother. (N.B. the biological father is only rarely mentioned in these discussions, although attachment to a father can be as strong as or even stronger than that to the mother.)

The implication of the Verrier perspective and that of my correspondent quoted earlier is that adoption is never an acceptable solution to the problem of care for a child. This, I think, is a wrong conclusion, given what is known about early emotional development. Certainly it would be repugnant to buy a child from a poverty-stricken mother, when she could be helped to care for her family, and I consider it highly reprehensible for church groups to go to Ethiopia or elsewhere and take children from parents who do not actually have a concept of adoption, but believe the children will return to them. But these concerns are often irrelevant to the choices to be made for infants born to very young or incompetent mothers, to mothers who are very sick, or to mothers who are mentally ill, all of whom may lack social support systems and adequate resources to care for a child. In those cases, the narrative of sadness will be part of the child’s life whether or not he is adopted, and in fact may be worse if he remains with the birth mother.

Incidentally, I have communicated with [person’s name] mentioned earlier. Interestingly, she had no idea that the Verrier position was known outside the pathology of my correspondent—an inadvertent comment on the plausibility of that position.