Tuesday, July 12, 2016
How to Deceive the Public About Reactive Attachment Disorder for Fun and Profit
In a recent essay in the newsletter of the Society of Clinical Child and Adolescent Psychology, Eric Youngstrom described the “hyper-abundance of information on the Internet” as including “a wild mix of good information with opinion, direct-to-consumer marketing, and snake oil sales pitches, all clamoring for attention”. The latter two commercial approaches are all too easily absorbed by naïve print reporters, repeated as accurate in print, and then doubled down back on the Internet as statements of fact. Deception of an unwary public is multiplied during this process.
A fashionable topic for intentional or unintentional public deception is Reactive Attachment Disorder. As presented by representatives of the Snake Oil Manufacturers Educational Association (SOMEAss), this is a juicy topic, including serial killing just like in the movies, hypersexuality, and failure to be grateful to one’s mother—all to be treated by a strict regimen of authoritarian and intrusive parenting. (In reality, RAD is a diagnosis that describes young children’s difficulty in feeling comfortable with or staying close to adult caregivers; the term does not describe feelings or behaviors of school-age children or older individuals.)
Mistaken articles about RAD appear every other day, but my friend and colleague Linda Rosa has put me onto a beaut out of Oklahoma City: kfor.com/2016/07/11/camp-for-families-with-children-dealing-with-rare-mental-disorder/. This article makes mistaken claim after mistaken claim and does not allow for the public comment that might correct these mistakes.
The piece begins with a remark that alerts all knowledgeable readers: “Bonding with your baby is one of the most precious moments in a parent and a child’s life.” What’s wrong here? Don’t I think that happy moments with a baby are precious? Yes, of course I do. But “bonding” is a term that describes a parent’s sense of engagement with and commitment to a baby—“falling in love” with the baby is what we are talking about. The parent’s deep involvement leads to a cascade of positive events for the baby, but “bonding” is not in itself part of a child’s life. You have to be grown-up to “bond” in this way. Babies will later develop attachment to a consistent, sensitive, and responsive caregiver, but this is not “bonding” and it is not the matter of a moment, precious or otherwise, but takes months and continues to change form for many years. Parents’ “bonding”, too, may or may not be a quick process; although some parents feel smitten by their babies the first time they hold them, many others feel a bit worried that they don’t “feel more”, but some weeks later will realize that now they are intensely engaged with the baby. The Oklahoma article is deceptive in its statement that both parent and baby go through a rapid and permanent emotional change, and that their feelings about each other are similar. This is not just a problem of a little detail about child development, because it wrongly suggests to readers that young children have adult-like feelings that are established at a very early age-- and would take severe methods to change later on.
The Oklahoma article goes on to state that Reactive Attachment Disorder is a rare condition, and that is quite true. So what is deceptive? It’s the slightly later description of children with RAD as “lacking a conscience”, being aggressive, lying, stealing, and having fits of rage. None of these characteristics have anything to do with RAD as the term is conventionally used. The behaviors listed are in fact far from rare, and are related to conduct disorders, oppositional defiant disorder, obsessive-compulsive disorder, PTSD, even autism or early-onset schizophrenia. These disorders are not associated with attachment issues but are certainly more common among children who have been mistreated and who end up in foster care or placed for adoption. The basic cause is the mistreatment, and although developing good relationships with caregivers may be very helpful to the children, after early childhood this is no longer an issue of attachment.
One more-- extremely important—point from the Oklahoma article: an interviewee is quoted as saying that “traditional therapy can have the opposite effects for a child with Reactive Attachment Disorder.” While the man may not have known and may have had the best intentions in saying what he did, the fact is that this statement is a bald-faced lie. Pseudoscientific approaches to childhood mental and behavioral problems have been making this claim since the early 1990s, when Foster Cline appears to have been an early adopter of this mistaken view. His protégée Nancy Thomas (of whom I will have more to say) has followed up and repeated the idea frequently. In fact, there are several conventional evidence-based therapies well-known to be effective in treating children with the problems mentioned earlier; these include Sheila Eyberg’s Parent-Child Interaction Therapy and Mary Dozier’s Attachment and Biobehavioral Catch-up. There has never been a randomized controlled study of the effects of the therapy proposed by Cline, Thomas, etc. , much less a study comparing their treatment with conventional methods.
The Oklahoma article proposes a “RAD camp” to treat the problems they have defined (incorrectly) as Reactive Attachment Disorder. Click on the “learn more” link and what do we see? Yes, it is a Nancy Thomas camp, which will, by the way, cost $895 for each family member over 3 years old, an expenditure of almost $3000 for a couple with one child, and not, I can almost assure you, covered in any part by health insurance. This woman, a former dog trainer, has re-issued herself as a Therapeutic Parenting Specialist (UClc, for impressiveness, but unassociated with any actual certification or licensure). The Oklahoma reporter has been most cooperative in providing free advertising for Thomas as part of what Youngstrom called the “wild mix” including “snake oil sales pitches” and what I call deception of the public.
What actually happens at these camps is not clear, so I will refrain from suggesting that it includes the holding therapy known to have caused child deaths and injuries. In other material about the camps, however, Thomas has said that she takes recalcitrant children away for “tune-ups”, and I think we can make some educated guesses about what she does.