Friday, August 24, 2018
There is no question that some children and adolescents in divorced families refuse to visit one of their parents. It’s also very possible that some of these reluctant kids have been influenced by the attitudes or even the insistence of their preferred parent. What’s not so likely is that all cases of resistance or refusal on the part of children, unless they are connected with abusive treatment, are matters of “parental alienation” deliberately brought about by the preferred parent’s campaign of denigration against the other parent.
Very few human attitudes or behaviors are determined by single factors in the way proposed by parental alienation (PA) proponents. That’s why psychologists tend to be suspicious when they come across single-factor theories or theories limited to a very small number of factors but used to explain complex situations. Unfortunately, single-factor theories—so easy to explain, and apparently, to understand—are all too easy to introduce into legal decision-making, while more complex and realistic views may be excluded.
The PA view has been that there are only two categories of children who resist or refuse contact with one parent. One group has been physically abused by that parent, and the abuse has been documented, so their reluctance is seen as rational. The other group, with no documented history of physical abuse, have only “irrational” explanations for their aversion to one parent, and therefore must have been intentionally alienated by the parent they prefer. A range of bad consequences for the children are predicted if they remain with the preferred parent, and a complete change of custody is demanded.
Given that it’s possible that the PA claims are true in some cases, can we list some other possible reasons for children’s avoidance of a parent in the absence of a history of physical abuse? Of course we can, and I am far from the first to mention this. Children and adolescents may prefer to exercise their developing autonomy; to stay in the house they call home rather than having to go back and forth; to be in easy reach of their friends; to spend their time with friends’ companionship rather than having to devote time to a parent; to avoid criticism or demands from a parent or emotional abuse; to manage to ignore a parent’s disturbing sexual or romantic relationship with one or more new partners; to avoid a step-parent, step-siblings, or parents’ boyfriends or girlfriends; to arrange school, sports, or social activities as they prefer; to escape from questioning about the preferred parent.
Any or all of these issues may have very different impacts on children at different ages, so the child who at age 8 was indifferent to a parent’s romantic life may at age 14 find any evidence of such excruciatingly embarrassing. A child who at age 12 was delighted to spend a weekend camping may at age 16 want only to socialize with peers. In addition, individual differences in temperament may make one child easily distressed by unsought changes, while a brother or sister of different temperament can accept changes with equanimity.
When we examine psychological and behavioral issues that are not well-understood, one useful strategy can be to find some analogous events that are easier to study. Given that there are so many factors that can help to explain a child’s avoidance of a parent, it seems to be a good idea to find some parallel situation that may give insights into this kind of avoidance. Are there other things children avoid with intense emotion and resistance? Yes, and one of them is not uncommon: school refusal. About 35% of children sometimes refuse to go to school without a “rational” explanation-- some do this infrequently, while others may manage to avoid school most days for long periods of time. Children who refuse school not infrequently fight against going to school each morning, plead stomachaches, even vomit, scream and have tantrums. The great majority of their parents do not like this, want the child to go to school, fear the consequences for their own work responsibilities, and are disturbed about the social and educational outcomes for the child. (Parents who actually want the child to stay at home have the option of homeschooling, after all.) The parents don’t know what to do to get the child to go to school, and it is noticeable that they are rarely if ever accused of alienating the child from school.
In a 2009 article in Child Development Perspectives (Pina, Zerr, Gonzales, & Ortiz; “Psychosocial interventions for school refusal behavior in children and adolescents”, Vol. 3, pp. 11-20), the authors discuss children’s motivations for refusing school. I will list these, and in each case state in brackets a possible parallel with refusal to visit a parent:
1. 1.To avoid school-based stimulation like bullying that provokes negative emotion such as anxiety and depression [A child avoiding a parent may also be distressed about parental behavior that is anxiety- or depression-triggering, such as criticism of the child or the other parent, demands for more time or attention, poor parenting skills, insufficient attention paid to the child when he or she is present, or issues that have to do with the parent’s home, friends, or partners and their children]
2. 2. To escape aversive social or evaluative situations like difficulty in making friends or public exposure for lack of school achievement [A child avoiding a parent may find it difficult or awkward to have social interaction with that parent, especially a parent who lacks social or parenting skills, or may feel exposed to criticism for failures to perform scholastically or athletically to the parent’s expectations]
3. 3. To get attention from significant others such as parents and concerned teachers [A child avoiding a parent may find his or her behavior rewarded by the attention of one or both parents who have been distracted, perhaps for several years, by their own marital situation]
4. 4. To pursue reinforcing events outside school, like playing or shopping [The child avoiding a parent may enjoy his or her own devices, toys, and books and “own room”, as well as familiar foods and routines, a parent who is easier to be with, and the availability of siblings and friends]
In addition to this list of motivations with their possible parallels in avoidance of a parent, Pina et al noted characteristics of children who refuse school, such as poor social skills, social isolation, high levels of family conflict, and a poor sense of self-efficacy in stressful situations.
Friday, August 17, 2018
A year or so ago I commented on the real shortcomings of some residential treatment centers (RTCs) focused on child and adolescent behavior and mood problems, especially those associated with the CALO group (https://childmyths.blogspot.com/2017/07/calo-and-transferable-attachment-love.html). As we have seen repeatedly for many years now, residential treatment in the form of psychotherapeutic programs or of “specialty schools” can feature cruel, unsafe, and ineffective practices that aggravate existing problems—sometimes by forcing young people to “confess’ to behaviors that never occurred, or by using isolation and restraint as punishment.
In more than a few cases, the problems that cause a child to be placed in a RTC are ones that can be overcome by treatment of the family as a group and especially by training of parents in management skills. But often families do not realize the difficulties that are developing with a child’s behavior until adolescence is upon them and they are faced with a large, strong, defiant individual who is able to act out sexually and whose aggressive actions can have serious outcomes. When children become involved with drugs and gangs, when they threaten their parents or siblings, when they are frightening to school and neighborhood contacts, when the police are summoned, there may be few choices open except residential care.
The question is, does a RTC simply incarcerate the young person, or does it provide treatment that will make possible a return to society and a normal developmental trajectory for education and work? How can a family decide which RTCs will provide this help, and which will simply keep the child off the streets for the time being?
Peter Gillen, writing in the September 2018 Brown University Child and Adolescent Behavior Letter (a very useful source!) notes the challenges presented by children with severe emotional disorders who present chronic safety issues in their homes, as well as in their schools and communities. He describes a “roller coaster” of treatment successes and failures that lead to continued needs for mental health care, and the revolving door of services that cuases children to think of themselves as “bad kids”. Gillen also points out the real criticisms of RTCs such as “the significant costs, the lack of empirical evidence demonstrating their clinical effectiveness, the potential iatrogenic effects from exposure to others’ maladaptive behaviors [potentially both those of other children and of staff members—JM], the disruption to the caregiver-child attachment bond, and the poor maintenance of post-discharge progress” (p. 6). As a result of these criticisms, Gillen comments, a workgroup has recommended a set of principles with shared values that should govern what they call “therapeutic residential care” (TRC).
An important principle suggested by the workgroup is “building a strong partnership with families and engaging them in a meaningful way throughout the residential process”. Family involvement and contacts appear to lead to more successful completion of treatment and better outcomes for the children. Examples of family involvement are “integrating caregivers [parents and family members] into the daily routines of the residential programming, considering caregivers as the experts of their children’s needs, and improving the overall family’s functioning”, including sibling relationships as well as relationships between parents and the child in treatment.
In an exemplary program at Bradley Hospital in Providence, RI, families participate in weekly family therapy, have phone contacts updating them on issues like schoolwork, and have home visits. At a weekly Family Night, “families are invited to attend a one-hour family-style dinner with a free meal for all, followed by a one-hour caregiver support group with free child care fro siblings. Family Night brings families together with a focus on practicing the real-world skills of sitting and talking together as a family”—without cellphones.
Gillen notes about the Bradley Hospital program that one of its ways of partnering with families is to recognize and discuss their ambivalence about the decision to place a child in a residential program. These families recognize on the one hand the safety issues of keeping a child in the home and community, but on the other hand feel sadness and guilt about what they perceive as their failure, as well as concern that the child will feel unwanted and unloved as a result of the decision.
Historically, many RTCs have fostered the view that families need to deliver a challenging child to the ministrations of staff, need to stay out of the picture except for paying the fees, and can expect to receive the child back at some point (perhaps age 18), “fixed” or otherwise. Certainly some RTCs severely limit children’s contacts with family members other than parents, particularly if their programs claim that they are focused on child attachment issues. Gillen’s article notes the lack of evidence for effectiveness of programs with these positions, and I would point out the strong possibility that such programs can be part of the “school to prison” (or other institution) pipeline.
Most parents who feel they need RTC care for a child will ask questions about the physical facility and about the experiences the child will have. Gillen’s comments suggest that the time has come for parents to explore carefully the role they themselves will play in residential treatment. The idea of family engagement has been an important part of preschool education philosophies for many years, and it is associated with improved outcomes for children. It may well prove to be an equally important factor in residential therapeutic care for children and adolescents.
Thursday, August 16, 2018
In the litigious atmosphere of the modern United States, it is common for personal, professional, or financial allegations against someone to be brought into the courtroom as ways for another party to achieve a goal. Divorce courts and family courts frequently see arguments based on such allegations, deployed for financial or other gains. An increasingly common allegation by one parent against another is parental alienation—generally defined as the refusal of a child to have contact with one parent, in the absence of rational objections (usually limited to a history of substantiated physical or sexual abuse), and as the result of a campaign of denigration and “brainwashing” by a favored parent. When parental alienation (PA) is successfully argued in the courtroom, the consequences for the accused parent may be dire, involving prohibition of contact with the child and financial responsibility for treatments offered by PA proponents. This continues despite the absence of evidence supporting the PA diagnosis or the safety and effectiveness of the treatments used.
The question I want to raise in this post is whether some organizations promoting PA concepts and treatment methods are in fact similar to cults.
Let me state at the beginning that I am far from claiming that PA cannot happen. I have no doubt that this parental behavior and child outcome do sometimes occur. However, I am equally far from accepting that the behavior and resulting outcome are present in most of the cases where PA allegations are made. The burden of proof for a claim to that effect is on PA proponents, who have not provided evidence either for their diagnostic approach or for the treatments they advocate.
Given that no adequate evidence has been provided, and that organizations nevertheless strongly support PA views, the obvious question is how and why people are persuaded that claims about PA are valid. Do the practices of PA groups resemble those of cults?
The Wikipedia definition of cults says this: “The term cult usually refers to a defined by its , , or beliefs, or its in a particular personality, object or ”. This broad definition would include the Boy Scouts, the Green Party, and the Pennsylvania Association for Infant Mental Health, because of their common interests and goals, and presumably PA advocacy groups also fit here. But most uses of the term imply or say overtly that a group called a cult is potentially harmful in some way, to its members or even to society in general. To match that aspect of the meaning of the term, various checklists of cult characteristics have been offered.
For example, material at
· Absolute authoritarianism without meaningful accountability.
• No tolerance for questions or critical inquiry.
• No meaningful financial disclosure regarding budget or expenses, such as an independently audited financial statement.
• Unreasonable fear about the outside world, such as impending catastrophe, evil conspiracies and persecutions.
• There is no legitimate reason to leave, former followers are always wrong in leaving, negative or even evil.
• Former members often relate the same stories of abuse and reflect a similar pattern of grievances.
• There are records, books, news articles, or broadcast reports that document the abuses of the group/leader.
• Followers feel they can never be "good enough".
• The group/leader is always right.
• The group/leader is the exclusive means of knowing "truth" or receiving validation, no other process of discovery is really acceptable or credible.
Then, states the website, “ Parent Speak meetings are for you. Completely anonymous, these meetings are by and for parents like you because you deserve to be supported, nurtured and uplifted.”
Monday, August 13, 2018
On a number of occasions I’ve pointed put how Christian fundamentalists have attributed mental illness to demonic possession, and demonic possession in turn to some malfeasance, not just of the possessed person, but perhaps of a near relative or parent. I’ve felt a little guilty about making this connection and citing (for example) Pigs in the parlor, a book originally published in the 1970s but reprinted more recently. Maybe (I’ve said to myself) I’m not being quite fair to present-day fundamentalists—maybe they have dropped these ideas and I just don’t know about it.
But, no. My finger-pointing was fair. The pig-in-parlor analogy is still at work. For example, see the following article: Owen, C. (2017). Obscure dichotomy of early childhood trauma in PTSD versus attachment disorders. Trauma, Violence, & Abuse. https://doi.org/10.1177/1524838017742386. I can’t quite figure out what is going on here, but this article may originally have been published under a different title in 2016 in Fidei et Veritas: The Liberty University Journal of Graduate Research. This is not a veiled accusation—I have only found this at ResearchGate, and the sources are not easy to follow.
In any case, Owen begins by objecting to the 2013 descriptions of Reactive Attachment Disorder and Disinhibited Social Engagement Disorder in DSM-5. She insists that these descriptions fail to include many symptoms she ascribes to RAD, such as lack of conscience, destruction of property, pathological lying, food hoarding, etc., etc., combined with superficial charm. These symptoms and behaviors, which have never been considered to be aspects of RAD except in an alternative, fundamentalist-influenced belief system, are the ones described by Hall and Geher (2003), whom Owen cites. For example, Owen states that “Some of the typical RAD behaviors (such as deliberate enuresis/encopresis) are designed as self-defense measures to repulse caregivers and make them back away from the child—thus insulating the child from further rejection and trauma” (p. 3)..Hall and Geher picked up this list, including this quite unsupported claim of intentional wetting and soiling-- from an obscure paper by Reber (1996), in which the author stated firmly that these are symptoms of attachment disorders—without referencing any empirical work or even speculative peer-reviewed material to support his claims. Owen sees DSM-5 as omitting full descriptions of RAD, rather than realizing that the symptoms she lists have never been associated with RAD by any of the mainstream researchers like Zeanah whom she also cites. Some, but not all, of them have been described as aspects of PTSD, but it is not, as Owen suggests, inexplicable hat they are not included as part of RAD. They may be part of problems that are co-morbid with RAD, but they are not part of RAD—by definition.
Owen’s paper continues with a vivid, not to say histrionic. account of an adopted child who was extremely uncooperative, screamed, bit herself, ran away, and made her family’s life difficult, despite “intensive” treatment, including holding therapy (which Owen interestingly classes as a fringe therapy even though she appears to accept many of the beliefs behind the use of this treatment). The child’s treatment at the time of Owen’s writing was in a residential program described as a “non-profit ministry”.
Owen’s treatment plan for the child contains elements of family therapy, of psychoeducation, and of TF-CBT, but also sets as a treatment goal “Train the child up in the ways of the Lord without inadvertently retraumatizing her”. This goal is of interest first in its acknowledgement that this kind of training may be retraumatizing, but also in its emphasis on religious authority as a source of decisions about needed behavior change.
Owen goes on to search for religious argument about the causes and cures of mental illness, and she finds it in the work of the Texas Christian University psychologists David Cross and Karyn Purvis. “Using Scripture, Cross and Purvis defined the nature of evil, the nurture of evil, the roots of evil, and the pathology involved. In the end, they concluded ‘with some degree of certainty, that although not all maternally deprived (or psychologically abandoned) individuals will become antisocial, virtually anyone who in fact becomes antisocial will have been maternally deprived’ (p. 77). Thus, it is clear that ‘maternal deprivation may actually be the root of all evil’ (Cross & Purvis, 2008, p. 77)”[typos corrected-JM]. Owen thus accepts a convoluted argument about the existence and causes of evil as a substitute for consideration of the complex causes of antisocial behavior, omitting, in particular, the factors that would have to exist in addition to maternal deprivation in order for the Cross and Purvis statement to have a possibility of accuracy. But presumably shifting codes from the psychology of early development to a statement of religious belief has been taken by Owen as a good way to avoid either empirical evidence or strictly logical argument.
Toward the end of her article, Owen abandons the pretence that the discussion is about identifiable trauma or about treatments like TF-CBT. Instead, she says this: “ Christians need to be aware of and vigilant against the dark spiritual forces that undergird these children’s behavioral and emotional disturbances (Eph. 6:10-18). Above most other disorders, the dynamic of the conflict in children with PTSD from ECT [early childhood trauma] and their new caregivers has a particularly demonic element to it. Many of the night terrors, for example, include emission of a deep, guttural-growl that sounds non-human. The level of rage and cold, calculating revenge that these children can inflict (i.e. evidence of deprivation, according to Cross and Purvis,2008) defies rational explanation ….Competent counselors in full armor who recognize a child with PTSD from ECT as rooted in fear and work to overcome the dark, spiritual influences that threaten to destroy the family, can help bring hope and healing to these families in a way that those treating for RAD/DSED cannot” (p. 16).
If I interpret these last sentences correctly, the claim seems to be that for full religious authority and therapeutic power, practitioners need to accept the argument that the RAD/DSED categories are wrong, and that they are wrong because they do not fit into the belief system shared by this author and other Christian fundamentalists. Acceptance of a scientific view that excludes supernatural causes and demon possession makes good therapeutic outcomes impossible, Owen implies.
The pigs of yore seem to have been moved out of the parlor and into the clinic.
Friday, August 10, 2018
Ten years ago I was involved in the trial of Sylvia Jovanna Vasquez, an adoptive mother in Santa Barbara who had been found to keep some of her adopted children in cages with buckets as sanitation. Vasquez claimed to have been given this idea by a book by Nancy Thomas, given to her by her adoption caseworker—and although Thomas does not exactly say that, it’s true that she implies that restraint and seclusion are suitable ways to treat adopted children if the mother is dissatisfied with them. I will always remember from that trial the day that sheriff’s officers brought the cages on a truck to the underground parking lot of the courthouse, and judge and all went to examine them. The judge actually crawled inside one of the cages, and when he came out it was evident that he had formed a whole new view of what had happened to the children. Vasquez was convicted and given a short jail term—she had bargained for assurance of this in exchange for her telling what she had done and why.
Other caged kids cases have occurred, almost always with adopted children, and usually with those who have been labeled as “RAD”—a term that actually means Reactive Attachment Disorder, but is used by proponents of some alternative therapies to indicate disruptive and aggressive behavior as well as lack of affection for the adoptive parent. The reasoning (if I may call it such) behind caging these children is two-fold: first, that the children are dangerous, and cages protect them from themselves and protect others from them; second, that such children are suffering from disorders of attachment that are corrected by displays of adult power and authority. (I am just reporting the news here, so please don’t assume that I agree with these views.)
I was hoping that we had come to a lull with respect to child-caging, but a new case (pointed out by my invaluable colleague Linda Rosa) shows that this is not the case. In Farmington, MO, a couple have been arrested and charged with several counts of endangering the welfare of a child and of second-degree kidnapping after caging four adopted children between the ages of 6 and 12. You can read more about this at these links:
The adoptive mother, Laura Cheatham, was said to have adopted the children together with her ex-husband, who seems not to have been her co-torturer, a man called Daryl Head. Cheatham, who had worked for the Missouri corrections department, ordered child-size prison uniforms for the kids, and she and Head constructed and used cell-like boxes, closed with plywood and screws, in which the children had no light, water, or toilet access.
However, on the Missouri attorney general’s page listing 501c3 organizations, I do not see any mention of RADDLE or the organization’s full name. Could it be that Cheatham and Head went through some of the motions of organizing a non-profit, but did not actually finish the job? And did anyone make charitable contributions to the supposed non-profit RADDLE, I wonder?