Monday, August 13, 2018
Of Pigs, Parlors, and Unconventional Views of Attachment Disorders
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.