NOTE: No sooner had I posted this comment than a message forwarded to me stated that UW staff had intended to take the paper down and somehow the process had not worked. I am going to leave this post in place in case there is some mysterious archive or cache where the paper I discuss remains, but I want to give credit where it is due for a good decision.
MY ORIGINAL POST
Some months ago, I came across a master’s thesis from the University of Wisconsin, with the title “Effective Interventions for Children With Reactive Attachment Disorder”. I read the document, which was on the Internet, and felt very disturbed by the misconceptions that it passed on to the public. Most unpublished master’s theses never really see the light of day and quickly tumble into the academic abyss, but when things are available on the Internet it’s a different story. I was concerned that this paper would be read, believed, and repeated in the form of undergraduate psychology or education papers handed in to unwary instructors who didn’t use turnitin.com. This would mean that the misunderstandings contained in the paper would multiply and multiply further, following the psychological version of Gresham’s law-- “bad ideas drive out good.”
Because of these concerns, I contacted the department that awarded the master’s degree and stated my concerns. They were very polite and said they would take down the document and discuss the matter, and I suppose they did. They didn’t tell me, and I could hardly expect them to.
But guess what: here’s the paper on line again, at minds.wisconsin.edu/bitstream/handle/1793/42939/2008/wiersumc.pdf?sequence=1.
The author begins her paper by referring to a claim by Nancy Thomas to the effect that Ted Bundy, Saddam Hussein, and Adolf Hitler probably all had Reactive Attachment Disorder. Thomas is a former dog trainer who has achieved a considerable following among a group of foster and adoptive parents by stating, among other things, that the way you know whether people are good parents to foster or adopted children is that the children still have their arms, legs, and heads attached. She is completely without training in child development or clinical psychology and is a most inappropriate source for a master’s thesis to quote as an authority. As for the statement about the three frightening figures, little accurate information about their childhoods exists, particularly about the preschool period in which it might be possible to diagnose Reactive Attachment Disorder, a problem that is difficult to identify in any case (as the author herself later notes).
The master’s candidate goes on to discuss Reactive Attachment Disorder, citing a couple of published sources. She then lists without citation characteristics that she attributes to RAD, including tantrums, destructive behavior toward self or property, problems making eye contact, and being affectionate toward strangers while failing to show affection to parents. None of these are characteristics of Reactive Attachment Disorder as it is described in the Diagnostic and Statistical Manual of the American Psychiatric Association. They are, however, included in various checklists available on line and recommended by their promulgators for use by parents deciding whether their child needs therapy for attachment problems or for diagnosis of the entirely notional “Attachment Disorder” suggested by various unconventional therapists. Our author, incidentally, does not reference DSM-IV-Tr and presumably has not read it; her only citation to this important volume is in a secondary source edited by Dziegielewski (of which the first edition recommended Holding Therapy and failed to discuss criticisms of that method).
By p. 5, the master’s candidate states that children with RAD have been unable to complete the “attachment cycle”, a term she fails to define or cite a source for, and one that is completely unknown to John Bowlby’s attachment theory. Although she refers to Bowlby, she does not reference his work and it is fairly clear that she has only come across it in secondary sources.
The author eventually concludes that there is no evidence supporting any of the methods of treatment she outlines, nor, for that matter, is there any clear method of diagnosing RAD. While I would certainly agree with these conclusions, I must point out that she discusses none of the efforts that have been made at testing the methods she refers to, nor does she touch on the numerous critiques of that research and of diagnostic approaches that have been published in the last 10 or 12 years. Neither does she refer to the 2006 report of the APSAC Task Force on Attachment Disorders, published in Child Maltreatment; instead, she cites authors who were specifically mentioned in that report as using inappropriate treatments. In addition, she omits to mention evidence-based treatments like Parent-Child Interaction Therapy.
I am especially concerned about the flaws in this master’s thesis (of which I have mentioned only a small portion) because the degree is in school psychology, an area where it is all too easy for professionals’ misunderstandings to spread to teachers, parents, and children themselves. The fact that a school psychology professional means well is not a sufficient saving grace when harm can be done in this way. As authors writing about fads in special education have pointed out, meaning well can be dangerous; “politically correct treatments are… adopted… because they resonate in their purported nature and effects with ideological perspectives, or because their use contributes to the realization of other, perhaps tangible, socially progressive goals… The rationale… may be no more complex than ‘ to do the right thing’ “ (Jacobson, J.W., Foxx, R.M., & Mulick, J.A. (2005). Preface. In J.W. Jacobson, R.M. Foxx, & J.A. Mulick [Eds.], Controversial therapies for developmental disabilities [pp.xi-xvii]. Mahwha, NJ: Erlbaum, p. xv).
It’s hard to see what motive other than political correctness allowed this paper to be approved and a degree awarded, or indeed any reason why the paper should be on the Internet to confuse and mislead readers who are unlikely to know how to critique it. What those reasons may be, I leave to others to consider. My sole hope is that when students or parents Google and find the master’s thesis, they will also find my comments-- and perhaps be warned by them.
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Showing posts with label misunderstandings. Show all posts
Showing posts with label misunderstandings. Show all posts
Monday, May 23, 2011
Tuesday, November 2, 2010
Symbiosis: More Fun with Metaphors
There was annoyance expressed by a reader last week when I was perceived as saying that something was “just a metaphor”. I didn’t say that, and I plan to not say it again today. In the study of mental health and other aspects of psychology, metaphors are extraordinarily important because they can guide our thinking into useful-- or useless—channels. A useful metaphor is one in which the psychological event can accurately be “mapped” onto the better-understood event we’re comparing it to, so a lot of things about the psychological event are like aspects of the comparison event. A useless or even harmful metaphor is one where the reality of the psychological event is very different from the reality of the comparison event.
Why am I bringing this up? I’m interested in the metaphor of symbiosis, so much bandied about in discussions of adoption. I believe this is a useless, even a harmful, metaphor. It was used by the psychoanalytically-oriented infant-toddler expert Margaret Mahler, and later by Daniel Stern as well as by others. They used the term symbiosis to describe a period of early life, beginning not at birth but at a few months of age, and going on until about the time that attachment behavior begins. For these authors, the word “symbiosis” was chosen to express the deep intimacy, physical and emotional, that often prevails between mothers and babies at this time in the baby’s life.
The word symbiosis, literally “a living together”, deceives us by looking as if it might be a good word to describe the best mother-infant relationships between about 2 and perhaps 6 or 7 months. But it’s not a word that was invented for this purpose. It describes another, more easily understood phenomenon, and because of this introduces a metaphorical usage into the discussion. Symbionts, or animals that live in symbiosis, are not uncommon in the natural world. They belong to different species but live near each other and behave in ways that are mutually beneficial. For example, pilot fish and sharks benefit each other and contribute to each other’s survival, as the fish eat the parasites that can infest the shark’s skin.
Real symbiosis does not provide a good metaphor for any stage of the mother-child relationship, because mothers and babies are not mutually beneficial to each other’s survival, either before or after birth. Mothers take care of babies; babies do not take care of mothers. On the contrary, aspects of motherhood are so potentially damaging to the mother that we have to look to evolutionary advantages for the species before we see any survival-related reason for having children. (I’m not talking about love, fun, or cultural pressures here, just plain survival of the kind that symbiosis aids.) Aside from a few possibilities like reduction in breast cancer caused by breastfeeding, we see virtually all the benefits of the relationship going to the baby, while the mother serves as an auxiliary immune system as well as an auxiliary ego.
What would be a more suitable metaphor, drawn from the natural world, to guide our thinking about young babies and their mothers? If we’re going to choose a comparison to animals living together, a better choice than symbiosis would be parasitism. A parasite, like a tapeworm living in a human gut, takes what it needs from the host, but usually does only slight damage, as it benefits from the host’s continuing life. Unborn babies function like parasites to a considerable extent, sometimes endangering or even killing their host[ess]. During the first year, or even longer, the long slow maturation of human beings makes them require constant care which they are completely incapable of reciprocating and keeps them in a parasitic relationship to adults.
Well, this is really an ugly metaphor, isn’t it? Babies as tapeworms is a pretty disgusting idea. But they’re not pilot fish either, and look at the problems we get into with the symbiosis metaphor. That way of thinking leads us to believe that the early mother-baby relationship is mutual, a two-way street in which the feelings and needs of one partner reflect the feelings and needs of the other one. We can make a lot of mistakes with that metaphor. One is to assume that anguish of a mother separated from her baby is necessarily mirrored by the anguish of a young baby separated from the mother, though observation of babies of a few months tells us this assumption is false. Another is to confuse the mother’s and child’s feelings as attachment develops and to think of “bonding-and-attachment” as if they meant the same thing. The parasite metaphor actually works much better as a description of the early mother-child relationship because it protects us from making mistakes about mutuality.
Of course, one of the difficulties of choosing a good metaphor for mother-baby relationships is that, like other aspects of development, those relationships don’t follow the same rules throughout life. Babies function in different ways at different points in their development, and within the second year will become less parasitic and more capable of reciprocating care and affection in a faintly adult-like way. Mothers, too, operate differently at different times in their own and their babies’ lives. As time passes, new metaphors need to be chosen to help us understand social and emotional development. It’s possible that symbiosis could be a good metaphor for some kinds of adult relationships, but I doubt that it ever works well for relationships between parents and their children of any age.
Why am I bringing this up? I’m interested in the metaphor of symbiosis, so much bandied about in discussions of adoption. I believe this is a useless, even a harmful, metaphor. It was used by the psychoanalytically-oriented infant-toddler expert Margaret Mahler, and later by Daniel Stern as well as by others. They used the term symbiosis to describe a period of early life, beginning not at birth but at a few months of age, and going on until about the time that attachment behavior begins. For these authors, the word “symbiosis” was chosen to express the deep intimacy, physical and emotional, that often prevails between mothers and babies at this time in the baby’s life.
The word symbiosis, literally “a living together”, deceives us by looking as if it might be a good word to describe the best mother-infant relationships between about 2 and perhaps 6 or 7 months. But it’s not a word that was invented for this purpose. It describes another, more easily understood phenomenon, and because of this introduces a metaphorical usage into the discussion. Symbionts, or animals that live in symbiosis, are not uncommon in the natural world. They belong to different species but live near each other and behave in ways that are mutually beneficial. For example, pilot fish and sharks benefit each other and contribute to each other’s survival, as the fish eat the parasites that can infest the shark’s skin.
Real symbiosis does not provide a good metaphor for any stage of the mother-child relationship, because mothers and babies are not mutually beneficial to each other’s survival, either before or after birth. Mothers take care of babies; babies do not take care of mothers. On the contrary, aspects of motherhood are so potentially damaging to the mother that we have to look to evolutionary advantages for the species before we see any survival-related reason for having children. (I’m not talking about love, fun, or cultural pressures here, just plain survival of the kind that symbiosis aids.) Aside from a few possibilities like reduction in breast cancer caused by breastfeeding, we see virtually all the benefits of the relationship going to the baby, while the mother serves as an auxiliary immune system as well as an auxiliary ego.
What would be a more suitable metaphor, drawn from the natural world, to guide our thinking about young babies and their mothers? If we’re going to choose a comparison to animals living together, a better choice than symbiosis would be parasitism. A parasite, like a tapeworm living in a human gut, takes what it needs from the host, but usually does only slight damage, as it benefits from the host’s continuing life. Unborn babies function like parasites to a considerable extent, sometimes endangering or even killing their host[ess]. During the first year, or even longer, the long slow maturation of human beings makes them require constant care which they are completely incapable of reciprocating and keeps them in a parasitic relationship to adults.
Well, this is really an ugly metaphor, isn’t it? Babies as tapeworms is a pretty disgusting idea. But they’re not pilot fish either, and look at the problems we get into with the symbiosis metaphor. That way of thinking leads us to believe that the early mother-baby relationship is mutual, a two-way street in which the feelings and needs of one partner reflect the feelings and needs of the other one. We can make a lot of mistakes with that metaphor. One is to assume that anguish of a mother separated from her baby is necessarily mirrored by the anguish of a young baby separated from the mother, though observation of babies of a few months tells us this assumption is false. Another is to confuse the mother’s and child’s feelings as attachment develops and to think of “bonding-and-attachment” as if they meant the same thing. The parasite metaphor actually works much better as a description of the early mother-child relationship because it protects us from making mistakes about mutuality.
Of course, one of the difficulties of choosing a good metaphor for mother-baby relationships is that, like other aspects of development, those relationships don’t follow the same rules throughout life. Babies function in different ways at different points in their development, and within the second year will become less parasitic and more capable of reciprocating care and affection in a faintly adult-like way. Mothers, too, operate differently at different times in their own and their babies’ lives. As time passes, new metaphors need to be chosen to help us understand social and emotional development. It’s possible that symbiosis could be a good metaphor for some kinds of adult relationships, but I doubt that it ever works well for relationships between parents and their children of any age.
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