Authority versus Evidence: Arguing About Adoption and Psychological Interventions

Off and on for a couple of years, but especially in the last few months, I’ve found myself upholding the idea that there must be an evidence basis for treatment, against others who believe that statements by people who claim authority are the most powerful of all arguments. I’ve referred to this conflict as a “culture war”, and I am convinced that it is an argument between ideological, a priori assumptions about the world, on the one hand, and positions based on systematic observations and evidence, on the other-- same old Plato versus Aristotle, if you like.

Von and other adoption bloggers argue strongly for a Primal Wound, on the basis of their own experience and on the authority of Nancy Verrier (who, incidentally, has not yet answered the questions I asked a month or so ago). They reject the systematic research evidence provided by Michael Rutter and the English-Romanian Adoptees Project or by other investigators, showing that most adopted children, even those adopted late and after intense social deprivation, do quite well in the long run. For Von and friends, the vividness of personal experience and the statement of an authority establish a set of assumptions that do not need to be tested against other evidence. For Rutter and other researchers, evidence is to be explored carefully as a test of existing assumptions.

Valle Oberg, a proponent of Ronald Federici’s methods of dealing with post-institutionalized children, also appeals to authority as the foundation of her argument. She states (in comments on this blog) that Federici has worked with thousands of children (although the arithmetic on this does not seem to work out very well) and has “saved” them, and that her own children were among those. Therefore, she argues, what she says, and what Federici has said, must be correct. In addition, she proposes that peer-reviewed publication of outcome research is not evidence that methods are effective. Oberg dismisses the view that Federici needs to report his evidence to the public before his methods are said to be effective.

While mulling over these disagreements, I came across a letter to the editor published in Science in 2004 (a silent testimony to the number of papers on my desk). That LTE was in response to discussion at that time about hormone replacement therapy and the way it failed to provide the benefits to heart health that had been expected of it. The authors, Philip Guzelian and Christopher Guzelian, pointed out that it was not surprising or anomalous that the predicted results did not occur. They commented that the outcome was a “dramatic example of the difference between authority-based conclusions (arising from opinion, experience, intuition, judgment, and scientific inference)… and evidence-based conclusions (derived from an objective, unbiased, and systematic analysis of scientific knowledge)… The lesson is quite generalizable. Uncritical acceptance of authority-based opinions as conclusive evidence is pervasive, even though top authorities unsuccessfully predict what scientific knowledge will be preserved as ‘fact’ “. Guzelian and Guzelian noted that there are times when decisions need to be made without adequate scientific evidence, but warn against confusing them with evidence-based conclusions and propose that “the obvious solution is to explicitly acknowledge when shortcomings in the amounts or quality of evidence necessitate a reversion to authority”.

An important point in the contribution of Guzelian and Guzelian is the acknowledgment that evidence-based conclusions are not always available. Those authors were not talking about psychological interventions, but that acknowledgement is an important one in discussion of psychological treatment, where design and implementation of research can be extraordinarily challenging. Although Guzelian and Guzelian did not mention levels of evidence (the idea that some forms of research offer stronger arguments than others), they did imply the need to balance evidence and authority differently in different situations. When evidence is strong, it should be weighed far more heavily than authority; when evidence is weak or non-existent, authority and personal experience are better to rely on than flipping a coin or casting the I Ching.

Perhaps the most important message in the Guzelians’ letter is the need for explicit statement that in the absence of systematic evidence, one is appealing to authority for support of a claim. This is only appropriate, of course, if there is no evidence or if the existing evidence is weak or open to interpretation, and if the maker of the claim can show that this is the case. It is not sufficient to do as Von, Valle Oberg, and many others have done-- to ignore the existing evidence and put forward instead a contradictory claim based on authority, and not only authority, but the authority whose views are welcome.

But, of course, if your way of thinking is to appeal to authority, this will make sense to you only if stated by an authority of your choice.

You Can Pick Your Friends, But You Can't Pick Your Monkeys: Origins of Attachment Theory

One of the greatest temptations in the field of psychology is the urge to leap from research on animal behavior to a conclusion about human beings. Unfortunately, unless research about human beings substantiates the conclusion, the landing may be a bumpy and unreliable one. This danger does not always stop leapers; Alan Schore’s “modern attachment theory” is based on a number of such leaps, and as I have pointed out elsewhere, Schore does not make much of an effort to insure that readers realize which animals were the actual subjects of the research he cites.

The history of attachment theory, right back to John Bowlby’s time, has been characterized by generalization from animal behavior to human beings’ child care and early development. Bowlby originally compared human emotional attachment to the “imprinting” of ducks on the first moving objects they saw, and their later following of the imprinted object (usually the mother) and eventual courtship and mating with another member of their own species. Imprinting had an enormous impact on the duck’s life, determining that it might spend its early life following a toy train, or in adulthood “fall in love” with a human caretaker and ignore available mates of its own species. Considering the facts of duck behavior, Bowlby at first thought that human attachment would have similar mechanisms and effects, including “monotropy” (an inability to make an attachment to more than one human being). But further observation showed that attachment did not occur in the first days of life as imprinting did, that human beings had the ability to develop more than one attachment, and that a child who lost the first attachment relationship was capable, under the right circumstances, of developing a strong emotional attachment to a new caregiver.

Bowlby realized that the leap had gone too far and had landed on the wrong spot. Although human attachment was in some ways analogous to imprinting, it was not the same thing, and it was not possible to draw safe conclusions about human development simply from observations of duck behavior.

Bowlby and his colleagues then moved on to consider another type of animal behavior-- this time, an animal much more like human beings than ducks are. As is well known, Bowlby was much interested in the work of the comparative psychologist Harry Harlow on rhesus monkeys. Harlow demonstrated that rhesus babies, when separated from their mothers, sought out soft fabric model “mothers” and clung to them even though those “mothers” offered no nourishment. They would leave the soft mother to drink from a wire-framed “mother” that contained a bottle of milk, then scurry back to the soft model. Both Bowlby and Harlow were taken with the fact that the rhesus babies did not seem “attached” to the models that supplied milk; this result was in contradiction to Freud’s belief that the experience of feeding created emotional attachment, and it supported Bowlby’s argument that there was something in the social experience with the caregiver that triggered the development of attachment. Bowlby and Harlow were also interested in the later difficulties of the rhesus babies as adults, when they were reluctant to mate and did a very poor job of caring for their own infants if they had them. This outcome seemed to suggest that attachment experiences determined a great deal about personality development, an idea that was later built into Bowlby’s attachment theory and that has informed much of the later research on attachment.

Here’s an important question, though: What if Harlow had chosen some other kind of monkey? This was an issue which in fact received much attention from psychologists and zoologists in the couple of decades following Harlow’s reports and Bowlby’s adoption of the Harlow studies as evidence for attachment theory. The discussion at the time-- largely forgotten now that everyone has seen films of sad-looking rhesus babies on wire “mothers”-- focused on the fact that monkeys exhibit species differences in maternal-infant behavior. A monkey is not “just a monkey”, but a particular kind of monkey. (Much less work on these differences is done today because of the great expense of field studies and current concerns about the ethical treatment of lab animals.)

Harlow worked with rhesus monkeys, Macaca mulatta, a monkey that has frequently been employed in various types of research and which gave its common name to the Rh factor well-known to influence human reproductive success. But other researchers pointed out that the results of behavioral work with rhesus monkeys might not be the same as similar work with other types of monkeys. In one review article (Seay & Gottfried [1975]. A phylogenetic perspective for social behavior in primates. Journal of General Psychology, 75, 5-17), the authors described typical maternal-infant behavior and responses to separation in several monkey species in addition to Macaca mulatta.

Seay and Gottfried noted that in spite of the developmental difficulties of the “surrogate”-reared rhesus infants, rhesus monkeys who had somewhat less deprivation all eventually did well, whether they were reared in small groups of infants, reared alone but had a play period with other infants daily, were reared by brutal or abusive mothers, or had normal rearing by their mothers. They concluded that only an extremely unfavorable environment would alter these animals’ play, aggression, or sexual behavior. In addition, they stated that “even the organism maturing in an environment inadequate to support species-typical behavior will not develop unique techniques for coping with that environment. Rather, his behavioral repertoire will consist of fragments of the behavior patterns which ensure individual and species survival for most of his species-mates” (p. 10).

Comparing the rhesus monkey to other species, these authors noted that their own work on a different monkey, Macaca fascicularis, showed results rather similar to that on Macaca mulatta. However, the African red monkey (patas) showed a different pattern of social behavior. If rhesus monkeys were housed in cages such that the infants could go out to a central playground, when one came out, one or more others would join him. When an infant patas monkey came out, though, other patas infants did not join him—or, if one did, the first baby went back to his mother. As patas monkeys got older, they played chasing games, but unlike rhesus monkeys did not contact each other much.

Rhesus mothers object to physical disturbance from their infants, and will bite or hit an annoying baby. However, they will allow “strange” babies to come into the cage, as long as they “behave”. Patas mothers allow their babies to explore or play-attack them, and either do not respond or respond playfully-- but they will not allow a strange baby to come in. When nursing, rhesus babies are belly-to-belly with their mothers; patas babies do not have much of the body surface touching the mother. All monkey babies are disturbed by separation from the mother, but patas babies recover more quickly than rhesus babies do.

Who are we humans like? Should we accept a theory of personality development based on rhesus monkeys, or are we more like patas monkeys? The best guess is that we are like ourselves. Like other species, we have our own patterns of social interaction and of response to environmental changes. We may resemble other species, and their behavior may seem familiar and appealing to us. But when we come down to it, the behavior and development of other species can only provide a hint about what human beings might be like. We need to be cautious about our leaps from animal evidence to theories about humans--- however, cute, sad, and sympathetic those baby monkeys look to us.

What is Reactive Attachment Disorder? Further Discussion

I’ve made a number of statements to the effect that violent or aggressive behavior, lying, stealing, and so on, were not diagnostic of Reactive Attachment Disorder. Some readers disagree strongly with this perspective. Reader Valle Oberg, for example, has been arguing against my position for several days at http://childmyths.blogspot.com/2010/12/federici-v-mercer-story-behind-lawsuit.html.

I’d like to call people’s attention to a paper by Charles H. Zeanah and Anna Smyke from Tulane University, arguably the leading U.S authorities on Reactive Attachment Disorder (Zeanah, C.H., & Smyke, A.T. [2008]. Attachment disorders in family and social context. Infant Mental Health Journal, 29, 219-233). This paper discusses criteria for attachment disorders and compares the DSM and ICD-10 versions, as well as referring to categories suggested by Zeanah in previous work.

In none of this material is there any reference to violent or aggressive behavior, self-injury, lying, cheating , stealing, refusing eye contact, or any of these issues so much stressed by therapists and parent groups outside the mainstream of psychological and psychiatric thought. Zeanah and Smyke come no nearer to these issues than referring briefly to the possibility of risk-taking as one aspect of a RAD-like category.

Zeanah and Smyke discuss measures of inappropriate behavior suggesting a disorder of attachment. They point out three ways in which such measurement has been approached. One method looked at whether children wandered away from caregivers without becoming distressed, whether they approached strangers, whether they were never shy with new adults, whether they were friendly with new adults, and whether they would go off with strangers. A second approach considered whether children failed to differentiate among adults (that is, treated all adults the same way and did not have a preferred caregiver), readily went with a stranger, and failed to check back with a caregiver (i.e., by looking back to them or calling to them as distance between them increased or separation became likely). The third method looked at not having a preferred caregiver, lack of reticence with a stranger, failure to check back, and willingness to go with a stranger. (Once again, none of these methods looks at aggressive behavior, lying, self-injury, etc., etc.)

Zeanah and his colleagues several years ago wanted to develop a technique of assessing preschool children’s attachment to caregivers without depending on parent or teacher reports. They developed what they called the “Stranger at the Door” procedure. One of the researchers knocked at the door of the child’s home, and the caregiver and the child answered the door together. The stranger looked at the child and said, “My name is ____. What is your name? Let’s go for a walk.” Observers coded the child’s behavior in response (if the child was willing to go, they walked a few feet, then came back into the house). Children’s willingness to go with the stranger was greatest in the group who had been institutionalized, but there was also atypical willingness in a comparison group of children who had been in foster care.

The Zeanah and Smyke paper noted that in a group of children adopted from institutions, there were no cases of the inhibited form of RAD, but a “substantial minority” showed the disinhibited type, with less avoidance of strangers and less preference for familiar caregivers than is typical among family-reared children.

In discussing “self-endangering” behavior as an aspect of RAD (the nearest thing mentioned to the claims of aggression and self-injury made by some advocates of an unorthodox view of attachment disorders), Zeanah and Smyke emphasize the possibility that risk-taking is part of a “two person” disorder which is difficult to describe in present language. They raise the issue of possible relational attachment disorders (different from RAD as now defined) that are evident only in the context of the association between the child and a specific caregiver. I would add that this is a very interesting idea with respect to the claims made by members of ATTACh and similar groups that children with RAD behave angelically outside their homes, but are difficult or even dangerous in interaction with their mothers.

What Is Attachment?

What IS attachment, anyway? This word is used constantly by parents and teachers, attorneys and judges, as well as psychologists and social workers. What do they mean? Is attachment one of those things like obscenity, that we can’t define, but “we know it when we see it”?

Actually, one of the problems with understanding attachment is that many people don’t know it when they see it. As a discussion of attachment and child custody decisions pointed out a couple of years ago, “few custody evaluators recognized the distinction between a highly dependent or demonstratively affectionate relationship between a parent and a child and a secure attachment” (Calloway & Erard [2009]. Introduction to the special issue on attachment and child custody. Journal of Child Custody, 6, 1-7). Some quasi-professionals who emphasize attachment believe that the attachment of a child to a caregiver is indicated by physical demonstrations of affection, eye contact “on the parent’s terms”, obedience, and gratitude.

Many textbooks define attachment as an “emotional bond” or “tie” between two people, especially a parent and a child. The organization ATTACh (Association for the Treatment and Training of Attachment in Children) gives the following lengthier definition of attachment:
“Attachment is a reciprocal process by which an emotional connection develops between an infant and his/her primary caregiver. It influences the child’s physical, neurological, cognitive, and psychological development. It becomes the basis for development of basic trust or mistrust, and shapes how the child will relate to the world, learn, and form relationships throughout life.” (www.attach.org)

But let’s parse these definitions. Is it of any help to say that something is an “emotional bond”, without saying what an emotional bond is? Actual bonds involve close physical proximity, enforced by physical methods like ropes or handcuffs. Attachment, then, is being said to be like a bond in that it maintains proximity, but the way it does this is through emotional factors rather than with ropes. This is an analogy rather than a definition, and it is inadequate for two reasons. One is that although attachment does maintain a young child’s physical proximity to a caregiver, continuing development alters the way in which attachment is expressed. In any case, the seeking of proximity is not the same at all times, but occurs when the child feels threatened or uncomfortable. The other problem is that this description of attachment leaves it unclear whether both members of the pair behave in the same way or have the same emotions or motivations relative to maintaining proximity. In fact, in the course of development, parent and child trade several times the position of being the one that wants more proximity; the child who has a toddler clung to the parent who was leaving for work grows to the teenager whose parent is anxious to know where he is going and when he will be back

Now let’s look at the ATTACh version. It’s longer and more complicated, but is it any better? It begins by saying that “attachment is a … process”. No doubt there are processes leading to attachment, but if attachment is a process, it’s difficult to see how we can determine whether attachment is secure or even present. Surely attachment is some sort of end state, and not simply an ongoing process. Perhaps the “emotional connection” which is said to result from the attachment process is the actual attachment, but it too remains undefined.

ATTACh also says that attachment is not just a process, but a “reciprocal process”. I interpret this as meaning that attachment develops in the course of interactions with other people and could not exist in a social vacuum, and this is certainly correct. ATTACh may also intend to say that attachment (emotional connection?) in a child develops in tandem with some emotional change in the adult caregiver, which may be true, but seems to be irrelevant to the later emphasis placed on the child’s own development.

ATTACh speaks of connections between an infant and the primary caregiver and appears to be limiting attachment to this relationship. Here we encounter some problems, because all the evidence is that young children can have many attachment relationships, some more obvious than others, and that these relationships may or may not share qualities like security. On the other hand, caregivers tend to be monotropic and have one or two preferred infants, even if they work with a group of children of similar ages; perhaps the ATTACh authors were thinking of the adult’s connection with a “primary” baby when they wrote this.

ATTACh goes on to cite the various aspects of development that are influenced by attachment (although whether as a process or as a loosely-defined emotional connection is not clear). It is not stated how attachment affects the child’s physical development, or how psychological development is different from cognitive development, but even if these points are set aside, these remarks do not contribute to the definition of attachment, but simply say more about things that are related to the undefined process or end state. Similarly, in the last sentence, references to basic trust and to shaping relationships do nothing more than to say that something called attachment is involved here. (As to the statement about learning, it is far from clear what the authors meant.)

It would seem that neither the textbook definition nor the ATTACh effort is of much use in clarifying what attachment actually means. I’d like to offer an alternative definition that I believe cuts through some of the difficulties we’ve seen here.

I would suggest that attachment is best thought of as an attitude, or a readiness to behave in particular ways toward the object of the attitude. It is an attitude toward human beings that involves the readiness to behave differently toward familiar and unfamiliar people, but to do so in different ways when there is perceived threat than when there is not. Like other attitudes, attachment changes with development, and although young children show their attachment by seeking proximity to familiar people when uncomfortable, they gradually move toward other related behaviors. Also, like other attitudes, attachment involves characteristic emotional responses that may occur together with or instead of observable behavior, and these too change with development. Attachment attitudes vary with experience as well as with age and culminate in an internal working model of human relationships in general as well as the specific reaction to threat which is their foundation.

This may not be the perfect definition, but at least it actually is a definition. Comments and editing are invited.

Infant and Toddler Overnights: A Focus of Divorce Disagreements

When couples have children of infant and toddler age, the breakdown of marriage is often followed by intense and bitter argument over allowing the child to have an overnight visit and sleep away from the familiar home. In most cases, the mother is the custodial parent and continues to live in the marital home, while the father is more likely to be the one who moves out, lives elsewhere, and does the “visiting”.

Mothers are very likely to resist overnight visits for young children. They are concerned that the father is unaware of the child’s bedtime rituals or needs, that the child may be distressed by the experience, or even that a father who has behaved violently in the past may lose his temper if the child cries or fusses in the unfamiliar night-time setting. Fathers, on the other hand, may be concerned that the child spends less time with them than with the mothers and may therefore be less attached to the fathers. They may also believe that if the child does not form a strong attachment to the father in the first couple of years, no real relationship will ever be possible.

However the estranged couple work things out, this problem will pass (and of course will be replaced by different issues). The child will get older and reasons to resist overnight visits will gradually disappear. At the beginning, though, the overnight issue seems to be of overwhelming importance. In a recent special issue of the journal Family Court Review (2011, Vol. 49), the issue editor noted that when she surveyed readers to ask what they wanted to know about attachment and child custody, 60% of them asked what to do about overnights.

Several well-known psychiatrists and psychologists who contributed to the issue made a point of commenting on the overnight question. And all of them said about the same thing: overnight visits are problematic for about the first two years of the child’s life. Depending on the child, it may be best to wait as late as age 4 before beginning overnights (George, Solomon & McIntosh [2011]. Divorce in the nursery: On infants and overnight care. Family Court Review, 49, 521-528). The reasoning behind this advice is that children have real individual differences in temperament (for instance, the ease with which they accept a new situation) and in language development (which allows them to understand what they are told about the length of a visit). Children who are easily distressed, who have little concept of time, and who are still immature in their understanding of language may interpret an overnight visit as permanent abandonment by the custodial parent and may not be able to communicate their fears to the other parent-- who may have no wish to hear of the child’s longing for the divorced spouse. When children have handicapping conditions that affect communication and cognition, their level of development may be much more important than their chronological age.

But what if there are no overnights? Does this mean that the child’s relationship to the noncustodial parent is negated from the beginning? Charles Zeanah, the well-known attachment researcher, commented about this: “it’s not necessary for both parents to have attachment relationships with the child in the early years. That can happen later, when the child has more sophisticated abilities to sustain attachment relationships over time and place. Where it is possible, it does make sense for the child to keep contact at the level of comfort and familiarity until they are ready for more” (Lieberman, Zeanah, & McIntosh [2011]. Attachment perspectives on domestic violence and the law. Family Court Review,49, 529-538). Alan Sroufe, another leading attachment researcher, said, “I think that if parents, judges, lawyers, and so on took the view that attachment is a gradual building process, and that each relationship is built on its own terms, there would be less paranoia about this… even if they had no overnights for the first 2 years” (Sroufe & McIntosh [2011]. Divorce and attachment relationships: The longitudinal journey. Family Court Review, 49, 464-473).

These commentators are stressing the best interests of the child, a vague standard indeed, but one which we can clearly distinguish from an emphasis on parents’ rights. They seem to agree that it’s in the child’s best interest to have as calm an infancy and toddlerhood as possible and not to be asked to adjust to unnecessary changes and transitions. They also agree that two caring parents-- even if separated-- are better than one, but that there is no natural process that demands that both sets of relationships must develop simultaneously and early on. The fact that no “window of attachment” closes at age 2 means that it’s possible both to preserve family connections and to support a child’s early needs for a peaceful life.

Separated parents with very young children would do well to take these cautions to heart, but at the same time they may want to consider whether they want to try out visits with an eye to overnights. A gradual approach, including nap-time at the noncustodial residence, may give them an idea whether a child is ready to take the step to an overnight stay. If the child copes well with one overnight visit, it is wise to wait a while for the next one rather than rushing to a new schedule of frequent changes and risking overwhelming him or her. But none of this will work well unless the parents are able to concentrate on the child’s needs and reactions rather than hurrying to blame each other for any distress the child shows.

When overnight visits begin, one point that can be difficult for separated parents to deal with is co-sleeping. Plenty of parents let infants and toddlers sleep with them part or all of the time (and I am far from criticizing this practice). In addition, if a father leaves the household, the mother is likely to respond to the child’s distress and her own by letting the child sleep in her bed. What happens, then, if the child stays overnight with the father? Can the co-sleeping mother deal with having the child share a bed with the father, or will this trigger concerns about sexual behavior? How does the father comfort the child who is accustomed to sharing a bed, except by co-sleeping? This highly emotional situation is one in which straightforward discussion with neutral parties is essential in order to avoid distress, fears, and accusations that are in the great majority of cases completely unrealistic.

P.S. The comments of Alan Sroufe about attachment as a gradual building process are also highly relevant to adoption issues.

P.P. S. The issue of Family Court Review I'm referring to is available for free on line. Google the journal name and you'll see how to get to the articles.

An Open Letter to Nancy Verrier

Dear Nancy:

As you probably know, some of your strong supporters are very mad at me for contradicting the idea that adoptees suffer from a lasting emotional trauma that you have called the Primal Wound. I’m told by people who know you that you are a sensible and friendly person and a supportive, helpful therapist. I wonder whether you might be willing to answer some questions for me. They are more challenging questions than I suppose you often get, but I am asking them in a genuine spirit of inquiry after reading some of your work. I am curious about unconventional theories and have been working on a book that examines some of the ideas shared by such theories and the therapies that are associated with them, and that work is the source of some of my questions. In addition, I believe that better understanding of these issues could facilitate mutual understanding between the “pro-PW” and “anti” groups.

1. Why do you accept and use the idea of cellular consciousness or memory? I’m sure you know that conventional views attribute consciousness and memory to the functioning of cells of the nervous system and not to other types of cells. Are there aspects of memory that you feel are better explained by cellular memory than by the conventional perspective?


2. Do you think personality development can be explained in terms of natural, material events, or would you say that some non-material/spiritual factors are needed for an explanation?


3. It seems that different adoptees have different feelings about their adoptions. What do you think are the factors that lead them to have one opinion or another?


4. What are some examples of what you call biological mirroring, ways people look or behave that you say have special meaning for biologically-related children? What are your reasons for thinking they have special meaning?


5. You have been involved for some time with the organization APPPAH, which in turn has connections with primal therapy and other “primal” ideas. I assume that this connection
is why you chose the term Primal Wound. Do you share beliefs with Arthur Janov and earlier contributors like Frank Lake and Francis Mott? Do you consider their LSD and “breathwork” experiences to give an accurate depiction of the experiences of an unborn baby?

6. Do you recommend that adoptees use any of the “primal” or “rebirthing”therapies to help with distress that they consider a result of adoption? Would you say there are other treatments that are helpful?



I think the answers to some of these questions might help explain the very intense commitment of some adoptees to the Primal Wound concept. It’s possible that the attractiveness of this idea to its proponents may have to do with a broader set of beliefs, not just with the single idea-- that discussions of this issue are culture wars in miniature. If that’s the case, discussing the “real problem” might be the beginning of a way for well-intentioned people concerned about adoption to come together for good purposes rather than attacking and blaming each other.


I hope you will take the time to answer at least some of my questions, not necessarily all at once. I would be grateful for your help on this, and I believe readers of this blog would also appreciate it.

Yours sincerely.
Jean Mercer


[9/1/2011 Nancy Verrier has kindly responded that she will be answering these questions in the near future. ]

Examining Unconventional Theories: More on the "Primal Wound"

Like many other unorthodox belief systems, Nancy Verrier’s “Primal Wound” theory just keeps on keeping on in spite of clear evidence that it can’t be correct. For those who are just coming in, the Primal Wound idea is the entirely speculative notion that babies adopted in the first days or weeks of life are deeply troubled by separation from the birth mother, and that this disturbance causes psychological difficulties that continue to be experienced right into adulthood.

An interview with Verrier at http://blog.adoptionmosaic.org/interview-with-nancy-verrier/ shows a continuing emphasis on some easily refutable points.

The first of these is the assumption that infants are psychologically more vulnerable in the period soon after birth than they are later. This belief depends on a logical fallacy; it’s based on the idea that if childhood is a vulnerable period, and people in later life are less psychologically vulnerable, then earlier and earlier developmental periods are times of greater and greater vulnerability. In fact, though, both physical and psychological vulnerability have schedules in which a somewhat later period is more sensitive than the earliest time. As an example, the probability of birth defects from exposure to rubella is much less right after conception than it is 6 weeks later.

Critical periods in development, when normal events are more easily disturbed by trauma or disease, are different for different aspects of developmental change. Emotional attachment to a caregiver has not developed at birth and is not apparent until 6 months or so later. Think about this a bit-- what has there been for the baby to attach to, before birth? In the interview with Verrier, she says the baby knows nothing but that mother. In fact, though, the baby knows nothing but the inside of that mother, not the outside.

Are we to assume that newborn babies are grieving for the taste of the amniotic fluid and for the sound of the mother’s stomach rumbling, not to mention other less socially-acceptable noises? If not, what are we to think they miss? Is it the “psychological connection” mentioned by Verrier, which she says is not severed with the umbilical cord? What was that connection? Are we actually talking about a telepathic communication between mother and baby, as posited by the ‘50s psychoanalyst Nandor Fodor? If so, why doesn’t such a connection continue after birth-- is it somehow dependent on physical transmission through the cord? There seems to be quite a confusion of material and non-material events here.

Verrier argues that babies remember not only birth but prenatal events back to conception because of cellular consciousness. This idea, that experiences are imprinted on cells and need not be represented in the nervous system, has been popular among Scientologists for many decades (see Janet Reitman’s recent history of Scientology). It has also much been much favored among advocates of Janov’s primal therapy, including the Australian physician Graham Farrant, who believed that there were memories from the egg and sperm stages too (see http://primals./org/articles/farrant3.html). There is certainly no evidence that this type of memory exists or that either subjective experience or recall can occur without the functioning of high levels of the nervous system; this also applies, by the way, to the “body memory” idea much discussed by Bessell van der Kolk. Once again, this belief seems to involve a confusion between functions of cells and some posited non-material component of the personality.

Now let’s consider Verrier’s idea of “biological mirroring”, which seems to be the experience of observing others who share some of one’s genetically-determined behavior traits. I wonder whether Verrier is aware that human infants don’t even recognize themselves in the mirror until 15-18 months of age? How are they then to compare their own more subtle behavior characteristics with those of others until a much more advanced age? And when they do notice differences, what does this mean--- would we see psychological problems caused by being the only girl in a large family of boys, or the blue-eyed child of heterozygous brown-eyed parents? As for genetically-determined behavior traits, I would be at a loss to name even one that is obvious and is inherited according to a dominant-recessive pattern (we can’t expect tongue-rolling or tasting certain chemicals to be easily observed). Instead, behavior traits like temperament are determined by combinations of genes and environment. The big similarities in behavior of some separated twins, so much emphasized by the media, need to be considered in the context of other separated pairs who have little in common. Before arguing for the positive impact of “biological mirroring”, Verrier needs to present evidence that children in families where there are strong resemblances are somehow psychologically healthier than those in families where the roll of the genetic dice has produced varying temperaments and appearances.

The Sunday New York Times (Aug. 28, 2011) this week carried an obituary whose details reminded me strongly of Verrier’s claims. This was the obituary of Budd Hopkins, an abstract expressionist painter-- and, more to the point, the instigator of the “alien-abduction movement”. According to the Times, “Many who shared their stories with Mr. Hopkins had no conscious memory of their abductions at first. But they had lived for years, he said, with the nagging feeling that somewhere, something in their lives had gone horribly wrong….. by his reckoning, 1 in 50 Americans has been abducted by an alien and simply does not know it.” Here is a theory of emotional discomfort that is as much supported by evidence as the theory of the Primal Wound. Is there the slightest reason why anyone should accept either of these ideas?

A Russian Adoptee, Child Abuse, RAD, and MAD

In an all too common scenario, the Alaskan adoptive mother of a Russian child is on trial for child abuse, and her defense argues that the child is so awful that it was suitable to punish him by putting hot sauce in his mouth and by forcing him into a cold shower. (See http://articles.ktuu.com/2011-08-19/hot-sauce_29907825 and http://www.ktuu.com/news/ktuu-jessica-beagley-child-abuse-trial-closing-statements-082211,0,2078692.story for information about this.) Jessica Beagley’s actions toward her adopted son might never have been detected, or if detected might not have “made news”, except for the fact that she wrote to “Dr. Phil” and made a tape for the show, describing her anger and frustration and the use of worrisome disciplinary methods.

During Beagley’s child abuse trial, her attorney argued that she had done nothing wrong. Her family therapist, Chantal Cohen, and others stated that the 7-year-old was difficult because he suffered from Reactive Attachment Disorder as a result of his early life in a Russian orphanage. Cohen stated that such children can be “sweethearts at school and monsters at home.” Other testimony said that children with Reactive Attachment Disorder “are uncontrollable and don’t show empathy”. Cohen also testified that the children “intuitively find the one button that’s intolerable to you and then they smack it really hard.”

This all seems pretty inconsistent; how can a person without empathy, the capacity to know what others feel, also have a capacity to figure out what someone else’s concerns are? But, be that inconsistency as it may, there’s a much bigger issue to consider about these statements regarding Reactive Attachment Disorder. My question is, what did Chantal Cohen and others think they were talking about when they referred to Reactive Attachment Disorder? The characteristics they referred to and attributed to Beagley’s adopted 7-year-old form no part of Reactive Attachment Disorder as it is defined by the official source, the Diagnostic and Statistical Manual of the American Psychiatric Association (often called just DSM).

Here is how DSM describes the characteristics of Reactive Attachment Disorder (code 313.89):

Markedly disturbed and developmentally inappropriate social relatedness in most contexts [not just at home-- J.M.], as evidenced by either (1) or (2):

Persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions [again, not just at home-- J.M.], as manifest by excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses…
Diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (e.g., excessive familiarity with relative strangers…).
[The DSM description goes on to cite other points that are irrelevant here but can easily be found by interested readers. ]

There is nothing in this description about being a “monster at home”, about lacking empathy, or about intuitively finding and pushing a parent’s most sensitive button. What, then, is Chantal Cohen talking about? Chances are that she misunderstands Reactive Attachment Disorder because she has been “trained” in an alternative view, put about by quasi-professional family therapists and life coaches, that describes either Reactive Attachment Disorder or something called just “Attachment Disorder” in a way completely different from the DSM description. They sometimes call it RAD, sometimes AD; I’d like to call it MAD for Misunderstood Attachment Disorder (and because it makes me mad to see this deception practiced).

Here are the characteristics of this MAD/RAD as stated at http://www.attachment.org/pages_what_is_rad.php:


Superficially engaging and charming.
Lack of eye contact on parent’s terms [this does not seem to preclude the existence of normal eye contact most of the time-- J.M.]
Indiscriminately affectionate with strangers.
Not affectionate on parent’s terms (not cuddly).
Destructive to self, others, and material things (accident prone).
Cruelty to animals.
Lying about the obvious (crazy lying).
Stealing.
No impulse controls (frequently acts hyperactive).
Learning lags.
Lack of cause and effect thinking.
Lack of conscience.
Abnormal eating patterns.
Poor peer relationships.
Preoccupation with fire.
Preoccupation with blood and gore.
Persistent nonsense questions and chatter.
Inappropriately demanding and clingy.
Abnormal speech patterns.
Triangulation of adults [might be difficult to do without empathy-- J.M.].
False allegations of abuse.
Presumptive entitlement issues.
Parents appear hostile and angry.

This list is on a web site belonging to Nancy Thomas, a foster parent and advocate of Holding Therapy, as well as in print and Internet publications by similar authors. In no case is evidence provided that such a group of characteristics is in any way associated with emotional attachment of children to caregivers, or that these characteristics tend to be shared in the form of an identifiable syndrome. Only two of these characteristics (“indiscriminately affectionate with strangers” and “inappropriately demanding and clinging”) overlap conceptually with the description of Reactive Attachment Disorder in DSM.

It appears that Jessica Beagley’s defense is arguing that she has been abusive in the course of her well-intentioned efforts to deal with a child with Reactive Attachment Disorder. However, nothing reported about the testimony suggests that the child has been professionally diagnosed with Reactive Attachment Disorder as it is properly defined. On the contrary, the testimony suggests that the witnesses wish to use the established term Reactive Attachment Disorder as a way of normalizing their unconventional diagnosis, the MAD/RAD concept. Assigning a child to the MAD/RAD category, with the characteristics listed above, enables the defense to argue that the child is lying and making false allegations of abuse, that the mother’s hostility toward him is in response to his personality disorder, and that the mother’s escalation of unacceptable punishments was entirely an effort to control the uncontrollable.

The RAD defense is regrettably becoming more common as a way to extricate abusive, even homicidal, parents from legal difficulties. In the Salvetti case which I discussed some months ago on this blog, the defense argued that another Russian adoptee had refused to eat until his weight dropped noticeably, rather than having his food limited by his parents as a disciplinary measure. The Salvetti defense stressed the idea that as a RAD sufferer, the boy was a persistent liar.

Prosecutors and judges need to be aware of the real and the false Reactive Attachment Disorder descriptions so they can respond appropriately when the RAD defense is mounted during child abuse trials. It’s time to stop the repetition of this scenario, with its tendency not only to do injustice, but to spread disinformation and encourage mistreatment of adopted children.

P.S. Aug.24-- Jessica Beagley has been found guilty, and SLATE, in commenting on this, has invented something called Radical Attachment Disorder!

When Will My Baby Understand....?

Concerned parents (and what other kind is there, really?) pore over lists of developmental milestones, checking out the average age for the first independent step, first word, and so on. Even more important-- but much harder to establish-- would be developmental milestones for ways of understanding and communicating with other people.

As it happens, an American developmental psychologist who has contributed much to our understanding of infant understanding, Michael Tomasello, has just received the 2011 Wiley-Blackwell/British Academy prize for contributions to psychology. I’ve been going through some of his research articles (kindly posted for free by Wiley-Blackwell), and I put together some “milestones” that I think will be of interest to parents. Some of these developmental achievements may seem pretty ordinary at a casual glance, but if you think it over you’ll see that they’re very significant steps in understanding other people.

12-month-olds:

How do 12-month-olds understand pointing? Do they just look where you point, as they look where you look, or do they understand that a pointing person means to communicate some information? When an adult pointed at a hidden toy, 12-month-olds could usually find the toy. Those who had understood the pointing could also point correctly themselves when an adult asked them where a toy was. This suggests that 12-month-olds know that a gesture like pointing means that another person knows something and wants them to know it too.
[Behne, T., Liszkowski, U., Carpenter, M., & Tomasello, M. (2011). Twelve-month-olds’ comprehension and production of pointin. British Journal of Developmental Psychology, 29, 1-17.]

Do 12-month-olds point just because they are interested in a toy or an entertaining sight? No, they point for various reasons. One is to call a person’s attention to something she does not know about or isn’t looking at; one is to share a positive or negative attitude about things they are both looking at; and one is in reference to things that are mentioned but are not there--- for example, a puppet that is no longer in a window the baby can see. These different purposes seem to be related to the 12-month-old’s developing understanding of other people’s mental states.
[Liszowski, U., Carpenter, M., & Tomasello, M. (2007). Pointing out new news, old news, and absent referents at 12 months of age. Developmental Science, 10, F1-F7.]

14-month-olds:

Do 14-month-olds just remember things like toys, or do they pay attention to the toy experiences they have shared with other people? In this study an adult and a baby played with three toys. The adult acted excited and encouraged the baby to be excited about one toy but was bland about the others. Later, the baby was shown all three toys on a tray, and the adult excitedly said “give it to me!” (leaving it unclear which toy was meant). 14-month-olds most often chose the toy they had been excited about--- but they did not make the same choice if they had only watched the adult acting excited without being involved. The babies could use the past history of playing together to figure out which toy the adult meant.
[Moll, H., Richter, N., Carpenter, M., & Tomasello,M. (2008). Fourteen-month-olds know what “we” have shared in a special way. Infancy, 13, 90-101.)

Do 14-month-olds understand when someone else is having trouble, and do they want to help? In one study, an adult pretended not to be able to reach a dropped clothespin. 14-month-olds spontaneously tried to help. When the adult was struggling with a more complicated task like opening a box, though, 14-month-olds did not always try to help. The toddlers could understand that the adult had a problem, and wanted to help, but they could apparently also figure out whether they could do the task or not.
[Warneken, F., & Tomasello, M. (2009). The roots of human altruism. British Journal of Psychology, 100, 455-471.]

18-month-olds:

Will 18-month-olds work hard to give help when they see it’s needed? When older toddlers saw an adult “struggling” to reach a dropped object, 18-month-olds would walk around obstacles to help, and they did this without being rewarded. They not only understood what another person might want, but they were eager to help and would do something difficult for them to manage while they were still amateur walkers.
[Warneken & Tomasello, above]

Do 18-month-olds understand that different people can know and mean different things, even if they say or do the same things? In one study, when 18-month-olds played with a toy one way with the first adult and another way with a second adult, they started the first activity when the first adult pointed at the toy, and the second activity when the second adult pointed at the toy.
[Liebal, K., Behne, T., Carpenter, M., & Tomasello,M. (2009). Infants use shared experience to interpret pointing gestures. Developmental Science, 12, 264-271.]

20-month-0lds:

Will 20-month-olds put helping someone above their immediate play interests? In one study, 20-month-olds would stop playing and leave an attractive group of toys to help someone who seemed to be having trouble. They would not only do this without reward-- if they were rewarded they became less likely to help on another occasion! Their understanding of the need for help and their motivation to help were both apparently very high.
[Warneken & Tomasello, above.]

Can 20-month-olds use other information to figure out the meaning of words they don’t know? In one study, 20-22-month-olds were shown pictures of puppets doing odd things that were described with nonsense words like “tamming”. If they were shown a picture and just told “this is tamming”, they did not seem to learn the meaning of the word. But if they were helped to practice by seeing pictures and hearing about one thing doing something to another thing, they were later able to use that kind of information to choose the right meaning for a word. If they saw a picture of a frog “tamming” a monkey, and heard it described with a complete transitive sentence, they would later look toward the correct picture -- for example, they would look at a frog doing something to a monkey, not at a picture of a monkey doing something to a frog. They used the relationship between the two animals to help decide what the unknown word probably meant; they did not need to be “taught” every word.
[Dittmar, M., Abbot-Smith, K., Lieven, E., & Tomasello, M. (2008). Young German children's early syntactic competence: A preferential looking study. Developmental Science, 11, 575-582.]

24-month-olds:

Children of 24 months know that if someone leaves the room before an event occurs, that person does not know about the event. But in one study, when an adult stayed in the room but could not see a new object because of a barrier that was above her eye level, 24-month-olds did not act as if the adult knew more about the hidden object than about two other objects she had seen. Just being together when the child saw the object was a factor that confused the children about what the adult might know—suggesting that for all the social and cognitive skills described here, there was still a lot of development ahead.

[Moll, H., Carpenter, M., & Tomasello, M. (2011). Social engagement leads 2-year-olds to overestimate others’ knowledge. Infancy, 16, 248-265.]

36-month-olds:

Do three-year-olds understand enough about what others can see or hear to be able to be “sneaky” in disobedience? Even though this might be something we don’t want them to do, we have to give credit for understanding to anyone who is able to manage this task. In one study, 3-year-olds were told not to peek in a box that had a very nice toy in it, and told they could play with it when the adult said it was all right. They were more likely to peek when they could tell that the adult could not see what they were doing. Given a box with two doors, one decorated with bells and one that would not make noise, they chose the silent door to peek through. To manage this “sneakiness”, they had to be able to think about what the adult could see or hear and whether they could do what they wanted to without being “caught”. (This is one of many cases in child development where being “bad” is evidence of good development.)

[Melis, A.P., Call, J., & Tomasello, M. (2010). 36-month-olds conceal visual and auditory information from others. Developmental Science, 13, 479-489.]

Can 3-year-olds really pretend, by playing that an object is one thing at one time, another thing at another time? In one study, they were able to switch back and forth from one pretend identity of an object to another and could talk about whether a wooden block “was a car” or “was an apple” at different times. This advance in pretend play may be associated with the earlier understanding that different people may mean the same thing by different gestures.
[Wyman, E., Rakoczy, H., & Tomasello, M. (2009). Young children understand multiple pretend identities in their object play. British Journal of Developmental Psychology, 27, 385-404.]

Do 3-year-olds mind if bad things are done to other people? Does their earlier “helping” tendency extend to social problems? In one study, each child and each of two hand puppets made a picture or a paper sculpture. One hand puppet “left”. For half of the children, the remaining hand puppet then destroyed the other one’s work; for the other half, the puppet destroyed some extra materials that had not been used. The children seeing the departed puppet’s work destroyed were more likely to protest, tell the puppet not to do that, and tattle on the destructive puppet; they also comforted or helped the second puppet on its return. The children’s concern extended to situations where another person was hurt, even though the child had no problems of his or her own. “Tattling” in this situation seemed to be a natural part of the child’s attempt to help.
[Vaish, A., Missana, M., & Tomasello, M. (2011). Three-year-old children intervene in third-party moral transgressions. British Journal of Developmental Psychology, 29, 124-130.]

Tomasello’s work shows that young children already know a lot about how to learn from other people and how to communicate with and act toward them. But what if your child can’t do all these things at the “right age”? Should you be worried? Parents usually ARE worried, but there are a lot of reasons not to panic here. One is that even in these studies there were some children of a given age who did not manage to do the task. They may have been having a bad day, or maybe the successful children were having good days. (Some of the children didn’t complete the tasks at all.) Also, the researchers did not just march up to each child and try to get him or her to do a task. They spent a long time with “warm-up” tasks and with getting the child ready. In addition, they were in a specially-designed lab, without a lot of familiar objects and people to distract the child from the job at hand. You may try this at home-- but results will vary!

Holding Therapy in the UK

For an audio account of his experiences by a young man who when in his early teens was given holding therapy in a well-known UK residential treatment center, go to http://anyachaika.wordpress.com/2011/07/29/first-audio-account-of-holding-therapy.

Those who think this method is "nurturing" may have their minds changed by listening to this disturbing account.

Back to School, Maybe for the First Time

I recently participated in a very pleasant interview/discussion with a representative of the organization care.com. We talked about issues belonging to this time of year (August), especially “back to school” events. Because my interviewer has a four-month-old, we also discussed entry into day care. You can see a version of the discussion at http://www.care.com/child-care-back-to-school-troubles-p1017-98420002.html, but here are some other thoughts about these issues..

Not all children are concerned about staring back to school. Older kids may be bored with summer and ready for a change, especially if they are returning to a familiar school with familiar classmates. But younger ones may have some anxiety about the whole thing--- after three months of vacation they may not remember all the details they once knew well-- and are especially likely to feel worried if they are going to a new school, with a new teacher and new classmates.

Whether or not children express concern about starting school, it’s probably a good idea to make sure that their last week or two out of school is a calm, undemanding period. Unless there’s absolutely no choice, this is not the time to take an elaborate and fatiguing family vacation. Traveling with children is hard on the whole family, as we can see when everyone gets home and younger children demand even more attention than usual of their exhausted parents. Although a vacation trip may end with wonderful memories and a sense of family solidarity, it’s also a time of stress when new experiences demand extra consideration of each other’s needs if “meltdowns” (of parent or child!) are to be avoided.

Don’t forget that even a trip of a week in length really takes two weeks when you count planning, packing, unpacking, and catching up afterward, and those are two weeks when young children experience unpredictable events that are inconsistent with their usual lives. Yes, those are valuable experiences, and we want children to learn that things aren’t just the same all the time; however, it’s probably better for children not to have those experiences just when they are about to enter a new situation that will not become completely familiar to them for a couple of weeks.

Most children of school age are only a little anxious about school and adapt readily and quickly. Entry of younger children, toddlers, and infants into out-of-home child care is not such a simple matter, and how complicated it is depends on the child’s age and temperament. This matter is confusing to parents because it contradicts the usual rule that children get better at doing things as they get older. In the case of starting and attending child care happily, we see instead that babies under about 6 months of age are generally comfortable with non-parent care (always assuming that it is of good quality, of course), but that starting at some point in the second half of the first year, the great majority of babies will express distress at out-of-home care and will take some time to adapt to it. Preschoolers of 3 or more will probably show some reluctance to go into a new situation, but their developing language skills help them understand that a familiar caregiver will be back to get them, and that this will occur at a predictable time (“after juice” or “after circle time”, for instance).

This relationship between age and adaptability to child care does complicate life. Many parents are reluctant to use out-of-home care in the early months because of a realistic concern about infectious disease, or about the amount of attention a young baby needs, or about continuing to breastfeed. The parents may at that point also have access to continuing maternity leave that gives them the option of caring for their baby at home. Although the baby at this point may be able to adapt very easily to out-of-home care, there are many reasons not to use child care at that point.

A few months later, in the second half of the first year, parents may have weaned the baby from the breast, may feel he or she needs less individual attention, and perhaps have become more accustomed to common childhood illnesses. Maternity or paternity leave has probably run out in the U.S. (if indeed they had such a luxury). There are growing reasons for out-of-home care. But, whoops! The baby has developed to the point of feeling quite anxious about strange people and places. Adapting to care outside the home is a lot more difficult than it used to be.

What to do at this point? Are there ways the parents can ease their baby’s transition and make the family arrangements they need without excessive stress on anyone? Yes, most babies can be guided into greater comfort with a strange care situation, and the key word here is “gradualness.” Perhaps a few people have learned to swim by being thrown into water over their heads, but more have been frightened badly-- and the same thing is true of babies having new experiences. A gentle introduction fine-tuned by observation of the baby’s reactions is the best way to achieve a happy acceptance of any new situation.

Ideally, a baby should be introduced to a new care arrangement by short visits with a parent, leading after a few days to a short period there without the parent, and gradually increasing to the desired amount of care time. (A child care center that will not cooperate in this or that does not want the parent to stay is not a place you want to leave your child, by the way.) Ideally, also, the baby will have an assigned caregiver, and at least at the beginning will be cared for by that person most or all of the time, rather than having to deal with “floating” staff who work with any baby who seems to need attention. In addition, the ideal arrangement will involve careful attention to transitions, having a staff member greet the child and engage with her when she enters, and say goodbye as child and parent leave. Child care centers that are accredited by the National Association for the Education of Young Children are well aware of these points.

Real life is not ideal, of course. What if things just don’t, or can’t, work out this way? Let me give just one hint about what a parent can do: Don’t Sneak Out. Don’t ever sneak out. Tiptoeing away is easier on parents than hearing babies cry, but it’s very important for a baby to learn that a parent will not go away without making it clear that this is about to happen. Otherwise, anxiety may be constant that at any moment Mom or Dad could be gone, and when the baby feels this, it’s much harder to play and learn, or even to get used to day care.

More on the Russia-US Adoption Treaty

When I commented a few weeks ago on the need for the conditions of foreign-adopted children to receive independent monitoring, rather than monitoring by the placing agency, a number of readers stated their agreement. I want to point out to you a way to bring your opinion on this to the attention of the State Department.

I've received a response from Sarah Shaffer of the Office of Children's Issues (ShafferSF@state.gov). She said that the treaty itself has been signed, but she can receive comments as the agreement moves toward ratification and implementation. More information on the treaty itself is available at http://adoption.state.gov/content/pdf/FAQs_re_agreement_07_13_2011_FINAL2.pdf
and at http://www.uscis.gov/adoption
and http://adoption.state.gov.


Changes will be posted on those sites, and you can request e-mail or feed notification.

I hope readers will join me in passing on opinions to Ms. Shaffer.

Adoption, Trust, Complacency, and the Barahona Case

While most of the nation was intensely involved with the trial of Casey Anthony in Florida, another case in the same state got much less attention in spite of its seriously disturbing nature. In that case, a grand jury investigated the death of Nubia Barahona and the serious injury of her twin, Victor, apparently at the hands of their adoptive parents, Carmen and Jorge Barahona. The death and injury followed a series of reports of child abuse, including complaints from Nubia’s teachers that she seemed to be very hungry and that she was nervous and afraid to go home. Other complaints stated that the twins were bound with duct tape, locked in the bathroom, left to sleep in the bathtub, and fed on bread and milk once a day. The Barahonas took the children out of school and said they were homeschooling them. Following the pattern of the all-too-familiar-story, caseworkers had not succeeded in seeing the children, but had accepted Carmen Barahona’s statement that they were fine. Then, on Feb. 14, 2011, Nubia was discovered dead and rolled up in a carpet in Mr. Barahona’s truck; her brother was there too, badly hurt.

The Miami-Dade County grand jury that indicted Carmen and Jorge Barahona filed a final report that is of great interest (http://media.miamiherald.com/smedia/2011/07/25/14/27/1aTHrq.So.56.pdf). In this report, while acknowledging all the many problems of caseworkers, including poor training and heavy caseloads, the jury members emphasized a problem that is prevalent but rarely mentioned. They referred to it as a bias of trust and complacency.

The bias of trust stressed by the grand jury report is the assumption on the part of the social work profession that adoptive parents are by definition good people, and that they cannot be the source of harm to the children in their care. Without wishing to accuse an entire professional group, I must agree strongly that this belief characterizes many adoption caseworkers and the staffs of adoption agencies. All adoptive homes are described as loving and nurturing, as if adoption were synonymous with excellent child-rearing. Adoption-oriented web sites describe adoptive parents as “awesome moms”. When adoptive families are functioning poorly, there is haste to say that someone, somewhere, did not tell the truth about the children, who are considered the causes of any trouble. These common beliefs may be the basis for the caseworkers’ bias of trust in adoptive parents which the grand jury report points to so explicitly.

Come, let us reason together about this. Why should adoptive parents be uniformly “awesome”, wholly loving and nurturing, and worthy of the unquestioning trust of society, when birth parents as a group do not meet these standards? Some would assume that adoptive parents must be excellent because they must have wanted the children; these people attribute child abuse to being saddled with unwanted offspring and resenting them. But, in fact, birth parents too may abuse children whom they wanted and even planned. (Shockingly, the grand jury report suggested that the investigation of the Barahona case would have been more careful if the children had been with their birth parents.)

Others who think adoptive parents are always good rely on screening and evaluation of adoptive parents to mean that only those who can do a good job are allowed to adopt. It’s true that screening makes it much less likely that people who are physically ill will be allowed to adopt, or that those living in poverty or substandard housing will become adoptive parents. Those with florid mental illnesses are also likely to be screened out. But in actuality there is no screening that will allow us to know exactly how a person will behave toward a particular child, and that is why post-adoption monitoring by an independent observer should be an essential part of the adoption process.

It would be a grave mistake to attribute cruelty and abuse to all adoptive parents, most of whom manage their families’ relationships in such a way that their children grow up as healthy, competent, successful contributors to society. It is an equally grave mistake, however, to assume that adoptive parents must not be the cause of evident problems in their children-- problems as serious as constant hunger, bruising, and fearfulness of going home. Adoptive parents are human beings; human beings can do wrong. If we are to do right by vulnerable children, we cannot let this be forgotten.

Is it too difficult for caseworkers who have known adoptive and foster parents for years, who may have been involved in the placement of children with them, to approach these families without bias? Is it too important to some caseworkers to be the friends of adoptive parents and to feel their approval? We can hardly blame the caseworkers if these things are true. Human beings trust people they have known for a long time, and human beings don’t enjoy being disliked by the people they work with. So, can we trust caseworkers to avoid that “bias of trust” when they have been involved with screening parents or placing children? It may well be that we cannot, and that the solution is to change the system so that strangers do the monitoring.

The Miami-Dade County grand jury report is a remarkable document. I congratulate the grand jury members for their ability to cut through the bureaucracy and to suppress temporarily the distress they must have experienced at the details of the Barahona story. By homing in on the trust issue, they have pointed out an essential flaw in our efforts to prevent abuse of adopted children in the United States. I would hope that this report will become required reading for all social work students and social services staff.

Behind the Norwegian Terrorist: The Grande Dame of Conspiracy Theory

I really don’t believe in “synchronicity”, but I made a find that startled me yesterday. I turned on my laptop and saw headlines about the Norwegian domestic terrorist Anders Breivik. Then, sighing and shaking my head, I turned to EBSCOhost to continue the work I had been doing, which involved reading articles about some unconventional belief systems.

The first thing I saw was a small number of articles discussing the life and work of one Nesta Helen Webster (1876-1960), an Englishwoman whose writings were a powerful influence on the John Birch Society, the Patriot movement, Pat Robertson-- and now, believe it or not, even radical Islamist groups. Her 1924 book “Secret Societies and Subversive Movements” told of organizations “gathering strength for an onslaught not only on Christianity, but on all social and moral orders”. It’s very likely that Nesta Webster’s views helped form the framework for Breivik’s fears and actions.

Mrs. Webster believed that subversive groups, initially in the form of the Illuminati, had conspired to bring about the French Revolution in an effort to destroy the aristocracy and break down class barriers so they could rule the world. In her own time, she thought, this work was being done by Communists, Freemasons(!), and “international finance” (read: secular Jews). She had a general admiration for the Nazis, but felt that they were not Christian enough and was concerned about their treaties with Russia.

According to some commentators (Ruotsila, M. [2004]. Mrs. Webster’s religion: Conspiricist extremism on the Christian far right. Patterns of Prejudice, 38, 109-126), Mrs. Webster’s beliefs about international and multicultural conspiracies were based on her own upbringing as a member of the Plymouth Brethren, a dissenting group whose “existential gloom” was matched only by a few members of the Church of England. Like some fundamentalist Christian groups in the modern United States, the Plymouth Brethren were premillenialists, believing that the “end times” would soon arrive and would involve a battle for souls between the forces of good (basically, themselves) and those of evil (everybody else). Premillenialism usually includes a concept of an Antichrist as the incarnation of evil, although the specific identity of the Antichrist is left unclear, enabling groups to fill in the blank with the name of their most concerning enemy. Of course, non-Christian groups can readily adapt the story to their own needs by using some term other than Antichrist but keeping the rest of the narrative.



Mrs. Webster’s conspiracy theory seems to have done little but insert the names of her particular feared people into the Antichrist blank. The rest of her concerns (and those of modern complex conspiracy theorists) mirror the premillenialist narrative. The basic story is as follows: there is a battle that has been going on for a long time; many enemies conspire against us; they want to destroy our cherished ways and replace them with an immoral and disgusting society; they operate secretly and unfairly; the end of the battle is near, and we must counterattack if we are to survive; no compromise is possible; they hate us, and we are right to hate them.

It was just as simple for Anders Breivik and many others to make use of this narrative as it was for Mrs. Webster. Breivik easily inserted Islam and multiculturalism into the Antichrist blank-- just as radical Islamists can insert the names of European and North American people and institutions into the same opening. It’s a terrific story, very exciting and engaging, and even contains some partial truths. How difficult, then, for many people to question or resist it!

Whether Anders Breivik is “crazy” is already being debated, as happens every time there is violence committed by one of these true believers in conspiracy. Even Mrs. Webster had some personal beliefs and assumptions that are likely to raise some eyebrows-- she thought she might be the reincarnation of an aristocrat who died in the French Revolution, she believed in ESP , “ancestral memory”, and the influence of “spirit presences” (see Lee, M.F. [2005]. Nesta Webster: The voice of conspiracy.Journal of Women's History, 17, 81-104). Yet having unusual beliefs is not clear evidence of “craziness”, and neither is killing a lot of people, an action for which we reward soldiers with high praise.

In fact, it may not be particularly relevant whether Breivik is “crazy” or not. Focusing on this issue may be important for the making of legal decisions about him, but it can also have the effect of distracting us from the much larger problem shown by Internet sites like “Gates of Vienna”. In fact, to declare Breivik “crazy” may have the unfortunate effect of hiding the power of the basic Antichrist story which motivates modern conspiracy theories of the kind Breivik acted out. Christians, Muslims, and other religionists, can you recognize this dangerous narrative, this self-fulfilling prophesy, and speak out against it before it creates more mini-Armageddons?


[Incidentally, I fully expect a number of attachment therapists to declare that Breivik was suffering from Reactive Attachment Disorder. Let me point out that there is no reason whatever to think that this was the case, or that if it had been, that this would have offered an explanation for his actions.]

What About the Fathers? The Anthony Case and Danieal Kelly

I confess that I winced away from watching the Casey Anthony trial and only inadvertently picked up information from people who wanted to tell me about it. Now that the trial is over, though, I find myself thinking about an aspect that rated some sidebars: what about the father?

The Internet remains full of discussion of who the child’s father might have been, whether he’s alive, why he hasn’t come forward. A woman in New England has even declared that her son is the father, carrying family solidarity and maternal pride (?) to unheard-of levels. The comments on this issue are a melange of different types of disapproval, ranging from the idea that the father might have saved the little girl’s life if he had been paying attention, to the concern that anyone putting himself forward at this juncture is merely acting in hopes of cashing in on the selling of the Anthony story.

Not many people have mentioned the possibility that an identified biological father may have some legal responsibility in the child’s death and the mother’s subsequent ill-judged actions. I don’t know what the Florida law is, or what prosecutorial intentions might be, but a somewhat parallel case in Philadelphia shows that a father may be found guilty of various offenses in connection with the death of a child with whom he has no contact.

A lengthy legal process has tried several people for their culpability in the 2006 death of Danieal Kelly (see http://articles.philly.com/2011-07-12/news/2976489_1_danieal-kelly-mickal-kamuvaka-kelly-household). Danieal, who was physically very much impaired by cerebral palsy, died at age 14, weighing 42 pounds and covered with bedsores. She essentially starved to death. Her mother, Andrea Kelly, is already serving a prison term, but a few days ago, after trial, the social workers who had failed to respond to the child’s condition, and Daniel Kelly, Sr., Danieal’s father, were convicted of charges in this case. Daniel Kelly, who had at one time had custody of his children, returned them to their mother, who, he claimed, denied him access to Danieal. He did not report the matter to authorities or make any effort to be sure that Danieal’s special needs were met. He has been convicted of child endangerment and may be sentenced to as much as 7 years in prison.

Would Daniel Kelly have been convicted if he had never seen Danieal, or if he did not know he was her biological father? It’s possible-- even likely-- that he would not even have been tried under those circumstances. As it was, having spent some time living with Danieal, he was well aware of her physical incapacity and her special needs for physical care and for educational services. He must have had some idea of the degree of danger involved in leaving her to the sole care of her mother, although he also may have legitimately assumed that the social work service would oversee what was happening to Danieal. Nevertheless, some will object to his conviction for events that occurred when he wasn’t fully aware of the situation, and might well argue that if he had never known there was a baby, he would not have been at all responsible for Danieal’s death.

Daniel Kelly’s conviction is a message to some disengaged fathers of their minimal responsibility toward their children; even if they never provide a meal or pay child support, they must be sure that their children are receiving the basic care they need. But what is the message to those who never saw the baby, or even paid enough attention to know there was a pregnancy? What are the legal implications for those men of coming forward at a later time? Generally, unknown fathers are thought to lie low in order to avoid paying child support, but where a child has been harmed or killed, such men might also have possible concerns about charges of child endangerment.

This situation is fraught with ethical and practical dilemmas. On the one hand, it seems completely unfair to bring serious charges against someone who didn’t know what was going on-- but is Daniel Kelly’s “failure to know” any more or less culpable than the failure of a man to know that he impregnated a woman? And what would happen if unknown (but later identified) fathers of abused children were charged with endangerment? Would this encourage such men to take responsibility for their children’s well-being-- or would it encourage them to withhold their identities from partners and avoid serious relationships?

Perhaps the various candidates for Casey Anthony’s impregnator should think over their positions before they rush to declare themselves and sell their stories.

Eye Contact With Babies: What, When, Why, and How

IF YOU WOULD LIKE TO COMMENT ON THIS TOPIC, PLEASE READ THE FOLLOWING FIRST! IF YOU HAVE ALREADY COMMENTED AND DO NOT SEE YOUR QUERY OR MY REPLY, PLEASE GO TO THE PAGE SHOWN BELOW.
DEAR READERS--  I AM HAVING TROUBLE READING AND REPLYING TO COMMENTS ON

THIS POST. I THINK THIS IS BECAUSE THERE HAVE BEEN SO MANY. IF YOU WOULD

 LIKE TO ADD A COMMENT OR A QUERY, I HAVE ADDED A NEW PAGE:


http://childmyths.blogspot.com/2016/02/eye-contact-with-babies-part-2-what.html

THANK YOU!




When I look at the statistics Blogspot gives me, I see that day after day, large numbers of people end up at this blog when they Google questions about babies and eye contact. Parents are obviously worried about this issue, and that fact is confirmed by the existence of quite a few websites that give instructions about how to get your child to make eye contact more often. But what are the facts about all this? Can you get your child to increase eye contact? Do you need to? Why are we concerned about this matter at all?

What is eye contact? The term “eye contact” might be better replaced by “mutual gaze”, because of course there is no real “contact” about this common human action. In mutual gaze, two people’s faces and eyes are aligned so that each set of eyes is gazing at the other set. This is often very brief, although it can also be maintained for seconds at a time. Mutual gaze may also be performed in a sequence of episodes, for example as two friends approach each other, joining and breaking gaze along the way, stop and briefly engage in mutual gaze, and finally avert their gazes slightly while talking. Prolonged mutual gaze may indicate deep emotional involvement-- but it can be either a loving look or a hostile or frightened stare, depending on the context and the rest of the facial expression. Mutual gaze has a terrific communicative power for human beings, but it can have more than one meaning.

When does eye contact happen? From birth, babies are interested in looking at faces and especially eyes, and do this so carefully that they can and do accurately imitate facial expressions in the early days of life. Nevertheless, most new parents find that it is quite difficult to get a sense of mutual gaze until some weeks have passed. At about 4 to 6 weeks, as babies begin to do what used to be called “taking notice”, they start to look more responsively at people who are looking at them-- especially if the adult does something attention-getting like opening eyes and mouth wide and “looming” closer to the baby’s face. Soon, the baby smiles in response to a smile, and maintains a mutual gaze with a friendly adult (familiar or unfamiliar). If the adult looks blank or “stares through” the baby, though, the latter will avert the gaze, appear uncomfortable, and begin to cry. The baby expects the adult to “manage” his or her gaze in a way that coordinates with the baby’s gaze.

By about 6 months, babies begin to look toward an adult’s face and eyes for “social referencing” purposes, not for eye contact in and of itself, but to get information from the facial expression and the direction of the adult’s gaze. This information guides the baby in understanding the environment and knowing whether unfamiliar things are worrisome, neutral, or pleasant. The baby continues to pay attention to the direction of people’s gazes and between 9 and 12 months begins to show “joint attention”-- using the gaze as a “pointer” to show someone else where to look, and following another person’s gaze to see an interesting sight. These are not examples of mutual gaze, but they are other forms of communication that may emerge from mutual gaze.

It can be hard for an inexperienced parent to know whether a baby makes eye contact soon enough, long enough, or often enough. Anyone who expects prolonged mutual gaze many times a day from the time of birth is bound to be disappointed and frightened. The earliest eye contact events are fleeting, and even at 2 months the baby may not pay much attention without a good deal of adult effort. Mutual gaze during breastfeeding is not likely until the child is old enough to pause in sucking and look around, or let go the nipple temporarily and move the head-- perhaps 5 or 6 months of age.

Why is eye contact important? Mutual gaze is an important form of communication that conveys information both to the baby (“hey, people are quite interesting and pleasing”) and to the adult caregiver (“oh, my baby’s looking at me-- this feels so good-- he thinks I’m important and interesting”). It may be the foundation of other uses of gaze and other gestures for communication.

Looking at whether young children engage in mutual gaze can be a helpful way of understanding whether their development is typical or whether they have certain special needs. One of the best-known aspects of autism is the infrequency of eye contact. Individuals with Asperger’s syndrome, a disorder related to autism, may say that they dislike being looked at and find mutual gaze very uncomfortable. Persons with Fragile X syndrome are also known for their poor use of the gaze in social communication.

When people avoid looking at other’s eyes, or when they are simply inattentive to gaze information, they can miss much other information too. If an adult uses a word a child does not know, for instance, the child can often make a good guess by watching the adult’s gaze, to see what he or she is looking at. When a child also has poor language development, as is common in autism, the combination of underdeveloped language and of lack of gaze communication can make for serious difficulties, the appearance of deliberate noncompliance, and frustration for both child and adult. These facts all suggest that if a child is really not using mutual gaze or other gaze information, helping him or her gain those skills would be a valuable achievement.

However, it’s important to realize that increasing mutual gaze is not a way of increasing the child’s emotional attachment. Toddlers are more likely to engage in mutual gaze with people they are attached to, but increasing gaze episodes does not make them attached. Blind children become strongly attached to their familiar caregivers just as sighted children do; attachment is a very robust developmental phenomenon that involves hearing and touch as much as, or instead of, sight. Mutual gaze may have its strongest effect on adults, who are much influenced by the child’s gaze and feel a sense of emotional contact when exchanging gazes, so it’s possible that increasing mutual gaze can have an indirect effect on children through its influence on their caregivers. However, of course, blind parents also have strong emotional involvements with their children; they too can use other sources of communication to develop these intense relationships.

How to increase mutual gaze? I notice on several websites a variety of instructions for improving eye contact with children. These include wearing funny glasses (something like this was suggested by Nikolaas Tinbergen 40 years ago), playing games based on prolonging eye contact, and giving the child sweets while maintaining mutual gaze.

Whether these methods are a good idea depends in part on whether the child really does show too little eye contact for his age and situation. This is a point on which most parents need professional guidance. If the parent’s motivation comes from the belief that more eye contact would cause better attachment, and especially if the parent believes the child is poorly attached because he or she is disobedient, there is certainly little point in doing any of these things.

However, if the child is being treated for a developmental problem that is characterized by poor mutual gaze, the parent may already have received some training in rewarding eye contact or may at least be aware of how the behavior therapist works with this. An article that describes one method is to be found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2649838/ (Hall, S.S., Maynes, N.P., & Reiss, A.L. [2009]. Using percentile schedules to increase eye contact in children with Fragile X syndrome. Journal of Applied Behavior Analysis, 42, 171-176). Similar work can be done at home, but it needs to be carefully thought out beforehand.

**** Readers, if you accessed this post in a search for current work on eye contact and autism, please look at my post for Nov. 7, 2013, which discusses the Nature article by Warren Jones and Ami Klin.****


!!!!!!                                                                                                                                       !!!!!
THE AREA FOR QUERIES AND RESPONSES TO THIS POST SEEMS TO BE COMPLETELY FILLED. IF YOU HAVE A QUERY, PLEASE SEE THE TOP OF THIS POST FOR INSTRUCTIONS.

The Russian-U.S. Adoption Treaty: The Psychological Evaluation Issue

After a considerable period of discord, and a history of disasters for children adopted to the United States from Russian institutions, Russia and the U.S. have signed a treaty intended to address problems that have caused harm to adopted children (M. Schwirtz, “Pact on adoptions ends a U.S. Russian dispute”, NY Times, July 14, 2011, p. A12). In addition to improving the mechanisms for monitoring families after adoption, this treaty requires improved screening of potential adoptive parents and better information about the children’s medical and psychological histories.

How are people evaluated before they are accepted as adoptive parents? Psychological evaluations, often done through private sources or as recommended by the adoption agency, generally involve an open-ended interview less than an hour long, and may include a paper-and-pencil psychological test, usually the Minnesota Multiphasic Personality Inventory (MMPI). The MMPI provides an assessment of the individual on a number of scales (including whether they are so inconsistent that they are probably lying) as well as on some combinations of scales.

The MMPI does a good job of identifying individuals who are seriously mentally ill-- schizophrenics, for example. But most adoptive parents who harm or reject their children are not actually mentally ill. Instead, they have other personality characteristics, beliefs, habits, or social circumstances that culminate in child abuse or neglect, or even in the child’s death.

Can the MMPI identify those concerning personality characteristics and help to prevent adoptions that may lead to harm? Regrettably (considering how much people rely on this test), the answer is probably that it cannot. Of the thousands of studies done on the MMPI, very few have focused on the success or failure of adoptive parents, nor have most considered whether the responses of potential adoptive parents to the MMPI should be interpreted in any special way.

Almost 20 years ago, one researcher, J.E. Dalton, looked at a group of prospective adoptive parents and analyzed their scores on MMPI scales and on other personality tests (“MMPI-168 and Marlowe-Crowne profiles of adoption applicants.” Journal of Clinical Psychology, Vol. 50, 863-866). Dalton noted that there was a serious lack of normative data that would allow adoption applicants to be compared to other adoption applicants rather than to people who were free of the stresses peculiar to the adoption situation. He noted that the typical MMPI profile for the applicants he tested was “characterized by a high degree of defensiveness, particularly among females… the [average] female profile on the validity scale would be interpreted as follows: “This is a valid profile. Persons who obtain similar scores are often seen as naively defensive individuals who have a strong need to present an image of virtuousness or perhaps strong moral character. They tend to have little insight or awareness of their own stimulus value… “(p. 865). Dalton then went on to say-- and this is the significant part--- “Although it is possible that defensive people are more likely to apply to adopt children a more likely interpretation is that the [preadoption] screening process creates a defensive attitude” (p. 865). Dalton strongly advises comparing the MMPI scores of potential adoptive parents to those of other such people rather than interpreting them in terms of the larger population, in comparison to which the adoption applicants may appear to have some undesirable personality traits.

It is doubtful that preadoption psychological evaluations often do follow Dalton’s suggestion. Even if they did, however, there is little or no information to show us whether successful adoptive parents have different MMPI profiles than those involved in serious failures. Few evaluators who specialize in preadoption screening are research-oriented, and few potential adoptive parents would give permission to include their data in research reports. As a result of this lack of information, we may have a situation in which psychological evaluation can screen out seriously mentally-ill applicants, but fails to determine characteristics that may or may not fit a potential adoptive parent to do a successful job with a child.

I suggest that preadoption evaluators may do better to focus on certain personality and social characteristics that are not assessed by the MMPI but may be highly relevant to adoptive parenting. One of these is authoritarianism, a personality characteristic focusing on the issue of obedience to authority. Authoritarian persons are concerned with the obedience children owe to their parents and are simultaneously concerned with the obedience they, the parents, owe to persons in authority over them. Authoritarianism values obedience in and of itself, not simply as a means to an end; a nonauthoritarian parent may work to instill obedience in children so they will come out of the street or away from a hot stove when told, but the authoritarian parent sees child obedience as a goal in itself, independent of child safety or health outcomes. Some authoritarian parents consider child obedience to have special value in a religious context and consider obedience to a parent to be the foundation of obedience to God, while others want obedience as part of a secular value system.

A high degree of authoritarianism motivates a parent to require obedience of children even if they cannot do what is required of them or do not understand what is being ordered. When there are cultural differences which the parent does not understand or accept and which the child cannot articulate, there may be apparent intentional disobedience that an authoritarian parent finds unbearable. An example here might be the conflicts over pet animals so often noted in adoption blogs; poor or post-institutionalized children or those from the Third World may have had no contact with pets and may regard them as predators or vermin that should be killed, whereas an authoritarian adoptive parent may demand what he or she sees as appropriate affectionate behavior toward animals. More and more severe punishment may follow the child’s failure to comply.

Authoritarianism may also make adoptive parents especially susceptible to adoption counselors or therapists who focus on child obedience and parental control as the sole route to family success. Such semi-professional or professional advisors may advise physical restraint and control over food intake as appropriate means to achieve the obedience they have claimed as the key to positive development. These methods, or similar techniques like exposing the child to heat or cold or forced drinking or eating, all have very real potential for causing injury and even death.

Psychological evaluators, do your assessments consider authoritarian personalities as matters of concern for preadoption psychological evaluations? Do your interviews explore adoption applicants’ connections with advisors who may suggest potentially harmful paths to inappropriate goals? The U.S.- Russian adoption treaty will not tell you to do these things, but you may find them more genuinely useful in preventing adoption disasters than the MMPI’s standard textbook interpretation. The same goes for the post-adoption monitors required by the treaty.