This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Thursday, October 18, 2012

Attachment therapy

Facebook post by a friend of mine, and my response.

"The American Professional Society on the Abuse of Children convened a task force on Attachment Therapy/Parenting because of the numerous high profile criminal child abuse and death cases associated with these practices. The task force found (in the journal *Child Maltreatment* Feb 2006) that the parenting method that Nancy Thomas promotes is "inappropriate for all children" and recommended child welfare workers investigate where it is used as "suspect abuse." (Thomas is mentioned by name in this report.) The American Psychological Association adopted the APSAC task force's recommendations and findings. ...The mental health profession, as well as the general public -- to say nothing of our court system -- knows that using abusive "therapy" and parenting methods *never* helps a child. There also have been numerous criminal cases of abuse and even death, where people have used Attachment Therapy parenting (aka Nancy Thomas parenting).A child with RAD, as described in the DSM-IV, can be challenging, but not overwhelming. Their problem is being either very withdrawn or overly friendly with with unfamiliar people. While there is no science-based treatment for RAD at this time, most legitimate professionals advise gentle, consistent, and patient parenting. RAD is rare, and so it is likely that you aren't parenting a child with RAD either.What Nancy Thomas and other proponents of Attachment Therapy talk about is an unrecognized diagnosis ONLY used by Attachment Therapists called "Attachment Disorder" (AD). AD is a catch-all "diagnosis," meaning all adopted/foster or other children can potentially get this diagnosis if sent to an Attachment Therapist. The critera for AD are so broad as to be useless. For example, even "good behavior" characterized as the child "stalking his prey."Any child diagnosed with AD (or "RAD" since the two are conflated by Attachment Therapy proponents) does not have a good diagnosis. And it is necessary to have a good diagnosis in order to proceed to the next step of treatment. So it is fair to say that children caught up in this "therapy cult" are not getting the help they need.Dismissing critics because they might not have lived with a difficult AD ("RAD") child is often just an attempt to inoculate "awesome moms" from charges of child abuse. What you're really saying is: "If you lived with a horrid child, you'd use abusive methods, too."Attachment Therapy and its parenting methods have been around for four decades, having treated thousands of children. Where are the success stories of Attachment Therapy/Parenting? Where are all these grateful children-now-adults? Where are the happy families created by this highly authoritarian parenting method? What we see is lots of divorced families. And the survivors of Attachment Therapy are severely wounded young adults, alienated from their families, with horrific stories to tell:

.... I'm sorry that you don't comprehend what I have written. You are saying that the RAD diagnosis in the DSM-IV is inadequate, but it has been developed from research. In over four decades, Attachment Therapists have failed to show that their AD diagnosis is valid. Actually, they haven't bothered to change the definition of RAD because their version is laughably absurd. The RADQ, however, has been shown to be a dud for helping therapists to diagnose anything.From what you say, your children appear to have been diagnosed with "AD" (not RAD), and that is no diagnosis at all.What makes the AD diagnosis laughable? AD is a patently a quack diagnosis, and typical of all quack diagnoses, it includes *all* behaviors, developmental and speech problems, and even normal behaviors. That's what I meant by catch-all.AD was especially designed to ensnare foreign adoptees. For example, Attachment Therapists claim that lack of eye contact (on the parents' terms!) is a major sign of AD, although many foreign adoptees and children raised in subcultures within the USA have been taught that looking an adult in the face is a sign of disrespect.Worst of all, the AD diagnosis demonizes adopted children. That snarky Nancy Thomas is great at this, claiming these "little pukes" are each a Ted Bundy in the making, and that she doesn't even allow them to pray because she can't be sure who they aren't praying to! Are you defending an attitude like this?Several mothers who stopped Attachment Therapy and its parenting told me that everything gets so much better immediately for both the child and the mother. Unfortunately, it appears few mothers do stop it.I don't mean to be personal here, but I have a lot of questions about this "therapy." Why are the parents so amazingly loyal to a model of parenting that routinely mocks children and treats them harshly? Why are their no second thoughts when professionals call this parenting "child abuse"? Who lacks attachment here anyway -- the parent or the child? What loving parent would treat children like that bully Nancy Thomas professes to do? And why is there this incredible craving by the "awesome moms" for universal and unquestioning approval? Is this a cult? Typical cult one else can have a valid opinion unless she is an "awsome mom". Do you realize that Nancy Thomas continues to defend the death of Candace Newmaker by stating she had an undiagnosed heart condition? The child's autopsy did not indicate this, but a paid witness for the defense said it was a possibility, based on pure fabrication. According to Nancy Thomas, a fetus "knows" if he/she is unwanted, and, even if the child is to be immediately adopted as a much wanted child, the child has RAD. She believes that most children in foster care have RAD. The quality level of writing and logic NT exhibits is a measure of her professionalism and creedance. Blind faith following of this person's absurd teachings appears to be cult-based as success is anecdotal and no true scientific based data supports it. Nancy Thomas' concepts are dangerous. ...This line of argument is a tactic to divert blame from caregivers for using a form of "therapy" and parenting that others, such as grandparents and teachers, see as highly abusive. Often children caught up in this "therapy cult" are consistently good students, with no behavioral concerns by other people in the community; and only the "Awesome Mom" claims they are the are wicked.Nancy Thomas says she got the term "Awesome Mom" from the Old Testament, claiming that this is an adjective used for Jehovah. The intent, she explains, is to make the child fear their adoptive mother, just as Christians are supposed to be God-fearing. Thomas and her follows might be said to have a bit of a god complex, i.e. women who say they should never be questioned, even by their spouses.Regarding valid therapy: for the official Reactive Attachment Disorder diagnosis, there is currently no scientifically validated therapy, but many professionals suggest that consistent, patient, and gentle parenting is the best approach.Holding Therapy, on the other hand, is literal "torture" using any of the various definitions of the word. Only if there was research that showed the benefits of Attachment/Holding Therapy outweighed the risks could it possibly be considered. That evidence doesn't exist. Moreover, the fact that many children have been harmed by it means that it would be unethical to use children as research subjects. There is also evidence that Nancy/Beth Thomas parenting is ineffective, causing the Awesome Moms to escalate the abuse.Curiously, Holding Therapists threaten children they restrain with abandonment by their adoptive parents. Is it really the children who are unattached, or their parents?For my part, I think that there is entirely too much beatification of foster parents by foster parents. You don't need to abuse a child to know child abuse when you see it. And you don't need to by a psychotherapist (which I am not) to know a quack diagnosis when you see it.... Why is the "Attachment Disorder" (AD) diagnosis quacky? For a few things, it includes contradictory signs. It is also not age-dependent. (Some of the signs are appropriate for certain ages.) It is hung up on eye contact (from the days when Attachment Therapists claimed they could cure autism). Kids are dx'ed as AD whether they make eye contact or not -- both are considered signs of AD. Even good behavior is interpreted as AD (the child's motives are assumed to be malevolent, such as "stalking their prey"). Curiously, treatment for this bogus diagnosis includes threatening the supposed unattached child with abandonment by his adoptive parents. It would be a curiously funny diagnosis if not for the fact that it has the potential to do great harm. ... You can't imagine what it takes to parent these kids unless you actually do it.---This is a statement often heard by proponents of Attachment Therapy and Nancy Thomas parenting. It is nothing but a cheap attempt to deflect criticism and rationalize child abuse. ...I sure wish I had a dollar for every time a proponent of Attachment Therapy/Parenting (AT/P) attempted to deflect the issue of child abuse with the "you don't know what they're like" excuse. Child abuse is child abuse. Health care professionals (such as myself) are trained/required to report suspected child abuse to the authorities. And AT/P even meets the definition of "torture" as defined by the UN Convention on Torture. So there are no subtleties here.Attachment Therapists will tell you guys that heart surgery is also hard to watch, but heart surgery has research behind it so that surgeons can gauge the likelihood of a beneficial, even life-saving outcome. We know from years of good research on child development that the type of practices used in Attachment Therapy/Parenting are potentially harmful, depending on the resilience of the child. The likelihood is that parents who use these practices will be estranged from their children when they are adults, and the AT/P people themselves admit that the divorce rate is high among parents who engage in AT/PAT/P exists for the benefit of the mothers and the greedy, sadistic therapists. The practice is marketed to the "awesome mom" and is specifically designed to appeal to you. Let's take a look at this program: 1.) Dad's role is to always support mom; 2.) friends and family should pamper the moms with gifts, massage, etc; and 3.) the children should be gratefully and unquestioningly obedient. Many Attachment Therapists have spoken publicly about how much parents enjoy seeing the therapist get rough with their child from behind the one-way mirror. It's for the mothers' benefit, which is why the mothers stick with the program no matter what." the moms with gifts, massage, etc; and 3.) the children should be gratefully and unquestioningly obedient. Many Attachment Therapists have spoken publicly about how much parents enjoy seeing the therapist get rough with their child from behind the one-way mirror. It's for the mothers' benefit, which is why the mothers stick with the program no matter what."


I agree that Nancy Thomas' techniques are tough.  Since our RAD kids were much older when they came into our home (11 and 13) we never even attempted her techniques, but after a few years of living with RAD teens, I saw that my kids responded best to "tough love."  Teachers and people who hold them accountable, demand respect, and call them on their bad attitudes and inappropriate behaviors, while obviously caring about them, had my children's  respect and they did better with/for them.  People who try to love and nurture them, give them lots of second chances and a blank slate every time they misbehave... are walked on, patronized, triangulated and manipulated...  I started out trying to give them all the nurturing, unconditional love they missed, and they drained me dry, didn't learn anything, treated me (as the representative of all mothers and therefore an evil abandoner) abusively, drove a wedge between me and the rest of the family, and STILL felt unloved because they believed I wasn't strong enough to keep them safe.  Luckily after years of attachment therapy with my daughter I was able to be stronger and provide them the structure and discipline they need.

With the "poor little me" attitude fostered by well-meaning adults and a belief that all adults are stupid and there to be manipulated, my son is struggling in "real life" - where no one gives a crap that he had a tough childhood.  My daughter (chronologically 17) is emotionally and socially only 6, and struggles with emotional regulation (she often needs me to do it for her, and has had to be placed in physical holds to keep her from hurting herself or others as she calms down.  Even after she was calm, she often needed continued holding afterword to allow herself to rebuild our connection) and while her RAD is healing it caused extensive neurological and emotional damage.  She now has emerging borderline personality disorder in addition to her other mental illnesses.

My son who was "too old" for attachment therapy never really attached.  To outsiders, the strict structure and rules we gave him often looked abusive and we found very little support from all but those who knew him very well, BUT every time we or the school "lightened up" because he was doing well, he would act out until the structure war reinstated.  He finally succumbed to the opinions of others who said he "should be"  independent and moved out.  He stopped taking his medication and went back to drinking and doing/dealing drugs.  Within 6 months he was in jail for a first degree felony.  NOW he realizes that he needed the structure and support we provided.

I agree that some attachment therapy is abusive, "rebirthing" for example, BUT I don't think we should throw out all attachment therapy as evil... ESPECIALLY if you don't have something to replace it with!  Because I can tell you that attachment disorders are VERY real.  Every child and family dynamic is different and what works for one kid and his/her parent(s) most likely will not work for another.  Parents of kids with attachment disorders need to be given LOTS of options to find what mix works best for their family.  NO ONE else knows exactly what will work for me or this child.

I don't do "strong sitting" with my children.  I don't demand they treat me like a queen.  I also don't have children who are trying to kill me (although I have friends who do).  I don't use attachment therapy because it appeals to me or because it's to my benefit - it's NOT!!  Therapeutic parenting is the hardest thing I've ever done in my life.  My children direct much of their rage at me as the representative of the primary caregiver, so yes, I do need Hubby to provide back up and support.

I'd much rather hug and love on my adopted kids, but that's not what they NEED!  They NEED to learn how to have a reciprocal relationship.  They need to learn that mom's can keep them safe and provide what they need - often that means taking the control out of their hands and putting it in mine (which is NOT part of my personality which makes it HARD).  They need to surrender control and trust that we'll take care of them.  That's HARD for them!  It feels like life and death.  They fight it!  If it doesn't happen though, they will NEVER be able to have a relationship - that means loving another person, nurturing their own children, holding a job, living with a roommate... these are skills with which my children's disorder causes them to struggle and fail.


My adopted children didn't receive a lot of ("care, kindness, dignity, affection, trust, respect, generosity, love, forgiveness, honesty, support, encouragement, admiration, and empathy") in their early lives and cannot accept it now.  I'm trying to teach them to trust/ respect/ accept, things they consider themselves unworthy of (like love), because they KNOW they are horrible, unworthy, stupid, ugly... They KNOW that if they trust people to see the real kid inside, then those people will abandon them and/or use it against them.

How do you teach someone that they are worthy and loveable?  How do you show them they can trust you when their perception of reality is so distorted?  I have had to remove so much and make their lives so simple, because more overwhelms them.  They live in a war zone (entirely in their own heads) and those early years when they didn't get what they needed (positive interaction, a consistent caregiver...) led them to have permanent brain damage.  Their world is full of people who are out to get them.  Even when people give them these things (kindness, trust, love, generosity...), my kids distort and deny it.


Johanna said...

Your words about how therapeutic parenting doesn't come naturally really resonated with me. I don't have strict rules with my kiddo because I like being in control (I don't - and am not with my other kids). I do it because it is what he needs - and that's what a good parent does - meet the needs of the child. I can't speak to Attachment Therapy practices in the past, but I know that the therapist we saw was very helpful in helping us establish the kinds of boundaries and consequences that really helped our son. We were never encouraged to do anything mean or abusive in anyway. In fact every book I have read on the subject has emphasized love and empathy, even as the parent enforces the boundaries. That's the tricky part for me :). Thanks for your thoughts on the topic.

RADMomINohio said...

Great response! I applaud you. I have seen this argument before on the internet. It's riddled with false statements and in my opinion "fightin' words!" I wanted to possibly add a comment to your facebook post but its gone it seems. D= Anyway, I'm sorry your friend feels that way and pretty much called you a bad abusive mom. The worst part is that this is one more person who will make this already difficult journey that more difficult.

marythemom said...

RADMom - it wasn't my post on FB, it was one of my friends. I can still see it, but you probably have to be her friend to see it.

Johanna - It's very much perception. I've read some of Nancy Thomas' books and they do sound kind of harsh, but I agree they are not abusive.

Unless you live this life, you cannot understand how much the kids hate moms and how little they give back to us. No one can parent forever under these circumstances, nor is it good for kids to grow up believing this is OK.

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Sia said...

Hmm...I dunno how RAD works but if it's a spectrum (like I know autism is) and someone told me their child had 'mild RAD', or 'high-functioning RAD' I think I'd automatically hear that as 'AD' because mild and radical don't really ... in normal English, that doesn't really work.