When Love is Not Enough
Some traumatized orphans have brain damage that affection alone can't heal. So therapists are seeking new ways to simulate the nurturing they didn't get.
By Susan KuchinskasArticle Tools
- Chris Duffey
- By studying brain waves, doctors have been able to measure the differences in the brains of children exposed to early trauma.
Claire raised her arms above her head and did a cartwheel on the balance beam. Her ten-year-old body was taut and strong, her limbs flowed like water from pose to pose in her gymnastics routine. Watching this magnificent girl, you wouldn't suspect that she had recently used those powerful legs to kick her mom across the room because she'd told Claire to get up and go to school.
Getting to school has been a problem for Claire; she was late 54 times last year. And just the night before, she had broken the bow of her violin in a tantrum sparked by a careless remark by her dad. In fact, she's destroyed many things, like a portable DVD player she couldn't get to work. She's taken scissors to her hair and clothing — and once brandished them during a play date.
Claire is a challenging child. But that shouldn't be too surprising. She was abandoned in a market in South China when she was three weeks old, and spent the next twelve months in the municipal orphanage. "They showed us the room she lived in, maybe ten or twelve babies in little cribs," recalled Barbara, her adoptive mother. "There were rows of small cribs with rails maybe a foot high. They didn't let them crawl or walk, so they didn't need to have high rails. When they put them in high chairs, they'd just sit there."
After struggling for years to get pregnant and spending $16,000 on in-vitro fertilization, Barbara and Steven Pirelli had traveled from Oakland to China to adopt. They were drawn by nothing more than a single color snapshot. The baby they met was dirty and painfully thin: just fifteen pounds. From the waist down, she was atrophied. She couldn't crawl, roll over, or sit up, and didn't make eye contact. But Barbara and Steven didn't care. "You've waited so long, you're not going to say no," Barbara said.
While the couple had been warned about what physical condition to expect, they hadn't been prepared for Claire's strangely detached personality. She was friendly to everyone — inappropriately so when she got older — but not especially bonded to her new parents. When she started preschool, all the other toddlers cried and clung to their parents when they were dropped off, but Claire happily ran off to the swings without a backward look.
But as she got older, she developed a mean streak. She'd make one girl in her group her best friend and reject the rest. In 2005, on a fourth-grade class trip, away from adult supervision, she pushed another girl down and kicked her. Notes from teachers got more pointed; the word "vicious" was used.
When Claire was only two, a psychologist friend of Barbara's who also had adopted a baby from China had warned her that Claire needed help. Now, years later, it finally sank in.
"Oh My God, I Found It"
On a recent sunny afternoon, Elena emerged from the gaggle of fourth graders at her school on a hilltop in Pleasanton. She has soft brown hair, fair skin, and a lanky frame that's helped her become a starter on her school's soccer and basketball teams. She couldn't wait to tell her mom everything: how she did on her math test, what she wrote, what her friends said and did. Walking back to the SUV for the short trip home, she said, "Mom, I'm getting my hopes up about Chrissie coming on Friday. I'm getting my hopes up — but I'm trying not to keep my hopes up too much, so if Chrissie doesn't come over, I won't be too disappointed."
"It sounds like you're doing good in school and being fun to be around, so it just might happen," said Betty, her mom.
While some nine-year-olds live in a whirl of sleepovers and play dates, having a friend come over is a hard-won privilege for Elena. The four years she spent bouncing from a Romanian orphanage to a series of foster homes took their toll, cognitively, emotionally, and physically.
"She was so tiny, only 28 pounds," Betty recalled. "She didn't have much hair. She had ringworm, and couldn't speak." Betty thinks Elena was kept swaddled for the first year of her life; when they met her in the foster home, she was three years and nine months old and still sleeping in a bassinet.
Betty and Howard Sundahl had an American-dream life: Their biological sons, now ages eighteen and sixteen, were growing up strong and healthy. Their house, in a development of million-dollar homes, had all the right stuff, from the granite in the kitchen, to the swimming pool and terrace out back, to the two dogs lounging on their special cushions in the comfortable family room. "We wanted to give thanks for everything we have here and we wanted to do something to make a difference," Betty said. "I wanted a little bigger family, and I thought taking care of a little girl that's already on the earth would be better than bringing a new one. We chose Romania because the children there were in more need."
In her first year with her new family, Elena had some speech problems; they chalked that up to her getting used to a new language. But by her second year, it was clear that something wasn't right. Elena's silence gave way to incessant chatter. In kindergarten, she had trouble staying in her seat, seemed to have no sense of personal space, and constantly interrupted in class. "We wanted her to bloom here, and it just didn't really happen until we got into some therapy," Betty said
Betty took her to specialist after specialist, and each gave her a different diagnosis and treatment recommendation — autism, sensory integration disorder, auditory processing difficulties, attention deficit hyperactive disorder. Finally, a pediatrician suggested in passing that she might want to see an attachment therapist.
"I came home and Googled attachment therapy, and up comes this list of symptoms," Betty recalls. "I said, 'Oh my god, I found it. This is it."
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I would like to address a couple of the comments:
Regarding Holding Therapy: A number of Attachment Therapists try to pass off that pinning a child's arm behind the therapist's back is NOT restraint. "Look, no hands!"
While ATTACh has issued a White Paper denouncing coercive therapies, ATTACh gives mix messages to the public. ATTACh recommends books that promote coercive restraint practices. And Vicky Kelly, who has commented here on ATTACh's behalf, describes rationales for Attachment Therapy on ATTACh's current website. This document contains statements that suggest coercive restraint is still considered appropriate by ATTACh, the trade organization of Attachment Therapist. She writes:
"[T]he use of touch and physical holding in attachment therapy is utilized to create a context that facilitates access to these defensively excluded components. First, physical closeness of the head in the parent’s lap, coupled with encouraged eye contact, recreates a sense of dependency and vulnerability in the child. It is these feelings and the fears they induce that are often so heavily defended against in attachment disorders....The caregiver perseveres to prove that the defensive strategies that have defeated others in the past will no longer work to keep this caregiver away. If the child escalates into strategies of aggression, the child can be safely contained so that he/she is not able to hurt or drive others away." (http://www.attach.org/theorational.htm)
Regarding Virginia Keeler-Wolf's position on Holding Therapy. Her business -- Family Attachment and Adoptiong Center East Bay -- recommends Gregory Keck's book "Parenting the Hurt Child" which does promote Holding Therapy. A couple of quotes from this book which promote an aggressive approach to parenting and therapy:
"...only the parent who is powerful enough to kill also has enough power to love and protect." (p. 42)
"Holding the child or adolescent is accomplished by having him lie across the laps of two therapists and/or his parents. His right arm is behind the back of the lead therapist, who is sitting closest to the child’s head. His left arm is free, or may be restrained if he uses it to try to hit the therapist or to engage in self-stimulation such as scratching or fidgeting. Such self-stimulating activities may increase during holding as the child attempts to deflect contact with the therapist and to maintain awareness of self by avoiding others." (p. 252)
For more information on Attachment Therapy:
http://www.childrenintherapy.org
Parents should be very cautious when selecting a therapist. Make sure the therapy is evidence-based,. The therapist should be happy to provide citations for numerous papers in high level peer-reviewed journals. Therapists working with hospitals are less likely to be fringe practitioners. Psychiatrists and psychologists are less likely to use unvalidated practices.
The reporter failed to mention the APSAC Task Force on Attachment Therapy (see journal "Child Maltreatment" Feb. 2006) which found this practice, its parenting methods (aka Nancy Thomas parenting), and the unvalidated diagnosis "Attachment Disorder" to be inappropriate for all children and potentially abusive/dangerous. The APA's Division on Child Maltreatment endorsed the task force's findings and recommendations, which include advice to child welfare workers to investigate these practices as "suspected abuse."
Note that Reactive Attachment Disorder (RAD), a recognized condition defined in the DSM-IV, is nothing like what we see in this article. The real RAD has no violent features, but rather the children who suffer from this condition are either extremely withdrawn or overly friendly with strangers. This article is NOT talking about RAD, but "Attachment Disorder" (AD), a bogus, catch-all diagnosis ONLY used by Attachment Therapists. Anyone could get this diagnosis, which is a typical warning sign that you are dealing with quacks. The AD diagnosis is especially cruel because it demonizes children and makes parents fearful of their children. It probably also scares parents away from adopting in the first place.
Note that one of the supposed signs of "RAD" in this article is that the child does not make eye contact. Consider that many foreign and some American children are taught not to make eye contact with adults as a sign of respect.
I strongly disagree that Holding Therapy is usually gentle. The practice involves coercive restraint. See horrifying stories of young adult survivors:
http://stopchildtorture.org/
Also, there are numerous clips of Holding Therapy (aka Attachment Therapy) trainging tapes on YouTube:
http://www.youtube.com/user/waywardradish#p/u
Attachment Therapy claims to be the only option for adoptive children who many have trouble adjusting, but this expensive "therapy" is much more likely to destroy families.
Excellent article! I totally disagree with those who are offended by the comment "little monsters." It was not an inappropriate comment at all. I feel that those who took offense to that are just too touchy. I agree with everything Mom to 4 said and to Doug s. - You admit that your daughters are "moderate" and "attached". You are very lucky. Perhaps you would be more credible in your opinion if you were the parent of an extremely unattached child. ( RAD) I don't mean to slam Doug, but as the parent of a child with SEVERE Reactive Attachment Disorder I can testify accurately that this chis IS a "little monster." And before anyone calls me a bad mother, you can come live in my house and try to parent this child! Calling him a little monster does not mean I don't love him. In fact I love him so much it makes my heart hurt. Parenting a child that does not/cannot love you back is the most challenging thing a parent can ever do. My child has spray painted the house, severely abused the dog, swung the cat by its' tail, screams, tantrums, demands, lies indiscriminately, steals, pushes everyone who tries to become close to him away, has physically attacked us numerous times, hoards food, gorges, peed in the shampoo bottle, destroyed every toy we ever bought him. That is only the tip of the iceberg. We have totally exhausted ourselves in trying to heal him. I cannot even begin to tell you the amount of energy we have invested in trying to heal him to no avail. Parenting a child like this is extremely emotionally, physically and psychologically exhausting. I think that those who are trying to say that this article was sensationalism have no idea what Reactive Attachment Disorder is, for if you live with this disorder it is a completely validating piece of work. I speak not only for myself, but for my many friends that I have met in my support group. They would all be willing to say that their children are "little monsters" and not one of them is a bad, unloving parent. In fact those who choose to stay with their little monsters are about as loving and unselfish as can be. Anyone can parent a sweet child. Those who have had successful adoptions are truly lucky, I am envious. In my humble opinion, there is no way to know at first if the child you adopt is going to be attached, moderately attached or severely unattached. A lack of eye contact or any rigidity in the initial contact with the child will be a red flag. This article, I believe is just to inform you how bad it can get and what to be prepared for, although no-one can be totally prepared for the horrors, yes horrors, of raising a severely unattached child. It will change your life forever. Just be aware of that fact when considering adoption. No adoption agency will tell you of the horrors, and most of us go into adoption with stars in our eyes thinking that love will change them. I just want to say that I am happy for those who have had successful adoptions, but the other side needs to be heard also.
An incredibly informative article for everyone, whether in the situation or not. Thank you.
An incredibly informative article for everyone, whether in the situation or not. Thank you.
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