Sep 20, 2009

Book Review




This is a pretty decent text on the subject. There are a couple of chapters that I found most useful. The Chapter by Frank Putnam, “The Developmental Neurobiology of Disrupted Attachment: Lessons from Animal Models and Child Abuse Research,” is a good summary of current research on the linkages between abuse, brain development, and later behavior. Dr. Putnam does a very good job of explaining some quite complex issues here. He states, “In aggregate, research…conclusively demonstrates that early adverse experiences can have lifelong effects on subsequent responses to stressors. Maternal stress is clearly communicated to the infant and can be as detrimental as direct stress.” (p. 93). The next chapter by Alica Liberman and Lisa Amaya-Jackson, “Reciprocal Influences of Attachment and Trauma: Using a Dual Lens in Assessment and Treatment of Infants, Toddlers, and Preschoolers,” is also an excellent chapter. As you know, the field is increasingly moving toward an integration of trauma research and practice and disorders of attachment theory and research. This chapter is a very nice integration of those two domains. The inclusion of a very detailed case study makes this chapter quite useful.

The last sections of the book describe program and policies. In the chapter by Marinus H. van Ijzendoorn, Marian J. Bakermans-Kraneburg, and Femmie Juffer, “Why Less is More,” they describe the current state of affairs with regard to program research. They find that interventions that focus only on sensitive maternal behavior are most effective in changing insensitive parenting and infant attachment security. They found that sensitivity-focused interventions are more effective than interventions with a broader focus. As might be expected, interventions with involved families and at-risk infants were more effective than interventions with at-risk parents. The book also addresses the ongoing concerns with intrusive methods such as holding therapies, rebirthing, and rebirthing. The chapter by Thomas O’Connor and Wendy Nilson, “Models versus Metaphors in Translating Attachment Theory to the Clinic and Community,” discusses this issue and encouragingly states, “This is changing. For example, a recent issue of Attachment and Human Development…was dedicated to this problem, and several clinicians working with children with attachment disorder have begun to develop alternative intervention models that do not rely on holding (e.g. Hughes, 2003).”

Like too many books in the field, this one focuses primarily on theory, research, and treatment programs for infants and toddlers. It takes some adapting to see how this material can be useful in work with latency and teen age children. None the less, the material is helpful and useful for practitioners.

Sep 16, 2009

John Rosemond got it wrong

In a Baltimore Sun article, Sept 2nd 09, John Rosemond, wrote an article that is inaccurate regarding the factors sometimes associated with adoption. He claims that "Attachment Disorder lacks scientific proof," and goes on to state, "The facts: A consistent body of hard, objectively gathered scientific evidence to the effect that adopted children are more prone to psychological problems than children who live with one or two biological parents is lacking." The article goes on to criticize "adoption specialists," and describes the "case" of a three-year old to bolster his point. I find that the article is simplistic and distorted.

Mr. Rosemond has little or no training on the subject about which he is writing here. Mr. Rosemont is a "Psychological Associate," holding a MS. His background does not qualify him to offer expert advice on this particular topic.

Mr. Rosemond's statement is just wrong. Many children adopted through the child welfare system and internationally have suffered years of maltreatment (abuse and/or neglect). As you know, in the US and most countries, it is very difficult to remove a child from the parents and even more difficult to terminate parental rights. Things have to be pretty gruesome to have a parent's rights terminated and the child placed for adoption. So, the facts are: There is a consistent body of hard, objectively gathered scientific evidence to the effect that adopted children are more prone to psychological problems than children raised from birth. For example, Approximately 2% of the population is adopted, and between 50% and 80% of such children have attachment disorder symptoms (Carlson, Cicchetti, Barnett, & Braunwald, 1995; Cicchetti, Cummings, Greenberg, & Marvin, 1990).Children who have experienced chronic maltreatment and resulting complex trauma are at significant risk for a variety of other behavioural, neuropsychological, cognitive, emotional, interpersonal and psychobiological disorders (Cook et al. 2005; van der Kolk 2005). Many children with histories of maltreatment are violent (Robins 1978) and aggressive (Prino & Peyrot 1994) and as adults are at risk of developing
a variety of psychological problems (Schreiber & Lyddon 1998) and personality disorders, including antisocial personality disorder (Finzi et al. 2000), narcissistic personality disorder, borderline personality disorder and psychopathic personality disorder (Dozier et al. 1999). Neglected children are at risk of social withdrawal, social rejection and pervasive feelings
of incompetence (Finzi et al. 2000). Children who have histories of abuse and neglect are at significant risk of developing PostTraumatic Stress Disorder as adults (Andrews et al. 2000; Allan 2001). Children who have been sexually abused are at significant risk of developing anxiety disorders (2.0 times the average), major depressive disorders (3.4 times average), alcohol abuse (2.5 times average), drug abuse (3.8 times average) and antisocial behaviour (4.3 times average) (MacMillian 2001). The effective treatment of such children is a public health concern (Walker et al. 1992).

Mr. Rosemont goes on to state, " On the other hand, there is significant evidence to the effect that even orphaned children exposed during their early, supposedly "formative" years to severe conditions of emotional deprivation and material neglect recover quite nicely when adopted by loving parents." This statement does have an element of truth to it. One element of helping children who have experienced chronic early maltreatment within a caregiving relationship is loving parents. But there are other elements necessary to address and resolve the underlying traumas that may be continuing to distort the child's relationships and psychological functioning.