Controversial attachment

An O.C. couple say attachment therapy, though linked to deaths, has brought their raging son under control.
Orange County Register, Nov. 24, 2002
http://www2.ocregister.com/
By JENIFER B. McKIM, The Orange County Register

Josh was taken from an abusive home when he was 3. He had a black eye and a belly full of rage.

By the time he was 8, he’d blown through three foster homes, struggled in increasingly high-security group homes and been hospitalized in a psychiatric ward. He’d sent two staff members to the hospital, fought, raged, bullied and threatened suicide.

Many said he was too violent and combative to function in a normal home and was doomed to life in institutions.

But Kelly and Rich Frey – foster parents No. 3 – wouldn’t give up on the boy they considered family. They say that if it wasn’t for an unconventional treatment called attachment therapy, Josh could still be institutionalized.

They believe the county Social Services Agency and most therapists fail to recognize reactive attachment disorder and attachment therapy, the treatment they believe saved their son’s life.

“Half of (Josh)’s childhood was wasted with ineffective therapy, medication and parenting,” said Kelly Frey, 35, who with her husband recently adopted the boy, whose name was changed for this story to protect his privacy.

“If we had known earlier (about his disorder), he wouldn’t have to have gone through so much pain.”

The therapy is controversial, linked to the deaths of two children in Colorado and Utah over the past three years.

Critics say there is no scientific evidence the treatments work and that much of it is abusive.

“I think these people are nuts,” said Jean Mercer, a psychology professor at Richard Stockton College of New Jersey. “Children have died this way. This is more like a cult than a treatment.”

But advocates say treatments highlighted in the deaths – including a practice called rebirthing – aren’t valid attachment therapy.

ATTACh, the Association for Treatment & Training in the Attachment of Children, defines reactive attachment disorder as a treatable condition in which people have difficulty trusting anyone or creating intimate relationships. Usually it’s caused by serious disruptions forming bonds during early childhood.

Within a range of severity, children may experience insecurity, self- loathing and an obsessive need to control, therapists say. They may be overly demanding, steal, lie and, in extreme cases, kill animals and light fires, according to ATTACh.

The Orange County Social Services Agency recognizes reactive attachment disorder and believes most of the 4,300 children in the county’s foster-care system have some symptoms, said Children and Families Services Director Michael Riley. He said the agency trains social workers to recognize symptoms and that therapists contracted with the county should know of the disorder.

However, Riley said, children can be misdiagnosed, and the disorder can remain untreated. The agency does not support “radical forms” of therapy, linked to deaths in other states, Riley said.

“We would not recommend any form of therapy that would endanger a child,” said Riley, who would not discuss details. “It is nothing that is new to us. It is something that is starting to get more headlines.”

Attachment therapy gained nationwide attention in 2000 when a 10-year-old girl suffocated during a rebirthing treatment in Colorado. Four adults covered the girl with blankets and pillows, then leaned on her, applying several hundred pounds of pressure. Two therapists were sentenced to 16 years each in prison.

In September, the House of Representatives voted to condemn rebirthing as dangerous and urged states to ban the practice.

In July, a 4-year-old girl died after her adoptive parents allegedly tied her hands behind her back and forced her to drink a fatal quantity of water as a punishment for drinking without permission. The parents contend they were given the advice during training at an attachment therapy center.

The center denies the claim. However, Utah filed a petition in September accusing the center of using an intrusive form of holding therapy, called compression holding, in which therapists lie face to face on children and use hands, elbows or knuckles to press into children’s abdomens to release emotional pain and anger.

The Utah therapists say the state twisted their words and that they did nothing wrong.

ATTACh President Todd Nichols said that while the nationwide group doesn’t have a stance on compression holding, he doesn’t use it in his practice. He said he sees attachment therapy as something used to treat a certain group of children and that different therapists use different techniques. He said many of the more aggressive techniques have been phased out.

“(Attachment therapy) is gentler and loving,” said Nichols, head of the national group launched in 1989 to increase awareness of the disorder. “To inflict physical pain on a child is not acceptable.”

The Freys simply know that once they recognized Josh’s problem and began to use attachment therapy techniques, they saw immediate results.

“To me it’s a miracle how far he has come,” said Kelly Frey, looking fondly on her strapping, soft-spoken son. “He started like a scared little animal, this little ball of defensiveness, and emerged into a real live child.”

JOSH’S STORY

The Freys met Josh when he was 7. He had lived in a group home for four years as his biological parents battled in court to keep him. He had no close relationships.

The Freys volunteered through the Big Brothers and Big Sisters program to take Josh on outings. Within eight weeks they decided to adopt him. They felt like Josh was family. They knew he was a handful but thought a warm, loving family would turn him around.

Kelly Frey blames herself and county social workers for what she now sees as naivete. She said social workers told her Josh “would be fine when he gets home.”

Frey, who runs a support group for parents who deal with attachment disorders and sits on the board of ATTACh, says she’s heard many parents say the same thing.

“They say, ‘We had no idea what we were getting into when we brought these children into our home.’ Not that they wouldn’t do it, but they were completely blindsided.”

When they picked up Josh at the group home, he hardly showed emotion, Frey said. The thin little boy walked out with two garbage bags filled with ill-fitting clothes and toys.

Soon after, he was getting into trouble at school. He had a sweet side. He jumped into his adoptive parents’ laps, kissed and hugged them. He also raged, kicked walls and broke glasses. He got into Frey’s face and swore at her. He assaulted other children and was suspended from school repeatedly. He’d lie and steal.

Kelly Frey began to feel stalked. The couple locked their bedroom door at night, afraid Josh might hurt them.

They could not concentrate at work, waiting for the next call from the principal’s office. Rich Frey, a 40-year- old software engineer, said he preferred to stay at his office.

“You are always on pins and needles, trying to avoid a complete meltdown,” Kelly Frey said. “The balance of power was upside down. I felt like he was trying to get me to hit him. He was trying to re-create the cycle of abuse.”

They lasted nine months. But when Josh went after a butcher’s knife and threatened to kill himself, the couple sent him away. Their marriage was a shambles, their lives out of control.

They hoped the separation would help. Instead Josh moved to increasingly high- security institutions, farther and farther from the Frey’s three-bedroom Aliso Viejo home. Once, he was hospitalized after teetering on a roof, trying to fly like a bird.

The Freys got marriage counseling. They learned about attachment.

“It was like the light bulb just dinged,” Frey said.

Treatment seems to work

The Freys began to meet with Connie Hornyak, director of Attachment Center West and one of a small number of attachment therapists in California.

Hornyak said her three- member Santa Ana office treats about 80 families, who drive for as long as two hours for services.

About 80 percent of families who contact her are in crisis, ready to disrupt their adoptions or break up their families, she said. The center’s waiting list is full of people for whom traditional therapies didn’t work.

“We are kind of the end of the road,” she said.

Included in treatments is regressive therapy. Children relive stages of their development to heal traumatic memories and experience a nurturing environment. Eight-year-olds are encouraged to crawl on the floor and play with preschool toys at home.

Hornyak holds children in her arms to make them feel tiny and vulnerable, able to talk about a traumatic past in a safe place. Restraint is never allowed.

The Freys took their cues from Hornyak. They started with bottle feeding

At 8 years old, Josh climbed into his parents’ laps to suck chocolate milk or soda from a nipple. At first he wriggled, unable to stare into their eyes as needed. They played staring games.

Josh felt he had to maintain control at all times – even if it meant losing the Freys, they said. He would rather cause a separation than wait for it to happen to him. Their job was to change the pattern, to get him to give up control.

“When they do, it shows they trust you,” Frey said of children with attachment disorder. “They can learn it won’t kill them.”

Josh returned to their home after 16 months. Two years later, he agrees he’s a better person.

“I think I just needed control, attention,” said Josh, sitting at the kitchen table recently talking about his life. “I was testing them. It’s all over with. They’ve committed to having a difficult child.

“I was angry and obnoxious. Now I’m not. Well, sometimes I am, but most of the time I’m not.”

Last spring, months before Josh was to be adopted, he started raging again. On a family trip, he went into a fit that lasted five hours, kicking furniture, screaming obscenities and running through the neighborhood.

For the first time, he hit his foster mom. A punch to the face. The couple eventually restrained him.

A month later, days before the court date for the adoption proceeding, Josh kicked his mom in the nose, stomped on her foot.

Kelly Frey didn’t let the rage dissuade her.

“I hobbled into the court room with a swollen nose. He feels terrible afterward, but in a rage he’s trying to hurt me.”

The third time, several months after the adoption, the Freys called the police. Josh was hospitalized for eight days.

Frey attributes the rages to a form of attention deficit disorder, which leaves Josh unable to control his moods. They think the stress of the adoption was too much for him.

“I would be foolish to say it will never happen again, (that) we are out of the woods now,” Frey said.

Their family members have questioned their loyalty. For them it was instinct.

“Since we’ve been working with (Josh), it felt like he was a family member,” Rich Frey said. “The thought of giving up a family member is unthinkable.”

Kelly Frey tells other parents they must do everything in a spirit of teaching, not punishment.

“The philosophies that play into (attachment therapy), you could get into with the wrong spirit,” she said. “It is not about punishment. It is about helping them.”

Linda Rosa, Colorado coordinator for the National Council Against Health Fraud, said advocates of attachment therapy are running a public relations campaign to calm critics after deaths in Colorado and Utah. Rosa, writing a book with Mercer on the subject, said she believes what occurs behind closed doors is different.

“They are using smoke and mirrors on the press and the public,” said Rosa, who saw tapes of 10-year-old Candace Newaker’s death in Colorado on which she repeatedly cried out for help. “When the public learns what they are doing, it is appalling. It is barbaric what they do.”

ATTACh agrees the therapy still lacks scientific studies to prove the treatment works.

“There is a lot of controversy over whether (reactive attachment disorder) is a valid diagnosis,” said Nichols, ATTACh’s president. “That’s fine. Everything new has to go through trial by fire.”

Despite setbacks last summer, Frey feels she is in a new world with Josh. She hopes his story will educate others.

“This is a kid who they said would never get out of a group home,” Frey said. “Our life looks dangerously close to normal.”

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