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Jean Mercer Responds to Adoptive Parent’s Comments

September 23, 2010

In the previous posting, I responded to Faith, an adoptive parent who commented on one of my blog articles. What follows is Jean Mercer’s responses to Faith. My purpose in posting our responses is to hopefully clarify what our positions are on these issues and to hopefully promote greater understanding among people who disagree with one another.

Again, I will indent Faith’s comments and Dr. Mercer’s comments are in italics, so the reader can distinguish between them.

Faith wrote:

As an adoptive parent of a child adopted overseas from an orphanage, I must say that unless you have experienced parenting a child with diagnosed Fetal Alcohol Syndrome and Severe PTSD you really can’t know what techniques work and which ones don’t.

I’m sure your experiences as an adoptive parent are interesting and valuable. However, the most you can know about “what works”, based on those experiences, is what you felt comfortable and pleased with. Your child’s age and characteristics, and your family circumstances, may affect the outcome of any treatment, so you can’t assume that what worked for you will necessarily work for others. That’s why we test mental health interventions on large groups of people to see whether large numbers improved by meaningful amounts.
It’s also possible that children can change in the absence of any treatment, so in good research we compare children receiving one intervention with others who receive different or no treatments. When you consider your child alone, you can’t tell what would have happened if no treatment had been given.
For those reasons,I’d have to say that outcome research can tell us what techniques “work”, but individual adoptive parents can tell us only some things about their own experiences.
My child was a serious danger to himself and to those around him during a meltdown.
It would be helpful to know more about this. Did he actually injure himself or others? In what ways?
Without the use of touching him during these times and using the safety restraints taught in professional training through the state and by a trained specialist, my son could not calm himself down.
These are two very different things that you refer to, and it’s not very clear what the second is. Certainly touching can help calm and stabilize a person who is distressed. But what were the safety restraints you are referring to? Guidelines for the use of restraint in institutional settings require the minimum effective restraint in any situation, and they stress the importance of positioning correctly to insure safety. Prone (face-down) restraint is potentially dangerous. It would be of interest to know what restraint position or method you used.
To allow him to fling himself around the room banging his head on the floor, ect…there are times when restaints done with precision and with the motive of compassion and utmost safety are the kindest way to help the child.
As so often happens, there are more than two options here. Parents are not restricted to a choice between permitting wild and dangerous behavior, and using disapproved restraint methods.
Dr. Federici teaches THAT type of hold in his book and in his practice.
I am not in a position to know what Dr. Federici teaches in his practice.However, in his book he advocates prone restraint rather than safer positioning. Please correct me if I am wrong about his use of prone restraint.

My child has gone from completely unattached and labeled with conduct disorder at 4 years of age to a gentleman with an open and joyful heart.
How old is your child now?To what extent might the changes that please you result from maturation and from getting to know each other better? I am not sure what you mean by “an open and joyful heart”–   are you saying that he is affectionate to you in ways you enjoy?
Unless you are the parent of a child like this, you do not know what you talking about.
This would suggest that you reject the ideas of John Bowlby and Mary Ainsworth, the major attachment theorists, as neither one adopted (in fact I don’t think Mary Ainsworth had children at all). There’s the same implication about Charles Zeanah and Mary Dozier, two major modern figures who have investigated the treatment of attachment problems and who have not adopted. Do you actually believe that only adoptive parents have any understanding of relevant developmental issues?
I love my child and have only wanted him to have his best chance at breaking through the barriers of mental illness that he was an innocent victim of in his early life.
I’m sure this is true. As for myself, I would like adoptive parents to receive appropriate information to help them help their children.
His frame of mind was survival and manipulation.
Could you give some specific examples?

Of course he would say, “I promise to stop….” and as any parent of a child with reactive attachment disorder and PTSD would identify with as being manipulated into letting the child continue to try to run the world through his distorted and rageful mindframe.
I’m not sure what your sentence means. Are you saying that when he said he promised to stop, you interpreted this as an attempt to manipulate you?
They are so scared that they lose control.
This is certainly possible, but I’m not sure that it has anything to do with the use of restraint.
To let that go on when there are people who have used safe methods that work, to not try and help your child…is where I find the abuse.
The first issue would be, what is the evidence that the methods are safe? (For me and most psychologists and clinical social workers, this would mean we need reports of adverse events from a large group of children, not just your statement about your own child.) The second is, what is the evidence that the methods are effective?
There are safe, demonstrably effective treatments, like Parent-Child Interaction Therapy, but you apparently did not choose to use one of those.
Ther real world out there isn’t going to allow their violent tantrums or verbal abuse.
Very true, so using safe, effective interventions is especially important.

From experience as a therapist and as the client of a son in Play Therapy and Cognitive Behavioral Therapy, it doesn’t work.
I’m not following you. Do you mean your son was in Play Therapy and CBT? And that you are a therapist who practiced interventions that you think are ineffective?

Traditional therapies don’t go deep enough into their preverbal traumas.
The issue is not what we might think is the mechanism of a treatment, but whether there’s evidence of its effectiveness.
Only safety and development of trust can start to heal that wound.
No doubt this is correct, but the question remains–  how best to accomplish this?

The real world isn’t going to have “compassion” when he socks his future boss, wife, stranger or anyone in range when his PTSD rages hit.
Very true, and a serious concern for parents of conduct-disordered children.
No, the real world expects him to calm himself done, and this is TAUGHT.
Is what you mean that the child needs to learn to self-regulate from observing models and from other experiences, so the parent’s behavior is an essential part of the situation?

I am an advocate for doing what works,
Same here, but I require systematic evidence that it does work, not testimonials.

and the use of therapeutic holds as described in Federici’s book in emergency situations was totally appropriate.
I believe this would be more accurately expressed by saying that you liked it. I am curious as to why you describe these holds as “therapeutic”, though–   is there more to this than simply keeping the child safe at times of loss of control?

I am proud to say that with Dr. Federici’s help, my son is a healthy boy today who can handle his emotions as developmentally appropriate.
I’m glad to hear he’s doing well.
Recovery is possible.
This is undoubtedly true about many early childhood emotional disorders, but you might be cautious about suggesting to others that every problem is capable of amelioration with our present knowledge.

My son was a worst case scenario of complex diagnoses-and he overcame it with the help of his therapeutically trained parents and professional help from Dr. Federici.
It would be interesting to know what your training and experience are, and with what expectations you went into the adoption.

Monica Pignotti is slandering a person who she does not know and does not understand, clearly.
There is no slander when the statements are accurate. Information about Dr. Federici’s methods is available in his own self-published book and in court records.

It’s offensive to have such behavior from a person who claims to be a professional social worker.
Surely you would acknowledge that one professional can criticize another’s methods? I would argue that in fact it’s a professional responsibility to do so, and that such statements are protected under the First Amendment.

If left up to Monica Pignotti, my son would live in a group home where the staff would have no choice but to restrain him and THEY WOULD NOT BE DOING OUT OF COMPASSION.
I am not sure what the connection is. Has Dr. Pignotti  ever been consulted about your son’s placement?
Love goes along ways.  I pray that parents of adopted children with severe mental issues and attachment problems find professionals-such as Dr. Federici who can help them to help their child.

It’s understandable that this is an emotional issue for you, but that’s just another reason why approval or disapproval of interventions should not be based entirely on the personal reactions of people who have been involved with them.

Yours sincerely,

Jean Mercer, Ph.D.

  1. drcmann permalink

    It’s interesting to me, but also sad, that parents so limit the techniques they use with their children. Following a leader with an agenda is an old story in the history of psychology, etc. Psychology, as an evolving science, no longer thinks like it did 50 years ago or even 10 years ago. I am troubled by those who use one so called authority’s opinion on how to raise their children. So far, all this attachment theory has not yielded happy, high functioning children. The nature of true science is that we learn to accept peer review, criticism, and other challenges to our “authority”. If we think we have arrived and we know all the answers, like many guru type practitioners seem to do, this is harmful. Why would a child get better or become more “attached” in such a contradictory, mean spirited, and unloving environment? It defies common sense and it defies what the current research suggests.

    • Attachment theory may have an indirect contribution.

      Attachment therapy may be harmful.

      I take the points about criticism and peer review.

  2. drcmann permalink

    In my view, part of the problem that some attachment therapists and theorists put forward is the idea that children, many who come from backgrounds of incredible deprivation, should act like perfect children who grew up in the narcissistic culture of the US…or that they should act like little adults. One of the more troubling trends I read from some of the attachment therapists is that the child is supposed to give emotional nurturance to the parents…rather than the other way around. I think in some cases that some parents adopt children from other countries for their own needs and social significance, rather than having an honest view of what kind of problems they will be facing. It’s tragic really.

  3. Right, I just read a book called The Road to Evergreen by an anthropologist, Rachael Stryker, reporting on her ethnographic study on parents who chose the Evergreen Attachment Center and she described the attitude among the parents that their children were to be “emotional assets.” It is as if the child has no right to exist for his or her own sake and must instead live to please an authority figure.

    • For those of us who might be unlikely/unable to read the book in its full form, here is a page 99 summary of THE ROAD TO EVERGREEN.

      The Page 99 test of Rachael Stryker’s Road to Evergreen.

      The part about “love as a curative agent” is revealing. Perhaps no other emotion and action is expected to take this burden. Emotional management and the “projection of an affective future” are mentioned as hopes from the therapists to the parents.

      Reactive attachment disorder is treated as a black box (a very complex piece of technology). And how a person responds to threats to hegemonic logic is also very revealing!

      How the medical and social model are connected in our understanding of symptoms (signal symptom). The medical model is used to try to solve a social problem/conflict.

  4. Mary permalink

    So when I ask my daughter not to swear and she says she will try not to, she is manipulating me? Ugh!

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