When Adopted Children Are Incorrectly Diagnosed With Attachment Disorder, Things Can Go Very Wrong

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March 6 2014 4:15 PM

Extreme Tough Love

When adopted children are incorrectly diagnosed with attachment disorder, things can go very, very wrong. 

Last  week in Ohio, a $2 million settlement was reached between the state’s Stark County and 11 current and former adopted and foster children whom county officials had entrusted to the care of a couple who turned out to be far from ideal parents. Almost nine years ago, in September 2005, the children were removed from the home of Michael and Sharen Gravelle, an Ohio couple in their late 50s, after child protection workers found children shut in cages made of wood and chicken wire. The cages were stacked like bunk beds and often either blocked by furniture or rigged with alarms so the children couldn’t get out. Inside them, the children slept on mats that smelled of urine. But when confronted by authorities—and later charged with a wide range of abuses—the Gravelles defended their methods, claiming that the children, who had conditions ranging from autism to Down syndrome, were “special needs,” and had to be protected from themselves and each other.

The Gravelles, who had been receiving tens of thousands of dollars annually in adoption subsidies and benefits for the children, became known as the “caged kids couple.” They lost custody of all the children and were sentenced to two years in prison for the abuse. At the trial, Michael Gravelle, whom Cleveland Scene reporter Jared Klaus described in a sympathetic article as almost a casting-lot hillbilly—one half of “the white trash poster couple for child abuse”—gave an impassioned defense, describing how he and his wife had initially “felt that we were being led by the Lord” into their many adoptions, but had ended up with wild and damaged children who couldn’t be controlled.  

Abuse of adoptees in large, homeschooling, devoutly religious families is not a new thing. As I covered in Slate in November, a fundamentalist Christian couple in rural Washington was tried and sentenced to decades each for killing their adopted Ethiopian daughter and assaulting their adopted Ethiopian son, through years of abuse the prosecution called torture. An adoptee-run watchdog website, Pound Pup Legacy, has for years tracked cases of adoptee abuse or death.

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But in many of these cases, as in the Gravelles’, in addition to fundamentalist beliefs run amok or plain old sadism, another factor was in play: dangerous therapies meant to address adoptees’ attachment disorders that endorse an extreme form of tough love.

The role of attachment disorders and treatments in adoption is a complicated and varied subject that includes children who are in fact badly developmentally and emotionally hurt and in need of specialized counseling. Often, struggling adoptive families are counseled by peers to consider the possibility of reactive attachment disorder, or RAD, a severe and uncommon condition that traditionally results when children’s earliest bonds are broken. It’s a nightmare diagnosis that for many families conjures stories of adoptees who murder their parents, mutilate the pets, or burn down the home, and will grow up into sociopaths and serial killers. RAD and other attachment disorders are real conditions that can make normal family life incredibly difficult or potentially impossible. But academic critics who have studied RAD say the condition is being overdiagnosed—and sometimes diagnosed by parents or self-proclaimed experts—in children dealing with the routine challenges of adjusting to a new family. The RAD label, with its attendant threat that sufferers are dangerous children who require extraordinary measures, can pathologize the newest members of a family, and open the door to methods that go too far.

Rachael Stryker, an anthropologist and author of The Road to Evergreen: Adoption, Attachment Therapy, and the Promise of Family, undertook a thorough study of one model of radical attachment therapy popularized by practitioners in Evergreen, Colo. Among the model’s most well-known methods is “holding therapy”: restraining children in a caregiver’s embrace for long periods of time, while forcing the child to make eye contact and sometimes feeding them sweets. The goal is to spark a primal sense of rage and powerlessness that will lead to emotional catharsis, and a sense of returning the child to an infantlike state that can allow him or her to then attach to new parents. (A notorious extension of these methods led to the 2000 smothering death of adoptee Candace Newmaker during a “rebirthing” exercise, whose story largely discredited the therapy and was mythologized on an episode of Law & Order.) Other tactics often include “power sitting” sessions, sometimes of many hours, and a punitively restricted diet, like only feeding children peanut butter sandwiches for weeks on end.

These schools of attachment therapy have spawned a number of self-declared “attachment experts” who hang out a shingle offering to fix troubled adoptees. Dr. Jean Mercer, a psychology professor and author of the blog ChildMyths, is a staunch critic of attachment therapy, which she sees as demonizing children in order to justify extreme tactics, potentially rationalizing cruelty. “The very basic idea of attachment therapy is that you want the child to be obedient, and the child must recognize your authority,” she says. “They equate attachment with obedience. When you have that point of view, you go on to all the nasty kinds of things that human beings do to each other.”

Why these teachings have held such appeal to some adoptive families—part of a larger community of adoptive parents who are of course not abusive—is perhaps explained by what Stryker describes as the synergy between radical attachment therapies and the old-time folk wisdom of “spare the rod, spoil the child.” It’s probably no surprise to hear that the Gravelles turned to these attachment teachings in their approach to their children. They hired a local Ohio attachment therapy specialist, Elaine Thompson, who conducted holding therapy sessions with the family’s children for years, reportedly billing the county more than $100,000 for her services. (Thompson was indicted as well, charged with failing to report and aiding and abetting child abuse, but pleaded the charges down and ultimately received only probation.)

As horrifying as what happened in the Gravelle home is, there have been other cases that look nearly identical. During the years that the Gravelles were adopting, another extremely large adoptive family in Tennessee was using the same methods. In 2006, Debra and Tom Schmitz had 18 children in their home, most of whom were disabled or had special needs. The Schmitzes were accused of locking the children in cagelike beds, depriving them of physical aids like braces, or inflicting bizarre punishments like forcing the children to “dig their own graves.” The couple, who received a six-month prison sentence and probation, respectively, had employed attachment therapy methods as well, with Debra Schmitz saying that nearly all of her online connections revolved around it.

Attachment problems are real, and some children who have been badly traumatized may act out in ways that resemble the horror stories radical attachment therapists warn of. But amateur diagnoses of adopted children who aren’t adjusting quickly or well enough have a troubling history of justifying a wide range of abuse. That may explain the emphasis placed this week by the lawyer representing the former Gravelle children. Arguing that all of the children had later been successfully placed in other foster homes, attorney Jack Landskroner told the Associated Press, “These kids were good kids,” who had been wrongfully maligned by their abusive parents. “It’s amazing the positive results you see on children who are placed in a loving, caring home.”

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