Coercive Therapy

I read an article this morning about a psychologist in Oregon who primarily treated Reactive Attachment Disorder diagnosed children who lost her license and is being held accountable for wrongful doing after an 11-year-old child committed suicide.  I don’t know the intimate details of the case, so I am not writing this to you to say shame on anyone, her or the system.  I am writing this to you to say that treatment of children with attachment challenges is tricky and needs to be very thoroughly thought through.  
Be careful what advice you take.  There are coercive therapies still being readily practiced that have been deemed harmful to children. In the early years of having my own children I sought advice from many experts and the prevailing treatment for RAD was coercive.  I subjected my own children to recommended interventions, such as strong sitting for too long, forced calisthenics for punishment, therapies that demanded my children scream that they hated me, and lots of pointless hard labor.  I did this for about two years before my heart just couldn’t keep going.  
I made my children afraid of me through this coercive treatment.  I honestly had no idea what else to do and I followed the prevailing wisdom of the therapist I was seeing.  Actually, I sought many therapists who did this form of therapy and I did some myself. There is one popular book I still see parents come to me with that I have to dissuade them from using.  Every time I ask them not to use the interventions, they say…”But they work.”  Coercion works in the short run, but it causes long term-negative effects.  Trust me on this.
Over the years, I learned other ways of intervening with love and structure, empathy and understanding.  It is both harder and easier in the long run.  I had to repair much of the damage my early interventions caused, like fear and hatred in my children toward me. I did that to them, and I will be forever remorseful about it. YOU can know I have made my amends, but it doesn’t undo the damage to our relationships. 
Sometimes good therapies are used punitively.  Beware of your own desire to punish with perfectly fine interventions.  For example, it is okay to ask your children to sit by you until they calm.  It is okay to keep them safe by holding them until they can regulate.  What isn’t okay is using these things when you are angry and when you want to scare and control your children just because they are naughty and willful.  This is the tricky part.  It is not healthy for children to be able to hold all the power in a family, so a fine line is necessary.
Here is a link to what is called The White Paper on Coercion in Treatment that sets forth the standards for treatment of attachment challenged children.  It is long, about 12 pages, but an essential read in order to protect your children from misguided harm by therapists and by yourself.
Love Matters,
Ce Eshelman, LMFT
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The truth is hard to bear sometimes. 


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