In His Own Words

— Most Telling —

• Therapy with hurt children needs to include … close physical proximity, frequent touch, confrontation…

  — [with Regina Kupecky] Parenting the Hurt Child: Helping Adoptive Families Heal and Grow (Colorado Springs, CO: Piñon Press, 2002), p. 252

• Some people refer to holding therapy as rage reduction therapy. We think that the term “rage reduction” is a limited description of what holding encompasses. Of course reducing the child’s rage is a desirable and necessary outcome.

  — [with Regina Kupecky] Adopting the Hurt Child: Hope for Families with Special Needs Kids (Colorado Springs, CO: Piñon Press, 1995), p. 156

• In addition to accepting control, healthy children also develop a level of fear … the belief that parents are powerful — powerful enough to fear — and that is a concept that will serve a child well. Look at it this way: only the parent who is powerful enough to kill also has enough power to love and protect.

  — Parenting the Hurt Child (2002), p. 42

• Children with attachment difficulties will identify with, and attach to, only powerful images.

  — Parenting the Hurt Child (2002), p. 256

• The only way for them to learn to trust is to give up control…

  — Parenting the Hurt Child (2002), p. 63

• Perceiving parents as big, powerful, and God-like also helps children develop a conscience.

  — Parenting the Hurt Child (2002), p. 42

• Many people have also been misinformed by well meaning child activists who have either never actually seen our work, or have seen small clips of old tapes taken completely out of context.

  — “The Evolution of Attachment Therapy” [with Dianne Allred], Institute for Attachment and Child Development (2002, accessed 19 Dec 2005)

— Holding Therapy —

• Holding the child or adolescent is accomplished by having him lie across the laps of two therapists and/or his parents. His right arm is behind the back of the lead therapist, who is sitting closest to the child’s head. His left arm is free, or may be restrained if he uses it to try to hit the therapist or to engage in self-stimulation such as scratching or fidgeting. Such self-stimulating activities may increase during holding as the child attempts to deflect contact with the therapist and to maintain awareness of self by avoiding others.

  — Parenting the Hurt Child (2002), p. 252

• Holding the child or adolescent results in an intensity that cannot be duplicated in any other therapeutic format.

  — Adopting the Hurt Child (1995), p. 153

• Finally, [the family] participated in an intensive holding treatment program that focused on repairing attachment disorder and on reducing Bud’s anger. During treatment, Bud experienced much of his rage, and was able to direct it at the therapist.

  — Adopting the Hurt Child (1995), p. 154

• Very few clients refuse to be held; if they are hesitant, we talk until we get agreement. Absolute refusal usually indicates a poor prognosis for change…

  — Adopting the Hurt Child (1995), p. 158

• Traditional views of respecting a child’s physical space must be re-examined when working with children and adolescents whose boundaries do not serve them well.

  — Adopting the Hurt Child (1995), p. 161

• Ultimately, transference aids the therapeutic relationship because it allows the client’s issues and feelings to be resolved effectively.

  — Adopting the Hurt Child (1995), p. 159

• The therapist’s feelings may become part of the therapeutic process, since holding therapy requires a genuine sharing of self with the child…

  — Adopting the Hurt Child (1995), p. 160

• Simply put — the closer the therapist is to the child, the greater the chance for an effective, active therapeutic process.

  — Adopting the Hurt Child (1995), p. 160

• Therapists who do holding are more aware of the child’s non-verbal experiences — the physical tensing…

  — Adopting the Hurt Child (1995), p. 156

• Clearly for adolescents, I always start out, in the assessment, holding the kid, ‘cause they’re just so agitated and aggravated.

  — “How Do They Do It?” Presentation with panel discussion at 16th Annual ATTACh Conference. (Richmond, VA: Association for Treatment and Training in the Attachment of Children, 3-6 October 2004, audiotape).

• And so people ask, how do you get them to do this? Well, they would lay in anybody’s lap. I mean, it’s diagnostic. I mean, the healthy kids are the ones who resist.

  — “How Do They Do It?” (2004)

• We frequently do include the Theraplay.

  — “How Do They Do It?” (2004)

— “Catharsis” —

• When treating rage-filled children and adolescents, holding promotes heightened emotional release. Not all children who have attachment issues operate out of a rage state, but for those who do, the releasing process helps to clear away the rubble so they can begin to experience other feelings.

  — Adopting the Hurt Child (1995), p. 157
  (repeated in Parenting the Hurt Child [2002], p. 254)

— Treating Sexually Abused Children —

• People often ask — usually with great reservation — about holding a child or adolescent who has been sexually abused. What better opportunity for a corrective learning experience?

  — Adopting the Hurt Child (1995), p. 157

• When asked how it feels to be held, a child may say, “This is how I was abused.” Such a comment provides an excellent opportunity to address his painful feelings.

  — Adopting the Hurt Child (1995), p. 158

— Holding Therapy For Parents —

• [Welch] also does holdings with couples in an effort to resolve parental issues and strengthen their attachment to each other. This process certainly solidifies the marital union and ultimately helps the child attach effectively.

  — Adopting the Hurt Child (1995), pp. 155-156

— On The Child’s Past —

• In therapy, Rita [approx. age 7] was capable of expressing what she thought she might have felt when she was two years old.

  — Parenting the Hurt Child (2002), p. 82

• Therapy for a hurt child should provide corrective emotional experiences. Holding enhances the likelihood that this will happen, because it accesses the child’s feelings and prior experiences almost immediately.

  — Parenting the Hurt Child (2002), p. 254

• We need to validate their truth, document their truth, and where possible show them the truth. Sometimes in therapy we have used police or hospital photos to show the child exactly what “bad touch” means. These photos do more to affirm the child’s reality than the nice smiling photos taken at a supervised visit.

  — Parenting the Hurt Child (2002), p. 249

• I don’t think we should keep any information about a child from that child. And I don’t think we have to wait until he is old enough to understand what happened to him. After all, most atrocities committed by parents are done before their children can truly understand them. We talk to babies.

  — Parenting the Hurt Child (2002), p. 250

— Confidentiality —

• Parents should be intimately involved in the therapeutic process. … Parents should be seen as a part of the treatment team. … The child and therapist should not have confidentiality that excludes the parents.

  — Parenting the Hurt Child (2002), p. 174

• The hurt children with whom we have worked respond well to a contract that states, “Your parents are important people in your life. Because we believe they are the best people to help you, we want them to know everything that goes on in our work. There are no secrets here, and there will be no secrets about what goes on at home.”

  — Parenting the Hurt Child (2002), p. 33

— Eye Contact —

• Eye contact is critical, and is enforced nearly all the time. The child is responsible for maintaining eye contact with the person with whom he is talking. When he doesn’t, the therapist uses either verbal or physical cues — such as turning the child's head — to help him establish the connection he needs.

  — Adopting the Hurt Child (1995), p. 155

• Eye contact, too, is more easily established when the child’s spatial boundaries are invaded.

  — Adopting the Hurt Child (1995), p. 160

— “Attachment Transfer” —

• Holding increases the child’s attachment to the therapist/holder, and facilitates the transfer of this connection to the parents.

  — Adopting the Hurt Child (1995), p. 156

— “Frozen Development” —

• …[W]hen you tell [the parents], well, they’re really like four instead of eight, parents go, “Yeah, yeah, well, they’re so immature.” Well, they are immature. But it’s not just immature. I mean, they’re acting their age. Parents say, like,“We wish they would act their age.” And I usually say, “Well, they are. It’s just their age to you is different than their age to them.”

  — “How Do They Do It?” (2004)

• Holding is a process that often reactivates delayed development.

  — Adopting the Hurt Child (1995), p. 157
  (repeated in Parenting the Hurt Child [2002], p. 253)

• …[T]hose frozen stages in development can be reactivated. That reactivation can be compared to going back to fill in the blanks and is, in fact, the key to lasting change.

  — Adopting the Hurt Child (1995), p. 24

• A technique that’s appropriate for a four-year-old can work wonders with a ten-year-old who’s stuck at a younger age.

  — Parenting the Hurt Child (2002), p. 62

— “Attachment Disorder” —

• …[S]ymptoms [sic]…
  Lack of affection with parents on their terms (not cuddly)
  Little eye contact with parents
  Persistent nonsense questions and incessant chatter…
  Stealing
  Abnormal eating patterns…
  Abnormal speech patterns…
  Lack of cause-and-effect thinking
  Lack of conscience…

  — Adopting the Hurt Child (1995), pp. 29-30

• They just know how to take care of themselves and firmly believe that if they give up control, they may die.

  — Parenting the Hurt Child (2002), p. 82

• These same children are adept at engaging others in a superficial manner, thus therapists, teachers, and outsiders to the family feel that these children are easy to be around…

  — Parenting the Hurt Child (2002), p. 251

— Who Is Unattached Anyway? —

• …[M]any times, mothers particularly, will tell us, “I can’t hold her, I don’t want to touch her, I don’t even like to look at her, in fact I don’t even want to be in the same room with her.”

  — “How Do They Do It?” (2004)

— Scare Tactics —

• …[C]hildren who have been severely hurt … they fear nothing.

  — Parenting the Hurt Child (2002), p. 40

• …[T]hey often target their new mothers with great anger and venom.

  — Parenting the Hurt Child (2002), p. 199

• …[A] child may display an equally strong pull toward blood and gore.

  — Adopting the Hurt Child (1995), p. 43

• …[I]ssues with attachment are the ones that cause the greatest problems in adopting a child with special needs.

  — Parenting the Hurt Child (2002), p. 251

— “Cycle of Bonding” & Other Attachment Mythology —

• …[H]ealthy children first attach to their mothers — beginning in the womb.

  — Parenting the Hurt Child (2002), p. 26

• …[A] child’s first eighteen to thirty-six months … It is the time when the bonding cycle is repeated over and over again.
  • The child has a need.
  • He expresses that need by crying, fussing, or otherwise raging.
  • The need is gratified by a caregiver, who provides movement, eye contact, speech, warmth, and/or feeding.
  • This gratification leads to the development of the child’s trust in others.

  — Parenting the Hurt Child (2002), p. 26

• The cycle is repeated thousands of times … forming the foundation of every other developmental task of human life.

  — Adopting the Hurt Child (1995), p. 46

• One goal of therapy, then, is to approximate what occurs in the healthy attachment cycle…

  — Adopting the Hurt Child (1995), p. 152

• Children with attachment issues have missed thousands of cycle completions, and it is up to us to make them up. This takes time. Lots of time. … When a child has not securely attached as an infant, it is critical to give him the opportunity to experience the attachment cycle with his adoptive parents. This should be done over and over again. … Most of these children choose to remain distant, but that is their want, not their need.

  — Parenting the Hurt Child (2002), p. 59

• At this age [12], with this level of intensity that she goes through the cycle, we would probably use therapist holding in the beginning of the session.

  — “How Do They Do It?” (2004)

— View of Conventional Therapy —

• It is an unfortunate fact that many of those who attempt to provide treatment to adoptive parents with disturbed children know very little about issues related to adoption. This is particularly alarming when we realize that they not only fail to provide effective therapy, but also solidify the child’s existing pathology and complicate subsequent therapeutic efforts.

  — Adopting the Hurt Child (1995), p. 147

• Children with developmental delays (social, psychological, cognitive) who have been in traditional therapy tend to be extremely skilled at figuring out the therapist’s goals and style.…When the therapist buys into the con, his sympathetic response serves to empower the child.

  — Adopting the Hurt Child (1995), p. 148

— Food —

• • They hoard food.
  • They gorge themselves.
  • They eat only one or two things.
  • They eat everything in sight, including nonfood items.

  — Parenting the Hurt Child (2002), p. 93

• …[H]ere are some ideas to make food a part of nurturing. Don’t worry if it adds calories. … Serve a banana split for dinner. For no reason.

  — Parenting the Hurt Child (2002), p. 95

— “Reparenting” —

• Being treated well, like a baby should be, can help a child fill in the gaps in his development. John, age four, stayed home when his brothers and sisters went to school. Mom held him close for hours. She tickled, kissed, and bottle fed him. His eyes never left hers.

  — Adopting the Hurt Child (1995), p. 181

• Reparenting is what hurt children need, regardless of their chronological age.

  — Parenting the Hurt Child (2002), p. 24

• If your child wants you to, feed him a bottle when holding him, no matter what his age. (Ten is not too old.)

  — Parenting the Hurt Child (2002), p. 96

• …[Y]ou may need to do some things with him that seem to “childish,” given his age. He needs to learn that you can and will control him directly. When he gets the message, he will begin to develop trust. … We too often forget that control equals love for the infant, child, and even some adolescents.

  — Parenting the Hurt Child (2002), p. 192

• The word “control” generates a lot of negative response in the mental health field. We are never quite sure why, because every infant is completely under the control of his parents, completely vulnerable…

  — Parenting the Hurt Child (2002), p. 42

— Cutting Out Ancillary Services —

• I would really want to quickly evaluate whether or not the ancillary services are needed. … [W]hat we have found is that the more people involved in a case, the less empowered, the less central the parent is. … [W]e usually try to eliminate as many outside services as we can.

  — “How Do They Do It?” (2004)

• …[W]e want to make the parent central. And so we don’t allow the child to be central.

  — “How Do They Do It?” (2004)

— Parenting —

• We want to make it clear that foster and adoptive parents are not responsible for the development of their children’s problems.

  — Parenting the Hurt Child (2002), p. 21

• We do not want [the child] to believe that he can rely on himself.

  — Parenting the Hurt Child (2002), p. 55

• It is far more effective for the adolescent to know that he needs to get permission to do anything.

  — Parenting the Hurt Child (2002), p. 55

• …[I]t is better for children with attachment disorder not to be told what the consequences of their behaviors will be. … The child needs to be guessing what the parents are going to do. … The unknown is powerful.

  — Parenting the Hurt Child (2002), p. 68

• We therefore suggest that if parents feel the need to take something away [from the child], it should be something they will never return.

  — Parenting the Hurt Child (2002), p. 56

• So the challenge becomes how to increase touch with a resistant hedgehog. … Allow him to watch television only if he sits beside you and a part of his body touches a part of yours.

  — Parenting the Hurt Child (2002), p. 88

• If your child is having a temper tantrum … say something like, “Oh, a tantrum, I think I’ll get some iced tea and make myself comfortable while I watch.” … One family, inspired by the Olympics, had cards printed with the numbers 1 to 5 on them. When their child’s tantrum started, everyone in the family held up a card to judge it.

  — Parenting the Hurt Child (2002), p. 69

• If [parents are] faced with one hundred control battles a day, take on five, and win them all, they’ve won 100 percent. The rest of the battles simply do not count, because the parents didn’t engage. The result: the parents become more powerful in the child’s eyes, because they are perceived as being in control of the family.

  — Parenting the Hurt Child (2002), p. 64

• Jonathan, age six, flatly refused to put his cereal bowl in the dishwasher. Morning after morning, his mom would remind him to do it … Because his mom wasn’t prepared to stay home from work and battle with her son until the cereal bowl landed in the dishwasher, she changed her mind. … “Jonathan, how did you know that today I didn’t want your bowl in the dishwasher? I want to rinse the dishes in a special way, and you’re making it easier for me to do that. Thanks! We must be getting closer, because you can read my mind.” Mom avoided the battle … she took control … she won. To many parents, this scenario may seem as if Jonathan’s mom gave in to him. What she actually did was help jump-start the attachment cycle. … where the child learns that if the parent wins, so does he.

  — Parenting the Hurt Child (2002), pp. 66-67

• [Parent to child] “We had such a good time that I know you’ll go home and be horrible. That’s okay with me.”

  — Parenting the Hurt Child (2002), p. 77

— Pushing “Love and Logic” —

• As we have often repeated, the Parenting with Love and Logic materials provide an invaluable framework for helping your child get rid of his old ways.

  — Parenting the Hurt Child (2002), p. 152

• Don’t buy into claims such as, “That’s not fair!…” It is better to respond with a comment suggested in the Love and Logic material, “We’re all different, and the world doesn’t always treat us fairly or equally. It’s much better to learn this at a young age than on your first job assignment.”

  — Parenting the Hurt Child (2002), p. 58

• We were using a lot of Love and Logic stuff, which I think is good, but what we found … is that when you have angry parents, they don’t get the love, they just get the logic. And so they just lock into the consequencing. … So I think technique and anger together is not a good combination. That’s one of the major reasons that Regina and I wrote Parenting the Hurt Child…

  — “How Do They Do It?” (2004)

— Role of Father —

• First of all, it is incumbent upon the father to support and believe his wife.

  — Parenting the Hurt Child (2002), p. 199

• As part of their treatment, we suggested that [the parents] join our support group. … The other mothers rallied around the new mom, while the fathers quickly nudge the dad into reality.

  — Parenting the Hurt Child (2002), p. 33

— Respite —

• Sometimes families are frustrated by the respite program. The respite providers report that “he was just fine, and we didn’t have any problems.”

  — Parenting the Hurt Child (2002), p. 194

• …[T]he goals of respite should be related to enhancing the child’s capacity for attachment…

  — Parenting the Hurt Child (2002), p. 255

— Elimination —

• Children who have been hurt early in their lives seem to be continually trying to eliminate things from their lives — closeness, love, pain, and control by others. Their elimination difficulties are most often intentional and focused on sending a message to their parents. Without being too explicit in a publication such as this, let me say that your son is doing what many people say when they are angry — he is showing you “Urinate on it!” He is giving you defecation!

  — Parenting the Hurt Child (2002), p. 180

— State Support —

• Ohio is a special state for adoptive families. For years, there have been monies made available through the Post-Adoptive Special Services Subsidy (PASSS), program. These generous funds, supplemented by State Special Services Subsidies, allow adoptive families to access specialized services that their hurt children so desperately need. We know of no other place in the world that has such a post-adoptive program. Thank you, Ohio…

  — Parenting the Hurt Child (2002), p. 18

• …Dr. Keck’s column, “Ask An Expert” … appears in The Connection, the newsletter of the Wayne County Children Services Board in Wooster, Ohio.

  — Parenting the Hurt Child (2002), p. 177

— “Related Readings” —

• Foster Cline, Bruno Bettelheim, Richard Delaney, Sherrie Eldridge, Vera Fahlberg, Jim Fay, Daniel A. Hughes, Regina Kupecky, Ken Magid, Carole A. McKelvey, Lynda Mansfield, Christopher Waldmann, Tim O’Hanlon, Elizabeth Randolph, Nancy Thomas, Bessel Van der Kolk, Holly Van Gulden, Thomas Verny, Nancy Verrier, and Martha G. Welch.

— Resources —

• [Keck lists these resources, among others, but says the list “does not reflect our recommendation”:] ATTACH, Attach-China, Attachment Center at Evergreen (Institute for Attachment and Child Development), Attachment Center Northwest, Attachment Disorder Network, radzebra.org (Nancy Spoolstra), Attachment Disorder Site, Attachment Disorder Support Group, Children Unlimited (South Carolina), Family Attachment & Counseling Center of Minnesota, Forest Heights Lodge, Heal the Heart Foundation, Intermountain Home (Montana), International Adoption Clinic, Jewel Among Jewels Adoption Network, North American Council on Adoptable Children, The Theraplay Institute, Villa Santa Maria.