Nancy Spoolstra, DVM and adoptive mother of three children, has been active in promoting Attachment Therapy through her (now defunct) blog and several organization. She currently serves as executive director of the Attachment & Trauma Network, Inc., an organization which she founded originally under the name of Attachment Disorder Network, an organization devoted to promoting Attachment Therapy, its parenting methods, and an unrecognized diagnosis called “Attachment Disorder.” She has served on the board of directors of ATTACh, the national trade organization for Attachment Therapists and proponents, and founded KC ATTACh, a local group. She lectures schools and various groups about Attachment Therapy.
In Her Own Words
The concept of “Holding Therapy” continues to be a controversial subject among those who work with troubled children and their families. Even within the circle of those who believe in holding, there is further discussion about the various methods and approaches available. Some advocate for therapists holding children, and then transferring a calm and receptive child to the arms of their waiting parent or primary caretaker. The Attachment Center at Evergreen (ACE) practices such an approach. Others believe therapists should only facilitate the holding, and only parents should physically hold the child. Dr. Martha Welch, founder of the Mothering Center in New York, believes in this type of holding. There are enough different approaches to treatment that the national organization ATTACh has struggled to identify “standard” per se. ATTACh has no desire to restrict or define therapy in such a narrow way as to eliminate excellent therapists from practicing or evolving new techniques for reaching the most difficult children. — “Requirements for a Successful Intensive,” RADZebra Newsletter, 23 Mar 2003
There are several reasons why this disorder [Reactive Attachment Disorder] is rarely diagnosed. The description in the DSM-IV (Diagnostic and Statistical Manual of Mental Health Disorders) is poorly written and poorly understood. It states that the presence of RAD must occur before the child is five years old. This means that the origins of the disorder must originate before age five. Often this is misinterpreted to mean that the child must be diagnosed before age five. ATTACh is actively participating in developing a better description of Reactive Attachment Disorder to be included in the DSM-V.... These children require serious "re-parenting," and mental health practitioners are reluctant to admit the depth of the child’s pathology.— “Explanation of RAD to Wichita Eagle,” RADZebra Newsletter, 3 Nov 1998
The criticism that parents are often the ones making the diagnosis [“Reactive Attachment Disorder”] is true in part. Our culture does not always support the notion that parents are the foremost authority on their own children. Additionally, the lack of understanding of RAD and the inadequate description in the DSM-IV make it even more difficult to find a mental health practitioner who recognizes this disorder. — “Explanation of RAD to Wichita Eagle”
Holding therapy is not new. Annie Sullivan took Helen Keller to the guesthouse and "held" her for 2 days until she relaxed and trusted Annie. Helen Keller was a classic unattached child. — “Explanation of RAD to Wichita Eagle”
In the early 70’s, when Foster Cline began using this technique on the most disturbed of the disturbed, holding was more physical in nature and more confrontational. Today, the practice focuses more on the underlying sadness and helplessness of the child, rather than the rage that is closer to the surface. These children are so afraid of intimacy that the mere act of holding them close can provoke “rage.” So is it abusive for parents to insist that their children submit to human closeness? In the case of children with attachment issues, it should be expected that these children would exhibit some symptoms of fear of closeness and attachment. Holding them close, insisting on eye contact, and essentially duplicating what a content new mother would do with and for a wanted new child will enhance the connection between the child and their new parent. — “Explanation of RAD to Wichita Eagle”
One aspect of holding therapy is called an “intensive.” This consists of a condensed, intense intervention of between 5 and 14 days that facilitates breaking through the child’s resistance to human interaction. It is a labor-intense and expensive treatment tool. It is true that Kansas has paid for a few of these, in part because of a letter I wrote on behalf of a local family. — “Explanation of RAD to Wichita Eagle”
One of our adoptees is presently in a group home in Colorado. His therapist thinks a good outcome will be that our son can hold a job that requires few interpersonal skills, support himself, stay out of trouble, and maybe have one "acquaintance." That is certainly not the dream my husband and I had for him when he left Ecuador at the age of 9 years. But is he better off than he would have been in Ecuador? Certainly. — “Explanation of RAD to Wichita Eagle”
I have abandoned a career in Veterinary Medicine in favor of advocating for children and their families. — “Explanation of RAD to Wichita Eagle”
We continue to struggle with the profound attachment issues that accompany our own daughter who arrived home from Thailand at the tender age of 21 months. Her issues are severe enough to qualify as “attachment disorder”. — “Explanation of RAD to Wichita Eagle”
We do respite care on a moment’s notice for other members of our group. I am very tough on these little kids… Although I am not an officially trained therapeutic parent, I have attended many hours of workshops and experienced untold hours of personal practice. — “When to Hold and When to Fold,” Kathi’s Mental Health Review [no date; accessed 4/20/08]
I stumbled into a group of experienced Moms who started me on the teachings of Foster Cline. I credit those ladies with saving my sanity, and I am a lifelong fan of the teachings of Dr. Cline. — “When to Hold and When to Fold”
Martha Welch, M.D., is the foremost authority on parental holding. — “Explanation of RAD to Wichita Eagle”
In Dr. Welch’s approach, contracting [with the child] is not required, but she does not quit until the child capitulates and acquiesces to the family. — “Requirements for a Successful Intensive”
I had started a not-for-profit support and educational advocacy organization known as KC ATTACh.... Our policy of providing respite care (and a boot camp environment)… — “When to Hold and When to Fold”
By Tuesday morning her behavior was so obnoxious that I did an impromptu holding and confronted her about what the heck she was doing!... In spite of the catharsis of the "camp holding", Anchulee didn't regain the security she had before camp. — “When to Hold and When to Fold”
We talked to people all day [at the ATTACh Conference] and broke up the afternoon by doing two hours of therapy with Dora. Two awesome therapists tag-teaming...and Dora was venting her grief within moments of starting therapy. It was the longest purge session yet...she wailed for the better part of an hour. — Attachment Disorder Blog, AdoptionBlogs.com, 12 Oct 2007.
Tuesday night as I was putting her to bed I decided to sit and cuddle with her. … She started to fight me, and soon we were in a holding. I had come to Colorado with absolutely no intentions of doing any therapeutic work... When my husband heard her yelling, he joined me upstairs. It was a classic holding, with Anchulee screaming that she hated us both! But how necessary it was, for the venom just came pouring out. Things took a distinct turn, however, when my mom came storming up the stairs and declared, “No more holdings in my house!” Apparently she had articulated to my other children that we were emotionally abusing Anchulee. I refused to allow my mom to stop what I knew my daughter needed, so we finished what we started. … My mom did not want to talk to me, so I delivered a very clear message to my father. … I told him I could not promise “No more holdings,” so if that was a problem for them we needed to know. I made it clear we would vacate their home if our decisions were uncomfortable for them. … Anchulee, on the other hand, continued to simply feel the grief and fight the love and support we extended to her. — “When to Hold and When to Fold”
It is because of the reactions of others that don't understand that we, as well as parents like us, have essentially removed ourselves from the company of people who can't or won't understand what we are about. I know of many, many families split over this same issue. — “When to Hold and When to Fold”
Things rapidly deteriorated from there, culminating in Kathy's total defiance of our family and our rules. Even a weekend in respite care did not salvage the placement. As we had made it abundantly clear from the beginning, it was NOT going to be our family doing all the work. When given the option of moving to a temporary group home pending return to Indianapolis, or seriously owning and addressing her issues and continuing to stay with us, Kathy elected to quit and return to Indianapolis.... She burst into tears upon learning she was to return to the Indiana Girl’s School. Most likely she will remain there until she turns 18. She does not write or call. — “When to Hold and When to Fold”
We had Beth evaluated by Liz Randolph. — Attachment Disorder Blog, 20 Jun 2006. So around the end of February I told [Amy, 16] that in the real world, if she didn't work, she wouldn't be eating in the style to which she was accustomed. Therefore, as long as she was not gainfully employed, she was free to eat all the peanut butter and jelly, fruit, raw vegetables and milk she cared to ingest-but all other more expensive food items were not a part of her diet. … [H]ow many months do you think this went on? Three? Five? Six? [until August] — Attachment Disorder Blog, April 2006.
I have made it clear that this child will not begin school for a minimum of two weeks, and perhaps significantly more, depending on how things unfold. When I do register this child, it will be with the understanding that attendance will be half-days for a yet-unspecified period of time. No school lunches, no changing teachers for "specials" in the morning … just me and this hand-picked teacher. — “I’m Getting My Ducks in a Row,” Attachment Disorder Blog, August 2007.
The majority of [my adopted daughter's] Christmas vacation was spent moving firewood and "thinking about her life." — “When to Hold and When to Fold”