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Stephanie nearly drowned her foster brother and sister, ages two and five, in the backyard pool. She can't be left alone with the family's kittens, either.
Stephanie is seven years old.
Stephanie (not her real name) has been diagnosed with reactive attachment disorder (RAD). Therapists say that because of abuse and neglect in the past, Stephanie is unable to form attachments and bond with other people. She doesn't know how to love or trust, and she doesn't have a conscience, says her adoptive mother, Carol. Stephanie tells lies and is self-destructive, picking at scabs until they bleed and then smearing the blood on her bedroom wall and carpet.
Once a week, Carol (not her real name) drives Stephanie two and a half hours each way to attachment specialist Gabrielle New's office in Bellaire. In a room filled with afghans and teddy bears that sport I-survived-my-dysfunctional-family T-shirts, New works with Stephanie.
"Our goal is to get these kids to fall in love with their parents," explains New, a licensed professional counselor.
She says there are only a few other therapists in Texas that specialize in attachment therapy. Kids aren't getting the help they need because it isn't available, New says, and because RAD is often undiagnosed or misdiagnosed. Traditional talk and play therapy don't work with kids like Stephanie, New says, because they aren't able to trust and connect with the therapist. Without treatment, these kids can turn into psychopaths and serial killers, New and several other attachment therapists predict.
New talks to Stephanie about her past, her feelings and her plans for the future. She tries to teach Stephanie to be "responsible, respectful and fun to be with." New says that developmentally, kids like Stephanie get stuck before they learn to bond, so her job is to pull Stephanie out of her "developmental stuckness." Most of the therapy is done while Stephanie lies on New's lap looking directly into her eyes. As described by New, holding therapy, as the technique is called, sounds loving and nurturing.
But holding therapy also has a long, controversial history because children have died during treatment.
Horror stories have emerged about children being held down, screamed at, cussed at, punched, pinched, suffocated, smothered and even killed -- all in the name of therapy.
Critics say that attachment therapists are overdiagnosing RAD and overpromising parents results from unproven techniques. Fear tactics are used to pressure parents into believing that if holding therapy isn't done, the child will become the next Charles Manson, critics say.
After a ten-year-old girl was suffocated during an attachment-therapy session, Colorado outlawed a form of holding therapy called rebirthing. Lawmakers across the country are considering following suit.
Still, supporters say that attachment therapy is the only way to effectively treat these kids. They claim that the dangerous techniques that have killed kids have been abandoned.
Neither side has solid statistics that show any rate of success. All they have to offer is anecdotes, most of them horrific on either side.
"People think that if you treat a kid with attachment issues you're going to hurt that child, and it's not true," New says. "We go back and help the child understand what happened to them. We help them understand their hurt and live in the present."
Thirty years ago, psychiatrist Foster Cline founded The Attachment Center at Evergreen, about 30 miles outside Denver. Cline's theory was that abused, neglected children internalize rage that needs to be released. Using techniques he witnessed at rehab clinics, Cline would provoke a child until he vented his pent-up anger. The idea was to disturb the disturbed. Then the parent comforted and cuddled the child, and bonding began.
"The more difficult the person, generally, the more difficult the therapy," says Cline. "The more disturbed the individual, generally, the more disturbing the corrective experiences they need to go through."
In 1993, attachment therapist Neil Feinberg released a videotape demonstrating techniques used at Evergreen institute. The tape is difficult to watch. A ten-year-old boy lies on Feinberg's lap crying, his arms held down as Feinberg screams at him.
"I'll yell at you, I'll piss you off, I'll sit on you, I'll lick your goddamn face, but I'm not gonna hurt you," Feinberg yells at the boy. "Who thinks about hurting other people all the time?"
"Me," the boy says softly.
He asks the boy how he's feeling. Scared, the boy says.
"You ought to be scared!" Feinberg shouts. "Scared of the killing rage inside you."
If the boy doesn't deal with his rage, he's going to kill somebody someday, Feinberg says. He intermittently covers the boy's mouth and nose so he can't breathe, orders him to kick violently and stare into his eyes. Like a crazed drill sergeant, Feinberg forces the boy to repeat after him that he often thinks of killing his mother.