Holding On

Families search for a miracle therapy that won't hurt their troubled children

Therapy like this, and other videos that show children bundled in blankets and pinned down by adults three times their size, are examples of old-school, outdated attachment therapy that has been phased out and largely eliminated, says Forest Lien, a licensed certified social worker and director of training at the same center where Feinberg filmed his tape.

"That wasn't attachment therapy -- that was terrorism," Lien says. "You can terrorize anybody into compliance. That's what the old therapy did. If you're bigger and stronger and more powerful than the kid, they'll comply with you. But it's not gonna last."

In 1995, Lien says, he restructured and reorganized the institute's treatment protocol and told people who wanted to yell at children and forcibly hold kids down that they had to leave. Feinberg is no longer employed at the institute. The program changed, because therapists discovered that instead of internalizing rage, abused children often internalize sadness and fear, Lien says. Yelling at sad, scared kids didn't improve their behavior, it worsened it. And kids got hurt.

Some parents lock the bedroom door to contain their RAD kids.
David Terrill
Some parents lock the bedroom door to contain their RAD kids.

"There's unorthodox techniques, and then there's dangerous techniques," Lien says. "The old attachment therapy looked abusive, and I think it was."

Lien says the goal of the institute's intensive, two-week program is to get kids to learn to be vulnerable, trust their parents and deal with their scared, mad emotions. "We try to normalize the kids' behaviors." With both the parents and the child's hometown therapist in the room, Lien sits on the couch, puts a pillow on his lap, and the child lies down and looks into Lien's eyes.

"We hold kids in a cradling way so that they feel safe and at the same time feel vulnerable," Lien says. "They can't stay in their head."

If a child doesn't want to participate in therapy, Lien tells him he made a bad choice and fires him from therapy. Then he and the child's parents discuss how sad it is that the child doesn't want to change his life and make it better. Usually, Lien says, the child asks if he can rejoin therapy.

Still, attachment therapy doesn't work for every kid, Lien concedes. In those instances, parents have to decide if they want the child to come home, enroll in military school or -- worst-case scenario -- live in an institution. "These kids light your house on fire, they kill your animals, they do some pretty atrocious things," Lien says. "If kids continue to behave like that, then they're not family material. Is it normal to have a psychopath in your home? Where do psychopaths belong? Not in a family. Parents become prisoners in their own home with these little monsters."

Ten years ago, Lieutenant Governor Bob Bullock appointed the Senate Health and Human Services Committee to investigate private psychiatric hospital abuse. Senator Judith Zaffirini (D-Laredo) says the committee members were shocked and horrified when they witnessed rage-reduction and holding therapy.

"It was so cruel," Zaffirini says. "Sometimes people believe that things have to get worse before they get better. They had to completely break down a person's emotional state and have a form of regression and then rebuild. That just seemed cruel and unusual therapy to me -- and potentially harmful."

The Senate interim committee recommended that rage-reduction therapy be banned.

Senate Bill 210 included a ban on holding and rage-reduction therapy as part of an eight-point mental-health reform package. But before passing in the full Senate in the 1993 legislative session, the rage-reduction portion was removed to cut legislative program costs, Zaffirini says. The Treatment Methods Advisory Committee was established to review the technique. In 1994, the committee released a statement saying it did not endorse or recommend rage-reduction or trust-development therapy.

A year later, more than 30 former patients filed suit against Fort Worth psychiatrist Robert H. Gross, whom Cline trained in rage-reduction techniques. Cline was named as a co-defendant. In October 1996, Tarrant County state District Judge Ken Curry awarded Gross's former patient Jeannie Warren $8.4 million. Warren's Dallas attorney, Ken Jenson, says that when Warren was 15, she went through two dozen, five-hour therapy sessions where she was held down by four technicians who covered her mouth and nose, screamed obscenities at her and mashed knuckles into her stomach.

In a renewed effort to ban holding therapy, Warren spoke to the legislature with Jerry Boswell, the Austin-based president of the Citizens Commission on Human Rights of Texas. Boswell hoped that the multimillion-dollar judgment would show the legislature that rage-reduction and holding therapy are abusive. "They're brutalizing," Boswell says. "It should be outlawed."

No new laws were written, but Don Rogers, communications director for the Texas Department of Mental Health and Mental Retardation, says holding therapy is not sanctioned by his agency.

"It's not accepted. It's not something we promote or recommend," Rogers says. "Anytime somebody is restrained, it's not therapy."

Zaffirini is still considering writing a bill to ban all forms of holding therapy. A difficulty in writing legislation that outlaws holding therapy is that it has no standard, textbook definition. Four Houston-area therapists the Houston Press interviewed each define holding therapy differently and employ different techniques. One encourages kids to release rage, another swaddles children, another has kids lie across her lap, and another hugs and holds children.

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