In His Own Words

— Words Coming Back to Haunt —

• There has never been a child who has died as a result of holding therapy, despite what some people want to say. There’s never been a child seriously injured. There have been some therapists and parents who’ve had their lips busted. I still have a little scar from a bite the kid gave me. But in nine years, I’ve never had a child injured. Connell Watkins hasn’t. The Attachment Center [at Evergreen] hasn’t. It just doesn’t happen. — “Children with Reactive Attachment Disorder: An Introduction to Diagnosis, Parenting, & Treatment,” Annual Conference, Association for Treatment and Training of Attachment in Children (ATTACh) Conference, Alexandria, VA, 30 Sep-2 Oct 1999

• And then I just hold the child. And they use all their strategies: “I can’t breathe! Ah, I can’t breathe! You’re killing me!” [audience laughter] You know. And I don’t say a word. — ATTACh (1999)

— Most Telling —

• They have an endurance quality to them that says, “I can wait you out.” Yeah. And I had one kid … Well, it was 4:30 in the morning when we finished, because this was a 5-year-old kid who was, “Yeah, I can wait anybody out.” — ATTACh (1999)

• There are some of these children that you have to go to these more intrusive kinds of holding processes in order for them to confront the reality of their wound. It’s like lancing [an infected wound] so it can heal. — ATTACh (1999)

• [W]e will use some other fairly confrontive holding processes as the child gets more and more entrenched. … So if the child is insistent on lying to me, as a therapist, I’m right here, and I can get right in their face … and say, “Do I want to hear garbage coming out of your mouth or do I want to hear the truth?!” And they will almost always say, “You want to hear the truth.” I’ll say, “That’s right. Yeah. Kick. And when you’re ready to tell me the truth, then, yeah, say ‘ready.’” Now we got reciprocity going again. We’ve got compliance going. We’ve got cause and effect thinking going. All tied in with these very simple processes. — ATTACh (1999)

• [The child] hasn’t made improvement until she does it our way. — ATTACh (1999)

• Examination by defense attorney:
  Q: You testified … that the holding techniques that you use are in fact the same that you’ve seen Ms. Watkins use.
  A: Yes.
  Q: Have you ever considered that to be child abuse?
  A: No.
  Q: …to be causing trauma to a child?
  A: No.
  Q: How can you say that you don’t consider that to be traumatizing, when we have seen these children scream, they fight, they lash out as a result of the therapy? A: The screaming, the fighting, and the lashing out is actually sort of an externalizing of what’s going on inside of them all the time, the conflict and the rage. … [A]s I mentioned [before], the time where I went to the doctor and he cut my elbow open in order to drain out this major infection that was in there, what you’re seeing at the hands of a trained therapist is the release of that emotional infection, if you will. — Expert Testimony, People v. Watkins and Ponder (16 Apr 2001), Record on Appeal, Colorado 01CA1313, 19:57-58

• Cross-examination by prosecutor:
  Q: [A]bout the goals or purposes behind holding therapy … to express their rage?
  A: …[I]t is not designed to try to create rage in a child. The child already has the rage … And if you are working effectively with the child, the rage comes up. — Expert Testimony, People v. Watkins and Ponder (13 Apr 2001), Record on Appeal, Colorado 01CA1313, 18:250

• So the very first element of treatment intervention is compliance. … Because compliance is reciprocity. — ATTACh (1999)

• In my initial consultations … I’m not necessarily going to spend a lot of time with that child, because I know that I’m going to get what I need to know from the parents. And then, in my assessment process, I’m going to look at the child, but I’m really looking at the child just to confirm what I have heard from those parents. — ATTACh (1999)

• [W]hen the child is starting to say to me, you know, “I’m dying! And it really hurts! It really hurts!” And then suddenly we’re going to shift it, because then it’s like, “Yeah, I know. She really did hurt you, didn’t you. I want you to scream, you know, because that hurt a lot. And that, that little girl. That little boy really wanted to scream, and they couldn’t scream, and so you scream now.” And then I’m going to get them screaming. — ATTACh (1999)

• I take the child out of the mom’s lap, and say, “I see that you don’t want your mom to hold you, so I will do it for you. Thank you for letting me know that you wanted me to do that.” And then I put the child in my lap. … I snuggle them in very close, and I put … my cheek right against their cheek so that there is this very, very close physical contact. And then we just sit there. And I don’t say anything, because it’s not my life that’s being worked on. … I want the child thinking here … to start having this internal struggle that they have. … I say this to the child: “Yeah. You think this is a fight between you and me. But you know what? It’s a fight between you and you. This is a battle that’s going on inside of you, and I’m just playing the part of whatever’s inside of you. Because it’s got hold of you, just like I do.” — ATTACh (1999)

• Examination by defense attorney:
  Q: [I]n a sense, you’re forcing them to give up some control…
  A: Yes.
  Q: It’s not something that they volunteer for, the holding therapy, correct?
  A: Right.
  Q: Isn’t there, then, the possibility that the child is going to go into a rage by doing that?
  A: Yes, there is … There are very, very powerful emotions in there. … [T]hey’re like an infection in the child … that has to be drained out.
  — Expert Testimony, People v. Watkins and Ponder (13 Apr 2001), Record on Appeal, Colorado 01CA1313, 18:222

• Examination by defense attorney:
  Q: But [Connell Watkins is] confrontational as well; isn’t she?
  A: Yes.
  Q: And provocative?
  A: Yes.
  Q: In children’s faces?
  A: Yes.
  Q: Holding their faces even?
  A: Yes.
  Q: Raising her voice level?
  A: Yes.
  Q: Doesn’t that trouble you?
  A: No.
  Q: Why?
  A: Not with these children. If it were an average child who was emotionally disturbed, yes, because it would be very inappropriate. … [Y]ou’re talking about having to do emotional surgery. — Expert Testimony, People v. Watkins and Ponder (13 Apr 2001), Record on Appeal, Colorado 01CA1313, 18:237-238

• Examination by defense attorney:
  Q: [A]bout the possibility of retraumatizing children through the use of holding therapy … you kept saying with some children that’s possible. And my question is: What children were you referring to?
  A: Those are children who do not have this severe form of attachment disorder. A child who comes in … who has been through some trauma, who’s suffering from depression, we would never use this kind of process with them. — Expert Testimony, People v. Watkins and Ponder (16 Apr 2001), Record on Appeal, Colorado 01CA1313, 19:56-57

— State Funding of Attachment Therapy —

• Examination by defense attorney:
  Q: [Y]ou’re aware that Social services funds in North Carolina — funds Ms. Watkins’ two-week therapy?
  A: I know that it has been funded in the past, yes. — Expert Testimony, People v. Watkins and Ponder (16 Apr 2001), Record on Appeal, Colorado 01CA1313, 19:58

— Holding Therapy —

• We have the therapist do holding. — ATTACh (1999)

• We do a lot of Martha Welch’s Holding Time. — ATTACh (1999)

• Holding Therapy is incredibly effective. — ATTACh (1999)

• [T]hese processes have proven to be very, very effective. And children get well. — Expert Testimony, People v. Watkins and Ponder (13 Apr 2001), Record on Appeal, Colorado 01CA1313, 18:238

• Examination by defense attorney:
  Q: If the child is resisting the … holding therapy, should you stop?
  A: No. … [B]ecause one of the core pieces of this disorder is control, that the child has an obsessive need for control … a truly pathological need for control. — Expert Testimony, People v. Watkins and Ponder (13 Apr 2001), Record on Appeal, Colorado 01CA1313, 18:228-229

• Cross-examination by defense attorney:
  Q: You talked about the fact that you treat these children [with holding therapy] … for sometimes hours at a time. During that time, do you hear from them that they have to go to the bathroom? A: Yes.
  Q: …throw up? A: Yes.
  Q: …poop?
  A: Yes.
  Q: …that they can’t breathe?
  A: Yes.
  Q: Do you hear from then that you’re hurting them or torturing them?
  A: Yes.
  Q: Is that a rather standard reaction to your treatment?
  A: Yes.
  Q: And do in fact these children throw up?
  A: Occasionally.
  Q: Do they in fact go to the bathroom if you don’t let them go to the bathroom? A: On occasion, but it’s very rare. — Expert Testimony, People v. Watkins and Ponder (13 Apr 2001), Record on Appeal, Colorado 01CA1313, 19:50-51

• [Beth Thomas, adopted daughter of Nancy Thomas] acknowledges how when she was in holding therapy, she would tell them to, “Let me go! I don’t like this.” But if they had let her go, she would have felt abandoned. Because she would then would have been in control. — ATTACh (1999)

• His adoptive mother is supporting him. The therapist is supporting him. They’re giving him words to say to [someone role-playing his] birth mother. — ATTACh (1999)

— Holding Therapy for Sexual Abuse —

• [Reading question from audience:] If a child has been a victim of sexual abuse, our mental health center believes that holding therapy retraumatizes the child. Your comments?
  [answering] No, it does not. And I can say after nine years of working with these is what it does is it normalizes touch for these children. — ATTACh (1999)

• I’ve never seen a child retraumatized by appropriate therapy — attachment and bonding therapy. Ever. — ATTACh (1999)

— Kicking —

• [A]s a part of the holding process … we do a lot of kicking. The child is lying across my lap on the sofa, so their legs are out here, and they can kick the cushions on the sofa. And they kick, and they stop a certain way. Now again, I don’t care about kicking or stopping. But it helps them practice following my instructions in the therapy office. And if they don’t do it, then we’ll keep practicing the kicking. — ATTACh (1999)

• I have them kick while they tell me what’s going on. And again, this isn’t punishment for the child. Now the kid feels like they’re being punished. — ATTACh (1999)

— Holding Therapy for Adults —

• [W]e encourage people then to get involved in things like the PAIRS Program which is an attachment and bonding process for couples that involves holding. — ATTACh (1999)

— Confidentiality —

• [T]here is no confidentiality related to the child and the parents. So when the child is in my office, the parents are watching on the TV monitor out in the other room. And when a child lies to me, they can slip a note under my door. They can come in. They can knock on the door, and say, “Oh, here’s what really happened.” — ATTACh (1999)

— Compliance —

• If you cannot get basic compliance out of an attachment disordered child, you will make no progress in any form of therapy. — ATTACh (1999)

• [Reading question from audience:] Are you saying that you do not compromise at all with these kids?
  [answering] Yes, I am. — ATTACh (1999)

• So the way that I know that my child is ready to handle a choice is that when I give them two choices, they pick one of them. … I will say, “Would you like to have a orange juice or would you like Sprite?” And she might say, “Well, I would like milk.” Well, that wasn’t one of the choices. So I know she’s not ready yet for choices. — ATTACh (1999)

— The So-Called “Bonding Cycle” —

• So, we get this expression of a need, and if things are going normally, we will have a response to that need. And in that response, there is a relief of all of this tension. … And in that “ahhhhh” process, the child experiences a sense of gratification. … And so we’re laying the foundation of conscience. — ATTACh (1999)

• Now, but let’s look at what happens if that cycle doesn’t quite work right. … [T]heir brain says, “I’m going to die.” So you also have the element of fear in there. And the element of anger. — ATTACh (1999)

• That attachment and bonding work involves holding the child. … In a sense, we’re going to recreate the bonding cycle. Because what we want to do is reestablish that activation of those feelings, so that the child now is experiencing a need. — ATTACh (1999)

— Reparenting —

• [N]ow you have to go back, in a sense, and redo that developmental stage. — ATTACh (1999)

• We put the boy right in his adoptive mother’s lap. She begins to nurture him, cuddle him, rock him, give him something sweet, give him a bottle with chocolate milk or a soft drink, depending on what we’re going on. And this includes kids who are 12, 13, 14 years old at times, that we will do this reparenting piece with them. … We’re taking them back through the bonding cycle. And now when the relief and release comes, we’re connecting them with this new mom. — ATTACh (1999)

— So-Called “Attachment Disorder” —

• Poor eye contact.
  You see this stiff lip.
  Pushes away when adult initiates nurturing or hug.
  Incessant chatter and nonsense questions.…
  Is cruel to animals.
  Teases or is cruel to other children.
  These temper tantrums.
  Destructive to property.
  Aggressive towards others.
  This crazy lying we were talking about.
  Splitting and … — ATTACh (1999)

• Destructive of self or others.…
  No impulse control.
  Learning lags.…
  [L]ack of cause-and-effect thinking.…
  Lack of conscience.…
  They get incredibly sneaky.… — ATTACh (1999)

• [Y]ou cannot tell when an attachment disordered child is lying to you. They are too good. — ATTACh (1999)

• Now what we run into is that we have this group of kids who become very aggressive. They steal. They lie. They manipulate. They have a tremendous need to control. — ATTACh (1999)

• They’re extremely disrespectful, especially to the mom. — ATTACh (1999)

• They don’t need as much sleep. — ATTACh (1999)

• They can smear and throw feces. — ATTACh (1999)

• You’re going to begin to see anti-social personality disorder. If there is serious mental illness present, you’re going to see psychopathic personality disorder. You’re going to see borderline personality disorder. You’re going to see narcissistic personality disorders. … Out of the trauma of their early life, you’re going to see all of these very serious and very resistant to treatment personality disorders developing over time. So, this, this is the process out of which attachment disordered children now come. — ATTACh (1999)

— Scare Tactics —

• [T]he development of their life of fantasy, by five years old even, is equivalent to what you and I might see in an adult, very entrenched sex offender who lives in an unbelievable world of fantasy. These kids, at a very early age, are already there. — ATTACh (1999)

• [D]o not be fooled because it is a young child who looks so charming and so cute and so dear and sweet. — ATTACh (1999)

• We now have this child who has this kind of working model based on control, manipulation, fantasy, power, dominance, revenge. — ATTACh (1999)

• Threatens to kill other people. Especially the mother. — ATTACh (1999)

• [T]hese kids are incredible con artists. — ATTACh (1999)

• Preoccupation with weapons, guns, military stuff, objects of power. — ATTACh (1999)

• Well, these kids, in this process, develop a sense that THEY are the adults. THEY are the god-individual in the relationship. And that other human beings are their subjects. Other human beings are there to serve them and meet their needs. — ATTACh (1999)

• They have set fires or threatened to kill animals. Some of them have killed people. They accidentally hurt people and accidentally, they say it’s accidental. But if you watch, it becomes a pattern. — ATTACh (1999)

• Preoccupation with blood. You’ll see it in drawings, you’ll see their fascination with movies, in road kill. … Some of these kids want to play with it. — ATTACh (1999)

• [T]hey just suck people dry. Because it doesn’t make any difference how much attention you give them, how much love you give them, it can never touch that place where they feel so empty. — ATTACh (1999)

— Eye Contact —

• Lack of eye contact on parental terms. Or on adult terms. These kids can make wonderful eye contact if they’re lying to you or want something. — ATTACh (1999)

— Unvalidated Diagnostic Tools —

• [S]till very useful just for screening purposes are what has been known as the Attachment Disorder Checklist, or the Checklist of Attachment Disorder Symptoms. This one from Connell Watkins and Associates. — ATTACh (1999)

• Liz Randolph … came up with the Randolph Attachment Disorder Questionnaire [RADQ] … anything that’s a 65 or above, or in that vicinity, you’re looking at a child who almost certainly has an attachment disorder. — ATTACh (1999)

— Other Unvalidated Therapies —

• We use a lot of EMDR — Eye Movement Desensitization and Reprocessing. … It is one of those tools, that as far as I’m concerned, it’s going to become unethical for a therapist NOT to be able to do it. It is that effective. — ATTACh (1999)

— On “Nonsense” Questions —

• [Attachment Disordered children pose a] lot of nonsense questions, like … ”Why is that tree growing in the ground?” And so I answer, “Because I got some dirt under my thumbnail.” And it works quite well. — ATTACh (1999)

— Dismissing Standard Diagnosis and Therapy —

• [T]raditionally good mental health interventions do not work. Not until you have dealt with the attachment issue. … Attachment is not just an issue. It is THE issue. — ATTACh (1999)

• [O]ne of the most frequent misdiagnosis of attachment disordered children is that they are ADHD. And they’re not. They’re hypervigilant. — ATTACh (1999)

• It will not harm the child if you misread it at first. … Let’s assume it’s an attachment disorder, and let’s start working from that perspective. You will not harm the child. — ATTACh (1999)

• [Reading question from audience:] How do you diagnose when there is no history available for the first two and a half years?
  [answering] …We look at the behavior pattern. We look at the poor eye contact. We look at how much of it is directed towards the mother. In the assessment process, I … have the mother put the child down on her lap. Lay them across in a cradling kind of process and watch the child’s response. If the child snuggles in. If the child is responsive to the mom, I say, “Gee, we don’t have an attachment disorder here.” … But when the mom starts to lay the child back in her arms, the child immediately starts trying to sit back up, will not make eye contact, will not put their arm around the mom. Or they’ll sit there really stiff. I’m going to assume that we’re working with an attachment disorder. — ATTACh (1999)

— “Birth Trauma” —

• There was birth trauma and child was literally not available psychologically and emotionally during the first couple of days. — ATTACh (1999)

— The “ACE Litany” —

• [W]hat has become known as the “ACE Litany,” from the Attachment Center at Evergreen … [T]he criteria are the child will be respectful, responsible, fun to be around. They will do things fast and snappy, right the first time, and they’ll do it mom and dad’s way. — ATTACh (1999)

— Parenting —

• When a parent comes in to me and says, “…I am feeling like I must be crazy.” My first questions is, “Do you have an attachment disordered child?” — ATTACh (1999)

• [Y]ou cannot use all the wonderfully good parenting techniques that work with normal children — that work with normal, neurotic children. — ATTACh (1999)

• [The girl] needed more experience sorting wood into different sizes. And so she got it. Now, I luckily just had two dumptruck-loads of wood brought. — ATTACh (1999)

• [T]he mom would say, “I’d like for you to go get your coat.” And the kid would say, “Okay” [cheerfully]. Now knowing that part of her work was to say, “Yes, mom.” And when she said, “Okay,” it meant, “Screw you, mom.” And that was the message that, that she gave. So what she then would do, which she would what we call, “Yes Mom Jumping Jacks.” And on the hands going up, clapping one, down, “Yes, mom. Two. Yes, mom. Three. Yes, mom.” … She just had to do five of them. I can’t remember how high she got. But it was up there… — ATTACh (1999)

— Parents as “Co-Therapists” —

• And if you cannot incorporate some form of holding — parent holding, you know, Martha Welch’s holding process, holding time, some of those — you are not going to see these kids respond to treatment. — ATTACh (1999)

• In treating attachment disordered children, the parents. … They’re co-therapists, with you as the therapist. They have to be a part, an active part of each session. … [I]f you do not incorporate the parents, you’re going to be manipulated by the child. — ATTACh (1999)

— On Tantrums —

• [I]f the child is throwing a temper tantrum, you can throw a temper tantrum. — ATTACh (1999)

• [O]ne mom would just squat down beside him and say, “Wow, that’s really good! Could you scream a little bit louder? Yeah, man, that’s great! Yeah.” — ATTACh (1999)

— “Love and Logic” —

• And then as the child gets better, you can move into the parenting with “Love and Logic”… — ATTACh (1999)

— On Other Attachment Therapists —

• I love Rick Delaney’s metaphor: that an Attachment Disordered child is like — introducing a communicable virus into your home. — ATTACh (1999)

• I first started nine years ago … I ran across the book High Risk: Children Without a Conscience. And as I read it, it described the kid I was working with. Through a series of phone calls, I linked up with Paula Pickle, who’s now the Executive Director of the Attachment Center at Evergreen who came to my office. We worked with this child. — ATTACh (1999)

• …Child of Rage … this [documentary] does such an incredibly good job of giving you a sense of what these children look like. This is an interview being done by Ken Magid many years ago with a child named Beth. … Nancy Thomas is Beth’s adopted mother and was her treatment mother… — ATTACh (1999)

• I want to give you some more feel for what it’s like if you’re a parent living with these children. … This comes off of a “20/20” program called “Saving Dylan” [ACT note: filmed at the Attachment Center at Evergreen]. — ATTACh (1999)

• Greg Keck. … [H]e is just excellent. He is one of the best people in dealing with adolescents that you’ll find. And I would encourage you to go to him. — ATTACh (1999)

• And so you do what Connell Watkins talked about — putting the child in a steel box with a velvet lining. — ATTACh (1999)

• And this is off of … Neil Feinberg’s training tape. … It’s a two-tape set on Bonding and Attachment Therapy training tapes that are well worth investing in. — ATTACh (1999)

• [G]et Nancy Thomas’ video called Rebuilding the Broken Bond. And she has those, as well as Captive in the Classroom for sale out here. Because she goes into a lot of the parenting interventions and parenting techniques. Her book When Love is Not Enough … talks about the parenting kind of structure that you have to have. — ATTACh (1999)

• [S]pecialized parenting techniques … Deborah Hage — her book Therapeutic Parenting in combination with Nancy’s book When Love is Not Enough — are just two really great companions for parents. — ATTACh (1999)