Death by Theory

The WPATH Files revelations of pseudoscience in transgender care is the just latest in a litany of psychological quackery. Attachment Disorder reminds us of how deadly such false beliefs can be

My previous column on the World Professional Association for Transgender Health (WPATH) Files (courtesy of Michael Shellenberger, Mia Hughes, and their colleagues in a 242-page document titled The WPATH Files: Pseudoscientific Surgical and Hormonal Experiments on Children, Adolescents, and Vulnerable Adults) revealed the extent to which psychologists, psychiatrists, and medical and health practitioners blindly accepted the belief that adolescents and children can make medical decisions about life-changing and irreversible treatments such as puberty blockers, Hormone Replacement Therapy (HRT), and even surgeries to remove healthy breasts (double mascetomies, or “top surgery”) and surgically alter genitalia (“bottom surgery”). Putting this movement into context, among the extraordinary popular delusions and the madness of crowds of the past half century, I included:

The Subliminal Messages scare, the Satanic Panic, the Recovered Memory mania, the Self-Esteem movement, the Multiple Personality craze, the Left-Brain/Right-Brain fad, the Mozart Effect mania, the Vaccine-Autism furor, the Super-predators fear, the Drug Abuse Resistance Education (DARE) program that increased teen drug use, the Scared Straight program that made adolescents more likely to offend, the Critical Incident Stress Debriefing (CISD) programmed that worsened anxiety and symptoms of post-traumatic stress disorder (PTSD), and many more that have plagued psychology and psychiatry.

I neglected to include Attachment Therapy, a tragic case in point of what I highlighted in my 2011 book The Believing Brain, in what I called death by theory. In April, 2000, a 10-year old girl named Candace Newmaker began treatment for a psychological phenomenon that was popular in the 1990s called Attachment Disorder, purported to describe what happens when an infant fails to properly attach to a caretaker (loosely based on John Bowlby’s Attachment Theory, which is legitimate). Candace’s adoptive mother of four years, Jeane Newmaker, was having trouble handling what she considered to be Candace’s disciplinary problems, and when Jeane sought help from a therapist affiliated with an organization called Association for Treatment and Training in the Attachment of Children, was told Candace was suffering from Attachment Disorder and needed Attachment Therapy, based on the idea that if a normal attachment is not formed during the critical first two years of a child’s life, then reattachment can be done later in the child’s life through a “rebirthing” process in which the child is squeezed and smothered in a simulacrum of the birthing process.

This is a little like arguing that if imprinting in a baby duckling does not happen in the early critical period, it can be done at a later time. Early studies in the 1950s by Niko Tinbergen and Konrad Lorenz demonstrated the capacity of many organisms to rapidly form lasting impressions in the brain. Lorenz, for example, documented a type of phase-dependent learning they called imprinting, whereby the youth of a species at a critical period in their development forms a fixed and lasting pattern of memory for whoever or whatever appears before them during that brief span of time. In the baby greylag geese that Lorenz studied, for example, the object of gaze in the critical period of 13-16 hours old is normally a mother, and thus she becomes imprinted in their brains. To test this hypothesis, the mischievous Lorenz made certain that it was he who was in the ducklings’ visual field at the critical moment, and thereafter “momma” Konrad led his flock around the grounds of his research station.

According to Attachment Therapists, the attachment of a child is a form of imprinting, and if they miss that on the first go around they can re-attach later. In order for this later attachment process to be successful, however, the child must be subjected to physical “confrontation” and “restraint” (as in the birthing process) in order to release supposedly repressed abandonment anger. This process of later “attachment” repeats for as long as is necessary—hours, days, even weeks—until the child is physically exhausted and emotionally reduced to an “infantile” state. Then the parents cradle, rock, and even bottle-feed the adolescent, thereby implementing a “re-attachment.” This would be like taking a full-grown duck and attempting to reduce it back to its duckling stage through physical and emotional constraints (whatever that would be for a duck), and then see if it will attach to its mother. That’s the theory anyway. In the case of Candace Newmaker, however, the practice resulted in something rather different.

Candace was taken to Evergreen, Colorado, where she was treated by Connell Watkins, a nationally prominent attachment therapist and former Clinical Director for the Attachment Center at Evergreen (ACE), along with her associate Julie Ponder, a licensed family counselor from California. The treatment was conducted in Watkins’ home and videotaped. According to trial transcripts (you knew this was coming, right?), Watkins and Ponder conducted over four days of “holding therapies,” where they grabbed or covered Candace’s face 138 times, shook or bounced her head 392 times, and shouted into her face 133 times. When this failed to break Candace and reduce her to infantile status, they put the tiny 68-pound Candace inside a flannel sheet and covered her with sofa pillows while several adults (with a combined weight of nearly 700 pounds) lay on top of her so that she could be “reborn” through the ersatz womb. Ponder told Candace that she was “a teeny little baby” in the womb, commanding her to “come out head first” and “push with your feet.” In response, Candace screamed, “I can’t breathe, I can’t do it! Somebody’s on top of me. I want to die now! Please! Air!”

According to Attachment Therapists, Candace’s reaction was a sign of her emotional resistance; she needed more confrontation and restraint to reach the rage necessary to “break through” the “birthing canal” and achieve emotional healing. ACE (subsequently operating as the Institute for Attachment and Child Development), for example, claims that, “confrontation is sometimes necessary to break through a child’s defenses and reach the hurting child within. Confrontation of faulty thinking patterns and destructive behavior patterns is essential if change is to occur.” This is yet another bogus form of dualism wherein the “adult self” has within it a “child self” trying to break out. There is no such thing as an “inner child.” This is pure, Grad A, prime cut psychobabble bullshit.

Putting theory into practice, Ponder admonished Candace, “You’re gonna die.” In response, Candace begged, “Please, please, I can’t breathe.” Ponder instructed the others involved in this unfolding tragedy, to “press more on top,” on the premise that AD children exaggerate their distress. Candace vomited, then cried “I gotta poop.” Her mother entreated, “I know it’s hard but I’m waiting for you.”

After 40 minutes of this torture Candace went silent. Ponder rebuked her, “Quitter, quitter!” Someone joked about performing a C-section, while Ponder patted a dog that meandered by. After 30 minutes of silence, Watkins sarcastically remarked, “Let’s look at this twerp and see what’s going on—is there a kid in there somewhere? There you are lying in your own vomit—aren’t you tired?”

Candace Newmaker was not tired; she was dead.

“This ten-year-old child died of cerebral edema and herniation caused by hypoxic-ischemic encephalopathy,” the autopsy report clinically stated. The proximate cause of Candace’s death was suffocation, and her therapists received the minimum sentence of 16 years for “reckless child abuse resulting in death.” The ultimate cause was pseudoscientific quackery masquerading as psychological science.

Jeane Elizabeth Newmaker, upon her arrest for criminally negligent child abuse. In a plea bargain, she pled guilty and was given a deferred sentence of four years. The case was the motivation behind "Candace's Law" in Colorado and North Carolina, which outlawed dangerous re-enactments of the birth experience.

In their penetrating analysis of the case, Attachment Therapy on Trial, Jean Mercer, Larry Sarner, and Linda Rosa write: “However bizarre or idiosyncratic these treatments appear—and however ineffective or harmful they may be to children—they emerge from a complex internal logic, based, unfortunately, on faulty premises.”

These therapists killed Candace not because they were evil, but because they were in the grip of a pseudoscientific belief grounded in superstition and magical thinking. Let this—and the many other quack psychological theories—be a lesson for us all.

Michael Shermer is the Publisher of Skeptic magazine, Executive Director of the Skeptics Society, and the host of The Michael Shermer Show. His many books include Why People Believe Weird Things, The Science of Good and Evil, The Believing Brain, The Moral Arc, and Heavens on Earth. His latest book is Conspiracy: Why the Rational Believe the Irrational. His next book is: Truth: What it is, How to Find it, Why it Matters, to be published in 2025.