THERAPY: Seeking Cures, but Finding Anguish

Los Angeles Times

 

THERAPY: Seeking Cures, but Finding Anguish
By Carol Mithers

Last week, Connell Watkins, an unlicensed Evergreen, Colo., “therapist,” and her assistant Julie Ponder were convicted of reckless child abuse in the death of 10-year-old Candace Newmaker, who died of asphyxiation during a “rebirthing” session. Now that the two women face up to 48 years in prison, now that the nation has expressed its outrage at the radical therapy that led to the tragedy and Colorado Gov. Bill Owens has signed “Candace’s Law” banning rebirthing in his state, the temptation is to sit back, breathing a sigh of relief that justice has been done and a horror like this won’t happen again.

But it will.

As an example of therapy run amok, this incident involving a little girl wrapped tightly in a blanket, choking on her own vomit and vainly pleading for her life, was particularly grotesque, the stuff of nightmares. But it was far from unique.

For at least 30 years, stories of patients pursuing experimental treatments with similarly tragic outcomes to that of Candace and her mother, Jeane Newmaker, have surfaced at regular intervals. They all have at their center deeply troubled souls hungry not for help but cures, and programs that promised to provide them. In the 1970s, it was Synanon and the Center for Feeling Therapy, a Los Angeles program run by mostly unlicensed therapists who beat, abused, controlled and financially exploited 350 long-term patients, leaving their lives a shambles. A similar group, the Sullivanians, flourished in New York City.

The 1980s brought therapies for now widely discredited diagnoses of “recovered memory” and “multiple personality” disorders, which some therapists proclaimed the true cause of problems that ranged from depression to sexual dysfunction to obesity. In one typical case, a Des Moines woman who sought help for depression had her life ruined by a Chicago psychiatrist who encouraged her to believe she had 300 personalities, had participated in a satanic cult that plotted to kill her children, and that her father had ground human remains into hamburger for meatloaf. (Several hospitalizations and two suicide attempts later, she accepted a $10.6-million malpractice settlement.)

The ’90s brought treatment for “reactive attachment disorder,” a syndrome in which a deprived or abused child–like Candace–has difficulty forming intimate bonds. (The disorder remains controversial, because there’s no consensus on the uncertainty of the diagnosis.) The kind of rebirthing process Candace went through was just one of the experimental therapies devised to cure it; another was “rage reduction therapy,” a rough restraint of children intended to help them understand their emotional estrangement. It, too, led to excesses: A Utah 3-year-old died after her father attempted to apply the techniques, and a Tarrant County, Texas, practitioner was ordered to pay $8.4 million to a 15-year-old girl his treatment left covered with bruises. As early as 1998, Colorado medical examiners had accused psychiatrist Foster Cline, who pioneered the therapy, of grossly negligent practices.

Why do otherwise intelligent and well-meaning people embrace treatments that, in retrospect, seem so clearly mad? Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, points to desperation, tremendous guilt on the part of parents “when there’s something wrong with their child that they can’t fix.” But there’s another factor at work, too: widespread, unreasonable assumptions about what therapy should be and can do.

Nearly 50 years ago, humanist psychologists like Erik Erikson, Rollo May, Abraham Maslow and Carl Rogers challenged traditional Freudian claims that to be human was to be filled with inner conflict. Nor did they accept that the best analysis could do was help a patient understand and cope. Instead, they said, the natural state of humans is one of wholeness and joy, and treatment should aim to help everyone realize his or her full “potential.”

By the 1960s, when economic prosperity made room for more self- indulgent pursuits like examining one’s inner self, therapy, once drawn-out, exclusive and expensive, reached the masses in the form of encounter groups. The groups were frequently harsh and combative, and pushed the idea that change came fast.

By 1970, Arthur Janov, founder of “primal therapy” (made wildly popular by Beatle John Lennon), went one step further, flatly declaring that all neurosis came from infant trauma and that his therapy, which specialized in overnight transformation, could cure it.

Most ’60s and ’70s therapy programs didn’t last. But they left deep and permanent changes in the way we view our lives (we are entitled to be fulfilled and happy), our problems (they have specific, simple, diagnosable roots) and, above all, the practice and role of therapy. We now turn to therapists, whether as self- help authors, commentators or actual practitioners, for advice that in earlier times would have come from clergy, parents and community. We expect therapy to be dramatically transformative, with frequent, climactic “breakthroughs” (an expectation encouraged by the culture of advertising, which tells us that anything from makeup to a new car can turn us into a new person). We accept that it may be harsh– an acceptance, notes Caplan, that taps into fundamentalist American beliefs that suffering is redemptive. Above all, we expect it to provide a “cure.”

Although ethical, well-trained therapists refuse to go along with these beliefs, those who are less moral or more driven by their own convictions are happy to indulge. And the media, particularly talk shows, with their insatiable appetite for guests to fill airtime, help by parading every new guru who comes along, often without bothering to check out his or her credentials or the theory’s validity.

But while the pain that drives people to seek treatment is often deep and legitimate, the sad reality of life is that many problems have a complicated stew of causes and no definitive cures. A marriage can go pale and sour because of the family histories of each spouse, their gender beliefs, their feelings about themselves, their pleasure or disappointment in their individual lives. An intensive therapeutic weekend aimed at “teaching intimacy” can’t necessarily bring it back to life. Making peace with one’s inner child won’t guarantee weight loss in a sedentary, fast-food society. The despair of a man or woman stuck with a low-wage job and bad child-care options can’t be counseled away. And poor Candace, whose childhood was marked by poverty, constant moves and multigenerational family dysfunction, whose birth mother twice lost custody to social workers and who Candace said once dropped her out a second-story window, may not ever have become the well-adjusted, affectionate girl that Jeane Newmaker so craved.

Sometimes, good therapy can help us understand, face and tame our demons. Sometimes, it can greatly improve our lives. But neither it nor anything else can prevent life from being hard and unfair. It can’t guarantee happiness. It can’t guarantee cure. These are the hard lessons of adulthood, and there’s no sign that we as a culture have learned them. The next therapeutic tragedy is out there, waiting.

I cared for my dying parents. How is caring for my dying dog just as bad?

 

 

I thought it would be easier to care for an old dog than an old human — or maybe harder. But almost a decade after my husband and I cared for and lost three parents and an aunt, tragedy has repeated itself as farce in the form of our aging dog.

Casey, the handsome, thickly furred red dog we brought home as a puppy, is 15 — in canine years, what gerontologists would call “the old-old.” Suddenly, we’re back in the place we named Elder World, as managers of his decline.

The bulging disc in Casey’s back has outpaced the medication we’ve given him since he was 12, and he struggles to sit and lie down. His tail won’t wag; his gait stutters. His hearing is shot, and cataracts have left him nearly blind. The past six months brought “canine cognitive dysfunction,” a.k.a. doggy dementia. He gets stuck behind furniture, paces at night, has forgotten there’s a backyard and will only pee in front.

 
 

I never imagined that senior dog care would prove a weird resurrection of something I already knew. Instead of the shower chair, water bowls set atop risers, to make drinking easy; instead of the walker, a sling. A trail of absorbent puppy pads leading to the front door to catch the inevitable accidents takes the place of adult diapers. The mental changes hold echoes, too. Casey, part chow, ornery and snappish, has forgotten that he hates the dog down the street and strangers who presume to pat his head.

The newly agreeable Casey evokes my once sharply critical aunt transformed into a matron who marveled, “Look at the size of it!” in reference to a ShopRite. When Casey starts his evening shuffle, to the door, outside, back in again, his endless search for something that eludes him, I hear my father-in-law’s voice: “What day is it? Where’s my checkbook?”

As we did then, we ask ourselves the same questions: “What does he want?” Who knows? “Does he suffer?” We don’t think so. “Is he happy?” We don’t think that, either. “Does he want to die?” Our old people held fiercely to life, and to their habits of living — endless cups of weak coffee, coupon-cutting, a daily vanilla ice cream cone. In August, Casey fought his way back from a facial abscess we thought would kill him. Every single day, around sunset, his old walk time, he staggers to his feet and demands to go out.

 
 

We move through the weeks, trapped at home because we’re afraid to leave Casey alone; sleep-deprived from listening for the sound of him trying to get up in the night. We are driven to rage by the click-clicking of his nails as he turns in endless circles. In Elder World, we told each other, “If they were dogs, we could be merciful and end this.” Now it is a dog, and we can’t pull the plug. Which makes me think of the old people again, and how insistently the will to hang on demands respect. And another thing they taught me: that although caregiving feels endless, it always ends, though the empty space after doesn’t.

When Casey disappeared a few nights ago, I searched the house, then the yards with a flashlight, increasingly panicked, calling his name, though I knew he couldn’t hear me. Finally, after 20 minutes, I found him hidden behind a plant, frozen in place at the very edge of our back deck. He sensed the drop before him but couldn’t figure out what to do next.

“This can’t go on,” we tell each other; it goes on. When Casey doesn’t make it outside, we wipe up the mess. We help him to his feet in the morning, feed him by hand. We walk him, coax him to the end of the block — 30 minutes for what used to take five. We watch him sleep, looking for movement to signal he’s still alive. Think “how much longer will he last?” — and “It would be better if it wasn’t too long.”

Then we carefully turn away from those thoughts and get out his dinner, because the old man will probably be hungry when he wakes.

 

 

 

 

 

 

 

Opinion: U.S. cities are overrun with feral cats, and magical thinking isn’t the solution

Los Angeles Times

 

The alleys, parks and vacant lots of this country are alive with so many stray and feral cats that we don’t even know the precise number. Thirty-two million, says one estimate; triple that, another. The felines are the offspring of pets we didn’t bother to “fix,” the animals we adopted then dumped or left behind.

In the past, we called them pests and tried — brutally, unsuccessfully — to wipe them out. Today, the accepted strategy is to catch and sterilize them, then send them back outside, where they were. “Trap-neuter-release,” as the approach is called, has been hailed by the no-kill movement, which opposes routine euthanasia by animal shelters. And it has been adopted by animal control departments in more than 400 cities and counties. (Los Angeles has its own plan in the works.)

In theory, the tactic seems like an easy solution that lets us all sleep well: We don’t want these animals, but we also don’t want their blood on our hands. In reality, and as emphasized by a recent flare-up over the practices of Orange County’s public animal shelter system, it’s not that simple.

Originally, the promise of trap-neuter-release was to reduce stray and feral populations by curbing their prolific breeding — cats are fertile by six months of age and can give birth multiple times a year. But for cat populations to fall, more than 50% of the females in a given “colony,” or living group, need to be sterilized. That’s not easy, given cats’ ability to hide — and the fact that known colonies become dumping grounds for more unwanted, often unfixed, pets. As a result, herd sterilization hasn’t ever been achieved on a mass scale.

The approach has skeptics for other reasons, too. Many scientists, birders and wildlife managers oppose trap-neuter-release programs in general, noting that free-ranging cats are destructive predators, annually killing billions of birds and mammals, while also spreading diseases like toxoplasmosis.

The programs have been successful in one way, however. They have enabled shelters to sharply reduce the number of feral cats they impound, then euthanize, at a time when public shelters face immense pressure to reach a no-kill ideal, usually defined as not euthanizing any healthy or adoptable animals. An added bonus is reduced taxpayer cost: sterilizing and releasing cats costs less than housing, feeding and then killing them.

How well the cats themselves fare is less clear than you might imagine. Contrary to popular belief, cats are not self-sustaining. That means colonies under the watchful eye of caretakers willing to devote considerable time and money to their welfare may thrive. Those without human guardians may suffer from malnutrition, infection and parasites. Some of the cats get hit by cars or eaten by coyotes. Even the authors of a paper lauding trap-neuter-release programs acknowledged that “the welfare outcome for cats returned to location of origin were not tracked … [and] little research on this topic could be found.”

Some shelters run neuter-and-return programs in which individual strays that are brought in by concerned residents aren’t put up for adoption, but rather are neutered and returned to where they were initially found. In October, a lawyer representing a group of animal rescues and individuals sent Orange County Animal Care, the county’s government-run shelter network, a demand that it stop its practice of “abandoning” these cats.

According to signatory Sharon Logan, some of the more than 1,000 cats Orange County released between September 2018 and June 2019 weren’t feral, but roaming, lost or abandoned pets, or kittens still young enough to be socialized and made adoptable. Some were sick, she said, and in many cases, communities where the cats were returned weren’t told the felines were coming. There was often “no obvious presence of a feeder or caretaker.” As a result, she said, the animals suffered. Carol Barnes, another signatory to the letter, shared photos of one cat she said was released by Orange County and later found malnourished, with broken ribs, an upper respiratory infection and an injured eye crawling with maggots.

An Orange County Animal Care representative declined to comment, but a research and policy analyst for Best Friends Animal Society, which runs similar programs, has called some of the critics’ claims “misinformation and scaremongering.”

The answer? No one who’s ever loved a house cat or felt moved to feed a hungry feral (that includes me) wants to return to mass killing. And well-run trap-neuter-release programs may be an important part of dealing with our national cat problem. But increased and organized efforts to educate humans about their responsibilities to their animals are also crucial. So is more rigorous enforcement of existing spay/neuter laws and far more access to affordable services.

Maybe most of all, we need to abandon what one cat lover described to me as “magical thinking” — pretending that the only thing that matters is keeping stray cats alive; believing that any one effort holds a simple, painless solution. These fictions serve mostly to comfort those responsible for our cat problem in the first place. That is, us.