abusive therapy

Not being believed

Content note: This is a post about ABA, and not being believed about the harm ABA does.

Anonymous said to :

People don’t believe me when I say I was a victim to ABA abuse, not even my parents.

I was misgendered routinely, I could not drink water even though this was harmless and was often asked to write my name even though this was effectively pointless.

How should I convince people I was really abused?

Am I just whining and should I “get over it” because that’s not “real abuse” and I’m not autistic?

realsocialskills said:

It’s not your fault that therapists hurt you. It’s not your fault that people don’t believe you. What people did to you matters, even if no one believes you.

ABA is degrading on a level that it can be very hard to recover from or even describe. The basic methodology of ABA is finding out what you care about most and using it to get compliance with arbitrary demands.

I’ve written some here and here and here about the kind of damage that does, and that’s only scratching the surface.

Increasingly, one of the things behavior therapists demand is that you pretend that they’re not controlling you. They often go so far as to demand that you act like you like what’s happening and believe that it’s both necessary and enjoyable. And they do that even as they make you do obviously pointless things (like writing your name over and over), and even as they do obviously awful things to you (like denying you water and misgendering you).

That kind of thing can mess with your mind really badly, especially when you’re surrounded by people who don’t believe you.

It’s not your fault that people don’t believe you. They can refuse to acknowledge what people did to you; you can’t make it go away. It matters even if no one around you cares.

You will probably always have to deal with people who don’t believe you. Most people are reluctant to believe that therapists ever hurt people in ways that matter, and ABA has a particularly effective publicity machine. Some people will say that you’re whining, that you’re lying, and that the things you’ve described don’t happen. They’re wrong. It matters that people hurt you in the name of helping you. It’s horrible that people who you should be able to trust don’t believe you.

Some of them may eventually come to understand. Sometimes people come around, in the long term. But you don’t have to wait for that in order to be ok, you don’t have to explain it to them if you don’t want to, and what happened to you matters whether or not people believe you.

Also… You are not alone. What happened to you shouldn’t happen to anyone. There is a community of people who know that it’s wrong to treat people that way. Making connections with people who believe you might help a lot.

It’s much easier to hold on to your perspective if you’re not doing it alone. This is hard. It’s also possible. You’re ok.

tl;dr Abuse matters even if no one believes you. That said, making connections with people who believe you can help a lot. You are not alone, even if really important people in your life don’t believe you.

ABA therapy is not like typical parenting

withasmoothroundstone:

realsocialskills:

Content note: This post is about the difference between intense behavior therapy and more typical forms of rewards and punishments used with typically developing children. It contains graphic examples of behavior programs, and is highly likely to be triggering to ABA survivors.

Anonymous said to realsocialskills:

I just read your thing about people with disabilities and their interests. Don’t people do the same thing to typical children? Restrict access to things enjoyed until act ABC is completed? For example, growing up, I was only allowed to watch tv for 1 hour a day IF I finished all of my homework and schoolwork related things first.

realsocialskills said:

It’s not the same (although it has similar elements and I’m not a huge fan of the extent to which behavior modification techniques are used with typically developing children either.)

Here’s the difference: Most children actually should do their homework, and most children have interests other than television. Typically developing children are allowed to be interested in things, and supported in pursuing interests without them becoming behavior modification tools.

(Another difference: intense behavior modification is used on adults with developmental disabilities in a way that would be considered a human rights violation if done to typically developing adults.)

Using behavior modification tools for one or two things in a child’s life isn’t the same as doing it with everything in someone’s life. Intense behavior therapy is a violation on a level that it’s hard to describe.

Intense behavior therapy of the type I’m talking about typically involves:

  • Being surrounded by people who think that you’re broken, that all of your natural behavior is unacceptable, and that you need to be made to look normal in order to have any hope of a decent future
  • Having completely harmless things you do pathologized and modified (eg: having hand flapping or discussing your interests described as “a barrier to inclusion”)
  • Having those things conflated with things you do that actually *are* a problem. (eg: calling both head banging and hand flapping “sensory seeking behavior” and using the same reinforcers to eliminate both)
  • Being forced to stop doing things that are very important to you, by people who think that they are pointless and disgusting or “nonfunctional” (eg: using quotes from TV shows to communicate)
  • Being forced to do things that are completely arbitrary, over and over (eg: touching your nose or putting a blue ball in a red box)
  • Being forced to do things that are harmful to you, over and over (eg: maintaining eye contact even though it hurts and interferes with your ability to process information)
  • Having everything you care about being taken away and used to get compliance with your behavior program (eg: not being permitted to keep any of your toys in your room)

(Behavior therapy often also involves legitimate goals. That doesn’t make the methods acceptable, nor does it make the routine inclusion of illegitimate goals irrelevant.)

Here’s an explicit instruction from a behavior expert on how to figure out which reinforcers to use for autistic children:

Don’t assume that you know what a child with ASD likes. It is important to ask a child, observe a child or perform a preference assessment. When asking a child about reinforcers, remember that multiple reinforcement inventories can be found on the Internet.

You can also simply sit down with a child and ask them questions like “What do you like to do after school?” or “What’s your favorite food?“or “What toys do you like to play with?”

When observing a child, set up a controlled environment to include three distinct areas: food, toys, and sensory. Then allow the child somewhat free access to this environment.

Watch and record the area that the child goes to first. Record the specific items from this area that the child chooses. This item should be considered highly reinforcing to the child.

Continue this process until you have identified three to five items. Remember that simply looking at an item does not make it reinforcing, but actually playing with it or eating it would.

Notice how it doesn’t say anything about ethics, or about what it is and isn’t ok to restrict access to. This is about identifying what a child likes most, so that it can be taken away and used to get them to comply with a therapy program. (Here’s an example of a reinforcement inventory. Notice that some examples of possible reinforcers are: numbers, letters, and being read to).

People who are subjected to this kind of thing learn that it’s not safe to share interests, because they will be used against them. That’s why, if someone has a developmental disability, asking about interests is often an intimate personal question.

This isn’t like being required to do your homework before you’re allowed to watch TV.

It’s more like:

  • Not being allowed to go to the weekly meeting of the science club unless you’ve refrained from complaining about the difficulty of your English homework for the past week

Or, even further:

  • Not being allowed to join after school clubs because you’re required to have daily after school sessions of behavior therapy during that time
  • In those sessions, you’re required to practice making eye contact
  • And also required to practice talking about socially expected topics of conversation for people of your age and gender, so that you will fit in and make friends
  • You’re not allowed to talk about science or anything else you’re actually interested in
  • You earn tokens for complying with the therapy
  • If you earn enough tokens, you can occasionally cash them in for a science book
  • That’s the only way you ever get access to science books

Or even further:

Being a 15 year old interested in writing and:

  • Being in self-contained special ed on the grounds that you’re autistic, your speech is atypical, and you were physically aggressive when you were eleven
  • Having “readiness for inclusion” as a justification for your behavior plan
  • Having general education English class being used as a reinforcer for your behavior plan
  • Not being allowed to go to English class in the afternoon unless you’ve ~met your behavior targets~ in the morning
  • Not being allowed to write in the afternoon if you haven’t “earned” the “privilege” of going to class
  • eg: if you ask questions too often in the morning, you’re “talking out of turn” and not allowed to go to class or write in the afternoon
  • or if you move too much, you’re “having behaviors that interfere with inclusion”, and not allowed to go to class or write
  • or if you mention writing during your social skills lesson, you’re “perseverating” and not allowed to go to class or write

Or like: being four years old and not being allowed to have your teddy bear at bedtime unless you’ve earned 50 tokens and not lost them, and:

  • The only way to earn tokens is by playing in socially expected ways that are extremely dull to you, like:
  • Making pretend food in the play kitchen and offering it to adults with a smile, even though you have zero interest in doing so
  • You gain tokens for complying with adult instructions to hug them, touch your nose, or say arbitrary words within three seconds; you lose two for refusing or not doing so fast enough
  • You lose tokens for flapping your hands or lining up toys
  • You lose tokens for talking about your teddy bear or asking for it when you haven’t “earned” it
  • You lose tokens for looking upset or bored

Or, things like being two, and loving books, and:

  • Only having access to books during therapy sessions; never being allowed unscripted access to books
  • Adults read to you only when you’re complying with therapy instructions
  • They only read when you’ve pointed to a picture of a book to request it
  • You’re required to sit in a specific position during reading sessions. If you move out of it; the adult stops reading
  • If you rock back and forth; they stop reading
  • If you stop looking at the page; they stop reading
  • If you look at your hand; they stop reading
  • Adults interrupt the story to tell you to do arbitrary things like touch a picture or repeat a particular word. If you don’t; they close the book and stop reading.

Here are a few posts that show examples of the kind of thing I’m talking about:

tl;dr Intense behavior therapy has some things in common with methods that are used with typically developing kids, but it’s not actually the same. Intense behavior therapy involves violation and a degree of control that is not considered legitimate with typically developing children.


withasmoothroundstone said:

I was part of a behavior program where I was locked, with only one other child (we were banished from the adolescent unit for being too socially immature or some crap like that, I think the real reason was we’d banded together to take a stand against abuse that was happening in the institution on a daily basis), on the children’s ward of a mental institution,, and not allowed to go outside or walk to the cafeteria or do damn near anything normal unless I earned enough poker chips.  I also had a therapist who systematically struck me harder and harder in the leg until I made eye contact for a certain period of time.  These things are real and they are not like having to do your homework before you can watch TV.  At all.  Even slightly.  

boundary violations in therapy

all-women-kick-ass asked realsocialskills:

 

do you know what particular boundary violations in therapy AREN’T considered unethical? because i am also studying to be a therapist and would very much like to avoid said boundary violations with future clients.

Boundary violations that aren’t considered unethical:

  • Teaching people not to trust their own judgment
  • Telling people their reservations about therapy are just a symptom of their disease
  • Equating wanting to stop therapy with wanting to give up on improving one’s life. Those things are different.
  • Insisting that people speak verbally or make eye contact as a precondition for working with them
  • Insisting that someone repeat details of sexual abuse over and over, even when they are coming to you for help with something largely unrelated
  • Threatening to have someone institutionalized if they stop taking medication
  • Ignoring someone’s concerns about medication side effects
  • Asking questions in a way that makes it impossible for someone to refuse to answer

Any others y'all know of?

Beware of folks who trigger others on purpose

There are people who like other people to be intensely emotionally dependent on them. They like to control people through this emotional dependence. And they like to think of this control and forced dependence as understanding the target on a deep level, rescuing them, and helping them to heal.

One way this happens is that the controller will deliberately trigger the target over and over. And then get really good at triggering them and then comforting them. And this can – in the short term, make the target feel safe and understood. Because having someone react in a way that feels comforting when you’re triggered can be really reassuring, especially when people have reacted with fear or contempt in the past.

And it can be really hard to figure out that someone is intentionally and repeatedly triggering you. It can be *especially* hard to realize they’re doing this if they also have some actual insight about the issues you’re struggling with. And it can also be harder to understand what’s going on if they’re also supporting you in other ways, like offering a place to stay or help finding a job.

And the longer this goes on, the more they know about you. And the more they know, the more power they have to trigger you at will. And when you show independence, or do something they don’t want, or do something on your own initiative rather than relying on their help, or say no to help they’re offering – then they don’t react reasonably. They use your triggers to disorient you. They convince you that you don’t really understand anything that’s going on, and that you are just reacting to past traumas. And that in order to approximate being a real person, you have to rely on their judgement rather than yours.

A wide range of people do this. Sometimes it’s a friend. Sometimes it’s a licensed therapist with a good professional reputation. Someone’s it’s a coworker. Sometimes it’s a social worker. Sometimes it’s a partner. It can arise out of a lot of different kinds of relationships. It’s always wrong, no matter what someone thinks their intentions are.

And it’s not your fault. If you’re in that situation, someone’s probably got you half-convinced that this is only happening because you’re broken and need help. But that’s not what’s going on; this is something someone is doing to you, not something that inherently happens to people like you. No one, no matter what problems they have, should ever be treated like this.