The Dangers of Being Insulting and Misleading
Darcia Narvaez, PhD, launched quite the volley two days ago with her Psychology Today article, “The Dangers of ‘Crying it Out’: Damaging children and their relationships for the longterm.” Now, if you’re a reader of this blog, your first question might be, “Gee, that seems rather incendiary. Does this person have a real PhD?” Given that she’s a psychology professor at Notre Dame, I’m thinking yes. But that doesn’t disqualify her from being a judgmental ideologue who has only passing acquaintance with honesty!
She starts out by poisoning the well, linking “Cry it out” with discredited 19th century exhortations not to touch babies, to withhold love, not to be too kind, and the sentiment that watching and entertaining a baby is a waste of time. She refers to “Cry it out” without defining the term and also talks about “letting babies cry.” This vagueness about the very heart of her argument isn’t helpful to her case. What does she mean by CIO? Ferber? Weissbluth? Ezzo? “Letting babies cry” for how long? Does letting a baby cry for 5 minutes on one occasion “damage children and their relational capacities in many ways for the long term” and make the baby “less intelligent, less healthy but more anxious, uncooperative and alienated”? Note she doesn’t give any citation as she lobs these firebombs. She simply says “With neuroscience we can confirm [them].” This is the debating equivalent of saying, “Increase the Flash Gordon noise and put more science stuff around!” She’s trying to dress her philosophical opinion piece with science-y trappings without doing, you know, actual science.
Citing . . . herself, she declares that babies only grow when being held, and that basically you should never put your baby down, never mind sleeping apart from them. Then she states, “There are many longterm effects of undercare or need-neglect in babies.” While the terms “longterm,” “effects,” “undercare,” and “need-neglect” are left undefined, she has finally, in the fourteenth paragraph of her article about the risks of CIO, cited a scientific study that allegedly demonstrates the risks of CIO. Well, it’s not an actual study. It’s a survey of research used to make a public policy argument for early intervention “to provide an optimal environment in the first years of life.”
“There are many longterm effects of undercare or need-neglect in babies”
The article by Dawson, Ashman, and Carter, does discuss postnatal stress as an influence on child development. However, it’s difficult to pin down what is included in the term “stress.” The authors discuss animal studies where “separation from the mother” causes a surge in cortisol and other hormones. Unfortunately, some study abstracts don’t tell how long a separation they’re studying (and I can’t afford to buy all the studies!). And of course that would have a big impact on our concern about the risks of CIO. However, this one and this one used a 24 hour separation, and this one used isolation for 6 hours daily during postnatal days 2-20. The human studies of postnatal stress discuss the level of attachment exhibited by children, compared with their behavior and cortisol levels, but don’t inquire into what might cause poor attachment. The most damning statement I could come up with was “later attachment security was related to greater maternal responsiveness and lower cortisol baselines,” i.e., maternal responsiveness, as measured during clinic visits, was associated with children showing greater attachment security when they returned for follow-up testing. Needless to say, mothers who scored high on responsiveness during the day at the clinic might or might not have used CIO in some form at night, at some point.
When they discuss specific circumstances that cause stress for babies, Dawson et. al refer to babies in Romanian orphanages, and those with clinically depressed mothers. Note that these are serious, long-term, global stressors, not simply a short period of stress, confined to a certain part of the day, for a limited duration. Other circumstances they cite as influencing child development for the worse are fetal exposure to drugs and alcohol, developmental disabilities such as autism, poor nutrition, and violence. So by “stress,” they seem to be referring to very long isolation from the mother, or significantly traumatic events and conditions. There’s no indication that sleep training rises to this level, and Dawson et. al. never make any reference to sleep training or long periods of crying.
Moreover, the Dawson article undermines Narvaez’s confident doom-saying by noting that “the contribution of parenting factors to the development of self-regulatory brain mechanisms that have been hypothesized to relate to affective and attentional disorders is still poorly understood,” and “It needs to be determined whether psycho-biological measures such as neuropsychological performance, cortisol levels, autonomic responses, and brain electrical activity will be useful in identifying children at risk for psychopathology.”
So let’s go back to the statement she linked with this article: “There are many longterm effects of undercare or need-neglect in babies.” It might more accurately reflect the article to say, “There may be many long-term effects of lengthy separation from the mother, maternal mental illness, and chronic deprivation in an institutional setting, but we’re not yet sure what those effects are, and while we are guessing that certain brain mechanisms relate to emotional and attention disorders, we’re not sure about the details, and we don’t know if or how much parenting affects such mechanisms.”
“What does ‘crying it out’ actually do to the baby and to the dyad?”
We’re told that “neurons die” due to “the toxic hormone cortisol.” You know, that “toxin” that is needed for proper glucose metabolism, regulation of blood pressure, blood sugar maintenance, immune function, and inflammatory response. Is it more charitable to assume that Dr. Narvaez is ignorant, thinking that cortisol is unremittingly evil, or that she’s disingenuous, purposely ignoring the beneficial, normal function of cortisol while focusing solely on its effects in cases of chronic stress, when the body is not given the chance to return to baseline after a stressful event? I’m going to have to go with the latter, seeing as she follows up with the brazenly speculative cry, “Who knows what neurons are not being connected or being wiped out during times of extreme stress?” (That’s a fun game – I’m going to play. “Who knows how many of my neurons have been wiped out due to reading Dr. N’s screed?” “Who knows whether contact with her article might have given me an STD?” “There’s no telling how much my credit score has fallen due to such extensive contact with this text!” “Who can tell whether you’ll receive a pot of leprechaun gold if you write an angry letter to Psychology Today?”)
Next up, we’re told that “disordered stress reactivity can be established as a pattern for life.” Again, both citations refer to extreme stress such as child physical and sexual abuse, psychiatric illness, and PTSD. I admit I’m reading these late at night, but I’m pretty sure neither included “crying for 10 minutes” in their list of catastrophic stressors.
Likewise, when she argues that self-regulation is undermined, she cites a study that does indeed say “Stress during infancy that is severe enough to create insecure attachment has a dissociative effect,” but the stress they’re discussing involves experiences so severe they induce PTSD.
Next she argues that “trust is undermined,” referring to the philosophical work of Erik Erikson and delineating her personal belief that a baby left to cry (presumably for any period) learns to mistrust his caregivers, and the world at large. Piling fantastic speculation on wild conjecture, she sums up, “And self-confidence is undermined. The child may spend a lifetime trying to fill the inner emptiness.” Or, not. Either guess is equally valid.
She is also concerned that “caregiver sensitivity may be harmed.” Again, this is speculation. It’s not totally nonsensical – it makes sense that becoming inured to your child’s cries in one instance could make you generally more insensitive. On the other hand, every mom I’ve talked to who’s tried sleep training has agonized over her baby’s crying, and it’s equally plausible that empathy and good old mom guilt might make a sleep training mother more responsive, doting, and loving at all other times. It would also make sense that a fatigued mother would be less responsive, while a well-rested mother would have more resources for engagement with her baby. We’re dealing purely with “what-if” scenarios here, and Narvaez seems to acknowledge that by including the uncharacteristic equivocation “may,” and omitting any citations.
“But isn’t it normal for babies to cry?”
Here Narvaez really lays into parents, setting an impossible standard. She states that if your baby cries, or even “displays discomfort,” it’s clearly because you are depriving them of something they need. And she makes sure to remind you that your baby is rapidly growing – implying that your callous deprivation is particularly disastrous and cruel!
She continues, stating that any parent whose baby cries a lot is inexperienced and ignorant. If only you stupid incompetent parents had researched how to properly soothe a colicky, fussy, or high-needs baby, your infants would hardly cry at all. Get on that, would you?
Why Narvaez’s article is a double-scoop of obnoxious.
To sum up, this article really irritates me because it combines two things I hate. First of all, you guys know it irks me when people abuse citations. What’s billed as a research study supporting their assertion turns out to be an opinion piece or simply doesn’t say what the citing party says it does. I’m annoyed that to get a real picture of the supposed “science” here, I had to spend hours combing through abstracts and pony up $6 to rent an article. Narvaez no doubt has greater access to scientific publications than we lowly parents do – is it too much to ask that she not misrepresent what the studies say?
The second thing that makes me twitch is her intrusive, judgmental tone. I’ll be the first person to present the evidence showing formula feeding is statistically more risky than breastfeeding, or even to opine that routine infant circumcision is unethical. But I don’t charge into someone’s facebook status about their son’s bris screaming that they’re child abusers. I don’t post here intimating that formula is “junk food” and accusing bottle-feeding moms of not loving their kids enough, or being ignorant and callous. I acknowledge that people can choose parenting options that may be demonstrably inferior, all things being equal. But I don’t live their lives, and I don’t know what factors are interacting to ensure that all things aren’t equal. I just know that all things aren’t equal for most people, most of the time. The vast majority of parents love their kids like no tomorrow, and make the best decisions they can given their unique circumstances. The last thing they need is someone twisting the facts in an effort to make them look uncaring and stupid.
(By the way, that “formula is junk food” concept comes from another of Narvaez’s articles, which inspired a PhD in Parenting post saying that Narvaez was judgmental, vague, ignorant, and lacking scientific support for her statements, and that she “gives greater legitimacy to the argument that lactivists are cold-hearted, uncaring, uncompassionate, ‘Breastfeeding Nazis.'” Whoa. When a distinguished lactivist like Annie says you’re exemplary of the meme that lactivists are jerks, you know you’ve gone way overboard with the AP zeal!)
Posted on December 13, 2011, in Parenting, Skepticism and tagged CIO, cry it out, Darcia Narvaez, ferber, sleep training. Bookmark the permalink. 18 Comments.
I wonder if what is needed is a definition of Cry It Out? To me, CIO implies that the baby is left in the crib until they stop crying, however long it takes. Now, that could mean totally ignored, or the parents go in and pat the baby every 5-10-15 minutes, or even sit by the bed completely ignoring the baby until the baby stops crying. You said in your last post that you let your baby “CIO for 10 minutes” because that was all you could take. In my world, that would not be CIO. Presumably at the end of 10 minutes, you went in and did something to/for your baby — held her, fed her, changed her, rocked her — whatever. I remember trying CIO on my first child…and at the end of 45 minutes of her wailing, I went in and picked her up thinking, hey — this doesn’t work. I had been “promised” that she would only cry for 15 minutes and then go to sleep. Uh, not so much. (And this is long before the days of Ezzo — but CIO came long before Ezzo did). So I think part of the problem with the articles are that they aren’t defining what they mean by CIO. 10 minutes? 2 hours? I expect there would be a major difference in stress factors depending on the length of time and the age of the baby.
By the way, so far you have absolutely NAILED it on Ezzo. If you think what you are reading is bad, you should have seen the 1993 version of Babywise, and the even earlier versions of “Growing Kids God’s Way.” Yowza!
Thank you for this article!! I’m a cry-it-out, formula feeding Mom.
You are my personal hero this morning, Christine. This post is a giant bowl of awesomesauce, with a cherry on top, even.
Aside from the lack of citation, which made me twitch, my real problem with Darcia’s piece here was the insinuation that I’m an incompetent mother for allowing The Kid to cry. She makes absolutely no distinction between CIO, and a baby who’s needs have been met still crying. I’ve personally never dealt with colic, but I can only imagine how frustrating it would be, especially served with a side of guilt Darcia style–that all that crying MUST be the caregiver’s fault. Please.
Jan and Leslie, you make really good points about defining terms. Truly, I’m not sure people who say “CIO is bad” even have a solid idea of what they’re criticizing.
Sometimes babies cry – a lot – and you try everything, but in the end you just wind up holding them while they cry.
As for sleep training, some parents let a baby grumble and fuss for a minute or two after being put down, but pick up the baby if he starts to really cry. Some people allow a few minutes of crying. Some people allow a few minutes of crying, go in and comfort, and then allow a few more minutes. Some people allow those intervals to be as much as 20, 45, or 60 minutes. And some people do just put the baby to bed, and don’t respond to crying at all unless they sense there is a problem over and above “baby is asking for help going to sleep.” There are even more creative solutions that change things up or combine ideas, that may involve crying, such as crying with a parent in the room but not holding the baby.
NOTHING can be said with authority about “CIO” when the term covers so wide an array of behaviors. If someone posited that Marc Weissbluth’s extinction approach (don’t respond, no matter how long the crying goes on) causes levels of cortisol so high they are of concern, I would find that plausible and inoffensive. But this article says, “letting babies cry is a practice that damages children and their relational capacities in many ways for the long term. We know now that letting babies cry is a good way to make a less intelligent, less healthy but more anxious, uncooperative and alienated person who can pass the same or worse traits on to the next generation.” It’s vague, confused, and without any basis in evidence.
Just to clarify, I didn’t call Narvaez a breastfeeding nazi or nipple nazi. I don’t think that term is appropriate use under any circumstances, unless moms are being rounded up and dragged off to concentration camps for formula feeding.
I was simply making the point that articles like the one by Narvaez give greater legitimacy to those who do use horrible anti-lactivist slurs.
Annie, I apologize. I got a little carried away with my hyperbole. I’ve changed the wording to more accurately reflect what you wrote!
I think I love you. Nothing of substance to add, just that.
Thank you for the cogent analysis. I had a lot of the same doubts when reading this article (among others by Dr. Sears etc). I have to let my son cry sometimes (for a few minutes, never the “extinction” approach) simply because he has a stubborn streak a mile wide and fights sleep like nothing else. He is far from neglected – in fact, he’s probably tended more than most because he’s always been a high-needs baby. I suspect this is the case for most of the audience Dr. Narvaez et al. are writing for. I wish they would use some of these studies and the time they spend publishing these articles to help kids who are really are abused and neglected.
I love your article and had I found it sooner would have absolutely linked to it when I also wrote about this (the article was unfortunately highlighted on the Yahoo home page *sigh*). In fact I love what you wrote so much I might go back and edit the original post to link it now.
I cannot believe how irresponsible and ignorant this piece is. You are not a medical professional and it’s painfully obvious. You are supposedly a lawyer, but not a very good one. Here you are dissecting an article written by someone who DOES have experience in science and discrediting portions of it by typing things like “cortisol” into Google and posting the first site you come to: About.com. Hilarious. You have NO idea what you are talking about, lady.
Cortisol is a hormone produced in the cortex of the adrenal glands that is released in response to stress, the fight-or-flight syndrome, in addition to/outside of the body’s daily rhythmic levels. It is a very complex chemical that plays a vital role in the body’s survival. It does have many beneficial qualities when it is released by the body’s own natural mechanisms, but it is quickly countered by the parasympathetic system. How convenient that you waxed over all the information about prolonged exposure of the hormone from the very article that you sited, no less! Cortisol is the body’s self preservation chemical. The brain can only burn glucose as fuel. Not fat, not protein, only glucose. So, when the body/brain fears for its safety, it triggers the release of cortisol. This hormone conserves all the glucose in the body for the brain, even creating new glucose from other tissues (called gluconeogenesis) while simultaneously preventing the body’s tissues from uptaking free glucose into their cells. This raises blood glucose levels considerably. It is meant as a very temporary mechanism to get the body out of a dangerous situation. Repeated stress causes repeated release of this hormone. This repeated exposure has terrible consequences for the body, the part of your About.com article that you neglected to mention:
“Impaired cognitive performance
Suppressed thyroid function
Blood sugar imbalances such as hyperglycemia
Decreased bone density
Decrease in muscle tissue
Higher blood pressure
Lowered immunity and inflammatory responses in the body, slowed wound healing, and other health consequences
Increased abdominal fat, which is associated with a greater amount of health problems than fat deposited in other areas of the body. Some of the health problems associated with increased stomach fat are heart attacks, strokes, the development of metabolic syndrome, higher levels of “bad” cholesterol (LDL) and lower levels of “good” cholesterol (HDL), which can lead to other health problems!”
These consequences are indeed VERY real and Narvaez is not ” ignorant, thinking that cortisol is unremittingly evil, or that she’s disingenuous,” No, in fact, she is right on the money. She probably assumes that her audience has a minimal level of intelligence and a basic understanding of how the body works (or maybe willing to investigate further than the first two bulleted paragraphs of a non-scientific website), unlike ludicrous bloggers saying things like, “Who knows whether contact with her article might have given me an STD?” If you actually had anything of value to say in this piece, you just killed any credibility right there. Be a skeptic all you want. Blog your ignorant, narcissistic heart out. But, for the love of Zeus, put a disclaimer at the top of your blog stating that you are not a medical professional or scientist, and quit passing your blog off as informative, because it is anything but.
P.S. Here is a whole slew of scientific articles published on the very subject you are taking issue with. Good luck reconciling that.
Hey Astounded – thanks for reading! Clearly this article made you angry. I’m guessing that you are philosophically opposed to sleep training, and I can understand that. I do think your specific criticisms are based on misreading some rhetorical devices, which is certainly easy to do when you’re upset. I never meant to provide a treatise on cortisol, merely to point out that calling it “toxic” is misleading, unless it’s made clear that chronic exposure is the situation referred to.
Thanks for the citations – as a skeptic I try to question my own beliefs particularly carefully, knowing that bias tends to creep in. So hard facts are always welcome. I absolutely admit that we have science that indicates there might be some risk to some forms of sleep training, and I think it would be a great topic for study. Unfortunately it’s hard to know exactly how the studies you cite can be extrapolated to sleep training. If elevated cortisol levels are induced in rats for 8 hours a day for 3 months, and it causes neurological damage, does that mean that letting a human baby cry for 10 minutes at a time for 3 days will also cause damage? I don’t think we know – as in all things, solely the dose makes the poison.
Similarly, studies of abused and neglected children (for instance, here’s one of the scoring standards they used in that second citation: http://acestudy.org/yahoo_site_admin/assets/docs/ACE_Calculator-English.127143712.pdf) might make us cautious about how parental actions can influence later health. But sexual and physical abuse is so vastly different from a brief period of sleep training at night, interspersed with loving care during the day, it seems a pretty slight basis for lobbing the invective that Narvaez does.
I welcome further discussion, and I think it would be fine to argue against sleep training because you are against it philosophically. For instance, I would be against spanking even if there were no evidence of harm from it. It’s OK to think something is a bad parenting decision without having a randomized, controlled study showing you’re objectively right. But it bothers me when people have strong emotional objections to sleep training, and try to buttress that stance with dodgy scientific rationalizations to bludgeon others into agreement.
Here is a study on the long term effects of sleep trainig. Unsurprisingly there are none. http://pediatrics.aappublications.org/content/early/2012/09/04/peds.2011-3467
An Abstract report does not give enough information and the “study of LONG TERM EFFECTS” was only done over FIVE years. Come back to me in twenty when these kids are popping anti-anxiety and anti-depressants like candy, are fighting obesity and diabetes, etc. This study proves nothing.
Or come back to ME in twenty when those kids are living healthy, happy, productive lives, achieving their goals, contributing to society, having lots of great sex and enjoying remarkably well-adjusted emotional and mental health. Which is by far the more likely scenario.
Just curious, does anyone know if Dr. Narvaez actually has children of her own, or is her research just based off of lab rats????
I really enjoyed reading your critique of Dr. Narvaez’ article, which I saw after a Facebook friend shared it. I was going to write a reply on Facebook, but you did such a beautiful job and saved me the trouble! As the father of a child with a serious psychiatric illness, I am accustomed to slights from ignorant and judgmental people. Narvaez’ writings remind me of a time in the not too distant past when schizophrenogenic mothers were commonly blamed for the psychotic illness of their children. Raising a child with a serious psychiatric illness is a hard enough job without ignorant people going out of their way to blame the parents.
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