Noteworthy News Articles on Mental Health Topics, February 1-6, 2001

Suicide in New York Correctional Facility Symptom of a National Problem
U.S. Newswire, 2/1/2001

To: National Desk
Contact: Michelle Pruett of the National Mental Health Association, 703-838-7538 or e-mail: mpruett@nmha.org
ALEXANDRIA, Va., -- The following was released today by the National Mental Health Association:
As the rate of serious mental illness in America's jails and prisons rises to five times that of the rate found in the community, reports of inadequate mental health treatment continue to highlight a devastating national problem. The case of Felix Jorge, a person with a serious mental illness who committed suicide while incarcerated in New York, is a prime example of the inadequate treatment of people with mental illness in the criminal justice system.
    As reported on ABC Nightly News Wednesday, Felix Jorge, a 22 year old diagnosed with acute schizophrenia, had been on psychotropic medication since the age of 14. He was incarcerated in 1993 for holding up a person with a toy gun. After three months without medication or any mental health treatment, Jorge suffered a psychotic episode and banged his head against a prison van window during transport. He was given three months of solitary confinement and three months loss of commissary, phone privileges, packages and recreation for ''Self-Inflicting Bodily Harm'' and ''Refusing Direct Order,'' behaviors directly related to his mental illness.  For the next year, Jorge suffered numerous psychotic episodes, suicide attempts, solitary confinement and other punishments --still without receiving any psychiatric care, until his death by suicide in 1994. His family's lawsuit against the state is now going to trial.
    ''Our nation's prisons are becoming psychiatric warehouses due to poor recognition of the mental health treatment available in the community, inadequate training of law enforcement personnel, lack of collaboration between mental health and correctional systems, and poor release procedures,'' said Michael Faenza, president and CEO of the National Mental Health Association. ''Despite the high concentration of people with mental illness, our jails and prisons are not equipped to handle the range of treatment and support needs of adults with serious mental illness.''
    Currently, about 63 percent of jail detainees have a mental illness or substance abuse disorder and over half a million people with mental illness are on probation. In a recent study of jail administrators, mental health services were cited as one of the most serious institutional service needs. Incarceration poses special risks for people with mental illness, including victimization by other inmates, mental deterioration and death by suicide. People diagnosed with major psychiatric disorders commit almost all suicide attempts in prisons.
    ''Effective crisis intervention in jails requires more than mere segregation, seclusion or close supervision,'' said Faenza. ''Jails must be staffed with health care professionals who are trained in identifying, assessing and treating mental illness and suicidal behavior.''  Mentally ill offenders are often not linked with appropriate community treatment services upon release from prison, causing a recidivism rate of nearly 60 percent. Continuity of care is especially important for people with mental illness because of their risk of decompensation, their lack of support systems, and the potentially disturbing behavior that is sometimes a function of their mental illness.

University of Michigan Opens Developmental and Mental Health Center
Detroit Free Press, 2/1/2001

ANN ARBOR, Mich. (AP) -- The University of Michigan has opened its Center for Developmental and Mental Health with a $3 million federal grant. The center will research factors that contribute to mental health and illness from infancy to childhood, said Arnold J. Sameroff, director of the new center. It opened Wednesday at the university's Center for Human Growth and Development.  "We hope to identify the personal and social characteristics that influence a successful passage through life," Sameroff said. "Our ultimate goal is to provide a firmer basis for prevention and intervention efforts that foster mental health throughout the life span."  The center will allow researchers from throughout the Michigan campus to access mental health and development issues in a broader way than before possible, said Betsy Lozoff, director of the Center for Human Growth and Development. The funding for the center is from the National Institute of Mental Health.

Dopamine Deficiencies Linked to Obesity
Patricia Reaney, Reuters- 2/2/2001

L O N D O N, Feb. 2 — Obese people may binge on food just as alcoholics or addicts abuse drink or drugs because of dopamine, a brain chemical that produces feelings of satisfaction and pleasure, scientists in the United States said today. Researchers at the U.S. Department of Energy's Brookhaven National Laboratory in New York have shown that obese people have fewer brain receptors for dopamine and may eat more to stimulate the pleasure circuits in the brain. The findings, reported in The Lancet medical journal, could offer a completely new approach to treating obesity, which affects up to a third of Americans and a growing number of people around the world.  Weight-reduction programs, appetite suppressants and fat-blocker drugs have been used to combat obesity, but the Brookhaven scientists think targeting dopamine could be another line of attack. "The results from this study suggest that strategies aimed at improving dopamine function might be beneficial in the treatment of obese individuals," said Gene-Jack Wang, the lead scientist in the study.
    The researchers suspected that because eating, like using addictive drugs, is a reinforcing behavior that brings on feelings of pleasure, obese people might also have abnormalities in brain dopamine. They tested their theory on 10 extremely obese people and 10 others with a normal weight. Using sophisticated brain imaging, the researchers injected into each volunteer a chemical tag that binds to a dopamine receptor and then measured the signal from the tags. Strong signals indicated a high number of receptors.  "We found that obese subjects have fewer dopamine receptors than control subjects. This is one of the major findings," Wang said in a telephone interview. "The use of food is a way to compensate for the deficiency." In the obese group they also noted an inverse correlation between body mass index and dopamine receptors that wasn't evident in people with normal weight.
    BMI is a measure of weight relative to height. It is calculated by dividing a person's weight in kilograms by the square of their height in metres. A BMI of 18-25 is normal, 25-30 is overweight and more than 30 is obese. The obese people with the highest BMI had the fewest receptors. "It's possible that obese people have fewer dopamine receptors because their brains are trying to compensate for having chronically high dopamine levels, which are triggered by chronic overeating," said Wang. Alternatively, they could have had fewer dopamine receptors initially which would make them vulnerable to overeating and other addictive behaviors. Wang and his colleagues said methods to regulate dopamine, either through drugs, exercise or behavior modification could help obese people control their urge to overeat.

Seeking Child's Love, a Child's Life is Lost
Barry Siegel, Los Angeles Times- 2/4/2001

EVERGREEN, Colo.--Of all that can be said about Jeane Newmaker--and there is not much, for she has gone into retreat now--what seems most certain is that by last April, she was a desperate woman. It had been her dream to give and receive affection, to make someone happy, to cradle a needy, grateful child. So at age 42, single and living alone, she adopted a 6-year-old girl, Candace. Newmaker apparently did not get back from Candace what she had expected. Instead, she found herself struggling with an angry, defiant child who--like others from broken, abusive homes--did not want her adopted mother's love or hugs or parenting. What followed over the next four years was a litany of troubles. There were fruitless visits to a series of therapists and doctors in their home state, North Carolina. There were numerous diagnoses. There were experiments with various medications. There was, for Jeane Newmaker, a fair share of depression and exhaustion. Finally there was the journey--increasingly familiar among parents in her situation--here to Evergreen, a remote mountain town 30 miles west of Denver.
    Evergreen is the epicenter of therapy for "reactive attachment disorder," a mecca for parents who have been told that's what their kids have. Fourteen attachment therapists toil in six clinics in this hamlet of 8,000. Theirs is a world regarded by many in mainstream medicine as being filled with "wackos" and "cultists," but it's also an expanding world. The number of attachment disorder diagnoses, therapists and acolytes has multiplied in recent years, particularly since the adoptions of traumatized Eastern European orphans began in 1989. Evergreen has become the trail's end for distraught parents who find that mainstream medicine provides them neither solutions nor understanding.
    Connell Watkins--the particular Evergreen therapist chosen by Jeane Newmaker--was among the best known and most controversial in her field. It was to Watkins' home on Meadow Drive that Jeane and Candace reported last April 10 to begin a two-week intensive therapy program. And it was from Watkins' home eight days later that someone placed a frantic 911 emergency call. Even for a mountain town as accustomed to the unconventional as Evergreen, this call sounded unusual. A 10-year-old girl in cardiac arrest; a 10-year-old girl not breathing. Within minutes, two paramedics and a sheriff's deputy were rolling. Connell Watkins' two-story house, which served as both her home and clinic, had a look poised halfway between comfortable and disheveled. Green shutters framed some windows. Scattered out front were a pile of logs, a wheelbarrow, a small red bicycle and--behind a split wood fence--a yard full of toys. As the paramedics' ambulance pulled up, a man stood on Watkins' dirt driveway, waiting for them.
    We were doing a "rebirthing session," the man told paramedic Larry Ferree. We left the girl alone for five minutes, then found her not breathing. Inside, in a small room to the right of the entry, Ferree discovered Candace lying face up on the floor. Above her, Jeane Newmaker was performing CPR, both chest compressions and mouth-to-mouth resuscitation. Ferree knelt to examine the girl. She was blue, cool to the touch, without pulse or breath. Her pupils were fixed and dilated, her eyes full of red spots. She'd been down for more than 10 minutes, Ferree gauged. He suspected asphyxia. He thought her prognosis poor. Ferree looked around the room. He wondered what had happened here. So would all sorts of people, soon enough. Hours after being airlifted from Watkins' house, Candace Newmaker was pronounced brain-dead by doctors at Children's Hospital in Denver. Her severe brain injury, they said, was due to "mechanical asphyxiation," which occurred while she "was restrained during therapy session."
    A horrible accident, Connell Watkins explained in an e-mail to supporters. We don't know why this happened. We could never have caused this little girl's death. Watkins had videotaped the rebirthing session, though, and the tape provided a somewhat more graphic tale. Investigators watched it over and over with mounting dismay. This is not a horrible accident at all, the Jefferson County district attorney's office eventually decided. This is a horrible crime. In late May, prosecutors filed charges of reckless child abuse resulting in death against Connell Watkins and three of her associates. Days later they charged Jeane Newmaker as well, on a lesser count of negligent child abuse resulting in death. Now the trials loom--the first, of Watkins and an associate, is set to begin March 29. "This is a big national issue," one of the prosecutors told a reporter. "This whole medical approach will be on trial."
    That's just what many in the world of attachment theory fear. Evergreen therapists, shuddering at the sudden scrutiny from journalists and state regulators, scramble to distance themselves from Watkins. Supporters, including many parents of children she has treated, rise passionately to her defense. Various critics point fingers at mainstream medicine for driving parents into the arms of fringe therapists. Others denounce the Colorado Legislature for allowing unlicensed therapists such as Watkins to operate. Here and there, questions arise about those who expect perfection--or images of themselves--from the troubled children they adopt.

Togetherness and Trips
Through it all, Jeane Newmaker remains silent. Even those who would lynch the therapists shake their heads over this single mother. She is 47 now, a nurse practitioner who treats children at Duke University Medical Center in Durham, N.C. She was known by neighbors to be devoted to Candace. How could such a caring, educated woman come to entrust her daughter to a quartet of strangers in a rambling house on Meadow Drive in Evergreen? How could she stand by and watch as unlicensed alternative therapists did this to her little girl? These are unfathomable questions for most, but not, as it happens, for other parents who have journeyed to Evergreen with their troubled children. Over and over, these parents offer the same refrain when asked about Jeane Newmaker: It could have been us.
    Jeane Newmaker, who had never married, adopted Candace in 1996 and brought her to a large two-story brick home on a corner lot near downtown Durham. By all accounts, she was a loving, involved mother. Those who saw them together--Jeane large and heavyset, Candace a pixie with dark hair and eyes--thought they displayed a particularly warm bond. You didn't know just Jeane or Candace, you knew them both, as if they were a couple. Jeane always showed up at school parties and functions. When school was out, mother and daughter traveled often on vacation. They took trips to the Appalachians, and one to Florida to see the dolphins. They went hiking together, white water rafting, horseback riding. Once, while vacationing in the mountains, Candace saw a stray dog and asked Jeane if she could take it home. They already had two dogs, but by the time they got back to their Durham house, the dog was waiting. Jeane had arranged for it to be sent, as a surprise. Walter Wolsczuch, the father of Candace's best friend, still marvels about the time Jeane took his daughter and Candace to see a performance of "The Nutcracker" ballet. Afterward, they went to an ice cream social, then shopping at the mall. Wolsczuch's daughter had a blast. She'd met Candace in the first grade at Easely Elementary School. They shared the same class in second grade, ate lunch together in third grade, and had afternoon play dates every month or so for four years. During that time, Wolsczuch never once heard the two girls argue. What struck him most about Candace was her energy, her eagerness, her ambitions. When Jeane leased her a horse, Candace learned to take care of it as well as ride it. There was always a smile on Candace's face, always so much joy. Wolsczuch never saw any indications of a problem.
    There apparently were problems, though. Once, Newmaker said something to Wolsczuch about Candace being "on medication." Another time, she said that Candace had attention deficit disorder. Other accounts, one by a psychiatrist, refer to Candace's "assaultive behavior," displayed mostly behind closed doors with her mother. If true, such conduct would be no surprise to Evergreen therapists. Surface charm to outsiders is a hallmark of children with attachment issues, they say. So is defiance to those who would parent them. Both characteristics reflect children who, after enduring severe trauma in their early life, have come to operate in a survival mode, distrusting and refusing close attachments.
    Candace undeniably had her share of early trauma. Although adoption records are sealed in North Carolina, it's known, from an account in the Rocky Mountain News, that Candace became a ward of Lincoln County at age 5, after twice being taken from her birth mother. Candace's early years involved an angry father, a troubled mother, a household full of marital fights and domestic disturbance calls, constant moves from one ramshackle home to another, unceasing poverty and, finally, at age 3, her parents' separation. Given all that, it's not startling to learn that a county caseworker made note of her "angry outbursts and rebellion."
    What's not clear is whether such conduct meant Candace was severely disturbed, as some therapists would later conclude, or simply a difficult child from a harsh background. Was the treatment being sought by Jeane Newmaker really for Candace, or was it for a mother who longed to be hugged? This type of question colors many attachment cases. It's often suggested that the parents simply are too strict, or have poor child-rearing skills, or hold unreasonable expectations, or just don't match up well with their kids. Objective truth is not possible in a matter as personal as the relations between mother and daughter, particularly when they occur behind closed doors. All that can be said is that Jeane Newmaker made it plain to some friends that she found the girl to be a handful. In fact, Newmaker's later comments indicate Candace wouldn't let her adoptive mother hold her or look her in the eye. Newmaker had anticipated a reciprocally loving relationship and instead had found something far more complicated.
    It's known now that Jeane, in between all the vacations, parties and school functions, was taking Candace to a series of doctors and mental health professionals. They visited specialists in attention deficit disorder, depression and post-traumatic stress syndrome. They experimented with various therapeutic approaches. They tried mood-altering medications--the amphetamine Dexedrine (for ADD), the antidepressant Effexor, the psychotropic Risperdal. None of this worked; at least, none of this provided Jeane Newmaker the resolution she by now was so doggedly pursuing. She pushed on, continuing to read and seek out professional advice. She would later describe this process to an investigator as "frustrating" and "emotionally laden." For so long, she was "trying to hold it together."
Those few words echo an abundance of testimony offered by other parents in Newmaker's situation. Over and over, they talk about their "RAD kids"--as those diagnosed with reactive attachment disorder are often called--being charming to outsiders, a terror in their own homes. In stark detail, they describe unceasing wars being waged by remorseless, manipulative kids determined to resist, defy and above all maintain control. It's like "Chinese water torture," the parents say. They never get any of "the good stuff." Instead they get emotional, violent outbursts all day long. Some get hit, shoved, thrown to the floor. Stories abound about kids who disrupt dinners by projectile vomiting, who run hands up visitors' dresses, who bite dinner guests in the calf, who rip curtains off walls in the middle of the night.
    Most moms--it's mothers whom the RAD kids usually target--end up feeling isolated, not the least because so many neighbors, relatives, doctors and social workers seem to suspect the problem is more with them than their child. What they long for most of all is validation. They want someone to acknowledge that there is a problem with their kid and that the problem has a name. Somewhere in her constant reading and research, Jeane Newmaker finally came to the mention of such a name--reactive attachment disorder. At a workshop in North Carolina, she heard recited a list of the main symptoms. Inability to give or receive real affection; lack of eye contact on parental terms; extreme defiance and anger; extreme control problems; manipulative, superficial charm; lack of conscience. Newmaker was struck with how closely these symptoms reflected Candace's behavior. She began to expand her inquiry into attachment issues. In time, she turned to the Internet. There she found a bonanza: Web sites, discussion groups, chat rooms, links, clinics, bibliographies. Above all, she found other parents--parents with RAD kids, parents with her set of problems, parents who'd already made the journey to Evergreen. With open arms, a whole new community beckoned to Jeane Newmaker.

Rage and Restraint
The notion of attachment disorder has been around for years, but it gained a critical mass in the early 1970s when an Evergreen child psychiatrist, Foster Cline, founded what would eventually evolve into the Attachment Center at Evergreen, now the preeminent organization in the field. There Cline fixed on something he called "rage reduction therapy," borrowed from techniques developed by a California doctor, Robert Zaslow, in his work with autistics. Basically, rage reduction meant goading, confronting and physically restraining kids. You pinned them down, you rubbed knuckles in their ribs, you incited them to rage with lots of "who's the boss" taunting. The goal was to out-power the powerful, to force psychological engagement and surrender when a child would rather withdraw or retain control.
    Even those who felt uneasy with these methods had to admit they sometimes appeared to work. Although not a cure-all, they at least helped parents gain access to walled-off kids. Families began to flock to Evergreen, many for two-week intensive programs that involved 30 hours of concentrated therapy. If nothing else, there was a market here, a market that mainstream medicine wasn't pursuing or addressing. Soon therapists--some with doctorates, most with master's degrees in such fields as social work and family counseling--were journeying to Evergreen to get training. New clinics opened, spinoffs from the Attachment Center. Attachment therapy is not a specialty that can be licensed or board-certified--in fact, anybody in Colorado can practice it. Nonetheless, by 1987 reactive attachment disorder was a recognized psychiatric condition listed in the Diagnostic and Statistical Manual of Mental Disorders.
    Only occasionally did the troubling undercurrents to all this make themselves known. Cline's aggressive techniques looked an awful lot like child abuse to various adoption and social service agencies. Matters came to a head in 1988. Late that year, under general supervision by Cline, two therapists--one of them Connell Watkins--began treatment of a troubled 11-year-old boy from Florida. Days later, the boy ran away and reported to authorities that he'd been abused. Sheriff's deputies seized files and videotape. The videotape began to circulate. The Colorado Psychiatric Society filed a complaint against Cline. After review, the Colorado Board of Medical Examiners accused Cline of "grossly negligent medical practice." In a stipulated settlement, Cline eventually agreed to no longer participate in rage reduction therapy. Soon after, he moved to northern Idaho, where he remains an advocate but not a practitioner of intrusive restraint.
    The case jolted other Evergreen therapists. Those at the Attachment Center and elsewhere began to develop more humane methods that didn't force a child's utter capitulation. Over time, a new executive director pushed the Attachment Center toward the mainstream, insisting they follow state rules and guidelines. All the same, Evergreen did not totally transform itself. The centerpiece, and by far the most controversial element of attachment theory, remains a form of treatment called holding therapy. Even its advocates allow that it's not always pretty to look at, despite a nurturing essence. The child is held in a cradling position, face up on the therapist's lap as they sit on a couch. One of the child's arms is usually placed behind the therapist's back. The therapist holds the child's chin with one hand, forcing eye contact. The therapist provokes and confronts, trying to goad the child into venting his rage. Often the children resist. It is not uncommon for them to writhe and wail in wild-eyed anguish. Attachment therapists don't mind, for their goal is to force kids to see that they can let go and still survive. If the session goes well, the payoff comes after the rage is expressed, when the child gently cradles in the arms of the therapist or parent, who supports the rage, offering comfort and assurance. Foster Cline has called this final stage "the joy of surrender." At various times he and his associates have likened attachment therapy to the "gentling" of a wild horse, to invasive surgeons who must cut open sick patients and to the intrusive treatment Helen Keller received at the hands of Anne Sullivan.
    Critics are more inclined toward other comparisons: witchcraft, quackery and brainwashing. If there's a bond forced by holding therapy, they argue, it's a trauma bond, such as develops between hostage and captor. There's no hard proof this method works, they point out, no legitimate research into its effects. There can't be, for there isn't even a consensus as to what--if anything--constitutes RAD. It's a catchall phrase that can include kids with oppositional disorder, bipolar disorder, attention-deficit disorder and post-traumatic stress syndrome. Everything is anecdotal, and everything is vague. Ronald Federici, a developmental neuropsychologist in Virginia, says: "There are a lot of yahoos out there, professionally untrained to make proper assessments. Anybody and everybody is doing it. Parents are desperate and looking for magical solutions. Sometimes they find what they're looking for on the Internet. Unfortunately, some of those Web sites and chat groups are peopled with pseudo-experts. Attachment centers are cropping up all over the country. Many of the more extreme people tend to be cultish."
    The world of attachment theory, with its apocalyptic warnings and assorted legal problems, does often seem questionable. A scattering of cases--including ones in Houston; Arlington, Texas; and Midvale, Utah--are particularly troubling. The harshest critics don't paint a full portrait, however. Left out are the voices of the more temperate therapists, and of those level-headed families who turned to Evergreen simply because they had no alternative. Some went there with qualms, some didn't find what they sought, but a good number did come away satisfied. They found, if not a cure, a sort of rescue, a kind of solace. They tell of attending speeches by Foster Cline and pounding their companion's legs, whispering, "See, see, it's not just me." They describe the relief of being understood and supported, of being "not alone, not crazy." They talk of crying at the Attachment Center because folks there "were describing my child. . . . It felt like they were in my house." The testimony of Anne Marie Brown is as representative as any: "We'd heard terrible things about Evergreen. We feared what would happen. But we knew we couldn't keep going on as things were. We had to do something. Evergreen was the answer. They gave me validation. They said yes, there is a problem, but we can do something about it. My marriage improved. Everything improved. They gave us our lives."

Among the Therapists
Winding her way through the Internet, Jeane Newmaker came finally to the Web site for ATTACh (Assn. for Treatment and Training in the Attachment of Children), an international umbrella organization founded in 1989. At the ATTACh site, Newmaker downloaded a list of recognized therapists. She also downloaded information about ATTACh's upcoming 11th annual international conference.  It was scheduled, she saw, for Sept. 30 to Oct. 2, 1999, at a Holiday Inn in Alexandria, Va. Foster Cline would be there, talking in a general session on "Keys to Success & Satisfaction With Difficult Kids." The Attachment Center at Evergreen would be there, offering "An In-Depth Clinical Case Study and Review of Treatment Protocol." Newmaker decided she would be there too. The hotel was jammed when she arrived; 570 people had come from 44 states, Britain and Canada. Tables and booths lined the hotel hallways, offering brochures, books, tapes, posters, T-shirts. Throngs pushed into standing-room-only sessions to hear therapists and watch videos. Rooms filled with lunches, with cocktail parties, with special demonstrations. For three full days it continued, featuring 31 workshops, four general sessions and three keynote speakers.
    As she made her way through all this, Jeane Newmaker talked to therapists. She talked to parents of RAD children. She talked to the therapeutic foster mothers who host families enrolled in Evergreen's two-week intensive programs. It is likely she attended a session on "Children With Reactive Attachment Disorder" led by Bill Goble, a psychologist with a doctorate who hailed from her home state of North Carolina. After that session, Newmaker approached Goble. They stood squeezed together in the crowded hallway as hundreds pushed by, heading to their next session. Newmaker began to speak about Candace. She described her daughter's symptoms and the many therapies she'd tried in vain. What's available, she asked. Who could help us?
    Goble studied this woman. He thought Newmaker a very caring mom. Searching was the word that best described her. He had met so many parents like her. From the start of his practice, he'd seen kids from the two children's homes that operated in his community. They'd puzzled him as much as Candace puzzled Jeane. He tried everything with them. Nothing worked. He decided he obviously didn't know how to treat children, so ethically he shouldn't. Then he happened to pick up a book about attachment theory. Goble had heard negative things about Evergreen; at one workshop, everyone had talked about this horrible place in Colorado where they were so disrespectful to children. No matter; Goble felt he had no alternative. He traveled to Evergreen, where he trained with Foster Cline and Connell Watkins, who impressed him greatly. Back in North Carolina, kids under his care started to get better. Maybe, he decided, he wasn't so bad with kids after all. In time, he took a seat on the board of directors of ATTACh.
    At his side now, Jeane Newmaker talked on. She sounded as if she'd tried just about everything and heard every diagnosis. What's available? Who can help us? Goble asked her to fill out a checklist, an inventory of Candace's characteristics. Soon she was back, sheet in hand. She'd checked off almost all the major common symptoms. He'd never make a formal diagnosis in such a situation, Goble would later say--but he did make some kind of judgment. Clearly, Goble thought, Newmaker's daughter very much fit. To him it seemed a fairly severe case. Severe enough that a two-week intensive program might be appropriate. Goble recommended to Newmaker programs that would let Candace live in a foster home during the therapy. This appealed to Newmaker because it meant she wouldn't have to stay alone with Candace in a hotel for two weeks; she feared Candace's rage during the therapy would be even greater than at home. Could Goble suggest a particular place, Jeane asked. Some programs give you that live-in opportunity, Goble said, and some don't. One that does is Connell Watkins & Associates in Evergreen.

Movement's Godmother
Connell Watkins, 54 now, holds a singular position in Evergreen. She's been there since nearly the start, joining Foster Cline's group in 1977, not long after earning her master's degree in social work at Denver University. Although not licensed or credentialed in Colorado, she is regarded as the godmother of attachment therapy, a direct extension of Cline. Other therapists, in their own books, hail her in effusive dedications and acknowledgments. Many describe her as uncommonly intuitive with troubled children; some use terms such as "genius" and "incredibly compassionate." At the same time, Watkins is also regularly described as having a decidedly strong personality, "a mind of her own." Possibly to avoid excessive scrutiny, she chooses to remain unlicensed, something Colorado allows, to much dismay in some quarters. She is known for taking the "worst of the worst" cases and then doing "whatever it takes" to help them. She is also known for believing that she is always right.   When many in Evergreen began to moderate their techniques in the wake of the 1988 abuse case involving Foster Cline, Watkins resisted. She feared the "integrity" of the therapy would be hurt, she told a colleague at the time. She didn't want to abandon aggressive methods when she felt they were needed. A rift consequently developed between her and others at the Attachment Center, where she was then serving as executive director. In 1992, she left to open her own clinic.
    It is possible now to find people who are deeply offended by Watkins. It is also possible to find people who are utterly enthralled.  Annette Krulisky, who works in California as a child advocate on behalf of adopted special-needs children, met Watkins during the Evergreen therapist's several trips to California, where she has conducted unlicensed sessions in Nevada City, in the foothills east of Sacramento. "Within seconds of walking in our house," Krulisky said, "Connell was doing a selling job. She sees everything as evidence of attachment disorder. If you don't do this therapy, she tells parents, you'll have a Charles Manson. She frightens parents. But she offers what they so want, the love of a child. So they throw away all caution."
    Kathy Lee, a Sacramento mother, brought her 9-year-old daughter, Crystal, to see Watkins in Nevada City in June 1997. "Let's see if we can piss Crystal off," is what Lee recalls Watkins saying as she began a demonstration of holding therapy. When Crystal struggled, Watkins put her hand on her forehead and yelled, "So you don't like yourself very much, do you?" When Crystal grew angrier still, demanding that Watkins remove her hands, Watkins laughed, saying the girl had a terrible case of attachment disorder that needed urgent attention. Lee and her husband thought Watkins brash, crude and brutal. It was, Lee said later, "a $325 lesson for me."
    Others, in singing odes to Connell Watkins, talk of her "pure heart," of how she fights for families, of how she won't give up on kids. Gail Trenberth, on the board of directors of both ATTACh and the Attachment Center at Evergreen, and head of the Attachment Disorder Parents Network, is one whose child Watkins treated. "Connell has helped so many different parents," Trenberth says. "I have great respect for Connell as a therapist and as a human being." More vivid testimony comes from Gail Trenberth's daughter, Angie. Now 21, she was 9 when first treated by Watkins. She'd had years of traditional therapy by then, following an infancy of severe abuse from her birth parents. She viewed life "as a video game. . . . I was manipulating the whole world." Then her adoptive mom brought her to the Attachment Center. At Angie's first session with Connell Watkins, the therapist asked her to take her shoes off.
Why? Angie asked. Because I told you to, Watkins replied. Make it quick and snappy. Angie thought, What am I in for? They began a holding session, Angie across Watkins' lap. "So I hear you've been putting your parents through a lot of crap," Watkins said. Angie tried to mumble an answer. Watkins demanded she speak up. Watkins also told her to start kicking. Why? Because I told you to. Quick and snappy. What the heck is going on, Angie wondered. She was losing complete control. She didn't like it. But there she was, kicking away. Watkins asked about her birth parents. Angie mumbled an answer. Louder, Watkins said. They used to hit me. Louder.
    "Here was the first person I couldn't game," Angie recalls. "She knew what I was up to. She kept forcing me to answer, speak louder, to shout it out. She was in my face, very confrontational. I tried to charm her, tried to turn away. It didn't work. She kept right at it, kept right in my face. I was really mad by then, kicking and screaming at her. I spit on her. When I spit, she took the spit off her face and wiped it back on my face. Never spit in Connell's face. I learned that right away." In time, Watkins got what she wanted: Angie screaming not at her, but at her birth parents. My parents beat me. . . . My parents hurt me. . . . I hate my parents. . . . I'm so angry.  Then Angie was crying, true tears, not a game. At that moment, Watkins stopped the inquiry. She reached for Angie, hugged her, held her. You poor child, baby Angie, it's not your fault, you didn't deserve this, you didn't deserve to get hurt. "Normally I'd pull back from that," Angie recalls, "but I didn't. It felt good. By the third or fourth session, I kind of even liked therapy. I would not be here today but for that therapy. I'd be in jail or dead." Angie's sessions with Watkins continued for 18 months. She still keeps in touch with her, calling and writing. "Connell is awesome," she says. "She really knows. She really understands."

Classic 'Abused Mom'
On Jan. 20, 2000, Newmaker signed a contract with Connell Watkins & Associates for a two-week intensive therapy program that called for a payment of $7,000, the going rate in Evergreen. She and Candace arrived at Watkins' home on Monday, April 10--spring break at Candace's school--to start the treatment. Like many parents before her, Newmaker felt greatly relieved to be in Evergreen; she believed she finally was going to be getting some help. What particularly impressed her: Connell Watkins seemed to understand Candace's symptoms and to be familiar with Jeane's descriptions of their home situation. Right off, Watkins arranged a medical evaluation. On April 11, Candace and Jeane met Dr. John Alston, an Evergreen psychiatrist whom most of the attachment therapists there use as a consultant. Jeane Newmaker struck Alston as a classic "abused mom," weighed down by despair and frustration. He found her likable but exhausted. Alston recalls less about Candace. He judged her to be a "severe" case, though, clearly in need of treatment.
    The psychiatrist adjusted Candace's medications, stopping the Effexor she'd been taking but increasing the Risperdal by 50%. Risperdal has a sedating effect that can lead to lethargy, confusion and eventual calm. A prosecutor would later characterize its increased use with Candace as an effort to "modify her mental condition," but Alston told investigators he acted because of "a long history of assaultive behavior" in the girl's medical background. By all accounts available, Candace's therapy in its first days--which included the typical kind of taunting confrontation--did not progress as well as Watkins' team had hoped. Candace, they believed, was not "working" hard enough. Apparently, they could not break through, could not get her to engage or erupt in rage.
    Helping Watkins were three associates: Julie Ponder, 40, a California-licensed marriage and family therapist with two master's degrees who'd recently relocated to Evergreen without obtaining a Colorado credential; Brita Lynn St. Clair, 41, Watkins' office manager; and Jack Dudley McDaniel, 47, St. Clair's fiance, a high school graduate whom Watkins was paying $700 for the two weeks to serve as an "intern." To them all, Candace seemed emotionally withdrawn after her medication was changed. St. Clair--at whose home the girl was staying--thought her very bright but becoming passive, a reflective girl who wasn't violent, belligerent or defiant. Watkins later described her as having "a look in her eyes like nobody was home."
    On April 17, midway through the two-week program, John Alston placed Candace back on the antidepressant Effexor. He did so, he later explained to investigators, to counter her "disassociation." That same day, Watkins' team conducted what is called "compression therapy." They had Candace lie down on a mat. They wrapped her in a sheet, leaving only her head uncovered. On each side of her, they placed a large cushion. They instructed Newmaker to lie down on top of her child, bracing herself on the cushions to distribute her weight. The notion was to have Candace become "compliant" with her mother, to have the mother control the situation, not the child. The further notion was to have Candace visually connect with her mother, to form some kind of attachment. After a time, they unwrapped Candace. Jeane Newmaker now was sitting in a chair. They instructed Candace to crawl to her mother and sit on her lap, to lie in her mother's arms quietly. They gave Newmaker a plate of food to feed to Candace, as if she were an infant at her breast. Jeane Newmaker sobbed to investigators when recalling this moment: She thought she had a breakthrough, she thought she had connected with her daughter. For the first time, Candace had allowed Jeane to hold her; for the first time, Candace had allowed Jeane eye contact.
    The next day, Connell Watkins apparently chose to up the ante, to go further out on a limb she'd long been testing. They would, she decided, conduct a rebirthing session. Rebirthing is far from common--the Attachment Center's current staff say they've never heard of it--but it is used by at least a few therapists as a form of role-playing and psychodrama. By acting out a fresh start on life, the theory goes, a child can overcome early trauma and forge a bond with a new mother. There are several ways to do this, but the most familiar has the child wrapped in a blanket, head exposed, as others press on pillows to simulate birth contractions. In the summer of 1999, Watkins learned of a more extreme variation from Douglas Gosney, a California-licensed marriage and family therapist with a master's degree, who journeyed to Evergreen to exchange techniques and theories with her. There were lots of ways of doing birth simulations, in Gosney's view. One way was to wrap a child in a sheet "like a mummy," with the head covered. That's what he demonstrated in Evergreen. During Gosney's two-week stay with Watkins and Ponder, they used his rebirthing method on clients about six times. After he departed, Watkins used it several other times, including once in January 2000 on another family from North Carolina referred by Bill Goble. That family thought it a wonderful experience. Watkins' own view, as it happens, was conflicted. She didn't like conducting rebirthing therapy, she would later tell investigators, and wouldn't want to go through such a traumatic experience herself. For her clients, though, she was "optimistic that it was effective."

Candace's Nightmare
On April 18, Candace Newmaker's day at Connell Watkins' home began at 9:04 a.m. with art therapy. Julie Ponder asked Candace to draw pictures of six items. They then discussed what she'd drawn. On a tripod in a corner of the room sat a video camera, recording their exchange and all that followed. At 9:35, Ponder began talking to Candace about her upcoming rebirthing session. She described how Candace would be wrapped up, as if in her mother's womb. She asked Candace, do you want to be reborn to your new mom?  Yes, the 10-year-old said, because her old mom was abusive. Candace talked of being dropped out of a second-story window by her birth mother. She talked about going from foster home to foster home. She wanted to be safe, she said, and not fall out of a window.  Ponder explained more about the rebirthing process: You'll have a chance to act as a newborn baby. You'll have to kick and scream and fight through a pretend birth canal. Birth is a hard thing, you'll need to work hard. It'll be tight in there but you'll have lots of air to breathe. When you get through the birth canal, you need to reach out for your new mom.
    Candace yawned quite a bit as they talked. Ponder asked if she'd gotten enough sleep. Candace explained that she'd had a nightmare the night before. A nightmare where she thought she was being murdered, that she was going to die. Maybe, Ponder suggested, you as a little baby thought you were going to die. Candace agreed, saying she thought she was going to die when she went out of the second-story window. That's not going to happen now, Ponder said, because you have a mom who loves you. For the next 10 minutes, as Ponder and Watkins conferred, Candace remained still and quiet in a position the therapists called a "strong sit." Then, at 9:44 a.m., Ponder rejoined her. She would be the lead therapist this morning. Candace was wearing jeans and a T-shirt. She asked if she should take her shoes off. Yes, Ponder said. The therapist had with her a blue, queen-sized flannel sheet, which she spread on a pad on the floor. Candace stood, went to it and lay down on her left side in a fetal position. Ponder wrapped the sheet around her, tucking in each side. Then she gathered and twisted the top over her head. Watkins, joining them, placed four pillows around Candace. Jack McDaniel and Brita St. Clair now entered the room. So did Jeane Newmaker. She hoped this day would continue the breakthrough they'd had the day before. She hoped this day would produce some kind of response from Candace. They positioned themselves around the girl, with Ponder and Newmaker near the top, where Candace would eventually emerge to be reborn. Ponder and Newmaker spoke to Candace through the twisted opening. Then Watkins and her three associates, seated on the floor, began to press on the pillows, pushing in from the sides and top to simulate birth contractions. Newmaker stood to the left and behind Ponder, watching and encouraging Candace to be reborn.
    Push, Ponder told Candace. Candace didn't push, at least not hard enough, or not in the right way. Repeatedly she asked, "Where do I come out?" She sounded confused, as if she didn't know what to do. After 10 minutes, she began to plead. This was hard; she couldn't do it; she wanted to go to the bathroom; she was tired; she didn't want to be reborn. "Whoever is pushing on my head," Candace cried, "it's not helping. Please quit pushing on me. I can't do it." They didn't stop. Watkins and her associates kept pressing on the pillows.  Candace's protests grew more insistent. Within the first 24 minutes, she told them seven times she couldn't breathe. Within the first 16 minutes, she told them six times that she was going to die. "I'm gonna die," she said, crying, at 11 minutes and 35 seconds into the session. Less than a minute later: "I'm going to die now. . . . No, I don't want to die but I'm about to." Nearly two minutes later: "OK, I'm dying, I'm sorry." Forty seconds later: "OK, I'm dying." A minute and a half later: "I want to die." Just short of 17 minutes into the session: "OK, I'm dead."
    In response to Candace's protests, Watkins and her associates increased their pressure on the pillows. To gain leverage, Watkins braced her feet against a couch, Ponder against a brick hearth. Moments later, Ponder and McDaniel repositioned themselves more directly on top of Candace. Together, the four adults weighed 673 pounds; Candace weighed 70 pounds. "That's the way the baby feels," they told Candace. "Remember you did it once, Candace [being born]. You can do it again." "Scream, Candace."  "You want to die? OK, then die. Go ahead, die right now."
        Harsh as such comments might sound, Watkins' team was simply following attachment theory's fundamental precepts. Parents and therapists alike point out that oppositional, manipulative kids often will claim that they're dying or can't breathe, even when being made to do something like shovel snow. In such situations, says Evergreen psychiatrist John Alston, "you need to use 'paradoxical intention.' When they say 'I'm going to die,' you say, 'Go ahead and die.' That way, you defuse the oppositional element. If you respond to it, you buy into it." Later, to investigators, Connell Watkins would say of the girl's pleas: We did not take Candace seriously.
    Later, Jack McDaniel would say: We interpreted it as Candace trying to manipulate the situation; as Candace not wanting to work with the therapy. So they kept pushing, they kept pressing. Off to one side, Jeane Newmaker kept urging Candace to be reborn. Newmaker would say later she knew "little to none" about Julie Ponder's background. She was "relying on some basic level of trust" that Watkins knew what she was doing. Watkins, after all, had worked with "lots and lots of kids." At 10 minutes and 45 seconds into the session, Candace said, "I can't do it, I can't do it, I can't breathe, I can't breathe." You got to push hard if you want to be born, or do you want to stay in there and die? At 12:05 in, Candace said: "Please let me have some air. I can't breathe." It's so hard. . . . It's the hardest thing that you do. At 12:28: "Please, please, I can't breathe." No, the baby can't breathe in the womb. At 16:49: "Can't you let me have some oxygen?" You have to be really strong to live a life, a human life. At 17:07, laboring: "Please, I can't breathe." What else is it like to be dead? You don't need to breathe when you're dead. At 19:48: "Please, you said you would give me more oxygen." No, you gotta fight for it. At 21:21, gagging: "I'm throwing up. . . . I just threw up. I gotta poop, I gotta poop." Go ahead. "Ah, I'm going in my pants." Stay there with the poop and vomit. At 27:19, whimpering and gagging: "I can't breathe. I can't breathe." You still want to have this baby, Mom? With that, Candace's protests stopped. At 31 minutes into the session, she was only whimpering. "Are you OK?" she was asked. Candace, gagging, offered a faint "no."
    Over the next nine minutes, Watkins and her colleagues, apparently believing the girl was still resisting, challenged Candace further. Julie Ponder repositioned herself and increased the pressure, exerting herself so much that a prosecutor later described her as making "two grunting noises." "She needs more pressure," Ponder is heard to say on the videotape. "She really needs to fight if she wants air."  The others repositioned themselves again. Candace whimpered and gagged. "It's getting pretty tight in here," Watkins is heard saying.  "Yep," Ponder agreed. "Getting tighter and tighter, and less and less air all the time." At 40 minutes into the session, Jeane Newmaker asked, "Baby, do you want to be born?" To that question, they heard another faint "no" from under the pillows. That was Candace's last word. Nearly 20 minutes passed. No respiratory sounds at all were audible now. Julie Ponder reached through the pillows and sheet. "She's pretty sweaty, which is good," Ponder said. "It's wet inside there." Watkins gestured to her by putting her hand to her own face, apparently an inquiry about Candace's state. Ponder said, "Oh, I'm not sure. I touched her face and it's just sweaty. She's not answered. We could do this forever, just stay here."
    Another minute passed. Jeane Newmaker was distressed now, but not because she sensed danger. She felt rejected, she'd explain later, because Candace wasn't making the effort to be reborn. Watkins asked her to leave the room, saying she didn't want Candace to "pick up on your sorrow." Newmaker went upstairs and cried. Watkins joined her there briefly, encouraging her not to give up. Then Watkins returned to the rebirthing session, which Newmaker watched from upstairs on a closed-circuit TV monitor. Moments later, Watkins also asked McDaniel and Brita St. Clair to leave the room. Now Ponder and Watkins were alone with Candace. The two therapists talked together for four or five minutes. Then--70 minutes into the session, 30 minutes after Candace's last word--they decided to unwrap Jeane Newmaker's daughter.
    Her face was pale and flecked with vomit. Her lips and fingers were blue. Her skin felt clammy. Watkins said, "Oh there she is, she's sleeping in her vomit." Watkins called out Candace's name. There was no response. Watching on the monitor, Jeane Newmaker heard anxiety in Watkins' voice. She rushed downstairs. Candace looked so blue to her. In Durham, Newmaker was a nurse who cared for children, so at least now she knew what to do for her little girl. She began performing CPR. On and on she labored, even though she believed that Candace was already dead.

'Ramifications' of Death
Of all that has transpired since the death of Candace Newmaker, nothing is more telling than the passionate response of Connell Watkins' vocal admirers. The fusillade began with an Internet message from Watkins herself, declaring her innocence--"somehow the 10-year-old inexplicably stopped breathing"--and urging supporters to "pray for a total dismissal of all charges." Next came the supporters' Web site calling for letters and contributions to fight "a miscarriage of justice being carried out in the small town of Evergreen, Colorado." Finally came warnings about "ramifications"--How many more juvenile delinquents will we have? How many of these untreated children will kill another child? How many more Columbine incidents do we need?--if the therapists' trials went forward. The capstone was a comparison, offered by Foster Cline, that likened Watkins' situation to "what would have happened if Helen Keller, blind and deaf, had died in the hours-long battles that her young teacher, Anne Sullivan, was forced to put her through."
During all this, most Evergreen therapists were busy distancing themselves from both Connell Watkins and rebirthing therapy. The Attachment Center's Web site featured a red blinking press release that made clear it had nothing to do with Candace's treatment. "Across the country, it's going to have an impact," worried Paula Pickle, the center's executive director. "We fear that agencies and funding sources will back away. We fear that people who write rules and regulations will say there can be no holding. We fear it's going to drive off people who really need help."
    Of course, that's precisely what attachment critics ardently desire. It's not likely to happen, though. There will always be desperate parents struggling with troubled children, whether they're called RAD kids or not. They will always face limited options, for few exist. So they will always seek alternative therapies, however controversial. There could be no better proof of this abiding demand than the 12th Annual ATTACh Conference held in Minneapolis early last October. One year after Jeane Newmaker walked the conference's aisles, half a year after Candace's death, ATTACh drew an even larger group, some 600 in all. Crowds once again thronged the hallways; therapists once again leaned into microphones and rolled their videotapes. They were not all "wackos," no more so than the year before. If some were overly fervent or militant, others radiated gentle probity. The most conscientious met behind the scenes, trying to draft standards aimed at preventing further abuses.
    How to tell them from the zealots, how to choose a true savior when you're at your wit's end? That was Jeane Newmaker's challenge, one she failed. I don't justify what she did, came the whispered comments at the ATTACh conference. But I can see how it happened.  That was all to be heard in Minneapolis concerning the events last April at Connell Watkins' home. There was no public mention of Jeane or Candace Newmaker. Only an ATTACh membership directory, lying on a hotel counter, provided a visible reminder. There, on page 32, under the Ns, listed as a paid-in-full member, was "Jeane Newmaker, Durham, N.C." The identity she'd chosen for herself just weeks before Candace died: "Advocate."

Family Suing School over Educating Son with Tourette's
Associated Press, 2/5/2001

LANGHORNE, Pa. (AP) A school district and the family of an 11-year-old with Tourette's syndrome are facing off in federal court over how to educate the boy after he threatened a classmate and pushed a table at his principal. Tourette's, which doctors think may be caused by improper levels of chemicals in the brain, causes repeated twitches, movements or noises. Often the tics are harmless, but they can escalate to include obscene language or sexual gestures. Jim and Mary Brennan of Langhorne want their 11-year-old son Timothy educated in a regular classroom. The parents say his most noticeable tic is to constantly clear his throat. He also repeats phrases and sometimes blurts out vulgarities, they said. The family is suing the Neshaminy School District in Bucks County, which wants to put him in a special-education classroom. For now, Timothy, who was diagnosed with Tourette's when he was 5, is tutored at home 10 hours a week by an instructor paid by the district.
    Last March, Timothy encountered a student in his elementary school's hallway after classes and blurted a threat. Afterward, the Brennans met with Jacqueline Rattigan, the school's principal. At the meeting Timothy shoved the table at the principal. Police charged Timothy with making terroristic threats, simple assault and harassment. The charges were dismissed nine months later.  ''I'm not excusing his behavior, but I think they overreacted,'' said Jim Brennan, a retired police officer. ''I don't think they should use the police and the courts as a behavior tool.'' Nick Iampietro, Neshaminy's supervisor for special education, said staff and students have learned about Tourette's syndrome in an effort to better understand Timothy's behavior. ''The schools are in a quandary about what to do,'' Iampietro said. ''You have to balance the student's right to a fair and appropriate public school education the fact that it is a disability against the goal of promoting a safe environment in the school for students and staff.'' Researchers estimate Tourette's affects one in 2,000 people.
    On the Net: Pennsylvania Tourette Syndrome Association: http://www.patourettesyndrome.org/

Group Unites to Make Anti-Violence Course a Requirement
Heidi B. Perlman, Associated Press, 2/5/2001

BOSTON--Richard Davis still blames himself for missing the telltale signs that his daughter was in an abusive relationship her nervous tics, her bruises, and the excess makeup she wore to cover them. Now he is trying to ensure others won't make the same mistake. Davis, a retired police officer, is helping to spearhead an effort to require all Massachusetts college students to take a course in domestic and family violence in order to graduate. ''In most colleges they talk about people who profess to love one another beating the heck out of one another,'' he said. ''But there's more to it, and we need to know what it is, what to look for and what we can do about it.'' Davis is vice president of the board of directors for the Community Center for Non-Violence in New Bedford, which is circulating petitions to drum up support for the requirement. The course would cover recent facts and statistics on abuse, teach students how to recognize the signs of someone being abused, and what to do to help.
    But some say students as young as high school or middle school would be better served with this type of education.  According to the state's 1999 Department of Education Youth Risk Behavior survey, 18 percent of high school girls and 7 percent of high school boys say they have been physically or sexually hurt by a boyfriend or date. Karen Leiter, a spokeswoman for the Violence Prevention Program at the Harvard School of Public Health, said simple curricula should be developed for children as young as elementary school age. ''The university level is a little late to start,'' she said. ''Once you get to college age and you have a lot of ingrained behaviors, and it's a lot harder to change your mindset and behavior.''
    Degree candidates need the violence education most, so they can bring the awareness with them into their new careers, said June Mendel, director of the New Bedford center. Anyone dealing with people on a daily basis including teachers, doctors, and lawyers should be able to recognize the signs of someone in an abusive relationship, she said. ''I'm a woman, and I've seen this happen,'' she said. ''Women are getting killed, and children are being traumatized, and nobody is doing anything about it. That has to change.''  The center plans to present its petition to state legislators and college and university officials later this year.
    Logistically, making the course a required reality in every private school will be tough because there is no state-run body that can require private colleges and universities to do anything. The state's public schools answer to the Board of Higher Education, which would have to vote to make the course a requirement. ''To have a course required means altering your general education requirements,'' said University of Massachusetts spokesman John Hoey. ''It would take a significant amount of review before we could do such a thing.''
    Any change whether it be at all schools or just a handful will be an improvement and is desperately needed, said Tess Sneesby, director of the Abbey House, a shelter for battered and homeless women in Worcester. Many of the women who come through her door say they have been in abusive relationships for years, and only just realized they had a way out, she said. ''Some of these women just assume that violence is part of being in a relationship,'' she said. ''Maybe if they had taken a class like this one, things would have been different for them.''

Gritty Portrayal Of the Abyss From a Survivor
Rick Lyman, New York Times- 2/5/2001

HOLLYWOOD--There was the Christmas morning in 1996 that he spent, pretty much at the end of his rope, awkwardly trying to steal crack cocaine from a curb-side dealer who pulled a gun on him. But that was not enough to get him out of the junkie's life. Nor was the time a dealer working out of an abandoned elevator shaft on the Lower East Side of Manhattan put a knife to his throat. Not even when a 300-pound fellow inmate strung out on PCP chased him around a Manhattan holding pen singing the theme from "I Love Lucy."
   Not until a strange, dark kind of miracle occurred in July 1997, said Stephen Gaghan, did he finally hit the wall and realize that he had to change his life or die. "Over one long, five-day weekend, I had three separate heroin dealers get arrested," Mr. Gaghan said. "My dealer, my backup dealer and my backup-backup dealer. I was left alone, and I just hit that place, that total incomprehensible demoralization. That was the end of it; up five days straight, locked in the bathroom, convinced there was nowhere else to go, I had to kill myself, I'm going to kill myself. I just couldn't take another minute of it."
    You might have spotted Mr. Gaghan during the Golden Globe Awards broadcast a couple of weeks ago, seated at the table right behind Tom Hanks, grinning happily, never more so than when he won the award for best screenplay for Steven Soderbergh's "Traffic," an ensemble drama set in the world of drug smugglers, drug dealers and drug takers. Mr. Gaghan is 35, thin, with a rough-edged look, a wide smile (only recently acquired) and a loquacious nature.
    Mr. Gaghan, who said he won his Emmy in 1997 (as one of the writers for an episode of "NYPD Blue") while in the thick of heroin and cocaine addiction, and who is now considered likely to get an Oscar nomination for "Traffic," said he had been cleaned up for three and a half years. But now, he said, it is time to come clean about his past. "There was one person I knew who had stopped doing drugs, and his life seemed to be getting so much better," Mr. Gaghan said. "So at the end of that five-day weekend I just picked up the phone and called him. And he helped me." Mr. Gaghan has made references in interviews (and in his Golden Globes acceptance speech) to friends and acquaintances he made in the drug world.  But until now he has kept quiet about his own two-decade odyssey with drugs, a long slow spiral that he said started at a fancy private school in Louisville, Ky., and included several arrests, squandered opportunities and accelerating bleakness until he found help to make his way back.
    "People were asking me about where the movie came from, where I got the characters and situations for 'Traffic,' and I found myself starting to speak in code," he said. He would talk about research he had done in the drug culture, about unnamed acquaintances, but he never admitted the core truth: that a lot of it came from his own life. "Part of the recovery process is a commitment to truth, and I began to feel that I was not being truthful," he said. "The stigma and shame of drug addiction is part of what makes it difficult for people to raise their hand and ask for help, and I felt that by not being completely honest I was , in a way, perpetuating that stigma."
    Also, he said, so many people came up to him, especially after the Golden Globes, to say the movie had given them some hope. "If there is a message to the movie, I guess it's that drugs should be considered a health care issue rather than a criminal issue," Mr. Gaghan said. "And so many people came up to me recently, people who had gone through the wringer, half-dead people who came back to life, that I thought maybe saying a little bit about my own experience, might be interesting to people."
    Edward Zwick, the film director and television producer, said that he first met Mr. Gaghan four or five years ago, when the young writer was on the steepest slope of his descent, and that he could tell Mr. Gaghan was "in a slippery place." But he said he didn't know quite how slippery or quite how steep until, while working with him on the "Traffic" script (Mr. Zwick is one of the film's producers), it gradually became clear that actual experiences were being drawn upon. "You know, you sort of intuit things before you actually know them," Mr. Zwick said. "I've known a lot of other people in recovery, so it's not as if it's mysterious to me. My father was an alcoholic, and I went through that with him. I've been out here longer than Stephen, and I've watched several people not make it. I doubt he's smug about it, but the real triumph of Steve's life has nothing to do with his screenplay or its reception. It has to do with putting his life back together."
    It started, Mr. Gaghan said, as it often does for young people, with alcohol and marijuana. "I remember, when I was writing 'Traffic,' talking to top federal drug enforcement officials and having them say they read it and found it very good and believable, except the scene where the girl describes her resume," Mr. Gaghan said. It is the scene in which a prep-school student arrested for drug possession, ticks off her academic and athletic achievements to a disbelieving social worker. "They said to me, there is no way this girl could be achieving at the level you have her achieving at and be using cocaine," Mr. Gaghan said. "I didn't say to them--maybe I should have--that the resume I had the girl reciting was my resume exactly, at a time when I was drinking, every day, and smoking marijuana and taking cocaine. The only thing I changed is that, in reality, I had also been on the all-state soccer team in Kentucky. I just had her on the school volleyball team."
    The point, he said, is that drug addiction can attack anyone, even a high-achieving private-school student from a solid, middle-class family in Kentucky. "It starts out, you're running around with all your friends--hurrah, you know. If you said to me, you're going to end up locked in your bathroom thinking that police were spying from helicopters through the skylight, I'd have said, no way. I'm going to an Ivy League college, and I'm taking over the world." Mr. Gaghan said many of his school friends also experimented with drugs, but for most of them it was a short-term affair. They tried it, didn't like it or got scared and backed off. But for him, it became endlessly fascinating. "It was always just a point of trying to take it a little bit further than everybody else," he said. "You always end up finding lower and lower companions. People fall out, and you end up with people who are just right on the edge of criminals, people who can procure for you the various things you need."
    He was thrown out of school on the last day of his senior year, eventually got his equivalency diploma and went to a small business college in Massachusetts. There he hooked up with some Boston venture capitalists and started a catalog company, Fallen Empire Inc., hoping to make enough money to support his writing career and provide enough money for booze and drugs. One of his stories, "The Year With No Winter," was published in the Iowa Review in 1990. But the business was a disaster. And when he had lost everyone's money, he said, he simply ran away to New York: "I'd get in trouble in one place, so I'd just flee to someplace else." And the whole time, he was using drugs: sometimes more regularly than at other times, two or three times kicking the habit for a short while. His shift was steadily toward cocaine and eventually the sniffable heroin that became popular among young people in the early 90's. "Everybody was doing it," he said. "It was just the thing to do. You'd walk around the East Village in your hipster boots, listening to grunge music and being the prototypes of heroin chic. I don't know, it's so embarrassing."
    Though he didn't know it, Mr. Gaghan said, he was by this time a full-blown drug addict. "I thought I was just having this literary adventure, that I was really fine," he said. The dependence was getting worse. There were seizures, bouts of incontinence, a long, slow steady descent into mental and physical squalor. The amazing thing, he said, is that outside of his drug friends he was able to keep it a secret from others in his life. "I worked very hard on the mask," he said. "The one thing that I couldn't disguise was that I was getting arrested all the time." There were some 20 or 30 arrests, he estimated, all over the country, mostly for misdemeanor charges. "Even in my stupor, I realized that there was a pattern forming," he said. There were three D.U.I. arrests for which he was, amazingly, acquitted. But then he made a big mistake.
    "I used to buy drugs from these 14-year old kids who ran their operation out of an apartment on Eighth Avenue and 15th Street in Manhattan," he said. " I went over there one day in late 1992. I had maybe $4 worth of heroin in my pocket, and I wanted to buy a half-gram of cocaine." He bought the cocaine, left the building, walked around the corner to Seventh Avenue and was caught in a police sting operation. This was no small misdemeanor; this was heroin and cocaine. Mr. Gaghan borrowed money from friends, used all of his own savings and hired a good lawyer. (He kept it secret from his mother and stepfather in Kentucky.) Records of his Manhattan case show that he was arrested on October 10, 1992, on felony drug charges and less than a month later pleaded guilty to a misdemeanor charge of drug possession and was sentenced to a conditional discharge.
    Mr. Gaghan reacted the way he always did when backed into a corner in those days, he said. He fled, this time to Los Angeles. It was 1993, and the worst of his decline was yet to come, he said. He worked for a while answering phones and reading books for a production company. Then he stalked off on his own, hoping to make it as a movie or television writer. "I got 10,000 rejections. I was rejected on the phone by 'Baywatch Nights.'" Still, it meant he had plenty of time for his other life, the one filled with cocaine and heroin. He lived the West Hollywood life of a struggling writer, getting odd jobs here and there, up all night much of the time, high or strung out.
    "It starts out that you have a bunch of people around you, living the same drug life, and then people start to drop off," Mr. Gaghan said. "They die. They go into rehab. They disappear. Until finally you're down to a real hard core, the iron men. And then after a while they're gone, too. And it's just you, locked in the bathroom. I honestly believe that out of the last 10 years, I spent 3 of them locked in the bathroom." There is a scene in "Traffic" in which Michael Douglas, playing the young addict's father, breaks into the bathroom where she has locked herself and her drugs. Mr. Gaghan said he knew that bathroom had to be in the movie, because it was in his life.
    By the mid-90's, despite the drug use, he began to get work. He had jobs on various movie lots, wrote some television shows, even shared an Emmy. But he was a drug addict the whole time, he said. "I smoked crack in my office on the Universal lot, always with some heroin to even it out," he said. "I smoked crack in my office on the Fox lot. Oh God, what are people going to think when they read this? I will never work in this town again."
    Substance abuse, of course, is not a new story in the entertainment industry, which is, if anything, more willing than most to forgive such transgressions and cheer on those in recovery. The warm reception that has been given Robert Downey Fr. Since his release from jail on a drug charge, and subsequent arrest on another drug charge, is merely the latest case in point. Almost everyone in Hollywood knows someone who has been down that road.
    Mr. Gaghan said that at this point he was spending much of his money on drugs. When he ran out, he tried to make do. Sometimes he could. Sometimes he just sat in the locked bathroom, wondering if anyone was noticing. And then came the day he hit that wall--in July 1997--and the helping hand that led him to therapists, substance-abuse programs and what he hopes will be a whole new life. Mr. Gaghan declined to give the name of the person who saved his life. It is a fellow writer and actor, he said, who is well known and deserves his anonymity. He met a woman in recovery, a photographer named Michael McCraine, and now they have a 9-month-old son named Gardner. It's been 43 months since he hit that wall and found the way out, he said.
    As Mr. Gaghan finished his lunch one day last week on the terrace at the Chateau Marmont Hotel above the Sunset Strip, a bright-blue tropical bird fluttered out of the foliage onto the table's edge. Mr. Gaghan gently laid out a French fry. The bird cocked its head, bent forward, snatched the fry and whizzed back up into the trees. "That was just insanely beautiful," he said. "I have this life now where I am noticing all of these beautiful things around me." One day last week he had three things happen to him: Paramount Pictures gave approval for his next movie, "Abandon," a thriller based on his own script, which he will also direct; he received a nomination from the British Academy of Film and Television Arts for his "Traffic" screenplay; and he received a call asking if he was interested in writing the screenplay for the next Indiana Jones movie. Not bad for one day.
    "I'm happy now," he said. "No one who saw me a few years ago could believe I would be here. In don't know if drug addiction is genetic. I don't even know if it's a disease. But I do know one thing; you have to treat it like a disease. Because if you don't, you die."

Oakland County Officials Say Mentally Ill Inmates Need Alternative
Detroit Free Press, 2/6/2001

PONTIAC, Mich. (AP) -- Officials in Oakland County are trying to determine the best place for mentally ill inmates, who they say need treatment, not jail time. About 240 of 1,800 Oakland County Jail inmates are mentally ill. Commissioners were expected to consider creating a task force to study the issue at 1:30 p.m. Tuesday.
    The problem is not unique to Oakland County. In 1999, the U.S. Department of Justice estimated that at least 16 percent of jail and prison inmates have a serious mental illness, and that most jails and prisons cannot provide adequate services for them. Though Oakland County jail officials don't disagree with a decades-old policy of closing state institutions and treating the mentally ill in the community, they say the mentally ill inmates need to be diagnosed after they've been arrested and before they're jailed. "The key is the screening," said Ann Russell, Corrections Administrator for the Sheriff's Department. "We want to keep them from even coming in through the doors."
    The county jail has no separate area for mentally ill inmates, although counselors are on call 24 hours a day. Russell said there are three detoxification cells where deputies can watch prisoners. "It comes down to picking and choosing who is the most severe," Russell told The Oakland Press. "It's not a setting for any kind of serious treatment." The county plans to add 28 single cells to the old county morgue for mentally ill or problem prisoners. Commissioner Shelley Taub said an experimental program to alleviate crowding is necessary. "Where do we take them? We need some kind of a place between a hospital and the jail," Taub said. "We're going to run out of room for the real bad guys because of the situation."

Michigan Stalking Law Upheld on Appeal
Ann Arbor News, 2/6/2001

A federal appeals court upheld Michigan's anti-stalking law Monday, rejecting a convicted stalker's argument that the law was too vague and violated his free speech rights. The 6th U.S. Circuit Court of Appeals, based in Cincinnati, ruled that Jerry Lee Staley should remain in prison, overturning a ruling in Staley's favor last year by U.S. District Judge Richard Enslen of Kalamazoo. "A person of reasonable intelligence would know whether his conduct was violating the statute," 6th Circuit Judge Richard Suhrheinrich wrote in the unanimous opinion from the three-member panel. "The statute was certainly not vague as applied to Staley, as his conduct falls squarely within the heartland of conduct the statute is designed to prohibit."
    The ruling ensures that at least 126 inmates, including a total of five from Livingston and Washtenaw counties, will remain behind bars for stalking, said Michigan Attorney General Jennifer Granholm. Authorities had feared the inmates would have to be released, and that the ruling would jeopardize future stalking prosecutions. "It is a big victory for domestic violence victims in Michigan," Granholm said. The Livingston and Washtenaw County prosecutors both were confident that the law would be upheld on appeal, and both continued to file stalking charges even after Staley's conviction was thrown out.
    Enslen's decision, Mackie said, was based on "far-fetched reasoning." "I'm sure he thought he was protecting our Constitutional rights, but the Constitutional rights of Mr. Staley's victim were certainly set aside by him," Mackie said. Mackie said he can't tell, with a new computer system still in the shake-out period, exactly how many stalking cases have been filed since Staley's conviction was overturned, or how many local offenders might have been released if the reversal had been allowed to stand. "I'm glad that this has been cleared up," said Livingston County Prosecutor David Morse.  Staley's attorney, David Dodge, said Monday that he would appeal the ruling to all 21 members of the 6th Circuit Court of Appeals.
    Staley is serving a 15-to-25-year state prison sentence for stalking his ex-girlfriend. During his 1994 trial, he was accused of breaking into the victim's home, calling her up to 15 times per day, chasing her with a baseball bat and threatening to "slice her gut" with a knife. Under Michigan's law, which went into effect in 1993, people may be convicted of felony stalking if they make unwanted contact with a victim two or more times and make a "credible threat" at least once. The law defines stalking as repeated harassment that "would cause a reasonable person to feel terrorized, intimidated, threatened, harassed or molested." Staley was originally sentenced to life in prison. He sued, saying his punishment was excessive and that the stalking law was unconstitutional. The Michigan Court of Appeals agreed that his sentence was too heavy and reduced it. But the Michigan Court of Appeals and the state Supreme Court upheld the stalking law.
    Staley then took his case to federal court, where Enslen ruled that the law was so broadly written it might be used to prosecute journalists or telemarketers who pursued someone as part of their jobs. But the 6th Circuit Court said Michigan's law clearly defines what it means by stalking and, in doing so, protects legal behavior such as journalism. "Granted, the district court posed several examples of speech or expressive conduct that could conceivably be restricted under the statute," Suhrheinrich wrote. "Simply because the district court could cite several examples does not make the statute overbroad, however, especially since none covered the core of conduct the statute is designed to deter."
    State Sen. Dianne Byrum, D-Onondaga, sponsored the bill that became the anti-stalking law. She said lawmakers spent a year drafting the measure. "We believed right from the beginning that the statute was constitutional," she said. The Michigan Sheriff's Association, Michigan Prosecuting Attorneys Association and several domestic violence and women's organizations have backed the law.