Personality Disorders

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High RiskReview - High Risk
Children Without a Conscience
by Dr. Ken Magid and Carole A. McKelvey
Bantam Doubleday Dell, 1990
Review by Vicki Jung, M.A., CMHC
Dec 15th 1999 (Volume 3, Issue 50)

"Trust Bandits" permeate our society. They are people without a conscience, and they hurt--sometimes kill--others without remorse. When young, they are considered character-disturbed children. As adults, they are called psychopaths and diagnosed as having an Antisocial Personality Disorder. Not all psychopaths end up in prison. Most of them are highly intelligent and use their intelligence to con and manipulate others with their charm having done so since they were children. They are compulsive liars and have no concern for the feelings of others. We can easily become their prey. These "Trust Bandits" are everywhere. Most don't murder. A few even become powerful figures in the world, politicians or corporate presidents. So, what happens in childhood that enables a child to become a "Trust Bandit"?

High Risk approaches the problem from the theory that as children they did not bond with their parents resulting in unattached children (character-disturbed children). It is in the first year of life that a child learns to bond and attach to the primary caregiver (mother) and extends the attachment to the father. Without forming that attachment these children learn that there is no adult to care for their needs. Consequently, he fails to learn to care for others and to develop a conscience. Behaviors indicative of unattached children are:

  • inability to give and receive affection
  • self-destructive behaviors
  • cruelty to others and animals
  • phoniness
  • abnormalities in eye contact
  • problems with stealing and hoarding
  • extreme control issues with authority
  • preoccupation with blood, fire and gore
  • lack of long-term friends
  • various types of learning disorders
  • crazy lying

Unattached children do not grow socially. They turn into psychopaths as adults. Incomprehensible pain (in the form of rage) is forever locked in their souls because of the abandonment they felt as infants.

If we look at how little time the majority of our parents spend with their children, it is no wonder we have a bonding crisis in our society. Though this book was published in 1987, it is even more relevant to our society now if we look at the increase in violence among our young children. Almost everyday in the news is another report of an act of violence or murder by a child or teenager. The authors stated (page 111)..."In the last decade alone the number of working women with children under the age of one had increased by 70%. Never in the history of the world have so many children been raised by strangers".

High Risk does not say that women shouldn't work outside the home, but that parents need to be aware of the importance of bonding and attachment in the early years to enable the healthy development of our children. Other areas of concern that contribute to the development of unattached children are lack of quality daycare, lack of extended periods of time for maternity leave, adoptions and foster care, teenage pregnancy, abusive parents, and divorce.

Magid and McKelvey base their theory of unattached children on the work by Dr. Foster Cline, an authority on unattached children, from Evergreen, Colorado. He has treated and trained others to treat unattached children for over 30 years. His "bonding cycle" consists of four stages:

  1. Need
  2. Rage Reaction
  3. Gratification or Relief
  4. Trust

The infant usually expresses Rage Reaction through crying. It is between the Rage Reaction Stage and Gratification or Relief Stage that there must be "Necessary Input" in attending to the needs of the infant emotionally and physically. If these needs are neglected, the bonding cycle is broken, and trust is not developed resulting in an unattached child.

Cline's work was originally called "Rage Reduction Therapy" (now called Attachment Therapy) and was considered quite controversial in the field of mental health. Some clinicians considered his form of therapy abusive in that the therapist engaged in physically holding the child. High Risk describes in detail the guidelines and procedures in how to facilitate holding time with an unattached child. I was fortunate enough to have attended one of Dr. Cline's workshops in 1987. While at the time I found it interesting, I was not in a clinical situation that allowed me to apply what I had learned.

It wasn't until 1992 that I became a true believer of Attachment Therapy. I was working with a 4 year old girl who had been sexually molested by her father. For over a year I used the traditional play therapy techniques with no success. Her acting out behavior continued and at times escalated. She lied, would smear food on the kitchen cabinets, was physically aggressive towards her 8 year old sister (who was terrified of her), and was constantly defiant with her mother. She was hospitalized five times during that year for Encopresis (impacted bowels). Finally, out of a desperate need to help alleviate some of her anger (which was so blatantly being acted out) I sought the help of a trained therapist in Attachment Therapy.

After 4 days of intensive work in holding time this little girl was finally able to work through much of her rage that had left her unattached and out of control with her life. Her mother was a drug and alcohol abuser at the time, and was able to hide her addictions for the first two years in counseling with her daughter. Over the past 7 years I have periodically continued to work with this little girl. I have now come to the conclusion that her rage was not only about being molested by her father, but the emotional neglect by her mother from infancy. Through the trust that she established with me, she has learned to confront her mother with her anger in an appropriate manner.

To further my understanding of Attachment Therapy, I read the book Holding Time by Martha G. Welch (1989). It became my primary resource for parents in counseling who had children with Attachment Disorders. Though I had bought High Risk shortly after it was published, it sat on my bookshelf for 12 years. It wasn't until this year that I started reading the book when an 8 year old boy was referred to me. His father brought him to counseling after he had made verbal threats of killing the teacher, had taken a pair of scissors and held them to his neck, and eventually threw them across the classroom.

In one counseling session he was working in the sand tray room, and we were discussing his mother. Having been told that he and his mother did not get along, I was trying to explore with him the possibility that he might be angry with her. As he continued to bury the dinosaur in the sand, he denied ever being mad at his mother. Then, her raised his head and looked at me very intently with sinister eyes and said, "If you say I have a bad mother, I'll have to kill you!" As I read the book, I could see more and more of this boy's symptoms. The book spoke of modified holding techniques, so I started using them. Sometime his father held him in counseling. By administering minimal holding time he has learned he is too young to be "the boss" and has improved in eye contact and following instructions given in counseling. His teacher reports marked improvement in his school work and interpersonal skills with fellow students. He is also learning to identify and express feelings appropriately especially his anger. In fact, he has gone so far as to confront his mother with some of her behavior that upsets him.

There are two other young children with whom I have used Attachment Therapy. What amazes me about all of these children is that at the end of the holding time sessions when they are ready to go home, they have all on their own volition given me hugs. With one little girl I held her for two hours with her raging in my face the whole time. I thought when we were through, she'd never speak to me again. The next time I saw her she ran up to me and threw her arms around me and gave me this big hug. What I've learned from this is that not only does Attachment Therapy work, but the kids are so relieved of their rage that they have bonded with me and that trust has started to develop.

Mental health and medical professionals, teachers, counselors, and even the general public could benefit from reading High Risk. I would also recommend it to parents, but I'm afraid many parents would not be able to 'see" their child as "high risk", let alone look at their part in creating these little "Trust Bandits". It behooves every adult to become educated on how to recognize a "Trust Bandit", whether a child or an adult. You never know when you might end up dating or working with one. Who might even be married to one! One thing for sure, the sooner we reach these children the better. There is a strong consensus that adult psychopaths cannot be rehabilitated. The authors reference the age of eight as a possible turning point for these children with Attachment Disorders. Certainly the older they get, the harder it is to intervene in their rage-filled lives.

Some books are classics, and over time, I believe High Risk will fall into that category. We need to take heed to what Magid and McKElvey have to teach us. They predicted that if Attachment Disorders were not more aggressively diagnosed and treated, our society was only going to get worse. Considering what has take place over the last few years in the escalation of children's' violent behaviors, they were right. There is something that can be done to alleviate Attachment Disorders and reduce the number of "Trust Bandits" ravaging our society. It will take time to reverse the process, but we have to start somewhere. Reading High Risk is a beginning. The more educated we become about Attachment Disorders, and Attachment Therapy, the healthier our children and society will be.


Vicki Jung has been in the field of mental health for over 16 years.  Since  1990 she has worked in  private practice through Jung, Jung and Associates in Bothell, Washington.  As co-founder of the Youth Suicide Prevention Center in 1985, she counseled over 450 youths-at-risk of suicide through group intervention until it closed in 1990.  Her work has a broad range of experience including not only suicide and self-harm behaviors, but grief and loss, survivors of sexual abuse, victims of crime, anger and violence, marriage and family counseling, Post Traumatic Stress Disorders, and Dissociative Disorders.  Through her career she has worked extensively with individuals, couples, and groups including children, adolescents, and adults.  In addition to traditional therapeutic skills, she utilizes art and sand tray therapy and has a special interest in pet-facilitated therapy.  Her Chihuahua, Sarina Marie, works as her co-therapist.

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