When Ethical Violations Threaten Our Social Work Home: Links Between Yesterday and Today in “Three Identical Strangers”
by SaraKay Smullens, MSW, LCSW, DCSW, CGP, CFLE, BCD
(Editor’s Note: SPOILER ALERT. If you have not seen Three Identical Strangers and plan to do so, we recommend that you read this commentary AFTER you have seen the film. Major points are revealed in this commentary.)
Three Identical Strangers starts off as an uplifting tale of triplets, separated at birth, who meet when they are 19 years old. They feel an immediate closeness to each other, and a media frenzy ensues. As life events unravel, however, viewers experience a shattering descent. We are face to face with deception and startling condescension in a preeminent social service adoption agency. The impact of these actions is palpable—a joyous fairy tale progresses into a study of devastating psychological pain. Our profession is front and center in this true story, both fascinating and horrifying, one holding deep relevance in challenges faced today.
Documentary director and executive producer Tim Wardle not only reveals agreed upon collusion; he also highlights a period of time that connects to present-day professional challenges. In careful orchestration, the viewer becomes privy to disdainful agency investment in a study led by highly credentialed psychoanalyst, Peter Neubauer (a leader in Manhattan’s Child Development Center, which merged with the Jewish Board of Family and Children’s Services). Several sets of twins and one set of triplets were separated at birth and placed in different adoptive homes by the esteemed Manhattan-based Louise Wise Services, which closed in 2004, for the purpose of executing Neubauer’s long-term study beginning at infancy to determine what is more important in childhood development—nature or nurture.
Three Identical Strangers concentrates on the life journey of the triplets in Neubauer’s study, David Kellman, Bobby Shafran, and Eddy Galland, born in 1961 to a single mother, and intentionally placed with families of different economic levels—one blue collar, one middle-class, and one with very secure financial status. It is unclear if or how deeply the study concentrated on the impact of parental caring and emotional involvement or differing parental styles within these families.
At the time, there were no laws to protect against this kind of study. Today, such laws exist. The parents, who were not aware of the birth separations, were told that ongoing visits by researchers to evaluate their adoptive sons were routine agency procedures.
Results of the Neubauer study, concluded in 1980, were never published. Neubauer died in 2008, and records of this research are sealed at the Yale University Library until 2066. We now recognize an ongoing, perpetual interaction between nature and nurture, referred to as epigenetics. A child with strong genetic music and dance ability will not develop this gift without at least some environmental support. Although we know that certain genes show an increased tendency toward depression, environmental surroundings are a large factor in determining the resilience one will develop to withstand life’s injustices and disappointments. Further, although they originate from the same egg and sperm, because each cell division can bring small DNA change, “identical” twins and triplets are no longer viewed as 100% identical.
This said, however, many prominent research leaders in the psychiatric field underplay the importance of environmental factors. Today, a medical “brain disease” emphasis has impacted the DSM-5, and as a consequence the depth of clinical services offered in mental health centers. On the other hand, as a student and in the early years of my social work experience (more on this later), genetic factors were largely discounted. As an example, it was believed that the love and nurturance offered through adoption would offset the impact of childhood trauma. When a child did not thrive, we were taught the cause was adoptive parental rejection.
Presently, Shafran and Kellman seek an apology and compensation from The Jewish Board, as well as full release of official documents from the study of their lives. All three brothers suffered from depression, but requested materials received hold no insights, as they have been heavily redacted. The brothers share that as media sensations, they exaggerated genetic similarities, glossing over personality differences. An ever-present loneliness is described, as if the triplets were looking for something lost, something taken. And something surely was—their two brothers.
Permit me some personal reflections about the professional period of Three Identical Strangers, as well as its significance to our present. I received my MSW in 1965, when David, Bobby, and Eddy were four years old, and I worked in differing social work settings in the 1960s and 1970s. As said, during this “nature versus nurture” period, nurture was given paramount significance. It was standard procedure to invite psychiatrists to social work agency staff meetings to gain further insight into individual and family dynamics of our most difficult cases.
As with Peter Neubauer, our consultants were usually viewed as Gods who knew so much more than we. As social workers, we never discounted the relationship between mental health and the quality of love and care offered a child. Yet, when we were told that schizophrenia resulted from “double-bind” mothering, our private reactions were a united “Huh?” We would have been horrified at the thought of separating infants who had spent nine months together in their first emotional home. But speaking up about our beliefs was an entirely different matter.
Case in point: One afternoon while working at a psychiatric teaching hospital (and needing my job, as I was pregnant with my first child), I saw a resident beating and shaking a patient in a locked room, as she screamed for him to listen to her. I turned to a nurse and asked what could be done. Her response, looking at my bulging belly: “Nothing if you want your job.” As the screaming of the terrified patient and the resident’s slaps increased, I could not find my supervisor, the director of our social work department. Fearing grave injury to the patient, I knocked on the door of the psychiatric director of the hospital and explained what was happening. His furious response, as he waved me out of the room: “Residents are here to learn. If patients are helped, that’s gravy.” I was fired the next week.
Yes, standards were different in the early 1960s. The first edition of the NASW Code of Ethics had just been published in October 1960, about 9 months before the triplets were born, and surely was not as detailed as today’s Code. The modern Institutional Review Board system wasn’t in place until the passage of the National Research Act in 1974. The film does not specifically address whether, indeed, there was anyone on staff at the agency who questioned this study or attempted to stop the separations. If they had, what do you think would have happened?
Let’s fast forward to present day. How many times have you and I witnessed poor quality or unethical practice in ours and related fields, yet know that options to bring change are limited or non-existent, especially if you need your job?
Realities like these led me toward five years of research into the inextricable link between our professional, personal, social, and physical Selves; the lack of emphasis on the individuality of each Self in selected self-care offerings; and strategies to deal with the burnout inevitable when expected to deal consistently with rude, dismissive, manipulative behavior and impossible situations, with no support. Under such conditions, research clearly shows the toll on all aspects of our Self and the well-being of our clients.
In the last two years, I have been invited to share my findings in many settings. Often, there is a preference that questions or comments be submitted on cards, in this way protecting identities. In responses to certain questions and descriptions, I clearly state that some behaviors and communication patterns are not acceptable and should not be tolerated. I speak freely about the importance of respectful interaction within and between departments, and the impact of ethical violation, moral distress, overload, and exhaustion. My hope is that the urgency of this direction will be discussed in consultation with supervisors, in staff meetings, and in interdepartmental leadership meetings.
Situations have been described to me in which attempts to address intolerable circumstances will result in being scapegoated, ostracized, or demoted. In these instances, outside consultation is recommended, as well as awareness that there are times when it is necessary to shift social work skills in a new and creative direction,
As a realist, I well know that if employed in certain settings, I would pay a price for my strong stance that certain behaviors and lack of options must be addressed and not tolerated. Parts of my emphasis can and do unsettle and anger, for conditions leading to burnout (that can be addressed with proper leadership) are often pervasive in both micro and macro settings. However, my motivation is not to please. It is to inform, to leave behind something of value, knowing well that a request to share my findings is not merely an opportunity. It is a privilege.
The fields of research ethics and social work practice have changed considerably since the 1960s, when the lives of Three Identical Strangers and their unknowing parents were cruelly and cavalierly violated. Still, the true unfolding of their lives remains an important cautionary tale for all social workers, for all the reasons mentioned.
SaraKay Smullens, MSW, LCSW, DCSW, CGP, CFLE, BCD, whose private and pro bono clinical social work practice is in Philadelphia, is a certified group psychotherapist and family life educator. She is a recipient of a Lifetime Achievement Award from the Pennsylvania chapter of NASW, and the 2013 NASW Media Award for Best Article. SaraKay is the author of Whoever Said Life Is Fair, Setting YourSelf Free, and Burnout and Self-Care in Social Work. Her writing has been published in peer-reviewed journals, newspapers, and blogs. SaraKay's professional life continues to be devoted to highlighting destructive societal forces through communication, advocacy, and activism. Read more about her work at SaraKaySmullens.com.
