attachment presentation
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Attachment
Developing and repairing the bond between parent
and child
Attachment: where does it begin?
Attachment is always a two way street
Before birth in the womb
After birth: attachment chemicals (oxitocin) in the brain of child and mother
Taking care of the baby- responding to his basic needs
Pattern of care in early years set an expectation of relationships within the individual for life
What is attachment?
Special enduring emotional relationship (bond) with a special person
Involves familiarity, comfort, soothing and pleasure
Threat of losing that specific person is distressing
Security and safety within the context of the relationship
Emotional glue between people
Phases of attachment
Birth to six weeks: neutralSix weeks to six months: developing attachment with primary care giverSix months to 15 months: discriminate between carers, preferred attachment16 months and three years: established-start to experiment and expanding to othersThree years and onwards: repeating attachment patterns in all relationships
Discuss
What age were the children placed in your care, removed from their birth parents? ORAt what age was your child separated from you?In what phase of attachment were they?What implications do you think this had in the children? [10 min]
Attachment patterns
Secure: safe well balanced emotional connection between parent and child
Parent is attuned and responsive to the child's needs
Child respond to the carer with affection respect and accepts guidance from adult
Trust is established
Attachment patterns continued
Insecure attachment:
Avoidant: parent not giving attention to the child- child gives up-avoid making contact.
Ambivalent: parent sometimes gives attention sometimes not. Child becomes hyper demanding to ensure parents attention
Attachment patterns continued
Disorganised: could be avoidant or ambivalent but with element of fear or abuse-child disconnects
Indiscriminate: multiple placements multiple carers- child will attach to anyone- superficial attachments
Case study
Peter was removed at 18 monthsChronic neglect- hospitalised for infected nappy rash for third timeDid not talk sit crawled or walked and did not eat solidsHospitalised for 8 weeks where he caught up most of milestonesWas in three places of safety before entering long term foster careAt age 15 he does not interact with peers and has been reprimanded for setting the dog on fire and watching while the dog burned
Discuss
Does he have a secure / insecure attachment?What possible attachment pattern does he have?Can you recognise any possible attachment patterns of your child/foster child?How does this make you feel? [10 min]
Internal working model
From birth to 3 years a child form an opinion about themselves and the world based on the interactions with their primary care givers-engrained in implicit memory If the child has been abused / neglected they would view the world as a hostile environment without any warm place for himselfIf that inner working model goes unchallenged they would use this as their point of departure in all their interactions
How do you change this inner working model?
Healing takes place through positive repetitive ,specific, predictable, experiences in a cognitively stimulating and attachment rich environment
What is the effect of insecure attachment of children
Problems accepting adult controlChild: “I must take charge of things or no one will”- internal messageRefuses to co-operate not accepting leadership of parentParents: Threatens parents belief that they have the right to parent the childFeels frustrated or like failure+Response: safety, understanding, structure, completing tasks –lead by doing not saying story telling.
DISCUSS
What is your child’s inner message about accepting adult control?
How have you been affected by his/ her refusal to accept your leadership?
What is the effect of insecure attachment of children
Engagement and relationship problems
Child: “I must stay away to avoid getting hurt” internal messageNo eye/ physical contact, superficial relationships, unpredictable, not thereParent: difficult to claim child as own or develop mutual feeling of belongingFeels rejected by child+Response check up list, wonderment, eye contact, repetition story telling
DISCUSS
What is your child’s doing to avoid engaging with you?
How have you been affected by this?
What is the effect of insecure attachment of children
Problems in accepting care.Child: “ I can take care of myself-don’t need anyone” internal messageDon’t ask for help. Don't allow assistance with care- wear dirty clothes wont let you wash hair.Parents: feel rejected and frustratedNot easy or pleasurable to sooth comfort these childrenCaretaking becomes devoid of emotion foster family vs. board & lodging+ Response: soothing, singing, rocking, lotioning feeding, tucking in at night. Repetition story telling
DISCUSS
How is your child avoiding your attempts to care for him/ her?
How have you been affected by this?
What is the effect of insecure attachment of children
Problems with competence and self- worth
Child: “ I deserved the bad treatment- its my fault” ” I'm worth nothing” internal message.
Cognitive and developmental delays
Poor school performance, child feels like a failure
Parent: Too high expectations, disappointment with child's performance
Extra expenses of occupational therapy or remedial classes
Enrol child for activities they are not ready for
+ Response: more nurturing and warmth than challenge
Lower expectations so that the child can achieve success
DISCUSS
What is your child’s inner message about their self –worth?
have you been expecting too much or have you been disappointed by their lack of performance?
What is the effect of insecure attachment of children
Problems with regulation and expressing of emotionsChild: “emotions are bad and scary” internal messageCant control emotions- “loose it” and has low frustration threshold. Emotional age is much younger than actual age.Hurt others tantrums, no remorse, or cut off from their feelingsParent: sometimes panic in fear or become out of control themselves.Parents own emotions become a barrier between them and the child.+ Response: acknowledge and validate their emotionsDon’t react but parent from safety- provide emotional safety for child to feel and express their emotions.
DISCUSS
Can your child express his/her emotions?
How have you been affected by their emotional state?
Intervention dimensions
Structure: routine, guidance, consistencyEngagement: catching them off guard, new interesting experiences.Nurture: physical and emotional care, involvement Challenge: challenging old ways, stretching, moving out of the comfort zone
References
Jenberg, A.M. & Booth, P.B. 2005. Theraplay: Helping parents and children build better attachments through attachment based play.2nd ed. San Francisco: Josey Boss PublishersMay, J.C. 2005. Family Attachment Narrative Therapy: healing the experience of early childhood maltreatment. Journal of Marital and Family Therapy, 81-99, Jul.Peluso, J. P. Peluso, P. R. Kern, R. M. & White, J. F. 2004. A comparison of Attachment Theory and Individual Psychology: A review of literature. Journal of Counselling and Development, Vol. 82:139+Single, T. 2005. Long term foster care for abused and neglected children: how foster parents can help healing the trauma. Unpublished training manual for John Hunter Children's Hospital.