ATTACHMENT

 1. Introduction
In adults and children, biological and adopted, attachment is an act of seeking care, a life-long instinct to seek closeness to a specific person who will comfort, protect, and help organize one’s feelings.

As an act of giving care, attachment is also an instinct to observe a specific person in order to provide comfort, protection, and/or to help organize or give understanding to that person’s feelings, when needed.

When children feel safe, their exploratory system or innate curiosity is activated and they need support, verbally or non-verbally, to explore. As they are exploring, sometimes they need their parents to watch over them, sometimes they need help, and sometimes they need their parents to enjoy with them. When they have explored long enough, (or if they get tired or anxious, or find themselves in an unsafe situation) they need their parents to “welcome them back” – even from the other side of the room. They need their parents to comfort, protect, delight in, and/or help them to understand or manage - "organize" - their feelings.

2. Much of a child’s early learning occurs before the use of language.*
Long before an infant has words, s/he is learning the specific “procedure” necessary for relationship with her/his caregivers. "When I do this she comes closer. When I do this, she backs away or gets upset.” Gradually each child forms a template or set of expectations of what significant others will accept, reject, attack, delight in, withdraw from, support, etc. Over time, the child’s learnings tend to replicate into a kind of self-fulfilling prophecy. In this light, serious psychological problems can be understood as repetitive, maladaptive, self-fulfilling prophecies based on early relationship with the primary caregiver.

3. Levels of attachment problems
Children with mild to moderate attachment problems may behave in ways that are overly dependent, rule-breaking and defiant, anxious, distant or somewhat detached. They may lie, be “hard to read,” and at times show more upset or excitability than expected for their stage of development.

Children with severe attachment problems may have little or no capacity for closeness and trust, independence and positive self-image, impulse control, and social relatedness with peers.

4. “There is no such thing as a baby. There is only a baby and someone.” D. M. Winnicott, MD
As a psychological concept or approach to assessing and helping a child, attachment is not a “child problem.” Many people refer to a “child with an attachment problem” or a “child with Reactive Attachment Disorder.” However, as a psychological concept, attachment does not primarily refer to something within the child, or to the nature of the child (or adult). Attachment refers to the child-parent relationship or to the adult-adult relationship (adults suffer from attachment problems as well).

5. Classifying attachment patterns**
Several traditions in psychiatry, codified in the mental health classification manual DSM-IV TR, created a mistaken impression that attachment problems result from problems within an individual child. In these traditions, an attachment problem is a problem of psychopathology within the child.

More usefully, and more consistent with expert research, the diagnostic system for infants and young children developed by Zero to Three (DC: 0-3), defines attachment problems in terms of the parent-child relationship.** Attachment problems may also develop as a combination of an organic or constitutional problem within the child and the parent's well-intentioned ways of responding to the child's difficulty. There are six types of problematic relationships:

  • the overinvolved relationship (parent interferes with the child’s goals and desires, over-controls, etc.)
  • underinvolved relationship (with sporadic or infrequent genuine involvement, the parent is insensitive and/or unresponsive, ignores, rejects, or does not comfort the child, etc.).
  • anxious/tense relationship (the relationship is tense, with little sense of relaxed enjoyment or mutuality, the parent is overprotective and oversensitive, etc.)
  • angry/hostile relationship (the relationship is harsh and abrupt, often lacking in emotional reciprocity, the parent is insensitive to the child’s cues, the child is frightened, anxious. Inhibited, impulsive, or widely aggressive, etc.)
  • mixed relationship
  • and abusive relationship (verbally, physically, sexually abusive).
6. Types of attachment problems***
Attachment research has identified 4 patterns of attachment-caregiving interactions during infancy and preschool. These mutual, reciprocal behaviors or “the parent-child dance” are as follows:
  • Secure pattern: Parent secure / Child secure
    When the parent is securely attached, the child will have a secure attachment.
  • Insecure pattern: Parent dismissing / Child avoidant
    When the parent’s attachment style is dismissive, the child’s attachment will tend to become avoidant.
    The parent often “over focuses” on the child’s natural interest to explore, in order to avoid activating the child’s attachment behavior. The parent will act in ways that are dismissive or distant to avoid having the child show normal distress or need, such as a child might be expected to show at a time of separation or when the child is reunited with the parent. This pattern creates a dilemma for the child: "If I get close, I will be rejected. If I take steps to grow and separate, I will be rejected by my parent."
  • Insecure Pattern: Parent preoccupied or ambivalent / child resistant
    When the parent’s attachment style is preoccupied, the child’s attachment will tend to be ambivalent.
    The parent’s statements may have an immature or babyish quality, with dramatic facial or vocal expressions. The parent seeks to convince or plead with child when the child shows negative emotions. The parent is willing to accept misbehavior without comment or teaching. This pattern creates a dilemma for the child: "When I am close, I feel smothered. When I separate from my parent in my feelings or my behavior, such as when I play alone, I feel abandoned by my parent."
  • Insecure Pattern: Parent unresolved/ child disorganized
    This pattern reflects severe and chronic trauma, deprivation, neglect, and other forms of maltreatment.
    When the parent’s own attachment style is unresolved, often as a result of childhood abuse and trauma, the child’s attachment will tend to be disorganized. A parent with this pattern often looks to the child to help her (or him) to regulate her own emotions. He (or she) often describe himself as helpless to protect his children from threats and danger. His caregiving often contains themes of inadequacy, helplessness, and/or losing control. He may describe his child as “bossy,” “too much for me to handle,” or as a “best friend” and caretaker (“My little man takes care of his daddy.” Children in this pattern may appear “overly bright” and “very competent,” when in fact they may be also frightened by the lack of structure in the relationship and thus desperately seeking to provide the level of order that they need to feel secure. This pattern creates a dilemma for the child: "The source of my support is also the source of my danger."
7. Change
Lasting change comes from parents' developing specific relationship capacities rather than merely learning techniques to manage behaviors. The capacities needed for a secure relationship include:
  • Observational skills based on children’s developmental needs, ability to observe and talk about one’s own behaviors, becoming able to help children regulate their emotions, and empathy.
  • Changes aim to respond to any “specific challenges in the caregiving environment, and [to create] specific opportunities to make a positive difference in the development of children and parents” (Kathryn Barnard).
  • The therapist helps the parent to interpret the child's cues, understand what the child is likely thinking, feeling, and needing, and what the parent, herself or himself, is thinking, feeling, and needing at a specific time.
Attachment treatments with strong empirical support for effectiveness include Dyadic Developmental Psychotherapy (D. Hughes), Circle of Security (R. Marvin, G. Cooper, B. Hoffman, B. Powell (2000), and Attachment & Bio-Behavioral Catch-up (M. Dozier, et al.).

* Adapted from "Differential Table," http://www.circleofsecurity.org/
** Adapted from “Understanding the Value of Circle of Security Relationship to Adult Psychopathology,” www.circleof security.org
** *Adapted from DC: 0-3 Casebook (1997).





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