In our clinical work we are often referred children or youth from our foster care system or from stressed adoptions who exhibit extremely challenging behaviour and who seem to have a bewildering array of difficulties. We’ve found that our first priority must be to help to calm the child’s over-reactive stress response system. Second, we’ve found that we must provide positive attachment experiences geared to the particular attachment style and needs of that child. This blog continues are discussion of the CTR “Therapeutic Bookends” of Decreasing Stress and Strengthening Attachment. What we have seen over and over again is that if our plan addresses both of these goals then we will be successful. If we miss either one, we will usually be frustrated. This blog will focus on Strengthening Attachment and is Part 2 (b). If you haven’t yet read my previous blogs (listed below), I encourage you to read them first to have some context for our work.
- The CTR Therapeutic Bookends (Part 2-A): Strengthening Attachment
- The CTR Therapeutic Bookends (Part 1): Decreasing Stress
- What’s All the Fuss about Complex Trauma?
The Development of an Attachment Style
It is important to note that all attachment is relational and interactive –that a child will have a different attachment relationship with each of his or her main caregivers. Attachment isn’t something that is just about the child. It is always about a particular relationship. So any child might learn more than one attachment style, although this will be most influenced by the parent(s) or caregiver(s) who are the ones most available when the child is an infant and toddler. Theoretically, a child can be securely attached to one caregiver, avoidant in their attachment to another, and so on.
Parenting infants and children has been described as a dyadic dance in which each partner is initiating and responding or reacting to the other. Video or film of interactions between mothers and young infants shows how this dance is carried out beyond conscious awareness at a level of subtle movements, smiles, sounds and touch7. Patient and attentive caregiving creates security – Eric Erickson called this a sense of “basic trust” — in the world, in others, and within themselves.
Attachment between primary caregivers and children are created through tens of thousands of such momentary interactive experiences. When this goes well enough, the child is learning that their periodic discomfort and distress can be calmed, and that relationships with others are pleasurable. In fact, the high level of positive emotion experienced in a playful, responsive, and joyful relationship broadens their emotional and cognitive abilities and allows them to build upon them throughout their lives.
Additionally, these children sense intuitively that they have value and worth. For most parents and children (60%) this process goes well enough. The parent mostly responds appropriately, promptly and consistently to needs. In response, the child develops a secure attachment. The child uses the caregiver(s) as a secure base for exploration. They protest the caregiver’s departure, seek closeness, and are comforted quickly on their return. This re-connection allows the securely attached child to quickly feel settled enough to return to exploration. Securely attached children may be comforted temporarily by other adults but show a clear preference for their main caregiver.
Insecure Attachments and Attachment Style
Parents’ inadequate caregiving and response styles create particular patterns of response in their children. It’s as if the child has learned a particular pattern in an attempt to stay secure in a stressful situation in which they have little control. In our CCI Model we characterize this as either a Move Toward Others (preoccupied) or a Move Away from Others (avoidant).
Some children learn that relying on others is uncomfortable or risky because their primary caregivers or caregivers are uncomfortable in providing emotional connection and attunement. In this scenario the parent may be consistent in their response, but be emotionally distant. For these children, an avoidant or dismissive style of attachment develops which allows them to remain distant from personal connection8. The child may not have experienced pleasure in relationships in any consistent manner as he endured neglect or emotional distancing from parent figures. In turn, he may appear distant or aloof and give off strong messages of wanting to be independent. Children or youth at this end of the attachment continuum may appear emotionally cool and relationally disconnected.
Other children and youth learn that their main attachment figure(s) is inconsistent in their availability, responses and ability to meet their needs. The parent might be loving and attentive at one moment and angry and rejecting at another. This type of inconsistency leads some children to develop a preoccupied and reactive attachment style. Often these children appear to be desperate for relational connection and attention. It is as if the child is working extra hard to get a parent’s love and attention, however, there is a paradox at work because these children may show anger at the parent when the attention is gained. This type of attachment style may be confusing for a foster or adoptive parent because they find that the child engages in a “push-pull” style of relating. In this situation the child may demand the adults’ attention when they are least able to give it and then push the adult away when the adult is able to respond.
Different Children Need Different Adult Responses
Perhaps you can begin to imagine that children with different experiences and different attachment styles may require a different response from their caregivers, at least at the beginning. Some research suggests that children’s attachment styles will begin to change to be like that of a good foster or adoptive parent – which makes sense when we remember that attachment describes a relationship and interaction pattern. So, a healthy and secure adult will provide healthy, secure experiences for a child which will gradually produce secure attachment in the child. In the meantime, however, we have found that it is important for the adult to start where the child is at and to be respectful of the attachment style from which the child is currently operating. For Moving Away (avoidant) children the general principles are to: (1) Avoid giving the child choices about joining you – because they will usually say no. Instead try to create situations in which the child needs to be with you for one reason or another; and (2) Pair pleasurable experiences such as sensory experiences with relationship with the adult. For example, one adoptive mother takes great time and care to brush and braid her adoptive daughter’s hair every evening – much more than seems necessary. We are pairing the brushing, which the daughter finds pleasurable, with the time together in order to gradually pair the two experiences.
For those children who are preoccupied/reactive and are Moving Toward you as the adult — often in a way that feels clingy and intrusive at times — our goal is twofold: (1) To meet the child’s need for connection and security before they begin to feel the need to be clingy. For example, we might coach you to approach the child to “fill their tank” rather than waiting for them to approach you (probably at a time that is inconvenient). We might add the idea of intensifying the connection with a longer than necessary hug or close intimate eye contact; and (2) To gradually teach the child to delay their need for your response by teaching them some things they can do while they wait. This would include teaching them about the “waiting skill”, about the feeling that might go along with it, and then reinforcing any steps they take to learn to wait.
If you’d like more information on Strengthening Attachment or working with insecure and reactive attachment you may wish to consider joining CTR as a member — CLICK HERE NOW.
- (Ainsworth, Blehar, Waters, & Wall, 1978)
- (Griffin et al., 2012; Main & Hesse, 1990