ATTACHMENT DISORDER WHAT

IT LOOKS LIKE AND HOW WE

MIGHT HELP
 WHAT IS ATTACHMENT?
• An instinctive system in the brain that evolved to ensure infant safety
and survival
• Early attachment occurs in a unique way
• The ‘attuned’ primary caregiver will observe and follow the lead of
the infant
• Attachment is essential for the foundation of a healthy personality
 SECURE ATTACHMENT
• The caregiver aligns their own internal state with that of the infant
and communicates this alignment in non-verbal ways
• This ‘communication’ forms a bond of trust that makes the infant feel
that they are acknowledged and loved
• This allows the infant to balance their emotions and states of mind.
• The comfort, pleasure and mutuality of the attuned interaction
creates a sense of safety and inspires interpersonal connection to
others
 SECURE ATTACHMENT & DEVELOPMENT
• Attachment experience directly influences the development of
children and is directly responsible for activating (or not) their genetic
potential
• Establishes the basis on which the child will form relationships with
others; their sense of security about exploring the world
• Establishes their resilience to stress
• Assists in their ability to balance their emotions
• Aids the development of meaningful interpersonal relationships in
the future
RESILIENCE ATTRIBUTES
• Social competence:
• Communication skills
• Sense of humour
• Responsiveness to other
• Problem-solving skills:
• Planning
• Seeking help
• Critical & creative thinking
• Autonomy
• Secure sense of identity
• Self worth
• Ability to cope
• Sense of purpose
• Hope for the future
• Personal goals and values
• connectedness
 RESILIENCE BUILDING
• Connect to family, friends, school
• Relationships – caring adult, role models
• Self esteem
• Belief in one’s own ability to cope
• Sense of control
• Developing skills & competence
 DOES SECURE ATTACHMENT HAVE TO BE
PERFECT
• If communication is secure at least a third of the time or more, that is
enough to support a secure relationship
• Repair is an important part of the attachment process – not being put
off by disruptions to closeness
• The primary caregiver (who sets the limits) needs to initiate repair as
soon as the child initiates a desire for reconnection
 WHAT IS AN ATTACHMENT DISORDER
• A condition in which individuals have difficulty forming loving, lasting,
intimate relationships
• They typically fail to develop a conscience and do not learn how to
trust
 WHAT CAUSES INSECURE ATTACHMENT AND
ATTACHMENT DISORDERS?
• Physical neglect
• Emotional neglect
• Abuse
• Separation from primary caregiver
• Changes in primary caregiver
• Frequent moves of placements
• Traumatic experiences
• Maternal depression
 WHAT CAUSES INSECURE ATTACHMENT AND
ATTACHMENT DISORDERS?
• Undiagnosed painful illnesses
• Lack of attunement between main caregiver and child
• Young or inexperienced mother with limited parenting skills
• Maternal addiction to drugs or alcohol
 IMPLICATIONS FOR BRAIN DEVELOPMENT
• If the attachment process is disrupted, the child’s brain will develop
stronger neural pathways focussed on meeting their day-to-day survival
• The pathways that help to regulate and control their emotions and an
awareness of others emotions are not well developed
• The child lives in a persistent state of hyperarousal or dissociation –
anticipating threats around every corner
• Their ability to benefit from social, emotional and cognitive experiences
may be impaired
• The child may not be functioning at their chronological age in terms of
their physical, social, emotional and cognitive skills
 IMPLICATIONS FOR BRAIN DEVELOPMENT
• Poor experiences impact specific structures in the brain including:
• Abuse
• Violence
• Chronic neglect
• Key brain structures are shrunken or less developed including:
• Anterior cingulate
• Hippocampus
• Corpus callosum
• Other structures are also affected that help a child succeed or
function through regulating their feelings and emotions – which is a
key capacity to be able to succeed at school
 BEHAVIOURS
• A child’s language is their behaviour e.g.
• Loss, grief, sadness can all be expressed in angry alienating behaviours
• Attachment disorders are protective – they protect the young person from
further hurt, shame and anxiety and they will use their behaviour to push people
close to them away
• Their difficulties will be:
• Trust in adults but also their peers
• Paying attention
• Managing their behaviour
• Early attachment disruption disrupts all areas of development – the young people
do not ‘trust’ the caregiving environment to be there for their needs
 SIGNS & SYMPTOMS OF INSECURE
ATTACHMENT
• Symptoms may include:
• Low self esteem
• Needy, clingy or pseudo-independent behaviour
• Inability to deal with stress and adversity
• Lack of self control
• Inability to develop and maintain friendships
• Alienation from and opposition to parents, caregivers and other authority
figures
 SIGNS & SYMPTOMS OF INSECURE
ATTACHMENT
• Antisocial attitudes and behaviours
• Aggression and violence
• Difficulty with genuine trust, intimacy and affection
• Negative, hopeless, pessimistic view of self, family and society
• Lack of empathy, compassion and remorse (no conscience)
• Behavioural and academic problems at school
• Speech and language problems
• Frequent lying & stealing items without a need for them
 SIGNS & SYMPTOMS OF INSECURE
ATTACHMENT
• Incessant chatter and questions
• Difficulty learning
• Depression
• Apathy
• Susceptibility to chronic illness
• Obsession with food: hordes, gorges, refuses to eat, eat strange
things, hides food
• Repetition of cycle of maltreatment and attachment disorder in their
own children when they reach adulthood
 ANXIOUS ATTACHMENT
• What it looks like:
• Can be charming or whiny & complaining
• Non-stop talking, constantly interrupting or asking questions
• Looks like ADHD
• Uses ‘impression management’ i.e. people pleasers
• Rarely openly defiant or passive-aggressive
• Falls in love easily – focusses on the ‘other’
 AMBIVALENT / DISORGANISED ATTACHMENT
• Extreme self-reliance
• Very controlling with others
• Push-pull style
• Odd behaviours and unpredictable moods
• Focus on injustices done to them/consider themselves victims
• Openly angry, defy rules, high-risk behaviours, superficially charming,
lack of empathy, delinquent acts, self-harm, suicide attempts, cry to
get other to engage, lying, aggression, promiscuity
• RAD, ODD, CD
 REACTIVE ATTACHMENT DISORDER (RAD)
• Now clinically recognised severe insecure attachment
• Children with RAD are so neurologically
• disrupted that they cannot attach to a primary caregiver or go
through normal developmental processes
• They have no consistent or organized strategy for responding to
stress as the person that should have made them feel safe is usually
frightening (e.g. abusive parent) or is communicating fright (e.g.
parents being abused)
• Extreme neglect
 REACTIVE ATTACHMENT DISORDER (RAD)
• Homes characterised by
• Child maltreatment
• Parental depression
• Bipolar disorder
• Substance abuse and/or unresolved trauma, grief or loss
• They cannot establish positive relationships with others
• Many are misdiagnosed as having severe emotional and behavioural
disturbances e.g. ADHD
 WHY ARE THESE DEFENCE MECHANISMS USED?
• To protect the child from overwhelming and intolerable feelings and
memories of traumatic experiences (idealisation, projection, denial,
displacement, dissociation, splitting
• Over idealising an abusive or neglectful mother allows the child to
avoid and deny the painful reality that they received insufficient
nurture, love and protection
• Denial – saves the child from having to experience the grief and rage
that accompanies facing the truth
• Dissociation – is an automatic response that protects the child during
trauma
• Displacement – enables the child to project onto carers or
professionals the feelings and perceptions that they actually have
towards maltreating biological parents or others.
 REPAIRING INADEQUATE ATTACHMENT
• The learning that accompanies new experiences can alter neural
connections in the brain
• Relationships with relatives, teachers, social care
 WORKING WITH ADOLESCENTS
• Developing trust is a crucial issue when working with adolescents with
attachment issues (eye contact, empathy & listening)
• Often substance abuse becomes their way of dealing with the pain of
attachment disorder
• Trying to change or modify specific behaviours are notoriously unsuccessful
with children who have attachment disorders – it is more effective to
deflect attention away from specific negative behaviours (the problem
behaviour should be viewed as the child’s way of keeping others at a
distance
• Gangs can be used by young people with attachment disorder to build a
sense of trust and relationship with their peers through the strong bonds
formed within gangs
 WORKING WITH ADOLESCENTS
• Encourage student to openly express thoughts and feelings
• Use are, play or role play to practice expressing emotions
appropriately
• Discuss and confront lying and stealing when it occurs
• Explore the student’s talents, traits and accomplishments
• BE DEPENDABLE
 CHALLENGES FOR WORKING WITH YOUNG
PEOPLE IN CARE
• Many interventions designed to ‘protect’ young people e.g. removal
from home may actually reinforce the young person’s view of the
world as ‘unknown’, ‘uncontrollable’ and ‘frightening’
• They need nurture, stability, predictability, understanding and support
repeatedly in order to begin altering their view of the world from one
that is uncaring and hostile to one that is caring and supportive
• Until that view begins to take hold in the child’s mind, they may not
be able to truly engage in a positive relationship