Help For Your Family

What is Attachment Disorder?

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What is Attachment?
Attachment is the deep and enduring connection established between a child and caregiver in the first several years of life. It profoundly influences every component of the human condition – mind, body, emotions, relationships and values. Attachment is not something that parents do to their children; rather, it is something that children and parents create together, in an ongoing reciprocal relationship. Attachment to a protective and loving caregiver who provides guidance and support is a basic human need, rooted in millions of years of evolution. There is an instinct to attach: babies instinctively reach out for the safety and security of the “secure base” with caregivers; parents instinctively protect and nurture their offspring. Attachment is a physiological, emotional, cognitive and social phenomenon. Instinctual attachment behaviors in the baby are activated by cues or signals from the caregiver (social releasers). Thus, the attachment process is defined as a “mutual regulatory system” – the baby and the caregiver influencing one another over time.

Beyond the basic function of secure attachment – providing safety and protection for the vulnerable young via closeness to a caregiver – there are several other important functions for children:

  1. Learn basic trust and reciprocity, which serves as a template for all future emotional relationships.
  2. Explore the environment with feelings of safety and security (“secure base”), which leads to healthy cognitive and social development.
  3. Develop the ability to self-regulate, which results in effective management of impulses and emotions.
  4. Create a foundation for the formation of identity, which includes a sense of competency, self-worth, and a balance between dependence and autonomy.
  5. Establish a prosocial moral framework, which involves empathy, compassion and conscience.
  6. Generate the core belief system, which comprises cognitive appraisals of self, caregivers, others, and life in general.
  7. Provide a defense against stress and trauma, which incorporates resourcefulness and resilience.

Children who begin their lives with the essential foundation of secure attachment fare better in all aspects of functioning as development unfolds. Numerous longitudinal studies have demonstrated that securely attached infants and toddlers do better over time in the following areas:

  • Self-esteem
  • Independence and autonomy
  • Resilience in the face of adversity
  • Ability to manage impulses and feelings
  • Long-term friendships
  • Relationships with parents, caregivers, and other authority figures
  • Prosocial coping skills
  • Trust, intimacy and affection
  • Positive and hopeful belief systems about self, family and society
  • Empathy, compassion and conscience
  • Behavioral performance and academic success in school
  • Promote secure attachment in their own children when they become adults


What is Attachment Disorder?

One of the areas I specialize in is working with children with attachment disorders.  If that term is new to you, please allow me to explain.  Attachment is the relationship a child forms with their early caregivers that shapes how we form connections to other people throughout our lives.  We are all born relying completely upon adults to meet our needs.  I am no animal expert, however, I believe humans are one of the few species that cannot feed ourselves soon after birth.  For basic nourishment and caretaking, we rely heavily upon adult caretakers for a relatively long period of time.

As infants, while we are relying on our caretakers, we are also building the neurotransmitter systems in our brains.  When babies look into the eyes of their parents, literally thousands of neurons per second get activated and the building of this neuron wiring sets up the building block of our attachment system or structure.  When you think of it this way, it is simple: if baby gets her needs met “enough,” she develops what we would call a secure attachment, if baby does not get her needs met “enough” she develops what we would call an “insecure” attachment.  By the way, ”enough” has been studied and it means that we meet our babies/ children’s needs 30% of the time (or preferably more).  That does not mean that 7 out of 10 times are gimme’s!  Think about when a baby is crying.  You try to figure out what is wrong…diaper?  No.  Hungry?  No.  Rocking and singing?  Bingo!  You just got it wrong twice and right the third time.  The trick to this is to keep trying to label and meet a child’s needs and to help them learn to label and name their needs to make it easier for you as they grow.  But I digress…

Securely attached children tend to think more along the lines of:

  • The world is a safe place.
  • I am loving and loveable.
  • I get my needs met.
  • Adults are reliable.
  • If I have a problem, I can usually fix it or get someone to help me.
  • My choices make a difference.

Children with insecure attachments tend to think more along the lines of:

  • I need to get my own needs met.
  • I am bad.
  • When I trust people I usually get hurt.
  • My choices don’t make any difference.
  • I need to fix my own problems.
  • People are not trustworthy.

In the classification of insecurely attached children there are two categories.  I see these categories as insecurely attached with a structure (anxious or avoidant) and insecurely attached without structure (disorganized) .  Why the distinction?  Because if you have a child who tends toward anxious/avoidant, you are more likely to be able to predict behaviors and their response to different challenges.  However, with a disorganized structure, because the child has no system for tackling issues in place at all, it is incredibly difficult to predict what the child will do in a given situation.


Attachment Disorder: Traits and Symptoms
Attachment disorder affects all aspect of a child’s functioning. A child may display some combination of the following primary symptoms:
  • Behavior: oppositional and defiant, impulsive, destructive, lie and steal, aggressive and abusive, hyperactive, self-destructive, cruel to animals, irresponsible, fire setting.
  • Emotions: intense anger and temper, sad, depressed and hopeless, moody, fearful and anxious (although often hidden), irritable, inappropriate emotional reactions.
  • Thoughts: negative beliefs about self, relationships, and life in general (“negative working model”), lack of cause-and-effect thinking, attention and learning problems.
  • Relationships: lacks trust, controlling (“bossy”), manipulative, does not give or receive genuine affection and love, indiscriminately affectionate with strangers, unstable peer relationships, blames others for own mistakes or problems, victimizes others/victimized.
  • Physical: poor hygiene, tactilely defensive, enuresis and encopresis, accident prone, high pain tolerance, genetic predispositions (e.g., depression, hyperactivity).
  • Moral/Spiritual: lack of faith, compassion, remorse, meaning and other prosocial values, identification with evil and the dark side of life.


Children who begin their lives with compromised and disrupted attachment are at risk for serious problems as development unfolds:

  • Low self-esteem
  • Needy, clingy or pseudoindependent
  • Decompensate when faced with stress and adversity
  • Lack of self-control
  • Unable to develop and maintain friendships
  • Alienated from and oppositional with parents, caregivers, and other authority figures
  • Antisocial attitudes and behaviors
  • Aggression and violence
  • Difficulty with genuine trust, intimacy and affection
  • Negative, hopeless and pessimistic view of self, family and society
  • Lack empathy, compassion and remorse
  • Behavioral and academic problems at school
  • Perpetuate the cycle of maltreatment and attachment disorder in their own children when they reach adulthood


Basic objectives of effective parenting (goals for children/teens):

    • Develop the capacity to form secure attachments and reciprocal relationships; the ability to give and receive love and affection.
    • Develop the internal resources necessary to make healthy choices, solve problems, and manage adversity effectively.
    • Cultivate a positive and realistic sense of self and self-in-relation to the world.
    • Learn to identify, manage and express emotions in a constructive manner.
    • Learn prosocial values and morality, as well as the self-discipline and self-control necessary to function successfully in society.
    • Develop the capacity for joy, playfulness and a positive meaning in life.
Creating Secure Attachments
It is your job as a foster parent to create a therapeutic environment. By being a healthy role model, and offering a predictable, safe, and nurturing family experience, you can help children achieve positive changes and heal emotional wounds. Below are the ingredients for creating a healing family environment.

Creating a Healing Environment

  1. Cannot “fix” a Child

    Parents cannot “fix” a child, but can create a healthy environment with opportunities for positive change, healthy growth and development, and secure attachment. You can encourage, guide, and be a role model for your child, but you cannot control him.

  2. Look in the Mirror

    Your own background — how you were raised and the type of attachments you formed — play a major role in how you parent your children. Your child will trigger unresolved issues and sensitivities left over from childhood. By knowing yourself well — looking in the mirror — you are more likely to be proactive rather than reactive; able to respond constructively to your child’s attempts at blaming, distancing, and controlling you, rather than reacting in a destructive “knee-jerk” manner.

  3. Labels Affect Actions

    The way you interpret, explain, and label a child’s behavior will determine how you intervene to help or change that child. For instance, children labeled as biochemically imbalanced (e.g. bipolar disorder) are given medicine to change their behavior. When you understand your child’s behavior as symptoms of compromised attachment, your goal is to find a way to connect with, not control, your child.

  4. Family and Community Systems

    A system is a set of connected parts that work together to form a whole. In families, all members affect one another in ongoing, circular patterns — the dance of family dynamics. Everyone works together to keep the dance going, either in a healthy or dysfunctional way. Attachment develops within the larger emotional network of the family system, including birth, foster, and adoptive family relationships, the roles of other siblings, the marital and co-parenting relationships, and extended kin (e.g. grandparents). Social and community systems also affect the child, parents, and development of attachment. This is illustrated by the family-school connection. It is crucial for parents and school personnel, such as teachers and counselors, to be a cooperative team for the benefit of the child.

  5. Love and Limits

    Balancing love and limits is important for all children, but especially crucial when creating a healing environment for very challenging children. Nurturing and loving care fosters the learning of trust, empathy, and a positive mindset. Providing limits and structure, including rules, clear expectations, and consequences, helps children feel safe, secure, and learn from their mistakes. A sense of order and predictability is particularly important for children who come from chaotic and frightening backgrounds.

  6. Opportunity vs. Crisis

    In order to create a healing environment, you must be aware of your mindset. Do you view stressful and challenging situations as crises to be dreaded or as opportunities for teaching, learning, and growth? Your child’s problems are opportunities for you to teach coping skills and strengthen the parent-child relationship. The opportunity for learning and growth is not only available for your child, but for you as well. Parents often tell us that their most challenging children are their “gurus” — providing the richest opportunities for personal and marital growth.

  7. Proactive vs. Reactive

    To create and maintain a healing environment you must be proactive: you set the emotional tone, create the emotional climate, take the initiative, and maintain the rules. When you are reactive, you are allowing your child to set the emotional tone, placing her in a position of control. Being proactive involves remaining calm, not taking your child’s behavior personally, and dealing with issues and problems as soon as they occur — on the front-end — not waiting until the situation escalates out of control.

  8. Positive Role Model

    Your job is to show by example how to effectively communicate, solve problems, set boundaries, cope with stress, manage emotions and conflict, and care about others. It will be easier to be a positive role model when you know yourself and your triggers, possess effective parenting skills, and have adequate support. By presenting your child with a positive role model you can and will make a difference.

All foster parents are therapeutic parents — agents of healing and change. Via your day-to-day actions and reactions, you provide many opportunities for your children to make positive changes: learn effective coping skills (e.g. anger management, communication, self-control); develop a positive sefl-image and good values; overcome prior trauma and loss; and develop secure attachments, with the ability to trust, love, and have compassion for others.

We all know that foster children need lots of love, nurturance, security, and consistency. However, there are certain characteristics of children in foster care, both young and older, that makes it difficult to give them what they need.

First, they commonly behave in alienating ways toward caregivers: will not show their needs for nurturance or reassurance; will turn away or push away, as if to say, “I don’t need you.” You must realize they are afraid to connect. Don’t focus on their rejecting behavior; deep down they need love and support.
Second, they developed a viewpoint or belief that caregivers will be hurtful, and they will expect the same cruel and insensitive treatment from you. You must show them something different and better, and eventually they will learn to trust. Third, many of these children are biologically and biochemically imbalanced, due to prior abuse, neglect, prenatal exposure to drugs and alcohol, and multiple moves. They are unable to cope with stress, lack self-control, and are difficult to soothe. You must provide a consistent, predictable, and structured environment to help them feel safe. Lots of hugs and love helps, but you must be patient and respectful of your child’s timing.
Last, it is important to remember that your child is bossy and controlling because he learned that control means survival. So, when your child is being manipulative or defiant, it is really about fear: afraid to trust, connect, and be emotionally vulnerable.

Foster parents often feel particularly challenged by teenagers. There are two practical methods to enhance attachment that we find very helpful with teens: the autonomy circle and ACT (Attachment Communication Training).

The Autonomy Circle: Parents often argue with children about how much structure or freedom to provide. The amount of freedom you give your teenager should be based on his or her abilities or competencies in four areas: knowledge, skills, self-control, and judgement. When your child shows how she is responsible and competent in these areas — has the information and skills, exercises self-discipline, and makes good decisions — you can “loosen the reins.” Teenagers like this idea because they have the power to get more freedom by their own actions; they have some say in the matter. Parents like this because it is not arbitrary — children either earn the freedom or not — and there is nothing to argue about.

Attachment Communication Training (ACT): Teenagers are renowned for not communicating directly. ACT is a way to learn effective communication skills, including honest sharing and empathic listening. There are basic ground rules: no blaming, criticizing, defensiveness, or stonewalling; take turns, no interrupting; agree to disagree, each person can have their own viewpoint; no running away.

There are four steps.
(1) Share: One person speaks while the other listens; tell about your own feelings and thoughts; be honest and brief; be aware of your tone of voice and body language.
(2) Listen: To really listen, you must have empathy (think how the other person feels), be non-judgemental (don’t judge, try to understand), be aware of yourself (is your body language telling the sharer that you are safe or threatening?).
(3) Re-state: Tell the sharer what you heard. “I hear you saying…”; This prevents misinterpretation — message sent, message received.
(4) Feedback: The sharer tells the listener how he or she did; “Thank you, you heard me” or “No, I didn’t say what you heard; let me try again.” Make sure there are plenty of opportunities for each person to share and listen. With practice, ACT leads to safe and constructive confiding. You and your teenager will be practicing effective communication skills which are a part of healthy attachment.






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