THERAPY WITH CHILDREN, ADOLESCENTS, AND ADULTS
Connie Hornyak, LCSW, specializes in working with clients of all ages who have had traumatic experiences that are impacting their daily lives. Some conditions addressed are attachment disorder, developmental trauma, post-traumatic stress disorder, depression, anxiety, child and adolescent behavior problems, ADHD, adoption issues, relationship problems, and parenting. Connie also provides pre-adoption counseling and consultation for mental health professionals.
What is attachment?
Attachment – the “give and take” relationship between a child and his or her parents or primary caregiver – is the foundation for a child’s healthy social, emotional, behavioral, and neurological development. A healthy attachment teaches a child to trust and to form positive relationships throughout his or her life. Healthy attachment occurs when an infant experiences a primary caregiver as consistently providing emotional essentials such as touch, movement, eye contact, and smiles in addition to the basic necessities such as food, clothing, shelter, and medical care. It is critically important to human development.
What is Attachment Disorder?
Attachment disorder is a treatable condition characterized by problems with the formation of emotional attachment to others. Children, adolescents, and adults with this condition have had problems, or serious disruption, in early childhood parent-child relationships; such problems affect social, emotional, behavioral, and neurological functioning.
- weak crying response
- constant whining
- sensitivity to touch and resistance to cuddling
- poor sucking response
- poor eye contact and lack of tracking
- no reciprocal smile response
- indifference to others
CHILDREN and ADOLESCENTS:
- lack of conscience development
- superficially charming with those who are not their parents
- lack of eye contact
- inability to give and receive affection
- parents describe “hugging a stepladder”
- extreme control issues
- destructive to self, others, animals and property
- lying which does not benefit child or adolescent
- no impulse control
- learning delays and disorders, depressed I.Q. scores
- no cause and effect thinking
- unusual eating patterns (hoarding, gorging, or refusal to eat)
- unsuccessful peer relationships
- persistent nonsense questions
- incessant chatter
- very demanding
- unusual speech patterns (mumbling, robotic speech, talking very softly except when raging)
- inconsistent behavior (may be the best behaved student in class while destroying everyone
and everything at home)
- parents appear unreasonably hostile and angry
- extended family members, school personnel and other members of the community may never
see the child or adolescent’s ‘home’ behavior
- difficulty forming interpersonal relationships
- conflicts with authority figures
- discomfort in social situations
- difficulty with giving and receiving affection
- control issues
- inability to trust and attain full intellectual potential
Without appropriate treatment, children and adolescents with attachment disorder suffer an inability to form lasting, loving relationships. They lack conscience development and cannot trust. They often grow into distant, manipulative, uncaring adults.
Children and adolescents with a mild degree of attachment disorder benefit considerably from intensive attachment therapy. Without such therapy, these children are likely to develop borderline personality disorder in late adolescence, and will have serious difficulties forming adult relationships and parenting their own children.
Children and adolescents who have a moderate degree of attachment disorder are in definite need of intensive attachment therapy if there is to be any hope for them to be able to function outside of mental health or criminal justice institutions as adults. Most respond quite well to intensive attachment therapy. Without such therapy these children and adolescents are apt to develop either borderline or antisocial personality disorder, may have persistent difficulties in interpersonal and work situations as adults, and may be unable to appropriately parent their own children. In fact, their children are likely to experience serious maltreatment and end up in foster care themselves.
Children and adolescents with a severe degree of attachment disorder have many of the symptoms of conduct disorder. They are extremely disturbed and are highly likely to enter the juvenile justice system or mental health facilities if they do not receive treatment. Treatment may include placement in a therapeutic residential setting. Their behavior problems make them dangerous to family members, schools and the community. Without extensive attachment therapy it is highly likely that they will develop antisocial personality disorder and psychopathic personality style, and will engage in persistent criminal behavior. They may be completely unable to parent their own children, as they are highly likely to seriously maltreat them. They may kill or otherwise seriously harm others and show no remorse for these actions. They represent a serious threat to society.
Adults who do not receive appropriate treatment may experience difficulties in their personal and work relationships. Those who have conflicts with authority figures may be unable to hold jobs or may engage in illegal behavior. Adults with untreated attachment disorder are usually unable to form lasting love relationships. Those who are parents often find it impossible to form healthy emotional connections with their own children.
The ability to attach or bond begins in the womb. The developing fetus is affected by the birthmother’s emotional condition, physical health, substance use, and other factors. From the time of conception through approximately the third year of life, the child needs to attach in order to develop physical and emotional health. This early attachment is the foundation for the child’s ability to feel empathy, compassion, trust and love.
Children and adults with attachment disorders and issues have experienced a break in the bonding cycle.
This break can be the result of:
- genetic predisposition
- maternal ambivalence toward the pregnancy
- traumatic prenatal experience
- in-utero exposure to alcohol and/or drugs
- birth trauma
- separation from birth parents
- inconsistent or inadequate day care
- multiple moves and/or placements
- institutionalization (e.g. children adopted from orphanages)
- undiagnosed or untreated painful illness (e.g. untreated ear infections)
- medical conditions which prohibit adequate touch
Parenting children and adolescents who have attachment disorder is hard work! By creating a therapeutic home environment, you can help both your child and your family to heal. Creating a therapeutic home environment means putting a system in place that is designed strategically to meet your child’s needs. These needs include the need for a secure attachment, the need to give up control, and the need for positive reinforcement to build self-esteem.
Parenting children and adolescents who have attachment disorder requires structuring your household around the child’s needs, rather than trying to force him or her to conform to a “normal” way of life. Yes, this is more difficult with other children in the home. But children and adolescents who have attachment disorder have special needs, and to be effective you need to approach parenting them as such.
It is important to learn to address issues and behaviors that arise in a way that helps your child or adolescent move forward, while preserving and nurturing your relationship with him or her (as opposed to taking behaviors personally and ending up in power struggles that set your child and your relationship back). Creating a therapeutic home environment is critical. To heal, children who have attachment disorder need to be immersed in an environment designed to work on their issues as close to 24 hours a day/ 7 days a week as is possible. While an attachment therapist, and often a psychiatrist, is a critical piece of the formula, one hour in therapy each week is not going to “fix” your child all by itself. Every minute the child spends in a school or home environment that is not designed to help him is probably hindering his progress.