ONLINE CONSULTATION AND THERAPY FOR YOUNG ADULTS, PARENTS, MENTAL HEALTH PROFESSIONALS, AND EDUCATORS
Connie has been treating children and families in her psychotherapy practice for over 40 years. She works with widely diverse families and has educated parents and professionals across the country on disorders of attachment, child development, adoption, and creating trauma-informed schools. For nine years, she served as a Board Director of the Association for Training on Trauma and Attachment in Children (ATTACh) and is currently a member of their Advisory Committee. Connie chaired the committee that wrote Hope for Healing, published by ATTACh.
Connie is the adoptive parent of two grown children, and the grandmother of a young adult who grew up in an open adoption.
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 of 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.
The ability to attach and 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 disorders of attachment 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
- neglect
- abuse
- abandonment
- separation from birth parents
- inconsistent or inadequate day care
- divorce
- 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
INFANTS:
- weak crying response
- rage
- 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
ADULTS:
- 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, especially with those who attempt to be emotionally close to them, such as their partners and their own parents. They may rage toward, or emotionally distance themselves from, anyone whom they fear could abandon them. Those who are parents often find it impossible to form healthy emotional connections with their own children.
Parenting children, adolescents, and adults who have attachment disorders is hard work! By creating a therapeutic home environment, you can help both your child or adolescent 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 or adolescent’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 disorders 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 disorders 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/adolescent and your relationship back). Creating a therapeutic home environment is critical. To heal, children who have attachment disorders 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 that your child or adolescent spends in a school or home environment that is not designed to help him is probably hindering his progress.
Parenting adults with attachment disorders cannot at all be compared to parenting those who have not experienced trauma at an early age. Adults with disorders of attachment may be immature compared to their peers because of the events that caused their disorders. They may live at home longer than most young adults, and may experience difficulty in achieving independence. They often sabotage their own efforts to become independent due to a subconscious fear of abandonment and loss. Well-meaning parents may continue trying to achieve an emotional closeness with their adult children, only to be rebuffed and rejected. These parents may need to radically adjust their expectations of their adult child, who simply may not be capable of the closeness their parents desire.
Children with disorders of attachment are children with special needs. They have experienced trauma, and often do not trust adults to keep them safe. They may act out in the school environment because they are anxious and overwhelmed, or they may hold their feelings in until they go home where they feel safe, and then they explode. Teachers sometimes cannot believe the stories that parents tell about their “double agent” children, who may be exceedingly well behaved in school, while terrorizing their families at the end of the day.
It is critically important for the welfare of these children that their parents and teachers communicate regularly with one another, and that they provide the same clear, consistent structure at home and at school. All children need a secure base, but traumatized children cannot function effectively without it at home and at school.
Children who have suffered early trauma, rejection, or abandonment have learned to be in control in order to survive. They may engage in overt or covert behaviors in order to be in control; their parents and teachers must be watchful of each and every effort to control situations. Adults who provide clear, consistent structure are showing these children that they can gradually give up control and eventually learn to trust the significant adults in their lives. Once this trust has been established, children can relax and use their energy to learn.