Overview of Attachment
by Nancy Thompson
Let's begin with an overview of what we mean by Primary Attachment. Along the way I will be referring you to other sites where you can get more in-depth information on the various aspects of attachment theory and resources for treatment.
In his book THE HEALING PATH WITH CHILDREN, Dr. Mark A. Barnes quotes from a 1979 thesis by Bronfenbrenner in which he compares early attachment to falling in love. He says that every child needs "at least one adult who is simply crazy about the child." This means that the adult (or adults) will enjoy interacting with the child and this will be felt by the child during the daily caretaking activities such as feeding, changing diapers, bathing etc. (et cetera). The first way that a baby takes in information about the world is through his/her senses-hearing, seeing, smelling, touching and tasting. These sensory experiences are what begin to organize and connect the billions of cells and neurons in the baby's brain. If these sensory experiences are not received consistently, if they are interrupted or distorted by illness, pain, fear or confusion, the connections that prepare the child to move into the next developmental stage may not be completed. These disruptions can occur for many reasons such as premature birth, early medical problems in the child, multiple caretaking situations, physical, sexual or emotional abuse, and neglect.
Some of the most common complaints of foster and adoptive parents are that the child "doesn't listen" or " seems phony" or "seems to enjoy fighting." Others are more behavioral such as lying, stealing, arguing, and sneaking. It is also common for many foster and adopted children to be diagnosed with learning problems or attention deficit disorder. The most damaging symptom of attachment disorder is a lack of trust in and respect for adults. Since the original caretakers were not able to provide consistent nurturing, these children are afraid to get close to adults. Their behaviors are intended to push adults away and maintain control of every situation. They do not appear to care about others because they are impulsive and do not have cause and effect thinking. Many attachment disordered children have strange eating patterns such as hoarding or stealing food and eating exceptionally large amounts of food. It seems that they are mistaking their emotional hunger for a physical one, as they never seem to feel they have had enough food, no matter how much or how often they eat.
In my travels around the state I hear many stories of frustration and concern from foster parents and adoptive parents who choose to adopt a foster child. It is very puzzling to parents when a child seems to deliberately try to get him/herself removed from a home in spite of saying that he/she likes the foster family. As a matter of fact, it is not unusual for a child to misbehave more than normal right before an adoption is to take place or right after having a particularly enjoyable experience with the foster family. It seems to hit at the core of attachment problems. It is as if the child is saying," Oh my God! These people are really being nice to me, but I know something terrible is going to happen and I don't want to be hurt anymore, so let's just get it over with right now." The parents feel completely baffled by the child's behavior at this particular time and, of course, the child does not have the maturity or the self awareness to explain what is happening. The child is simply responding to a deep feeling of anxiety and perhaps even some pain over the loss of the biological family, which, somehow, becomes linked with success in the foster or adoptive family.
The key to working with attachment disordered children is in the parents being able to de-personalize the negative attitudes and behaviors displayed by the child. Consequences need to be delivered unemotionally and the parents need to seek support from family, friends and professionals in order to keep their own feelings under control. They need to gain an awareness of every opportunity for attachment behaviors to take place, such as helping with grooming, giving high fives or pats on the back, expressing concern about any mentioned "owie" or illness, no matter how slight. These moments are little gifts in which the child allows his/her need to show and the foster parents get a chance to share in filling the need or reacting positively in response to the child. Many children act much younger than their biological age and this is also an opportunity to take part in filling in some of the missing experiences from their earlier life. Sometimes an older child will want to "play baby" which might mean rocking, reading a story, singing nursery rhymes or even, paying peek-a-boo, all in the guise of a game. This makes some parents nervous because it seems they are encouraging the child to regress or act immaturely. In fact this is often the only way that the child can allow him/herself to get the kind of attention that was missed earlier in life. My advice to parents about this is to enjoy it and, if you have concerns, make it a time limited game in which you might say "We can have 'baby time' for fifteen minutes tonight after dinner." As with other things, the child will eventually be less and less interested in the game.
Obviously, having an attachment disordered child in your home takes a lot of knowledge, not to mention patience! They need structure and a lot of warning about any changes in plans. The adults need to be prepared to remove the child if behavior in public is a problem. Consequences and rewards need to be clearly spelled out BEFORE an incident takes place and applied as quickly and calmly as possible when something does occur.
There are many resources available for parenting attachment disordered children. One of my favorites is by Vera Fahlberg, A Child's Journey Through Placement. Another is Fostering Changes: Treating Attachment Disordered Children by Richard Delaney, Ph.D. These books not only explain attachment disorder more fully than I can do here, they also have many practical suggestions for handling problems that come up every day in a foster and/or adoptive placement. Evergreen has posted a very complete list of resources that can make a real difference in the way you deal with these children.