“Young children, who for whatever reason are deprived of the continuous care and attention of a mother or a substitute-mother, are not only temporarily disturbed by such deprivation, but may in some cases suffer long-term effects which persist.”
John Bowlby’s widely accepted attachment theory, which has since been expounded upon and refined by other child psychologists, provided the foundation for the development of attachment-based therapy for children. According to this theory, there are four types of attachments. The four types are secure attachment, anxious-ambivalent attachment, anxious-avoidant attachment, and disorganized attachment.
According to a psychotherapist, children whose primary caregivers are unable to respond to their needs can develop a condition known as reactive attachment disorder (RAD). Children with an anxious-ambivalent attachment display anger or helplessness in an effort to control the situation and keep the caregiver nearby. Those with anxious-avoidant attachment exhibit behavior designed to express a desire for closeness while reducing the risk of frustration resulting from expressing needs that remain unmet. Children with disorganized attachment may try to control crying.
Every parent’s desire is for their children to form a secure attachment. However, parents often face traumatic emotional events in their own lives which affect their ability to respond to their children’s needs. For example, one study showed that 56% of mothers who had experienced the death of a parent before they finished high school had children who were later diagnosed with disorganized attachments.
Despite our human imperfections and occasional inconsistencies, children are remarkably resilient, and reactive attachment disorder (RAD), one of the most extreme forms of attachment disorder, is relatively rare. The disorder usually manifests itself in either a display of excessive attempts to gain affection even from relative strangers, or a reluctance or inability to accept affection even from familiar adults, even when in distress. However, psychotherapists have reported success in treating it.
While such a disorder is cause for concern, there is also evidence that child-parent psychotherapy (CPP) can successfully treat the disorder. In this type of therapy, psychotherapists view the relationship between the child and the caregiver as the patient, rather than just the child. In five randomized trials conducted with low income families and families with a history of depression or domestic violence, it was demonstrated that children’s attachment security was increased, while avoidance, resistance and anger were reduced. The degree of empathy that caregivers were able to display also increased.
For successful treatment of an attachment disorder, psychotherapists use a combination of group sessions, video feedback and educational and therapeutic discussions over the course of 20 weeks. Caregivers are able to observe themselves and their children’s responses, then learn and practice healthier and more beneficial ways of interacting. As an exercise in sensitivity, for the first part of each session, the caregiver remains on the floor with the infant, observing and responding only to interactions initiated by the infant. The infant is then able to experience negotiating a relationship with the caregiver through expression of its needs.
Many psychotherapists have written books on the subject of attachment disorders as well as the best way to successfully treat them. Unfortunately, many people who are not trained psychotherapists have written about it as well. While they are a cause for concern, thankfully we have come a long way from believing that attachment disorders are a sure sign of future sociopathy. That fear led to some kinds of treatments that proved to do more harm than good. For example, some therapists held the opinion that attachment disorders were rooted in rage and advocated deliberately provoking the child in order to release it.
Critics of attachment-based therapy for children argue that theories that advocate the use of aggressive psychological, or even physical, means to provoke the child towards an emotional catharsis can cause more damage. Some therapies have utilized techniques that included repeated sessions of holding the child down or forcing them to engage in prolonged eye contact. Most of these techniques have since been discredited. Anthropologist and author Rachael Stryker studied the effects of such radical attachment therapy and published her findings in The Road to Evergreen: Adoption, Attachment Therapy, and the Promise of Family.
In reality, help is available for children of adoptive parents suffering from an attachment disorder. Any parent who has suffered a loss or trauma and is concerned about how their emotions may be affecting their children, which might be any parent at any time, can benefit from attachment–based therapy. Despite the pain of loss, the loving bond of relationships, and the joy they bring, can be restored.