help4yourfamily

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Training Announcement

Hello Friends,

I am very excited to share with you that I am collaborating with the wonderful Lisa Ferentz through her organization, The Institute for Advanced Psychotherapy Training and Education, Inc., to bring you a course for mental health professionals: When Nothing Else Works, Start at the Beginning: Attachment 101.    If you do not know about Lisa Ferentz’s work, she provides excellent training for professionals in the Maryland, DC, Virginia area.  I highly recommend you check her out.  I am so honored to be joining her team to provide this training.  I would love to see you there on October 24, 2012.  To register, click here.  If you are interested in having me come to do a training in your area, please let me know.  You can email me: helpforyourfamily@gmail.com

Sincerely,

Kate

August 9, 2012 Posted by | attachment, attachment disorder | 1 Comment

Taming the “Nasties” in Your Children- Part 1

Mid-Tantrum

Mid-Tantrum (Photo credit: LizaWasHere)

Written by, Kate Oliver, MSW, LCSW-C

Any parent with a child old enough to speak has most likely experienced what I call “the nasties.”  The nasties are the times when your children say or do mean, nasty things to you or other caregivers.  Sometimes you can even see them fishing for something to be nasty and angry about.  When kids have a case of the nasties is when they say the most hurtful things they can think of to say such as, “I hate you.”  “I wish I had a different (fill in the blank, mom, dad, sister, brother)” and even,  “I wish you were dead.” These words hurt and even on the days when we are able to understand they do not mean it, it still hurts your heart to hear it.  Other days, when we are feeling more vulnerable as parents, we can begin to wonder if perhaps our children are saying what they really think about us, and/or whether we are doing right by our children, and we can begin to catastrophize about the ways our relationships with our children are going to turn out.  While we all know that the nasties are a pretty normal part of growing up and many of us work to control them, even as adults, it still feels pretty bad when they strike your children.

The first thing to do when the nasties are tearing through your house is to assess what is causing the nasty behavior.  I had a professor once that said the most important piece in addressing any behavior is to find out it’s cause, and while you may not be very curious about the root of the problem when your child is yelling at you, perhaps I can persuade you by pointing out that figuring out the root cause is way more pleasant for you than beating yourself up over having such a mean child.  Here are some ideas to take into consideration when you are trying to figure out what is going on:

1. The first thing I assess for children and adults of all ages who are experiencing a case of “the nasties” is whether they are hungry or tired.  I know, you may have read this before, but in many children this is the main culpret.  I know I get pretty nasty when I’m hungry  (or tired)- ask my husband, he sometimes figures it out before I do.  Our children are no different.

2.  Look at your child’s diet.  Did your child just have an ice cream cone?  Have they been eating junk all day?  If your child is pretty consistently nasty and it seems outside of developmental norms, the foods I have seen that have the greatest impact on mood in order of most to least common tend to contain: gluten, food coloring, caffeine, sugar, dairy, soy.  I also have had families who switched to a mainly organic diet who have had good results in mood stabilization.

3.  Is it possible your child has been trying any mood altering substances?  I have seen parents of teenagers who do not always consider this question, especially if they have a “good kid” most of the time, but even good kids can make poor choices.  It is not unusual for teens to experiment, you remember high school right?  Mood altering substances do not just alter your mood for a few hours, there is a kickback, like a hangover.  Remember, what goes up, must come down. Remember too that there are other substances besides alcohol and pot.  Middle and high schoolers can get access to all kinds of prescription medication and over the counter products, like cough medicine and whippets, that can alter moods, and kids may think that because they are so easy to get or because a doctor would prescribe them, they must be safe.  Ask your children about whether they are using substances or not and make it an ongoing conversation where you let them know your feelings about this issue.  Do not forget that caffeine is a mood altering substance.  Even though it is a mainstream substance, a child that has been drinking a lot of those highly caffinated drinks,  coffee, sodas, etc. can have major side effects.  We are all impacted differently by substances and children are more likely to have major side effects than adults.

4. For children with recurring cases of the nasties, ask a doctor to check for any underlying medical conditions that could be contributing such as a thyroid issues, diabeties, lymes disease, teething, bladder and ear infections.

5.  Is there something going on at home, school, camp or child care?  Is there another child bullying your child and you are unaware of it?  Have you been less available for one reason or another?  Are you moving, or is there another major change coming down the pike that your children are aware of, say their first year in middle school?

6.  Is it possible your child is suffering from a mental health issue?  Children show they are depressed differently than adults.  While adults may be depressed to the point that they cannot get out of bed, children are more likely to be irritable, angry and sullen.  If this happens more often than not for a period of two weeks or more, it is time to have your child evaluated for depression.  Similarly, OCD (obsessive compulsive disorder) and anxiety disorders can be accompanied by nasty outbursts.

Next week, I will address how it is that you can address these nasty behaviors in your children when they occur to try to change them.  Before I post that, do you have any behaviors that your children do that leave you scratching your head about how to address them?  Have you had children that had the nasties and you figured out the origin?  Please feel free to share with the rest of us.

July 26, 2012 Posted by | attachment disorder, discipline, help for parents | 5 Comments

Preparing Children for Major Transitions

Summer Camp 2010

Summer Camp 2010 (Photo credit: Olds College)

Written by, Kate Oliver, MSW, LCSW-C

It’s summer.  Anyone with a child in school recently has, or is about to experience a major transition from having the school routine schedule to a summer schedule.  Perhaps your children have camps, vacations, different childcare arrangements, or long stretches of time at home, or, if you are like my family, a combination of all of those depending upon the week.  Even though summer can be a time of excitement and activities that children love, remember, even something exciting can be stressful.  To illustrate this, think about the last time you went on vacation.  Did you experience any stress before you went away?  Did you worry you were going to forget to pack something?  Did you have to work to make sure you stayed in budget or planned accordingly for activities vs. rest?

Even though your child does not necessarily have the same stressors you do, they have others.  Their stressors may include concerns like whether any other kids they meet on the trip or at camp might like them, whether this is going to be a fun place to go or not, whether the rules will be the same or different for them than what they are used to, whether they will have the food they like to eat on the trip, and what to expect next.

The adopted children I see can often have additional concerns such as whether someone from their birth family might spot them (I have heard this even from children adopted at birth), whether people in public will spot their family and ask why they look different or whether their family will be accepted.  They may worry if they are going to see relatives that they feel treat them differently from children born biologically into the family, or that their adoptive family is planning on leaving them in the new location.  Many of the children I see have the additional worry about embarrassing themselves by wetting the bed or their pants during the day if that has been a problem for them.

So, how can we prepare children for all of these transitions?  Here are a few tips to get you started.  The first few are for everyone, then I have a few special tips just for people with children with attachment issues.  Remember, every child is different.  That is why I am giving you several suggestions.  I encourage you to use those that feel right for you and your child.

1.  Prepare your child by telling them in a matter of fact way about what to expect.  For example: “Remember, you are going to camp tomorrow, I don’t know if you will know any of the kids there but I do know Ms. Suzie from last year will be there again.  I’m going to pack you an apple and some cereal in your lunch instead of a peanut butter sandwich because the camp does not allow peanuts in your lunch.”  Or, “We are going to Grandma’s.  Remember, we went there last year and you slept in the same room with your cousin Joey.  Sometimes you got to go to bed later and one night Aunt Cindy is going to watch you while Mom and Dad go out.  If two adults tell you two different things to do, I want you to come ask me if you are confused.  If I’m not there, I will always let you know who is in charge.”  You may need to break this information up into several conversations if you have a child that has difficulty taking in too much information at once.  I also like to ask children what they heard me say so I can hear them say it back and confirm that they heard what I think I said so I know if they got it.

2.  Always let children know who is in charge if you are not with them.  Meet the camp counselor, introduce your child to them and point out that that person is in charge.  “She’s in charge of this camp and I expect you to listen to her.”  Or, “We are going out and you are staying with Nana and Pop, I expect you to listen to both of them.”

A side note about tone here: I am not suggesting any kind of accusatory tone.  I always recommend a matter of fact, friendly tone that takes into account that our children are little humans with feelings.  I could see the above statement being said in an accusatory way and I hope you will refrain from that as much as possible.  If you have a child that has attention or attachment issues making it possible that they were not hearing you, or that they will pretend they did not hear you later, you can have them repeat it back.  Make it a game: You: Who’s in charge?  Child: Ms. Jenny’s in charge.

3.  Talk to your child about any transitions before they happen a few times so you can figure out if your child has questions that are causing anxiety so that you can get answers for them.  It is difficult to predict the ways in which children will formulate stories to fill in the gaps in their understanding.

When I was around 13 and my youngest sister was five, my family moved to a house about five miles away from the home we were living in.  I remember one night at dinner, we were talking about the move and someone asked my sister if she was excited to be moving.  She hesitated and got a little teary, then blurted out, “Yes!  But, I’m going to miss you guys!”  Remember, even if your child has made this transition before, it may only be their second or third time doing it.

A year in the eyes of a child is infinitely longer than a year in the eyes of an adult.  For a 33-year-old, a year is 1/33rd of their lives, for a four-year old, a year is 1/4 of their lives.  That’s a big difference.  A lot happens in the year of a child, and going somewhere, like a camp or vacation, where they have not gone for a year still qualifies as a major transition in their eyes.

4.  While you are making sure that you are talking about the upcoming transition some, I want to caution you to refrain from talking about it too much.

Recently my family and I went for a vacation weekend to a child friendly hotel/amusement park.  While we were there, my husband and I walked through the lobby where there was a show going on.  The show had animatronic characters singing a song.  I can only assume the song was called “There’s Nothing to Be Afraid Of.”  I assume that was the title of the song because the characters sang that line at least twenty times in the short time we were walking through the lobby.  I turned to my husband and remarked that while I was not scared before, I was thinking I might need to be scared now!  After all, why are they so adamant about telling me that there is nothing to be afraid of unless there is, in fact, something that might be kind of scary?

My point is, I have seen many parents who are worried about their child’s response to something new, prepare their child by talking about it endlessly.  A child who might not otherwise have been so worried, can then become fearful and put more energy and focus more anxiety on this thing Mom and Dad seem to be so worried about…it must be big.  Discussions about a transition need not be endless, just check-in, answer questions gently and matter-of-factly, and refrain from shaming or embarrassing children for asking what you think is a silly question.

I have two additional tip for parents with attachment disturbed children:

1.  Attachment disordered children still need safety and predictability, however, be mindful that they can often find ways to mess up vacations for themselves and put extra strain on the family by acting out when they are anxious.  Often a child worries they will mess up a vacation until they torture themselves internally about it so much that they go ahead and get in trouble just to get it over with.  Depending on your child, you may want to keep some things about a vacation private until just before they happen and to keep your plans flexible.  For example, say you have decided to go to a water park for one day during the vacation.  If possible, give yourself a window of days and times to go.  That way if your child is having a rough day you can just go the next day so they do not feel you are taking it away because they ruined things.  Then, on the day you do go, you can tell your child that morning or even on the way there and field questions as they come.  Children with attachment issues can get overly anxious and have temper tantrums as their anxiety builds and giving them a few surprises can actually save them from this anxiety in the long run.  Reserve this for things you are all doing together, do not surprise your child by telling them you are leaving them with someone else, even someone else they like.

2.  Be mindful that as you tell a child your expectations, you are not also handing them “the keys to the kingdom” as one of my colleagues likes to say.  What she means by this is that attachment disordered children are interested in what makes you the most upset so that they may use that against you whenever they are feeling anxious, insecure or fearful.  Be careful that when you are telling them your expectations as detailed in the suggestions mentioned earlier that you are not also highlighting the things that will annoy you the most if they do them.  “We are going to grandma’s and she is making cookies.  You may have two.  I expect you to use your manners.  If there is something you would like to have, please let me know so I can tell you if it is okay,” is very different from, “We are going to Grandma’s house.  No stealing, no lying.”  The first example encourages children to meet expectations, the second informs the children of the ways they can disappoint themselves yet again.

For all children, stating what you do want is always preferable to stating what you don’t want.  If I told you not to look at the title of this post, what is the first thing you think about doing?  Reading the title of course!  However, if I said to you that I hope you keep reading this post to the end, where is your attention?  Children are the same way.  High energy children, and attachment disturbed children are like this more than others and if you say, “Don’t steal,” their little minds say over and over, “Don’t steal.  Don’t steal.  Don’t steal.” until they have thought it so hard they find a chocolate bar in their pocket that they really may not have meant to have there.  If you give a child another thought such as, “Ask me if you want something,” and they say this over and over in their heads, even if it does not always work out, it plants a better seed in a child’s mind.  The more seeds like that you plant, the more likely they are to take root.

What are some transitions your children are going through?  Are there other ways you help your child with major transitions?

Related Posts:

June 21, 2012 Posted by | attachment disorder, child development, help for parents, Parenting | , , , , , , , | Leave a comment

Delighting in Children Who are Not Used to Delight

Cover of "Feelings"

Cover of Feelings

Written by, Kate Oliver, MSW, LCSW-C

When I speak to parents of children with attachment related issues about trying to delight in their children, I hear a couple of common responses.  The first response is that, to be honest, their children are not all that delightful.  The parents I work with have children that lived their first several months or even years with a marked lack of being delighted in, so, because they do not know any better, they do not desire to be delighted in and, rather than feeling good, being delighted in can actually be scary, or intimidating to the child.

Even if you can find a moment of delight during the day, for parents with children with insecure or disorganized attachments I hear that they, the parent, often experience repercussions, sometimes extreme repercussions, (like the kids I have known who have taken what was otherwise a nice day and ruined it by destroying something their parents loved by, say, urinating on furniture on purpose, or cutting up a cherished item) soon thereafter.  I also have parents tell me that allowing themselves to delight in their child leads to the child becoming more demanding because the child either believes that if they do something to make their parent happy they should get some immediate reward, or the child feels good and falsely believes that the good feeling comes from something outside of them (such as the item they were delighting in or an amusement park ride).  In an attempt to continue the good feeling, the child demands more and more of the parent until the parent is sorry they delighted in the first place since they have such an ungrateful little so and so.  While some of that feeling is normal for any parent, for this post, I am focusing on those parents with a child on the far end of the attachment disordered spectrum.  All children test limits sometimes and may engage in some of these behaviors, but attachment disordered children do this as part of an ongoing pattern of behavior, rather than as a part of the normal limit-testing all children do.

What is a parent to do?  If you have a child that engages in the above mentioned behaviors when you try to delight in them, I have a few reminders to help you stay sane and remain in a place of loving kindness toward your child.

1.  Your child may not know how to share a good feeling.  In other words, due to early neglect and/or trauma, your child may not have developed the understanding of how to share good feelings with others.  They may have what I have heard called “scarcity thinking,” meaning that only one person can feel good at a time and, because they may not also have had a chance to develop empathy, they decide the person feeling good is going to be them.  Because they did not have an early environment of shared good feelings, they just do not know how to, well…share good feelings.  Remember too, that having someone notice them may have had a very different meaning for them and the meaning may not have a positive association for them.

2. Your child may not know how to experience delight.  Remember the neuron transmitters from my previous post?  Your child did not get that so, guess what, you get to teach them!  This would be a good time to review my post about chronological age vs. developmental age.  No matter the chronological age of your child, their developmental age is quite a bit younger.  How do you teach a child delight?  Like this: say something along the lines of (with a tone like Mr. Rogers, remember him?) “Look at us!  We are so happy together!  We are feeling the same feelings at the same time!”  Allow the feelings for a few moments but, as you observe your child beginning to take it over the top, in the same tone, “Sometimes I wish we could feel so happy all the time, but feelings come and go don’t they?  It was so nice to have that good feeling.  It looks like we are going back to the regular feelings now and that’s okay.”  In this way, you are teaching your child about the normal ebb and flow of feelings, and building in normalcy about delight to address the first reminder, that all feelings are around for a little while, then leave, then come back again, and that is part of being human.

3. It takes many, many encounters for a child with attachment issues to actually learn how to genuinely delight.  While a baby is primed for good feelings and eagerly absorbs them, they do that because they are also open and actually vulnerable.  When a baby learns to delight, their vulnerability has paid off.  For your child, the vulnerability did not pay off, so they stopped allowing themselves to feel vulnerable.  Remembering this can help to ease the frustration for a parent that says, “But she’s lived with me longer than she lived with them!  When is she going to learn that we are safe!”  The answer is that she will learn to feel safe if we can capture the moments where she allows herself to be vulnerable, and during that quick window, you prove to be a safe and loving person.  You prove this by maintaining a playful, loving, accepting, curious, empathic (PLACE) attitude as much as possible so that each time that window opens a little you enhance the opportunity for growth and change in your child, so that next time the window opens a bit farther for a bit longer until, eventually, it stays wide open.

4.  Think of the alignment of the planets in our solar system.  If one planet were to be knocked off-balance, the others pull it back into place using their gravitational pull.  Similarly, for your child, when they come to you having become accustomed to being the “problem child” then you treat them as if they are not, they seek familiarity (they realign the planets as they know them) by doing something to make you as angry as they are used to parents being.  We call this seeking homeostasis.  I find one way to help if you have a child who does this is to name what is happening.  In a matter of fact, gentle tone, I would suggest saying something along the lines of, “Having fun can make people uncomfortable or worried sometimes.  I think it makes you feel that way.”  Or, “I am so sad when you are too scared to let yourself be happy without making yourself pay for it later.”

I find we can be most compassionate when we can look to the origin of the issue rather than taking the response of our child personally.

If you have a child with a history of attachment issues, what have your experiences been with delight?

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June 15, 2012 Posted by | attachment, attachment disorder, help for parents, Parenting | , , , , , , | 6 Comments

The Spectrum of Attachment

This picture by Sovanna Ly -csc- can be used f...

This picture by Sovanna Ly -csc- can be used for any purpose, provided that his name is credited. (Photo credit: Wikipedia)

Written by, Kate Oliver, MSW, LCSW-C

When we look at children’s attachment styles, they typically fall into one of three categories, secure, insecure and disorganized. I explained some about these categories in my post, “What is Attachment Disorder?” This post will go more into attachment disturbance and how to tell the difference between an attachment “issue” and an attachment “disorder” and some of the symptoms you might see from a child (or adult) with attachment issues. If you are interested in learning about attachment disorders, you can find the diagnostic criteria here. I personally do not find it helpful to diagnose a disorder vs. disturbance of attachment unless I need to as a means for getting insurance reimbursement because if you look at attachment across the spectrum, you would find that we all have attachment issues.

In my world, where I see many actions through the lens of attachment, I think of it like this: picture the security of a person’s attachment on a scale from 1-10. A person with a 1 would be a person who feels worthless and unlovable in all situations across the board. They do not believe they have the power to make any positive changes in the world, nor do they believe that anyone cares about or wants to help them to make positive changes. This person would constantly live in the moment, since they do not feel as though planning helps anything and would constantly look to meet his or her own needs (without distinguishing between wants and needs) by whatever means necessary. A person operating at a  “one” steals and lies constantly, manipulates with as much sophistication as possible for their developmental level, does not seem capable of forming any lasting relationships, etc. A” 10” would be a person who never worries about rejection or abandonment from the people they love, knows they are loving and loveable at all times, and understands that all problems can be solved, etc.

The way I see it, most of us fall between a 4 and an 8. From 1-4, I would say you have a disorder: an attachment style that presents major problems in your day to day life that requires specialized therapeutic treatment. A 5-8 is what I would call a good, healthy neurotic: while therapy is an option for difficult times, the gaps and insecurities in attachment are manageable most of the time as long as life is relatively stable for you. Yes, you worry about people leaving you sometimes and might avoid conflict when it might be healthier for you to confront an issue, or make a confrontation out of something that really could have been a constructive conversation, but, overall, life feels manageable and you have areas you do well in even if there are parts where you feel you struggle.

All of our internal feelings and perceptions about ourselves can be seen through behaviors. To figure out if someone has serious attachment issues, we need to look at what the symptoms are of an attachment disturbance. Here are some of the things practitioners who see people with attachment disturbance look for:

Difficulty maintaining eye contact with primary caregivers (especially when someone is saying something loving)

  • Constant lying
  • Manipulating situations
  • Lack of language to express feelings
  • Lower developmental age than chronological age
  • History of multiple primary caregivers (foster care, adoption at an older age, frequent changes in child care providers)
  • Stealing
  • Identification with the villain in movies
  • Playing with fire
  • Bullying and/or blindly following others who are a bad influence
  • Abusing animals
  • Seeming lack of remorse or conscience
  • Difficulty empathizing with others
  • Lack of understanding of cause and effect
  • No trust in authorities
  • A constant seeking for control of every situation

Now, before you start worrying that you and your child will be featured on the next segment of “Kids who Kill” on 20/20, let me point out that it is a combination of all of these features that would point toward a diagnosis of attachment disorder. Even though headaches are associated with brain tumors, you would not automatically assume you have a tumor every time you have a headache. Also, it is not only the presence, but the severity and consistency of the symptoms that informs the diagnosis. For example, we have all probably lied a few times this week. We said we were fine, or even great when asked “how’s it going?” rather than saying, “Well, everything’s going well except for my job.” Or maybe a telemarketer called and asked you for a few minutes of your time but you said you were busy when really you were not.

Just like with attachment being on a spectrum, so are the symptoms. If you stole $20 out of your mother’s wallet once when you were 13 and felt awful about it, that is very different than being 13 and stealing from your mother, your brother, and the teacher’s desk at school whenever you get the chance, and your stealing includes anything from candy and treats to money, toys, and clothes. Also, when you were 13 and stole that time, maybe you had a specific purchase in mind or something you were going to do with the money. That too is different from stealing whenever the chance presents itself as if you needed to fill a perceived lack with any and every chance that comes along.

I have mentioned before Daniel Hughes book, “Building the Bonds of Attachment.” This, to me, really is the best book with the most readable format* that explains what happens with a child with attachment disorder, while simultaneously showing how secure attachments are made.  You can easily link to find his book, and other books about attachment that I recommend on Amazon by clicking on the “Amazon widgets” link at the top right corner of my webpage.**

Something that can make an attachment related diagnosis difficult to make, is differentiating it from other diagnosies, such as post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), or even early bipolar disorder or schitzophrenia. That is why, this post should never substitute for seeing a mental health practitioner. It is possible for children and adults to have any or all of those issues and each needs to be carefully treated. If you are concerned that your child needs therapy for attachment disorder, please find a mental health practitioner. I give tips on how to do this here. I give tips on how to get insurance to reimburse specialiazed therapy here.

What are your questions about attachment? Do you have a question about something that your child does and whether it is attachment related? Please feel free to ask here or comment. Or you can contact me directly, helpforyourfamily@gmail.com.

*If you are not a practitioner, I would suggest that you skip or skim the first 50 pages of the book.  Even as a practitioner, I found them difficult but I am glad I kept reading after that.

**see disclaimer page

June 8, 2012 Posted by | attachment, attachment disorder, help for parents | , , , , , , | 15 Comments

Here is the blog I was referring to in my post earlier today.

daniellesstory

Figure 1 The doll was one of a few ragged  items sent with my daughter from the foster home in 2001

I am “Danielle’s” adoptive mother,  I was at the doctor’s office one morning while my mother in law was babysitting her; at the time, she was only eleven years old.  In the waiting room,  I picked up the newspaper and read the headlines: “Woman Admits to Killing Her Son”. It was an article about the confession– there were intimate details about Wendy’s life and the murder of her two-year old son. Initially, I thought it was an article about some stranger in a faraway place. As I read on, it became evident that this was MY daughter’s birth mom! This was how I discovered the details about Danielle’s previous family. I was shocked and saddened by the information!

December 20, 2010 President Obama signs the S.3817 the “CAPTA Reauthorization…

View original post 1,369 more words

April 17, 2012 Posted by | attachment disorder, social services | 1 Comment

Finding a therapist for a traumatized and/or attachment disordered child

Some elementary school counselors use books an...

Some elementary school counselors use books and other media to help their counseling (Photo credit: Wikipedia)

As therapist who specializes in both trauma and attachment disorders, I can tell you it is important if you are searching for a therapist for one or both of these issues, that you find the right therapist for your child.  Doing so will save you a lot of money and aggravation and is more likely to speed the healing time for your child.  To start, look at my post on  finding the right therapist for you or your child (you can find the link at the bottom of this post).  With these particular children, and probably people with other specialized issues as well, there are further steps you would want to take to ensure that you have the right person.  I see the steps for this particular issue as follows:

1.  Figure out if your child has “only” trauma, or has trauma with attachment related issues.  Here is the distinction, a child with trauma without attachment disturbance usually experienced a one time occurence, or something that happened over a relatively short period of time and was quickly identified.  Trauma with attachment related issues is trauma that also impacts a child’s ability to bond with their caregivers in a healthy way, for example abuse or neglect by a primary caregiver or ongoing abuse or neglect that a child did not disclose.  If you feel as though your child’s trust in adults to provide care for them has been altered significantly, you will want to see someone with knowledge of attachment related issues.  To clarify this distinction, a teenager carrying on a short-term, secret relationship with a much older adult that they thought was younger or who was tricked into a situation where they kept a secret because they were breaking the rules when they were traumatized does not fall into this category of attachment disturbance.  It is within reason to anticipate that teenagers will try to stretch or break the rules and it does not signify a break in a child’s core ability to trust that their parents will care for them.  A teenager whose step sibling was abusing them for an extended period of time whenever their sibling came to stay at the home does fall under the category of possible attachment disturbance.  The difference is the primary caregivers were around at the time of the trauma and did not know to stop it, while in the first example, the teen was doing an activity it would be reasonable to assume is developmentally expected but someone took advantage of them inappropriately.  When in doubt, I would see someone who specializes in both trauma and attachment.   If you find that there is an attachment related issue for your child’s situation, I would always make sure to take the child to a therapist that understands attachment because in order to work on attachment disorders or disturbance, you must know about trauma since the two go hand in hand.

2.  Once you have determined whether you are looking for a therapist with trauma training or whether you need someone with an attachment and trauma focus, follow the steps from my first post on finding a therapist and ask these additional questions.

  • What is your training in attachment and trauma?
  • What recent trainings have you attended or conducted that relate to attachment and/or trauma?
  • How do you conduct your sessions?

The answers to these questions, if you are talking to the correct therapist, should indicate that the person stays actively engaged in seeking training for attachment and trauma related issues.  Additionally, an attachment specialist will indicate to you that you will be in the room for most, if not all, of the time that your child is in therapy with them.  Attachment oriented therapy is significantly different in that a therapist focuses much more on your relationship with your child rather than their relationship with your child.  In traditional therapy including therapy for singular trauma, you would take your child to see the therapist, you might check in with the therapist at the beginning or the end, then your child would see the therapist alone for the majority of the session.

While traditional therapy is effective with many children, for children with attachment disturbance, it can actually damage a child’s relationship with their parent.  I have seen this happen, since a child with attachment disturbance has a tendency to reject caregivers, and, while they are alone with a therapist they may talk to their therapist about how terrible and difficult their parents are.  The therapist and child will bond over this and the therapist shakes their head in disbelief, meanwhile they may be overlooking a parent who is really trying their hardest to meet the child’s needs while reinforcing for the child that the caregivers in their lives are, in fact, inadequate.  Remember, children with attachment disturbance see adults as unsafe on some level and tend to fit them into these categories.  A skilled attachment therapist will spot when a child is doing this and help them to retrain their system of trust by teaching them how to find trustworthy adults and by training the adults in their lives to be trustworthy in the way the child needs them to be.  To learn more about attachment disturbance you can see my post linked below “What is attachment disorder?”

**A note to providers- I understand that you have seen parents who are, in fact, inadequate.  For this post, I am assuming that a parent who cares enough to read this post is adequate because they are involved and caring enough to research this issue.

Stay tuned for my post on getting specialized treatment for your child- the things insurance companies won’t tell you that can help you get your child’s treatment paid for.

April 16, 2012 Posted by | attachment, attachment disorder, health insurance, help for parents, thinking about therapy? | , , , , , , | 8 Comments

What is attachment disorder?

Mother and Child watching each other

Mother and Child watching each other (Photo credit: Wikipedia)

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.

To find out more about attachment disorder please visit the website I participate with www.attachmentdisordermaryland.com.  There you will find a wealth of information on this topic.

Stay tuned for future posts on attachment as well!

March 31, 2012 Posted by | attachment disorder | , , , , , , , , , | 10 Comments

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