help4yourfamily

Create the family you want to have

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

An Attachment Therapist on Attachment Parenting

At the Baby Loves Disco party Sunday afternoon.

At the Baby Loves Disco party Sunday afternoon. (Photo credit: Wikipedia)

Maybe it’s just because I’ve been a bit more attuned to the media’s interpretation of parents recently but I’ve noticed that there seem to be a lot of people talking about attachment parenting being the newest thing.  I’ve known about attachment parenting for years now.  Just like with any other parenting style, the media reports tend to focus on extremes where in order to say you are an attachment parent you must rigidly follow the tenants of wearing your baby everywhere, co-sleeping, and breast-feeding past the societal norms for the United States.  Attachment parenting becomes just like “tiger moms,” “helicopter parents,” and “back-stage parents,” so that you either you are or you are or are not with no in-between.

I would like to suggest that we all take a breath for a moment.  Put your hand on your heart.  While you are at it, breathe a few times slowly, in and out.  Ask yourself this question.  “Is this true?”  Is it true that so many people subscribe to rigid parenting styles?  Or are we all just trying to get along the best way we know how with the information we have?

I would like us all to dial it down a notch.  Here are the things I care about as an attachment therapist– meaning that I am a therapist that looks at the attachment styles between parents and children and helps to guide children with insecure attachment styles toward a more secure attachment:

Do you have a genuine, loving relationship with your child?

If not, are you working to make your relationship genuine and loving?

Do you care more about your relationship with your child than you care about being right or dominating your child?

Are you playful and loving with your child when you can be?

Do you set appropriate limits?

Does your child look to you for comfort and protection and do they have faith that you will care for them?

Are you empathic toward and accepting of your child’s feelings, even if they are different from yours?

Do you have insight into the parts of parenting that are hard for you and do you work to change the parenting moments or actions you are not proud of?

These are the foundations of parents that form secure attachments with their children.  Dan Hughes, author of several books, including one of my favorites, “Building the Bonds of Attachment,” (you can purchase this book by following the link “Amazon widgets” at the top right of this page*)calls this way of parenting PLACE parenting.  PLACE stands for Playful, Loving, Accepting, Curious, Empathic.  I find using this way of parenting builds a strong bond between parent and child and is especially useful for the children I see with attachment disturbance.

I do my best to use it with my children as well, but, guess what?  I’m human.  Sometimes, like when I take my oldest clothes shopping and she refuses to try on a single item of clothing even though she complains several times a week that she has nothing to wear, I lose it.  If you were in Target with us last Tuesday, I apologize.  Seriously.  But, just like when our children make mistakes, so do we need to gather ourselves together and learn from those things we do that we wish we could take back and move on.  It is my strong belief that the best parenting style for any parent is the one that works best for them!  The style that most truly matches your internal desire and ability to parent, and which models a life you would like your child most to emulate.  I imagine that would be a life in which: they are free to love themselves without being narcissistic, they care for others so that they might experience loving relationships, and they explore their own interests and build on their own talents and abilities, among other things.

What do you think creates a strong foundation in a parent/child relationship?

*see disclaimer page

May 23, 2012 Posted by | attachment, help for parents, parent support/ self improvement | , , , , , | 4 Comments

Is Chimpanzee good for your child to see if they are adopted or have lost a parent?

See description on File:Chimpanzee mom and bab...

See description on File:Chimpanzee mom and baby.jpg. I cropped it slightly to remove the original black frame. (Photo credit: Wikipedia)

Written by Kate Oliver, LCSW-C

Just from watching the commercials, we can easily see that  the new Disney movie, Chimpanzee, is going to be all about adoption.  While it is predictable that the movie will have warm fuzzy messages about adoption overall, if you have an adopted child, or any child who has lost a parent through divorce, abandonment, death, etc. it is a good idea to take a moment to consider whether this is a good movie for your child.  Of course we know all children are different and only you can decide what is right for your child so please do not use my post as a replacement for your own judgment since obviously you know your child way better than I do.  Also, spoiler alert, you will know all about the movie by the time I’m done with the post.  My hope is to attempt to address the adoption related issues in the movie so you can make the best decision for you and your family and to be ready for any conversations or feelings it might bring up for your child (and you).

First, let me say, the movie was pretty entertaining for the children seven and up in our group, the youngest (5) got bored half way through and I saw several younger children leave during the movie.  The parents were thoroughly entertained and there were quite a few “aww’s” and chuckles throughout.

The movie starts in an idealic world where little monkeys are taken care of by mommies (no mention of daddies).  Little Oscar and his mom, Esha, are the focus.  Children who were not taken care of by their first mommies or whose first mommies have left them in some way may have some feelings about the portrayal of moms in this part as the idea of mommies taking care of babies is presented as the only way things can go.  I can see how a child who feels bad about having a mommy who did not take care of them might be triggered if they carry residual feelings of guilt or believe it was their fault their birth mother did not take care of them.  Additionally, the mention of dads is not just downplayed, it is completely non-existant in this part of the movie.

Soon, the idealic world of the chimps is threatened by another group of chimpanzees who want to take over their territory.  Esha keeps Oscar safe during a particularly scary time when this group attacks and the movie continues to highlight Oscar’s reliance on his mother and her role in keeping him safe, fed and protected.  Sadly, the other group of monkeys attacks a second time and it is during this attack that Esha and Oscar are separated and Esha disappears forever with the assumption being that only death could keep her away.  It continues to be quite heartbreaking as we see Oscar get harshly rejected by several other female chimpanzees who already have children (triggering for children who have been in multiple foster care placements).  During this time, Oscar tries, and fails, to find his mother.  Obviously, no one is able to explain to him where she is and he is left to fend for himself.  Oscar is sad and lonely and experiences difficulty finding food and caretaking.  Do I need to point out the many opportunities for adopted children and/or children who have a parent that is not in their lives will have to identify strongly with this section of the movie?

After suffering for an intense ten minutes or more during the movie, Oscar begins to follow the alpha male, Freddy.  He begins gently befriending Freddy (there is a good conversation to be had about shadowing adults and learning from thier modeling behaviors here).  Freddy, who it was earlier emphasized in the movie, had no interest in the younger chimps, slowly also begins turning toward Oscar and teaching him to get food.  Over time, their friendship grows and, in a particularly heartwarming scene, Freddy grooms Oscar and lets him ride on his back.

During this portion of the movie, there is no mention of moms and, knowing that I see children with attachment disorder in my practice who work pretty hard to come between their parents and who often punish the mom and complian to the dad (because moms are scary for them since they represent the original abandoning mom), I can see this particular part of the movie reinforcing that behavior a bit.  Additonally, I can see how children who have struggled to bond with an adoptive parent would be triggered to wonder what it is about them that caused them to be first rejected or abandoned by other parents if that is their emotional experience.  Those children who struggled to bond with an adoptive parent may also wonder why it is so easy for Oscar (no internal loyalty struggle here, also no negative behaviors from Oscar) to bond with Freddy and just what must be wrong with them that they have difficulty bonding.

While Freddy and Oscar are bonding, however, trouble lurks nearby, the narrator, Tim Allen, says that while Freddy and Oscar have been building their relationship, Freddy has neglected to protect his area and the other chimpazee group is closing in for another attack.  Freddy senses this and begins to do some team building again.  Oscar feels ignored by his new dad and we see him again feeling lonely because he does not understand why Freddy is turning away from him to take care of other chimps.  This made me think about moms or dads taking care of new babies or other siblings and the triggers that has for many of my adopted children, not to mention kids in step-parent families.

I can see this movie being especially nice for single and/or adoptive dads as it reinforces that dads always protect their children even if they didn’t always know how to parent at first.  I can also see it being an issue for moms and other primary, nurturing caregivers (including dads) who, like I said before, have a child that uses them as a representation of all abandoning people in their lives, and for children who did not have a mother that took good enough care of them before entering an adoptive family.  I would also recommend it for children who are able to articulate their feelings about adoption, parental loss, etc. over children who are still unable, or unwilling to discuss those issues.  Ultimately, it is up to parents to decide what is right for their children.  Either way, in the end, the movie has a happy ending where Freddy and Oscar get to be together and Freddy focuses on Oscar again.

I see multiple opportunities for parents to bring up good conversations for kids about: whether Esha’s disapperance was Oscar’s fault; how Oscar must have felt when the other mom’s rejected him; how Oscar befriended Freddy and whether they loved each other right away; how dads and other parents protect children even though sometimes it is hard to see how (like when they go to work or pay attention to other kids); and why Oscar had an easier time of bonding with Freddy (because his first mom was good at teaching him how to love other chimps).

Have you taken your child to see this movie?  What did you think?  Did I miss anything?  I would love to hear how the experience was for your child.

April 23, 2012 Posted by | attachment, resources/ book reviews | , , , , , , , , , | 2 Comments

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

Trash Your Behavior Charts!

Kids (film)

Kids (film) (Photo credit: Wikipedia)

I have a pet peeve as both a parent and as a clinician about behavior charts.  You know, those charts where kids get stickers for doing things they are supposed to be doing anyway, and then they get a treat or prize for doing it enough times?  I am aware this opinion may be upsetting to some clinicians and especially school professionals where behavior charts are relied upon so heavily.  As a parent, I just think they are annoying and hard to follow for me.  As a clinician, I believe they set up a tit for tat system in a family where everyone starts measuring who did what when.  For my parents with children with attachment disorder they are especially frustrating because by the time a child has earned the prize, you might feel as though you are so angry about all the work it took for you to get them to do the chore/ desired behavior that you don’t really feel like giving them anything.  Sometimes kids make you sorry you gave the prize after the fact by deciding now that they earned the prize they don’t need to do anything for a while.  What a pain.

I have a much better alternative to traditional behavior charts.  It’s the only one that works and it requires little effort from you!  This will take all of two minutes of your life.  Here’s how it works:

  1.  Take a piece of paper and write down one or two (I would only do a couple at a time because it’s easier to keep track of) things your child does that bug the heck out of you i.e. lying, “forgetting” to do their chores, sassing back.  Pick something that is realistic for their developmental level.
  2. Think of a few prizes you might like to earn that involve self-care: a massage, getting a cup of tea with a friend, take a long bath, etc.
  3. Let your child know that you are now giving yourself a behavior chart.  When you are able to successfully handle this behavior from your child in a manner you feel is appropriate (without you yelling, whining, engaging in a back and forth battle), you get a point!  Decide how many points you need to earn to get a prize.   Tell your child that when they engage in that behavior from now on you (not they) will earn a point.
  4. When they do engage in the behavior, calmly remark on what an opportunity this is for you to earn points so you can take care of yourself.  It’s important for parents to take care of themselves when kids are giving them a hard time.  You can wonder aloud how long it’s going to take to get your prize.
  5. This is the most important step.  Follow through!  When you earn your points, do the thing you said you would do to take care of yourself, even if you don’t feel like it.  Remember you picked things you like to do so perhaps they can help you now.

I have successfully used this “behavior chart” with many parents now and I have used it myself.  It works like a charm.  I used it with my own daughters who kept coming in at night to have me take them back to bed when they had their normal cycle of lighter sleep.  I modified it so that if one kid came in, she earned her sister a point!  Guess who sleeps without interruption for weeks at a time?  This lady, right here does! J  It’s really a win-win either way since even if you don’t get the desired behavior right away (and you will because kids get annoyed at the idea of earning you a prize) you at least get some self-care.

April 5, 2012 Posted by | attachment, discipline, help for parents | , , , , , , , , , , , , , , , | 7 Comments

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