Attachment Disorder

To understand what attachment disorder is, you must first know what attachment is.

To understand what attachment disorder is, you must first know what attachment is. Attachment is the deep and enduring connection established between a child and caregiver in the first several years of life. Attachment is not something that parents do to their children; rather, it is something that children and parents create together, in an ongoing reciprocal relationship. Attachment to a protective and loving caregiver who provides guidance and support is a basic human need. Children who begin their lives with the essential foundation of secure attachment fare better in all aspects of functioning as development unfolds. Some basic functions are listed below that show how attachment shapes a child.

Learn basic trust and reciprocity, which serves as a template for all future emotional relationships.
Explore the environment with feelings of safety and security.
Develop the ability to self-regulate, which results in effective management of impulses and emotions.
Create a foundation for the formation of identity, which includes a sense of competency, self-worth, and a balance between dependence and autonomy.
Establish a pro social moral framework, which involves empathy, compassion and conscience.
Generate the core belief system, which comprises cognitive appraisals of self, caregivers, others, and life in general.
Provide a defense against stress and trauma, which incorporates resourcefulness and resilience.

So, now that you understand the basics of attachment. What is attachment disorder? Children who are failing to develop secure attachments to loving, protective caregivers. These children are left without the most important foundation for healthy development. Attachment disorder is transmitted intergenerationally. Children lacking secure attachments with caregivers commonly grow up to be parents who are incapable of establishing this crucial foundation with their own children. Instead of following the instinct to protect, nurture and love their children, they abuse, neglect and abandon their children. Children who begin their lives with compromised and disrupted attachment are at risk for serious problems as development unfolds.

Here is a list of some of the developmental problems that a child with attachment disorder are at risk for:

Low self-esteem

Needy, clingy or pseudo independent

Decompensate when faced with stress and adversity

Lack of self-control

Unable to develop and maintain friendships

Alienated from and oppositional with parents, caregivers, and other authority figures

Antisocial attitudes and behaviors

Aggression and violence

Difficulty with genuine trust, intimacy and affection

Negative, hopeless and pessimistic view of self, family and society

Lack empathy, compassion and remorse

Behavioral and academic problems at school

Perpetuate the cycle of maltreatment and attachment disorder in their own children when they reach adulthood

Attachment disorder affects all aspect of a child's functioning. A child may display some combination of these symptoms:

Behavior: oppositional and defiant, impulsive, destructive, lie and steal, aggressive and abusive, hyperactive, self-destructive, cruel to animals, irresponsible, fire setting.
Emotions: intense anger and temper, sad, depressed and hopeless, moody, fearful and anxious (although often hidden), irritable, inappropriate emotional reactions.
Thoughts: negative beliefs about self, relationships, and life in general ("negative working model"), lack of cause-and-effect thinking, attention and learning problems.
Relationships: lacks trust, controlling ("bossy"), manipulative, does not give or receive genuine affection and love, indiscriminately affectionate with strangers, unstable peer relationships, blames others for own mistakes or problems, victimizes others/victimized.
Physical: poor hygiene, tactilely defensive, enuresis and encopresis, accident prone, high pain tolerance, genetic predispositions (e.g., depression, hyperactivity).
Moral/Spiritual: lack of faith, compassion, remorse, meaning and other pro social values, identification with evil and the dark side of life.

Attachment Disorder takes place through various situations and experiences. There are three contributing factors, the parent or caregiver, the child and the environment. It is important to know what a child is at risk through these factors. Listed below are situations and experiences that place children at high-risk for developing attachment disorders:

Parental/Caregiver Contributions:

Abuse and/or neglect
Ineffective and insensitive care
Depression: unipolar, bipolar, postpartum
Severe and/or chronic psychological disturbances: biological and/or emotional
Teenage parenting
Substance abuse
Intergenerational attachment difficulties: unresolved family-of-origin issues, history of separation, loss, maltreatment
Prolonged absence: prison, hospital, desertion

Child Contributions:

Difficult temperament; lack of "fit" with parents or caregivers
Premature birth
Medical conditions; unrelieved pain (e.g., inner ear), colicky
Hospitalizations: separation and loss
Failure to thrive syndrome
Congenital and/or biological problems: neurological impairment, fetal alcohol syndrome, in utero drug exposure, physical handicaps
Genetic factors: family history of mental illness, depression, aggression, criminality, substance abuse, antisocial personality

Environmental Contributions:

Poverty
Violence: victim and/or witness
Lack of support: absent father and extended kin, isolation, lack of services
Multiple out-of-home placements: moves in foster care system, multiple caregivers
High stress: marital conflict, family disorganization and chaos, violent community

It�s never too late to create positive change in a child�s life, or in an adult�s, for that matter. The learning that accompanies new experiences can alter neural connections in the brain. Relationships with relatives, teachers and childcare providers can provide an important source of connection and strength for the child�s developing mind. In attempts to repair attachment disorder, here are some things to consider:

Attachment is an interactive process. It is an evolutionary fact that our brains are structured to connect to one another. The attachment process alters the brains of both parent and child. But what makes attachment so unique is that the stronger, older, more experienced parent attunes and follows the lead of the younger, less experienced, more vulnerable child.

Attachment is a nonverbal process. It takes place many months and even years before speech and thought develop. Communication is accomplished through wordless means that rely on several things to convey interest, understanding and caring. Children vary in what they find soothing. There is no �one size fits all� for every child. In determining what constitutes �just right� communication for a particular child, it will be up to the adult to follow the nonverbal cues of that child.

Some cues to take from the child:

eye contact

facial expression

tone of voice

speech rhythm and rate

posture

gesture

body movement

timing, intensity and voice modulation

Attachment is akin to falling in love, but can�t begin until both parties feel safe with one another. When adults are anxious, mad, tuned out or overwhelmed, they will not be able to make a connection with a child. They should regulate themselves before attempting to connect. If a child is overwhelmed or inconsolable, he may not be available for an attuned emotional connection until he feels safer. Sensory activities such as rocking, singing, moving, touching, and feeding can sooth children, but youngsters vary in their sensory preferences. What soothes a parent may not soothe an infant. Thus, parents may have to become sensory detectives to determine the best techniques for soothing their child and soothing themselves in order to make connection with the child.

The key to shared emotional experience is not simply to mirror or give lip service to the child, but to share his experience by feeling it to some degree within your own body. This process of shared experience helps both infants and children regulate their feeling states. It is usually more important to share a negative state with a child than to problem solve. Sharing enables children to learn to problem solve for themselves.

The shared positive emotional experiences of joy are as important to the attachment bond as the shared negative emotional experiences of fear, sadness, anger and shame. Some parents are very good at detecting a child�s distress and responding appropriately to it. Other parents share joyous moments but leave or space out in times of trouble and unhappiness. A strong attachment bond includes the full range of shared emotional experience.

Rupture and repair is a crucial part of secure attachment. No matter how much we love our children, there comes a point where we are not in agreement with them, a point when we have to set limits, and say �no.� This is usually a point of rupture in the relationship as the child angrily protests. Such protest is to be expected. The key to strengthening the attachment bond of trust is to be available the minute the child is ready to reconnect. It is also important to initiate repair when we have done something to hurt, disrespect, or shame a child. Parents aren�t perfect. From time to time, we are the cause of the disconnection. Again, our willingness to initiate repair can strengthen the attachment bond.

Families who have children with Reactive Attachment Disorder (RAD) will benefit from treatment and therapeutic parenting. Other disorders may accompany severe attachment disorder.

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