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Understanding Attachment

What is attachment? And how do we attach? How we attach to caregivers and build relationships depends greatly on our experiences as infants. Children who have experienced some grief, loss and trauma early in life can find it difficult to form new attachments to their adoptive parents.  This does not mean that older children cannot form healthy attachments because children can learn to trust and build new attachments in their adoptive family over time. This section is a brief overview of attachment and attachment development to help families start on their journey of learning about this complex issue.

Reactive Attachment Disorder

Definition of attachment

Attachment is the connection between a child and caregiver. Attachment is a bond developed from birth through the early years of childhood. Attachment allows children to feel safe, secure and loved. Positive attachment stimulates the development of a child’s brain and helps a child develop the lifelong ability to experience stable and loving relationships.  

Types of attachment

How attachment is developed for an infant can result in different attachment styles. There are four main attachment styles. The style of attachment a child develops depends greatly on the way their caregivers treated and responded to them during infancy.  

  1. Secure Attachment- A child with a secure attachment has had a consistent and supportive relationship with their parent(s) during infancy. The parent would have been available and responded to the infant’s needs and cues while comforting and soothing them to feel safe. This child views their parent as a “secure base.” When a child is able to rely on their parent in their early years they gain a better understanding of themselves and the world around them. The child’s relationship with their parent also allows that child to trust the people in their lives.
  2. Avoidant Attachment- If a child has been repeatedly rebuffed or ignored when in need of soothing; an avoidant insecure attachment style may develop.  This child’s experiences during infancy have not been reliable or consistent; therefore, their attachment needs have been minimized. This child does not pursue emotional connections to people and may also feel disconnected from others and from their own emotional needs.
  3. Ambivalent Attachment- Children who have had experiences with caregivers being inconsistent or intrusive with their care may have Ambivalent Attachment. This child has not been able to rely on their caregiver to sooth and care for them. This child does not know what to expect from their caregiver and does not feel safe and secure. Sometimes their caregiver was available to meet their needs and other times they were not.  This child can be anxious or “clingy” and can be very distressed when separated from their parent/caregiver. This child can also be uncertain about his or her own needs, and have a difficult time being soothed. This is due to the inconsistency during infancy.
  4. Disorganized/Disoriented Attachment- This insecure attachment style is a mixture of ambivalent and avoidant attachment behaviours (possibly even occasional secure behaviours). These children have feared their parents for a variety of possible reasons. Their needs were not met and their parents did not have the ability to sooth and relax them.  This mixture of both fearing their caregiver and needing to be soothed by same caregiver creates the disorganized behaviour.  These children are vulnerable and could have difficulty balancing their own emotions and building positive long-term relationships. These children may also dis-associate and separate themselves from their feelings. 

Reactive Attachment 

Attachment styles fall on a spectrum from secure to the insecure styles of attachment. There is another category identified as Reactive Attachment Disorder (RAD). There can be situations where there is a complete absence of attachment altogether in the early years. This can be caused by neglect, abuse, severe instability or other extreme environments.  The absence of love and trust in the early years of life can impact a child profoundly later in life.  An individual with Reactive Attachment can have difficulty balancing their emotions, building relationships and developing a positive self-image.  Emotional connections being established throughout childhood, adolescence and into the adult years are heavily impacted by the individual’s early years’ attachment experiences. For these children it can be difficult to form healthy bonds with parents, primary caregivers or peers.

If you suspect or see signs of RAD make an appointment with your pediatrician for a professional diagnosis. 

How is attachment developed? 

As infants we act in certain ways to gain our parents’ attention and nurturing responses. An infant will cry, coo, reach, or cling and the parent will come and nurture, protect or defend the child. The parent is “bonding” with the child, while the infant is forming an “attachment” with the parent. The importance of this attachment and bonding are “hard-wired” into our beings. If an infant’s needs are consistently met they will develop a healthy attachment. When a need is expressed, the caregiver responds to that need. Since the need is met, the infant can relax. The outcome of this reciprocal interaction is shared trust, enjoyment and satisfaction of the needs of both the child and caregiver.

Here is a cycle where healthy attachment is developed:

Attachment Cycle Developed

Healthy attachments create the lifelong capacity for positive, rewarding, intimate and reciprocal relationships. A healthy attachment allows for a child to be able to receive love and affection, and have a positive sense of self, others and the world. They are able to depend on others but also rely on themselves. This builds the child’s foundation to have safe and secure relationships because their views of relationships are positive and dependable. Different attachment styles can develop based on this cycle of attachment and the infants needs being met in the early stages of life. 

What happens if the attachment-bonding process is compromised? 

There are times when the attachment and bonding cycle can change. There are many reasons why a parent may not be able to meet the attachment and nurturing needs of a child. There are two ways this process can be compromised:

  • If the parent is unable to respond to the child’s attachment behaviours in a reliable, predictable and sensitive way that ensures the child’s physical and psychological security or
  • If the child is unable to demonstrate attachment behaviours that then elicit bonding behavior from the parent.

The attachment cycle can be interrupted at any of these times: when the need of the infant is expressed or not expressed; when the caregiver does not respond to that need; or when the infant is unable to relax and is left in a state of distress.  

Attachment Cycle Broken

For a child who has experienced this disrupted attachment cycle it can lead to mistrust, insecurity and insecure attachments. This does not mean this child cannot attach to their caregiver. It means the process of attachment is different. Knowing about attachment styles is helpful when addressing a child’s needs because it helps to see where the child is with regards to attachment. It is important to address trauma when talking about attachment. Trauma is defined as experiencing a threat to one’s survival, or witnessing that threat to a loved one (as in domestic violence), or causing overwhelming fear. There are usually elements of helplessness, inescapability, and powerlessness. Chronic fear and chronic pain (such as neglect or abuse) have long term consequences on the brain and body; especially when the source of pain and fear is also the source of comfort. It is important to note, most children have some experience of attachment that is able to create resilience. That experience is used as a foundation for future attachments and bonds, and developing different attachment styles. 

Symptoms of attachment issues 

Attachment issues fall on a spectrum, from mild behaviours that are easily addressed to more serious forms such as an attachment disorder.

An attachment disorder is a fear of intimacy/dependency with a parent. A child may have signs and symptoms in the following areas:

Attachment- push/pull, cling/reject parents, overly self-reliant, indiscriminately affectionate with persons other than parents, fear of closeness, lack of trust in parents

Cognition- Trauma interferes with cognition, poor concentration, hyper attention to environment, poor attention control, language and learning difficulties

Social Relationships- Poor peer relationships due to lack of reciprocity, reading social cues, lack of trust in others, lack of pro-social skills such as empathy, compassion, altruism

Emotional Regulation: More volatile emotions and poorer emotional control, poor emotional awareness in self and others

Behavioural Regulation: Since the emotions are volatile, the behavior is more likely to be volatile also

Self Concept- Feelings of unworthiness, being unlovable, being “bad”

Dissociation: Feelings of being overwhelmed, shutting down, zoning out, dissociate rages

Physiological Regulation: Chronic fear causes psychological changes in sleep patterns, eating, urination, defecation, heart rate and rhythm, blood pressure startle responses, muscle tension.

Supporting a child with attachment issues

Managing attachment issues is a long-term commitment. Appropriate treatment can help with coping, and children can develop stable, healthy relationships with parents and others. Seeking counseling for yourself; or taking other steps to learn and practice self-care, to better support a child with attachment issues or an attachment disorder is recommended.

There is no standard treatment for addressing attachment needs. It requires advocating and learning to build that trust and security. Safety is a main issue for children experiencing attachment needs and attachment disorders. They do not trust the people in their lives because they do not feel safe and have not been able to depend on their caregivers. These children protect themselves by being emotionally distant and keeping a guard up. This can prevent them from accepting your love and support. To support these children in building their trust and security, it is important to have clear and realistic expectations and most importantly be consistent. They need to be able to trust that no matter what they do you will always be there and they can count on you.

If your child is experiencing more severe signs of attachment needs seek professional support. Treatments can involve a combination of therapy, counseling and parenting education. There is no quick solution when it comes to attachment issues and attachment disorders.

Parenting a child with attachment issues

Since attachment issues stem from difficulties in the attachment – bonding process, attachment issues can only be resolved within the child-parent relationship. Parents can learn to respond to a child’s attachment behavior in a way that helps that child feel unconditionally loved and safe.

The early negative experiences of children have not prepared them to bond with their caregivers or recognize them as a source of trust, security and love. If you have or are thinking about adopting a child that may be experiencing attachment needs this does not mean that your child does not love or care about you. Your efforts to love them will have an impact- it just may take some time.

Since every parent and every child is unique, it is impossible to create a step by step manual for resolving attachment problems. Here are a few guidelines:

1. Parents are the key to resolving the child’s attachment and trauma difficulties. It is important to look after yourself: eat properly, rest adequately, relax enough, and exercise regularly. Without a healthy, happy parent, progress will be slow. 

2. If your child experienced trauma or neglect and shows signs of trauma, never resort to frightening behaviour such as yelling or spanking or threatening separation. Your child will likely be overly sensitive to raised voices, angry faces, and frustration. Notice your child’s response and talk calmly about always being safe with your child, even if he or she does not believe this. 

3. Remain calm, open, engaged and kind. Use PACE (playful, accepting, curiosity and empathy). It is more important how you “be” with your child than what you do. Be consistent, reliable, present and attuned to your child.  Helping your child identify emotions and express his or her needs is a way to be helpful.

4. Share joy. Find ways to increase positive emotional and relational moments.

  • Face to face play
  • Touch that feels good
  • Eye contact that feels good
  • Heart to heart more than head to head 
  • Take the time to listen, talk and play with your child

5. Get good information to help you understand your child’s inner world and then explain it to them. You might be wrong, but your child will appreciate your efforts to get to know them.  Your child might even be better able to tell you what is right. 

6. Get support from other parents experiencing the same difficulties.  Parents of typically developing children will not understand how it is to parent a child who fears parenting. 

7. If you are worried about your child, get an assessment and get professional guidance. Your child will sense your worry and feel a loss of security.

8. Therapy can be helpful in addressing attachment difficulties. Finding adoption competent professionals and the right therapy for your child are key.

9. Maintain consistent structure, routines and limits. Know that setting limits (saying no) feels like rejection to the child and may cause emotional upset. Find ways to help the child understand and feel the “I love you” part of “no”. 

10. If you are frightened by your child, seek help urgently.

When adoptive parents and their adopted children have access to the appropriate information, resources and support, children with attachment issues or an attachment disorder can form strong emotional attachments to their families. 

Links or Useful Resources for Attachment Disorder:

AttaCH - www.attach.org 

The Attachment Association of Canada - http://www.attachmentcan.ca/

Content references:

Mary- Jo Land, Child Therapist and Play Therapist. Dyadic Developmental Psychotherapist. Personal Communication July 9, 2014

Susan Schumacher, President of the Attachment Association of Canada, Personal Communication July 26, 2014

Siegel, D.MD (2013). Brainstorm: The Power and Purpose of the Teenage Brain. 150-155.  The Penguin Group ,2013

Bowlby, J. PhD (1988). A Secure Base- Parent-Child Attachment and Healthy Human Development. 166-167. Retrieved from: http://www.abebe.org.br/wp-content/uploads/John-Bowlby-A-Secure-Base-Parent-Child-Attachment-and-Healthy-Human-Development-1990.pdf