From Cradle to Crime: Attachment Tips
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Indiscriminate Friendliness
Children with attachment disorders may be indiscriminately friendly with strangers; walking up to them and showing intimate affection or asking to go home with them. They may proclaim to love the person and tell the stranger their real caregiver is abusing them. It is important to warn others to prevent them from feeding into the problem.
Definition of Attachment
An attachment is the "lasting psychological connectedness between human beings" (Bowlby, 1969, p. 194). Some believe a child's first attachment becomes the internal working model on which the child bases all other future relationships. A healthy attachment may inoculate the child from atypical behavior in later life while an unhealthy attachment may set the child up for behavior problems.
Attachment Theory
Attachment theory began with the work of Sigmund Freud in the early 1950s. Freud believed that an infant was born with innate survival behaviors that attracted the attention of caregivers. And that caregivers had innate responses to these attraction behaviors that caused for a reciprocol relationship to form between the two. Freud also believed in imprinting, whereas this relationship between self and caregiver made a permanent pattern in the child's inner psych. Freud believed the attachment was based purely on gratification of physical need.
Hyperactivity/Impulsivity
Children with attachment disorders often display many of the same symptoms as attention deficit disorder (ADHD). They may be fidgety, impulsive, and have difficulty concentrating. Therefore, they may experience difficulty in school.
Eating Disorders
Children with attachment disorders often have eating disorders. As children, they may hoard or stuff food, or eat until they are overly full. They may also develop anorexia nervosa, or bulemia. They may starve themselves or become obese.
The Autonomy Stage of Attachment
The final stage of attachment is the emergence of autonomy stage that takes place sometime around 4-5 months. The infant now begins to search the environment for social cues and to respond to others and other objects. Object permanence (Piaget, 1954) begins and the caregiver, along with other significant people in the infant's life, become important to the infant.
Homeostasis Stage of Attachment
Coined by Dr. T. Berry Brazelton, this stage of attachment takes place during the first 7-10 days of life. The infant begins to develop control of input and output systems. The child may tune out irritating noises or turn its head toward a welcoming sound. The care giver begins learning to read infant cues and must also learn to empathize with the infant's needs.
Inhibited Attachment Disorder
There are many types of attachment disorders. A child with Inhibited Attachment Disorder may exhibit an ongoing reluctance to approach, touch, or manipulate inanimate objects such as toys in unfamiliar surroundings, and especially in the presence of unfamiliar people. The child may actively avoid or withdraw too readily from social interaction with people, or may exhibit a restricted range of affect in social situations, even in the presence of the attachment figure, with predominant mood ranging from sober scrutiny to hypervigilance.
Mood Swings
Children with attachment disorders often have unpredictable mood swings, going from happiness to anger in seconds. Their moods may also not match what is actually happening, for example, they might laugh as something tragic happens, or might become very sad over something that should have caused happiness.
Poor Hygiene
Children with attachment disorders often have poor hygiene. They may resist taking baths or brushing teeth unless forced to. They may not care if they wear the same clothes day after day or if their clothes are dirty. They do not see the necessity of washing their hands to prevent the spread of germs or in simple grooming tasks, such as brushing the hair.
Testing Stage of Attachment
Around 3-4 months of age, the infant and caregiver begin testing each other's responses and cues while building additional behaviors to attract and signal each other. Dr. T. Berry Brazelton called this the testing limits stage.
Manipulation
Children with attachment disorders often manipulate those in their environment, sometimes for something they want or need, but often just for the sake of manipulating another. They are often know to tell one adult one thing, and then tell another adult another as a way of setting them up against each other. They may play one adult against another just for the sake of the thrill of watching what happens as their drama unfolds.
Fascination with Blood & Gore
Children with attachment disorders are often fascinated with blood and gore, becoming spellbound as they watch gory movies on television. They often get "stuck" on stories about others being hurt. They may even resort to torturing a pet or other animal.
Lack of Respect for Authorities
Children with attachment disorders often have a lack of respect for authority. This includes parents, teachers, police officers, and others in charge. This lack of respect comes from the distorted perception that no adult can be trusted and that the child must fend for him or herself.
Poor Relationship and Social Skills
Children with attachment disorders often have difficulty initiating and sustaining relationships with others. This is because of their lack of trust and respect for others, and their innate need to protect themselves from others.
Whiny and Clingy
Children with attachment disorders may become excessively clingy and whiny, demanding of constant adult attention. They may perceive themselves as helpless and constantly call on another to help them as if they were a victim.
Aggression
Children with attachment disorders are often aggressive. They may fight for something they want or need, or simply are aggressive for the sake of being aggressive. Often the aggression is linked to inability to control anger, or to feelings that everyone is out to get them.
Symptoms of an Attachment Disorder
Symptoms of an attachment disorder may include:
1. Superficially charming; uses cuteness to get his/her own way,
2. Cruelty to animals/people,
3. Fascination with fire/death/blood/gore,
4. A severe need for control over adults or even minute situations,
5. Being excessively manipulative (playing adults against each other),
6. Difficulty in making eye-contact,
7. Being overly affectionate to strangers,
8. Being overly bossy,
9. Showing no remorse (seems to have no conscience), 10. Lies and steals,
11. Having difficulty making and keeping friends,
12. Speech and language problems,
13. Overall developmental delay,
14. Demanding/clingy,
15. Incessant chattering or question asking,
16. Hoarding/sneaking/stuffing food,
17. Emotions do not match the situation and are unpredictable,
18. Overly sensitive to sights/sounds/touch/smells, 19. Overly active.
20. Impulsive,
21. Cannot regulate eating/sleeping/toileting patterns.
Obsessive Compulsive Behavior
Many children with attachment disorders exhibit obsessive compulsive behavior, needing their environment to be predictable and orderly in order to function. They may become very agitated if their order is disrupted and may actually show symptoms related to Autism or PDD, such as lining objects up, or requiring objects to be in a certain order.
Lack of Trust
The key feature of attachment disorders is a lack of trust in the environment. The child believes that no one can be trusted to take care of his or her needs, and that the child must do anything within his or her power to perserve the self.
Sabotaging Placement
Children with attachment disorders that have been placed in foster care or an adoptive home will often sabotage the placement by displaying some excessive behavior that causes the foster or adoptive parent to give the child back. This is because the child cannot risk loving or being loved by someone for fear that that someone will go away.
Fire setting
Many children with attachment disorders develop a fascination with fire. They can be at risk, both to themselves, and to others, and they often do not think of the consequences of their actions, nor do they care if they inflict harm on others. Even their immediate family.
Prolonged Attention Stage
According the Dr. T. Berry Brazelton, during the prolonged attention and interaction stage (1-8 weeks of life), the infant and care giver begin to recognize and read each other's behavioral cues and to use those cues in a give-and-take synchronization.
Bedwetting
Children with attachment disorders often wet the bed. Wetting the bed is not a disorder if the child is under the age of six, and sometimes not even after the age of six. Bedwetting can also be related to a biological disorder. But, children with attachment disorders of an older age often wet the bed for no biological reason.
Attachment Over Time
Longitudinal studies of attachment patterns over time, show a high level of stability in attachment styles with the same style of interaction in infancy and early childhood being seen in later school-age and early adolescence years. Such findings suggest that children may not "grow out" of significant problematic behavior without intervention.
Secure Attachment
Children who are securely attached tend to have the following characteristics:
higher self-esteem
stronger relationships and friendships
more control over their emotions
less impulsivivity
are more cooperative
are more independent
have stronger core beliefs and values
have resilience
A child with a secure attachment thinks: "I am good, worthy, and wanted". Whereas, a child with a insecure attachment may feel: "I am bad, worthless, and unloveable."
Role-Reversal Attachment Disorder
A child who is not securely attached may be oversolicitous, bossy, overnurturing, or controlling during interaction with the caregiver. The child may alsomaintain an unusual degree of scrutiny about caregiver's psychological well-being.
Steps of Attachment
Some attachment theorists suggest that attachment develops through a series of steps in which the infant:
1. Shows indiscriminating responsiveness (0-3 months of age)
2. Focuses on one or more figures (3-6 months)
3. Develops a secure base behavior (6-24 months)
4. Develops a goal-corrected partnership with the adult caregiver(s)(24-30 months)
Phase I Behaviors in Attachment
In Phase I of attachment, which takes place during the first 6 months of life, the infant is totally dependent upon the care giver, a passive player in the attachment process, and fairly indiscriminate in who provides care or meets the infant's needs. By about 3 months of age, however, the infant begins to recognize and discriminate between care givers, vocalizing and crying differently for the primary care person.
Socialization
Fraiberg stated that unattached children have three specific problem areas in their socialization:
1) They form relationships only on the basis of need with little regard for one caregiver over another and their capacity to attach to any one person is impaired;
2) Their development is retarded, as is their language, limiting their social interaction; and,
3) Behaviors of anxiety, impulsivity and aggression tend to further limit socialization.
Phase II of Attachment
During Phase 2 of the Attachment Years, typically from around age 6 months to 12 months, the infant begins to form patterns of behavior in response to the care being received. For example, if the infant is in a caring and stable relationship, the infant may learn that by crying, s/he can get needs of hunger or discomfort met. If, however, the infant is in a situation where needs go unmet, the child may develop patterns of intense fear, anger, or withdrawal, when attempts to get needs met are not recognized.
Ainsworth's Strange Situation & Attachment Styles
In the 1960s, Ainsworth developed a method for assessing the attachment behaviors. From these studies, Ainsworth identified four types of attachment patterns:
Secure - the infant seeks out the caregiver when distressed, is easily comforted upon the caregiver return, and maintains close contact with the caregiver.
Insecure-Ambivalent - the infant is excessively distressed by the separation, difficult to soothe upon return, and resisted the caregivers comforting attempts. Insecure-Avoidant - the infant seems disinterested in the caregiver and rejects them upon return.
Nonattached Attachment Disorder
A child THAT IS not attached often fails to demonstrate a preference for a particular adult caregiver, even when hurt, frightened, sick , or in other situations that ordinarily stimulate the attachment behavioral system.
Self-Abuse
Children with attachment disorders may self-abuse. They may head bang, cut themselves with sharp objects, or even try to commit suicide. Self abuse often increases when the child is put into treatment and issues or outlets of behavior are challenged, therefore, it is important to provide supervision during these times.
Strange Situation Procedure
The Strange Situation Procedure was developed by Jane Ainsworth as a way of measuring attachment security. There are 8 steps to the procedure:
1)Mother and baby introduced into room,
2)Mother and baby alone, baby free to explore (3 minutes),
3)Stranger enters, sits down, talks to mother and then tries to engage the baby in play (3 minutes),
4)Mother leaves. Stranger and baby alone (up to 3 minutes),
5)First reunion. Mother returns and stranger leaves unobtrusively. Mother settles baby if necessary, and tries to withdraw to her chair (3 minutes),
6)Mother leaves. Baby alone (up to 3 minutes),
7)Stranger returns and tries to settle the baby if necessary, and then withdraw to her chair (up to 3 minutes),
8)Second reunion. Mother returns and stranger leaves unobtrusively. Mother settles baby and tries to withdraw to her chair (3 minutes).
Adoption & RAD
The National Adoption Center reports that 52% of adopted children have attachment related atypical behavioral symptoms serious enough to require intervention. Other experts argue with this finding, saying that adoptive parents are more alert and sensitive to a child's problems, thus may take their child in for help more often than a biological parent might do and are therefore reported more often. For an online course on attachment and child behavior, Click Here!
Secure Attachment in Second Year
By the time an infant turns one year of age, the child has developed behavioral patterns that become internal and that are based on the relationship the infant had with the primary care giver. If the attachment experience has been positive, the infant is more likely to develop attachment behaviors that include feeling good about him or herself, feeling lovable, and worthwhile. The infant will generally look at the world as a safe and joyous place and will be eager to explore the environment. The infant will also show beginnings of being able to regulate his or her own emotions.
Attachment Disorder
Some children with attachment disorders perceive threat and hostility in others even though there may be no reason to do so. This most often is the result of the child being on the defense for long periods of time, as in the case of abuse or multiple transisions beween caregivers. These defense patterns become set over time, with the child using aggressive, hostile, and manipulative behaviors even in situations that do not call for such behaviors.
Child Factors in Attachment
Child factors that influence the attachment process include:
Phase III Attachment Behaviors
During the third phase of attachment, sometime between the 6 months and 18 months, the infant solidifies attachment patterns and becomes more sophisticated at verbal communication of needs. The infant also negotiates conflicts and differences in interactions, and becomes a partner in the relationship. It is believed that many adopted and foster children never reach this stage of development.
Phase I of Attachment
During the first six months of life, an infant learns to either trust or mistrust the world around him/her depending upon the type of care the infant receives. When the infant's needs are met in a relatively timely and consistent manner, s/he learns to trust the world. If needs go unmet, the infant may learn to mistrust the world. During the first 3 months, the child is totally dependent upon caregiver, a passive player in the attachment process, and indiscriminate about who s/he receives care from. Sometime during the 3-8 months time period, the infant differentiates between primary caregiver and others, and will vocalize or cry differently for that person.
Birth-6 months
The attachment years are a period of time in a child's life when s/he experiences a first real connection with another human being. The person the child attaches too is typically, but not necessarily, the child's mother.
Experts do not agree on which phase of the attachment years is the most important in a child's development. Some argue that the birth-6 month time period is the most crucial, while others argue that the 6 month - 12 month time period is the most important. It is probably safer to assume that the entire 12 months is a critical time for attachment.
Depression
Many children with attachment disorders suffer depression. They are often misdiagnosed with bipolar disorder or major depression, which often delays treatment. The symptoms of Reactive Attachment Disorder are very similar to bipolar disorder, and share common characteristics with opposition defiance disorder, conduct disorder, attention deficit disorder, and several other disorders.
Q-Sort Attachment Assessment
Waters (1985) developed a measure of attachment security called the Attachment Q-Sort (revised 1987). This assessment tool has 100 items describing various types of behavior which were indicative or related to attachment. Questions are directed to the primary care giver and the tool can be accessed from Water's web site found in link section.
The Development of Attachment
Attachment is a term used to describe the relationships that forms between a child in the first years of a life with a caregiver, typically, the child's mother. Through patterns of routine care, such as changing diapers, feeding, and comforting the child, the infant child learns what to expect from the world and other people. If the child's needs are met, the child develops a trust in the world. If needs are left unmet, the child is faced with uncertainty, or mistrust of the world.
Many experts believe that this first relationship between a child and the primary caregiver serves as a "template", of sorts, from which all other relationships are formed. A securely attached child can then form secure relationships with others, while an unsecurely attached child will experience difficulty in relationships with others.
Fifth Attachment Style
An attachment pattern was identified in the 1970s by Mary Main called the Insecure-Disorganized Attachment Style. In this style of attachment, the infant displays a combination of avoidant and ambivalent attachment styles. Many of those children identified with this type of attachment pattern were found to be abused. This style of attachment develops as a result of the child adapting an avoidant style of interaction that enables him to maintain proximity if conditions are harsh, or an assertive or aggressive interaction style if the situation is highly competitive.
Phase III of the Attachment Years
During Phase 3 of the Attachment Years, typically from 6 months to 18 months, the infant continues to practice behavioral responses and initiations in getting wants and needs met and these patterns become solidified. In other words, the brain "records" experiences and behaviors that will then be reused in later, similar situations.
For example, if an infant has been in a hostile environment where needs have gone unmet or met inconsistently, the child may have developed behavioral patterns of being fussy, screaming, or withdrawing. If the infant is then placed in a nurturing situation where needs are met, these old behavior patterns are still set, so the infant may scream uncontrollable to get needs met even if the need is now quickly and efficiently taken care of.
Internal Working Model
The internal working model, first described by Bowlby (1969) is the cognitive representation of early attachment relationships. In other words, the infant's first experiences with a parent or caregiver, become the "working model" from which the child bases all future relationships.
Key Points of Bowlby
Key points of Bowlby's Attachment Theory are:
Infants possess instinctive behaviors (i.e. sucking, clinging, crying, smiling) that serve to keep the caregiver in close proximity.
The infant activates these attachment behaviors when faced with an uncomfortable situation (i.e. fear, anxiety, illness, fatigue).
The loss or separation of the caregiver or any other factor that disrupts or interferes with the infant-caregiver relationship is traumatic and prevents the fulfillment of a biological need.
This interruption or loss then causes pathological mourning and disturbed development.
Freud & Attachment Theory
Freud's psychoanalytical approach to attachment most notably focused on the oral and anal stages of need gratification in the infant. He also believed the attachment was limited to the mother-infant dyad and did not include other caregivers or individuals in the infant's life. The image of the mother fulfilling the infant's needs was believed to leave a lasting impression, or imprinting, on the infant's brain that then became the base from which the infant formed, perceived, and reacted in other relationships.
Phase II Behaviors
During phase 2 of the attachment process, the infant clearly shows preference for the primary care giver. In addition, the infant shows stranger reaction, will visibly touch base with the care giver, or look to care giver's face for input, explore the environment without anxiety. The infant acts independent and dependent intermittently, while also practicing separating from the care giver.
Indiscriminate Attachment Disorder
There are many different types of attachment disorders. A child that is indiscriminately attached may repeatedly leave the safety of the attachment figure (wanders off without checking back), exhibits a pattern of entering situations that place him or her at risk for physical harm, or may exhibit socially promiscuous behavior by demonstrating friendly overtures toward or by seeking comfort and nurturance from relatively or completely unfamiliar adults.
A child who is not securely attached may fail to exhibit separation protest. The child may cry when almost anyone leaves the room, not just the parent. Or, the child is overly affectionate with anyone, even strangers.
Aggressive Attachment Disorder
One of the confusing aspects of attachment disorders, is that behavior may vary from child to child. For example, a child with an aggressive style may show clear preference for an attachment figure, but the child's aggressive and angry outbursts prevent bonding to occur. The child's aggression and anger may be directed inward, at the self, or outward, at the child's caregiver or someone else. Sometimes, anger is directed outward toward someone who did not cause the anger, adding to the confusion and obstruction of building a relationship. I highly recommend High Risk if you have not read this book, as a starting place for understanding attachment disorders. |
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John Bowlby's Attachment Theory
Bowlby expanded on Freud's work in the 1950s and developed what he called an internal working model theory to explain attachment. Bowlby believed the infant was born with innate behaviors to attract a caregiver. These behaviors included crying, cooing, grasping, reaching, etc. and served to keep the caregiver within close proximity. Unlike Freud, Bowlby did not believe these innate behaviors were for the sole purpose of satisfying a physical need. He believed they were social in nature and served to connect the infant with other social beings.
Insecure Attachment
While a child with a secure attachment is able to form meaningful relationships with others, a child with a non-secure attachment may have problems. There are three types of insecure attachment: 1) insecure-avoidant, insecure-ambivalent, and insecure-disorganized.
A child with an insecure-avoidant attachment may be aggressive, anti-social, or withdrawn. A child with an insecure-ambivalent attachment may be uncaring, distant, or depressed. A child with insecure-disorganized attachment shows characteristics of both insecure-avoidant and insecure-ambivalent attachments.
These patterns of behavior tend to persist over time and life.
Insecure-Avoidant Attachment in the Second Year
Infants with insecure-avoidant attachment behaviors typically exhibit behaviors that are hypervigilant. They may block their own feelings of anxiety, fear, or need while learning to cope with rejection and punishment. They feel they must fend for themselves against any vulnerability. In doing this they tend to display rejecting behaviors towards their care givers and develop their own moral value system with the core belief system as preservation of self. For example, they may show mixed drives of approach and avoidance, with a burst of anger followed by a sudden frozen watchfulness.
Sexually Promiscuous
Children with attachment disorders are often sexually promiscuous. They may use artificial charm, false commitment, or sexual behaviors to attract others to them. They may also show inappropriate sexual conduct in the presence of others. Many of these children have been sexually abused or have witnessed sexual behaviors in others.
Ainsworth & Attachment Theory
Jane Ainsworth described the attachment as occurring in five phases or steps:
Causes
An attachment disorder occurs when the attachment period -- typically during the child's first 12 months of life -- is disrupted or inadequate, leaving the child with the inability to form a normal relationship with others and an impairment in development. This can happen as a result of a number of factors, including adoption, foster care, illness on either the part of the parent or child, frequent changes in primary care giver, abuse or neglect, inadequate or inconsistent parenting, among other reasons.
Love on Their Terms
Children with attachment disorders often only allow love or affection on their own terms. In other words, they may come to you for comfort and affection but when you ask them to come to you for love and affection, they resist. They may become stiff and uncomfortable if you hug them or get into their space.
Jane Ainsworth's Attachment Theory
Jane Ainsworth's work in attachment theory began in the early 1960s and she is most recognized for her development of the Strange Situation attachment assessment that she developed in the 1970s (1979). Based on Bowlby's idea that there are specific attachment behaviors associated with the security of attachment, she developed a method of assessing the security of the attachment between a caregiver and child using 8, 3 minute episodes in which the child was exposed to situations that would cause these attachment behaviors to come out. That included fear, trust, the opportunity to explore, the absence of the primary caregiver, etc.
Environmental Factors
Some of the environmental factors that influence attachment include:
Poverty
Violence
Social support
Marital relationship
Use of drugs/alcohol
Stressors
Illness/disabilities
History
Culture
Social environment.
Bossy and Controlling
Children with attachment disorders are often bossy and demanding to be in control, even of adults in their world. This comes from the internal framework that they must control the world around them and from their general lack of trust in adults.
Parenting Factors
Parenting factors that influence the attachment process include:
Abuse/Neglect (80% of children exposed to abuse or neglect have reactive attachment disorder symptoms),
Alcoholism in care giver (typically the father),
Depression in care giver (typically the mother),
Inadequate parenting skills (too lax, strict, unpredictable, unresponsive),
Pathological care, and
Inadequate day care.
Bedtime Problems
Children with attachment disorders often have bedtime problems, such as fear of going to bed, inability to relax and go to sleep, waking during the night or too early in the morning, or not being able to wake and sleeping too much during the day.
Bowlby & Attachment Theory
John Bowlby is most often credited with our understanding of attachment theory in a developmental sense. Based on Freud's previous work, Bowlby constructed a model of attachment theory based on what he called 'the internal working model theory'. Bowlby believed that the infant's innate attachment behaviors were not only physical, but social in nature, for he discovered that infants would still bond with a caregiver even if the caregiver did not fulfill basic physiological needs. For example, an infant that was not being consistently cared for, or even abused, could still form an attachment with the primary-caregiver regardless that these needs were not being adequately met.
Insecure-Disorganized Attachment in Second Year
Infants who develop an insecure-disorganized attachment styles tend to show unpredictable behavior, sometimes reacting to their care giver with avoidance and at other times clinging to the care giver with great dependence. This style of attachment occurs more often in children that have been abused or neglected. The child may also develop patterns of compulsive compliance in order to charm and please the care giver.
Insecure-Ambivalent Attachment in the Second Year
Infants who have developed insecure-ambivalent attachment styles have a difficult time making sense of their relationship experiences because the experience has been inconsistent or disrupted. The infant cannot predict whether the care giver will meet his or her needs, be hostile or rejecting, or whether the care giver will disappear. These children tend to be angry or anxious much of the time and may exhibit clingy, whiny behavior, or throw tantrums a lot.
High Pain Tolerance
Children with attachment disorders often have a very high pain tolerance, not responding when they are physically or emotionally hurt. Some children may self-abuse to the point of penetrating the skin or causing excessive bruising with no reaction.
Foster Care and RAD
It is estimated that 60-80% of children who have spent time in foster care have attachment disorder related behavior that is significant enough to require intervention. This is most often related to children who are placed in multiple settings over the course of the attachment process, preventing the child from attaching securely to an adult care giver.
Brazelton's stages of attachment
T. Berry Brazelton described four stages in the early infant-caregiver interaction (check out his book in the Book Section). These stages are:
For more information about Dr. Brazelton's book, click here: Touchpoints
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