Psychotherapy

Attachment Theory

So, what is attachment disorder, and how do we treat it? An attachment disorder is usually created in a child as a result of significant trauma in early childhood. The severity of the disorder will depend upon the severity and / or duration of the trauma and the subsequent care of the child.

The types of trauma which can lead to an attachment disorder can include: neglect; physical and / or sexual abuse; prolonged hospitalisation (parent or child); being unwanted; severe maternal postpartum depression; multiple placements; a climate of violence; parents addicted to alcohol or drugs etc

Combinations of these situations quite routinely produce children with an attachment disorder.

For a child to become securely attached, he needs positive experiences of reliable, consistent parenting, repeated thousands of times during the crucial first two years. What this does is create specific brain connections which he will use throughout his life.

However, if he receives poor, inconsistent, distant, chaotic and or abusive parenting, he will make different brain connections.

These connections in his brain will have a direct effect on how he sees himself, how he sees others, and how he sees the world; they will affect his ability to accept and give care; crucially, they will affect his capacity for empathy. Damaged and disturbed people are not born that way – they have come to be that way.

Some people continue to debate what is nurture and what is nature.

Well, the truth is, both are vital to the way we develop. Our brain is genetically programmed to develop as a human brain, but it is also genetically programmed, through thousands of years of evolution, to be adaptable.

Therefore, a child’s brain adapts to the environment in which it is living. The adaptations which form in the first few years are the ones which stay for life, in varying degrees. So, when we see the child at 10, 12 or 14, their brain is very well programmed.

Consequently, if we are to seek to re-wire the child’s brain, we will need to work in specific structured ways, with very clear consistent boundaries and consequences. It is by working in a structured way that we can hope to bring about the necessary changes in behaviours, it is not just about caring for children, and it is not just about telling them what to do. For them, the way they are is as normal as it is for an Englishman to speak English.

Change takes great patience and great effort, but, the potential rewards are worth all the hard work. To be able to give a child the opportunity to change the way they operate, and give him the opportunity to be a full, autonomous member of society is a wonderful way to spend your time.

My only suggestion is only get involved in the child’s life if you really want to make a difference, and can commit to supporting him through the painful changes.

It is not going to be easy.

I would heartily recommend that anyone who wishes to work with these children reads books such as “Building the Bonds of Attachment” or “Facilitating Developmental Attachment” – both by Daniel Hughes.

I have only been able to give a very simplistic brief introduction to Attachment Theory in this article, so I would recommend that people read, and most certainly attend the training sessions on Attachment.

Peter Kelly
Bed DPSE (Special Needs), DipPsych
UKCP / UKATC Registered Psychotherapist
Head of Therapeutic Services
Five Rivers Child Care Ltd