working-with-attachment-disorder

Working with Children with Attachment Disorder: The Bonding Process

Bonding Happens in the First Year of Life

The first stage that an infant will reach in emotional development is forming trust and attachment. In a healthy environment, an infant will naturally develop basic trust in their caregivers so that by 12 months of age, they have a secure attachment and are ready to start on the next emotional developmental stage.

Mary Ainsworth found her work with The Strange Situation experiment to be true, in that children develop their attachment style by 12 months of age. By 1 year of age, infants have a clear attachment style with their primary caregiver, whether it is a secure attachment or one of the three insecure attachment styles.

While events in early childhood can influence a child’s way of interacting with the world and others, they have a fundamental trust or mistrust by 12 months of life. If an infant develops a fundamental mistrust during the first year of life, resulting in one of the three insecure attachment styles, it is possible to help them develop a secure attachment later in life.  Building attachment in an older child involves re-enacting the first year bonding process.

How Does Bonding Happen?

Let’s look at the bonding process that occurs throughout the first year of life, which can results in either a secure or an insecure attachment. Bonding is a specific way of engaging the brain and wiring it for an instinctual relationship dynamic. Bonding establishes an instinct for people and relationships that is subconscious, but guides all future interactions. It engages all of the right faculties including touch, facial expressions, tone of voice, and body language in a subconscious guide to reading people.

If an infant bonds with a secure attachment style, their relationships with themselves and others are based on mutual worth and respect. A secure attachment style results in a capacity for intimacy, transparency, and acceptance of self and others.

Are All Relationship Bonding Healthy?

On a side note, all bonding is not healthy bonding, and there is a very real form of unhealthy bonding referred to as “Trauma Bond.” This type of bond results in a felt connection with another individual in an unhealthy dynamic; this is commonly thought of as co-dependency. A trauma bond is not one characterized by felt security with the other person, but more of a survival instinct to stick together no matter what the circumstances are, or how the individuals treat each other.

On the other hand, a secure attachment will always result in actions that are good for both parties, never sacrificing health, happiness or safety of either, but instead promoting mutual and shared joy and happiness. This is an attachment where you can truly be yourself, openly share your weaknesses and faults without shame, knowing instinctively that they will understand and support you, and will never force, coerce, judge, or try to change you.

The First Year Bonding Process

The first year bonding process, whether done with a newborn infant or later in life, is a science that is translated into a daily relationship, practice, and art, which will later become natural. The science includes re-wiring the right brain for an earned secure attachment.  This process requires the dynamic of respect to be established as discussed later in this blog, and also includes involving all of the faculties of the right brain: touch, facial expressions, tone of voice, and body language.  All of these are essential to the bonding process, whether done during the first 12 months of life or through re-creating the emotional environment later in life.

The principle behind healing attachment disorder later in life is, to the best of your ability, to recreate the emotional environment of infancy for them to go back and meet the first emotional developmental stage.

Erickson’s Stages of Development

The first emotional stage of psychosocial development according to Erick Erickson is the development of basic trust vs. mistrust.  (hyper-link to an image of Erick Erickson’s psychosocial stages of development). An insecure attachment reflects a development of mistrust rather than trust at this very first stage of emotional development. A child will not be able to develop the other emotional and psychosocial stages if they did not develop a healthy trust in the first developmental stage. Thus, in order for a child to go through the other psychosocial developmental stages in a way that will result in a balanced and healthy relationships in their future they will need the foundation of their emotional development to be redone.

What is the emotional environment of an infant?  Evoke an image in your mind of a mom with a newborn.  What do you picture? Did you imagine a mom playing peek-a-boo with her infant, a mom breastfeeding, or a mom changing clothes and a diaper?

These recreate environments in which there is dependency, a lot of physical, and emotional connection. We discussed the Trust Cycle, which is the process by which an infant develops trust through being completely dependent on the adult and the adult providing their needs in a consistent, calm, and caring manner.

Trust-Building Starts With Respect

The process through which an older person develops attachment, or earns a secure attachment is similar. An older person will start with respect, which will lead to trust, and then to love/attachment.  In an older child, we start with respect, establishing high and clear expectations on his or her words and actions.

An older child will establish respect by watching an adult maintain those expectations, no matter what he or she does. An infant develops trust by seeing his mother as both physically and emotionally stronger than he or she is. The definition of “Stronger” here is, for example, the idea that the infant’s mother is physically bigger than her child, yet is still protective, gentle, has the baby’s best interest in mind, can emotionally stay calm, consistent, and engaged no matter how upset her infant gets. Thus, “Stronger” than the infant, is able to contain him or her, and therefore protect him.

This dynamic of respect and strength needs to be set up at every age, even adulthood, so that one might earn a secure attachment from an insecure attachment. To a child learning healthy attachment, the feeling of being seen, loved, knowing that they will be protected by their caregiver, who they perceive as strong and safe, is vital when that child is scared and needs to be comforted.

Similar to bonding with an infant, respect is established in an older child or adult by watching you maintain calm and consistency no matter what they might do. This includes maintaining boundaries and expectations no matter what, remaining emotionally engaged, but also staying calm when they lose their cool, such as becoming hurtful or violent as toddlers might do.

This can be very intense, because it takes all of your attention, time, and energy to maintain this therapeutic environment and relationship. It takes a lot of energy to keep yourself grounded, centered, and able to bring positive energy into the dynamic, especially when your child brings in a lot of negative energy.

I am reminded of how Ann Sullivan healed Hellen Keller from her attachment disorder through this process. Rather than having pity on Hellen and cater to all of her insecurities, Ann Sullivan made expectations very high. For example, Ann set expectations for Hellen that she could and would have to communicate respectfully her needs, even though she could not talk or hear.  Ann was not harsh, but rather stayed emotionally calm and connected when Hellen naturally would go into violent tantrums in response to these expectations.

Similarly, I encourage parents when first starting with a child that has an attachment disorder or who is perhaps just beginning the attachment work, to start from the very beginning with expectations for respect and responsibility that you would like. I encourage you to make these as high as possible, because it will not work out well to make these expectations higher later.

How do you re-enact an infant feeling contained and safe with an older child?

One obvious form is physical containment.  This can have positive or negative associations, depending on the context, just as it would for an infant.

Positive containment can be emotional containment. For an infant and an older child, this involves activities, such as having the caregiver engaged with a child while they are playing, sharing in disappointments when things don’t work out, and sharing in the joy when things do work out, like when a puzzle or lego tower is finished. This is a form of containment that results in the feeling of both being seen and loved.

Positive containment can also be safe and mutually pleasurable with physical containment.  This can be in the form of snuggling, cuddling, and for infants, breastfeeding.  For children with attachment disorders, some parents have been very creative in providing creative means of physical containment.  This has included bottle-time with older children, where they snuggle and play just like an infant does during breastfeeding.

Another form of positive physical containment for some children can be incorporating playful wrestling. Of course, this is only if the activity remains playful and enjoyable for both child and caregiver!  Some parents use penguin sitting, where the child sits quietly between the parent’s legs while the child does their reading or coloring. This has been a very creative way to provide positive physical containment when a child needs it, and it also allows the parent a few minutes to finish up a conversation or work.

Physical touch can be very helpful in teaching children how to regulate their emotions. Positive physical touch is a powerful reminder that physical containment should always be accompanied by emotional connection in order to ensure it builds trust rather than leads to mistrust.

An example of negative connotations for physical containment would be if an infant was scratching, pinching, or biting Mom during breastfeeding or while playing, and Mom just holds their arms or hands until they stop. Or another example would be if Mom protects an infant from getting into something harmful by physically picking them up and carrying them away.

Both of these situations might be negative containment for the baby, because it will be against their will, but if Mom remains calm, understanding, and engaged in using the right brain methods of soothing voice, soft eye contact, and soft facial features, these situations can be used as a positive step towards trust and attachment forming.

So when dealing with attachment disorder in older children remember to stay cool, calm, and collected, but never disconnected for bonding purposes! Hopefully this has provided some hope, understanding, and tools to your process of helping your child rebuild the bonds of attachment. It is possible – they can heal!

Although this is hard work and requires authentic emotional calm, I highly encourage every adult working with children who have attachment disorder to continually be doing their own work. Whether with a friend, a therapist, and meditation from a workbook, or all of the above – maintain your own health and happiness, so that in return, you will be able to help someone else find their way to health and happiness.

To Healing,

Dr. Aimie

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