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Working with Children with Attachment Disorder: Frequently Asked Questions

What can I honestly expect when working with my child with attachment disorder?

These are questions every parent grapples with when trying to understand a child’s diagnoses, issues, and symptoms: What does the future look like for my child? For me? Will they always have these limitations? Let me reassure you that these questions are normal, therefore, let us explore what you, as the parent, can expect from your child if he or she has attachment issues.

There are many factors that go into creating an attachment disorder and many factors that go into healing it. If intentional work is put into healing a child, they will improve in their capacity for healthy relationships. I have seen some children heal where they gain a secure attachment, and have no limitations in their communication, their self-worth, and are able to engage in healthy, stable, and intimate relationships.

It would be very rare for a child to show improvement in their current or future life and relationships if there is no intentional attachment work. Early childhood relational trauma and insecure attachment is how their brain got wired, this is how they will subconsciously run their life and make every decision through this lens. It does not fix itself! 

They will not naturally develop trust in someone unless specific attachment work is done. Putting them in a good school, surrounding them with siblings, cousins, or friends their age will not lead to their healing.  Secure attachment is accomplished in childhood through bonding with an adult caregiver who they perceive as both strong and safe.

Thus, healing can be accomplished, but cannot be guaranteed.  The more time that is invested in the child’s attachment intervention, the more likely they are to heal, thus more of a assurance that your child will undergo healing. In addition, healing is more a reflection of the specific methods used for the attachment work, not just general time and energy invested. Many parents have expressed frustration and regret having invested so much of themselves into a process that has not accomplishing that purpose, because they did not have the knowledge or resources at that time.

In consolation, healing is possible! I encourage you to keep reaching for that goal.  Be intentional in the methods, ensuring that it has the most benefit for the time and energy you have invested. However, know that complete healing is not always guaranteed, despite your best attempts. Please, please, do not lose yourself or your health in the process.

Does My Child Need Residential Treatment?

Residential treatment can be a hard choice for parents. There is the cost and the anxiety of not knowing whether it will help or hurt your child. Add that to the mixed emotions of feeling like a failure as a parent if you cannot keep your child at home.

If you are considering residential treatment, it is usually because your child is becoming unsafe to have at home. This may be due to their violence, property destruction, or behaviors such as, running away or lying to others that you are abusing them. If this is your child, you have been in an environment that has made it very difficult to keep a sense of calm, and your reality is one of drama and commotion. But it is impossible to put this lens aside.

Thus, it is advised not to make this decision alone, and do not nor seek advice from others who don’t have wisdom in this area.  Carefully choose your source of insight, weigh the risks and benefits, explore and understand your specific fears, and then move forward with the decision that seems best for your family and your child.

What are the behaviors of Attachment vs. ADHD vs. Food Sensitivities or Toxins?

All insecure attachments are a result from a disruption in the bonding process.  The reasons for the disruptions are due to factors on either the caregiver or the infant. Some of the factors that lead to disruption of bonding in infants are pain and negative stimulation of the nervous system. If one does not feel good engaging and connecting with others, then feeling love will be very difficult. Not feeling loved, seen, heard, or understood for an infant results in insecure attachment style. When we are healing an older child from attachment disorder, it is harder to redo the attachment with on-going pain and uncomfortable sensory stimulation.

However, having an insecure attachment or unresolved trauma will always cause the nervous system to be dysregulated as well. This is why functional medicine, trauma healing, and attachment healing go hand-in-hand.  If you have pursued the functional medicine side, but are still stuck with mood and behavior imbalances, the trauma and attachment piece is likely what is missing.  If you have done the attachment work, but have not explored specific trauma therapy or biology conditions that is likely the missing piece.  Healing the insecure attachment will have the biggest impact on a dysregulated nervous system.

Top Reading for In-Home Attachment Parenting Intervention:

 It can be hard to know how to do the in-home attachment work.  Seeing it happen is very helpful, and experiencing it is the best; seeing it can partly be done through reading and other methods.  From my experience, different books are helpful in different ways. Some of these helpful books are:

Some other excellent readings that can help you to understand your child’s personality, as well as their way of thinking before you look into intervention are:

  • Foster Cline’s work.

Information on the effects of trauma on the brain and body, neuroplasticity, and the inter-personal neurobiology you are fostering through the bonding work includes books by:

  • Norman Doidge
  • Daniel Siegel
  • Tina Bryson.

What Support Do I Need To Be Successful?

To be successful at healing your child from attachment disorder, you need a team. You should try not to be everything to your child.  It is not helpful or healthy to your child to be the parent, the respite provider, the teacher, and the therapist.  Those are the people you need to be on your team to help heal your child, as well as, help you to maintain your health in the process.

The respite provider needs to be someone who is trained specifically in working with attachment disorder children. There are some personalities who do not need extensive training, because the methods come naturally to them. These are people who don’t get caught up in emotions, drama, and who maintain boundaries really well with a no-nonsense type of way.

They are people who will not try to bond with your child, but will see their role as helping your child to bond with you. As a respite provider, they stick to the expectations, schedules, and boundaries you have set for your child; they will not entertain negotiation attempts by your child.  In addition, they will need to know how to emotionally regulate a child without also disrupting the primary bond with you as the parent.

As you can see, this is a different dynamic than that of a parent building the bonds of attachment, which is why the parent should not attempt to be both.

Also important for the healing process is having an attachment therapist on board. A therapist who meets with you and your child on a regular basis to check in about their progress in meeting boundaries and facilitate bonding activities that may be too difficult for your child to be willing to do with just you. There are times when your child will need a third person present who can facilitate the activity and be willing to go along with it.

Your child also needs to hear from the therapist how they (the therapist) support you, as the parent, in your attachment work with your child. Remember, it is natural for your child to get tired and discouraged of the attachment work. They might start to feel like it is not fair and they might voice that to others in a dramatic way to bring attention and sympathy to themselves.  But empathy from the parent is healing, and sympathy from others is not.

Thus, it is good for your child to hear from others that they not only are aware of the attachment work that you are doing, but are supportive of it.

Because of the defiance, it is common for children with attachment disorders to fight schoolwork as well. It may become necessary to take your child out of school for the attachment work, and you should consider hiring a tutor so your child can resume schoolwork at home. It is likely your child will fight you more with schoolwork because you are the parent, so you should try to bring alongside someone else who will help your child with his or her school work. This could be a win-win situation for you and your child; you might get a break and your child might get through their schoolwork better!

However, it is not recommended to bring in a tutor until either your child is healed enough or the tutor is trained to have high expectations with no second chances so your child can feel they are safe and strong.

My Marriage is Struggling;  Why Can’t We Get Along?

With families who have children with attachment disorder, the divorce rate is reported higher than 80%.  The 20% of couples who stay married are not necessarily happy, but they do manage to stay married.  Why is this?

There are several reasons that play a role in a higher divorce rate in this situation, but the most common factor in all the contributing reasons is that challenging children puts a high amount of stress on each parent. When any individual is stressed, their insecurities are higher and they unconsciously start to act in survival mode; they start protecting themselves in their default subconscious programmed ways. It is rare for two people to maintain a thriving relationship when they are both in their own independent survival modes.

Another thing that makes marriages more difficult than an average marriage is that a child with an insecure attachment will likely have defense mechanisms that include triangulation and splitting of parents.

What is triangulation and splitting?

This is where the child will play one parent against the other.  For example, the child may tell Dad, “Mom is so mean, you are so much more understanding.”  In general, this works because the Dad feels like he and his kid are really connecting, and is then more giving and forgiving to the child. However, this can also look like throwing mom under the table, while smiling big at Dad, or some version thereof.  The result is so predictable!

Mom feels very hurt by her kid and betrayed by her husband. She snaps at her husband, sends her kid to his room, then sits down and bursts into tears trying to figure out what went wrong on her part. Her husband, watching all of this, might think she really has gone crazy and is being too hard on the child, so he takes the kid out to play ball.  The child has gotten away with treating his/her mother awful, and now has Dad on his/her side, thus this marriage is on the rocks. They are struggling and will continue to struggle until they can recognize this pattern.

What Are the Most Helpful Adjunctive Therapies?

There are several helpful adjunctive therapies, but the most helpful ones will be the ones that target your child’s specific symptoms the best, as well as fits into your budget and schedule. Taking too much on is not helpful, as one of the most important aspects of attachment work is time and space to just be together with your child. Your child will need a lot of personal time and attention during the attachment work.

They will be dysregulated a lot at first, and having to be places and get things done will be very counter-productive to the attachment work. You need the time and space to help them work through their emotions and build the relationship attachment.  Thus, my advice is to choose only one or two adjunctive therapies that have the best chances of being the most effective and works the best within your budget and schedule.

Some adjunctive therapies to consider:

  • Neurological Reorganization: includes things like Developmental Neuro-Reorganization and Neuro-Fit
  • Biofeedback – examples are HeartMath or SweetBeat, and programs that teach how to breathe in a way that calms down the nervous system and moves to parasympathetic (calm) rather than sympathetic (fight, flight) control
  • Neuro-feedback – example is LENS
  • Occupational Medicine – can do neurological work including sensory and sound integration
  • ILS – Sensory Integration – has been found to improve the brain’s ability to grow and develop new patterns of working
  • EMDR
  • Trauma Therapy – dual-brain models that address pre-verbal relational trauma
  • Trauma Yoga
  • Emotional Releasing– Includes Emotional Freedom Techniques and Emotions Alive Never Die

Do you have any questions you would like to ask about working with a child with an attachment disorder? Do you have something to add to one of the answers above?

I would love to hear your experience and thoughts!  Please share!

Dr. Aimie

Want to read more about this topic? Check this out: Working With Children With Attachment Disorder.

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