Working With a Child With Attachment Disorder: Role of Trauma Therapy

By | 2016-12-15T19:10:10+00:00 December 6th, 2016|

Before we get to the role of trauma therapy for children with attachment disorder, let’s look at your current situation.

As a parent, teacher, or caregiver of a child with attachment issues, the questions that always linger in the back of our minds are: what will help this child heal? How can I help them heal?  Can they even heal, and by how much?  And what methods are effective?

Parents tend to react in different ways when they having a child who has challenging emotional and behavioral problems. Some parents turn their whole lives upside down seeking a full healing for their child, while others seem to take it in stride, do damage control, try to avoid major outbursts, and seek services and activities that they think will help, within reason.

No matter what the approach the parents choose, healing does become the child’s responsibility once they reach adulthood. No matter what age, healing is possible, even if it is adulthood. There is always hope and healing.

Today, let’s look at the role of trauma therapy in healing from attachment disorder. While this blog will specifically address the role of trauma therapy in children with attachment disorder, the same goes for adults who have insecure attachment disorder.

All insecure attachment disorders are caused by an interpersonal or relational trauma, generally in the first year of life, though traumatic disruptions can happen throughout the first three years of life.

Relational trauma in the first year of life looks like a disruption in the normal wiring of right brain to right brain, that happens between infant and primary caregiver, usually the mother. If for any reason, this non-verbal emotional dance is disrupted, it results in wiring of the right brain of the infant in a way that develops anxiety, rather than comfort, from healthy intimacy with others.

A disruption in the relationship dance between a mother and her infant can occur because of physical separation, due to medical care or emotional separation caused by stressed, inattentiveness, or a depressed mother.

The Role of Trauma Therapy in Children With Attachment Disorder

Trauma therapy can be very helpful in repairing relational trauma that caused the insecure attachment. The trauma therapy needs to have specific features to heal relational trauma.

Those features are essential to effective relational trauma therapy, include methods that target both right and left sides of the brain and resolve the trauma. If the trauma lacks any of these features, it will likely cause things to become worse in terms of moods, behaviors, physical symptoms, or diseases that are related to the trauma.

When the trauma therapy has all essential features, it can heal the relational trauma, because the person quickly feels heard and understood in an instinctual and emotional level. Some children with severe attachment disorder have earned a secure attachment without all of the essential features in trauma therapy; however, it does seem to take longer time and requires more intense attachment therapy alongside the trauma therapy.

What If I Adopted My Child at Birth, Before There Was Trauma, Abuse or Neglect?  

The understanding of trauma has, up until now, been more limited to physical and sexual abuse, as well as neglect; but perhaps emotional abuse as well, because it is hard to define, we have not really known how to quantify it.

At the root of all insecure attachment or attachment disorder is relational trauma, which is the most severe form of trauma for an infant and young child.

From the moment we are born, our brains are primed to attach to a caregiver. This makes evolutionary sense, because how else can babies of any species survive without a wiser, advanced, and stronger caregiver that can teach the babies how to survive, how to thrive, and how to grow big and strong.

While some animals are born and are quickly able to walk on their own, infants are completely at the mercy of their caregiver for even holding up their head. A colt can come trot to its mother horse when it is hungry, yet a human infant cannot do this until several months into its life at best.

An infant depends on communication with its caregiver to have all of its needs met. This communication is completely non-verbal for at least its first year of life, so it is the right-brain to right-brain emotional connection that facilitates a caregiver and an infant to be closely bonded, to the point where they can understand each other without needing to speak.

So, while the infant is completely vulnerable without choice, the infant and caregiver enter into what we term as “The dance.” It is through this dance of non-verbal communication of needs that the caregiver must provide all needs, including the emotional and physical need of touch for that baby. In meeting all of the baby’s needs, in his or her vulnerability, that infant will feel secure and loved.

This is how a secure attachment develops.

Unfortunately, there are many things that can disrupt that dance. I am sure you can call forth several situations that come to mind. What if the caregiver is a mom who struggles with postpartum depression? The physical needs may be well met, but the emotional needs are not, thus disrupting the dance. The infant responds by feeling an inherent unworthiness that they are somehow bad, that they do not deserve to be well-cared for, that no one enjoys spending time with them, and that they are a burden to others. Of course, this is not at all what the mother intends, but this is a form of a disruption of the relational dance.

Perhaps the mother is in a stressful marriage and her mind is preoccupied with that. Or the mother may be a single mom working extremely hard to provide for her kids.

One of the most important findings of recent research with Attachment Theory is how the relational dance begins during the third trimester of pregnancy, at least. The birth is merely the continuation of this dance on a different level.

When a child is adopted at birth, or for whatever reasons, becomes separated from its birth mother shortly after birth, can also cause a major disruption in the relational dance the infant knows, and results in relational trauma.

When to Do Trauma Therapy for a Child With Insecure Attachment

Ideally, you want to do some trauma therapy when you begin the attachment intervention. However, the children may not be at a place where they can do the work yet. If the child is not yet at an emotionally stable place to do the trauma work, there are a few options.

One option is to wait until they are more attached, can be more cooperative, and more honest. It has been my experience that for the trauma work to be the most effective, the child needs to already feel a degree of security and containment. They also need to have clear expectations of their words and actions in relation to others, and they need to want to meet that expectation.

Starting with attachment work helps develop a child’s sense of security and containment when they have an attachment disorder. The attachment intervention provides them both the clear expectations and the desire to feel well, and have fun in life with secure relationships.

In addition, tor the trauma therapy to be the most effective, they need to be aware of their hurtful words and actions towards themselves and others, as well as wanting to be different and change. As they gain attachment, they become progressively more aware of their interactions with others and therefore, become more empathic.

Thus, with time doing the attachment intervention, they get to a place where the trauma therapy will be the most effective. This can happen as early as 1-2 months into the attachment work.

There are therapists who do not integrate the trauma and attachment work, but do the trauma therapy as an intensive week, regardless of the state of the child’s attachment. Consistently, families who go after doing intensive attachment work, tend to have the best results from the trauma work.

Trauma Yoga

Any form of trauma involves a discharge of energy from the sympathetic nervous system, which is the fight or flight system. When fighting or fleeing is not possible, the response to an overwhelming stress is freeze, and rather than being released in muscle activity, the sympathetic energy discharge is stored in the nervous system, especially in the psoas muscle region.

The psoas muscle region is the area of a whole network of nerves that receive messages and energy from the fight or flight sympathetic system. In an overwhelming stress or trauma, this serves to shut off the internal bodily functions, because your body believes it is not the right time to relax and digest.

Movements that help stretch and release that stored energy in the largest network of sympathetic nerves, helps to energetically heal a trauma. Trauma yoga can help stretch and release the psoas muscle.

Here is one practitioner I have had the pleasure of working with over the years. 

Somatic Experiencing

Somatic experiencing is another form of release of stored sympathetic nervous system energy. This can be done through a number of methods. Peter Levine has led the growth of understanding in this area. He has been very instrumental in developing somatic experiencing methods to heal veterans from PTSD.

Deep Tissue Massage

There is also a form of massage that specifically targets the psoas muscle and can help release the stored energy in the associated sympathetic network. Not all massage therapists are familiar with, or trained in this technique, so look for one if you specifically want this form of deep tissue massage. Otherwise, in general, all massage will be helpful as touch directly decreases our stress hormone, cortisol.

Internal Family Systems

I am including Internal Family Systems within this discussion on trauma therapy, because it is an essential piece to achieve self-compassion and get out of the cycle of shame, fear, and loneliness that is associated with surviving a trauma. One of the biggest feelings coming out of relational trauma and an insecure attachment disorder is shame.

Internal Family Systems provides a model of seeing yourself as separate from the shame one might feel after healing, which helps to identify and understand its source.

The essence of the therapy model of Internal Family Systems is to identify different parts of ourselves, just like we have one part that wants to be in relationships, and another part that is scared. Internal Family Systems helps one achieve a group cohesiveness of all of our parts so that they are not in conflict with each other, which creates much of the exhaustion and internal turmoil living with the effects of trauma.

Have you or your child done some form of trauma therapy? What has your experience been?

Please share what methods and experiences you may have undergone trying to accomplish healing for yourself or your child. I’d love to hear back from you.

Dr. Aimie

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