Symptoms, Treatment, and Hope for Children with Insecure Attachment. Understanding attachment problems and disorders. Children with attachment disorders or other attachment problems have difficulty connecting to others and managing their own emotions. This results in a lack of trust and self- worth, a fear of getting close to anyone, anger, and a need to be in control. A child with an attachment disorder feels unsafe and alone. So why do some children develop attachment disorders while others don’t? The answer has to do with the attachment process, which relies on the interaction of both parent and child. Information on person-centred therapy/person-centred counselling, including the person-centred values, who can benefit and how it can help. As an adult, Beth Thomas has joined Nancy Thomas in promoting Attachment (Holding) Therapy, its parenting methods, and the unrecognized Reactive attachment disorder The following information is provided in order to help you identify what attachment disorder looks like in children. Lack of impulse control: Self destructive behaviors. Portland Therapy Center is an online directory listing hundreds of local mental health practitioners. PTC makes the experience of finding a therapist easy. Attachment Issues and Reactive Attachment Disorder Symptoms, Treatment, and Hope for Children with Insecure Attachment. Attachment is the deep connection. Dysregulation of the Right Brain: A Fundamental Mechanism of Traumatic Attachment and the Psychopathogenesis of Posttraumatic Stress Disorder. Attachment disorders are the result of negative experiences in this early relationship. If young children feel repeatedly abandoned, isolated, powerless, or uncared for—for whatever reason—they will learn that they can’t depend on others and the world is a dangerous and frightening place. What causes reactive attachment disorder and other attachment problems? Reactive attachment disorder and other attachment problems occur when children have been unable to consistently connect with a parent or primary caregiver. This can happen for many reasons: A baby cries and no one responds or offers comfort. A baby is hungry or wet, and they aren’t attended to for hours. No one looks at, talks to, or smiles at the baby, so the baby feels alone. A young child gets attention only by acting out or displaying other extreme behaviors. A young child or baby is mistreated or abused. Sometimes the child’s needs are met and sometimes they aren’t. The child never knows what to expect. The infant or young child is hospitalized or separated from his or her parents. A baby or young child is moved from one caregiver to another (can be the result of adoption, foster care, or the loss of a parent). The parent is emotionally unavailable because of depression, an illness, or a substance abuse problem. As the examples show, sometimes the circumstances that cause the attachment problems are unavoidable, but the child is too young to understand what has happened and why. To a young child, it just feels like no one cares and they lose trust in others and the world becomes an unsafe place. Early warning signs and symptoms of insecure attachment. Attachment problems fall on a spectrum, from mild problems that are easily addressed to the most serious form, known as reactive attachment disorder (RAD). Although it is never too late to treat and repair attachment difficulties such as reactive attachment disorder, the earlier you spot the symptoms of insecure attachment and take steps to repair them, the better. With early detection, you can avoid a more serious problem. Caught in infancy, attachment problems are often easy to correct with the right help and support. Signs and symptoms of insecure attachment in infants. Reactive attachment disorder (RAD) occurs in children who have been neglected and are unable to form a healthy emotional attachment with their primary.Avoids eye contact. Doesn’t smile. Doesn’t reach out to be picked up. Rejects your efforts to calm, soothe, and connect. Doesn’t seem to notice or care when you leave them alone. Cries inconsolably. Doesn’t coo or make sounds. Doesn’t follow you with his or her eyes. Isn’t interested in playing interactive games or playing with toys. Spend a lot of time rocking or comforting themselves. It’s important to note that the early symptoms of insecure attachment are similar to the early symptoms of other issues such as ADHD and autism. If you spot any of these warning signs, make an appointment with your pediatrician for a professional diagnosis of the problem. Comforting a crying baby. It’s common to feel frustration, anxiety, and even anger when faced with a crying baby—especially if your baby wails for hours on end. In these situations, you need to be calm and centered so you’ll be better able to figure out what’s going on with your child and how best to soothe his or her cries. See When Your Baby Won't Stop Crying. Signs and symptoms of reactive attachment disorder. Children with reactive attachment disorder have been so disrupted in early life that their future relationships are also impaired. They have difficulty relating to others and are often developmentally delayed. Reactive attachment disorder is common in children who have been abused, bounced around in foster care, lived in orphanages, or taken away from their primary caregiver after establishing a bond. Common signs and symptoms of reactive attachment disorder. An aversion to touch and physical affection. Children with reactive attachment disorder often flinch, laugh, or even say “Ouch” when touched. Rather than producing positive feelings, touch and affection are perceived as a threat. Control issues. They are often disobedient, defiant, and argumentative. Anger problems. Children with reactive attachment disorder may hide their anger in socially acceptable actions, like giving a high five that hurts or hugging someone too hard. Difficulty showing genuine care and affection. Children with reactive attachment disorder may act like they don’t have a conscience and fail to show guilt, regret, or remorse after behaving badly. Inhibited reactive attachment disorder vs. The child is extremely withdrawn, emotionally detached, and resistant to comforting. The child is aware of what’s going on around him or her—hypervigilant even—but doesn’t react or respond. He or she may push others away, ignore them, or even act out in aggression when others try to get close. Disinhibited symptoms of reactive attachment disorder. The child doesn’t seem to prefer his or her parents over other people, even strangers. The child seeks comfort and attention from virtually anyone, without distinction. He or she is extremely dependent, acts much younger than his or her age, and may appear chronically anxious. What you need to know about parenting a child with attachment issues. Parenting a child with insecure attachment or reactive attachment disorder can be exhausting, frustrating, and emotionally trying. It is hard to put your best parenting foot forward without the reassurance of a loving connection with your child. Sometimes you may wonder if your efforts are worth it, but be assured that they are. With time, patience, and concerted effort, attachment disorders can be repaired. The key is to remain calm, yet firm as you interact with your child. This will teach your child that he or she is safe and can trust you. A child with an attachment disorder is already experiencing a great deal of stress, so it is imperative that you evaluate and manage your own stress levels before trying to help your child with theirs. Helpguide’s emotional intelligence toolkit can teach you valuable skills for managing stress and dealing with overwhelming emotions, leaving you to focus on your child’s needs. Helping a child with reactive attachment disorder or insecure attachment. Have realistic expectations. Focus on making small steps forward and celebrate every sign of success. Patience is essential. The process may not be as rapid as you'd like, and you can expect bumps along the way. But by remaining patient and focusing on small improvements, you create an atmosphere of safety for your child. Foster a sense of humor and joy. Joy and humor go a long way toward repairing attachment problems and energizing you even in the midst of hard work. Find at least a couple of people or activities that help you laugh and feel good. Take care of yourself and manage stress. Reduce other demands on your time and make time for yourself. Rest, good nutrition, and parenting breaks help you relax and recharge your batteries so you can give your attention to your child. Find support and ask for help. Rely on friends, family, community resources, and respite care (if available). Try to ask for help before you really need it to avoid getting stressed to breaking point. You may also want to consider joining a support group for parents. Stay positive and hopeful. Be sensitive to the fact that children pick up on feelings. If they sense you’re discouraged, it will be discouraging to them. When you are feeling down, turn to others for reassurance. A note to parents of adopted or foster care children with reactive attachment disorder. If you have adopted a child, you may not have been aware of reactive attachment disorder. Anger or unresponsiveness from your new child can be heartbreaking and difficult to understand. Try to remember that your adopted child isn’t acting out because of lack of love for you. Their experience hasn’t prepared them to bond with you, and they can’t yet recognize you as a source of love and comfort. Your efforts to love them will have an impact—it just may take some time. Tips for making your child feel safe and secure. Safety is the core issue for children with reactive attachment disorder and other attachment problems. They are distant and distrustful because they feel unsafe in the world. They keep their guard up to protect themselves, but it also prevents them from accepting love and support. So before anything else, it is essential to build up your child’s sense of security. You can accomplish this by establishing clear expectations and rules of behavior, and by responding consistently so your child knows what to expect when he or she acts a certain way and—even more importantly—knows that no matter what happens, you can be counted on. Set limits and boundaries. Consistent, loving boundaries make the world seem more predictable and less scary to children with attachment problems such as reactive attachment disorder. It’s important that they understand what behavior is expected of them, what is and isn’t acceptable, and what the consequences will be if they disregard the rules. This also teaches them that they have more control over what happens to them than they think. Take charge, yet remain calm when your child is upset or misbehaving. Remember that “bad” behavior means that your child doesn’t know how to handle what he or she is feeling and needs your help. By staying calm, you show your child that the feeling is manageable. Therapy for Attachment, Therapist for Attachment. Attachment refers to the ability to form emotional bonds and empathic, enjoyable relationships with other people, especially close family members. Insecure attachment early in life may lead to attachment issues and difficulty forming relationships throughout life. Because early intervention often proves most effective, children who shows signs of attachment issues may benefit from speaking to a therapist. Attachment Theory and Research. Developmental psychologist John Bowlby originally described the concept of attachment, focusing on the bond between mother and infant. Attachment, according to Bowlby, is not a one- time event, but a process that begins with birth and extends into the early years of life. A child's relationship with the primary caregiver, who is often the mother, can affect the child's attachment style throughout life, and insecure attachments can often interfere with future romantic relationships. Children generally develop healthy, secure attachments to mothers who competently and regularly respond to the child's needs by, for example, feeding the child when the child cries. There has been significantly less research investigating the process of attachment between father and child, but preliminary studies indicate that the process is similar, with perhaps more emphasis on play. In this test, a mother leaves her child with researchers, who observe the child's reactions. Children with secure attachments demonstrated a strong attachment to the mother, while children with insecure attachments exhibited a variety of unusual and unhealthy reactions, including becoming angry with the mother upon her return. The test results determined four types of attachment: Secure: The child will interact with others in the presence of the mother and will become upset when she leaves and avoid contact with strangers. This demonstrates a healthy attachment. Anxious- Resistant Insecure: The child will become anxious at the presence of strangers and will not interact with them. When the mother leaves, the child will become very upset and will be unreceptive to her attempts to interact when she returns. This may demonstrate that the parent does not consistently meet the child's needs. Anxious- Avoidant Insecure: The child shows ambivalence toward the mother and toward strangers, does not want to be held, and shows no preference toward caregivers. This attachment style typically means that a child has learned that efforts to have needs met will be ignored. Disorganized/Disoriented: Though a child with this attachment issue may become upset when the mother leaves and appear relieved when she returns, the child may refuse to be held, hit or rock repeatedly, and show anger toward the mother. Over half of the mothers of children with a disorganized or disoriented attachment were shown to have experienced trauma- induced depression shortly before giving birth. Understanding Attachment Issues. The attachment bond, or an infant's first bond with the primary caregiver, generally the mother, is essential to later attachment. A weak attachment bond can result in both social and emotional developmental disruptions. Attachment issues typically result from an early separation from parents, lengthy hospitalization, incidents of trauma, instances of neglect, or an otherwise troubled childhood. These issues may have an affect on a child's ability to form healthy, secure attachments later in life. Attachment is related to trust and empathy, and when attachments are not developed early in life, a child may not learn to trust and may not develop a conscience. Studies show that between 3. US experience some kind of attachment issue, while approximately 3. United States have been diagnosed with an attachment disorder. Many of those who develop attachment issues are never diagnosed or treated, so the actual number of children affected is unknown. Attachment issues are more likely to develop in maltreated infants, primarily due to neglect or the child's being moved from one caregiver to another. Prolonged institutional care, long- term hospitalization, or other separation from parents might also lead to the development of attachment issues, as can inconsistent behavior from caregivers. Signs of insecure attachment may include: Avoidance of eye contact. Avoidance of physical contact. Rejection of touch or attempts at emotional connection. Frequent, inconsolable crying. A tendency to self- comfort. A lack of interest in toys or interactive play. Reactive Attachment Disorder (RAD)Reactive Attachment Disorder (RAD) is a serious, diagnosable condition that develops in childhood, typically between 9 months and 5 years of age. Diagnostic criteria from the Diagnostic and Statistical Manual (DSM) indicate that children with RAD do not often seek out or respond to comfort from caregivers in the face of distress, establishing a pattern of consistently withdrawn behavior. A child might also fail to respond emotionally and socially to other people and be irritable, sad, or fearful, with no apparent reason. Children with this condition may dislike physical affection, have anger and control issues, and experience difficulty showing affection. According to the DSM, this condition is rare: In the general population, it probably occurs in less than 1% of children. In populations of maltreated children, RAD occurs at a rate of about 1. The only known risk factor for the condition is severe social neglect, but in the majority of cases of neglect, RAD does not develop. If care improves following the neglect, this condition is less likely to develop. How Psychotherapy Can Help with Attachment Issues. Attachment issues that are left unresolved can interfere with the ability to maintain relationships of any kind later in life. Children who have attachment issues can often benefit from therapy, as in therapy they may be able to learn what healthy relationships look like, explore ways to form constructive bonds with caregivers, and develop ways to cope with the symptoms that resulted from their early attachment issues. Play therapy is often effective for children experiencing RAD. A child with this condition might attend therapy with the caregiver, and treatment generally focuses on strengthening their relationship and working to develop a healthy attachment. Adults who have never addressed problems with attachment and who see the result of attachment issues in their lives might, in treatment, identify and explore early losses, grieve for the childhood bonds that were not experienced, and gain closure while learning how to develop healthy attachments and accept love, if they have difficulty doing so. Through therapy, adults who have experienced attachment issues may become able to build stronger bonds with friends, children, and partners. Case Examples. Attachment issues in adopted son: Shawn, 6, is brought in for therapy by his newly adoptive parents, who adopted him from the foster care system last year. Though he had been loving and sweet in the beginning, he had also been impulsive, prone to sudden bursts of aggression, and displayed sexualized behavior, but they overlooked this, assuming the behaviors would improve as he grew accustomed to a stable life. Instead, things deteriorated rapidly. Shawn's parents tell the therapist he is aggressive with his older siblings, is impossible to discipline, is frequently in trouble at school, and wets the bed nightly. He seems angry for no reason and does not allow anyone to comfort him. His parents worry they may have to send him to a group home for children with behavior problems. The therapist recognizes the signs of attachment issues, and instead of trying to change Shawn’s behavior with reinforcement and punishment, as Shawn's caregivers have, the therapist works on creating positive attachment experiences in therapy between the parents and Shawn. In addition, the therapist helps the parents understand the motivation behind Shawn's behaviors, and they explore ways to provide attachment- facilitating parenting experiences at home. After several months, results begin to appear. Shawn accepts hugs and is less easily triggered. Instead of hitting his siblings when upset, he cries and asks for help. Because his behavior was a symptom of intense emotional ambivalence, when positive parenting addressed the issue, the symptoms began to fade. Intimacy issues in marriage: Mei, 3. Her sex life with her husband began to worsen almost immediately after their honeymoon, and she admits the problem is hers; she is repulsed by sexual invitations from her husband, and she is afraid of touching him in bed in any way. She feels angry at him for no reason she can identify and feels that she would like to live “separate lives.” However, the thought of divorce terrifies her, and she does not want that. Mei cannot explain her feelings, but an examination of her childhood reveals instances of severe neglect Mei had thought she had gotten over. Therapy reveals Mei has intense fears of both rejection and of being enveloped or dominated by others. Through work on communication skills and by experiencing catharsis (emotional release) in the presence of, at first, the therapist and, later, her husband, Mei is able to develop a bond that feels safe with her husband, and she can begin to repair her marriage. References: Adoption USA: Social and emotional well- being. Retrieved from http: //www. NSAP/chartbook/chartbook. Adult Attachment Disorder and Treatment. Retrieved from http: //attachmenttherapy. Brotherson, S. Understanding Attachment in Young Children. Bright Beginnings, (6). Retrieved from http: //www. Cassidy, J., & Shaver, P. Handbook of attachment: Theory, research, and clinical applications. New York, NY: Guilford Press. Diagnostic and statistical manual of mental disorders: DSM- 5. Washington, D. C.: American Psychiatric Association. Reactive attachment disorder. Retrieved from http: //www. Reactive attachment disorder of infancy or early childhood.
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