Considering Attachment in the Context of Adoption and Foster Care

1. Considering Attachment inthe Context of Adoption and Foster Care Douglas Goldsmith, Ph.D. Executive Director The Children’s Center

2. Special Thanks • Dr. David Oppenheim University of Haifa • Dr. Janine Wanlass Westminster College For their contributions and support on conceptualizing issues around attachment and permanency

3. Overview • Attachment Theory • Internal Working Models • Reflective Functioning • Insightfulness • Application to Permanency • The Attachment Toolbox

4. Understanding Attachment

5. Attachment • Emotional bond with another person • Behaviors promote proximity with one perceived as older, stronger, and wiser • Motivational system to seek proximity • Enhances feelings of security • Motivates baby to take action when frightened

6. Attachment Theory • When I am close to my loved one I feel good, when I am far away I am anxious, sad or lonely • Attachment is mediated by looking, hearing, and holding • When I’m held I feel warm, safe, and comforted • Results in a relaxed state so that one can, again, begin to explore Holmes (1993)

7. Attachment in Action • Behaviors shown by careseeker and caregiver • Aware of and seek each other out if careseeker is in danger due to physical separation, illness, or fright

8. Secure Attachment • The caregiver is perceived as a reliable source of protection and comfort

9. Cooper, Hoffman, Marvin &Powell , 2000

10. Attachment Classifications • The strange situation • Secure 65% • Avoidant 20% • Ambivalent 10% • Disorganized 5-10% (80% maltreated)

11. Secure (B) • Uses mother as secure base • Signs of missing mother • Actively greets with smile or gesture • Signals or seeks contact if upset • Once comforted resumes exploration Solomon & George (1999) p.291

12. Secure Attachment • “Attachment is mediated by looking, hearing and holding: the sight of my loved one lifts my soul, the sound of her approach awakes pleasant anticipation. To be held and to feel her skin against mine makes me feel warm, safe and comforted.” Holmes (1993)

13. Avoidant (A) • Explores readily • Little visible distress when left alone • Upon reunion, looks away or actively avoids • May stiffen or lean away if picked up Solomon & George (1999) p. 291

14. Ambivalent (C) • Distressed, fretful, passive • Fails to explore • Unsettled, distressed by separation • Alternates bids for contact with signs of angry rejection • Fails to find comfort from the parent Solomon & George (1999) p.291

15. Insecure Attachment • Intense love and dependency • Fear of rejection • Irritability • Vigilance • Punish their attachment figure for any sign of abandonment

16. Insecure Attachment • The insecurely attached person is saying: “Cling as hard as you can to people – they are likely to abandon you: hang on to them and hurt them if they show signs of going away, then they may be less likely to do so.” Holmes (1993)

17. Disorganized (D) • Behavior lacks an observable goal • Look fearful • Behavior is bizarre • May try to leave after the reunion or freeze

18. Attachment Behavioral System Felt security, love, self-confidence Attachment figure: Near, responsive, attuned Playful, smiling, Exploratory, sociable Holmes (1993)

19. Attachment • Attachment is a reciprocal relationship • The parent offers caregiving behavior that matches the attachment behavior of the child • The child, using social referencing, checks in with the mother “looking for cues that sanction exploration or withdrawal” Holmes (1993)

20. Parenting • Overanxious Parent – inhibits child’s exploratory behavior • Child feels stifled or smothered • Neglectful Parent – inhibits exploration by failing to provide secure base • Child feels anxious or abandoned Holmes (1993)

21. Attachment ProblemsBowlby • A severely hurt child fails to seek comfort • Signals that ordinarily activate attachment behavior fail to do so • System controlling attachment, and the feelings and desires associated, is rendered incapable of being aroused

22. Attachment From the Child’s Point of View • How do children view their parents? • How do children learn to think about themselves as separate from their parents?

23. Internal Working Model • Based on the child’s real-life experience of day to day interactions with his parents • Reflects the images the parents have of the child • Images communicated by how each parent treats the child and what each parent says to the child

24. The model governs how children feel toward each parent and about themselves, how they expect to be treated and how they plan their own behavior toward their parent Impact of the Internal Working Model

25. Securely Attached Child • Internal Working Model • Responsive, loving, reliable caregiver • Self is worthy of love and attention Holmes (1993)

26. Insecurely Attached Child • The world is dangerous • Treat others with great caution • Self is ineffective and unworthy of love • These assumptions are stable and enduring and terribly difficult to modify Holmes (1993) Video – Rosie’s Kids

27. Development of Relationships • “For a relationship between any two individuals to proceed harmoniously each must be aware of the other’s point-of-view, his goals, feelings, and intentions, and each must so adjust his own behavior that some alignment of goals is negotiated.

28. Development of Relationships • This requires that each should have reasonably accurate models of self and other which are regularly updated by free communication between them. It is here that the mothers of securely attached children excel, and those of the insecure are markedly deficient.” Bowlby (1988) p. 131

29. Parenting • How do parent’s foster secure attachment? • What should we look for when we observe parents?

30. Mothers of Secure Infants • Continuously monitor the infant’s state • Accurately interpret the signal for attention • Act accordingly to meet the infant’s needs

31. Mother’s of Anxious Infants • Monitor the infant’s state only sporadically • Inconsistently notice the infant’s signals • May interpret the signal inappropriately • Respond to the signal inappropriately, or tardily

32. Ambivalently Attached Child • Shows overt aggression toward the inconsistent mother • “Don’t you dare do that again!” but has to cling because he knows from experience that she will. Holmes (1993)

33. Outbursts of unprovoked aggression Needs to appease to the mother because the child wants so badly to feel close Fears she’ll rebuff him if needs are revealed too openly; or if anger about abandonment is shown too openly Holmes (1993) Avoidant Child

34. John: Seventeen Months For Nine Days in a Nursery James & Joyce Robertson

35. Phases of Response to Separation • Protest • Upset, confused, frightened by loss of mother • Urgent desire to find mother • Looks eagerly toward any sight, sound • Despair • Increasing hopelessness • Less active, withdrawn, apathetic • Decreases demands on environment

36. Phases of Separation • Despair may be misinterpreted by presuming that distress has decreased because the child is settling in • Detachment • Makes the best of the situation by repressing longing for mother • When mother returns “he hardly seems to know her” • May appear to not need any mothering at all

37. John – The Follow-up • First Week • Rejected his parents • Won’t accept comfort or affection • Won’t play • Shuts self in room • Cried a great deal • Can’t cope with the slightest frustration • Aggressive and destructive

38. Follow-Up • Second Week • Undemanding • No tantrums • Plays alone – quietly

39. Follow-Up • Third Week • Dramatic change • Tantrums return • Refuses food and loses weight • Sleep is disrupted • “Gulf” between parents and John

40. Follow-Up • One Month • Relationship with mother improves • Joyce visits and he regresses • Refuses food and attention • Three weeks later, second visit from Joyce • Extreme disturbance for 5 days • Includes aggression toward mother

41. Follow-Up • “Three years after his stay in the residential nursery, when John was four and one half years old, he was a handsome, lively boy who gave much pleasure to his parents. But there were two marked features which troubled them. He was fearful of losing his mother and got upset if she was not where he thought she would be. And every few months he had bouts of provocative aggression against her which came out of the blue and lasted for several days.”

42. Attachment: The Parent’s Point of View • How does the parent’s past impact attachment? • How do we get in to the parent’s head?

43. Impact of Empathic Failure • “Whatever she fails to recognize in him he is likely to fail to recognize in himself. In this way, it is postulated, major parts of a child’s developing personality can become split off from, that is, out of communication with, those parts of his personality that his mother recognizes and responds to, which in some cases include features of personality that she is attributing to him wrongly.”Bowlby (1988) p.132

44. Reflective Function • “The reflective function refers to the psychological processes underlying the capacity to mentalize. . . mentalizing refers to the capacity to perceive and understand oneself and others’ behavior in terms of mental states, i.e., reflection.” • Fonagy, Steele, Steele & Target (1997)

45. Reflective Function • Allows the individual to make sense of his or her own and others’ psychological experience, to enter into another’s experience, to “read” another’s mind • Allows the child to make others’ behavior meaningful and predictable, and permits him to respond adaptively • Slade (1999)

46. Reflective Function • The mother’s capacity to understand the child’s mental states create the context for a secure attachment relationship • The mother is able to view the infant as intentional • Reflective functioning provides protection against damaging effects of abuse and trauma • Slade (1999)

47. The capacity to tell a story that is affectively believable The capacity to understand emotional processes The ability to accurately understand ones own and others behavior Slade (2002) Reflective Function

50. Dyadic Patterns Marvin et al (2002) • Secure child – Autonomous Parent • Easily approach and interact when distressed • The reunion calms the child and facilitates exploration • Child can shift between exploration and using the parent as a safe harbor with little anxiety • Close attunement – disruptions easily repaired