Understanding Attachment Understanding Attachment Disorder and the implications Disorder and the implications for learning and achievementfor learning and achievement

Understanding Attachment Understanding Attachment Disorder and the implications Disorder and the implications for learning and achievementfor learning and achievement

Session 3B led by: Dr Tina Rae (UEL)

Optimus Conference 17th May 2011

Handouts

• Powerpoint Presentation

• Case Study – Ella – Insecure avoidant

• Case Study – Shahin – Insecure ambivalent

• Case Study – Jamie – Insecure disorganised

• Top Tips for Attachment Disorder

Understanding Understanding Attachment Disorder and Attachment Disorder and

the implications for the implications for learning and achievementlearning and achievement

Understanding Understanding Attachment Disorder and Attachment Disorder and

the implications for the implications for learning and achievementlearning and achievementlearning and achievementlearning and achievementlearning and achievementlearning and achievement

Tina Rae (UEL ) Tina Rae (UEL ) OptimusOptimusConference 17Conference 17thth May 2011May 2011

AIMS• Identify challenges to LAC in Education with

attachment as a key influencing factor

• Define attachment disorder & implications for • Define attachment disorder & implications for learning

• Identify practical strategies for teachers & support staff

Key Aim• Behaviour has meaning

protect the teacher from being adversely affected by pupil’s

feelings and defence patterns

• To offer an alternative • To offer an alternative understanding/explanation of behaviour

How early Impacts of learning

Attachment cognitive development

Definitions• The term attachments:

• Used to describe the process of bonding • Used to describe the process of bonding that takes place between infants and caregivers in the

first two years of life, and most

important, the first nine months of life.

•Winnicott felt that a good-enough mother allows herself to be used by the infant so that he or she may develop a healthy sense of omnipotence

Maslow’s “Hierarchy of Need”

1954 “Motivation and Personality”

Self-fulfilment and Actualisation

Self-Esteem

The “Value” Need

Love and Friendship Needs – to give and receive love, to belong

Safety Needs-Safe from threats, treated fairly, trusted and to trust

Physical Needs:- Air, food, water, shelter, medical care, rest and recreation

The Attachment Process• Calming

core identity

• Attunementtrust

• Affective attunementfeelings and empathy

• Impulse regulationmorality

• Shame regulation• Shame regulationsocial learning

• Rage managementsocial acceptability

• Pre-cognitive patterningthinking

Quick ActivityWhat can interfere with this process?

So what are the risk factors?

• Factors which present risk to the quality of attachment of parent and child:child:

*How many of these sound familiar…?

• Pre-birth stress (DSH)

• Domestic Violence

• Alcohol/drug taking during pregnancy

• Parental illness

• Neglect

• Abuse

• Home instability

• Poverty

• Abandonment• Parental illness

• Post Natal Depression

• Premature baby

• Medical complications

• Bereavements in the family

• Baby Having a disability

• Abandonment

• Mental health difficulties in the caregivers

• Multiple home and school placements during child’s early years

Research – The ‘Brain’ bit• = highlighted the importance of early relationships and brain development specifically emotional development.

• First three years of life= critical/sensitive period in development

If the ‘right’ experiences are NOT available

• Eye contact

• Responsive face to face gazing

• Vocalisation and tone

• Smiling

• Body language

• Containing emotions• Containing emotions

• Then the baby’s brain will not develop to realise his/her full potential

• Children are born with a fragile sense self and are extremely vulnerable

• If they experience ‘abuse’• This leads to fear• This leads to fear• Which leads to abnormally high levels of stress hormones

* Cortisol

• These high levels can affect

– Child’s ability to think

– Retrieve information

– Manage behaviour– Manage behaviour

– Immune system – vulnerable to infection

Brain Stem• The brain stem

= responsible for fight, flight and freeze responses

• Those children with attachment difficulties

. Have a highly developed brain stem, since they use it on a

continual basis

So what…• Over-use of the brain stem compromises the developing pre-frontal cortex

• Which is responsible for:. Empathy

. Logic. Logic. Cause and effect

. Reasoning

. Organisation

• Clearly, implications for learning and behaviour in the classroom………

Types of Attachment…….• Secure Attachment

• Insecure attachment

- Avoidant attachment- Avoidant attachment

- Disorganised attachment

- Ambivalent attachment

Secure Attachment• Indicates = a healthy and

appropriate style of

relating to another person

• Bowlby

- “good enough” parenting

- to suggest that if a baby had the experience of their needs - to suggest that if a baby had the experience of their needs

being attended to and satisfied on a consistent basis, then he

can develop

secure attachment to his parents

Secure attachment:• Feel safe

• Develop meaningful connections with others

• Deal with stress

• Balance emotions

• Experience comfort and security• Experience comfort and security

• Children believe they are loveable

• That others can be trusted to meet their needs

• They have the capacity to learn new things

• Develop

- Positive self esteem- Independence- Resilience- Friendships- Social skills, trust, intimacy, affection, empathy, - Social skills, trust, intimacy, affection, empathy, compassion, conscience, positive and hopeful belief systems

• Their behavioural performance and academic success in school is good

Avoidant attachment• The child actively seeks to attend to their own needs.

• Avoidant behaviour:- relating to a depressed or abusive care-giver

- care-giver may have given precedence to their own needs over the child’s needs

- child may have been viewed as annoying- care-giver may have been irritated or agitated by theirpresence

• These children may:

- Shut down or dissociate

- Be emotionally distant- Be emotionally distant

- Be self sufficient and task orientated

- Be reluctant to ask for help

- Need to be in control

- Comply and try to please us

- Be perfectionist and may develop compulsive tendencies

• Do not seek to connect with others but may experience isolation and deep sadness

• Sometimes show flashes of aggression

• Try to keep adults sweet so adults don’t get too close or get angry • Try to keep adults sweet so adults don’t get too close or get angry with them. Their behaviours are anxiety driven

• They may internalise their pain and anxiety which may effect them at a physiological level

Ambivalent Attachment• These children have become so tuned into their care-givers

that they are continually on edge

• Get their needs met by- consistently working out how the care-giver is feeling

• Attachment behaviour = relating to an inconsistent care-giver

• These children can become addicted to attempting to gain the care-givers attention in order to survive

• Clingy• Rejecting• Superficially charming• Attention seeking and in your face

• These children have never been kept in mind or considered by another person

• These children have never been kept in mind or considered by another person

• They will meet their needs however they can

• They are extremely anxious and insecure

• Use up most of their energy gaining the adult’s attention

• Little energy left for learning

• They are quick to blame others for upsetting them

• They can be resentful and hold grudges• They can be resentful and hold grudges

• These children are often exhausting

Disorganised attachment• Their attachment behaviours are

- result of severe neglect and chaotic

terrifying abusive environments

• Adaptive responses

= unpredictable and frequently difficult to

manage, both emotionally and physically

• Behaviours can be bizarre, extreme and erratic

• Find it hard to be in touch with their vulnerability

• Expect the worst and think no one genuinely cares

• Try to be in control of everything and cannot bear • Try to be in control of everything and cannot bear the risk of being dependent in any way

• Extremely defensive

• Behind their façade of defiance there is a profound sense of fear, panic and helplessness

• They can not relax or get involved in the learning process as they have to survive

• They are hyper-vigilant

• Their self awareness is poor

Case Studies• Ella – Insecure Avoidant

• Shahin – Insecure Ambivalent/resistant

• Jamie – Insecure Disorganised

• What might help in the classroom?

Learning ProfileLearning profile of a child with avoidant attachment

• Approach to school/classroom- Apparent indifference to uncertainty

• Response to the teacher- Denial of need for support and help from the

teacher• Response to the task

- Need to be autonomous and independent of the teacherteacher

- Hostility towards the teacher is directed towards the task

- The task acts as an emotional safety barrier between the pupil and the teacher

• Skills and difficulties- Limited use of creativity- Likely to be underachieving- Limited use of language

Strategies to use:

• RELATIONSHIP

BETWEEN PUPIL AND THE TEACHER

MADE SAFE BY THE PRESENCE OF THE TASK,MADE SAFE BY THE PRESENCE OF THE TASK,

OR

Highly structured encounters such as games with clear rules and outcomes

• Use of another child to moderate intensity of teacher proximity

• Paired/small group work

• Clear lesson plans• Clear lesson plans

• Structured tasks- completed with little help from teacher

• Concrete, structured activities with little use of imaginative skills

• The curriculum provides many opportunities to explore hidden or dangerous feelings.

• Boxes, bridges, houses, castles, journeys are the basis of may stories and all have symbolic significance about may stories and all have symbolic significance about closeness and distance, containment and fears. Without any conscious disclosure, many strong feelings can be given words and meaning. Emotional literacy can begin by trying to describe the experiences of characters in stories.

• Structured GAMES with rules likely to provide an arena for safe engagement

Learning Profile Linked to Resistant/Ambivalent Attachment

• Approach to the school and the classroomHigh level of anxiety and uncertainty

• Response to the teacherNeed to hold onto the attention of the teacherApparent dependence on the teacher in order to engage in learningExpressed hostility towards the teacher when frustrated

• Response to task• Response to taskDifficulties attempting the task if unsupportedUnable to focus on the task for fear of losing teacher’s attention

• Skills and DifficultiesLikely to be underachievingLanguage may bee well developed but not consistent with levels of achievementNumeracy may be weak

Intervention Implications

• CHILD – the first step they need to take is to ENGAGE WITH THE TASK, in order to begin the process of change

• TEACHER the first step is recognising the pupils SEPARATION ANXIETY

• The pupil can be experienced as DEPENDENT, IRRITATING and INTRUSIVEIt can help to be aware of the child’s powerful wish to achieved a merged state with the adult

To think of this behaviour as an anxious dependence and a need to To think of this behaviour as an anxious dependence and a need to control the significant adult who has not been experienced as reliably present

• Important adult remains the ADULT IN CHARGE

neither replicates the neediness of the primary carer nor collude with the child’s apparent pseudo-adult helper role

Strategies to use

• Approach to the school and the classroomHigh level of anxiety and uncertainty

• Response to the teacherNeed to hold onto the attention of the teacher Apparent dependence on the teacher in order toengage in learningExpressed hostility towards the teacher when frustrated

• Response to the taskfrustrated

• Response to the taskDifficulties attempting the task if unsupportedUnable to focus on the task for fear of losing teacher’s attention

• Skills and DifficultiesLikely to be underachievingLanguage may be well developed but not consistent with levels of achievementNumeracy may be weak

In the Planning

PLANNING BEGINNINGS SEPARATIONS AND ENDINGS

Help transition into school and at the end of the day

PLANNING AND WARNINGS OF CHANGESAND CLASS MOVEMENTAND CLASS MOVEMENT

Can ease separation anxiety being triggered when changes take place

Regular absence from school= triggers procedures that respond quickly to absence help the child to feel held in mind

appropriately by the school. This will lead to an experience of the reliability of the school system

Learning Profile Linked to Disorganised Attachment

• Approach to the school and the classroomIntense anxiety – controlling and omnipotent

• Response to the teacherFinds it hard to accept teachers authority but may submit to Heads authority. Finds it hard to be ‘taught’/accept teacher might know more than they do

• Response to the Task• Response to the TaskProduce fears of incompetence, humiliation may have difficulty in accepting not knowing or may appear omnipotent i.e. “I know it all already”

• Skills and DifficultiesMay seem unimaginative and uncreative, may find conceptual thought difficult. Likely to be underachieving and at immature stage of learning

Strategies to use:• Actively practice RULES which focus on keeping people and

things safe

• Frequent positive feedback can help to develop and reinforce more positive responses

• Engage in Reflective Network meetings in order to avoid • Engage in Reflective Network meetings in order to avoid reactive adult responses – especially to a crisis

• Concrete, mechanical and rhythmic activities which engage left brain function can be used to sooth highly charged states – counting, colouring, sorting, building structures sequencing sorting, building structures sequencing objects and copying.

• Rhythmical physical exercise also has a regulating influence on brain rhythms

• Start day with brain gym/cross-stitch!• Use of metaphors related to symbolic containment-buildings, houses, boats and bridges

• Make use of rich opportunities in curriculum to explore feelings and curriculum to explore feelings and situations without reference to self

• Ensure do-able/differentiated activities• Step back from aggression and use “safety routine” – accompanied “time out”

• Use of Worry Box and Permission Cards.

Supporting Individuals via DIRECT INPUT across all Key Stages:

• Solution Focused approaches to • Solution Focused approaches to increase self-esteem and engagement

• PACE approach (Dan Hughes 2003)

A Solution Focussed Approach to increase self-esteem and

engagement• Change the focus from the problem to solution of a preferred future for the young person;

• see a person as being more than their problem;problem;

• look for resources rather than deficits;• to explore possible and preferred futures;• and to treat young person as the experts in all aspects to their lives

Problem Free Talk

I know very little about you except what brings you here today. How do you spend your day? What are you interested in? What are you good at?

ExceptionsWhen doesn’t the problem happen?When doesn’t the problem happen?When does it seem to be less intense?When do you resist the urge to ….?How come you still go to school/work/etc on some days?

CopingThat situation sounds pretty overwhelming, how do you cope?

How have you been getting through?What might your friends admire about the way you have coped with this?

Locating resources/building on strengthsWhen you’ve faced this problem in the past, Locating resources/building on strengthsWhen you’ve faced this problem in the past, how did you resolve it?

How would you know if you were doing that again? What would it look like?

What can help?View of Self: identify questionsWhat does that teach you about yourself?What do you know now about yourself that you

didn’t know last week?If you read about someone who had been through

exactly this, what would you think of them?ScalesScalesOn a scale of 0-10, with 0 being the worst that

things have been in your life and 10 representing the achievement of your best hopes, where are you today?

What is it you are doing that means you are at … and not 0?

What point on the scale would you like to reach? Who can help you? How can you help yourself?

Other people’s perspectiveWho will be the first teacher to notice you’ve moved up one point on your scale?

Who will be the hardest to convince Who will be the hardest to convince that you mean business this time? What will he/she need to see?

Finally,PACE – means of ensuring that the ADULT (you!) remain emotionally engaged and available to the child – A TALL ORDERTALL ORDER

- Don’t forget the value and importance of peer support and networks

“PACE” – Playful Accepting, Curious and Empathic

Therapist/Teacher becomes attuned to the child’s “subjective experiences” and reflects these back to the child by means of eye contact, facial expressions, voice of eye contact, facial expressions, voice tone, timing and touch – “co-regulates” emotional affect and co-constructs an alternative autobiographical narrative with child.

Curiosity: This is the starting point of being able to relate to the YP and to help the child to learn to manage feelings and to think about experience

• Includes wondering with the YP about the meaning behind the behaviour being displayed. It is different from asking a YP why s/he did something in a confrontational manner. It is more an attitude of figuring out what is going on.

• Having an attitude of curiosity can lead to • Having an attitude of curiosity can lead to feelings of empathy for the YP

• The YP will then be more willing and able to think about the behaviour and the consequences that ensued

• Curiosity sometimes means making best guesses about what is going on. The YP and adult can figure it out together as the YP may genuinely not understand the behaviour themselves.

Acceptance: Following curiosity come acceptance. Acceptance means understanding why the YP felt s/he had to behave as s/he did

• The adult accepts both the behavioural choices the YP is making and the feelings that underlie these choices

• Acceptance conveys understanding rather than condoning of the behaviour. As the YP feels understood s/he will be more willing to think with understood s/he will be more willing to think with the adult about the consequences to the behaviour that s/he now has to face

• To empathise the adult needs to enter imaginatively into the experience of the YP. Acceptance of this inner experience is communicated to adult helping the YP to feel that his or her inner life is important and valued.

Playfulness: At times a playful attitude can be a key factor in helping a YP feel connected within the relationship

• A light-hearted, relaxed and playful attitude can help the child, sometimes unexpectedly, to experience fun and love. unexpectedly, to experience fun and love. If the resistant YP does not see it coming and if it is over quickly s/he will find it harder to avoid and disengage

In Summary:

• Schools make a significant contribution to emotional well-being with implications for achievement, social inclusion and mental health

• Education – clearest ROUTE to achievement and inclusion in later life

• Education – clearest ROUTE to achievement and inclusion in later life

• VITAL – that teachers (and others) respond to the meaning of behaviour rather than react to difficult feelings

Vital:

• Schools adopt a POLICY of talking and reflecting in structured settings – will enhance capacity to contain anxiety for both staff and enhance capacity to contain anxiety for both staff and students

• Early identification and intervention system needs to be embedded.

Thank you for Listening and Participating

Take care of your own well-Take care of your own well-being!

Bibliography• Bomber L M (2007) “Inside I’m Hurting”, Worth

Publishing, London• Boyd Webb N (ed) (2006) “Working with

Traumatized Youth in Child Welfare”, Guildford Press, NY

• Cairns K & Stanway C (2004) “Learn the Child”, British Association for Adoption and Fostering (BAAF), London(BAAF), London

• Geddes H (2006) “Attachment in the Classroom”, Worth Publishing, London

• Hughes D (2003) “Psychological intervention for the spectrum of attachment disorders and intrafamilial trauma. Attachment and Human Development 5, 271-279

• Jemberg M and Booth P (1999) “Therapy”, 2nd ed, Jossey-Bass, San Francisco