IECA Annual Fall Conference, Atlanta, November 9, 2012

Using Attachment TheoryTo Understand Parent-Child Conflict in Non-Adopted Kids

Robert Burroughs, PhD

Ike & Burroughs, Educational Consultants

Cincinnati, OH

First Thoughts

✤ At some time of their lives, I believe, most human beings desire to have children and desire also that their children should grow up to be healthy, happy, and self-reliant. For those who succeed the rewards are great; but for those who have children but fail to rear them to be healthy, happy and self-reliant, the penalties in anxiety, frustration, friction, and perhaps, shame or guilt may be severe. Engaging in parenthood therefore is playing for high stakes. [Emphasis added.]

John Bowlby

A Secure Base, 1988, p. 1

Introduction

✤ The high proportion of adopted kids in programs has sensitized IECs to attachment issues.

✤ In our practice, we assume attachment issues in adopted kids until ruled out.

✤ Yet, it isn’t only adopted kids that can present with attachment issues.

✤ This presentation will use a cross-case-study approach to assess the value of using Attachment Theory to understand long-standing family conflict.

The Road Map

✤ First, a review of Attachment Theory, especially Ainsworth’s (1978) discrimination of types of attachment.

✤ Second, a look at critiques of the theory, especially those centered on the parents’ roles in attachment issues.

✤ Then, we’ll review Kagan’s (2004) discussion of temperament as a factor in parenting and perhaps attachment.

✤ Finally, we’ll look at three case studies of current non-adopted clients through the lens of attachment.

The “Strange Situation”

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“Strange Situation” Procedure✤ 1. Parent and infant are introduced to the room.

✤ 2. Parent and infant are alone; infant explores without parent.

✤ 3. Stranger enters, converses with parent, approaches child, as parent leaves inconspicuously.

✤ 4. First separation episode: stranger gears toward infant behavior.

✤ 5. First reunion: parent greets and comforts infant, then leaves again.

✤ 6. Second separation episode: infant is alone.

✤ 7. Stranger enters and gears behavior to that of infant.

✤ 8. Second reunion episode: parent enters and picks up infant.

“Strange Situation” Observations

✤ During the experiment, observed behavior focuses on:

✤ 1. The amount of exploration by the child throughout the episodes

✤ 2. The child’s reaction to the departure and return of the parent or caregiver.

Ainsworth’s “Strange Situation” Attachment Categories

✤ Secure Attachment

✤ Anxious-Ambivalent Attachment

✤ Anxious-Avoidant Attachment

Secure Attachment

✤ Child engages with stranger if parent is nearby.

✤ Child cries when parent leaves the room.

✤ Child is happy when reunited with parent.

✤ Child does not engage with stranger if parent is not nearby.

✤ Interpretation: Child has positive, close relationship with parent that creates a “secure base” from which to explore

Anxious-Avoidant Attachment

✤ Child shows little interest in any adults in the room, including the parent.

✤ Child shows little emotional response.

✤ Little difference in how child reacts to parents or strangers.

✤ Interpretation: Child lacks affect and comes to believe that adults in their lives will not respond to their needs.

Anxious-Ambivalent Attachment

✤ Child shows distress with stranger, whether parent is present or not.

✤ Child expresses anxiety and distress when parent leaves.

✤ Child has difficulty or is resistant to being soothed when parent returns.

✤ Interpretation: The child is anxious in new situations and inconsistently uses the help of adults to self-soothe.

Why Attachment Matters

✤ Attachment is essential for the foundation of a healthy personality:

✤ to attain full intellectual potential

✤ to develop a conscience

✤ to cope with stress and frustration

✤ to develop relationships

✤ to handle fear and worry

✤ to handle any perceived threat to self

The Role of Trust in Attachment✤ Through repeated bonding with parent in which needs are

met, trust is created:

✤ Trust that the world is safe

✤ Trust that one’s needs will be met

✤ Trust that one can effectively influence the world

✤ Trust that parent is reliable and good

✤ Trust that one’s self (the child) is good

Why Trust Matters

✤ Trust created through attachment can be transferred to others, as well as the process of creating bonds transferred.

✤ In contrast, when trust is tenuous relationships are difficult to create or sustain.

✤ Difficult to trust oneself, as well as others.

Critiques of Attachment

✤ Because trust matters, great stress is put on the role of parents in creating the bonding necessary for secure attachment.

✤ Much of Bowlby’s early work was done in orphanages, where neglect was clear.

✤ In middle-class families, neglect on that scale is rare.

✤ Attachment theory puts too much stress on early weeks and months of infants life.

✤ Cross-cultural studies suggest that children can thrive at later ages after difficult beginnings (Kagan, Three Seductive Ideas, 1998).

Attachment and Temperament✤ Returning to the idea that difficult children are difficult to parent: might the

temperaments of parent and child affect attachment?

✤ Infant differences in temperament may influence the development of parent-infant attachment either directly or indirectly. (Goldsmith et al, 1986)

✤ “An infant whose fear system is chronically easily activated tends to experience correspondingly quick deactivation of the exploratory system; such an infant seldom moves far away from the mother. Less exploration means fewer opportunities to use the mother as a secure base. Hence, the secure-base aspect of [development] is not often tested and is not highly elaborate.”

✤ Other temperament dimensions may also affect attachment. “For example, a difficult-to-soothe child may be more likely to experience the mother’s interventions as insensitive because only rarely will her efforts quickly succeed in overcoming distress. Despite prompt and frequent maternal responses, such infants may [experience the parent] as not well able to meet their needs, resulting in a tendency toward anxious attachment.”

Temperament

✤ Because attachment refers to an emotional bond, it is reasonable to investigate how the development of this bond may be mediated by individual differences in emotionality, or temperament. (Goldsmith et al, 1985)

✤ Some examples of temperament traits proposed by researchers:

✤ Sociability

✤ Attention span and distractibility

✤ Fearfulness

✤ Reactivity

✤ Persistence

Jerome Kagan and Temperament

✤ Most scientists define temperament as a biological bias for particular feelings and actions that first appear during infancy or early childhood and are sculpted by environments into a large, but still limited, number of personality traits.

✤ The emotional components of a temperament, which many regard as seminal, refer to three qualities:

✤ variation in susceptibility to select emotional states,

✤ variation in the intensity of those states, and

✤ variation in the ability to regulate them. (40)

Temperament’s “Long Shadow”

✤ A longitudinal study that uses a variety of measures to characterize high- and low-reactive temperaments as infants, toddlers and pre-adolescents. In general, study found that a temperamental bias in an infant was likely to still be present at 11 yo. The goal of the study was to demonstrate that the concept of temperament has a biological basis and that temperament is somewhat stable across time and contexts.

✤ Sample size: 237 eleven-year-olds

✤ Behavioral, physical, and medical measures: mother and child Q-sorts, ratings of inhibited behavior, observations of smiles and spontaneous comments, blood pressure, EEG tests, ear temperature, and heart rate during test of auditory acuity and more.

✤ All the participants had been assigned to a temperamental category as infants (and were observed for inhibited or uninhibited behavior at 14 and 21 months).

Consequences of Temperament?

✤ Carl Jung’s descriptions of the introvert and extrovert, written over 75 years ago, apply with uncanny accuracy to a proportion of our high- and low-reactive adolescents. (218)

✤ Parents perceive low-reactive children as “easier” than high-reactive children. (24)

✤ The combination of [emotional fluctuations] and concern with the private evaluations of others places high-reactives at a somewhat higher risk than most for developing serious anxiety over social interactions with non-intimates. (220)

✤ A majority [of high-reactives] find an adaptive niche that protects them from dealing frequently with unfamiliar people on an unpredictable schedule. (221)

✤ High-reactive, inhibited children feel a bit more secure in a social structure that sets relatively consistent rules for behavior, does not regularly pose demands for excessive risk, and rewards loyalty to the community’s standards with praise and status. (236)

Attachment and Temperament, II

✤ What might happen when a high-reactive child is parented by a high-reactive parent?

✤ What might happen when a high-reactive child is parented by a low-reactive parent?

Case Studies

✤ Three boys ranging in age from 13-17.

✤ All three boys present with long-standing conflict with parents.

✤ All three boys present with difficulties making and keeping friends; two of the three were formally tested for Spectrum Disorder, with equivocal results.

✤ All three boys have been diagnosed with ADHD.

✤ Two of the three boys have long-standing psychiatric diagnoses: anxiety, mood disorders, bi-polar.

Tom White

✤ High IQ and high scores on standardized tests.

✤ At age 7, DX: mood disorder and pediatric bi-polar with rapid cycling.

✤ Over the years, conflicting DX from different psychiatrists.

✤ Parents are anxious and afraid of Tom, mother more so than father.

Dick Green

✤ Avg IQ, though no full scale due to great PS disparity.

✤ At 5, DX: Specific Phobia, masks and costumes. Considerable separation anxiety.

✤ Extensive Spectrum testing with negative results, though language issues detected.

✤ Conflicting diagnoses by school staff, local hospital, and local psychiatrist.

✤ Parents worn out by long-standing conflict: the 3-inch binder.

Harry Black

✤ Avg IQ, with little disparity in subscales.

✤ ADHD, with significant impulsivity and opposition; he reports feeling alienated from family.

✤ Socially clueless, but Spectrum testing did not meet threshold.

✤ High conflict and tension at home; no problems at school.

✤ Mother presents as highly anxious; father presents as more aloof.

Your Turn

✤ Divide yourselves into groups of 3; read and discuss the case given to you.

✤ Consider whether your case might exhibit “anxious-ambivalent” attachment style

✤ If so, consider whether temperament might be implicated as well.

✤ If not, what else do you think might be going on here?

So What?

✤ How does this discussion impact our recommendations for residential treatment?

✤ If attachment is salient here, how does that impact recommendations?

References

✤ Ainsworth, M.D., Blehar, M, Waters, E. & Wall, S. (1978). Patterns of attachment. Hillsdale, NJ: Erlbaum.

✤ Becker-Weidman, A. (2012) What is attachment? Why does it matter? Center for Family Development [www.center4familydevelopment.com].

✤ Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. London: Routledge.

✤ Kagan, J. (1998). Three seductive ideas. Cambridge, MA: Harvard University Press.

✤ Kagan, J. & Snidman, N. (2004). The long shadow of temperament. Cambridge, MA: Harvard University Press.

✤ Goldsmith, H.H., Bradshaw, D.L. & Rieser-Danner, L.A. (1986). Temperament as a potential developmental influence on attachment. In J.W. Lerner and R.M. Lerner (Eds.) Temperament and social interaction during infancy and childhood. New Directions for Child Development, no 31.