The Attachment Center at Beech Brook

One of Beech Brook's areas of expertise is in working with children who have difficulty developing and maintaining healthy relationships with parents or caregivers. Living with and loving these children can be very challenging because they often do not respond well to traditional parenting or therapy.

What is attachment?

Healthy attachment is a process during which an emotional connection develops between an infant and his/her primary care giver. This connection becomes the basis for how the child learns to view the world and form relationships.

Successful attachment occurs in a nurturing environment where both the physical and emotional needs of the child are met with consistent, caring interactions. Behaviors such as smiles, eye contact, nurturing touch, and reciprocal play help the child develop a sense of trust and security and build healthy relationships.

This process may be disrupted by abuse, neglect or other trauma that interferes with the physical and/or emotional needs of the child being met. Children with attachment problems often have relationships that are limited or unsatisfying because they do not know how to engage in the "give and take" of a healthy relationship. Many exhibit behaviors that become increasingly difficult to manage as they mature. These disturbing behaviors serve to protect these children by keeping family members or others at a distance, thereby reducing their feelings of vulnerability. Often this creates a cycle that perpetuates their belief that they are unlovable.

Attachment Therapy

The goal of attachment therapy is to help a child learn how to trust, to give and receive love, and most importantly, to live in a family.

In a healthy attachment cycle, an infant expresses a need, usually by crying, and that need is met in a consistent and nurturing way by a parent or caregiver. The child calms, relaxes and learns to feel good again in connection with the caretaker.

Attachment therapy seeks to recreate the learning from this healthy attachment cycle. Sometimes this is done through the creation of corrective emotional experiences. In successful attachment therapy, children learn to trust and express needs. They learn that these needs will be met, and through time and consistency, they learn to feel good about themselves and their caretakers. Most importantly, they learn that the world is a safe place where they are valued or cherished. In working through the rage, fear and sadness, these children begin to accept and attach to the parents in a healthy way.

Common Causes of Attachment Problems

The child is at highest risk if these occur within first two years of life:

• Sudden or traumatic separation from the primary caretaker (through death, illness, hospitalization of caretaker or removal of child)
• Physical, emotional or sexual abuse
• Neglect (of physical or emotional needs)
• Illness or pain which cannot be alleviated by caretaker
• Frequent moves and/or placements (foster care, adoptions, changes of caretaker within family)
• Inconsistent or inadequate care at home or in day care (care must include holding, talking, nurturing as well as meeting basic physical needs)
• Chronic depression of primary caretaker
• Neurological problem in child which interferes with perception of or ability to receive nurturing (i.e. crack cocaine-exposed babies)

Behaviors Associated with Attachment Problems

Inability to engage in satisfying, reciprocal relationship:

• Superficially engaging, charming (not genuine)
• Lack of eye contact
• Indiscriminately affectionate with strangers
• Lack of ability to give and receive affection on parents' terms (not cuddly)
• Inappropriately demanding and clingy
• Persistent nonsense questions and incessant chatter
• Poor peer relationships
• Low self esteem
• Extreme control problems; may attempt to control overtly or in sneaky ways

Poor cause and effect thinking:

• Difficulty learning from mistakes
• Learning problems/disabilities, delays
• Poor impulse control

Emotional development disturbed; child shows many traits of young child in "oral stage":

• Abnormal speech patterns
• Abnormal eating patterns

Infantile fear and rage, poor conscience development:

• Chronic, "crazy" lying
• Stealing
• Destructive to self, others' property
• Cruel to animals
• Preoccupied with fire, blood, and gore

Negative attachment cycle in family:

• Child engages in negative behaviors which can't be ignored
• Parent reacts with strong emotion, creating intense but unsatisfying connection
• Both parent and child distance and connection is severed