The%20Continuum%20of%20Attachment

1
The Continuum of Attachment

• Attachment disorder can be seen as a continuum
  with the child often recreating the attachment
  environment that they first experienced.

2
Secure Attachment

• Secure attachments provide safety and protection,
  teaching basic trust and reciprocity. Secure
  attachment is the basis for self-esteem and
  self-concept. It promotes socialization,
  facilitates development of morality, empathy,
  conscience, creates a positive "inner working
  model", promotes health and physical development
  and increases resiliency.
• Seek primary care giver when distressed
• Easily comforted
• Absorbed play
• Curious
• Responsive to environment cues
• Reciprocity in relationships
• Use care giver as a secure base from
  which to explore

3
Insecure-Anxious Attachment Disorder

• May result from a dysfunctional attachment during
  the early years. There may have been some
  attachment to a caretaker but it may have been
  inconsistent, or abusive.
• Charming, superficial
• Appear emotionally empty
• Eager to please, chameleons, (hyper
  vigilant)
• Bossy, demanding of affection and
  attention
• Intrusive into others space
• Clingy and dependent
• Whines and pouts when limits set
• May hurt adult when being affectionate,
  or be seductive
• Lie, steal and hoard
• Buy friendships
• Manipulate, manipulate, manipulate

4
Insecure-Avoidant Attachment

• Probably caused by a neglectful environment. Make
  themselves very hard to like-which fulfills their
  belief about themselves and the world-that they
  deserved rejection.
• Avoid close relationships, loners,
  distant
• Self-reliant, believe they can meet
  their own needs
• Rarely distressed when caregiver leaves
• May reject caregiver following
  separation
• Feel safe when in control
• Do not seek out friends
• Hostile, passive-aggressive
• Avoid eye contact
• Chatter nonstop, ask nonsense questions
  
• Annoying behaviors that keep others at
  a distance
• Avoid feelings, may have flat affect or
  fake emotions
• Low self-esteem
• When held, complain, wiggle or itch

5
Insecure-Ambivalent Attachment

• Probably caused by an abusive early environment
  or one which was both abusive and neglectful with
  little predictability.
• Openly angry and defiant and destructive
  especially when limits set
• Distressed during separation, difficult
  to comfort
• Seeks contact yet may be angry and
  resist closeness upon return
• Destructive to self, others, animals and
  property
• Sneaky
• Lie and steal
• Superficial and manipulative to get what
  they want
• Stiffen in response to affection
• Sabotages closeness
• When stressed appears disorganized
• Regresses or acts immature when needing
  affection
• Lack of remorse
• Obsessed with fire, blood and gore.

6
Disorganized Attachment

• May have experienced a very chaotic environment
  in early years. May have experienced both
  nurturing and abuse
• Concurrent psychological disorders
• Odd, bizarre behavior
• Unpredictable, excitable, changeable
• Unable to maintain consistent attachment
  strategy when distressed
• Go from crisis to crisis
• Behavior marked by conflicting drives to
  approach and avoid
• Sudden bursts of anger followed by
  sudden freezing or dazed behavior
• May dissociate memory of abuse to
  maintain attachment

7
Children with Attachment Disorder Have Often
Experienced

• Abuse (physical, emotional, sexual)
• Neglect
• Prolonged separation from primary caretaker
• Undiagnosed and/or painful illnesses
• Frequent moves and/or placements
• Inconsistent or inadequate daycare
• Chronic maternal depression
• Poor parenting skills
• Separation due to death or divorce
• Prenatal injuries
• Organic or neurological insults

8
Behaviors

• Superficially engaging and charming behavior
• Indiscriminate affection toward
  strangers-affection on their terms only
• Lack of eye contact
• Persistent nonsense questions and incessant
  chatter
• Inappropriate demanding and clingy behavior
• Chronic, crazy lying
• Stealing
• Destructive of self, others and property
• Sexualized behavior
• Abnormal eating patterns
• Problems with impulse controls
• Learning lags and disorders
• Abnormal speech patterns
• Poor peer relationships
• Lack of cause and effect thinking
• Lack of guilt or remorse
• Cruelty to animals

9
Associated Behaviors
10
Hierarchy of Brain Function

• Abstract thought
• Concrete thought
• Affiliation
• Attachment
• Sexual behavior
• Emotional reactivity
• Motor regulation
• Arousal
• Appetite/Satiety
• Sleep
• Blood pressure
• Heart rate
• Body temperature

• Cortical

• Most Complex
• Most cells
• Develops later

• Limbic

• Midbrain

• Least Complex
• Fewer cells
• Develops earlier

• Brainstem

11
Role of Amygdala

• Sensory Cortex

• Amygdala

• Sensory
• Thalamus

• AD Reaction

• Emotional Response

• Emotional Stimulus

12
Assessment

• History
• Discovering What the Parents Know
• Testing
• Observation
• Behavior

13
Attachment and Attunement

• Attunement Lack of Attunement
• Supports making sense of experience No help
  making sense of experience
• Enhances emotional regulation Overwhelming
  emotions
• Gives coherent narrative Incoherent narrative
• Supports language development Impaired language
  development
• Supports sense of self Dysfunctional sense of
  self
• Increases capacity to plan and inhibit Decreased
  ability to plan and inhibit

14
Attachment Behaviors Daily Checklist
Check the behaviors you observed today
________________ (date).
____Accepts redirection, parental
limits. ____Able to play independently but
returns to parent to re-energize. ____Able to
delay gratification for increasing periods of
time. ____Exhibits feelings other than mad, such
as sadness, fear, happiness. ____Enjoys
games, time spent with parent. ____Smiles
and makes eye contact for increasing length of
time. ____Accepts cuddling or physical
contact. ____Initiates physical
contact. ____Allows parent to comfort them when
distressed. ____Has been fun to be
around today.
15
(No Transcript)