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Attachment,

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25 April 2008. NORWICH. London. David Howe et al. Attachment Theory, Child Maltreatment ... John Bowlby 1907 - 1990. In the relationship between the child and ... – PowerPoint PPT presentation

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Title: Attachment,


1
Attachment, Development and Neglect
Stavanger 25 April 2008
David Howe University of East Anglia Norwich, UK
2
NORWICH
London
3
David Howe et al Attachment Theory, Child
Maltreatment And Family Support Palgrave/Macmilla
n
4
David Howe Child Abuse and Neglect attachment,
development and intervention Palgrave/Macmillan 2
005
5
John Bowlby 1907 - 1990
6
In the relationship between the child and the
parent, the term attachment applies to the
infant or child and the term attachment figure
invariably refers to the primary carer…It is
incorrect to refer to a parents attachment to
their child or attachment between parents
and children.
Prior and Glaser 2006
7
Attachment, therefore, is not synonymous with
love or affection it is not an
overall descriptor of the relationship between
the parent and child (which includes a number of
parent-child interactions such as feeding, play,
teaching, stimulation, problem-solving,
discipline). The attachment figures equivalent
tie to the child is termed the caregiving bond.
Prior and Glaser 2006
8
DEVELOPMENT OF MIND AND PSYCHOLOGICAL SELF
SURVIVAL
Attachment system
Intersubjectivity
9
DEVELOPMENT OF MIND AND PSYCHOLOGICAL SELF
SURVIVE
For both of these, the vulnerable human infant
needs another who is stronger (safety and
protection) and wiser (in the ways of the
mind and the world)
A relationship with a caregiver
10
How attachment influences adaptation
First, the attachment system serves a major
protective and coping function when the
individual is faced with danger (safe haven
function of the attachment relationship). Second,
confidence in the caregivers availability is
thought to enhance the childs ability to explore
in novel and challenging situations
(secure base function)

11
Attachment and internal working models
These aspects of personality are activated in
situations of danger, challenge or threat and
provide the individual with strategies for
managing or coping with stress. More extreme
stress is generally thought to lead to more
intense activation of the attachment system. In
this sense, the childs emerging confidence in
the availability of an attachment figure is
thought to play a major role in shaping the
stress regulatory aspects of personality.
12
Affect regulation
How young minds form in the context of close
relationships
(Allan Schore)
13
ATTACHMENT
None of us in born with the capacity to regulate
our own emotions. The caregiver- child
regulatory system evolves where the infants
signals of changes in state are understood and
responded to by the caregiver, thereby becoming
more regulated.
Peter Fonagy 2000
14
Affect Mirroring
15
Psychological availability/ mindedness
16
Secure caregiving
  • Mind-minded, attuned and responsive
  • Emotional understanding and regulation
  • Mentalise their own and other peoples feelings
    and behaviour (emotion and cognitive discourse,
    narrative coherence)
  • Focus on mental attributes of situations
  • Develop childs mentalising abilities

17
Birth of the Psychological Self
Bateman and Fonagy 2004
Attachment figure discovers infants mind
(subjectivity)
Internalization
Representation of infants mental state
Core of psychological self
Inference
Attachment figure
Infant
Child
Infant internalizes caregivers representation to
form psychological self
18
Internal working model
  • self
  • others
  • relationship

19
Patterns of attachment
SECURE
INSECURE organised
INSECURE organised
AVOIDANT
AMBIVALENT
INSECURE DISORGANISED
20
Disorganised/disorientated patterns infancy
Patterns arise when the attached infant has been
alarmed by the parent rather than the external
situation.
The parent is experienced as
Frightening physically alarming/hostile
dangerous parental behaviour
Frightened psychologically alarming
parental behaviour/helpless
21
DISORGANISED/ DISORDERED ATTACHMENTS
Simultaneous activation of two
incompatible behavioural responses FEAR
and ATTACHMENT (avoidance)
(approach)
22
Caregiving and disorganised attachments
  • Physical, emotional and/or sexual abuse,
    including rejection
  • Severe neglect and deprivation
  • Misuse/abuse of alcohol/drugs
  • Serious affective disorder eg depression
  • Unresolved losses/childhood traumas
  • Domestic violence
  • Multiple placements

23
RELATIONAL TRAUMA
If children are not helped to regulate their
minds when they are in highly aroused states,
which is the case in situations of abuse and
neglect, the adverse developmental consequences
are far-reaching. (Perry and Pollard 1998).
24
Birth of the Alien Self
Bateman
Bateman Fonagy 2004
The caregiver fails to discover the childs
intentionality
Absent/hostile other internalised as part of the
self
Mirroring partly fails
Absence of a Representation of the infants
mental state
Self represent- ational structure
Internalisation
Attachment figure in state of temporary
helplessness/hostility/dissociation
Child
The child, unable to find himself as an
intentional being, internalises a representation
of the other into the self
25

Controlling Children
Controlling strategies empower the child,
allowing them to disown representations of the
self as helpless, vulnerable and needing comfort
- with this some degree of mental and behavioural
coherence is achieved.
26
Maltreatment and mentalisation
This image of the self undermines self-organisatio
n, and so needs to be externalised for the child
to achieve a coherent/integrated
self-representation - leads to a variety of
controlling behaviours compulsive
caregiving/parentification compulsive
compliance compulsive self-reliance
aggressive/punitive behaviours
27

Controlling Children
Controlling strategies empower the child,
allowing them to disown representations of the
self as helpless, vulnerable and needing comfort
- with this some degree of mental and behavioural
coherence is achieved.
However, when the childs attachment system is
strongly activated hyperarousal - this
coherence is quickly destroyed ? irrational,
catastrophic, self-destructive ideation, panic,
flight-fight-freeze
Under such stresses, the fragile unitary
representation of the self as controlling is
underpinned by a disorganised, dissociated iwm of
self.
28

Controlling Children
Many abused and neglected children find
mentalisation hard, particularly in interpersonal
and intimate relationships because mentalising
interactively is one of the most complex tasks.
It is at these times that we are all vulnerable
to hyperarousal and we need a buffer to protect
us against overwhelming affect it is
mentalisation that acts as a cushion.
But for maltreated children, hyperarousal throws
mentalisation off-line the result is panic,
impulsive behaviour, fight-flight-freeze
responses.
Bateman and Fonagy 2004
29
helpless hostile fearful out-of-control unreso
lved caregiving
parent-caregiver
Hostile persecutor controlling punitive aggressive
self-reliant frightening bad/evil
Helpless victim frightened compliant sad
Protective controlling caregiving rescuer comforti
ng
child
disorganised/rage/out-of-control
30
Child maltreatment
Abuse Physical abuse Psychological
maltreatment (emotional abuse) Neglect
Disorganised neglect Depressed neglect
Severe neglect/deprivation Abuse and Neglect
Out-of-control care - hostile/helpless care
Sexual abuse Problem states of the
carer substance abuse, depression,
and domestic violence
31
Maltreatment and mentalisation
Maltreated children begin to experience their own
arousal as a danger signal for abandonment or
danger. This triggers hyper-arousal
(fight/flight), dissociation (freeze),
disorganisation, and non-mentalising functioning
The child has an image of themselves as
unmanageable and frightening a self which is
rageful, frightened, hating, and persecutory.
Fonagy
32
Trauma and stress pile-up Allen 2001
PAST TRAUMA afraid and alone
Sensitised nervous system
CURRENT STRESS reminders of trauma
Unbearably painful emotional states
RETREAT isolation dissociation depression
SELF-DESTRUCTIVE ACTIONS substance abuse eating
disorders self-harm suicidal ideation
DESTRUCTIVE ACTS aggression violence rages
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