Impact of Broken Attachment

Posted by admin on April 8, 2013

Ok…we’ve now talked about what both healthy attachment and broken attachment look like.  Today, we’re going to spend a little time talking about the impact that broken attachment has on kids.

 
I’ve been around the block a few times now.  Because of the nature of what we’ve had to deal with in regards to our boys, I’ve had to learn a lot about this subject of attachment in order to survive.  I gotta tell you friends, the more I’ve learned and lived with it and worked to help my boys, the more I’m astounded that a) this isn’t taught in most colleges or during foster/adoptive trainings b) that more people involved in working with or parenting hurt kids don’t feverishly research this subject and c) I’m even more jaw dropping astounded that so many people are still content to live in denial about this stuff!  Even with all the great information that’s out there, I still continue to see SO many families, especially foster and adoptive families and those who serve them, not taking attachment anywhere seriously enough.  And that’s why I write about it. J
 
The common perception I still hear so very often – both from within and outside the adoption community is that *if* they know anything about attachment at all, they believe the attachment spectrum looks something like this:  there's secure attachment and then there's RAD...with some kind of nebulous gray matter in between.

 RAD_not_1.jpg
 
Even though attachment is an issue that affects every single human being that’s ever walked the planet, 90% of the world has never even heard of it. For 9.5% of the remaining population who have, it is still generally assumed to be just an adoption issue and/or that once a child is placed in a loving family and given the best of everything, children will be resilient, grateful, all that trauma stuff won’t matter, and attachment will just happen on its own. (And every parent who’s raising an attachment challenged child just laughed!) It’s almost as if the same principles of “innocent until proven guilty” apply to attachment. Unless there’s something big that happens to prove their children aren’t securely attached, it is assumed they are.
 
That’s all well and good and sounds nice on paper. Except that’s not the way attachment really works.

 RAD_not_2.jpg
 
But this is...
 
 RAD_1.jpg
 

Attachment – either healthy or unhealthy – falls on a spectrum, or a sliding scale. On one end you have healthy and secure attachment. This is the type of attachment you see in infants and children who are loved, cherished, and wanted from conception.  These children have devoted parents who either intentionally or maybe even seemingly by instinct met the needs of their precious little one during their infancy and early childhood.

On the other end of the spectrum, you have personality disorders.  These disorders aren’t diagnosed until adulthood and are extremely difficult to treat (IF they can be fully treated at all.) Very often, there is a strong correlation between personality disorders and untreated trauma and attachment problems earlier in life.

And then you have everything else in the middle. Notice that diagnosable Reactive Attachment Disorder (RAD) area takes up a significant portion of the spectrum. That's because there varying degrees of severity and manifestation of it.  You’ll also notice that in the grand scheme of things, secure and healthy attachment actually only occupies a very small portion of the spectrum. This is because a child is either securely attached or they are not. If they are not, they will fall somewhere in the attachment disorder spectrum.
 
So what is it that would cause the shift from a healthy and secure attachment to attachment problems? Broken attachment.  Plain and simple.  Something went wrong during the first few years of life (with the first two years being the most critical) that disrupted and/or completely severed the progression of the natural attachment cycle.  So really, the attachment spectrum should look more like this.

 RAD_2.jpg

Pretty much anything that causes a long term physical or emotional separation of a child from their first primary caregiver constitutes a break in attachment.  Some things that could cause this level of  separation and disrupt the attachment cycle include things like:
 

  • Abandonment/Institutionalization
  • Death of a parent
  • Adoption
  • Emotionally unavailable adults (both before and after birth)
  • Medical trauma (long term illness and/or hospitalization)
  • Undiagnosed/untreated painful child illness that can’t be soothed (colic, ear infections, etc)
  • Premature Birth
  • Poor prenatal care
  • Young mothers with poor parenting skills (especially if they have little support)
  • Military deployment of a parent
  • Caregiver depression or substance abuse
  • Abuse of any kind
  • Neglect (physical and emotional)
  • Inconsistent care (sometimes it’s there, sometimes it isn’t)
  • Multiple caregivers
  • Frequent moves or placements (foster care)
  • Autism
  • And the list goes on...
 
 Regardless of how the break happens, broken attachments distort and/or destroy a child’s ability to form deep, authentic, and lasting relationships with anyone.  This may manifest itself early in childhood through severe behavior problems…problems that may appear deliberate, but are really the child’s natural defense mechanism.  They already know at a core level (even if they don’t know it at a conscious level) that being rejected and abandoned is the most painful thing a human could ever experience.  As such, they become determined never to let anyone close enough to hurt them again
 
One of my boys manifest this right from the start.  We had NO honeymoon with this child.  From day one he was more interested in what food I brought and what was in my bag than me.  Looking back, and knowing what I know now, this child had never, ever attached or connected with another human.

Even though it might appear to be a natural instinct, it is not. It is a learned skill that comes from thousand of iterations of the healthy attachment cycle.  My son was absolute evidence of that.  When we first met him, life was all about insuring his physical needs were met.  He was always far more interested in what was in my bag than he was in playing with us.  If we were doing something that met his needs, he would engage with me and my husband.  Otherwise, he played much better with our daughter.  When we tried to get close or impose boundaries, he did everything he could to be naughty, evasive, aggressive, silly, prove he was in control, push us away emotionally, or shut down and make us not want to get close to him.  Yet at the same time, this child was and still is so very, very, VERY scared of being hurt, of losing me, and that he will once again end up in a place where no one will take care of him.
Not all kids manifest their stuff outwardly, though.  My other son didn’t (or at least not for long.)  He was touted as being very compliant, quiet, and preferring the company of adults to children.  Imagine our surprise when we took him out of the orphanage and he moved in with us.  We saw a TOTALLY different child.  All of the sudden we had over the top behavior problems that we weren't in any way, shape, or form prepared to deal with.  It was all stuff we’d never seen or experienced before.  Again, knowing what I know now, I can so clearly see that it was all driven by fear.  Fear of rejection, intimacy, authority, and the unknown.  Even though we were still in Ukraine at the time, everything was completely new to him...us, our American ways, our language, the city, the hotel, and yes, even much of the Ukrainian culture and foods were new to him.  Once he learned that boundaries exist, where they are, and what happens when you cross them, he settled back down.  He was back to being compliant (but still quite passive aggressive) while we were around, but often reactive when we weren’t.   He welcomed and gave affection most of the time.  But, he was still pretty prone to defiance and both being a bully to and being bullied by other kids.
 
I’ve since seen many, many, MANY families in the same situation. They don’t realize the problems are there or that they are as deep and significant as they really are until MAJOR problems start surfacing in the tween and teen years.  Of course, by then, the kids are naturally more resistant to anything adults think is a good idea anyway, which only makes treatment and the ability to reach these kids all the more difficult.
 
As I mentioned earlier, attachment is a human issue, not just an adoption issue.  Unfortunately, as society’s values shift, abuse becomes more prevalent, and families continue to disintegrate and become more and more emotionally disconnected with each other, I believe that insecure and disorganized attachments even among bio kids are becoming more common. Kids are being bounced back and forth between parents, foster homes, and/or are growing up in day care and after school programs.  If you don't believe me that things have a huge impact on kids, go spend a little time in any school classroom or playground and watch how kids behave when their parents aren’t around. It’s deplorable! And the adults are to blame!! Unfortunately, most people just see these kids as “difficult”, "spirited" or "bratty" kids who are making bad choices. They’re not seeing the hurt kids who are being forced to grow up way too quickly and have never learned how to engage in healthy relationships because they don’t have descent role models to show them the way.
 
Does that mean I believe that all adopted children have RAD?  No!  Many kids, even kids like mine who hadn’t ever been attached to another human being prior to their adoption or who’d only had inconsistent care at best, will eventually be able to heal and form healthy and functional attachments. That healing will create a bridge that will allow them to live and function very close to normally.
 

RAD_3.jpg Regardless of how perfect the kids seem or how ideal the situation surrounding their adoption may have been, EVERY adopted child (or any other child who isn't living with the woman who birthed them) has still experienced a broken attachment. At some point in their lives, that broken attachment IS going to be a big deal, too.  It might show up when they’re kids or it might not be until they are teens or young adults and start to wrestle with their own identity. Just like shattered glass, even when those attachments heal and are functionally strong, they will never look or feel exactly like an attachment that’s never been broken.
We’ll be talking about some of the specifics of attachment problems and disorders in later posts. To wrap things up for this one, though, the long and the short of it is that attachment is serious stuff.  For better and for worse, it has a lifelong impact.  If you’re parenting a child who has experienced any form of broken attachment, take it seriously.  Treat it seriously, even if you’ve never had “big” problems.  Learn all you can about attachment.  Seek help and practice therapeutic parenting techniques.

No matter how awesome and how amazing your family is now, and no matter how much love you pour into these kids, if you’re parenting a foster or adopted child who has had multiple attachment breaks or has experienced multiple things that cause them (such as neglect or abuse on top of abandonment), and ESPECIALLY if you’re parenting a child who was institutionalized (even just for a relatively short time) or was bounced around the system or between various relatives at all during their first few years, your child is at very high risk of having attachment problems.  That risk level is so high that it's almost safe to assume they DO have some kind of attachment issues that will need to be recognized and properly addressed.   If that same child experienced significant trauma on top of their multiple attachment breaks, that risk increases even further...really, almost to the point that it's a given.   
 

It really doesn't matter if your child been formally diagnosed with attachment problems or not.  The whole diagnostic thing has it's own set of problems anyway (which we'll talk about later.)  It's kind of like that age old question "If a tree falls down in the forest and no one was there to see it or hear it, did it really fall down?" Of course it did.   It likewise doesn’t matter if the symptoms are manifest externally or internally or are obvious or subtle.  A break is a break is a break.  Just as you wouldn't expect a broken arm to heal properly on it's own without some kind of intervention, it's kind of naive to think broken attachments will heal properly if ignored.  The sooner those problems are recognized, accepted for what they are, and they are appropriately treated through parenting and/or therapy if necessary, the more likely it is that the children will be able to heal and have functional, healthy attachments and all types of relationships throughout their life.

-Diana (who blogs at From Survival to Serenity)

Comments Welcome

Posted by Debbie Dixon on
Thank you very much for your insight.
Posted by Fred on
There are so so so many kids who experienced trauma and neglect, were exposed to drugs/alcohol in utero, had broken or no attachments and turned out FINE --- my BFF (daughter of an alcoholic, bounced around foster care til age 16) and her little sisters among them! BFF is now a doctor, both her sisters were college graduates before their 23rd birthdays! Despite the worst possible conditions in utero and afterwards!! My fave blogger, an aged-out foster kid (also the daughter of an alcoholic) called Rebeka Geer is a Horatio Alger scholar, will graduate from the University of Georgia next month at the ripe old age of 21 and gave an awesome TED Talk about her foster care experience a few weeks back: http://rebeka21.tumblr.com/

The fact that your neglected kids aren't doing so well doesn't mean that LOTS of equally mistreated kids will face similar challenges.

It's possible that the entire medical establishment (all licensed providers - doctors, nurses, psychiatrists, PTs, OTs, etc) knows nothing about trauma and attachment -- and the importance of both when caring for kids. But it's equally possible that those providers understand it just fine and you just don't like the answers you're given. That healthcare providers who disagree with the "therapeutic parenting" approach that many self-proclaimed trauma mamas practice (based on Heather Forbes, Katherine Leslie, Karen Purvis) might have a rational basis for doing so. At the very least SOME providers *do* - and give solid treatment plans, based on peer-reviewed, evidence-based, peer-reviewed studies. It's impossible that every single healthcare provider you encounter is stupid, ignorant or both about attachment/trauma.

(It's kinda like finding a bug in your salad at every single restaurant you go to -- at some point you should clue into the fact that the bugs are on *you*, ie you have bugs and every salad you encounter has bugs in it BECAUSE of this).

This "therapeutic parenting" business - does it involve giving your kid "time-ins", permission to destroy stuff, encouragement to poop/pee in inappropriate places (to take away the thrill of the forbidden) and/or micromanaging your kid's encounters with the world at large (ie going postal if the sunday school teacher gives your kid a candy bar, freaking out if your kid's teacher fails to alert you that there will be a fire drill on Tuesday, cutting people who love you and your kids lives if they violate one of the billion dictatorial edicts you've told them to follow)?? Have you considered that *your* the unreasonable one?? That perhaps every teacher/doctor/relative isn't out to get you??

It's a free country and you're certainly welcome to adopt any parenting approach you like and cut folks out of your life for any reason (life/death critical or simply whimsical)... but it's worth noting that many alcohol/drug-exposed, abused and neglected kids (Rebeka Geer, BFF and her sisters, among others) have done super-duper well using an approach that differs significantly from *your* "therapeutic parenting" efforts.

How are *your* kids doing relative to the successes of differently-parented kids from "hard places"? Are they on an equally successful track??

Here's a fun little mental health riddle -- involving kids who experienced significant trauma who demonstrate behaviors that sound *exactly* like RAD + FASD. But are caused by something else entirely (according to prestigious, peer-reviewed journal Science):

http://www.reformtalk.net/2013/03/10/mental-health-riddle/
Posted by Rachel on
Fred, I wanted to take a minute and back you up a bit, I think we are on the same page. I am the director of BeTA and an adoptive mother of many. I couldn't agree with you more that so many kids growing up in horrible situations are able to rise above it and do better for themselves. Most of my children are healing from their traumatic histories and I fully expect them to go onto college and live very satisfying and full lives. They are amazingly strong, like your BFF. I also have their siblings and 2 are not doing well. They verbalize that they do not have feelings towards anyone and can feel a difference between what they view others feeling. They want it for themselves.

I agree with you that not all kids are suffering with attachment disorders just because they are coming from traumatic lives. Not all kids that are adopted struggle with this. I think the extreme kids are the exception. I think their families are lucky to find other families struggling. My personal goal is to help those families find appropriate ways to help their families. I do not support many of the treatments and therapies that are out there. I personally think they can hinder attachment. I do NOT force my children into doing what I want them to do. I focus more on finding ways to have fun, express their feelings and thoughts appropriately, building a healthy relationship together in whatever way my child wishes and can handle, and providing a safe home to do that. I have higher expectations about my own actions and model appropriate boundaries and behaviors. I allow them to make huge mistakes without shaming them. I am considered by everyone that has personally viewed my parenting style to be very laid back, committed, accepting, protective, open, and loving. I have tried other ways but this is what works best for me and my children. I believe in natural consequences not punishments. My children learn more through conversations than through strong sitting, restrictions, and lectures.

With all that said, I know desperate families that have been willing to try all the other ways in order to help their families. (I will not be liked much for things I say here but I feel strongly it needs to be said.) These moms come looking for help to fix their kids when what really needs to be fixed is their expectations and reactions to the child. I have seen it myself. I also have been strong enough to say it to them. I will always be willing to put myself out there and tell a mom that she is doing damage to her relationship and/or her child. I have no problem telling a mom she needs to look at herself and try a different way because her's is not working or is mean spirited. I have told mothers that they may not be the right mom for a child based on their comments and complaints. I think the truth can be said in a supportive way that doesn't make them defensive. Believe it or not, this is what is happening in our support groups and our retreat. I have seen groups that are all about supporting moms and their delusions that the problem is all the child or that they are always right. We are NOT that kind of group. Every mom that has stayed has been thankful for the honesty and taken a hard look at themselves. Most have made changes trying to be a better parent for their child not increased their expectations for their child to be a better child.

I know many moms and therapies think that they need to be the one in control of their kids. Like you said, micromanage every move. I am not that parent. I do not feel that is healthy. I can't say I haven't tried it because I have. I was desperate. It felt unnatural to me. I prefer to take a step back and let my kids have the control of most areas in their lives. They are happier and trust me far more when I do step in to help them make a decision. I had to give up MY control issues to show them they were safe and be a good role model for them. I make huge mistakes. I show them how to apologize and make amends. I talk about my feelings and thoughts and ask theirs. Over time, they have chosen to follow to my lead.

When I agreed to take over ETAAM, I had to stop and think about what my visions for this group is. We changed the name to Beyond Trauma and Attachment and added some online support groups to reach more families. My vision is to provide support, honesty, and education. I knew some would stay and some would go. I had to be OK with that. I am. We can't help everyone. We can only help those that are willing to step out of their comfort zone. My philosophy is that when we know better, we do better. I welcome your thoughts and experience. I think it is vital to our growth to surround ourselves with people that disagree with us. It's a great way to learn. I want to hear from you. I would prefer it to be in a respectful way but you do not have to agree with me. I don't always agree with the blog posts here. I love that we can put it out there and talk about it.

I am open to further discuss anything any of you wish through email, as well. It's on the front page. Enlighten me any time.
Posted by Jim Lewandowski on
Perfectly written. I also am amazed that this information isn't on cable TV 24x7. Newtown shooting: likely (not guaranteed) a severe attachment rupture between him and his mother. The examples go on and on.

This book goes into new research of 2 add'l (fearful-avoidant already present and accounted for) "disorganized" subtytes of the 3 primary attachment categories.

http://www.amazon.com/Disorganized-Romantic-Attachment-Integrative-Model/dp/3639123239
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