Attachment Intro 2

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  • The attachment behavior system is based on evolution. It is, quite simply, an attempt by a vulnerable organism to survive.
  • INFANT ATTACHMENT BEHAVIRS1.Seeking Proximity- Infants seek security from adult attachment figure during times of danger, stress, and novelty. 2. Secure Base-Effective responses from attachment figures help promote a feeling of safety and wellbeing in the world, enhancing the infant/child’s capacity for affect regulation.3.Flight to attachment figure- Infants will flee to the attachment figure when they perceive threat.Observable elements are crying, proximity seeking, calling, clinging, searching
  • I. Secure attachment- Attachment figures are available responsive, protective, and comforting. Balanced view of early relationships, value attachment relationships, view attachment experiences as important in developmentII.Insecure attachment-If caregivers are unresponsive, unpredictable, or dangerous, children may develop states of chronic hyperarousal or hypoarousal. Affective disorders, addictions, and personality disorders often form as a way of coping with these chronically malfunctioning states of arousal. Insecurely attached individuals struggle with a chronic sense of incoherency. They fail to integrate memories of experience with assessments of the meaning of experience.
  • a. Insecure-Dismissing/Avoidant-Deny or devalue the impact of early attachment relationships, have difficulty with recall of specific events, often idealize experiences and usually describe an early history of rejection.b. Insecure-Preoccupied-Display confusion about past experiences, and current relationships with parents are marked by active anger or with passivity.
  • Insecure attachment is not necessarily caused by abuse. A caregiver who is depressed, anxious, or experiencing the aftereffects of trauma can contribute to insecure attachment in the infant.It has been shown that the single greatest predictor of a child’s attachment style is the attachment style of his/her primary caregiver.
  • The attachment system may develop in a number of ways, all of which directly affect biological functioning. If the attachment system develops in an environment in which the infants needs are not being consistently met, the infant may develop insecure attachment. In this case, it is likely that the infant’s fight or flight response engages often and the ventral vagal nerve is activated. This response sets the sympathetic nervous system in motion. In some individuals, this system is near-constantly turned on, causing severe anxiety and disproportionate reactions to normal, every-day stressors.If the attachment system develops in an environment in which the infants needs are rarely met, the infant may eventually “give up” and switch into a mode of despair. In this mode, the dorsal vagal nerve is activated, leading to states of hypoarousal. This is sometimes called “the death mode” in which hope for response is forsaken to the point that the organism enters a state mimicking death. Some individuals may switch between states of hyper or hypoarousal. This often manifests as disorganized attachment behaviors.In some individuals, the ventral-vagal “switch” is activated so often that it eventually “breaks,” leaving the individual in a state of chronic hyposarousal, which is the hallmark of sociopathy.On the bright side…due to neuroplasticity, the structures in the brain can be changed. Studies show that mindfulness training, a safe psychotherapeutic relationship, and exposure to individuals with healthy attachment can change brain structures and ANS functioning. The emerging field of interpersonal neurobiology is demonstrating how we are constantly shaping one another’s brains through our interactions.
  • Internal Working Model- The concept of who we are and what we are based on seeing ourselves in the eyes of others. For infants, the concept of the self is developed by gazing into the eyes of the primary caregiver. As we do so, mirror neurons are firing like crazy, creating a self based on how the other sees us.Experience- Through our experiences, our brain’s learn to respond in ways that promote survival. If we live in dangerous environments early in life, our brains may become amygdala-dependent, consistently leading with the most ancient, survival based mechanism in the brain. It is also the part of the brain least capable of reason. On the other hand, positive, novel experiences can teach our brains that it is possible to act in new ways and survive. We may also develop brains capable of thriving, not just surviving.Attention- By directing our attention to “notice our thoughts” and bodily sensations, we reshape the ability of the insula to channel information between the prefrontal cortex and the amygdala. By exercising the attention or mindfulness “muscle” we structurally enhance our brain’s capacity to respond rather than react.Use of Body- Neural circuits go two ways: from brain to body and from body to brain. The simple act of smiling can inform our brain that things are alright and help to soothe an aroused amygdala. Teaching our clients to engage in healthy body movements and to move their bodies in healthy environments can go a long way to improve client functioning. Dancing, drumming, hiking, and other exercise are excellent ways to improve brain functioning and overall psychological health.
  • It has been proposed that 90% of our experience of who we are is set into play during the the first two years of life, when the right hemisphere of the brain is developing. The left hemisphere will catch up much later and attempt to add words and logic to the experience accumulating on the right. When working with clients with attachment deficits, it is absolutely necessary to access right-hemisphere states. This is done through providing a sense of safety, empathy, attunement, affect magnification, and reflection. Mindfulness training and affective-reflective dialogue are hallmarks of attachment-focused therapy. One of the goals of treatment is to create new neural pathways between right and left hemispheres (lateral integration) and between the prefrontal cortex and amygdala (vertical integration). When clients gain the capacity to name bodily sensations while experiencing a heightened emotional state in the context of a safe holding environment, healing is happening!Treatment is nearing a successful conclusion when clients are able to create a coherent and meaningful narrative about their life history and traumas and use it as a foundation for future action.
  • Similar in concept to Freud’s “repetition compulsion,” the tendency to repeat early childhood attachment relationships later in life is actually a natural method employed by the psyche to heal past wounds.
  • This is a reciprocal attachment relationship, as opposed to the adult/child attachment relationship, in which there is an attached figure (child) and a caregiver.In order to foster secure attachment in romantic partners, each partner is encouraged to:1. Foster partner’s capacities2. Validate partner’s emotional life3. Foster feelings of assistance and alliance4. Foster feelings of competence
  • This approach is supported by Daniel Hughes, Diane Foshe, David Karen, among others.In this type of therapy, the clinician:Facilitates a sense of safety for all members of the family.Establishes safety with parents firstThen jointly provides sense of safety with the parents for the childrenEmpathically attunes to clients and help co-regulate emerging affectRequires emotional responsiveness, attunement, and acceptanceUse of voice, facial expression, and open communication about how therapist is affected by clientHolds the intention to understand the respective experience of each family memberCommunicates that there is no “right” or “wrong” experienceAssists the family to create a safer place for expression of all experiences
  • Schore, A.N. (2005).” A neuropsychoanalytical viewpoint: commentary on paper by Steven H. Knoblach.” Psychoanalytic Dialogues, 15, 829-854.Attachment and attachment therapy depends upon right-brain to right-brain intersubjective communications. Modern neuroscience demonstrates that our brains are literally shaped and reshaped by experience. Certain types of experience can actually increase or decrease the brain’s volume, structure, and functioning. Positive attachment experiences can occur at any time in life and reshape neural networks and brain functioning. This is the core of attachment-focused psychotherapy.Leaders in the field of neuropsychobiology include Allan Schore, Antonio Damasio, Daniel Siegel, Marion Soloman, and Bessel van derKolk. Excellent books for further reading on this subject are Healing Trauma, edited by Dan Siegel and Marion Soloman and Mindsightby Daniel Siegel. Another excellent book on how psychotherapy reshapes the brain is Louis Cozzolino’sThe Neuropsychology of Psychotherapy.
  • Parent/Child Assessment Informal Attachment Assessment Piccolo AssessmentCrittendon Relationships InventoryAttachment-Focused Family Therapy. PACE model – See HandoutIndividual Therapy AEDP Method established by Diane FosheParent/child attachment coaching Attachment coaching focuses on affective attunement, curiousity, empathy, spontaneity, attachment repair, and the development of affective-reflective dialogue.Psychoeducation The basis of attachment is taught, along with emphasis on mindfulness of one’s own affective states.
  • AAI-Developed In 1985 by Main et al, the AAI is consdered the gold standard of attachment measures. It may be used as an assessment tool; however, the administration of this tool works as an intervention in and of itself.Brief Attachment Assessment- This assessment can be easily administered in ten minutes or so and can give any caseworker a good picture of attachment dynamics within the family.Piccolo- Assessment of parent and child interaction that provides a score of attachment-related behaviors. This is a good tool for determining the severity of attachment difficulties between parents and children.CRI- This test may be taken and scored by computer and gives scores on attachment security as well as determines whether an individual has a primarily avoidant or preoccupied attachment style.
  • Systemic ChangeRequires shift in thinking from punitive to supportive, child focused modelDependent upon interagency collaboration Jackson County CourtsDepartment of Human ServicesChild AdvocatesAlcohol and Drug Treatment ProvidersMental Health Providers

Transcript

  • 1. Attachment Therapy
    Theory and Practice
  • 2. Attachment Theory
    John Bowlby
    Introduced the “Attachment Behavior System”
    This system has the primary and immediate responsibility for regulating infant safety in the environments of evolutionary adaptedness….it leads the infant to continually monitor the physical and psychological accessibility of attachment figures.
  • 3. Attachment Theory
    Mary Ainsworth- “The Strange Situation”
    “The Strange Situation”- Widely replicated experiment that studied infants’ interactions with their primary caregivers.
    Identified infant attachment behaviors
    Seeking proximity
    Secure base
    Flight to attachment figure
    The most important factor in the child’s developing psychological is not whether he/she has become attached, but how the attachment to the primary figure has become organized.
  • 4. Two Broad Categories of Attachment
    Secure
    Infant feels confident about the predictable response of the caregiver.
    Insecure
    Infant feels anxious about the unpredictable responses of the caregiver.
  • 5. Typesof Insecure Attachment
    Insecure-Preoccupied
    “Sometimes my caregiver meets my needs, but sometimes not, so I am anxious and will cling to her/him for reassurance.”
    Insecure-Avoidant
    “My security needs won’t be met, so I won’t look to my caregiver for reassurance. This would mean risking rejection.”
  • 6. Insecure-Disorganized
    “I have so much anxiety over my caregiver’s inconsistent (and sometimes threatening) responses, that I will seek out safety from anyonewho looks like they might meet my needs.”
  • 7. What Causes Insecure Attachment?
    • Unpredictable Caregiving
    • 8. Frightening or Dangerous Caregiving
    • 9. Unresolved States Within the Caregiver
  • Attachment is BIOLOGICAL!
    Attachment actually shapes many biological systems within the body.
    • Brain mass, volume, and functioning
    • 10. Autonomic Nervous System
    • 11. Heart
    • 12. Respiration
    • 13. Endocrine System
    • 14. Immune System
  • How are Brains Made?
  • THE GROWTH OF AN ATTACHMENT SYSTEM
    The explosion of right brain growth during the first two years of life is the basis of the attachment system. Right brain functions include:
  • Attachment theorists maintain that models of attachment develop initially in childhood relationships with parents and serve as prototypes for later relationships.
  • 25. AdultAttachment
    Mary Ainsworth (1991)
    “There is a seeking to obtain an experience of security and comfort in the relationship with the partner.”
    Romantic Partners can help each other develop secure attachment.
  • 26. Attachment-Focused Family Therapy
  • PACE Model of Parenting
    Playfulness
    Acceptance
    Curiosity
    Empathy
    The PACE parenting model rests on the principle that home should be a sanctuary…a safe haven for all. The rights of all members of the home, children and adults, deserve respect. The development of each person is encouraged without hurting the development of another.
  • 31. Allan Schore…
    “The essential biological purpose of intersubjective communications in all human interactions, including those imbedded in the psychobiological core of the therapeutic alliance, is the regulation of right-brain/mind/body states.” (2005)
  • 32. OnTrack’s Attachment Program
    Rationale: Research overwhelmingly show that children removed from their parents and placed in “better” environments fare worse than those who remain with their families of origin, however flawed they may be.
  • 33. OnTrack’s Attachment Program
    Goals:
    • Build parenting capacities
    • 34. Reduce attachment trauma
    • 35. Reduce intergenerational transmission of attachment-related disorders
    • 36. Reduce out-of-home placement of at-risk children
  • OnTrack’s Attachment Program
    Interventions:
    • Individual and Parent/Child assessment.
    • 37. Attachment-focused family therapy.
    • 38. Individual Therapy
    • 39. Parent/child attachment coaching.
    • 40. Psychoeducation in attachment for parents in treatment.
  • Tools
    AAI –Adult Attachment Inventory
    BAA-Brief Attachment Assessment
    Piccolo Assessment
    CRI-Crittendon Relationships Inventory
  • 41. Opportunities for Change
    Systemic Change
    Interagency Collaboration
    • Community partners working together towards the goal of reunification
    • 42. Recognition of common goals
    Recognition of Common Goal
    • Community partners recognize that we are all here to help children and families succees
    • 43. Foster parents mentoring bio parents
    • 44. Honoring bio parents’ cultural, social, and religious traditions when the plan is to return to parent
  • End
    Program Contact information :
    Elizabeth Fisher, OnTrack, Inc. (541)772-1777 ext. 53