Attachment in children

[ Attachment in children deals with the theory of attachment between children and their caregivers.

Attachment theory has led to a new understanding of child development. Children develop different styles of attachment based on experiences and interactions with their caregivers. Four different attachment styles have been identified in children: secure, anxious-ambivalent, anxious-avoidant, and disorganized. Attachment theory has become the dominant theory used today in the study of infant and toddler behavior and in the fields of infant mental health, treatment of children, and related fields.

Attachment Theory and Children
Attachment theory led not only to increased attention to attachments as a psychosocial process, it also led to a new understanding of child development. Freudian theory suggested that as libidinal drives fixed on different objects, former attachments would be broken; failure to break an attachment effectively would constitute a sort of trauma that could lead to later mental illness. Attachment theory, however, suggested that growing children did not break former attachments, but rather (1) learned to become more active (sovereign) within previously established attachments, and (2) added new attachments, which did not necessarily require a break with (and are not necessarily substitutes for) previous attachments.

Attachment theory assumes that humans are social beings; they do not just use other people to satisfy their drives. In this way, attachment theory is similar to object relations theory.

Attachment styles in children
On the basis of their behaviours, the children can be categorized into four groups. Each of these groups reflects a different kind of attachment relationship with the mother. (It should be noted that Bowlby believed that mothers were the primary attachment figure in children's lives, but subsequent research has confirmed that children form attachments to both their mothers and their fathers.

The most researched method for assessing an infant or toddler's style of attachment with a care giver is the Strange Situation Protocol, developed by Mary Ainsworth (see Patterns of Attachment).

Bowlby, like many of his colleagues at the time, infused the gender norms of the day into otherwise "unbiased" scientific research.) Modern studies use a variety of standardized interviews, questionnaires, and tests to identify attachment styles. The most commonly used procedures for children are the Strange Situation Protocol and various narrative approaches and structured observational methods. A frequently used method of assessing attachment styles in adults is the Adult Attachment Interview developed by Mary Main and Erik Hesse. Attachment styles in adults can also be assessed using a questionnaire developed by Shaver and colleagues. All of these methods can be used to classify people into the classic attachment styles described below.

Readers curious about their own attachment style can take the questionnaire developed by Shaver and colleagues at http://www.web-research-design.net/cgi-bin/crq/crq.pl.

Secure attachment
A child who is securely attached to its parent will explore freely while the parent is present, will engage with strangers, will be visibly upset when the parent departs, and happy to see the parent return.

Securely attached children are best able to explore when they have the knowledge of a secure base to return to in times of need (also known as "rapprochement", meaning in French "bring together"). When assistance is given, this bolsters the sense of security and also, assuming the parent's assistance is helpful, educates the child in how to cope with the same problem in the future. Therefore, secure attachment can be seen as the most adaptive attachment style. According to some psychological researchers, a child becomes securely attached when the parent is available and able to meet the needs of the child in a responsive and appropriate manner. Others have pointed out that there are also other determinants of the child's attachment, and that behavior of the parent may in turn be influenced by the child's behavior.

Anxious-ambivalent insecure attachment
A child with an anxious-resistant attachment style is anxious of exploration and of strangers, even when the parent is present. When the mother departs, the child is extremely distressed. The child will be ambivalent when she returns - seeking to remain close to the parent but resentful, and also resistant when the parent initiates attention.

According to some psychological researchers, this style develops from a parenting style which is engaged but on the parent's own terms. That is, sometimes the child's needs are ignored until some other activity is completed and that attention is sometimes given to the child more through the needs of the parent than from the child's initiation.

Anxious-avoidant insecure attachment
A child with an anxious-avoidant attachment style will avoid or ignore the parent - showing little emotion when the parent departs or returns. The child will not explore very much regardless of who is there. Strangers will not be treated much differently from the parent. There is not much emotional range displayed regardless of who is in the room or if it is empty.

This style of attachment develops from a parenting style which is more disengaged. The child's needs are frequently not met and the child comes to believe that communication of needs has no influence on the parent.

Disorganized attachment
A fourth category termed disorganized attachment is actually the lack of a coherent style or pattern for coping. While ambivalent and avoidant styles are not totally effective, they are strategies for dealing with the world. Children with disorganized attachment experienced their caregivers as either frightened or frightening. Human interactions are experienced as erratic, thus children cannot form a coherent interactive template. If the child uses the caregiver as a mirror to understand the self, the disorganized child is looking into a mirror broken into a thousand pieces. It is more severe than learned helplessness as it is the model of the self rather than of a situation.

This was not one of Ainsworth's initial three categories, but identified by Mary Main in subsequent research.

The relationship between disorganized attachment and the diagnosis of Reactive attachment disorder is complex and is more fully discussed in the linked article, Disorganised attachment and reactive attachment disorder

Attachment and Treatment
Attachment theory has become the dominant theory used today in the study of infant and toddler behavior and in the fields of infant mental health, treatment of children, and related fields. Several evidence-based and effective treatments are based on attachment theory including Theraplay and Dyadic Developmental Psychotherapy. In fact nearly all treatments for children with trauma and attachment difficulties are based on attachment theory today. Nearly all mainstream programs for the prevention and treatment of disorders of attachment attachment disorder use attachment theory. For example, the Circle of Security Program, (Dr. Robert Marvin, University of VA) is one such early intervention program with demonstrated effectiveness. Dr. Marvin and Dr. Siegel (University of California) both also endorse Dyadic Developmental Psychotherapy Other promising treatment methods include the Circle of Security Program of Dr. Robert Marvin at the University of Virginia, Developmental, Individual-difference, Relationship-based therapy (DIR or Floor Time) by Stanley Greenspan.

Dyadic developmental psychotherapy is an evidence-based treatment(1) approach for the treatment of attachment disorder and reactive attachment disorder. The treatment is based on sound clinical principles and uses methods, techniques, and approaches that have strong empirical evidence, such as relationship and unconditional positive regard. Children who have experienced pervasive and extensive trauma, neglect, loss, and/or other dysregulating experiences can benefit from this treatment. Dyadic Developmental Psychotherapy is based on principles derived from Attachment theory and Research; see the work of Bowlby. The treatment meets the standards of the American Professional Society on Child Abuse, The American Academy of Child Psychiatry, American Psychological Association, American Psychiatric Association, National Association of Social Workers, and various other groups' standards for the evaluation and treatment of children and adolescents. This is a non-coercive treatment.

Various organizations have adopted standards against the use of coercive interventions: APSAC, the American Academy of Child and Adolescent Psychiatry, the American Psychological Association, the American Psychiatric Association, the National Association of Social Workers. All of the aforementioned organizations have adopted formal statements (in some cases practice parameters) opposing the coercive treatments. Recognized professional organizations have been unanimous in recommending against the use of coercive treatments. Circle of Security, Theraplay, Dyadic Developmental Psychotherapy, and others being non-coercive approaches, meet these standards as evidenced by the support of Dyadic Developmental Psychotherapy by Dr. Daniel Siegel of the University of California at LA medical school and author of The Developing Mind, among many other articles and books and Dr. Robert Marvin of the University of Virginia Attachment Clinic.

Recommended Reading

 * Ainsworth. M.D.S., Blehar, M.C., Waters, E_ and Wall, S. (1978) Patterns of Attachment: a Psychological Study of the Strange Situation. Hillsdale, NJ: Lawrence Erlbaum.
 * Becker-Weidman, A., & Shell, D., (Eds). (2005) Creating Capacity for Attachment Wood N Barnes, Oklahoma City, OK. ISBN 1-885473-72-9
 * Cassidy, J., & Shaver, P., (Eds). (1999) Handbook of Attachment: Theory, Research, and Clinical Applications. Guilford Press, NY.
 * Greenberg, MT, Cicchetti, D., & Cummings, EM., (Eds) (1990) Attachment in the Preschool Years: Theory, Research and Intervention University of Chicago, Chicago.
 * Greenspan, S. (1993) Infancy and Early Childhood. Madison, CT: International Universities Press.  ISBN 0-8236-2633-4.
 * Holmes, J. (1993) John Bowlby and Attachment Theory. Routledge. ISBN 0-415-07730-3.
 * Holmes, J. (2001) The Search for the Secure Base: Attachment Theory and Psychotherapy. London: Brunner-Routledge. ISBN 1-58391-152-9.
 * Karen R (1998) Becoming Attached: First Relationships and How They Shape Our Capacity to Love. Oxford University Press. ISBN 0-19-511501-5.
 * Zeanah, C., (1993) Handbook of Infant Mental Health. Guilford, NY.
 * Parkes, CM, Stevenson-Hinde, J., Marris, P., (Eds.) (1991) Attachment Across The Life Cycle Routledge. NY. ISBN 0-415-05651-9
 * Siegler R., DeLoache, J. & Eisenberg, N. (2003) How Children develop. New York: Worth. ISBN 1-57259-249-4.
 * Sturt, SM (Ed) (2006). New Developments in Child Abuse Research Nove, NY. ISBN 1-59454-980-X
 * Bausch, Karl Heinz (2002) Treating Attachment Disorders NY: Guilford Press.