If your child is suffering from moderate to reactive attachment issues, you have undoubtedly suffered too. Attachment disorder can be profoundly painful for parents because it impacts their ability to have reciprocal closeness and connection with their child. Without consistent, predictable or healthy care-giving during infancy, a child’s learned and neurological ability to connect with others can be moderately to severely impaired.
Many parents who adopt are unaware of the trauma or neglect that may have occurred during their adopted child’s infancy, either in an orphanage or the family of origin. They wait a long time to meet the child. Like any eager parent-to-be, there is anticipation, dreaming and excitement; parents who are adopting because of their own inability to bear children may experience even greater, and more fragile, anticipation of the joys of parenting. When they realize that this beautiful child they love is not equipped to connect or to love back in the manner they’d hoped, it can be shattering and confusing. And because attachment issues have both a cognitive and developmental dimension, they don’t just go away. They can create chronic difficulties for the child and those around her through childhood, adolescence and adulthood.
InnerChange therapist and assistant clinical director Jeana Thomsen, LCSW, has worked with many families and adolescents struggling with attachment issues. While she acknowledges the incredible challenges parents face when their child has an attachment issue, she knows that with the right support, many families can experience hope and healing. Thomsen offers the following thoughts on both the challenges and the possibilities facing those suffering from attachment disorder.

What is uniquely challenging about working with attachment disorder?

There are several things that make working with kids with attachment disorders challenging. One of them is that attachment disorders are often masked by other issues. Kids who have attachment disorders often act out sexually, through substance abuse, and/or by cutting themselves. It is easy to become focused on these behaviors and miss the underlying attachment issue. Another reason that working with attachment disorders is difficult is because kids with attachment disorders struggle fundamentally with connection and relationship. Effective therapy depends upon a positive relationship between the therapist and client, and sometimes these kids don’t know how to participate in that kind of relationship. Often they don’t trust adults; this mistrust, of course, creates an obstacle to working on their attachment issues.
Once the child with an attachment disorder starts feeling close to another person, they often pull away or push the other person away. They have been hurt by relationships in the past and assume that all relationships will end, so they would rather be the one who ends the relationship than have it ended by the other person. This push and pull experience is very difficult for the person on the other end. Often the “recipient” of the pushing and pulling gets frustrated and reaffirms what the child feared all along, that people are going to become frustrated with them and potentially leave them.
All of the things I mentioned above are difficult for parents as well as practitioners. One of the hardest things for parents is that they usually had hoped and prayed for this child, finally had the child and were so excited, and then feel terribly saddened by the difficulty they are having with this child. Adoptive parents have a double dose of pain with infertility and the difficulty their child has later on. Another very hard thing for parents who have kids with attachment disorders is that the parents get pushed and pulled by the child more than anyone else does.

What are some effective approaches for treating attachment disorder?

One of the most helpful things to teach kids and families is a new way of doing relationships. When there is a break in a relationships (and there are many), there needs to be a repair. Connection-Break-Repair. This model teaches the child that relationships are going to be damaged at times, but it doesn’t mean that all is lost. They can work through the relationship by apologizing and making any other necessary repairs and then moving on. This also helps the parents because they learn that there will be breaks, but that the whole family can move past them.
I’ve also had parents tell their adopted children what they would have said at their child’s birth had they been there. This imaginative, heart-based exercise has been really healing for both children and parents.
Helping an adolescent establish her identity as a human being with strengths, talents, and people who love her is also helpful because many kids with attachment struggles view themselves as “broken,” “not good enough,” “unlovable,” “replaceable,” etc. We work with kids to identify this deep negative belief they have about themselves (core issue), work through the pain of it, and then help them establish a deep positive belief about themselves (core meaning). We help them learn to believe the core meaning more than the core issue.

How do parents factor into the treatment equation?

Several of the things listed above relate to this. Parents can also journal for their children. Some examples of this journaling would be: how the parents felt the first time they saw their child; what they did during their first week of life; how they felt when they found out they would be able to adopt; how much they loved their child instantly; that the child’s worth was never dependent on their behavior- that the child has inherent worth. This would be especially helpful if the child is shut down and unwilling to talk. It gives her something that is tangible, that she can read over and over again and that is reassuring. Parents can make scrapbooks for their children documenting their time together, this shows love and dedication; it’s another tangible reminder that the parents have always been there for their child. Home videos would work this way as well.
Despite the pain and difficulty many of our parents have experienced with their child, their love turns out to be the most powerful resource we have in the therapeutic process. We work to empower parents to express this love in increasingly powerful and effective ways, and the results can be profound.