Attachment: It Takes Two, At Least

Attachment: It Takes Two, At Least

A look into the over-use of the label
"Attachment Disorder"

By Joyce Maguire Pavao, Ph.D.

Attachment is a popular word in the world of foster care and adoption. The difficult thing is that it is being used in a pathologizing manner that is not helping kids, but rather, hurting them.

Of course the children who are fostered after abuse, neglect, war, several foster placements, domestic abuse and addictions by birth parents during pregnancy are all going to have more difficulty with attachment than a child who has not had those experiences — in utero and out.

Did you know that even children born into a great and untraumatized family life can have attachment issues? Someone may have four children by birth, and the third child may have some difficulty with attachment.

So why, all of a sudden, does every child who is in foster care or adopted, who has any problems at all get labeled as having “attachment disorder?”

All humans have to attach. We are, after all, inter-relational beings. So, why is it that we never look at the attachment style of the adults when we are seeking a placement for a child?

Why is it that we never do the work to help the parent to attach with the child at placement, and at post-placement visits, rather than waiting years and years until parents then say, “I was ill prepared for a child with trauma and I never understood this child?” If we are inadequately working with adopting parents in the attachment department, we are far more inadequate in working with the fostering parents to support attachment for the child.

Many children are resilient and they can learn to reattach. We used to think that if children were completely and totally detached from their birth families and birth countries they would be more available — like a clean slate — to attach to their “new” family. We now realize that a sign of good attachment is learning to attach, and trusting that attachments can happen again and again. This is why we try to keep the relationships that are not dangerous for a child, in the child’s life in some way, through contact that is safe and visitations that are clinically appropriate. Once an attachment bond is formed, the child can learn to elicit appropriate attachment behavior from his and her caregiver. Most individuals experience some trauma during their childhood. However, children are learning constantly, and as a result they are often quite resilient following these traumatic events.

Sometimes children’s reactions occur by learned associations or triggers. It is helpful for parents, or other caregivers, to help the child to identify these triggers. Some of the child’s associations lead to tantrums. Abused children, for example, often suffer feelings of anxiety, shame, embarrassment, anger or pain. These feelings often do not go away, and may be associated with other things. It is important to observe your child for what occurs prior to, and after the problem behavior occurs. It is also important for the adults to be able to reflect on their own reactions, and what things happen prior to and after their buttons are pushed. The consequences that follow a behavior influence whether or not the behavior is likely to be repeated. It is important to give a child attention for positive behavior, and to sometimes ignore negative behavior when possible and appropriate.

In some foster and adoptive families, the parents are new at this, and are not wanting to discipline too much as a child is settling in. It is usually important to help parents to identify bottom lines for what is “allowed” and to start from the beginning to give the child a sense of safety, by knowing what the rules are in this new environment. It seems counterintuitive to set boundaries for a child as you are trying to attach, and yet it is this clarity, and these boundaries, that will be evidence of safety to the child. If a parent waits months — and sometimes years — to start setting limits, the child will already have had to develop his or her own way to behave in order to feel safe, and some of these behaviors will not be ones that are well liked by the parents.

The consequences that children want to achieve when they are behaving poorly are generally reasonable if understood. It is the child’s means of achieving the consequences that are problematic. When you know what motivates your child’s negative behavior, you will be more likely to change the behavior by teaching the child the appropriate positive behaviors. This is difficult for parents, who did not parent the child from the beginning, or who are temporary caregivers, but it is not impossible and it is essential to positive attachment and a feeling of safety.

At Center For Family Connections we believe in a preventive approach to attachment problems. We are eager to help the parents to understand their own attachment styles and some strategies and models for successful redirecting of a child’s problematic behavior. Children do not have attachment “disorders,” they have attachment difficulty because of the chaotic and complicated lives they have lived prior to their current placement.

The fantasy of immediate bonding and attachment is quite rare in fostering and adoption, and sometimes doesn’t happen with a child by birth. We need to help new parents understand that not only does it take “two to tango,” but it takes time to deconstruct old patterns and reconstruct a new life for the child and family.

ABOUT THE AUTHOR: Joyce Maguire Pavao, Ed.D., LCSW, LMFT, is the founder and CEO of Center For Family Connections, Adoption Resource Center, Pre/Post Adoption Consulting Team, and Family Connections Training Institute. She is a clinical member and approved supervisor of the American Association of Marriage and Family Therapy, clinical member of the American Orthopsychiatric Association, and clinical member of the American Family Therapy Association. She is currently on the Practice Board of the Evan B. Donaldson Adoption Institute in New York. BY JOYCE MAGUIRE PAVAO, PH.D.

© 2004 Fostering Families TODAY magazine, all rights reserved.