Monday, January 28, 2013

With or Without BPD - Attachment Styles: Children

Oh attachment. I’m quite attached to all of you dear Readers. I hope you know I appreciate you. Let’s get back to attachment shall we?
Attachment is simply that recognition of a connection that you have with someone. Or should have with someone, like say, a parent or caregiver. John Bowlby devoted extensive research to the concept of attachment, describing it as a "lasting psychological connectedness between human beings" (Bowlby, 1969, p. 194). [1] Bowlby believed that there are four distinguishing characteristics of attachment:
 
Characteristics of Attachment
1. Proximity Maintenance - The desire to be near the people we are attached to.
2. Safe Haven - Returning to the attachment figure for comfort and safety in the face of a fear or threat.
3. Secure Base - The attachment figure acts as a base of security from which the child can explore the surrounding environment.
4. Separation Distress - Anxiety that occurs in the absence of the attachment figure.
However when there are developmental issues in the relationship between caregiver and child, attachment becomes faulty.  Infants and children don’t just one day make a decision and choose to not attach. It’s learned. When a parent or caregiver is negligent of the childs needs, that child learns that someone is unreliable, that they can’t trust them to be there to provide for their basic human needs. They don’t learn to trust. They don’t learn to attach. If this is left alone, worsens, or is never given a chance to heal it can become a disorder of attachment.
“Drs. Boris and Zeanah use the term "disorder of attachment" to indicate a situation in which a young child has no preferred adult caregiver. Such children may be indiscriminately sociable and approach all adults, whether familiar or not; alternatively, they may be emotionally withdrawn and fail to seek comfort from anyone. This type of attachment problem is parallel to Reactive Attachment Disorder as defined in DSM and ICD in its inhibited and disinhibited forms [we’ll talk about this specifically later].
Drs. Boris and Zeanah also describe a condition they term "secure base distortion". In this situation, the child has a preferred familiar caregiver, but the relationship is such that the child cannot use the adult for safety while gradually exploring the environment. Such children may endanger themselves, may cling to the adult, may be excessively compliant, or may show role reversals in which they care for or punish the adult.
The third type of disorder discussed by Drs. Boris and Zeanah is termed "disrupted attachment". This type of problem, which is not covered under other approaches to disordered attachment, results from an abrupt separation or loss of a familiar caregiver to whom attachment has developed. The young child's reaction to such a loss is parallel to the grief reaction of an older person, with progressive changes from protest (crying and searching) to despair, sadness, and withdrawal from communication or play, and finally detachment from the original relationship and recovery of social and play activities.”
 
How someone learns to attach to their core group as a child sets the groundwork for how they will learn to attach to others as an adult. So let’s look at some of the ways that these can attach (or not) as children and then tomorrow we’ll look at how those styles evolve in adults. Then I’ll have a fun interactive survey for you that provides a good idea as to the kind of attachment style you may have.  
 
Attachment Styles are broken down into either Secure or Insecure.
Secure Style
Children: A toddler who is securely attached to its parent (or other familiar caregiver) will explore freely while the caregiver is present, typically engages with strangers, is often visibly upset when the caregiver departs, and is generally happy to see the caregiver return. The extent of exploration and of distress are affected by the child's temperamental make-up and by situational factors as well as by attachment status, however.
Adult: Securely attached people tend to agree with the following statements: "It is relatively easy for me to become emotionally close to others. I am comfortable depending on others and having others depend on me. I don't worry about being alone or having others not accept me." This style of attachment usually results from a history of warm and responsive interactions with relationship partners. Securely attached people tend to have positive views of themselves and their partners. They also tend to have positive views of their relationships. Often they report greater satisfaction and adjustment in their relationships than people with other attachment styles. Securely attached people feel comfortable both with intimacy and with independence. Many seek to balance intimacy and independence in their relationship.
This is the goal. This is what we would consider Healthy Adult functioning in relationships. However many of us tend to lean more towards these….
 
Insecure Styles  (we’ll start with expressions in Children)
Anxious-Resistant Insecure Attachment
In general, a child with an anxious-resistant attachment style will typically explore little (in the Strange Situation = a new situation that the child has not previously been exposed to) and is often wary of strangers, even when the parent is present. When the mother departs, the child is often highly distressed. The child is generally ambivalent when she returns. This attachment pattern can be caused from the parents lack of affection during infancy and early childhood. These infants are depicted as anxious-resistant insecure when:
"...resistant behavior is particularly conspicuous. The mixture of seeking and yet resisting contact and interaction has an unmistakeably angry quality and indeed an angry tone may characterize behavior in the pre-separation episodes..."
These infants are often seen as demonstrating 'passive' resistance. As Ainsworth et al. (1978) originally noted:
"Perhaps the most conspicuous characteristic of C2 infants is their passivity. Their exploratory behavior is limited throughout the SS and their interactive behaviors are relatively lacking in active initiation. Nevertheless, in the reunion episodes they obviously want proximity to and contact with their mothers, even though they tend to use signalling rather than active approach, and protest against being put down rather than actively resisting release...In general the C2 baby is not as conspicuously angry as the C1 baby."
 
Anxious-Avoidant Insecure Attachment
In general, a child with an anxious-avoidant attachment style will avoid or ignore the parent when he or she returns (in the Strange Situation) - showing little overt indications of an emotional response. Often, the stranger will not be treated much differently from the parent. This attachment pattern can be caused from little to no interaction between the parents and the child during infancy and early childhood. These infants are depicted as anxious-avoidant insecure when there is:
"...conspicuous avoidance of the mother in the reunion episodes which is likely to consist of ignoring her altogether, although there may be some pointed looking away, turning away, or moving away...If there is a greeting when the mother enters, it tends to be a mere look or a smile...Either the baby does not approach his mother upon reunion, or they approach in 'abortive' fashions with the baby going past the mother, or it tends to only occur after much coaxing...If picked up, the baby shows little or no contact-maintaining behavior; he tends not to cuddle in; he looks away and he may squirm to get down."
These infants are often seen as demonstrating a mixture of both some avoidance and resistance. Often, though not always, these infants are judged as Disorganized (D). As Ainsworth et al. (1978) originally noted:
"...[the infant] shows a mixed response to mother on reunion, with some tendency to greet and approach, intermingled with a marked tendency to move or turn away from her, move past her, avert the gaze from her, or ignore her...there may be moderate proximity-seeking, combined with strong proximity-avoiding...If picked up, the baby may cling momentarily; if put down, he may protest or resist momentarily; but there is also a tendency to squirm to be put down, to turn the face away when being held and other signs of mixed feelings [i.e., resistance/ambivalence]."
 
Anxious-Ambivalent Insecure Attachment
Children who are ambivalently attached tend to be extremely suspicious of strangers. These children display considerable distress when separated from a parent or caregiver, but do not seem reassured or comforted by the return of the parent. In some cases, the child might passively reject the parent by refusing comfort, or may openly display direct aggression toward the parent.
According to Cassidy and Berlin (1994), ambivalent attachment is relatively uncommon, with only 7% to 15% of infants in the United States displaying this attachment style. In a review of ambivalent attachment literature, Cassidy and Berlin also found that observational research consistently links ambivalent-insecure attachment to low maternal availability. As these children grow older, teachers often describe them as clingy and over-dependent.
 
Disorganized Attachment
A fourth category is termed disorganized attachment (Main & Solomon, 1990). It can be conceptualized as the lack of a coherent 'organized' behavioral strategy for dealing with the stresses (i.e., the strange room, the stranger, and the comings and goings of the caregiver) of the Strange Situation Procedure. Evidence has suggested that children with disorganized attachment may experience their caregivers as either frightening or frightened. A frightened caregiver is alarming to the child, who uses social referencing techniques such as checking the adult's facial expression to ascertain whether a situation is safe. A frightening caregiver is usually so via aggressive behaviors towards the child (either mild or direct physical/sexual behaviors) and puts the child in a dilemma called 'fear without solution.' In other words, the caregiver is both the source of the child's alarm as well as the child's haven of safety. Through parental behaviors that are frightening, the caregiver puts the child in an irresolvable paradox of approach-avoidance. This paradox, in fact, may be one explanation for some of the 'stilling' and 'freezing' behaviors observed in children judged to be disorganized. Human interactions are experienced as erratic, thus children cannot form a coherent, organized 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.
There is a growing body of research on the links between abnormal parenting, disorganized attachment and risks for later psychopathologies. Abuse is associated with disorganized attachment. The disorganized style is a risk factor for a range of psychological disorders although it is not in itself considered an attachment disorder under the current classification.
I was debating whether or not to do the Child and Adult side by side, but they don’t quite match up that way and this post is already getting really long so I’ll leave you with this nice chart breakdown and we’ll get to those Adult Attachment Styles tomorrow!
 
 
Child and caregiver behaviour patterns before the age of 18 months[36][38]
Attachment
pattern
Child
Caregiver
Secure
Uses caregiver as a secure base for exploration. Protests caregiver's departure and seeks proximity and is comforted on return, returning to exploration. May be comforted by the stranger but shows clear preference for the caregiver.
Responds appropriately, promptly and consistently to needs. Caregiver has successfully formed a secure parental attachment bond to the child.
Avoidant
Little affective sharing in play. Little or no distress on departure, little or no visible response to return, ignoring or turning away with no effort to maintain contact if picked up. Treats the stranger similarly to the caregiver. The child feels that there is no attachment; therefore, the child is rebellious and has a lower self-image and self-esteem.
Little or no response to distressed child. Discourages crying and encourages independence.
Ambivalent/Resistant
Unable to use caregiver as a secure base, seeking proximity before separation occurs. Distressed on separation with ambivalence, anger, reluctance to warm to caregiver and return to play on return. Preoccupied with caregiver's availability, seeking contact but resisting angrily when it is achieved. Not easily calmed by stranger. In this relationship, the child always feels anxious because the caregiver's availability is never consistent.
Inconsistent between appropriate and neglectful responses. Generally will only respond after increased attachment behavior from the infant.
Disorganized
Stereotypies (repetitive gestures) on return such as freezing or rocking. Lack of coherent attachment strategy shown by contradictory, disoriented behaviours such as approaching but with the back turned.
Frightened or frightening behaviour, intrusiveness, withdrawal, negativity, role confusion, affective communication errors and maltreatment. Very often associated with many forms of abuse towards the child.

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