Attachment to presentation by Dr Dianne Camilleri on ‘Working with Children with Attachment Disturbance and their Families’ on 10 June 2014
ATTACHMENT 1 – ASSESSING ATTACHMENT:
Trying to develop an understanding of both the infant/child’s and the parent’s attachment (both the observable behaviour and mental representations of attachment) will be important. Some aspects of your Ax may include:
Infant’s/Child’s attachment:
· observation of how the child manages separation from parent(s) during individual assessment (use with children ~4 years and older); how do they respond to the separation? Eg crying, clinging, refusing to go with you to, go with you but do not explore the consulting room and toys once inside, frequently ask when they can go out to their parent or wanting reassurance that their parent is in the waiting room, etc;
· observations during family or parent-infant/child interview – how is infant/child relating to parent; does child seek comfort at any stage; if so, how does parent respond; how in tune with the infant/child is the parent [eg the infant signals she is tired, but the parent interprets this as the infant wanting to be put down on the mat to play with the toys];
· observation of infant/child and parent(s) playing together (instructions may be something like: “I’d like the two/three of you to just play freely as you might at home together, and I’m going to sit back and not be involved. Try and forget I’m here (I know that’s difficult). We’ll do this for about 10-15 minutes.” Purpose of doing this is that it is (a) unstructured; (b) produces a little bit of anxiety which will make the attachment style more overt; (c) see how the child initiates comfort from parent, proximity seeking, is there reciprocal interaction, evidence of symbolic play; for older children, how does conflict get managed (eg does it emerge and how is it responded to/dealt with/managed – also looking for how the parent is managing this; eg does the parent try to shut things down, do they respond with anger, do they freeze, do they criticise, do they follow the child’s lead or do they lead the play, etc;
· what does the child say (if old enough) about his/her relationship with parent(s)/others?
· pay attention to transitions – often children with attachment difficulties find transitions difficult – could be transitions to bedtime, to school, to childcare, etc, as reported by parents and child.
Parents’ own attachment history:
· Parents’ own history is important as it will provide information as to their attachment experience in their family of origin. Important as there is a strong correlation between parent’s attachment style and their infant/child’s attachment style. Eg insecure-dismissing parents tend to be associated with more avoidant style in child and they tend to overly encourage autonomous behaviour; insecure-preoccupied parents tend to be associated with insecure-avoidant style in child and feel anxious about their child’s exploratory behaviour and so discourage it (Prior, V., & Glaser, D., 2006, p. 51).
· Some of the areas you may want to hear about (whether during assessment or during treatment phase):
o what was their relationship with their parents like?
o can you tell me what was your mother like? what was your father like?
o were they able to receive comfort from their parents?
o how would you describe your relationship with your parent(s) growing up?
o what are the things from your own experience of being parented that you believe have influenced you in terms of your own parenting [could be positive, eg “My parents were always very supportive of me being creative, and this is something I try and do with my own child(ren)”, or negative, eg “My parents never had time for us as kids, and I am determined to be more available for my child(ren)”]?
o were his/her parent(s) affectionate? supportive? caring? sensitive? or distant? cared for physical needs but not emotional needs? not affectionate? etc.
Activating both child and parent’s attachment system during the Ax phase:
· We are aiming via our Ax to activate both the child’s and the parent’s attachment system to produce just enough stress, but not too much – eg, by creating scenarios that activate “distress, fear, and the need for proximity” (Slade, 2004, p. 273)). In children, separation during individual Ax may do this, or asking the child about their relationship with their parent(s); in parents, it may be via asking them about their attachment histories, or asking them to ‘play’ with their infant.
Formal Ax of Attachment:
· A range of Ax tools are available. However, most of them require training, as the coding may be quite complex, video recording of some: see pp. 97-98 in ‘Understanding Attachment and Attachment Disorders’, Prior, V., & Glaser, D. (2006) if interested.
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