Behind the Rages of Disorganized Attachment Style

Many caretakers begin the first session with heartbreaking tales of rage, rejection, betrayal and violence from the child in their care.  “She said she wants to hurt the baby!”  “She said she is stronger than any of us — and she’s five!”  “He can’t be alone for two seconds without trying to destroy the upholstery.”  Sometimes understanding the normal thoughts and feelings under those behaviors helps the adults to see things with less discouragement and personalization.

It is easy to forget how ego-centered children can arrive.  Knowing nothing about the outside world, they assume that things happen because of them.  Good things happen because I am good.  Bad things happen because….I must be bad…

From there a child surrounded by neglect, chaos or other maltreatment may logically conclude that they are so bad no sane person would really like them, care for them or want them.  Along comes a new caretaker, full of love but ignorant of the child’s ego-centered beliefs…  Trouble.

For one thing, being hugged and loved by a new person can feel like that person just doesn’t know who I am.  As someone put it, “It’s like having to rub noses with a stranger.”  Sorry, nice person, but you don’t know how bad I am or you would not get half this close to me.  Maybe I am smarter than you.  (Always a scary thought for a child.)

Then if the child is given choices and independence normal for their chronological age, but premature for their emotional age level, they can feel overwhelmed with too much freedom for their thinly-formed social skills and regressed defenses.  “What if I can intimidate these nice people?” may be a thought which both terrifies them and which they cannot let go of.

Finally, if they try something intimidating and the parent hesitates and appears to lose confidence, the child can feel compelled to recreate this drama over and over — both trying to resolve the problem of getting the parent to parent them, and exploring the first interpersonal theme over which they seem to have complete control.  Their little fight-flight amygdalas (survival brain) are working overtime, triggered by more and more situations to go for control, because it makes the something predictable (intense conflict) happen over and over, on cue.

What helps caretakers is to realize the need of an out-of-control child for the parent to be in charge instead of be intimidated.  This may bring up old issues for the adult, and that can become an early focus — how to remove old feelings of intimidation, of being bullied, for instance, in order to be the best parent this suffering, desperate child needs.  As Dan Hughes points out, bullying children often have a constant fear of desertion.  Acting violent can be their fastest route to forcing us to come to them, to think intensely about them, to feel strongly about them, to say their name and say it with real feeling…..

Inside the child is often an ongoing conversation something like this, “Are you thinking of me now?  How about now?  Are you looking at me?  Don’t leave me!  I can make you grab my arm, say my name, show me some feeling,…”

What can help is to find our confidence, move in, be close, say their name and show our deep feeling for them early and often — way, way, way before they become desperate for it.

More on this in a later blog.

When Parents and Caretakers Struggle…

“We tried to explain to her…”

“I don’t know how many times I’ve told her…”

“If only she understood…”

Understanding the difficulties —

It can be very difficult for parents — newer, older, natal, foster or adoptive — to raise any child who has a troubled history.  Caretakers of all kinds come to the intake session with a range of frustrations.

It is important for counselors to acknowledge the adults’ own experience of inner and outer conflict about wanting to do a good job of parenting, while up against the inner life of a child who does not appear to behave in his/her own best interest.

In that respect, it helps to tend to the feelings in the room — the distress of the parents or other caretakers who have come to the intake.  Before trying to problem-solve, it pays to give empathy and acceptance to the caretaker adults who may feel unappreciated, unheard, and unsupported in their family.

It can really help when we are curious about all the thoughts and feelings which the adults may have wanted to express safely for quite awhile.  Underneath it all may be an unacknowledged grief — grief for the dream of how things would be or should have been by now.  Grieving their original dream can be where grown-ups need to start.

Crossing Adult with Child Attachment Styles — some thoughts

While preparing for an upcoming conference presentation, I created a matrix which crossed the four adult attachment styles (Autonomous, Dismissive, Preoccupied, and Unresolved) with the four childhood attachment styles (Secure, Avoidant, Ambivalent, and Disorganized.)  You may recall that each childhood style tends — without intervention — to lead into the corresponding adult style.

From this Vermont therapy practice, I have collected examples to fill each of the matrix blanks — Dismissive style parent seen with Avoidant style child, etcetera.  I don’t have much to fill the Securely attached child column, as they rarely have need of services.  But the other columns are busy.  A brief look at the patterns:

Dismissive style adults seen with Avoidant style children shows a combination in which both adult and child are working hard to avoid relationship and emotional vulnerability.  They seem to benefit most not only from acceptance and empathy, but also from my “speaking for” them to each other.  “Sorry, Dad, about what happened yesterday — I just didn’t now how to approach you to fix it, so I didn’t say anything…”  That makes sense, as all their practice has been at avoiding sharing their own inner awareness with another person.  “I’m fine.”

Dismissive style adults seen with Ambivalent style children are another matter.  The adult is trying hard to avoid conflict, while the child is busy seeking conflict in a bid to feel safe through control of the people and objects around them.  They tend to present with the parent intimidated and the child frequently dysregulated.  They benefit most from support for the adult to find their voice, step up to the plate and be in charge again.  Kids need parents (safe parents) and they need the parent to be in charge.  Because of child development realities, that’s the only way kids are going to be okay.

Preoccupied style adults, on the other hand, are looking for conflict, due to so much difficulty resolving issues from their earlier years.  Through no conscious fault of their own, the presenting problem is often one of drama.  One parent who daily clashed with his nine year-old asked me in hushed tones whether I thought that his daughter might need an exorcism.  (I didn’t.)  Unfortunately the dramas are rarely resolved, because they tend to be emotionally founded in unspoken hurts from the past.  Only when this is interpreted do the problems in the present lose their power and people become less stuck.

Combine a Preoccupied parent figure with an Avoidant style child, and you have a chase-and-evade dyad, not unlike some unhappy marriages.  But a Preoccupied style adult raising an Ambivalent style child will be a dyad often in flames — each person trying aggressively to force recognition and appreciation from the other, while both were denied these things long ago.

Not to paint too bleak a picture, the Autonomous style adult can usually make gradual headway with both Avoidant and Ambivalent style children.  Why?  They can rely on their own “secure emotional base”, and their own positive “internal working model” to carry them through long periods of the child’s dysregulation — while continuing to project their image of the child as capable and important.  That is an important image which children need from adults — a projection of themselves which they can absorb, test, push-against, even reject, but gradually internalize.

The Disorganized style child is usually the most challenging of the childhood styles, due to learning few ways to survive unpredictable maltreatment other than creating immediate chaos in the moment.  Parenting this style requires some skill and many outside supports.

Thoughts on Presenting at Conferences

In my experience presenting and training, the most effective presentations seem to include a combination of

theory,

brief Powerpoint,

audience question/discussion,

story examples from clinical practice, and

illustrative video clips pulled from actual sessions.  (I generally subtitle my video clips for clearer sound and better audience access.)

Audiences also appreciate a variety of handouts.  Handouts help attendees to take the training home with them.  My most popular handout gives examples of alternative explanations for typical dysregulated and disruptive behaviors. Second most popular handout gives suggestions for counter-intuitive responses to dysregulated behaviors — these can be hard for caretakers to remember in the distress of the moment.

Our first New England DDP Conference was held near Burlington, Vermont, on November 18, 2011.  Deb Shell did the organizing, Dan Hughes gave the keynote, and four of us presented aspects of “Dyadic Developmental Psychotherapy”, as developed by Dan Hughes, PhD.  The invited audience for this first annual conference consisted of professionals — of the 75 who registered 81 showed up, so it was standing-room only.

For the 2012 New England DDP Conference we hope to include parents/foster-parents and other caretakers of children with trauma and attachment issues.

 

What Can We Do About Lying?

Q.  What can we do about lying?

A.  Often a child’s lying, like cheating, shoplifting, stealing, evasion and many other ‘hiding’ behaviors, is rooted in a felt need to hide themselves.  From a sense of shame about their own worthiness, a child (or adult) might say if they could, “I’m not good enough to be known for who I really am, and that means my (new) parents would get rid of me if they really, truly knew how worthless I feel.  So eventually, when people really see me, then I will have to get my needs met by sneaking.  Under the table.  On the sly.  By hook or by crook.”

With adopted children, this can flow from a nagging fear that what happened once can always happen again — being “given away” because they were “not good enough to keep”.  So they are sure they must practice surviving on their own, under the radar, for when the nightmare of abandonment happens again.  With incest survivors, the unconscious need to hide ones identity from others can feel like life or death.

One time an adoptive mother with her own horrid childhood lied to me in session.  I had suggested some communication exercises for her family.  She replied, “Oh we do that all the time at home, let’s just move on.”

You do?

“Yeah, let’s just move on.”

I’m curious.  When do you do it?

“Well…..we really don’t, but I just told you we did so you’d move on to something else,” and she grinned like her teenager whom she complained was compulsively lying.

(From my perspective this was solid gold.)

“You lied to me!” I exclaimed in mock horror, opening my eyes wide.

“No, I didn’t,” she giggled.  “I told you the truth in the end.”  She was 46.

“You LIED to me!  And you ENJOYED it!!”  I played this like a hooked sailfish.

“No, come on, I didn’t LIE!”  (i.e., Finally someone caught me!)

“And now you’re lying about LYING to me!!  Like a TEENAGER!!  WHOA!!!”  At these words she collapsed into giggles.

This playful incident became part of our therapy history.  We referenced it many times as a crucial deepening of our therapeutic relationship: the day she was caught in a lie, but not shamed for it.

"NOW what?"

What would be an equivalent response to a child’s lying?

Dan Hughes once role-played a nice response during a training.  In the role-play he neither shamed the “child”, nor accepted the lie — he found a balance:  “Hey, you’re giving me baloney!  You got any cheese in there?  C’mon, hand it over!”

The message:  1. You’re trying to put one over on me….2. I won’t even PRETEND to buy it….3. And I sure like you!

"Baloney!"

This good message offers the child both a challenge to the lie (I’m not stupid) and face-saving through humor (I still like you).  We can use this formula with teens and adults as well.

An exception might be when the child is lying from within deep depression.  In children this can appear as fierce hostility.  “I never took anything!  (while hiding stolen item behind back.)  I hate you!  Get out of here!  You’re stupid!!”  At those times responding with playfulness will sound to them like sarcasm.  I will cover responding to depressive lying in another blog — it can require some reflection on our part to find the voice we (and they) need.

 

What are the four attachment styles of children? 1978 and 1986

The perplexing relational behavior of alienated children was first demystified by the insightful research of Mary Ainsworth.  Her brilliant Strange Situation study findings were published in 1978 and remain relevant today.  She correctly identified the various responses of different toddlers upon seeing their parent walk out of a room and then return.  Additionally a strange woman simply came in, sat, and went out — at two specific times.

Ainsworth identified three childhood attachment styles, eventually called Secure, Avoidant, and Ambivalent.  Her explanations were later enhanced by Mary Main (1986), who, with her assistant Judith Solomon, recognized that a leftover, chaotic fourth group (10%) had developed no patterns to make sense of themselves or their world: “Disorganized” style.

Knowing the four attachment styles of children does not guarantee an emotional connection — a quick fix.  But it does provide a useful explanation of what may be going on in the child’s head — their inner life of thoughts and feelings.  This in turn lets us parents and helpers feel accurate empathy for the struggling child’s difficult inner life.  (There is empathy, and there is accurate empathy.)  It also allows us to set limits and name our expectations with some degree of confidence that we are doing no harm.  We now know how to understand and repair the child’s shame when it becomes triggered.  The combination of accurate empathy plus safe limit-setting gradually unlocks emotional doors to trusting.  Still, the path to close, intersubjective connection with a child may be easier for some adults than for others.

Give an example of an Ambivalently attached child

Sometimes children have grown up experiencing not total chaos, but a confusing combination of closeness mixed regularly with rejection or neglect.  “What happened to our good little girl?  Why are you acting like this?  Maybe you’re telling me you don’t want to live with us, is that it?  Is that the message I’m getting?  What is it you want!!??”  (Child hearing this may feel more and more desperate, as children are generally not able to understand or explain their various needs.)

The discouragement may eventually lead children to take charge in a desperate and disruptive manner.  They act out to force the parent to respond, to get mad, to stay close, to get something, to leave them alone, to not set limits, to never say No (or the child will quickly try to reject the parent before the parent rejects them, “I hate you!”)

To all appearances the child and parent are organized together by conflict.

“Anxious/Resistantly [the original name for Ambivalently] attached children under-regulate [themselves], heightening their expression of distress possibly in an effort to elicit the expectable response of the caregiver. There is a low threshold for [feeling] threat, and the child becomes preoccupied with having contact with the caregiver, but frustrated even when it is available (Sroufe, 1996).”

            –PeterFonagy (U.K.)

Example of a 12 year-old child with ambivalent attachment:

A single-father was arrested for drugs and sent to prison for a year.  Unfortunately he was the more functional parent, and his bright 12 y.o. daughter was left with her mother who ignored her daily.  The daughter tried to cope alone with powerful feelings of abandonment from both parents.  At the time of referral to me she could not tolerate allowing adults to be in charge.  She was in the special behavioral day school, and acting very badly.  Father arrived in session with an attitude assigned to him by his daughter – “The teachers have it in for her.  I know my girl would not say the things they tell me she says.”

As I met mostly with father, we worked on saving his bright daughter from further nosediving into residential placement.  Already she had daily out-of-control rages against authority figures.  I gave father tons of empathy and support for himself, then suggested father imagine parenting his bright daughter in such a way that she could eventually go to college.  Father soon reported a shift at home.

“Last week she was barfing in the middle of the night.  She told me she was putting her finger down her throat so she could skip school.  I suddenly stood up and told her, ‘Don’t do that anymore!  That’s not a good thing to do!’  And she stopped.

“Then last night I took the Playstation out of her bedroom and said it wasn’t going back until the homework was finally done.  At first she said she’d stick a knife in my heart if I didn’t put it back.  Then she threatened suicide.  Then she tried beating me up and pulling my hair.  Finally she broke down and sobbed and asked me to get her up early to do the homework.  I left the Playstation out of her room and we both got up early to help her finish the homework.  It only took 20 minutes – she amazed me!”

Naturally the daughter resisted father’s stepping up to the plate and taking charge as the parent, but she also welcomed it.  Children deeply need a safe adult to be in charge.  As things gradually turned the corner, father reflected, “I’m not as bad a parent as I thought.  But I have to deal with more than ordinary parents do.  I don’t know why sometimes I have more authority than other times.”

 

Why does my child have a fit over little things?

Q.  My child tries to control everything and everybody.  Her demands and rages absorb every bit of patience and compassion in the house, and still she wants more.  She’ll act out to keep us paying attention to her.  Any ideas?

Robert signs the Bean Seed book at ATTACH conference

Book signing for The Bean Seed

A.  This is not easy.  These “ambivalent attachment style” children, who create drama and burn out the patience of everyone around them, are usually desperate to stay in your thoughts.  The quickest way to do that is to break things — rules, pets, objects, people.  Because if they are not in your thoughts, as Kevin Creedin points out, they are afraid they will disappear.  Each of us would do anything in the world to keep from disappearing.

With ambivalently attached children especially, you will end each day exhausted — your real choice is whether you want to be exhausted from trying to respond all day to your child’s lead, or be exhausted from planning and consulting in advance, staying four steps ahead of their desperation, and being proactive.  That is actually  the easier and more therapeutic way to end up exhausted.

Try delivering good times in combination with No.

“I’m so happy when we are snuggling like this.  And you know when you knocked your sister over yesterday?  That’s the last time.  I expect you to change, and I will help you change.  That’s what adults do for kids — did you know that?  Our job is to recognize when you are stuck feeling little, and then we help you with that stuckness.

“So you have work to do, and I’ll coach you and provide consequences later and also some help giving repairs to people.  I might yell at you if you break the rule again, and I still won’t swear or call you names.  I might yell because I pay attention now, and I care about how you’re doing.  I want to feel so close to you.”

 

“This attachment stuff is important for everybody, but it never gets examined until it breaks down.”

— single father, librarian

Eye contact to see motives.

One day an adolescent client with a very wounded history told me how annoying it was when I would express empathy for her rough life.

(“That sounds really hard.”  “I’m sorry it was a difficult time.”  etc.)

“I hate that!” she confessed.

I thanked her for being honest.  Then I shared with her the story of a career professional in her 50s who came in for a similarly troubled early history, and also was uncomfortable hearing empathy from a counselor (or from anyone, including her family.)

My younger client asked, “Didn’t she hate your saying ‘I’m sorry’ all the time?”

I replied, “Yes, but she started to look at my eyes and see that I was not being sarcastic or making fun of her, as people used to in her childhood.  Then it felt safer.”

That story seemed to help, and the young client went on to do very good work.

A dismissive attachment style in an adult

An adult client, a professional man who was several years into his new marriage, came into therapy struggling with “Who am I?”  After a short time I found he would change the subject each time I got close to focusing on his thoughts and feelings.  This is typical of an adult who avoids placing any attention or importance on their own inner life — an adult with “dismissive attachment style”.

In such cases I usually ask whether the client’s partner might join us.  It helps get to core issues when I have a second safe person on board.  He agreed to ask her.  She was a social worker.

Next session the spouse joined us, saying, “I’m not sure why I came today.”  My client started chattering about some other topic — his usual response to anything risky.

Suddenly it struck me that he was avoiding his thoughts and feelings because she was a social worker.  I shared my thinking:  “I wonder if you brought her along so she and I would talk shop and stay safely away from your emotional stuff.”

A home run with that — and it laid the groundwork for future sessions.  Before leaving he warned me, “I might go to my grave without dealing with my feelings.”  I replied, “Yes, but that could get old for her.  Spouses like their partners available to work on issues together.”

Good work followed.