Understanding and Supporting the Attachment Connection

A relationship for life:Understanding and

Supporting the Attachment Connection

Dr. Vanessa Lapointe, Registered PsychologistClinic Founder, The Wishing StarInvited Professional Associate, Neufeld Institute

Dr. Vanessa Lapointe, R. Psych, Copyright

Plan

Some discussion around current research

Presentation of current theory and understanding

Bringing relationship to life – ideas on “how to”

Learning objectives - Participants will learn about: (1) current research in the area of attachment, brain development,

and general outcomes;

(2) related theory as applied to the pre- and perinatal period; and

(3) associated best practices for support that focuses on concrete application of research and theory.


What does it mean to be held in another’s mind? Why does it matter, and how does such a feeling develop? Everything that we know about [children] leads to the conclusion that they seek human connection, not only to survive but for its own sake. They are born looking for us. Given a choice of what to look at in their first hours, it is always the human face they choose. -Dr. Jeree Paul


Presenter

Presentation Notes

http://www.wested.org/online_pubs/ccfs-06-01-chapter1.pdf

What’s all this talk about “relationship”

Defining Attachment


What is attachment?

Attachment is the relationship between a key big person and a child

Primary attachments are the big people of central importance to a child’s life – typically parents

• Attachment system is activated in times of stress (upset, hurt, ill) and child then initiates attachment behaviors


Attachment

The most significant “environment” of a young child’s life

“Coherent interpersonal relationships produce coherent neural integration within the child that is at the root of adaptive self-regulation.” (Siegel, 2001, p. 86)

In early childhood, positive relationships offer the best environment for optimal brain development (Davies, 2004)

What is attachment?

Attachment is biological, evolutionary, neurological, and emotional in nature

As children we are born to attach – the developmental process constantly drives at this

As adults, we are primed to facilitate the attaching of our children – it is part of our wiring


What is attachment?

Attachment is the relationship “super glue” that holds a child in close PROXIMITY to a parent/key caregiver

Children are meant to PURSUE proximity

Adults are meant to PROVIDE proximity When proximity is disrupted, a parent is intuitively driven to

restore it


What is attachment?

What is attachment? Purpose of attachment is to keep the child safe AND make

the child feel safe/secure Hierarchy is an essential component of attachment Attachment is as important to healthy child development as

eating or sleeping When attachment is compromised, children are affected on a

physiological level


What does it all come down to?

1. Brains

2. Relationships

3. Hierarchy


Brains


The brain and experienceThe brain is organized in a hierarchical fashion – from the bottom up

Neural system change is “use-dependent”

The brain develops sequentially

The brain develops most rapidly early in life

Neural systems can change but some are easier to change than others

The human brain is designed for a different world – a more relational world

Dr. Bruce Perry – Applying key principles of neurodevelopment to approaches to intervention

Presenter

Presentation Notes

Perry, B. (2006) Chapter 3: Applying Principles of neurodevelopment to chilinical work with maltreated and traumatized children

Brain Development and Caregiving Relationships

Human infants are designed to “orient” to caring adults

As babies are lovingly cared for, there is created “a set of specific sensory stimuli which are translated into specific neural activations in areas of the developing brain destined to become responsible for socio-emotional communication and bonding” (Perry 2002, p. 95)

Relationship


Relationship Dimensions

1. Physical proximity Bowlby

2. Emotional proximity Tronick


Relationship – The Physical Dimension

Quality of Caregiving Loving Rejecting Inconsistent “Atypical”

Type of Attachment Secure (55%) Avoidant (23%) Resistant (8%) Disorganized (15%)

Dr. Vanessa Lapointe, R. Psych. 2011

Relationship – The Emotional Dimension

Tronick – The Still Face (video clip)


Hierarchy


Hierarchy as Essential

The dance of proximity Providers and seekers

Provider has their “alpha” role fully engaged

Child has dependent instinct fully engaged

Promotes softness (no defenses) and paves the way for development to unfold

Never ever ever should the hierarchy reverse!


Bringing it altogetherBrains, relationship, and hierarchy come together to

profoundly change outcomes for children


The Profound Impact on Outcomes

“Most striking … were the contrasts observed between the three FASD groups and Group 4 (the group with no evidence of CNS abnormality). FASD groups characteristics: Physical and sexual abuse was 2- to 5-fold more prevalent 2x as likely to be in adoptive care Significantly less likely to receive prenatal care.

Yet, prenatal exposure to alcohol and other illicit drugs was comparably high across all four groups.”

Presenter

Presentation Notes

Can J Clin Pharmacol Vol 17 (1) Winter 2010:e132-e164; March 26, 2010 © 2010 Canadian Society of Pharmacology and Therapeutics. All rights reserved. Profile of the first 1,400 patients receiving diagnostic evaluations for fetal alcohol spectrum disorder at the Washington State Fetal Alcohol Syndrome Diagnostic & Prevention Network

Making a DifferenceNurturing attachment in the parent-infant relationship


A Note on Effective Intervention

Guarlnick: We need a “second generation” of research that tells us what works, with whom, and at what stages.

Bowman (2000): “Early intervention programs appear to be a little like preparing a gourmet meal from an incomplete recipe. We have a general idea of the ingredients but are not sure about how much, in what order, at what temperature and for how long those ingredients should be cooked. Even with a good chef, the meal doesn’t seem to fit all of the diners all the time.”

Landy (2001): “Perhaps what we must aim for is the availability of a smorgasbord, deftly adapted to the needs of the families.”

Landy 2001Copyright Dr. Vanessa Lapointe, R. Psych. 2011

Nurturing attachment

1. Celebrate intuition

2. Work from a sensory-based place

3. Build upon the existing strengths

4. Provide concrete, simple orienting suggestions to parents who are struggling

5. Build up ‘villages’


The Nurturer in Us – Intuitive Care


Sensory Based Connections

Connection through being with Children in the first year of life experience the emotion of

connection primarily through their senses Connection is all about the senses – touch, taste, smell, hear,

see Children connect through the concretes Brains are changed in incredible ways with this input…

Dr. Gordon Neufeld


Strengths-based approach

Work with a parent to have them notice what is working in the relationship with their child

Do this quietly and without parade

“oh…look at how he turned his head at the sound of your voice”

“it seems her cry is a little less stressed when she is in your arms – she sure knows who is mom/dad”

“look how he is always coming back to your face – it is like it is the most important face in the world to him…”


Concrete Orienting Suggestions

A Simple Gift Series (IMP)

Simple Gift

Voices

Aversion to comforting the child

Intrusiveness

Not “being there” for the child

Parentification of child – having child worry about parent

Prepared by Dr. Lapointe, R. Psych.


Always comfort a child who is emotionally upset, physically hurt or ill…you cannot spoil a child by comforting in these circumstances. Instead, you help them to learn how to calm themselves down and make them feel safe

Caregivers should always respond to a young child’s cries Underscore the importance of the first 2 years of life Encourage parents to: Cuddle/have close physical contact with child Organize their child’s day Plan for uninterrupted playtime with their child

Encourage parents to watch their child’s face and eyes, try to imagine what they are thinking and feeling…watch, wait, wonder*

*Not the therapy program. Adapted from IMP/Benoit.Prepared by Dr. Lapointe, R. Psych.


Help big people think about the child’s feelings How does your baby/child “talk” to you? How does your child/baby tell you he needs your help? What makes your baby/child upset? When your baby/child is crying, what is she thinking/feeling?

Prepared by Dr. Lapointe, R. Psych.

It takes a village

Look for outside sources of support

Family, friends, community, baby groups, etc.

Parents were never meant to go this alone!


“When a child is held in mind, the child feels it, and knows it. There is a sense of safety, of

containment, and most important, existence in that other, which is vital. ... It seems to me that one

of life’s greatest privileges is just that - the experience of

being held in someone’s mind.”

-Dr. Jeree Paul


Resources

www.gordonneufeld.com

www.sickkids.ca/imp Simple Gift series

www.odinbooks.ca

www.childtrauma.org

References Astley, S. J. (2010). Profile of the first 1400 patients receiving diagnostic evaluations for

fetal alcohol sprectrum disorder at the Washington State Fetal Alcohol Syndrome Diagnostic & Prevention Network. Canadian Journal of Clinical Pharmacology, 17 (1), Winter 2010:e132-e164.

Bowman, T. G. (2000). Home visiting for infants and their familes. In Newsletter of the Infant Mental Health Promotion Project (IMP) Volume 29, Winter 2000-2001.

Guralnick, M. J. (1997). Second-generation research in the field of early intervention. In M. J. Guarlnick (Ed.), The Effectiveness of Early Intervention (pp. 3–20). Baltimore, MD: Paul H. Brookes Publishing.

Landy, S., (2001). Fulfilling the promise of early intervention. In Newsletter of the Infant Mental Health Promotion Project (IMP), Volume 32, Winter 2001-02.

Paul, J. (2006). Being Held in Another’s Mind. In Concepts for Care: 20 essays on infant-toddler development and learning, Eds. Lally, J., Mangione, P.L., & Greenwald, D.

Perry, B. D. (2006). Applying Principles of neurodevelopment to clinical work with maltreated and traumatized children. In Working with Traumatized Youth in Child Welfare, Ed. Boyd Webb, N.

Perry, B.D. (2002) Childhood experience and the expression of genetic potential: what childhood neglect tells us about nature and nurture Brain and Mind 3: 79-100.


Dr. Vanessa Lapointe, R. Psych& Associates

778-294-8732www.lapointepsychology.com

South Surrey, BC

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Understanding and Supporting the Attachment Connection