Attachment

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Specific Techniques to Increase
Family Attachment

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by Deborah N. Silverstein

Many foster and adopted children exhibit signs of impaired attachments. It is important for parents to recognize these difficulties and to engage in behaviors, activities, and techniques which repair and establish developmentally appropriate attachments. See Vera Fahlberg (1991) A Child's Journey Through Placement for an excellent discussion of how attachment develops and the signs and symptoms of children with attachment problems.

The following principles guide my work with families to increase attachment:

Based on arousal / relaxation cycle and re-education of parent and child;

Experiential in nature;

Physical-involving all 5 senses;

Reciprocal; mutual in nature; "shared" activities among family members

Permits parents offer child comfort, safety and security;

Helps tie past trauma and lost attachments (for parent and child) to present behaviors and affect; helps parents not take child's behavior personally;

Provides positive experience for family and child;

Frequently based in some form play;

Permits child to regress and replicate early parent/infant relationship in all its aspects;

Many aspects modelled on normal mother/infant interactions-physical, playful, frivolous, fun-filled, and personally engaging,

Involve reassuring, consoling, comfort-providing, stress-and-anxiety reducing behaviors, heightened emotional levels, and mutual pleasure;

Increases parent's self-esteem, capacity to cope , and enjoyment of child

Demonstrates strength of parent and protection that offers

Helps parents identify own attachment style and blocks

Promotes healthy grieving

Offers opportunities encourage and praise when child's defenses are down

All the techniques involve repeated episodes of highly focused attention between adult & child and often involve physical contact.

Techniques divide into 7 major categones:

1. HOLDING / TOUCH

Holding or rage reduction techniques (as described by the Attachment Center at Evergreen, Colorado) are used only with very disturbed children where other treatment modalities have failed

Rocking / play babyholding for pleasure & holding for relaxation, including gentle touching, close eye contact, singing, caressing, feeding, "nursery games"--raspberries on neck & belly, counting fingers & toes, patty cake, "I'm gonna getcha" holding child up on parent's feet, play horsey, bouncing child

Bottle feeding at least few minutes each day

Parents initiate close physical contact by wearing short sleeves and soft fabrics--avoid buttons and buckles

Take showers, baths, swim together (as is developmentally appropriate)

Carry smaller children in snugglies

Stroke, touch, sit close during feeding times

One Minute Scolding (see G. Nelson's book of same name, 1984)

Wrestling, always include "cool down" close time

Tickling

Massaging / applying lotion

Lap time- have child sit on lap for 3-5 minutes with kitchen timer

2. PLAY

IT IS VERY IMPORTANT THAT THE PLAY IS RECIPROCAL IN NATURE, THAT THE PARENT AND CHILD INTERACT TOGETHER

Doll play-feeding babies, nurturing them; play out child's situation

Ball, rolling back and forth

Swinging

Board games-taking turns

Hide and seek; peek-a-boo

Making faces-link facial expressions with feelings

Imitative play-adult follows child's lead in play

Feeding each other, M & M's for example

Sound--singing rounds, movement, drumming together

Parents use "surprise" behaviors which intrude on child--kisses, blowing in child's face, unexpected hugs

Staring contests

Screaming matches

The following techniques come from Jernberg's "Theraplay": "Magic button" -adult searches for magic button on child, when he or she finds it, the child sticks out their tongue; "Gingerbread boy"-pretend to turn the child into gingerbread figure by mixing ingredients (rubbing) rolling out dough, cut shape (trace around body) decorate & bake eat up with kisses; "Race track"-pretend child's back is race track and parent's thumbs are cars; "Pass-it-on"- Pass a touch around circle, or handshake, or pat on back

Cradle rocking-wrap child in blanket and swing between two adults, while singing

Trick time-magic trick with partners-child and adult

Puppets-tell stories back and forth, one can begin story and next person pick it up; stress themes which are similar to child's own life story

Doll house figures, as with puppets

Animals, as with puppet play

Mutual storytelling-Parents and children tell stories which include themes of attachment and "teach" children that attachment is safe and desirable

Face painting

Role plays; family charades-change roles and play or mimic another family member

Family drawing-Family portrait; family collage;

3. FEELINGS EDUCATION

Making faces, sounds, music, art projects about specific feelings

Discuss feelings of others in books, magazines, on tv, in videos

Learn to label feelings & validate/ give permission for child to have feelings

Develop ways to assess and discuss feelings of closeness in the family. For example, use the following scale to help family members rate how various activities or behaviors change their feelings of closeness or belonging:

ATTACHMENT SCALE

1=1 DON'T FEEL CLOSE AT ALL
2=1 DON'T FEEL CLOSE
3= I FEEL MEDIUM
4= I FEEL A LITTLE BIT CLOSE
5= I FEEL CLOSE

Keep daily log of closeness-track with any variables want to plug in

Practice moving bodies-come closer, go away, hide-inquire "when do you feel closest? "

Figures-use dolls, figures, puppets, etc. to discuss closeness using scale

Planning together ways to increase feelings of closeness

4. HEIGHTENING OPPORTUNITIES TO NURTURE

Activities which involve soothing, calming, quieting, reassuring

Child sit between parents at dinner, touch child while eating

Attentively nurse sick children; encourage child to cry and accept comfort. Physical complaints are common in the grief process and for child with attachment difficulties parents must respond, respond, respond. This gives increased opportunities for emotional and physical nurturing-band aids, special foods, rocking

Sleeping arrangements-consider child sleeping with or near parents for a time; use bedtime rituals to heighten attachment

Put snacks next to child if he awakens during night to remind child parent is always available

"Pajama days" family stays home, goofs off, and builds relationships

5. CLARIFICATION OF LIFE EVENTS
Children need to understand what has happened to them; that they are blameless, and that they now "belong" in this family

Life Books / Life Mapshonoring previous attachments, help child and family visually understand child's history

Visits ( relating to foster care, open adoption, and visits with other significant figures from child's past)-all significant figures should be together if at all possible. This makes it clear to the child that there are no choices or loyalty conflicts necessary

Future planning so that child knows s/he will be with the family in the future, builds hope and trust

6. ACTIVITIES WHICH HIGHLIGHT AND PROMOTE IDENTIFICATION WITH FAMILY

Developmental re-parenting. Adjust parenting style to developmental (not chronological) age or needs of child

Dressing alike-family members wear same 'T" shirts or colors

Family rituals and traditions (bedtime, birthdays, placement day, etc. )

7. DlSCIPLINE--One of primary techniques

Discipline without distance; do not reward misbehavior with parental distance; do not use techniques which involve any form of separation or loss

Use techniques which increase "attachment" "house arrest" chores done together, physical activity, etc.

Must not let child get out of control-must limit behavior BUT not reinforce old maladaptive attachment behaviors; parents must not struggle to get control

Parents must work as team

Set firm consistent boundaries

Make punishments brief, relevant and immediate