Chapter One
CHAPTER I
Introduction
Across this nation, within
state foster care systems, juvenile courts and detention centers, and schools,
professionals are beginning to recognize the enormous role of attachment
disorders in the lives of the children receiving services. It is hard to
imagine any professional in these fields who has not encountered children
whose overt behavior problems can be traced to a disorder of attachment.
Parker and Forrest (1993) have characterized the population growth of children
with severe attachment problems as a societal problem needing immediate
attention. Levy and Orlans (1998) have called it a "time bomb." While the
schools are finding many of their students' most difficult behavioral problems
are related to attachment disorders, dedicated foster and adoptive parents
are discovering that children with attachment issues are very difficult
for even the best-intentioned and most-dedicated adult to parent. Without
proper bonding, these children have a base of mistrust and deep-seated
rage which often results in children who appear to have no conscience.
Behaviors such as fire starting, sexual molestation, animal abuse, and
a complete inability to be affectionate or accept affection from others
are common among children with severe attachment disorders. Though many
organizations and treatment centers focused on treating attachment issues
have been formed in the last 15 years, it is becoming increasingly clear
that better parenting skills need to be taught as a preventative measure.
Foundations of Attachment Theory
John Bowlby (1988), the
father of modern attachment theory, believed all infants would become attached
regardless of the type of care they receive. Infants can be cared for in
a responsive, abusive, or inconsistent manner, yet will still develop an
attachment to their caregivers; the important difference is the quality,
or type, of attachment. This characteristic, the quality of attachment,
creates the foundation upon which children build their sense of self, determining
the way they relate to others throughout their life (Sroufe, 1983). Attachment
behavior is generated by perceptions of fatigue, pain, the unavailability
of the caregiver, frightening, or other stressful experiences on the part
of the child (Bowlby, 1988). Attachment is typically measured using the
Ainsworth Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978)
which involves observing the mother-child dyad interacting together through
a series of short separations and the introduction of a non-threatening
stranger. Infants who have experienced their caregivers as readily accessible
and available psychologically, providing prompt and consistent responses
to the baby's stress signals, are secure in their attachment. These infants
seek their caregivers during times of stress and are easily comforted.
Infants who consistently experience neglect or abuse have been found to
be anxiously attached and ambivalent in their search for comfort, or anxious-resistant,
often actively resistant to attempts at comforting. Infants whose care
has been unpredictable, perhaps because of the parent's mental illness,
demonstrate a disorganized attachment pattern showing a disoriented reaction
to stress (Carlson, 1998).
Sroufe (1983, 2000a),
and Carlson (1998) are among several researchers working within the Minnesota
Mother-Child Project, an ongoing longitudinal, prospective study of attachment
among at-risk mother-infant pairs which is in its 25th year. Evidence from
that study shows that the attachment relationship between mother and child
measured, using the Strange Situation, at twelve months of age and again
three years of age are remarkably stable and can be linked to achievement
level and behavior problems during childhood and young adulthood. The practical
applications of their work are enormous. One example was a pilot parenting
program called Steps Toward Effective, Enjoyable Parenting [STEEP] to promote
healthy bonding and relationships among at-risk first-time parents and
their babies (Erickson & Egeland, 1999). This program was a relationship-based,
mentoring program which was designed to promote attachment by building
on attachment theory and research about the intergenerational transmission
of parenting behaviors. The mentors provided group and individual opportunities
for the mothers enrolled in STEEP to evaluate their own childhood experience
in an effort to confront their childhood pain and then enable themselves
to choose positive parenting models on which to focus. The mothers in the
intervention group were supported in becoming "good-enough" parents. Although
the program did not accomplish a significant increase in quality of attachment
in its pilot year, the intervention group of mothers did demonstrate increased
sensitivity to their baby's and toddler's cries and signals, better understanding
of general child development, and increased life management skills compared
to the control group. Current STEEP programs are built upon these results
and provide first-time adult moms with individual and group support, parenting
and child development information during their pregnancies and the first
two years of their child's life.
Recognizing Attachment Disorders
Attachment disorders can
present themselves in varying degrees. Reactive Attachment Disorder, the
diagnosis given the most severe cases, is defined in the Diagnostic
and Statistical Manual of Mental Disorders (IV) as "markedly disturbed
and developmentally inappropriate social relatedness in most contexts that
begins before age five and is associated with grossly pathological careî
(American Psychiatric Association, 1994, p. 118). The definition goes on
to describe two types. The Inhibited Type is a child who consistently fails
to participate in social interactions due to behaviors which are extremely
inhibited and hypervigilant, or are contradictory. This manifests in children
who might avoid or freeze rather than approach an attachment figure when
stressed, and will resist comforting by their caregiver. The Disinhibited
Type is manifested in a child who does not discriminate adequately between
attachment figures and strangers. Children with Reactive Attachment Disorders
show not only this limitation of ability to attach, forming relationships
on the basis of need only, but also suffer from deficits in language skills
and conceptual thinking as well as poor impulse control, especially in
the area of aggression (Reber, 1996). Some researchers and other professionals
in the field feel this DSM-IV definition is too narrow (Sroufe,
2000a) and that it neglects the children with less severe disorders of
attachment or those whose symptoms first manifested after the age of five
and whose behaviors are also quite destructive. Additional symptoms common
to attachment disorders of all degrees include: lack of trust in authority
figures; lack of empathy or remorse; resistance to nurturing; lack of cause
and effect thinking; demonstration of manipulative, cheating, lying, and
stealing behaviors; cruelty towards other children and animals; extreme
control problems; showing affection with strangers but not with parents;
and manifesting a superficially charming persona (Reber, 1996).
Treatment and Prevention
In the last two decades
there has been tremendous growth in the identification and treatment of
attachment disorders. Treatment centers and therapists have made great
strides in rehabilitating children with attachment disorders and their
families. It was quite evident from participation at the recent 12th Annual
International Conference on Attachment and Bonding, held in Minneapolis
in October 2000, that the adoptive and therapeutic communities are both
well on their way to confronting and treating attachment disorders in youth.
However, the active work within the educational systems is just beginning.
Recognizing students with attachment disorders and working with other agencies
to assist their families in accessing effective treatment is only the first
task. Parenting curricula need to be developed which stress the importance
of the attachment-promoting behaviors and child care practices that researchers
believe lead to secure attachment relationships. As the treatment side
of confronting attachment disorders grows stronger, so too must the focus
on prevention. Parker and Forrest (1993) recommended implementation of
training programs and curricula addressing the prevention of attachment
disorders. It is absolutely vital for society to recognize and act on the
need to teach good parenting skills to today's parents and to the next
generation of parents.
Attachment Parenting Defined
One potential answer for
quashing the further transmission of attachment disorders is called "Attachment
Parenting" (Granju, 1999; Sears, 1995a; Sears & Sears, 1993). This
involves a set of parenting skills and behaviors which seek to establish
a strong attachment between caregiver and baby starting at birth. This
movement of attachment parenting which has been popularized by Dr. William
Sears and his wife, Martha Sears, R.N., authors of over a dozen parenting
books, has the potential to change our culture's view of proper care of
infants to a style of care that actively promotes secure attachment. Attachment
parenting is a method of parenting whereby the parents recognize and accept
the unique temperament and needs of their child and work to meet the child's
physical, spiritual, and emotional needs with sensitivity and consistency.
Parents who practice attachment parenting recognize the primary importance
of the mother-child bond in the emotional development of infants and toddlers.
These parents also recognize the importance of the father-child relationship
which, although initially secondary to the mother's role, is nonetheless
crucial for healthy child development. There are five primary attachment
parenting practices which build upon this understanding. The first common
attachment parenting practice is strongly valuing the signal value of a
baby's cry, which mandates quick and sensitive responses to the baby's
cries regardless of the hour. The next two are birth bonding, the delaying
of any separation or routine procedures after birth until after the family
has spent time alone to bond and rooming-in after a hospital birth rather
than having the baby sleep in the nursery; and breastfeeding on cue, for
comfort as well as nutrition, with child-led weaning. Next comes cosleeping,
which may take many forms, but commonly results in a family bed; and finally
"babywearing," the wearing of the infant in a soft cloth carrier such as
a front pack or a sling, rather than relying on plastic seats, and strollers.
These practices, in isolation or together, help to provide the best environment
for parent-child attachment.
Focus of Thesis
The three hallmark behaviors
within attachment parenting, and the three for which the current research
will be reviewed in this thesis, are cosleeping, babywearing, and breastfeeding
on cue. Literature will be reviewed on the causes of attachment disorders
and current options in parenting education. Following the literature review,
a beginning curriculum on parenting for attachment will be presented. This
curriculum is intended to be used with young teenagers, especially those
most at-risk for becoming parents as adolescents and those with histories
of being abused as children, to teach them the benefits of attachment parenting.
The attachment parenting curriculum, designed to be used in tandem with
a basic curriculum that teaches child development and life management skills,
will stress the importance of the attachment-promoting behaviors and practices
reviewed. The key to our culture's battle against attachment disorders
will be the active use of such prevention-focused programming in the schools.
© 2001 Tami E.
Breazeale
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