This post in the third post in Adoption Attachment Resources series. You can read the other two here and here. Please note there are links to Amazon pages but I am not an Amazon Affiliate at this time so clicking through doesn’t benefit me one way or another.
Building the Bonds of Attachment by Daniel A. Hughes. When I met with the Clinical Director of the first residential treatment program I placed my son, the first thing he did was say “here, I want you to read this book, this is what we want you to do.” Hughes’ book is the story of a fictional girl, Katie, who is abused and neglected, removed from her birth family home, bounces around the foster care system until finally being placed in a therapeutic foster home where the foster-mother, with the help of a therapist, is able to break through the walls of trauma to build attachment. The child is not an actual client but rather a compilation of several of Hughes’ former clients. Building trust and attachment with the child through high structure, few choices, consequences which requires the child to stay close to the foster mother, and some intense therapy sessions to help the child awaken their hidden feelings related to her abuse, trauma, and neglect. You can go to his website here to read more about Dyadic Development Psychotherapy (DDP) and his parenting model. My thoughts: The book was very interesting in the sense I identified very much with the last foster-mother and her struggles with Katie. He includes “journal entries” which show the utter exhaustion and frustration of dealing with a child who constantly fights for control and lives daily in survival mode. I found his DDP to be similar to Dr. Purvis’ “Trust-based Relational Intervention.” Some ways in which I did not identify were 1) the foster mother is not emotionally invested initially, in the sense she is a foster mother not an adoptive mother. She doesn’t know how long Katie will be in her home, and she doesn’t really care one way or another whether Katie loves her though she does want to help Katie learn to attach; and 2) Though she has three other teens in her home they are in a fairly independent stage of life and she has a husband who can “keep the wheels on” for the rest of the family while the foster mother focuses almost all of her time exclusively to Katie. I’m not talking a few weeks or months, I am talking years. Beyond the fact that I felt overwhelmed by the level of time commitment, the therapist we worked with in the treatment center never facilitated sessions in a manner in any way close to what the book outlines. It was like I was told, “here’s a book that will help you to figure it out, good luck with healing your child.”
The Connected Child by Dr. Karyn Purvis and Dr. David Cross. Dr. Purvis, as I have mentioned before on my blog, was considered “the trauma child whisperer.” Her book delves into what happens in a child’s brain when they have suffered trauma and neglect during critical infancy months. She explains how it is necessary to “go back” and build or rebuild neuropathways in a child’s brain due to unmet needs. Below are images of a healthy attachment cycle, and a trauma attachment cycle.
(Images courtesy of the Attachment & Trauma Network Inc.)
When a baby can not trust a caregiver to meet their needs, they begin to find ways to meet their own needs. They learn the world is not a safe place, crying does not bring help, and they develop coping mechanisms to control their world. Drs. Purvis and Cross developed what is called the “Trust-based Relational Intervention” (TBRI) model of parenting. The idea is you begin to rebuild felt-safety and trust by constantly meeting a child’s needs and reassuring them you are going to continue to meet those needs consistently. One of the biggest ways trauma has affected my children is an inability to self-regulate, meaning when they get wound up, they can’t bring themselves down again, whether wound up looks hyper or looks like a tantrum. For adopted children under the age of 3 years, she recommends “wearing” a child so your heartbeat, your rhythms, can help a child regulate and eventually they will be able to self-regulate. For older children, you create connection through playful engagement, eye contact, consistently meeting their needs, and creating very firm boundaries. My thoughts: This has been by far the most useful resource I have used. My children were all over the age of three years at adoption so wearing them was not an option. So how did I help my children learn to regulate? Well for the three that were adopted as toddlers, they were still little enough to pick up and hold in my lap. For example, when we first adopted my middle son, he could throw some massive temper tantrums when he didn’t get his way. Not often, but they were hour-long ordeals when he did. Most of the time I would go to him and if I couldn’t calm him within five minutes by talking to him in a soothing voice, I would pick him up and start to rock him. I remember how he would keep his eyes jammed shut, the anger in his cries, and how he would not look at me. Then at some point, his cries would change. They were heart-breaking because the cries came from deep within his soul as he grieved for the loss of who knows what – birth mother, foster-mother, the life he knew in China. He would open his eyes but his eyes were unseeing. He would stare somewhere off in the distance and weep. Then he would begin to whimper, his little body would give a slight shudder as he finally gave in to my comfort and love, and he would look at me. The storm had passed, he felt calm and safe, and we’d walk out of whatever room we were in, exhausted but connected. With my two oldest sons, and my daughter, although they had varying levels of attachment trauma, they were deep down wired to connect. With my youngest son, he is not wired to connect, in fact I have really struggled to find a way for TBRI to work in our relationship as holding him, getting eye contact, helping him to regulate, and everything else related to creating a good attachment bond, has utterly failed either because I can not practice it to the level of intensity he needs, or because of my inability to attach to him. Attachment is a two-way street. I have helped my children to feel safe that I am trustworthy by “sharing power.” Giving kids as many “yeses” as possible, giving choices that are acceptable to me, dials down their anxiety about not being totally in control. So, with three of my children it looks this way:
Me: It is time to do homework. Do you want to do it before you have a snack or after your snack?
Then my child will choose. Sometimes I say we need to do something, say homework and they will “ask for a compromise,” as in “Mom, can I have a compromise? Can I finish this battle on Clash of Clans and then do my homework?” Usually I ask how long the battle (or video, or tv show, or computer game) will take and if it is less than five minutes I say “yes” and if it is longer, I say, “You can go back to your activity after your homework is done.” You can find more of these Life Value Scripts here. This is how a parent can “share power” so their child feels they have some amount of control over what they do or don’t do. A lot of it may seem counter-intuitive, like saying “good asking for _______” when your child asks for something, but when we use TBRI, we are trying to re-wire their responses so they will continue to use the behaviors we desire. Drs. Purvis and Cross are very big on the “do-over” and “respect.” Here’s an example:
Child: “Mom, tie my shoes.”
Me: “Uh-oh. Try it again, with respect.”
Child: “Mom, will you please tie my shoes for me?”
Me: “Great asking. Yes, I will tie your shoes for you.”
Sometimes we would practice our “do-over” half a dozen times if they couldn’t be respectful the first five times. I don’t have to do this with my kids any more but if they get a little demanding or sassy, I will remind them they need to speak to me with respect. They know the drill now. Really, you don’t even have to have a child with attachment issues to use the scripts, they just make for good parenting interactions. I thought it was really hard at first because I am not hard-wired to be soft-spoken and flexible with my children, I am more the “do this now because I asked you to do it and don’t give me any fuss about it.” But for a child with control issues, all this did was put us in opposition to each other. I worried I wasn’t really any good at it because I couldn’t remember to do it all the time, but our attachment therapist assured me that even Dr. Purvis says if a parent will do this just 33% of their interactions with their children, it can help to re-wire a child’s responses to the parent and build connection.
My younger son can not share power at all. Not.At.All. He must be hyper-vigilant and in absolute control at all times. It doesn’t matter if exercising that control is harmful to him, he can not allow anyone else to control his actions. It is frustrating, anger-inducing, and incredibly sad all at once. It has made finding him the right help incredibly difficult because to him, his very survival depends upon him resisting all outside influences in his decision-making.
To learn more about TBRI, and to see some teaching videos from Dr. Purvis, you can go to the Empowered to Connect website. If you do nothing else on this website, please listen to Dr. Purvis’ audio talk “Precious In His Sight.” It is worth the 20 minutes of your time, and if you are like me and have a child with RAD, you will go back to it again, to remind yourself that this child, too, is precious in His sight. As I mentioned above, the reason it worked (and continues to work) for three of my four, is they are wired to connect pretty quickly. It is very intensive, you will need to have a source of respite to get re-charged periodically, but it really works if you give it a chance.
I am currently reading Daniel Siegel’s books The Whole-Brain Child and I have another of his books, No Drama Discipline on my shelf to read next. I am not going to lie, The Whole Brained Child is dry. It is clinical and filled with research, but it is very good (so far) at explaining what happens in a child’s brain when their basic needs are not met in infancy, or when they are exposed to drugs or alcohol in-utero. Right now I am in all the scientific part and haven’t reached to meat of the “how-to” yet. I will post an update when I have read both books in their entirety.
Other books you might consider but I have not personally read:
Beyond Consequences, Logic, and Control by Heather T. Forbes and B. Bryan Post (actually, I did read this book about 10 years ago but I don’t remember enough about it to give it a fair review. I should probably pull this off the shelf too because I know a number of adoptive parents have found this book helpful.)
Do you have a attachment related book you like I have not listed? Please share in the comments below! I am always looking for new resources.