Responses by Dr. Erickson to Questions from Host Sites for the October 18th Attachment Series Workshop

1) Several attendees wanted to hear Dr. Erickson's material on working with older children who have not experienced healthy attachment. My work focuses on working with parents and infants to build secure attachments in the first place. However, several of my publications address how to work with parents who have not experienced healthy attachment (bringing about change in their “working models” by contradicting their expectations; helping them remember their own childhood relationships and move past their denial of – or preoccupation with – painful experiences so that they develop a more “secure-autonomous” state of mind about attachment). Principles for working with older children are very similar to what we do with parents. But people like Anne Gearity and Elizabeth Carlson may be more helpful in talking about working with older children with attachment problems. Also, Joanne May from the Family Attachment Counseling Center in Deephaven has a very promising approach of Narrative Therapy that addresses both corrective relationships and what attachment researchers call “state of mind” about attachment.

2) My question is how important/dependent is the emotional connection for the caregiver to do good attachment work with a child in their home with attachment issues?  Does the caretaker need to feel attached, bonded, or have a feeling of love toward the child in order for the child to make progress with working on attachment issues?  Stated another way, can a child make steps toward attachment with someone who does not feel attached to him/her but who may go through the motions of implementing therapy steps that help the child to attach? Interesting question! I don’t know anyone who has studied that, but I do think children often can tell the difference between someone who’s faking it and someone who really cares about them. At the same time, I do think it may be possible to provide sensitive, predictable care to a child even if you don’t feel love toward that child. And, over time, that could help the child feel more secure and become more open to attachment. Perhaps the child’s warming up to that person would even help the adult begin to feel love for the child. And wouldn’t that be nice!

3) Registrants were discussing the issue of Attachment and fostercare. We all agreed that this is a difficult issue.  Registrants asked about guidelines as to impact on children and optimum length of placement before it impacts attachment  and the healing process within the system.  Just lots of questions in this area and would like to have Dr. Erickson’s thoughts. It’s very difficult to answer this question with any precision. I’d say the time in placement required to bring about change would vary depending on how old the child is and how traumatic the child’s previous experiences had been. Working models are slow to change. And a child who has learned not to trust will perceive every little slight as confirmation that someone shouldn’t be trusted. The bottom line is, foster parents and adoptive parents need an enormous amount of support and training to be able to get close to a child who has learned that it’s dangerous to get close. (Others working in adoption may have more helpful answers to this.) There is good news, though, at least with respect to infants and very young children entering placement, particularly from the ongoing experiments with Romanian children. I’m sure Dr. Zeanah will talk about this work in his presentation in the ongoing CECMH series.

4) How do you work with an adult who had disorganized attachment as a child so that they can have a successful parenting experience?  What are the implications for children and grandchildren?  Are there parent-support or parent-education programs that have been successful? Our writings about the STEEP program address this, as well as parents with other types of attachment. But there still are many unanswered questions about the extent to which parents with disorganized histories require special strategies.

5) What are some models of effective support network for practitioners/professionals in communities to support healthy attachment/mental health development? Through CEED, we offer reflective practice groups, which aim to do just that. Interested people should contact the CEED office if they are interested in contracting with CEED to provide facilitation of that kind of group and/or to offer a training of supervisors to help them learn to do it. This also will be a part of the training included in the Infant and Early Childhood Mental Health Certificate Program, being developed by CEED in cooperation with CECMH.

6) What do I do working as an infant teacher when I suspect an attachment issue?  What’s my next step?  What is the process of referral and how to talk to parents about this issue? In order to determine if a child has an attachment issue, it’s important to see the child in interaction with the parent. There are two hallmarks of a secure attachment: 1) child seeks and accepts comfort from the parent when distressed, and that comfort helps the child calm down and go back to exploring or interacting; 2) in the presence of the parent – even in an unfamiliar environment – the child appears to feel secure enough that he or she can show interest in the environment. There are a few mental health professionals around the state who have had special training in infant mental health and attachment issues.  Perhaps Glenace Edwall or Antonia Wilcoxin of the Children’s Mental Health Division  of the MN Department of Human Services here in the Twin Cities could help identify people in your area. If so, such a person might be able to consult with you about the situation and/or provide service to the parent and child if that is indicated.  (An additional national resource is Zero to Three at http://www.zerotothree.org/.)

7) Suggestions for working with school staff to exempt specific cases (children with attachment issues) from getting suspended (rejection)? Anne Gearity would be a great resource on this question.  She will be presenting for at the 4th workshop in Attachment Series on April 25th.