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Attachment Theory - John Bowlby
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Disinhibited Social Engagement Disorder (DSED)
- Reduced or absent reticence in approaching and interacting with unfamiliar adults.
- Overly familiar verbal or physical behavior (that is not consistent with culturally sanctioned and with age-appropriate social boundaries).
- Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings.
- Willingness to go off with an unfamiliar adult with minimal or no hesitation.
- Biological Development
- Psychological Development
- Social Development
- Spiritual Development
Treatment
Limitations of Attachment Theory
Applicability to Infancy/Childhood
DSM-V Criteria
- Lack of empirical support
- Weakness of categories
- Cultural differences
- Temperament, Biology, Experience
“There's no standard treatment for reactive attachment disorder, but it should involve both the child and parents or primary caregivers. Early intervention appears to improve outcomes. Goals of treatment are to help ensure that the child:”
Has a safe and stable living situation (safe base)
Develops positive interactions with parents and caregivers (attachment)
Pathogenic Care
According to DSM, RAD is diagnosed only when there is a known history of
expressed as:
(i) persistent disregard for basic emotional needs for comfort, stimulation, and affection
(ii) persistent disregard for basic physical needs
(iii) and/or repeated changes of primary caregivers
Ainsworth's Strange Situation
Strengths of Attachment Theory
- Revolutionary
- Expandable
- Internal Working Model
A Two Year Old Goes to the Hospital
Consequences of Bad Parenting
Germany
Populations and Problems
Punitive and repressive theories about how to raise German children.
-defined children as out of control. Soothing pain was viewed as a dangerous act.
-Micro impact: these acts "injured the child's sense of self and the capacity to express his or her needs
-Macro impact: primed a generation who desperately longed for love and belonging to accept Hitler's omnipotent authority
- Ideological basis for foster care and adoption systems
- Maltreated children - especially in cases of neglect
- Clinical social work
- Helping professional - defines as observer
- Client - redefines client as both child and mother (caregiver)
- Medical social work, mental health
Attachment System Development
- 0-6 months
- marked mirroring, history, and agency
- After 6 months baby develops full attachment triad - proximity seeking, secure base effect, separation protest
- 6 months - 3 years
- "set goal attachment," "homing device", and beginnings of relationship
- 3 years onwards
- child thinks of parents as separate people and learns how to influence them to maintain attachment
Attachment Theory
Attachment Theory
John Bowlby
- Attachment style (Bowlby's model) - the state and quality of an individual's attachments
- subdivide into secure and insecure
- insecure divided into avoidant, ambivalent, and disorganized
- Attached feels safe and secure, but insecure attachments have mixed feelings
- Attachment behavior - any form of behavior that results in a person attaining or retaining proximity to some other differentiated and preferred individual
- Patterns of Attachment (Ainsworth) - secure, anxious-avoidant, anxious-resistant (ambivalent), and disorganized
Carly Shockley, Tyler Seabolt & John Burch
This American Life
"Unconditional Love"
http://www.thisamericanlife.org/radio-archives/episode/317/unconditional-love
"Psychology just didn't believe in love. And if you go back and you pull any of the psychology textbooks, really almost pre-1950, you don't even find it in the index because it was not a word that was used."
Limitations of Attachment Theory
1. As seen through the Attachment Theory lens
2. Not everyone subscribes to Attachment Theory
3. RAD (an environmental disorder)
- Developmental Trauma
- Conservation of Resources Theory COR explains the loss, threat of loss or failure to gain resources and the consequential stress and ability to adapt and cope with that stress. Objects, Conditions, Personal Characteristics, Energies
- Pathogenic care is ≠ RAD as Trauma ≠ PTSD
- RAD is not 100% predictive (even in abused populations)
- May be due to or influenced by temperament/cultural or unknown biological factors
Risk Factors
- Frequently change foster homes or caregivers
- Live in a children's home or other institution
- Have inexperienced parents
- Have prolonged separation from parents or other caregivers due to hospitalization
- Have a mother with postpartum depression
- Are part of an unusually large family, such that parental time is scarce or available unequally or rarely
Reactive Attachment Disorder (RAD)
- The child rarely or minimally seeks/responds to comfort when distressed.
- Minimal social and emotional responsiveness to others
- Limited positive affect
- Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers.
Psychoanalysis + Ethology = New Theory
- Basis on findings of ethology & his theoretical critique of psychoanalysis
- Drive theory and Object-Relations Theory both flawed - psychoanalysis
- Attachment as a psychological bond between infant and mother, not a secondary product of physical aspects (i.e. feeding).
- "primary motivational system"
Prologue to Attachment Theory
- Born from reaction to institutionalized care
- Questions surrounding the break of a parent-child bond: what is the nature of this bond, and how does it develop?
Reactive Attachment Disorder
Reactive attachment disorder is a condition found in children who have received grossly negligent care and do not form a healthy emotional attachment with their primary caregivers -- usually their mothers -- before age 5.