Issues Treated in Therapy:
Attachment is our ability to form emotional bonds and empathic, enjoyable relationships with other people, especially close family members. Attachment issues are most obvious and prevalent during childhood, and are often the result of abuse or neglect. The inability to form healthy, secure attachments is sure to cause disruptions to people socially and emotionally. Attachment is related to trust, emapthy, and self-esteem.
Reactive Attachment Disorder (RAD) is a severe childhood disorder in which children display one of two kinds of inappropriate social behaviors. The first, the “inhibited form”, is characterized by withdrawal and introversion. The disinhibited form involves a lack of boundaries with strangers, and, in severe cases, sexual or aggressive tendencies. Often, children exhibit both forms at different times.
Reactive attachment disorder is rare, and its causes are well recognized. While in the general population it probably occurs in less than one percent of children, among maltreated children between fifty and eighty percent are likely to develop RAD, and as many as eighty percent of maltreated infants exhibit some signs of attachment disorder. It is a disorder primarily caused by chronic early maltreatment within a caregiving relationship. Prolonged institutional care (orphanage) and extended stays in a NICU can also cause such difficulties. In other words, this is an illness undoubtedly caused almost entirely by environmental factors. -- edited Arthur Becker-Weidman
Attachment issues that are left unresolved can interfere with nearly all relationships people form. Children who have attachment issues can benefit from therapy by learning what healthy relationships look like. They can form constructive bonds with caregivers and learn how to cope with the symptoms that resulted from their early attachment issues. Adults who have never addressed the problems they have with attachment surely have seen the consequences in their lives. Whether it is with friends, children, parents or partners, these individuals have carried the sense of loss and yearning into all of their adult interactions. They may struggle with codependency or fear of abandonment and not fully understand why. Therapy can help these adults grieve for the bonds they never formed in childhood and gain closure. They can learn how to accept love and give love while setting boundaries that allow them to maintain their self-respect and gain fulfillment from within rather than relying on others to accomplish that goal for them.
Shawn, 6, is brought in for therapy by his newly adoptive parents, who adopted him from the foster care system last year. He had been so loving and sweet with them when he’d first moved in, they were willing to overlook his impulsivity, sudden bursts of aggression, and sexualized behavior. They figured these behaviors would get better as he got accustomed to a more stable life with them, and with his new brother and sister, both older. Instead, things had deteriorated rapidly. He was aggressive with his siblings, impossible to discipline, and always in trouble at school. He seemed angry for no reason, and would not allow anyone to comfort him. He wet the bed almost nightly. Shawn’s parents were almost ready to give up and send him to a group home for children with behavior problems. The therapist recognized the signs of attachment issues, and instead of trying to change Shawn’s behavior with reinforcement and punishment, as had been tried by foster parents, teachers, and now Shawn’s adoptive mother and father, the therapist worked on creating positive attachment experiences in therapy between the parents and Shawn. In addition, the therapist helped the parents understand the cause of motivation of Shawn's behaviors and provide attachment-facilitating parenting experiences at home. After several months, results began to appear. Shawn accepted hugs, and was less easily triggered. Instead of hitting his siblings, he cried and asked for assistance from his parents. His poor behavior was but a symptom of intense emotional ambivalence, and when that was addressed through positive parenting, the symptoms began to fade.
Melissa, 32, is married and having problems with intimacy. Her sex life with her husband began to worsen almost immediately after their honeymoon, and she admits the problem is hers; she is repulsed by sexual invitation from her husband, and even afraid of touching him in bed at all. She feels angry at him for no reason she can identify, and feels she would like to live “separate lives”. However, the thought of divorce terrifies her and she does not want that. Melissa cannot explain her feelings, but an examination of her childhood reveals instances of severe neglect Melissa had thought she “was over”. Therapy reveals Melissa has intense fears of both rejection and of being enveloped or dominated by others. Through work on communication skills and by experiencing catharsis (emotional release) in the presence of, at first, the therapist and, later, her husband, Melissa is able to develop a bond that feels safe with her husband, and begin to repair her marriage.
Last updated: 11-19-2013
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