Why Attachment Therapy?

A reader, JM, left the following comment:

I’m curious, if you don’t mind answering, why you chose to do Attachment Therapy with Hope as opposed to other therapies? Also, what do you think about the controversy and criticism of Attachment Therapy?

As we have recently made yet another four hour trip to see the attachment therapist, I thought this would be a good time to start to answer this question. I can only start to answer because Hope’s treatment is a work in progress.

When we Hope first joined our family, it was obvious that she had been severely neglected. Abuse, both sexual and physical, was red flagged by Hope’s behavior the first couple of weeks home. From the moment we took Hope, it was apparent that her rage was focused on the mother. That would be me. Hope has been seeing two trauma therapists since she came home. Last spring, the physical violence against me reached dangerous levels. A friend of mine, who had adopted a child from a Russian orphanage, had used the attachment therapist we are using with good results.

The therapist was Dan Hughes based, and also treated trauma. We did an eight day intensive in July and it was difficult. Difficult for us, difficult for Hope. The therapist told us how seriously disturbed Hope was. She said Hope maybe unable to live in a family, but there was still a spark there to work with.

Hope is not my first child with attachment issues. My first child was adopted at 10 weeks. He cried for the first three months he was home. My oldest daughter, who has FASD, was adopted at 6 months. When my daughter came home, she smiled at everyone. She never cried. She would take right away to anyone she came in contact with. Everybody, including me, thought it was a blessing that she adjusted so well. This was 27 years ago and nobody in the adoption world was talking about attachment issues. She wasn’t diagnosed with RAD until she was 17. She still struggles.

I was looking for a healthier outcome for Hope. I realize attachment therapy comes with a lot of controversy. The “holding” therapy is the source of much of that controversy. Children have died from it. Some of those deaths occurred because parents didn’t feel “in charge” and therefore did not educate themselves on the therapy their child was receiving. By not taking charge themselves, they became subservient to the therapist and allowed physical abuse. The Dad and I are always in the room with Hope and we always know exactly what is going to happen. The only time there is any “holding” involved is during trauma work. During trauma work Hope is rolled up in a blanket on a mattress before it begins.

I feel that since Hope is so young the best outcome for her is for us to become her psychological parents. I still think it is possible for The Dad. I am not sure it is possible for me. I do not know if Hope will ever let anyone be her mother again. This leads me right to where I am. Does Hope have to accept me as her mother in order to grow up healthy in our family?

I have no answer to that question. I can’t find anything in the literature. Most of the literature is written with the assumption attachment is necessary and then goes on to how to get the child attached. I am sure that secure attachment would be the best outcome. Nobody looks at  how to help a child who is not capable of attachment. There were some case studies of unattached child who grew up to be sociopaths, but no examination of unattached children who grew up without becoming sociopaths. I was looking for a study of the differences between the two groups.

I am sure this doesn’t fully answer the question, but I don’t really have an answer. We are a work in progress. Hope is a work in progress. Day by day, we look for new paths, partial answers.

4 thoughts on “Why Attachment Therapy?

  1. “Does Hope have to accept me as her mother in order to grow up healthy in our family?”

    I’m not a professional, but I think what a severely abused child needs to grow up healthy is (1) a safe and stable family with gentle, loving, consistent parents, (2) trauma-focused therapy with an experienced, knowledgeable professional (preferably M.D. or Ph.D. level) if PTSD symptoms are present, and (3) diagnosis and treatment (again, by an experienced, knowledgeable professional, preferably M.D. or Ph.D. level) of any other relevant psychological/psychiatric issues, (4) safe, appropriate, consistent, and long-term relationships with school teachers, friends, extended family, etc., and (5) the opportunity and instruction to develop skills which the child can one day use to help others and/or contribute to and connect with the wider community.

    Except for the last point, none of these are about how the child produces or performs, but rather how/what the adult world produces *for* the abused/traumatized child.

    Oh, and (6) Time.

    If we were talking about a 25-year-old, I’d have a completely different perspective. But children need loving safety, appropriate education/treatment, and *time* to heal, in my experience.

    And, in my experience, time (i.e., adult patience) is often the most difficult for the rest of us to give to hurt children. Me included.

    One of the biggest (and ongoing) mistakes I’ve made with my second daughter is to assume that, because of how much I learned with my first daughter, things would go more smoothly the second time around—and by “smoothly,” although I didn’t realize it at first, I also meant “quickly.”

    But that’s not the case. And why should it be? To make a medical analogy—a surgeon may get better at doing open-heart surgery every time she does that operation, but each patient needs to heal in their own time and way, and very little of that healing process will have anything to do with the skill of the surgeon beyond a certain threshold of surgery finesse. In other words. an averagely good surgeon’s patients will heal in the same amount of time as the brilliantly spectacular surgeon’s patients. Because the healing comes from within the patient–and is based on their general healthy, immune system function, etc.

    So, it turns out, I still had a lot to learn with my second daughter.

    Again, I’m no professional, and I don’t know if any of this is relevant to Hope.

    We’re into the relationship 6 months of visitation with my youngest daughter, plus 15 months of living together as a family. And one of our crisis workers (not so helpfully) asked, over the weekend, when I called the 24/7 hotline for some assistance, “Do you think it will ever work out?”

    I needed to ignore that question, with all the impatience it implies. I called for help for a particular problem in that particular moment—and it didn’t matter to me (or my daughter) how many problems there had been in the past or how many more problems there will be in the future. I wasn’t looking for a DNR order.

    Ironically, I received wonderful insight and suggestions from that worker, eventually. But I noted her despair and vowed to not reach out to her for a while. I can’t let her impatience with my daughter’s process “infect” me. There’s no magic time limit to any of this.

    When my mother was dying of breast cancer, I learned that there were some people who could accompany me as a friend on my journey of grief (while she was alive and suffering, as well as after she died), and some who could not. It all was taking so long, it was so painful, it reminded some of vulnerabilities that they believed they couldn’t handle. Once I figured out who could come with me, and who couldn’t, it made everything clearer. There was nothing else more important to me at the time than to be with my Mom through her disease and death. And then, to grieve.

    However long it took.

    And when I was done, I didn’t return to “normal.” I was a fundamentally changed person, in my 20s.

    Similar now, with my second daughter: our family will never be the same as it was, before she joined us. Some folks can accompany us on that journey, some can’t. And I don’t know how it’s going to change us in the end. I’m just very clear now that it will, and the change will come in its own time. Experience won’t help me much, except in terms of acceptance and patience.

    My thoughts are with you all. I hope you find some benefit in the treatments you are pursuing.

    • I am by no means neither a professional nor a parent.

      But may I suggest to you that next time you have the crisis worker’s impationt question, you remind her, politely but firmely, that your daughter is a child and that a child is not a miniature adult (therefore, they cannot expect quick results) ?
      Some workers and health care professional consider that you have to treat children like miniature adults, which explains (partially) their wanting quick results. They apply exactly, letter by letter, comma by comma, what they do with adults to children.
      And you can even tell her that if she continues to act impatient like that, she will only jeopardize your success with your daughter. So, you give her the choice to stay and being more patient, or leave if she cannot handle the situation.
      With these kind of professionals, psychologists, MDs, case workers… you need to be very firm. Don’t ignore their question and impatient behavior, it can only harm you and your daughter on the long run.

      You do your best.
      Keep only the best team players. Keeping a player who is not the best player is only harmful on the long run.
      Don’t be afraid of firing a bad team player. You pay them for the service they provide. If they don’t give you what you and your daughter deserves, then, you have no reason to be guilty for firing a harmful team player.

      However, as a child is not a miniature adult, they cannot ask

  2. If it helps, you could consider that unattached children who grow up to be productive family people, not sociopaths, would not be detected. My sister and I are professional people with happy secure children and friends. No arrests. Resilience is a funny thing but it’s real.
    It is of note that both of us along with our attached sibling have been unable to deal with our primary abuser since the secondary abuser died. We just gave both of them back to the universe to prevent constant daily damage from contact and memories.
    You are a good person with incredible strength and you will do the right thing for your family.

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