The ChildTrauma Academy

www.ChildTrauma.org
All rights reserved © 2001 Bruce D. Perry

BONDING AND ATTACHMENT IN

MALTREATED CHILDREN
CONSEQUENCES OF EMOTIONAL NEGLECT IN
CHILDHOOD
Bruce D. Perry, M.D., Ph.D.
V 3.0
This booklet is one in a series developed by the ChildTrauma Academy
to assist parents,
caregivers, teachers and various professionals working with maltreated
and traumatized children.
CAREGIVER EDUCATION SERIES
Edited by B. D. Perry
Adapted in part from: “Maltreated Children: Experience, Brain Development and the Next
Generation” (W.W. Norton & Company,
New York, in preparation)
Attachment in Maltreated Children, Perry
2
INTRODUCTION
The most important property of humankind is the capacity to form and
maintain relationships. These relationships are absolutely necessary for
any of us to survive, learn, work, love and procreate. Human
relationships take many forms but the most intense, most pleasurable
and most painful are those relationships with family, friends and loved
ones. Within this inner circle of intimate relationships, we are bonded
to each other with "emotional glue" - bonded with love. Each
individual's ability to form and maintain relationships using this
"emotional glue" is different. Some people seem "naturally" capable of
loving. They form numerous intimate and caring relationships and, in
doing so, get pleasure. Others are not so lucky. They feel no "pull" to
form intimate relationships, find little pleasure in being with or close to
others. They have few, if
any friends and more distant, less emotional glue with family. In
extreme cases an individual may have no intact emotional bond to any
other person. They are self-absorbed, aloof or may even present with
classic neuropsychiatric signs of being schizoid or autistic. The capacity
and desire to form emotional relationships is related to the
organization and functioning of specific parts of the human brain. Just
as the brain allows us to see, smell, taste, think, talk and move, it is
the organ that allows us to love -- or not. The systems in the human
brain that allow us to form and maintain emotional relationships
develop during infancy and the
first years of life. Experiences during this early vulnerable period of life
are critical to shaping the capacity to form intimate and emotionally
healthy relationships. Empathy, caring, sharing, inhibition of
aggression, capacity to love and a host of other characteristics of a
healthy, happy and productive person are related to the core
attachment capabilities which are formed in infancy and early
childhood.
FREQUENTLY ASKED QUESTIONS
What is attachment?
Well, it depends. The word attachment is used frequently by mental
health, child
development and child protection workers but it has slightly different
meanings in
these different contexts. The first thing to know is that we humans
create many kinds of “bonds.” A bond is a connection between one
person and another. In the
field of infant development, attachment refers to a special bond
characterized by
the unique qualities of the special bond that forms in maternal-infant
or primary
caregiver-infant relationships. The attachment bond has several key
elements: (1) an attachment bond is an enduring emotional
relationship with a specific person; (2) the relationship brings safety,
comfort, soothing and
pleasure; (3) loss or threat of loss of the person evokes intense
distress. This special form of
All rights reserved © 1999 Bruce D. Perry

What is Attachment?
• Special enduring form of “emotional” relationship with a specific person
• Involves soothing, comfort and pleasure
• Loss or threat of loss of the specific person evokes distress
• The child finds security and safety in context of this relationship

relationship is best characterized by the maternal-child relationship. As

we study the nature of these special relationships, we are finding out
about how important they can be for the future development of the
child. Indeed, many researchers and clinicians feel that the maternal-
child attachment provides the working framework for all subsequent
relationships that the child will develop. A solid and healthy
attachment with a primary caregiver appears to be associated with
a high probability of healthy relationships with others while poor
attachment with the mother or primary caregiver appears to be
associated with a host of emotional and behavioral problems later in
life. In the mental health field, attachment is used loosely has come to
reflect the global capacity to
form relationships. For the purposes of this paper, attachment
capabilities refer to the capacity to form and maintain an emotional
relationship while attachment refers to the nature and quality of the
actual relationship. A child, for example, may have an "insecure"
attachment or "secure" attachment.

What is bonding?
Simply stated, bonding is the process of forming an attachment. Just as
bonding is the term used when gluing one object to another, bonding is
using our emotional glue to become connected to another. Bonding,
therefore, involves a set of behaviors that will help lead to an
emotional connection (attachment).

Are bonding and

attachment genetic?
The biological capacity to bond and form attachments is mostcertainly
genetically
determined. The drive to survive is basic in all species. Infants are
defenseless and must depend upon a caregiving adult for survival. It is
in the context of this primary dependence, and the maternal response
to this dependence, that a relationship develops. This attachment is
crucial for survival.
An emotionally and physically healthy mother will be drawn to her
infant - she will feel a physical longing to smell, cuddle, rock, coo and
gaze at her infant. In turn the infant will respond with snuggling,
babbling, smiling, sucking and clinging. In most cases, the mother's
behaviors bring pleasure, soothing and nourishment to the infant and
the infant's behaviors bring pleasure and satisfaction to the mother.
This reciprocal positive feedback loop this maternal-infant dance, is
where attachment develops. Therefore, despite the genetic potential
for bonding and attachment, it is the nature, quantity, pattern and
intensity of early life experiences that express that genetic potential.
Without predictable, responsive, nurturing and sensory-enriched
caregiving, the infant's potential for
normal bonding and attachments will be unrealized. The brain systems
responsible for healthy emotional relationships will not develop in an
optimal way without the right kinds of experiences at the right times in
life.

What are bonding experiences?

The acts of holding, rocking, singing, feeding, gazing, kissing and other
nurturing behaviors involved in caring for infants and young children
are bonding experiences. Factors crucial to bonding include time
together (in childhood, quantity does matter!), face-to-face
interactions, eye contact, physical proximity, touch and other primary
sensory experiences such as smell, sound, and
taste. Scientists believe the most important factor in creating
attachment is positive physical contact (e.g., hugging, holding, and
rocking). It should be no surprise that holding, gazing, smiling, kissing,
singing, and laughing all cause specific neurochemical activities in the
brain. These neurochemical activities lead to normal organization of
brain systems that are responsible for attachment.
The most important relationship in a child’s life is the attachment to his
or her primary caregiver, optimally, the mother. This is due to the fact
that this first relationship determines the biological and emotional
‘template’ for all future relationships. Healthy attachment to the
mother built by repetitive bonding experiences during infancy provides
the solid foundation for future healthy
relationships. In contrast, problems with bonding and attachment can
lead to a fragile biological and emotional foundation for future
relationships.

When are these windows of opportunity?

Timing is everything. Bonding experiences lead to healthy attachments
and healthy attachment capabilities when they are provided in the
earliest years of life. During the first three years of life, the human
brain develops to 90 percent of adult size and puts in place the
majority of systems and structures that will be responsible for all future
emotional, behavioral, social and physiological functioning during the
rest of life. There are critical periods during which bonding
experiences must be present for the brain systems responsible for
attachment to develop normally.
These critical periods appear to be in the first year of life and are
related to the capacity of the infant and caregiver to develop a positive
interactive relationship.

What happens if this window of opportunity is

missed?
The impact of impaired bonding in early childhood varies. With severe
emotional neglect in early childhood the impact can be devastating.
Children without touch, stimulation and nurturing can literally lose the
capacity to form any meaningful relationships for the rest of their lives.
Fortunately most children do not suffer this degree of severe neglect.
There are, however, many millions of children who have some degree
of impaired bonding and attachment during early childhood. The
problems that result from this can range from mild interpersonal
discomfort to profound social and emotional problems. In general, the
severity of problems is related to how early in life, how prolonged and
how severe the emotional neglect has been.
This does not mean that children with these experiences have no hope
to develop normal relationships. Very little is known about the ability of
replacement experiences later in life to “replace” or repair the
undeveloped or poorly organized bonding and attachment capabilities.
Clinical experiences and a number of studies suggest that
improvement can take place, but it is a long, difficult and frustrating
process for families and children. It may take many years of hard work
to help repair the damage from only a few months of neglect in infancy.

Are there ways to classify attachment?

Like traits such as height or weight, individual attachment capabilities
are continuous. In an
attempt to study this range of attachments, however, researchers have
clustered the continuum into
four categories of attachment: secure, insecure-resistant, insecure-
avoidant, and insecuredisorganized/
disoriented. Securely attached children feel a consistent, responsive,
and
supportive relation to their mothers even during times of significant
stress. Insecurely attached
children feel inconsistent, punishing, unresponsive emotions from their
caregivers and feel
threatened during times of stress.
Dr. Mary Ainsworth developed a simple process to examine the nature
of a child’s attachment. This is
called the Strange Situation procedure. Simply stated, the mother and
infant are observed in a
sequence of “situations:” parent-child alone in a playroom; stranger
entering room; parent leaving
while the stranger stays and tries to comfort the baby; parent returns
and comforts infant; stranger
leaves; mother leaves infant all alone; stranger enters to comfort
infant; parent returns and tries to
Classification of
Attachment
Percentage at One-
Year
Response in Strange Situation
Securely attached 60-70 %
Explores with M in room; upset with separation;
warm greeting upon return; seeks physical
touch and comfort upon reunion
Insecure: avoidant 15-20 %
Ignores M when present; little distress on
separation; actively turns away from M upon
reunion
Insecure: resistant 10-15 %
Little exploration with M in room, stays close to
M; very distressed upon separation; ambivalent
or angry and resists physical contact upon
reunion with M
Insecure: disorganized
disoriented
5-10 %
Confusion about approaching or avoiding M;
most distressed by separation; upon reunion
acts confused and dazed – similar to
approach-avoidance confusion in animal
models
Attachment in Maltreated Children, Perry
6
comfort and engage the infant. The behaviors during each of these
situations is observed and
“rated.” The behaviors of children in this testing paradigm

What other factors influence bonding and

attachment?
Any factors that interfere with bonding experiences can interfere with
the development of attachment capabilities. When the interactive,
reciprocal "dance" between the caregiver and infant is disrupted or
difficult, bonding experiences are difficult to maintain. Disruptions can
occur because of primary problems with the infant, the caregiver, the
environment or the "fit" between the infant and caregiver.
Infant: The child’s “personality” or temperament influences bonding. If
an infant is difficult to sooth, irritable or unresponsive compared to a
calm, self-soothing child, he or she will have more difficulty developing
a secure attachment. The infant's ability to participate in the maternal-
infant interaction may be compromised due to a medical condition
such as pre-maturity, birth defect, or
illness.
Caregiver: The caregiver's behaviors can impair bonding. Critical,
rejecting, and interfering parents tend to have children that avoid
emotional intimacy. Abusive parents tend to have children that become
uncomfortable with intimacy and withdraw. The child’s mother may be
unresponsive to the child due to maternal depression, substance
abuse, overwhelming personal problems, or other factors that interfere
with her ability to be consistent and nurturing for the child.
Caregiver: perilaku Caregiver'S dapat merusak mengikat. Kritis, menolak, dan bertentangan
orang tua [tuju/ cenderung] untuk mempunyai anak-anak yang menghindari keakraban
emosional. Orang tua mengandung kutukan [tuju/ cenderung] untuk mempunyai anak-anak yang
menjadi gelisah dengan keakraban dan menarik. ibu Anak mungkin (adalah) tak menjawab/tak
bereaksi kepada anak dalam kaitan dengan maternal tekanan, penyalahgunaan unsur,
permasalahan pribadi berlimpahan, atau faktor lain yang bertentangan dengan kemampuan nya
untuk konsisten dan pemeliharaan untuk anak [itu].

Environment: A major impediment to healthy attachment is fear. If an

infant is distressed due to pain, pervasive threat or a chaotic
environment, they will have a difficult time participating in even a
supportive caregiving relationship. Infants or children in domestic
violence, refugee, community violence or war zone environments are
vulnerable to developing attachment problems.
Fit: The "fit" between the temperament and capabilities of the infant
and the mother is crucial. Some caregivers can be just fine with a calm
infant but are overwhelmed by an irritable infant. The process of
paying attention to, reading each other's non-verbal cues and
responding appropriately is essential to maintain the bonding
experiences that build in healthy attachments. Sometimes a style of
communication and response familiar to a mother from one of her
other children may not fit her current infant. The mutual frustration of
being "out of sync" can impair bonding.
BD Perry MD, PhD

ATTUNEMENT
• Reading and responding to the cues of another
• Synchronous and interactive
• Helps prevent mismatch between and provision
• Can be taught - reading the non-verba
- reading the non-verbal,
social-emotional “language” of another social-emotional “language”
of another

How does abuse and neglect influence attachment?

There are three primary themes that have been observed in abusive
and neglectful families. The most common effect is that maltreated
children are, essentially, rejected. Children that are rejected by their
parents will have a host of problems (see below) including difficulty
developing emotional intimacy. In abusive families, it is common for
this rejection and abuse to be transgenerational. The neglectful parent
was neglected as a child. They pass on the way they were parented.
Another theme is "parentification" of the child. This takes many forms.
One common form is when a young immature girl becomes a single
parent. The infant is treated like a playmate and very early in life like a
friend. It is common to hear these young mothers talk about their four-
year-old as "my best friend" or "my little man." In other cases, the
adults are so immature and uninformed about children that they treat
their children like adults - or even like another parent. As a result, their
children may participate in fewer activities with other children who are
“immature.” This false sense of maturity in children often interferes
with the development of same-aged friendships. The third common
theme is the transgenerational nature of attachment problems -- they
pass from generation to generation. It is important to note that
previously secure attachments can change suddenly following abuse
and neglect. The child’s perception of a consistent and nurturing world
may no longer “fit” with their reality. For example, a child’s positive
views of adults may change following physical abuse by a baby-sitter.

Are attachment problems always from abuse?

No, in fact the majority of attachment problems are likely due to
parental ignorance about development rather than abuse. Many
parents have not been educated about the critical nature of the
experiences of the first three years of life. With more public education
and policy support for these areas, this will improve. Currently, this
ignorance is so widespread that it is estimated that 1 in 3 people has
an avoidant, ambivalent, or resistant attachment with their caregiver.
Despite this insecure attachment, these individuals can form and
maintain relationships - yet not with the ease that others can.

What specific problems can I expect to see in

maltreated children with
attachment problems?
The specific problems that you may see will vary depending upon the
nature, intensity, duration and timing of the neglect and abuse. Some
children will have profound and obvious problems and some will have
very subtle problems that you may not realize are related to early life
neglect. Sometimes these children do not appear affected by their
experiences. However, it is important to remember why you are
working with the children and that they have been exposed to terrible
things. There are some clues that experienced clinicians consider when
working with these children. Developmental delays: Children
experiencing emotional neglect in early childhood often have
developmental delay in other domains. The bond between the young
child and caregivers provides the major vehicle for developing
physically, emotionally and cognitively. It is in this primary context that
children learn language, social behaviors, and a host of other key
behaviors required for healthy development. Lack of consistent and
enriched experiences in early childhood can result in delays in motor,
language, social and cognitive development.
Eating: Odd eating behaviors are common, especially in children with
severe neglect and attachment problems. They will hoard food, hide
food in their rooms, eat as if there will be no more meals even if they
have had years of consistent available foods. They may have failure to
thrive, rumination (throwing up food), swallowing problems and, later
in life, odd eating behaviors that are often misdiagnosed as anorexia
nervosa.
Soothing behavior: These children will use very primitive, immature
and bizarre soothing behaviors. They may bite themselves, head bang,
rock, chant, scratch or cut themselves. These symptoms will increase
during times of distress or threat.
Emotional functioning: A range of emotional problems is common in
these children including depressive and anxiety symptoms. One
common behavior is “indiscriminant” attachment. All children seek
safety. Keeping in mind that attachment is important for survival;
children may seek attachments -- any attachments -- for their safety.
Non-clinicians may notice abused and neglected children are “loving”
and hug virtual strangers. Children do not develop a deep emotional
bond with relatively unknown people; rather, these "affectionate"
behaviors are actually safety seeking behaviors. Clinicians are
concerned because these behaviors contribute to the abused child’s
confusion about intimacy and are not consistent with normal social
interactions.
Inappropriate modeling: Children model adult behavior - even if it is
abusive. They learn abusive behavior is the “right” way to interact with
others. As you can see, this potentially causes problems in their social
interactions with adults and other children. For children that have been
sexually abused, they may become more at-risk for future
victimization. Males that have been sexually abused may become
sexual offenders.
Aggression: One of the major problems with these children is
aggression and cruelty. This is related to two primary problems in
neglected children: (1) lack of empathy and (2) poor impulse control.
The ability to emotionally "understand" the impact of your behavior on
others is impaired in these children. They really do not understand or
feel what it is like for others when they do or say something hurtful.
Indeed, these children often feel compelled to lash out and hurt others
- most typically something less powerful than they are. They will hurt
animals, smaller children, peers and siblings. One of the most
disturbing elements of this aggression is that it is often accompanied
by a detached, cold lack of empathy. They may show regret (an
intellectual response) but not remorse (an emotional response) when
confronted about their aggressive or cruel behaviors.
WHAT CAN I DO TO HELP?
Parents and caregivers make all the difference in the lives of
maltreated children. This section
suggests a few different ways to help.
Nurture these children: These children need to be held and
rocked and cuddled. Be physical,
caring and loving to children with attachment problems. Be aware that
for many of these
children, touch in the past has been associated with pain, torture or
sexual abuse. In these cases,
make sure you carefully monitor how they respond – be “attuned” to
their responses to your
nurturing and act accordingly. In many ways, you are providing
replacement experiences that
should have taken place during their infancy – but you are doing this
when their brains are
harder to modify and change. Therefore they will need even more
bonding experiences to help
develop attachments.

Try to understand the behaviors before punishment or

consequences: The more
you can learn about attachment problems, bonding, normal
development and abnormal
development, the more you will be able to develop useful behavioral
and social interventions.
Information about these problems can prevent you from
misunderstanding the child’s behaviors.
When these children hoard food, for example, it should not be viewed
as "stealing" but as a
common and predictable result of being food deprived during early
childhood. A punitive
approach to this problem (and many others) will not help the child
mature. Indeed, punishment
may actually increase the child's sense of insecurity, distress and need
to hoard food. Many of
these children's behaviors are confusing and disturbing to caregivers.
You can get help from
professionals if you find yourself struggling to create or implement a
practical and useful
approach to these problems.

Parent these children based on emotional age: Abused

and neglected children will often
be emotionally and socially delayed. And whenever they are frustrated
or fearful, they will
regress. This means that, at any given moment, a ten-year old child
may emotionally be a two-
year old. Despite our wishes that they would “act their age” and our
insistence to do so, they are
not capable of that. These are the times that we must interact with
them at their emotional level.
If they are tearful, frustrated, overwhelmed (emotionally age two)
parent them as if they were
that age. Use soothing non-verbal interactions. Hold them. Rock them.
Sing quietly. This is not
the time to use complex verbal arguments about the consequences of
inappropriate behavior.

Be consistent, predictable and repetitive: Maltreated

children with attachment problems
are very sensitive to changes in schedule, transitions, surprises,
chaotic social situations, and, in
general, any new situation. Busy and unique social situations will
overwhelm them, even if they
are pleasant! Birthday parties, sleepovers, holidays, family trips, the
start of the school year, and
the end of the school year -- all can be disorganizing for these children.
Because of this, any
efforts that can be made to be consistent, predictable and repetitive
will be very important in
making these children feel "safe" and secure. When they feel safe and
secure they can benefit
from the nurturing and enriching emotional and social experiences you
provide them. If they are
anxious and fearful, they cannot benefit from your nurturing in the
same ways.

Model and teach appropriate social behaviors: Many

abused and neglected children do
not know how to interact with other people. One of the best ways to
teach them is to model this in
your own behaviors - and then narrate for the child what you are doing
and why. Become a play
by play announcer: "I am going to the sink to wash my hands before
dinner because….” or “I
take the soap and get soapy here and…." Children see, hear and
imitate.
In addition to modeling, you can "coach" maltreated children as they
play with other children.
Use a similar play-by-play approach: "Well, when you take that from
someone they probably
feel pretty upset so if you want them to have fun when you play this
game…" By more effectively
playing with other children, they will develop some improved self-
esteem and confidence. Over
time, success with other children will make the child less socially
awkward and aggressive.
Maltreated children are often "a mess" because of their delayed
socialization. If the child were
teased because of their clothes or grooming, it would be helpful to
have “cool” clothes and
improved hygiene.
One area that these children have problems in is in modulating
appropriate physical contact.
They don't know when to hug, how close to stand, when to establish or
break eye contact, what
are appropriate contexts to pick their nose, touch their genitals, or do
other grooming behaviors.
Ironically, children with attachment problems will often initiate physical
contact (hugs, holding
hands, crawling into laps) with strangers. Adults misinterpret this as
affectionate behavior. It is
not. It is best understood as "supplication" behavior and it is socially
inappropriate. How the
adults handle this inappropriate physical contact is very important. We
should not refuse to hug
the child and lecture them about "appropriate behavior." We can gently
guide the child on howto
interact differently with grown-ups and other children (Why don’t you
sit over here?). It is
important to make these lessons clear using as few words as possible.
They do not have to be
directive -- rely on nonverbal cues. It is equally important to explain in
a way that does not make
the child feel bad or guilty.

Listen to and talk with these children: One of the most

pleasurable things to do is just
stop, sit, listen and play with these children. When you are quiet and
interactive with them you
find that they will begin to show you and tell you about what is really
inside them. Yet as simple
as this sounds it is one of the most difficult things for adults to do - to
stop, quit worrying about the
time or your next task and really relax into the moment with a child.
Practice this. You will be
amazed at the results. These children will sense that you are there just
for them. They will feel
how you care for them.
It is during these moments that you can best reach and teach these
children. This is a great time to
begin teaching children about their different "feelings." Regardless of
the activity, the following
principles are important to include: (1) All feelings are okay to feel --
sad, glad, or mad (more
emotions for older children); (2) Teach the child healthy ways to act
when sad, glad, or mad; (3)
Begin to explore how other people may feel and how they show their
feelings - “How do you
think Bobby feels when you push him?” (4) When you sense that the
child is clearly happy, sad, or
mad, ask them how they are feeling. Help them begin to put words and
labels to these feelings.
Have realistic expectations of these children: Abused
and neglected children have so
much to overcome. And, for some, they will not overcome all of their
problems. For a Romanian
orphan adopted at age five after spending her early years without any
emotional nurturing, the
expectations should be limited. She was robbed of some, but not all, of
her potential. We do not
know how to predict potential in a vacuum, but we do know how to
measure the emotional,
behavioral, social and physical strengths and weaknesses of a child. A
comprehensive evaluation
by skilled clinicians can be very helpful in beginning to define the skill
areas of a child and the
areas where progress will be slower.
Attachment in Maltreated Children, Perry
11
Be patient with the child's progress and with yourself :
Progress will be slow. The slow
progress can be frustrating and many adoptive parents will feel
inadequate because all of the
love, time and effort they spend with their child may not seem to be
having any effect. But it
does. Don't be hard on yourself. Many loving, skilled and competent
parents have been
swamped by the needs of a neglected and abused child that they have
taken in.
Take care of yourself: Caring for maltreated children can be
exhausting and demoralizing.
You cannot provide the consistent, predictable, enriching and nurturing
care these children need if
you are depleted. Make sure you get rest and support. Respite care can
be crucial. Use friends,
family and community resources. You will not be able to help your child
if you are exhausted,
depressed, angry, overwhelmed and resentful.
Take advantage of other resources: Many communities
have support groups for adoptive
or foster families. Professionals with experience in attachment
problems or maltreated children
can be very helpful. You will need help. Remember, the earlier and
more aggressive the
interventions, the better. Children are most malleable early in life and
as they get older change
is more difficult.
Attachment in Maltreated Children, Perry
12
RESOURCES
There are many other places to learn more about attachment and
bonding in maltreated children.
A few starting places are listed below.
ORGANIZATIONS
ZERO TO THREE is a national, nonprofit organization located in
Washington, D.C., dedicated
solely to advancing the healthy development of babies and young
children. Founded in l977 by
top developmental experts, ZERO TO THREE disseminates key
developmental information, trains
providers, promotes model approaches and standards of practice and
works to increase public
awareness about the significance of the first three years of life.
ZERO TO THREE
734 15th Street, NW, Suite 1000
Washington, DC 20005
(202) 638-1144.
HOMEPAGE: http://www.zerotothree.com
PACT: A nonprofit 501(c)(3) organization begun by two adoptive
parents in 1991, Pact has
developed a national reputation for excellence in serving all members
of the adoption triad. Each
year, Pact offers educational events attended by more than 1500
individuals, provides - free of
charge - over 1000 crisis consultations to birth parents, and consults
with hundreds of potential
adoptive parents. Top priority is given to programs especially designed
to support and inform
adopted children and adopted adults of color.
Pact, An Adoption Alliance
3450 Sacramento Street Suite 239
San Francisco, CA 94118
(415) 221-6957
(510) 482-2089 FAX
e-mail: [email protected]
HOMEPAGE: http://www.pactadopt.org
ATTACHMENT PARENTING INTERNATIONAL is a coalition of
concerned individuals, professionals,
and grassroots organizations. They advocate special “attachment
parenting” methods to develop
and fulfill a child's need for trust, empathy, and affection in order to
create secure and enduring
relationships. This organization feels that attachment parenting, in
conjunction with support groups
can not only strengthen families but provide a simple and cost-
effective model to aid in the
prevention of child abuse, behavioral disorders, criminal acts, and
other serious social problems.
Attachment Parenting International
1508 Clairmont Place
Nashville, Tennessee 37215
(615) 298 4334
HOMEPAGE: http://www.attachmentparenting.org
Attachment in Maltreated Children, Perry
13
GLOSSARY
Attachment: A special form of emotional relationship. Attachment
involves mutuality, comfort,
safety and pleasure for both individuals in the relationship.
Attunement: The ability to read and respond to the communicated
needs of another. This
involves synchronous and responsive attention to the verbal and non-
verbal cues of another.
Bond: A bond is a relationship. Bonds may be of special mutual
emotional nature such as an
attachment or they may be based upon other emotions (e.g., fear –
such as seen in the bond
between captor and captive).
Bonding: Any activity, action or behavior that helps establish or
maintain a relationship.
Strange-Situation procedure: A specialized clinical-research
procedure involving eight
separations and reunions with an infant and their caregiver designed to
determine the nature of
the attachments.
Attachment in Maltreated Children, Perry
14
These resources will be periodically updated and posted in a
special section of the
ChildTrauma Academy web site http://www.ChildTrauma.org. Visit
this site for updates
and for other resource materials about traumatic events and
children.
About the Author
Bruce D. Perry, M.D., Ph.D.
Dr. Perry is the Senior Fellow of the ChildTrauma Academy. Dr.
Perry served as the
Thomas S. Trammell Research Professor of Child Psychiatry at
Baylor College of Medicine
and Chief of Psychiatry at Texas Children's Hospital in Houston,
Texas from 1992 to
2001. In addition he has served as the Director of Provincial
Programs in Children’s
Mental Health for Alberta, Canada, and is the author of more than
200 scientific articles
and chapters. He is the recipient of dozens of awards and honors
and is an
internationally recognized authority in the area of child
maltreatment and the impact of
trauma and neglect on the developing brain.
The ChildTrauma Academy
The ChildTrauma Academy, a not-for-profit organization based in
Houston, TX, is a unique
collaborative of individuals and organizations working to improve
the lives of high-risk children
through direct service, research and education. These efforts are
in partnership with the public
and private systems that are mandated to protect, heal and
educate children. The work of the
Academy has been supported, in part, by grants from Texas
Department of Protective and
Regulatory Services, the Children’s Justice Act, the Court
Improvement Act and through innovative
partnerships with academic and corporate partners such as
Powered, Inc., Scholastic, Inc. and
Digital Consulting and Software Services.
The mission of the ChildTrauma Academy is to foster the creation of innovations in practice,
programs
and policy related to traumatized and maltreated children. To support this mission, the
Academy has
two main activities; 1) Program development and consultation and 2) Specialized education
and
training services.
For more information or to direct donations: Web Resources:
Jana Rubenstein, M.Ed., LPC ChildTrauma Web site
Director, ChildTrauma Academy www.ChildTrauma.org
[email protected]
5161 San Felipe, Suite 320
ChildTrauma Academy
Houston, TX 77056
Attachment in Maltreated Children, Perry
15
The ChildTrauma Academy and Linkletter Media Products
To place your order, please send your check and this order form to:
The ChildTrauma Academy
5161 San Felipe, St. 320
Houston, Texas 77056
Attn.: Jana Rubenstein Checks payable to “The ChildTrauma Academy”
Orders may also be placed
by phone: (281) 932-1375
by email: [email protected]
or online: www.ChildTrauma.org
Single Program (VHS or DVD): $89.95 or Complete Series (VHS or DVD):
$549.00
Prg. # Title Qty.
SERIES 1
(Set includes
#1-01 thru 1-07)
UNDERSTANDING TRAUMATIZED AND MALTREATED
CHILDREN: THE CORE CONCEPTS
Please list
quantity &
cost
#1-01 Challenging our Beliefs
#1-02 The Amazing Human Brain
#1-03 How the Brain Develops: The Importance of Early Childhood
#1-04 Neglect: How Poverty of Experience Disrupts Development
#1-05 The Fear Response: The Impact of Childhood Trauma
#1-06 Living and Working with Traumatized Children
#1-07 Violence and Childhood
SERIES 2
(Set includes
#2-01 thru 2-07)
THE SIX CORE STRENGTHS
FOR HEALTHY CHILDHOOD DEVELOPMENT
#2-01 Developing Potential
#2-02 Attachment
#2-03 Self Regulation
#2-04 Affiliation
#2-05 Awareness
#2-06 Tolerance
#2-07 Respect
Sub-Total
S & H* add 10% *Within the US
Specify VHS or DVD
Total
Name: _____________________________ Organization:
_____________________________________
Address: ____________________________________________________________________________
___________________________________________________________________________________
_
Work Phone: _____________________________ E-Mail:
_____________________________________
Attachment in Maltreated Children, Perry
16
I am paying by: Cash Check # ________ Credit Card # ___________ Exp: ______
Attachment in Maltreated Children, Perry
17
UNDERSTANDING TRAUMATIZED AND MALTREATED
CHILDREN:
THE CORE CONCEPTS
“Understanding Traumatized and Maltreated Children” is a seven-part series
featuring Bruce D. Perry, M.D.,
Ph.D. and hosted by Art Linkletter. Comprehensive information is presented by Dr. Perry on the
primary problems
facing maltreated children and dynamic approaches for effective care giving for professionals and lay
people alike.
“One of the purposes of this video series is to try and provide some of the baseline information for frontline
providers — like teachers, caseworkers, mental health workers, and professionals — so they can better
understand these children and really begin to think about how to intervene in different ways. There is
presently
a real lack of useful and easy to understand information about this. We recognize that and that is what
we’re
trying to respond to in this series...We tend to pay more attention to information that
reinforces our beliefs, than
to information that challenges our beliefs.” — Dr. Perry
#1 Program CHALLENGING OUR BELIEFS (#1-01) In this introductory program to the series,
Dr. Perry
and Art Linkletter challenge us to evaluate existing childcare systems, and urge us to consider their
effectiveness.
Opportunities for change include better communication, corporate workplace involvement, community
involvement,
and increasing a maltreated child’s opportunities for affiliation to promote healing and hope. “Challenging
Our
Beliefs” is also an excellent stand alone program for both lay people and professionals.
#2 Program THE AMAZING HUMAN BRAIN (#1-02) Dr. Perry covers the basics of brain
anatomy and
function. An understanding of the hierarchical make-up of the human brain helps caregivers and
professionals to
better diagnose children’s problems and formulate effective treatment approaches. Adverse affects caused
by
neglect, fear, trauma, and violence are presented.
#3 Program HOW THE BRAIN DEVELOPS: THE IMPORTANCE OF EARLY CHILDHOOD
(#1-03)
Dr. Perry stresses the importance of bonding and attachment as the cornerstones of early childhood optimal
brain
development. Caregivers and professionals learn the various behaviors and problems of children who
missed these
early opportunities, and presents examples to help in recognition and appropriate treatment paths.
#4 Program NEGLECT: HOW POVERTY OF EXPERIENCE DISRUPTS DEVELOPMENT
(#1-04)
Severe neglect and even simple missed care giving opportunities cause various degrees of brain effects and
behavior
problems in maltreated children. An absence of stimulation and chaotic stimulation are both responsible for
promoting an absence of experience that contributes to disruptive childhood development. Dr. Perry
presents new
and dynamic information on this often ignored subject.
#5 Program THE FEAR RESPONSE: THE IMPACT OF CHILDHOOD TRAUMA (#1-05)
Caregivers
learn to effectively recognize the behaviors and physical reactions of children in the various stages of “the
fear
response.” This is particularly helpful for caregivers and professionals in assessment, treatment, and
intervention to
determine the degree of trauma, and Post-Traumatic Stress Syndrome, in children.
#6 Program LIVING AND WORKING WITH TRAUMATIZED CHILDREN (#1-06) Dr. Perry
presents in-depth information and effective skills for those who are “on the front lines” of care giving for
traumatized and maltreated children. Recording a child’s progress, identifying strengths and weaknesses,
and respite
care for caregivers all help to promote effective and optimal opportunities for a healing environment.
#7 Program VIOLENCE AND CHILDHOOD (#1-07) Children today are bombarded with
violence:
violence in the media, gang violence, domestic violence, abuse, and school violence. Dr. Perry presents
information
concerning how insufficient brain Cortex modulation and primitive Brain Stem impulsivity can lead to acts
of
violence. Dr. Perry concludes: “It’s a really unique form of heroism that is most often
unrecognized. There are a lot
more people than you might expect who are walking around that are very heroic just
in being ‘good people’ —
considering what they’ve gone through.”
Attachment in Maltreated Children, Perry
18
THE SIX CORE STRENGTHS FOR HEALTHY CHILDHOOD DEVELOPMENT
#1 Program DEVELOPING POTENTIAL (#2-01) In this introductory tape, Dr. Perry discusses the
core
strengths that provide a child with the framework for a life rich in family, friends, and personal growth.
Teaching
children these core strengths gives them a gift they will use throughout their lifetimes. They will learn to
live and
prosper together with people of all kinds—each bringing different strengths to create a greater whole.
#2 Program ATTACHMENT (#2-02) The template for future relationships Attachment is
the
capacity to form and maintain healthy emotional bonds with another person. It is first acquired in infancy,
as a child
interacts with loving, responsive, and attentive parents and caregivers. This core strength is the cornerstone
of all
the others. Healthy attachments allow a child to love, to become a good friend, and to have a positive and
useful
model for future relationships. As a child grows, other consistent and nurturing adults such as teachers,
family
friends, and relatives will shape his ability to develop attachments. The attached child will be a better
friend,
student, and classmate—which promotes all forms of learning.
#3 Program SELF-REGULATION (#2-03) The capacity to regulate internally Developing
and
maintaining the ability to notice and control primary urges such as hunger and sleep—as well as feelings of
frustration, anger, and fear—is a lifelong process. Its roots begin with the external regulation provided by
parents or
significant caregivers, and its healthy growth depends on a child’s experience and the maturation of the
brain.
Pausing a moment between an impulse and an action is a life tool. Developing this strength helps a child
physiologically and emotionally. But it’s a strength that must be learned—we are not born with it.
#4 Program AFFILLIATION (#2-04) Joining In The capacity to join others and contribute to a
group
springs from our ability to form attachments. Affiliation is the glue for healthy human functioning. It
allows us to
form and maintain relationships with others and to create something stronger, more adaptive, and more
creative than
the individual. Human beings are biologically designed to live, play, grow, and work in groups. The family
is a
child’s first and most important group. But most other groups that children join are based on circumstance
or
common interests. It’s in these groups that children will have thousands of brief emotional, social, and
cognitive
experiences that can help shape their development.
#5 Program ATTUNEMENT (#2-05) Thinking of Others Awareness is the ability to recognize the
needs,
interests, strengths, and values of others. Infants begin life self-absorbed and slowly develop awareness -
the ability
to see beyond themselves and to sense and categorize the other people in their world. An aware child learns
about
the needs and complexities of others by watching, listening, and forming relationships with a variety of
children. He
becomes part of a group and sees ways in which we are all alike and different. With experience, a child can
learn to
reject labels used to categorize people, such as skin color or the language they speak.
#6 Program TOLERANCE (#2-06) Accepting Differences Tolerance is the capacity to
understand and
accept how others are different from you. This core strength builds upon another - awareness (once aware,
what do
you do with the differences you observe?). It’s natural and human to be afraid of what’s new and different.
To
become tolerant, a child must first face the fear of differences. This can be a challenge because children
tend to
affiliate based on similarities—in age, interests, families, or cultures. But they also learn to reach out and
be more
sensitive to others by watching how the adults in their lives relate to one another. With positive modeling,
caregivers can insure and build on children’s tolerance. The tolerant child is more flexible and adaptive in
many
ways. Most important, when a child learns to accept difference in others, he becomes able to value the
things that
make each of us special and unique.
#7 Program RESPECT (#2-07) Respecting yourself and others Appreciating your own self-
worth
and the value of others grows from the foundation of the preceding five strengths. An aware, tolerant child
with
good affiliation, attachment, and self-regulation strengths gains respect naturally. The development of
respect is a
lifelong process, yet its roots are in early childhood. Children will belong to many groups, meet many kinds
of
people, and will need to be able to listen, negotiate, compromise, and cooperate. Having respect enables a
child to
accept others and to see the value in diversity. He can see that every group needs many styles and many
strengths to
succeed and he can value each person in the group for her talents. When children respect—and even
celebrate—
diversity, they find the world to be a more interesting, complex, and safer place.