Severe Attachment Disorder in Childhood : A Guide to Practical Therapy

A Guide to Practical Therapy

By: Niels P. Rygaard

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Hardcover | 1 January 2006

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230 Pages

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everyday examples are used to illustrate symptoms, theory and practice. If I have succeeded, the contents should not be difficult to understand, whereas working with the AD child in practice is a constant challenge to your convictions and responsibility. It is a guide trying to answer some of the common questions puzzling people working with children and juveniles suffering from Attachment Disorder: - Why is there an increasing number of AD children? - What are the causes of an AD development in children? - How does AD show in behavior and personality? - How do you practice treatment or therapy at different devel- ment stages during childhood? - What can you do to prevent an AD development, or to reduce the symptoms and consequences? - What happens to people, groups and organizations working with these children? - How do you develop and maintain your therapeutic attitude and the structure of treatment? First, let me give you a short introduction to the problem of AD in general. What is "attachment"? In brief, the theory of attachment was developed from 1950 and onwards by John Bowlby (1969, 1973, 1988). Bowlby suggested early attachment (0-3 years) as an inborn behavior program in primates and especially humans. Bowlby's main idea was that the attachment behavioral system had evolved to increase the likelihood of the infant's protection and survival.

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Non-Fiction Psychology Child & Developmental Psychology Medicine Clinical & Internal Medicine Paediatric Medicine Other Branches of Medicine Psychiatry Clinical Psychology Psychotherapy Education Schools & Pre-Schools

Primary Schools Social Services & Welfare Social Welfare & Social Services Social Work Educational Psychology

General introduction
What is "attachment"?	p. 2
What is "attachment disorder"?	p. 4
Early attachment: a worldwide challenge	p. 7
What happens when they grow up?	p. 12
It's not only your problem - it's ours	p. 13
Our unconscious basic concepts of children and childhood	p. 13
My own concepts	p. 16
Realism: this is a handicap like any other	p. 17
About terminology	p. 18
Contents - what can this book give you?	p. 19
A.D. development from conception to adulthood
Causes and symptoms
Two general causes of disorganized social behavior	p. 23
Normal early contact, self-organization and constancy	p. 26
The function of contact in child development	p. 26
The organization of the self	p. 27
The development of constancy	p. 28
Stages in self-organization
Stages in self-organization	p. 31
Physical self-organization	p. 31
Sensory organization	p. 32
Sensory-motor/movement organization	p. 33
Personality organization	p. 35
Social organization	p. 36
Stage development and diagnosis	p. 37
Contact disruption before age 2 - symptoms of physical instability
Contact disruption and failure to establish constancy	p. 41
Contact disruption and the AD child	p. 43
Abnormal contact between mother and child - results from studies	p. 44
The genetic background	p. 45
The course of pregnancy	p. 47
The course of birth	p. 48
Contact disruption and nervous system development
Central nervous system (CNS) development	p. 51
A hypothesis of neurological dysfunctions in AD	p. 53
The reptile brain: regulation of the basic activity level	p. 54
The emotional and social brain (the limbic system): linking sensations to emotional response patterns	p. 54
The cortical brain: control and focus	p. 56
Checklist for deprivation symptoms in babies	p. 58
Insufficient attachment behavior and lack of response	p. 58
Depression: lowered muscle tonus	p. 59
Un-stabilized basic body rhythms	p. 59
Lowered or permanently stressed immune function	p. 59
Abnormal sensory-motor development in the toddler
Sensation, attention, emotion, gestalt formation: the basics of learning	p. 61
Movement and motor development	p. 63
Phases in motor development	p. 64
The Reflex Movement Phase (0-4 months, coding sensory information)	p. 64
The Information Processing Phase (5-12 months, reflex inhibition, intention)	p. 65
The Rudimentary Movement Phase (1-24 months, pre-control, habits automated)	p. 65
The Fundamental Movement Phase (12-24 months, obtaining dynamic balance)	p. 66
The Fundamental Movement Phase (2-7 years, simple activities)	p. 67
The Transition (7-10 years) and Specialization (11-13 years) Phases	p. 68
Conclusion on motor development	p. 68
Checklist for preschool AD symptoms	p. 69
External sensation	p. 69
Boundary sensation	p. 70
Internal sensation	p. 70
Arrested emotional personality development
Personality development: the object relationship is the key to the world
Achieving object constancy	p. 73
The first stages in achieving object constancy	p. 74
Basic attachment and basic anxiety management	p. 75
Evocative constancy (0-6 months). Basic attachment	p. 75
Border constancy (6-12 months). Anxiety management	p. 75
An example: poor basic attachment	p. 76
An example: paradoxical attachment and poor anxiety management	p. 77
Basic internalization of the parent and basic social constancy	p. 79
Internalization constancy and identity (12-36 months)	p. 79
Social role constancy (36 months-6 years)	p. 80
Constancy of the self and traumatic separation experiences	p. 80
Emotional and cognitive deficits when arrested in stages 1 and 2	p. 81
Checklist for the AD personality function from preschooler to juvenile	p. 82
Sense of proportion in time, space and emotion	p. 82
Discerning reality as opposed to internal fantasies/wishes	p. 82
Conceptualization of the whole, elements of the whole, and their relationship	p. 82
Figure and background	p. 83
Discrimination	p. 83
Reorganization	p. 83
The social backgrounds of AD children	p. 84
Conclusions to background: the general AD risk checklist	p. 85
Family items	p. 85
Organic dysfunction items	p. 86
Emotional items	p. 87
Behavior and profile in test situation	p. 87
Therapy
How can you practice milieu therapy?
Some general principles of milieu therapy	p. 93
What's the difference between psychotherapy and milieu therapy?	p. 93
External constancy replaces a lack of internal constancy	p. 95
Reduce the number of contact-disrupting events	p. 96
Peel the onion: if contact fails, shift to a lower level	p. 97
Gradually prolong and expand contact at all times	p. 97
Postpone all common developmental thresholds	p. 97
Find support for yourself - keep your own point of reference	p. 98
Choose clear focus points	p. 98
Milieu therapy during pregnancy, birth to age 3
Therapy before conception	p. 99
Eugenic (genetic) therapy	p. 99
Goals	p. 99
Methods	p. 99
Obstacles	p. 99
Therapy during pregnancy, birth to 3	p. 100
Goals	p. 100
Methods	p. 100
Obstacles	p. 101
From birth to age 3: regression therapy	p. 102
Goals	p. 102
Methods	p. 103
Obstacles	p. 108
Regression and the adoption process	p. 108
Transient bonding problems and attachment disorder in adopted children
Transition problems when acquiring new parents	p. 109
Different reaction patterns at different developmental stages	p. 110
Psychological defense and survival mechanisms at different stages of development	p. 111
Physical stress symptoms in the transition period	p. 114
Regression is necessary	p. 115
The crisis of the adoptive parents	p. 115
Children with permanent attachment disorder	p. 116
Milieu therapy for the preschool child
Milieu therapy for the preschool child	p. 119
The professional's observations	p. 119
Behavior in child groups	p. 120
Behavior when learning or exercising	p. 120
Goals	p. 120
Methods: work at the relevant level of development	p. 121
When planning your behavior towards the child, divide the child's age by 2, 3 or 4	p. 121
Learning to make "one brick" successfully: be the mirror	p. 121
The chain of behaviors. Creating a series of bricks to form "a house" (a behavior sequence)	p. 122
Awareness of the relationship as well as of the exercise	p. 123
Be aware of "The Relationship in the Mind" and "The Relationship at Work"	p. 124
Be present - work only in the present moment and the immediate future	p. 125
Demonstrate clear focus of authority and borders	p. 126
Milieu therapy for the school age child
Milieu therapy for the school age child (7-12 years)	p. 127
Goals	p. 127
Methods	p. 128
The attachment disordered child in the classroom
Understanding the teacher / AD child relationship	p. 129
How, and under what conditions, do you basically learn how to learn?	p. 130
How to find the subject in a sentence	p. 133
The teacher as the relationship organizer or: stop giving him motorbikes - build a cradle!	p. 134
Being a clear object to the child	p. 135
Take full responsibility	p. 136
Teaching in phase I: establishing the object and the background	p. 136
Using multi-sensory impacts for conceptualization	p. 138
A method for developing social self-awareness in the child	p. 139
Mapping abnormal behavior patterns	p. 139
Directing attention towards patterns	p. 139
Recognizing behavior patterns	p. 140
Using the "behavior joystick". Exercise variations of basic baby behavior patterns	p. 141
The "class lab for alternative behavior	p. 142
Transferring the lab to the classroom	p. 143
Teaching others what we do in class	p. 144
Ethics	p. 144
How do we start?	p. 145
Summary: important goals/success criteria	p. 145
Necessary organization	p. 146
Results	p. 147
Daily life in the family, the foster family or the institution
Goals	p. 149
Methods	p. 150
Take away the burdens	p. 150
Having to decide, choose, argue, agree and feel motivated	p. 151
Background changes	p. 152
Complex social relationships and interactions	p. 153
Being blamed or reprimanded when something goes wrong	p. 153
Parents or caretakers leaning on the accelerator	p. 154
How to acquire new skills in six steps	p. 155
First sequence: mirroring your behavior here and now	p. 155
Second sequence: your voice as the organizer of behavior	p. 156
Third sequence: the childs voice as the organizer	p. 156
Fourth sequence: working in parallel positions	p. 156
Fifth sequence: being out of sight	p. 156
Sixth sequence: I can do it on my own!	p. 156
The AD child and other children in the family	p. 157
Milieu therapy for the juvenile
Leaving home with little baggage	p. 159
Goals	p. 160
Methods	p. 160
A mild case of puberty problems	p. 161
A difficult case of AD problems in puberty	p. 162
Some considerations on therapy with parents and AD youth	p. 163
Attachment disorder, sexual behavior problems and sexual abuse
Attachment disorder, sexual behavior problems and sexual abuse	p. 169
Evolutionary and biological survival theories: sexual preferences seen as "emotional imprints"	p. 171
Neurological theories	p. 172
Object relations theory: immature defense mechanisms in abuser and abused. Three degrees of arrested personality development	p. 174
Sexuality at random: the Stage I abuser	p. 174
Projection of the weak self: the Stage II abuser	p. 175
The lonely seduced child: the Stage III abuser	p. 176
Theories in social psychology: the frequency of abuse as a result of accessibility	p. 176
Definitions of sexual abuse	p. 177
Age at time of abuse	p. 177
Degree of abuse and physical intimidation	p. 177
Number of incidents	p. 178
The degree of proximity between child and abuser	p. 178
Degree of proximity between abuser and parent	p. 178
Degree of denial, concealment and stigmatization	p. 178
Degree of identification with the aggressor	p. 178
Method problems when studying prevalence	p. 179
Clinical observations of behavior changes and altered physical states in abused children	p. 179
Effects of child abuse in adulthood	p. 180
Prevention: helping the abused AD child prevent becoming an abuser	p. 180
Preventing possibilities for abuse	p. 181
Helping staff cope with abuse problems	p. 182
The attachment element; be stronger than the abuser in the eyes of the child	p. 182
Setting behavior limits: what can you do where?	p. 182
Sensory Integration Therapy	p. 183
Biofeedback - a possibility	p. 183
Helping the child recognize abusive situations	p. 183
Conclusion	p. 184
Guidelines for organizing the therapeutic milieu
The personal development of the AD caretaker
Introduction	p. 187
Developmental phases of the individual AD worker and objectives for the supervision process	p. 187
State of the magic wand	p. 188
Objectives for the supervisor	p. 188
State of reality depression	p. 189
Objectives for the supervisor	p. 190
Gaining authority and internal reorganization	p. 190
Objectives for the supervisor	p. 191
Developing the professional AD team
Phases in AD team development and leadership	p. 193
Inclusion - creating a secure common base and identity	p. 194
Control: realizing that we are different from each other	p. 196
Openness/affection - mutual exchange	p. 198
Methods for the AD teamwork
Some tools for team development	p. 201
Mapping "attachment knowledge" in the team	p. 201
The big ear	p. 203
The "mutual supervision" interview	p. 203
Action learning - a tool for analysis and alternative solutions	p. 204
Conclusion to organization of the therapeutic milieu	p. 205
Post scriptum and acknowledgements	p. 207
Literature	p. 209
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Severe Attachment Disorder in Childhood : A Guide to Practical Therapy

A Guide to Practical Therapy

At a Glance

Hardcover

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How to return your order

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