How Attachment Therapy Can Help You
By Sarah Fader
Updated December 11, 2018
Reviewer Tiffany Howard, LPC, LCADC
Attachment Therapy is one of the most controversial therapies used in treating children with disciplinary problems that pose a safety risk to themselves or their caregivers. These children are usually suffering from an attachment disorder causing the child not to be able to attach to their caregiver or feel love or empathy for them.
This type of therapy is only used in the United States and is sometimes also referred to as compression therapy, rage-reduction, or holding time. Another name for the therapy is called The Evergreen Model, named after the first clinic in Evergreen, Colorado used for attachment therapy and attachment-based family therapy.
Attachment disorders are commonly seen in foster children or children who have been adopted. Their inability to attach often stems from abuse and maltreatment before they were in the child protective services or during their time in foster or group homes. Attachment therapy is controversial because it is based on using the holding technique which is used to help the child let outrage while also achieving a cathartic effect.
It is important to note that this technique is not a mainstream therapy for children suffering from rage issues or abuse related mental illness. The Holding Technique is not based on science and has been described by many as being pseudoscience and therapy that borderlines abuse. In fact, there have been six documented cases of child fatalities associated with attachment therapy's holding technique.
Candance Newmaker died in 2000, and The Gravelle Family was in the news in 2003 for their attachment-based parenting techniques which including locking the children in cages, using the holding technique and food deprivation. The Gravelle Family was indicted for child abuse. Later, the family therapist was found to have been an attachment therapist who had advised her clients on the techniques and placed special needs children with the family.
Since these incidents, attachment therapists have formed Attach, an organization for attachment therapy practitioners and their clients. A white paper was published in 2007 that admonished using coercive practices and promoted attunement, regulation, and sensitivities therapies in place of techniques such as holding.
Attachment Therapy is now mostly practiced as Attachment-Based Psychotherapy. Another form of attachment therapy is relational psychoanalysis and the attachment style of parenting taught by famous Dr. William Sears.
Attachment-based psychotherapy, or attachment-based therapy, use intervention strategies and therapeutic approaches based on attachment disorders in children as defined by John Bowlby who created the practice. Modern psychology and attachment theory has used this approach to broaden the theories of socioemotional development in children and is gaining more clinical support than ever before.
These strategies have often been overlooked because they are so often mistaken for attachment therapy. There are individual as well as group approaches to treating individuals with attachment disorder.
Individual Therapeutic Approaches To Attachment Disorder
Child-Parent Psychotherapy- This family-based attachment therapy was created and stemmed from infant-parent psychotherapy. Infant-parent theory showed that disturbances in relationships between infants and parents stem from the parent's past unresolved childhood trauma or conflict. This therapy evolved into child-parent therapy as an intervention tool in families that have traumatized children under five years old. Child-parent psychotherapy is most often helpful when the family is dealing with substance abuse, mothers with depression or other mental illness, physical or sexual abuse, and low-income families.
Circle Of Security- This psychotherapy is for parents of troubled children and was developed as a way to shift caregiving interaction into a more appropriate environment to foster the child's development. Parents are educated about their child's wants and needs and how those coincide with attachment disorders through a circular representation. This technique has been tested on children between 2 and 4 years of age and their parents.
Play Therapy- Children is effective on younger children who have Reactive Attachment Disorder. The focus of the therapy is to help facilitate a better relationship between the caregiver and the child. This therapy also focuses on learning what healthy attachments are.
Individual Psychotherapy-Going to therapy can greatly help children and adults with managing their attachment disorder and learning what healthy attachments are. People who go to individual psychotherapy can freely discuss how they are feeling with a therapist, counselor or psychologist.
Four Types Of Attachment
No matter what style of attachment therapy you choose, therapists will need to determine what kind of attachment disorder you have. To do this, they use the Strange Situation Test which was developed in the 1950s by Mary Ainsworth. This test will tell the psychoanalyst what type of attachment a child has. Recent studies indicate that between 35-45% of children in the United States have attachment related issues and over a third of all adopted children have an attachment disorder.
Secure: Secure attachments are healthy attachments. When the child is with the mother, the child will play with other children. When the mother leaves, the child avoids strangers and is upset over mother but is calmed when she returns. This is a normal attachment.
Anxious-Resistant Insecure- Children with this type of attachment, are always anxious around other people and get overly upset when their mother leaves. They will not play with other kids, even when the mother is present and is avoidant or resistant to social interactions. This can sometimes be an indicator of needs not being met.
Anxious-Avoidant Insecure- This type of child is not upset when the mother leaves, but also is not happy when she is there. The child is ambivalent and does not show a preference for teachers or caregivers. This can sometimes be a sign of extreme neglect or consistently having their needs unmet.
Disorganized/Disoriented- Children with a disorganized attachment disorder may become upset when their mother leaves and seem to calm and be happy when she returns, they may also show anger towards mother, refuse to be picked up or embraced, and may rock back and forth. Postpartum depression in mothers has been linked in some cases to this type of attachment disorder in children.
Reactive Attachment Disorder
Reactive attachment disorder is a serious mental health disorder that usually develops between infancy and five years old. These children do not seek out comfort from caregivers in any situation and are extremely withdrawn. These children do not feel empathy and cannot respond in emotionally appropriate ways. They often seem sad, irritable, irrationally fearful.
When children develop this disorder that may have anger problems and control issues. They frequently dislike physical affection and will avoid it. This attachment disorder is very rare and affects less than 1% of the population; however, in maltreated countries, the rate of reactive attachment disorder is 10%. This has lead researchers to believe that this type of attachment disorder is related to massive social neglect.
Medications For Attachment Disorders
There are no medications or pharmaceuticals that are prescribed to treat attachment disorder specifically. Most patients that suffer from an attachment disorder are treated through behavioral, individual or family therapy. However, people who suffer from attachment problems or disorders are much more likely to suffer from other psychiatric disorders such as depression, anxiety, PTSD, or dissociative identity disorder, bipolar and more. There are medications available that treat this disorders that may also help to control some of the symptoms of attachment disorders.
In extreme cases, children may be hospitalized for their treatment of reactive attachment disorder. This intensive treatment is designed to address emotional issues and mistrust. Foster children usually benefit from inpatient treatment as well as children that are overly dependent or attached.
Long-term hospitalization for psychiatric problems is very hard to come by in the United States. Immediate care and assistance are also sometimes hard to find. For children that have anger or violence issues that stem from attachment disorders, doctors may prescribe a mild sedative to help make children easier to care for until a treatment plan can be put in place.
The Cure For Attachment Disorder
There is no cure for attachment disorder; however, through therapy individuals can learn to modify their behavior and recognize the signs of inappropriate attachments. The best way to cure attachment disorders is to prevent them from developing in the first place. Children should live in safe, secure, and trusting environments. Families that are broken, poverty-stricken, or facing extreme stress are at risk for children in the family unit to suffer trauma and develop an attachment disorder.
If you are suffering from an attachment disorder, showing symptoms of attachment issues, or have a child who has recently suffered trauma and become extremely withdrawn, you should consider attachment-based therapy. Your family psychologist can help you to work through attachment issues, rebuild healthy relationships, and be able to recognize the signs of and avoid unhealthy attachments.
You can start on the road to recovery by accessing a therapist or counselor through betterhelp.com. These online counselors are available to talk to you and help set you on the right path to finding a regular treatment provider and help for managing reactive attachment disorder and other attachment related issues.