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Disorganised Attachment? What can WE do?



How Dan Siegel inspired me

Last week I attended a masterclass with Dan Siegel on Disorganised Attachment. As with all great minds Dan’s revelations were both mind blowing in complexity and simplicity. The message of hope I took away from the masterclass is that we can all contribute to help children and young people recover from traumatic experiences by our willingness to engage with them in safe, respectful relationships to help integration of the brain. 

One question from the audience was what we can do as teachers, childcare workers, foster carers and people in counselling and case management related roles. Dan’s answer as I remember it was that children with disorganised attachment need psychotherapy to help address dissociation and neuro-biological disintegration. People in above mentioned roles can assist this process by applying the principles of No-Drama Discipline, the book written by Dan Siegel and Tina Payne Bryson. Since I had just read the book I am sharing some of the principles here in this blog and added some of my own favourites as well.

Just imagine what it would be like
Children with disorganised attachment have experienced relationships with important caregivers as frightening and unsafe. They are or were dependant (for food, shelter, safety, comfort) on a caregiver who abuses, neglects and/or frightens them (domestic violence, alcohol or drug abuse, parental mental health issues)…at least some of the time. Their experiences result in neuro-biological changes in the brain and body aimed at survival, which at the same time cause chaos and paradox in the child’s body, mind, emotions, behaviour etc. This severely impairs these children’s ability to connect and feel safe with adults and peers alike. You probably know what that looks like in everyday life if you are still reading this. 

Connection, connection, connection
The most important thing you can give children with disorganised attachment is your willingness to engage with them in a mutual, safe and respectful relationship. It may not look much like a relationship in the beginning, but repetitive experiences of safety, acceptance, patience is where it starts. 

Dan Siegel calls it the 3 S’s; Being Seen, Soothed, Safe
Dan Hughes calls it PACE; Playful, Acceptance, Curiosity, Empathy

It is about our willingness to meet a child on their terms; meaning at their actual developmental level, accepting their expressed needs and feelings (not necessarily their behaviour) or accepting they are not (yet) ready to engage or cooperate with us, which granted can be a pain in the b…. But when we are able to stay calm we are role modelling what we would like them to learn. When we communicate to a child we are willing to accept and be empathic of their big feelings, strong needs or their experiences and perceptions of us or a particular situation, chances are this is going a long way in helping them to calm down too. There is no need for lecturing, correcting or punishing. We may need to teach them some stuff later on, but right now it is the time to listen and help them make sense of what was going on. To help them calm strong feelings and impulses to retaliate. We can be curious by asking gentle questions or making some educated guesses about what made them feel or act a certain way. We can show our willingness (not our demands) to find out what this situation is all about from their experience and we will start to see and appreciate their reactions if not their behaviour. 

In their book ‘No-Drama Discipline’ Dan Siegel and Tina Payne Bryson state the benefits of connection before doing anything else are:
Short term benefit: It moves a child from reactivity to receptivity, so they get into a space where they are actually able to listen to what you want to teach them.
Long term benefit: It builds a child’s brain. By offering children consistent and repetitive experiences of safe relationships we can build and reshape connections or pathways in the brain. It will teach children necessary social-emotional skills and resilience.
Relational benefit: It deepens your relationship with your child/student/client.
Children with disorganised attachment may need a lot more of those experiences, as well as our patience before they are ready to trust and feel safe with us, before they are ready to learn different and more helpful responses to stress and frustration. But the principle is the same and we can help children build the necessary pathways in their disorganised and disconnected brains to calm the chaos, to relax rigidity and become receptive to connect and learn from others. 

Redirecting
Dan and Tina explain the word discipline means teaching. Not punishing, correcting, no time out, rewards or loss of privileges. But teaching and redirecting.

Redirecting could mean you first need to remove a child from a dangerous situation. It may mean you have to intervene when a child is out of control and (at risk of) hurting themselves, someone else or damaging property. Just try to stay calm and connected to the child while you are doing this.

Redirecting means you take a moment to reflect on what you want the child to learn from a particular situation and how you can best teach this.

Redirection only works when children are ready. This means they have to feel safe, connected and sufficiently emotionally regulated so they can pay attention to what you are trying to teach them. They have to be ready before they can reflect on their own behaviour and what this could mean for others. For children with disorganised attachment this may mean taking very small steps at first. Small steps to help them learn to trust you over time and small steps to guide them towards capacity to reflect.

Redirection means you may have to work out together what the child could do to make things right; to repair another child’s hurt feelings, a deliberately broken toy etc.

Redirection could mean you are setting developmentally appropriate boundaries, providing structure and organising experiences for a traumatised child. Not as a punishment, but to provide additional safety through structure so a child is able to learn. Just as you won’t allow a 3 year old to cross the road by themselves, you may have to refrain a traumatised child from going to a birthday party if they are getting so overwhelmed and overexcited they are at risk of harming themselves or others. Until they are developmentally ready at a later stage in their life of course.
A child’s ability to regulate their feelings, consider others, problem solve etc. will increase with their age and the opportunities they’ve had to practice those skills. This means we need to adapt our expectations, what and how we want to teach children valuable life skills to their developmental age. This is even more true for children who experienced relational trauma, resulting in disorganised attachment. They may be 8 or 15 years old, but developmentally ready for learning of social-emotional and other skills at a much younger age. 

Structure, predictability and repetition
Traumatised children need a structured environment, with predictability and routines. They also need a lot of repetition as a pre-condition for change and learning. This is simply how the brain works. Child care centres, schools, as well as home environments are well suited to provide a child with disorganised attachment with such experiences. People working in counselling related settings can structure their sessions with a clear beginning and end and setting up a routine of activities, but leaving space for free expression.

Play, creativity and the need to move
Children learn about themselves and the world through play, creative, physical and sensory expression, exploration and movement. The same is true for how they express their needs. This highlights the importance of balancing cognitive and other ways of learning. Children also learn in their own tempo and only when they are developmentally ready. The more a child expresses disorganisation in their functioning, the more they need your help in providing structure, connection and regulation of their experiences. This can be achieved by limiting time for an activity and limiting the amount of choices or toys, while allowing for opportunities of spontaneous expression when they occur. It may mean facilitating play, expression and learning experiences in a one on one situation on a regular basis, rather than only offering opportunities for learning in a group environment. A traumatised child needs to go through all developmental stages of play, gross and fine motor skills, emotional regulation etc. even when they are far behind compared to their peers. The more you can help them catch up on building foundational, early childhood skills, as precursors for more complex skills, the better they will be able to learn and catch up.

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