Shortly after Rhonda and Kevin brought their newborn son, Hunter, home from the hospital, he had a bad reaction to his formula and stopped breathing. After their baby was rushed by ambulance to an emergency room, he spent about a week in an intensive care unit.
Rhonda and Kevin visited daily, often staying until visiting hours were over. It was several weeks before the doctors could find formula that Hunter could accept.
That event was the beginning of Hunter’s anger, hyperactivity, and defiant behavior.
Rhonda initially denied that there were any traumatic issues before, during, or after Hunter’s birth. She thought she and her baby bonded well because Hunter was so sweet when he wasn’t angry or spinning out of control behaviorally.
By the time Hunter was seven, he was being treated for attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). He’d been violent toward Rhonda to the point of causing injury to her, and one time almost broke the glass door on the school bus.
One day, Rhonda talked with a counselor who explained attachment issues and how children with these issues behave.
“That’s exactly what my child does,” Rhonda said. “That sounds exactly like Hunter.”
Unbeknownst to his parents, Hunter’s normal attachment process to his mother was interrupted shortly after he got home from the hospital. Rhonda and Kevin worked with the therapist to help Hunter with his attachment issues and heal his brain using therapeutic parenting principles.
“The hardest thing for me in all this,” Rhonda told the counselor, “was not learning how to parent him out of this. It was getting through the guilt I felt. Because I thought it was my fault—that I was a bad parent for not seeing this problem sooner.”
This couple’s story is a good reminder that the attachment between baby and parent can be disrupted by no fault whatsoever on the part of the parents. With that in mind, it’s crucial to realize that positive attachment between parent and child is the foundation for raising kids who can thrive. Suicide prevention actually begins when a child is born.
Attachment: Why Does It Matter?
Attachment is paramount because it’s the first and most important stage of infant development. It’s the cornerstone of psychological health that begins in utero. As the relational part of a child’s developmental process, it enables a baby to connect in a healthy way with his primary caregiver. It teaches his brain how to process and interpret the information provided by the five senses so that he can feel safe in this world. As a result, it’s fundamental to the growth of a healthy worldview.
Attachment: What Is It?
Attachment is not the same thing as bonding. Bonding is what a normal, healthy adult will naturally and unconditionally do when presented with the responsibility of caring for a helpless infant. Attachment, on the other hand, is conditional. It’s what happens if and when a normal infant feels safe enough in her environment to form a deep connection with an adult. Secure attachment depends upon the parent meeting three conditions so that the child knows
- I’m safe,
- I can trust my parent,
- I have a voice, which means I’m confident enough to speak my thoughts (appropriately) and ask for what I need, knowing my parents will respond and meet my needs. (If a child does not develop a voice, she will resort to some nonverbal form of communication to make her needs known. Usually these are actions of a negative kind.)
Ultimately, attachment requires a proper balance between structure and nurture. If your child needs structure (form, order, rules) and you instead give her nurture (comfort, nourishment, compassion), you limit her growth. If a child needs nurture but you give her structure, you limit her trust. All of these elements are essential to the formation of a lasting parent-child relationship.
Attachment: How It Grows
There are four different attachment styles, and they can be used to describe both infant and adult behavior. Secure attachment is the only healthy style. If a child doesn’t develop a secure attachment, he will have one of the three types of insecure or broken attachments.
In an adult, this attachment style is called free/autonomous. A secure infant wants to be near his parent and is easily consoled by the parent’s presence. Secure adults are comfortable being independent and self-directing. They’re able to resolve any fallout of past hurts and disappointments. A secure child grows up to become a free/autonomous adult.
Nurturing experiences with a loving caregiver help attachment grow. The secure infant attaches to the adult caregiver because:
- he tries to be close to his caregiver, especially in times of trouble;
- he sees his caregiver as providing a “safe haven”;
- he trusts his caregiver to provide a secure base from which to explore the world;
- he feels fear or anxiety at the threat of separation from his caregiver;
- he feels grief and sorrow at the loss of his caregiver.
Secure attachment develops in three stages:
Stage One: From zero to two months of age, babies form emotional connections with caregivers. At this stage, a child will focus with pleasure on any human face. This is called indiscriminate social responsiveness.
Stage Two: From two to seven months, babies begin to show a preference for familiar faces. This is called discriminate social responsiveness.
Stage Three: The time between seven to thirty months in a child’s life is especially important for healthy attachment. If conditions are less than ideal, a child’s ability to form a healthy attachment may be harmed. This final stage is called specific attachment relationships.
For adults, this attachment style is called preoccupied. An ambivalent child is clingy and extremely and abnormally alert to any danger or threat. Ambivalent babies grow up to be preoccupied adults—codependent people who can never let go of past abuses and betrayals.
For adults, this attachment style is called dismissive. The avoidant infant shows little or no desire to be held or comforted by her mother. She’s already learned her mother can’t consistently provide the love and support she needs, so there’s no reason to look to her for those things. As an adult, this person may dismiss or deny emotions, relational connections to other people, and/or hurts. A dismissive adult is unwilling to deal with personal difficulties on any level.
For adults, this attachment style is called unresolved. A child with a disorganized attachment style expresses confusion, a sense of disconnectedness, or pure terror in the presence of his caregiver. This is often the case when he has experienced abuse. As an adult, he’ll likely display symptoms of unresolved issues and can become a prime candidate for addictions.
The normal process of attachment can be derailed in a number of ways. Some are under the parents’ control and some are not. Unfortunately, bad things can happen even in the strongest and most well-adjusted family. As a mom or a dad, you can save yourself a lot of grief and confusion by developing an awareness of these risks from the very beginning. They may also help explain some behaviors you currently see in one of your children that doesn’t seem to be able to be explained away. We can divide these risks into two categories: risks of nature and risks of nurture.
Risks of Nature
As we saw in Rhonda and Hunter’s story, a number of physical or medical situations can pose a threat to the development of healthy attachment in children, including:
- a difficult pregnancy or prenatal trauma. Included in this category are various forms of medical trauma, such as a small hemorrhage or a loss of oxygen experienced by the infant, drug or alcohol use, anxiety, depression, or stress in the birth mother during pregnancy.
- a difficult birth or delivery. This could be any medical trauma associated with complications during the labor process.
- early hospitalization of the infant due to premature birth or medical complications requiring surgery or special care. Related issues, such as the pain of injections or minimal nurturing during a hospital stay, may also add to the problem.
Risks of Nurture
Attachment can also be impaired by unfortunate life events and negative developments in the relationship between parent and child, including:
- toxic stress. Formally called adverse childhood experiences (ACEs), toxic stress can include a wide variety of illnesses, mental illnesses, childhood trauma, and circumstances that negatively affect a child. People with four or more adverse childhood experiences are four-and-a-half times more likely to develop depression than the general population, and twelve times more likely to become suicidal.
- adoption. If you adopted your child, the prebirth background and situation, and the situation into which the child is being introduced, may also qualify as significant stressors. Adoption always entails a period of readjustment, and this can be stressful even under ideal circumstances—even if the baby was taken home directly from the hospital after birth. Be careful not to jump to conclusions, though. Adoption doesn’t automatically mean your child has attachment issues, but it’s something to be aware of and keep in mind.
What happens when these risk factors interrupt or upset the normal attachment process? Here are some of the most noteworthy signs, symptoms, and consequences of attachment dysfunction.
If your child seems to be extremely needy or uses manipulative behavior, it’s worth checking with a licensed professional to see if she’s displaying attachment issues. Manipulative behaviors include:
- badgering: asking you over and over and over again for the same thing;
- throwing a tantrum: attempting to intimidate you;
- threatening: saying things like “I’ll never talk to you again” or “I’ll just kill myself”; and
- flattering: saying something like “My, Mommy, you look great today. Can I have a cookie now?”
Attachment can be harmed anytime a child’s needs, whether tangible or intangible, are frequently not met.
What Are ACEs?
Adverse childhood experiences (ACEs) are:
- physical abuse,
- emotional abuse,
- sexual abuse,
- emotional or physical neglect (which typically causes even greater trauma than abuse),
- parental mental illness,
- parental substance dependency,
- incarceration of a parental figure,
- parental separation or divorce,
- exposure to domestic violence.
Children are especially sensitive to repeated stress because their brains and bodies are still developing. High doses of ACEs affect:
- brain structure and function,
- the developing immune system,
- the developing hormonal system,
- how the DNA is read and transcribed.
All of these negatively impact a child’s ability to process life’s situations in a healthy way. No wonder statistics indicate that people exposed to numerous ACEs have a life expectancy twenty years lower than that of the general population.
Reactive Attachment Disorder
A child who can’t trust and doesn’t feel safe—even when he truly is safe—will not be able to attach to others. The child with reactive attachment disorder will not be able to attach, not even with an extremely loving and nurturing parent. Feelings of fear and insecurity will push him into survival mode. In this condition, he reacts without thinking with a fight or flight behavior, and he’s incapable of responding to his environment in a rational way.
This reactivity in this child’s brain comes because an unattached child sees the world—accurately or not—as an unsafe place and is in a chronic state of panic. This child perceives every new stimulus as a threat. Living in an unsafe world (as the child sees it), means he always has to be on guard. Since he can never know when, how, or from whom the danger will come, being superalert becomes a way of life. Under these conditions:
- the right hemisphere of the brain is overly activated (emotion, intuition, reactivity);
- the left hemisphere of the brain is underactivated (reason, logic, linear processing, evaluation);
- normal thinking becomes impossible, as a result.
A person who lacks attachment often has little or no concern for others. As a result, she has the potential to become destructive or violent.
Confusion with Other Symptoms
Attachment that isn’t secure can mix with or be hidden behind any number of legitimate social, psychological, and medical disorders. This makes it all the more difficult for you to figure out exactly what’s going on with your child. Attachment issues may be misinterpreted as
- processing disorders,
- developmental delays,
- learning disabilities,
- separation anxiety,
- post-traumatic stress disorder,
- slow learning,
- oppositional defiant disorder,
- autism spectrum disorder,
- being strong-willed,
- anger management issues,
- compulsive lying
- eating disorders,
- conduct disorder,
- obsessive-compulsive disorder,
- sexual promiscuity, violent, aggressive behaviors,
- sleep disorders.
If your child has been labeled with several of these issues, yet nothing seems to really fit well, consider professional help to see if attachment disorder is the underlying root cause.
Parents, please understand that attachment issues are not necessarily reflective of the quality of your parenting. Attachment can sometimes be disrupted or destroyed by forces beyond your control. Even so, you do have the power to respond effectively to the challenges these issues present. Here are some simple strategies to keep in mind:
Be aware. Once you’re clued into the various developmental and relational issues connected with attachment, you’ll be in a better position to confront them. For example, if your child went through a difficult birth or had to endure a long stay in the hospital as an infant, keep an eye out for symptoms of attachment disorder and start thinking of ways to counteract them. It’s also a good idea to cultivate an awareness of your own adult attachment style and its related issues.
Be intentional. Starting in your child’s infancy, make a conscious effort to establish meaningful connections. Provide a tactile, sensory-rich environment that includes close proximity between parent and child, plenty of eye contact, making your voice a familiar sound, playful engagement, displays of affection, physical activity that allows for healthy touch, and lots of bodily movement. Hold, touch, hug, and make room for lots of skin-to-skin contact. Give your child the attention he needs and craves.
Be encouraging. Be present and patient with your child. Encourage her to verbalize her needs and respond as appropriate. Provide the support and care required to let her know she’s safe. Remember, only the person with the need can determine how much reassurance is enough to meet that need.
Model God’s love. At the heart of healthy attachment is a deep awareness of God’s love and unconditional acceptance. Reflect and express this unconditional care in all your dealings with your child.
Let enough be enough. Be content to do what you can. Don’t fall for the false thinking that you have to measure up. As we said, there’s no such thing as a perfect parent. The good news is, we don’t have to be perfect parents—just good-enough ones. Do what you can and let that be good enough.
Conclusion: Getting Off on the Right Foot
A healthy outlook on life grows out of healthy attachment. As a parent, your number-one concern is to establish your child’s life upon a firm foundation of solid relational connectedness. The best research indicates that connected kids do well in almost every area of life. The disconnected child is more likely to face serious challenges down the road.
If this discussion about attachment doesn’t apply to any of your children, great! Congratulations! They are off to a fundamentally strong start. If, on the other hand, you’re reading over this list and realize you’ve been lax with some of these things, don’t beat yourself up. Pick one or two areas and begin with small steps. It’s never too late to make changes and seek additional professional help. Taking action now helps prevent a potential crisis down the road.
Score yourself on adverse childhood experiences. Make a mark beside each item you experienced during your childhood prior to your eighteenth birthday:
___ Did your parent or another adult often hit, slap, push, or shove you, or throw something at you? Did they ever hit you so hard you had marks or were injured? Mark this even if they said afterward that they were “just kidding.” (physical abuse)
___ Did your parent or another adult often call you names, yell at you, insult you either in private or public, put you down or humiliate you, or act in a way that made you afraid they might physically hurt you? (emotional abuse)
___ Did a person at least four years older than you ever touch or fondle you, have you touch his or her body in a sexual way, or have oral, anal, or vaginal sex with you? (sexual abuse)
___ Did you often feel that no one in your family loved you, didn’t look out for you, or didn’t support you when necessary? (emotional neglect)
___ Did you often not get enough to eat, have to wear dirty clothes, or have no one to physically protect you if needed? Or were your parents too preoccupied for some reason (busy, sick, drunk, etc.) to take you to the doctor when needed? (physical neglect)
___ Was a household member ever identified as having depression, anxiety, schizophrenia, or dementia? Or did a household member ever attempt suicide? (parental mental illness)
___ Was a household member ever a problem drinker or an alcoholic? Did a household member ever use street drugs or misuse prescription drugs? (parental substance dependency)
___ Did a household member ever go to prison? (incarceration of a parental figure)
___ Were your parents ever separated or divorced? (This also includes a parent being deployed in the military or being away for long periods of time because of business, etc.) (parental separation or divorce)
___ Did your mother, father, stepmother, or stepfather sometimes get pushed, grabbed, slapped, kicked, bitten, or hit with a fist or something hard; have something thrown at her or him; or get physically threatened with a gun or a knife? (exposure to domestic violence)
Count up the total marks. This is your ACEs score: ___
An ACEs score higher than a two is worth further consideration. Research shows that the higher the ACEs score, the greater the risk of experiencing negative social consequences and poor physical and mental health later in life.