Attachment Disorder

Attachment is a reciprocal process by which an emotional connection develops between an infant and his/her primary caregiver. It influences the child’s physical, neurological, cognitive, and psychological development. It becomes the basis for development of basic trust or mistrust, and shapes how the child will relate to the world, learn, and form relationships throughout life. Healthy attachment occurs when the infant experiences a primary caregiver as consistently providing emotional nurturing such as touch, movement, eye contact and loving interaction in addition to the basic physical nurturing of food, shelter, and clothing. If this process is disrupted fear and uncertainty replace the foundation of trust and security of well-being that is necessary to support normal social development.

Children with attachment disorders often project an image of self-sufficiency and charm while masking inner feelings of insecurity and self hate. Infantile fear, hurt and anger are expressed in disturbing behaviors that serve to keep caregivers at a distance and perpetuate the child’s belief that s/he is unlovable. Lessons of cause and effect come slowly for children with poor attachment. Such children often do not respond well to traditional parenting or therapy since both rely on the child’s ability to form relationships, and to internalize the parents and their values. Parents, confronted with their children's unacceptable behavior, react emotionally, creating an intense, but unsatisfying connection between adult and child. Therapy and parenting that utilize the elements of basic attachment have been found to be more helpful. A more directive approach using nurturing touch, eye contact, and physical and emotional closeness can provide a corrective emotional experience and create a foundation for a healthier attachment between child and parent.

Educationally, children with attachment difficulties often show signs of learning problems such as disabilities and delays. Their parents and teachers may catch them in chronic lying, cheating or stealing patterns. They may be destructive to themselves or others, cruel to animals, or preoccupied with disturbing or violent play themes. Often, they don't get along well with their peers.


Common Causes of Attachment Problems (Highest risk if occurring within the first few years of life.)

a.  Sudden or traumatic separation from primary caretaker (through death, illness, hospitalization of caretaker, or removal of child)

b.  Physical, emotional, or sexual abuse

c.  Neglect

d.  Hospitalization, chronic illness, or invasive or painful medical procedures which cannot be alleviated by caretaker

e.  Frequent life changes or transitions: multiple moves, caretakers, and/or placements

f.  Inconsistent or inadequate nurturing from primary caregivers

g.  Chronic depression of primary caretaker

h.  Medical/neurological disabilities which interfere with cognitive perception of or physical ability to receive nurturing

i.  Prenatal alcohol or drug exposure


Social Developmental Concerns with Attachment Disorders

(1)  Fixation in Early Psychosexual Development:

May demonstrate traits of "oral stage" fixation

a. Smoking

b. Constant chewing on gum, pens, pencils, etc.

c. Nail biting

d. Overeating or Drinking

e. Sarcasm

f. Verbal hostility

May demonstrate traits of "anal stage" fixation

a. Anal-Expulsive Personality: Deriving pleasure and success from immediate self gratification. Individuals with a fixation on this mode of gratification are excessively irresponsible, non-conforming, insatiable, distractible, disorganized, reckless, careless, defiant and self injurious/destructive (ie excessive piercing, tattooing, risk taking, etc.).

b. Anal-Retentive Personality: Deriving pleasure and success from planned and predictable perfection and order. Individuals who fail to progress pass this stage are obsessively clean and organized and intolerant of those who aren’t. They may also be excessively cautious, stingy, intolerant, prejudiced, obstinate, meticulous, conforming and passive-aggressive.


(2)  Fixation in Early Psychosocial Development

May demonstrate traits of unresolved "Trust vs. Mistrust"

a. Distrustful of social interaction

b. Cynical of others efforts/suggestions

c. Wary of new situations/environments

d. Inappropriately suspicious or paranoid

e. Insecure

f. Pessimistic

g. Defeatist outlook on life

May demonstrate traits of unresolved "Autonomy vs. Shame:"

a. Stubborn

b. Intolerant to change

c. Inappropriately jealous of others possessions and or achievement to the extent of chronic stealing, shoplifting, etc.

d. Explosive and angry at perceived bias

e. Easily embarrassed

f. Inappropriate or excessive emotional response to perceived personal failure

g. Excessive avoidance of personal failure to the extent of chronic lying, cheating, etc..


Fixation in Early Moral Development:.

Delays in Pre-conventional Stage 2 development result in self interest orientation to behavior: interest in the needs of others only extends to the benefit or furthering of one's own interests.


Fixation in Early Cognitive Development:

Delays in Sensory Motor and Pre-Operational thought development result in self-oriented, and egocentric thought patterns: only able to view the world from a personal (first person) perspective, and engaging in repetitive self gratifying behavior patterns.


Behaviors Associated with Attachment Disorders

(1)  Unable to engage in satisfying reciprocal relationship:

a.  Superficially engaging and/or charming

b.  Unable or unwilling to maintain eye contact

c.  Indiscriminately affectionate with strangers

d.  Unable or unwilling to give and receive affection on parents' terms

e.  Inappropriately demanding and clingy

f.  Persistent attention getting behaviors such as nonsense questions and incessant chatter

g.  Unable or unwilling to maintain appropriate peer relationships

h.  Low self esteem

i.  Significant impulse control problems

j.  May attempt manipulate adults with deception

k.  Chronic stealing/cheating/lying

l.  Destructive to self, others, property

m.  Cruel to animals

n.  Preoccupied with fire, blood, and gore


(2)   Disorganized or inappropriate cause and effect thinking:

a.  Difficulty learning from mistakes

b.  Learning problems - disabilities, delays

c.  May demonstrate excessively disruptive behaviors as attention getting or task avoidance technique

d.  May target peers who under-perform academically in retaliation for teacher assistance

e.  May target peers who outperform academically in retaliation for teacher praise


(3)  "Negative attachment cycle" in family

a.  Child engages in negative behaviors that can't be ignored

b.  Parent reacts with strong emotion, creating intense but unsatisfying connection

c.  Parent and child are unable to create or maintain a loving connection