Tuesday, March 8, 2016

Adult Attachment

Adult Attachment

Adult attachment is often examined within the framework of a scientifically designed instrument called the Adult Attachment Interview (AAI) which is given by a professional specially trained to administer the evaluation.  It consists of a series of questions about one’s self in relationship to one’s parents, spouse (or SO), and children.  The results place the individual within one of four main categories of attachment:  secure, ambivalent, avoidant, and disorganized.

This evaluation tool can be beneficial in helping the individual understand what type of attachment patterns he/she is enacting in his/her current life.  It can also predict the type of attachment patterns his/her unborn child will have.  Thus, it is a powerful tool which demonstrates the connection between the past and the present, and the present and the future.

Another way of looking at adult attachment is to consider the principles generated by the field of research in light of one’s personal experiences in life.  The research is explaining how a reasonably adequate (doesn’t have to be perfect) attachment experience creates the capacity for internal emotional regulation and thus enables us to have successful relationships.  If one has challenges with relationships or with impulse control, anger, anxiety, depression, or other mood or emotional regulation issues, then one can reasonably conclude that there are some issues with attachment that warrant attention.  The manner in which one does this could range anywhere from working with simple techniques to create internal emotional regulation in daily life, to deep emotional work with a therapist which incorporates an understanding of one’s inner child. 

The following are examples of simple techniques which one can incorporate into one’s everyday life.

  • Establish daily routines for self-nurturance such as meditation, exercise, listening to music, dancing, etc.
  • Work to be aware moment by moment of how you are feeling inside.  The moment you stop feeling peace, start a process of self regulation, such as deep breathing or the activities mentioned above.  Deep, nurturing breathing (as well as sound) calms our stress response system.
  • Be present with your emotions.  Allow them to rise to the surface, and pass through you like a gentle breeze, or a strong ocean wave.  Emotions are simply energy which can be experienced and released.  Their power is then diminished, and you will have more access to your neocortex (rational or cognitive brain).
  • When you are feeling any kind of negative emotion, allow yourself to consider that there is fear underneath.  Try saying to yourself, “I am feeling scared right now”, or other words with which you resonate.  Breathe into it, and feel it in your body.  The process of being authentically connected to your emotions in your body can provide relief, and allow the fear, or whatever emotion, to dissipate.  Sometimes adding sound (like a fog horn), or tapping on trigger points helps (as in EFT).
  • When faced with behavior, either from yourself or another, which is undesirable, consider viewing it as arising from an unconscious state of fear.  Your change in perception will automatically create a different set of responses in you.  This principle has enormous capacity to improve relationships of all types.
  • Much of our communication is unconscious and non-verbal. We influence each other through our state of being. 

Note:  The idea that negative behavior is likely to be connected to an unconscious state of fear comes from the understanding that an important function of an attachment system is to create internal security and emotional regulation.  Negative behavior typically arises from an internal state of stress and fear.  Research regarding the development and function of the emotional brain and the chemical responses generated in the body when faced with intense emotional situations helps provide a more complete explanation.  This science also explains how the expressing of and processing of negative emotional experiences within a trusting relationship provides soothing, and opens up the pathways to our thinking brain.

Science Supports Loving and Compassionate Parenting

Science Supports Loving and Compassionate Parenting

All parents struggle with determining which parenting approach or philosophy is best for their child.  With so many writers and theorists claiming to have the magic solution, what is a parent to believe?  I have been excited to discover that hard science is giving us some concrete answers.  Science is now confirming that loving and compassionate parenting, including parental responses of joy and delight in and with the child, is the most powerful tool available to influence children’s behavior, and to enhance their development in every area.   This is in contrast to a child raising culture which has been based on controlling discipline and on logic and behavioral consequences—what I would term fear based methods.

Developmental psychology and neuroscientists, through a very large body of interdisciplinary data, are explaining that our state of mind, and our ability to be tuned into our child’s emotional experience in such a way that our child “feels felt”, enables our child to think clearly and to be compliant.  Our facial expressions, tone of voice, and many forms of nonverbal communication are literally developing our baby’s and young child’s brain.  This continues, at a slower pace, throughout childhood.  In fact, the plasticity of the brain remains in tact through life, and can be influenced through loving relationships until the end of life.

Dr. Allan Schore, a faculty member of the UCLA School of Medicine, refers to a baby’s caretaker as the “psychobiological  regulator” of the infant, meaning that she or he is the regulator of the baby’s nervous system.  From thousands of interactions between baby and caretaker, and caretaker and toddler, the child develops his or her ability to manage stress and to have appropriate emotional responses to the world.  These interactions cause neurons to connect, and set off a cascade of chemical reactions within the body, including the production of serotonin and dopamine, two key brain chemicals targeted by mood regulating drugs such as Prozac or Zoloft, and many others.  The patterns of these interactions during the first two years of life beccome imbedded as biology, and sets the stage for the child’s response to environmental stress and stimuli throughout life. 

The experts are telling us that for optimum development, a child’s state of alertness, ranging from excitement to distress, needs to be maintained within a window of tolerance.  When the prevailing emotional climate in the child’s environment is chronically outside his or her window of tolerance, the child’s development may be impeded.  On the extreme, this may look like behavior problems, impulsivity, and childhood depression, or, on the opposite end of the continuum, it may look like withdrawal, anxiety, poor information processing, or a compromised attention span.  

Traditional child raising and educational practices such as consequences,  scolding, and various pressures to perform, can actually create an overactive amygdala (a small almond shaped portion of the limbic system in the right hemisphere of the brain at the base) which responds to stimuli with fight, flight, or freeze reactions.  These responses often occur so swiftly that they do not register with the hippocampus (the part of the brain which offers a rational response to fear or anxiety).  Thus, the cause of the response is outside the conscious awareness of the individual (child or adult), and, in that moment, the individual literally does not have the capacity to understand what is happening, or to have the capacity to reason and make choices.  These responses can occur when there does not seem to be a rational explanation for them.  

This message is not about indulgence.  But rather, it encourages us to be mindful of our own emotional state as we are providing consistency, structure, and limit setting for our children.  It also encourages us to create the space in our daily interactions with our child to listen to their behavior, to encourage the expression of their emotions, and to be ready to truly receive them.  Negative behavior is a form of communication which says that our child needs attention in some manner.  It is up to the adults to creatively and lovingly figure out what the child needs, and in this manner, to create emotional regulation for the child.  Through repeated interactions of this type, the child develops the capacity to regulate her own emotions, though assistance with this, from time to time, is needed for all human beings.

This type of parenting requires conscious attunement to the child’s cues, and sometimes may necessitate a change in lifestyle in order to pace the child’s and the parent’s stress level.  Attunement requires an undistracted parental mind. 

This paradigm shift, away from making our child responsible for negative behavior, to making ourselves responsible for regulating the emotional states of our children, can be a hard idea to swallow, especially when this runs counter to our own biological and cultural programming.  To take a step in this direction, I urge you to try an experiment.  The next time your child “acts up” or misbehaves, make your first response be taking deep breaths to calm yourself down.  When you are truly in a state of calm, approach your child with an arm on the shoulder, warm eye contact, or some other warm gesture (if your child is very young, get down to eye level with your child), and say, “Sweetie, it seems like you are upset or stressed about something.  It’s making it hard for you to _______ (fill in the blank.)  Let’s you and I figure this out.” Better yet, try this approach for two weeks. 

The Roots of Violence: of Stress and Children

The Roots of Violence: of Stress and Children

As a nation we are horrified by an epidemic of mass shootings at the hands of young killers and by an escalation of bullying in our schools.  Though many constructive solutions have been offered, something is being left out of our national dialogue.  This something is what science has to say.  

Findings from decades of child development research have given us a new lens with which to understand children’s needs, and may shed some light on the escalation of violence at the hands of young people. The field is exploding with new information, yet pediatricians, educators, and mental health therapists are often unaware of this science, or the breadth of the research and its implications.  Recently the American Academy of Pediatrics incorporated some of this information into a policy statement warning that toxic stress early in life, or even before birth, can harm children for life.  (“Early Childhood Adversity, Toxic Stress, and the Role of Pediatricians:  Translating Developmental Science into Lifelong Health” Pediatrics 2012; 129:e224-e231).

 The results of this research tell us that babies and young children are much more sensitive to stress and to nonverbal communication from adults than we ever knew. Scientists are also telling us that mutual interactions of joy and delight between parents and children, especially in the early years, are crucial to healthy brain development and to their ability to manage strong positive and negative emotions throughout life.  This ability to regulate the highs and lows of emotional life is the key to stable mental health as an adult.  Difficulties with emotional regulation are at the core of most mental health disorders.  

For children, a “felt sense” (different from an intellectual knowing) of being valued and understood on the inside is essential to the regulation of their nervous system, and their ability to have full access to their neocortex.  When there is something stressful in the child’s environment— everything from mom and dad being stressed about everyday life, to a divorce, to someone died, to moving, to a medical procedure—children need to have someone they can trust to help them understand how it makes them feel.  

We now know that children can be easily traumatized by everyday events without adults realizing it.  There are specific tools that can be taught to parents, to educators, and to every adult who relates to children, to help them help children manage these stressful events.  This would include right brain to right brain communication which soothes the limbic system and develops autonomous emotional regulation—for example, paying attention to eye contact, tone of voice, and timing and intensity of communication; offering validating comments such as “That must have been scary!; or “So, that’s how it was for you!”; or enjoying sensory rich activities together such as kneading dough, drawing, music, playing sports, or dancing.  Also, children can be taught to identify stress in their bodies, techniques to reduce their stress, and what to do if they are about to “flip their lid”. When this type of relationship connection does not happen for a child, we often see an escalation in difficult behaviors, from obstinacy to extreme violence. 

Attachment Theory scientists talk about “attunement.”  This is a special kind of connection with the child where the adult is completely undistracted, and can relate to the child almost as if the adult were in the mind of the child.  Attunement fosters spontaneous sharing, a feeling of being understood, and allows the adult to gently explore what is on the child’s mind.  Attuned communication has a huge impact on a child’s overall behavior, and builds their mirror neurons.  Strong mirror neurons are what gives children the ability to have empathy for others—not moral teachings or zero tolerance policies.  Empathy in turn prevents aggression and violence.

Doctors Gordon Neufeld and Gabor Mate, in their book Hold on to Your Kids, explain “counterwill” (disobedience) and the “the making of bullies”. They convey that, though counterwill (“I want my own way.”; “You can’t tell me what to do.” etc.) is normal in children, it can be tamed through, and only through, a strong attachment relationship, not methods to control and punish.  That means that if children feel truly connected to their parents or to the adults in charge, and feel safe to lean on them emotionally, they are more likely to listen and to drop their counterwill impulses. In other words, if I, as a child, feel safe to tell you how I really feel inside about stuff, and trust that you are not going to judge my feelings or dismiss them, I am going to feel close to you and want to listen to your rules even if I do not want to. I am also going to absorb your core values.  You do not have to drill them into me. 

Neufield and Mate go on to describe bullying as a lack of emotional vulnerability stemming from weak attachment connections.  If a child does not feel emotionally safe to lean on an adult attachment figure, then they harden their tender feelings, such as fear, anxiety, love, caring, etc., and defend them by lashing out.  Or, they may turn against themselves and harm themselves. They may also try to find an attachment substitute by becoming obsessively attached to their peers and push away their parents.  But this doesn’t feel safe either, because another child cannot protect them. 

Mate and Neufield explain how a strong peer orientation culture is harmful to children and that; in fact, there is much about our modern life which interferes with the type of attachment relationships children need for healthy mental development.

 So, yes, we need to get assault weapons off our streets.  And, as a society, we need to stop producing bullies and mass murderers.  Children are not born that way.  Society creates them.  No, it is not a specific gene.  The science of epigenetics tells us that the caretaking environment helps to determine which genes are expressed.

I hope that we can bring this vast amount of empirical science into our local, state, and national dialogue. We have the scientific evidence to prevent violence, but will our culture and our politics allow it?

Principles of Couples Relationships

Principles of Couples Relationships

1. No judgments, criticisms, or blame allowed.  There is always a genuine I statement underneath all grievances.  Blame and criticism triggers the threat center of the brain.

2. You are both right.

3. Find the genuine I statement—keep it simple and convey the most accurate emotional experience with it—“I feel hurt when you --------------------- I miss you; having quality time together is important to me, I need your support with ___________________ "  etc.

4. Emotional vulnerability is the horsepower behind close and satisfying connections.

5. We co-regulate (or dysregulate) each other’s nervous systems and bodily functions in relationship.

6. Our bodies were made to be in relationship and to co-regulate together.

7. Differentiation is a key to close relationships.

8. Boundaries must be respected.

9. You are not responsible for each other’s feelings, but you are responsible for listening with caring.

10. Just because your partner is mad or upset with you doesn’t mean you did something wrong.  You don’t have to defend or justify.  You just need to listen with empathy, and validate the experience.

11. Emotional experience has to be aired and processed before logic can kick in.  That is the way the brain and body are made.  Emotional triggers are often experienced in the body without conscious awareness of them, and drive our behavior.  These emotional triggers can be brought to conscious awareness by noticing internal sensations.

12. We all respond to our partners from the past (even if we think we don’t).  Working with the present can uncover past experiences which have imprinted certain patterned responses in close relationships, especially with intimate partners. These patterned responses are designed for self-protection.  They are there for a good reason but do not serve us now.  We can uncover these patterns by working with real life situations in the moment.  We can use this awareness to take responsibility for our patterns, and make different choices in the present moment.  As we discover patterns, we sit with them with curiosity and compassion.

13. Pausing, slowing down, and deep breathing, are important tools for discovering what is underneath.

14. Couple relationships are like the tango.  You either tune in to each other and dance, or you fall over each other.

15. We are each responsible for our own lives, and our own happiness, not our partner. 

16. There are just a few core emotions that we all are seeking in partnership: Am I loved/lovable; Am I a worthy/valuable/adequate person; Am I safe with you, will you come when I need you.  Offering reassurances to your partner in these areas will grow the emotional safety bank.  Emotional safety is the key to everything.  Practical issues will begin to fall into place easily.

Note:  Some of these principles may seem contradictory.  They are not.  This can be understood as we sort through real issues in real time, and see how they apply.  These principles are supported by decades of evidenced based research.  This information is available upon request.

Loving and Compassionate Parenting: A Short Summary

Loving and Compassionate Parenting: A Short Summary

Science is now telling us that loving and compassionate parenting is the most powerful tool available to influence children’s behavior. This is in contrast to a child raising culture which has been based on controlling discipline, and on logic and behavioral consequences. Attachment researchers and neuroscientists are explaining that our state of mind, and our ability to be tuned into our child’s emotional experience in such a way that our child “feels felt”, enables our child to think clearly and to be compliant. Our facial expressions, tone of voice, and many forms of nonverbal communication are literally developing our baby’s and child’s brain. 

 Dr. Allan Score, famous neuroscientist at UCLA, refers to the mother as the “psychobiological regulator” of the infant, meaning that she is the regulator of the baby’s nervous system. (This is also true for dad or any primary caretaker.) From the thousands of interactions between baby and caretaker, and caretaker and toddler, the child develops his or her ability to manage stress and to have appropriate emotional responses to the world. “What’s outside goes inside.” Repeated empirical studies also show that having experiences of joy, delight, and empathy with the parent are at the heart of healthy child development in all domains.

This message is not about indulgence. But rather, it encourages us to be mindful of our own emotional state as we are providing consistency, structure, and limit setting. It also encourages us to create the space in our daily interactions with our child to listen to their behavior. Negative behavior is a form of unconscious communication which says that our child needs our attention in some manner. It is up to adults to creatively and lovingly figure out what the child needs.

Science is also telling us that our own capacity as parents to be tuned into our child is largely dependent upon how we were parented ourselves. So, to understand our own parenting styles, we need to reflect on and to understand how we were parented.

Resources: Parenting From the Inside Out, by Dan Siegel and Mary Hartselle; circleofsecurity.org beyondconsequences.com; Attachment Parenting books by Dr. Sears; attachmentparentinginternational.org.

Keys for Building Secure Attachments with Your Baby

Keys for Building Secure Attachments with Your Baby

1. Enjoy your baby.

2. Delight in your baby.

3. Be completely absorbed in your baby.

4. Follow your baby’s lead.

5. Respond on demand.

6. Remember you cannot spoil a baby.

7. Gaze at your baby.

8. Play with your baby.

9. Stimulate your baby, but don’t overdo it.  Pace it.

10.  First, calm yourself if caring for your baby becomes frustrating.

11.  Give intention to self-care.  Your moods matter.

12.  Let some routine chores (like housekeeping) go.

13.  Ask the grandparents to take care of you rather than the baby.

14.  Self-reflect on how you were parented as a baby. This will give clues as to how you will respond to your baby.

15.  Read Parenting From The Inside Out by Dan Siegel and Mary Hartzell, and other attachment parenting books.

16.  Be conscious of eye contact, tone of voice, and facial expressions.

17.  Seek to repair quickly if your baby has become distressed.  Stay with your baby during times of distress, even if it seems that you cannot console her.  Your presence matters even if it seems that it doesn’t.

18.  Have lots of skin contact.

19.  Don’t hand your baby to someone else unless your baby let’s you know it’s OK.  Facilitate this transition by letting your baby know who it is and what is happening.

20.  Cultivate transition facilitating behaviors.

21.  Let your baby know you understand how she is feeling.  She will understand your tone of voice, and your nonverbal language.

22.  Introduce your baby to prospective childcare providers in advance.  Give your baby a chance to develop a relationship before leaving her alone with the provider.

23.  Nurture your relationship with your partner.  Having a baby can strain your relationship, and your baby will know it.  Learn to communicate honestly and lovingly.  It is possible to stay true to yourself while also validating how your partner feels.  (i.e. You don’t have to “give in” to your partner to express appreciation for how they feel.)

Children of Divorce

Children of Divorce (COD)

1.  COD  are, by definition, in a high state of stress.  The degree of stress will vary based on many factors, such as the circumstances of the divorce, the ability of the parents to attend to their own emotions, and the ability of the parents to be present (with an undistracted mind) to the emotional states of their children.

2. All children can cope with and manage stress, but they cannot do it alone.  They must have the attention of a close adult who is present to them and engaged with them.  Without such a relationship, their particular pattern(s) of stress can become imprinted into their brains and nervous system and become permanent. These patterns can then manifest as dysfunctional personality traits, and various mental health and physical disorders.

3. High states of stress in all children can look like behavioral problems such as aggression and opposition, and might get diagnosed as ODD or CD; or it may be expressed as withdrawal, tuned out, and difficulties with attention and concentration.  This pattern may get diagnosed as depression, or ADHD (ADD).  Another pattern, often overlooked as a problem, is the child who is “too good”.  Parents and teachers often exclaim how wonderful theses children are.  They do well in school and are always well behaved.  They may seem like little adults.  Adults may not realize that this child is suffering inside.

4. High levels of stress (that is stress that is beyond the child’s level of tolerance) overloads the autonomic nervous system (ANS).  The gas is on the pedal (activated sympathetic nervous system SNS).  But, the SNS becomes overwhelmed.  So, the parasympathetic nervous system PNS (the breaks) kicks in and establishes pseudo calm.  But the unexpressed energy remains in the body and creates various compensation patterns as described above—from hyper vigilant states such as anxiety, aggression, and opposition to states of hypo arousal such as shut down and tuned out.  Sometimes the gas and breaks are on at the same time.  

5. The answer:  build secure attachment relationships through attuned communication and genuine presence. Attuned communication is like being in the mind of the child. Presence is being with the child “in the now”. This is not about logic, rational thinking, or what make’s sense to the adult.

6.  Tools: slow down, take pauses, mirror, validate, and empathize.  In addition pay attention to your body language, tone of voice, and eye contact. Notice the child’s body language. Reassure the child that you are there, not going anywhere, and that she is safe.  A felt sense of protection is very important to building secure attachments.  We want to be curious about the child’s emotional experience, and to have the child feel like we get it.  It’s not about trying to change it.  Change may occur as a result of attunement.

7. Special challenges for COD: COD are always managing loyalty conflicts even in the best of situations.  There is usually some guilt or fear about the activation of the attachment system to the other parent.  The parent who has the child in the moment can help by making positive references to the other parent, especially with regard to comfort or soothing—i.e. “When you are with mommy and you are sick, she makes homemade soup for you and strokes your forehead.” Or “What does mommy do when you are sick?”  “Maybe you miss mommy right now.” Pause.  Give space for the child to respond.  Also notice the child’s body language. “Would it be OK if I rubbed your forehead right now?”

For COD children, transitions are going to be challenging.  They have to manage multiple emotional tasks in the moment.  They are saying good-bye to one parent (letting go of that attachment system—a loss) while preparing to say hello to the other parent.  This is biologically challenging to the nervous system.  Parents need to slow this down as much as possible, and be prepared for rough spots.  

A child may say he doesn’t want to leave this parent and go to the other (this may feel true in the moment for the child, but not to be taken as literal truth).  The departing parent can say, "We have had a lot of fun together.  I know it is hard to say good bye.  It is hard for me to say good bye to you too.  I miss you when you are not here.  I know that you miss me when you are at your mom’s.  And when you are with me you miss your mom.  It’s really hard to go back and forth isn’t it?  This conversation could take place in the moment, or at a quiet time, when parent and child are well connected.

The attachment patterns of COD may have been challenged before the divorce because of longstanding family stress or because of the parents’ own attachment patterns.

Note:  The ideas presented here are assuming that both parents have a reasonable capacity (doesn’t have to be perfect) to and are motivated to be sensitive to the child’s emotional needs.  If this is not the case, then a different approach is needed.