Attachment Theory and Child Protection Practice (EP.12)

In this episode I some learning from recent training on attachment delivered by Rebecca Carr-Hopkins. Check her out here: https://iswmatters.co.uk

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Transcript

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Welcome to rich divine social work, practice podcast. I am rich and I am a social worker. This podcast is about practice related issues. Self-development and transformation. It will give you. Knowledge ideas and practical tools for being an effective social worker. Supporting you with assessment skills, direct work, dealing with conflict. And importantly, helping you make a positive difference in the lives of children and families. Today. I am going to share some reflections. On some training that I. Have accessed over the last two days. The training is. About attachment and developmental trauma and it was delivered by Rebecca Gar Hopkins. Who has been my supervisor for a few years now. My clinical supervisor. And it's just an extraordinary. Uh, and engaging in charismatic teacher. And much of what she. Chaz in her learning. Is I think incredibly valuable for frontline social workers in terms of the work that we do. And. The main topic that she was exploring was the dynamic maturational model. By Patricia Crittendon. And I'll just briefly explain how it came across this model. And then I'll share some of the ideas that she shared. With our safer. Over the last couple of days. And. The reason. Y I'm going to share is because I'm going to try and integrate some of what I've learned today. Through sharing. That in this podcast. So when I began social work in 2010, I was curious about how individuals had come to develop the problems that had led to social care involvement. And I suppose as a consequence of growing up with my dad who misused drugs and alcohol. I never really conflated in individuals, morality or intrinsic worth with that behavior. Even when that behavior. Was objectively destructive for themselves or others. So wherever. I was working with a parent who suffered with depression or severe anxiety misuse drugs, and, or was controlled. And in coercive with that partner, I was intrigued by what they considered to be the benefits of such behavior. And significantly when it first. Emerged. But the latter question. I was always directed back to their childhood. So when I would speak to parents about some of the difficulties that they experienced in. And try to be empathic with them. And make sense of how these difficulties emerged. I like I mentioned was always taken back to their childhood where they talked about certain experiences and conditions. Which the development of the strategy or the behavior seem to make more sense. So I began looking at research and different theoretical frameworks to help facilitate my understanding of how childhood experiences impact upon development in a way that leads to individuals developing coping mechanisms. That appear. On the face of it, self destructive. And this was when I came across the dynamic maturational model of attachment and adaptation. By Dr. Patricia Crittendon in 2014. Um, since then, uh, I have done a lot of study in. Exploring and reading around the dynamic maturational model. Um, so it was really great to have Becca Hopkins come and deliver train and to 25 members of the workforce at Baines. And. One of the things that she was talking about is that often in social work with we're taught about. Attachment in, in two ways that, that firstly. We're taught about that. The idea is that they'll be originated and developed. Then about aims worth and the free patterns that she identified. And. Then we look at the work of Mary Maine. So. Bobi developed the kind of theoretical. Propositions end's worth was able to bring some empirical data to that. When she went and did observations of children and Uganda. What she found was that generally speaking, that seemed to be free distinct patterns. There was. The security, the secure children. And the secure children seem to have, uh, a positive representation of their. Parent or their caregiver. They expect comfort. They expect to be looked after they communicate their. Feelings clearly. And. Securely attached children. Had carers who were emotionally available, sent Steph and supportive. And then another category was the two children who seemed to be avoiding. And they seem to not have a positive representation of themselves. And. Would try and maintain a relationship with their parents. Will they. Create some distance overbuy approach. And then, and yet look in a way. Or, um, Could I put in a boundary in terms of holding up a toy. So it kind of blocked the iContact. And that was often in the context of the carer who was quite rejecting. But predictably quite redacting. And then the third plan was. Um, Um, bivalent children. Who seem to exaggerate that emotional distress. In order to try and bring the caregiver or to attract the caregiver's attention. And that was often in the context of the care. If he was inconsistent. So she had identified these free. Broad patterns. And then there were two students of Ainsworth. One was called Mary Maine. Um, one was called Patricia Christian dummy. And Mary remains. Interpretation of. Basically there were the free patterns, but then there were these anomalies. The there were these kind of. Individuals who didn't quite readily fit into the three categories. So in examining these anomalies, Mary remained put forward the idea that these children develop a disorganized attachment strategy. So in the face of caregivers who were both frightening and frightened. That would create a conflict within the child in terms of whether to comply or to. Scape and avoid and. That would manifest itself in certain behaviors. And so that's generally the primary school of four that we get to about in social work. And then there's Crittenden's work. Who looked at the same children. That Mary mane looked at, but she developed a different set of ideas around. Children. Being organized in the face of danger. And her argument was that kind of evolutionarily speaking. It would've made sense. For children to become disorganized in the face of danger, because that would compromise their safety and their survival. So her, her belief or our argument was that. The higher, the level of danger, the more sophisticated. The organization would need to be, even if on the face of it, it didn't look obviously. Come here. Ma'am. And so. That, that was one key distinction. And so a lot of that. The content and the training provided was based on Crittenden's model. We're trying to get in to try and explain a little bit in a minute. The other point that she made was that often. Attachment gets associated with. Connection. Reciprocal affection. Love care sensitivity. Attunement. All of these kinds of, uh, positive descriptions. And. Actually. What she was arguing is that only a few children have, are fortunate enough to receive that, that, that kind of care where it is available in a sensitive and attuned. Um, especially when you look for now the course of human history, when we would have faced. Famines and wars and all sorts of extremely challenging conditions that, uh, are probably incomprehensible to, to. To a modern individual within the. Within a Western society. And that. The function of attachment is too. Ensure that you can. Elicit and maintain your caregiver's attention so that they will meet your needs because in the absence of that, Fundamentally you, you will die. Because we, as humans were born prematurely. Compared to other species. And so in the absence of a caregiver, And taking responsibility. The infant is unable to obviously take care of themselves. So they develop. Ways to ensure that the. Uh, the parent can be available. To them. And. One way of thinking about. Attachment that Becca was talking about today. Was that being two sources of information. On the one hand you have cognition, I'm thinking. The rules and what you learn and what, what you get from outside of the world. And then on the other hand, you have an effective information, which is the feelings, those that, which, which gets generated internally and the sensory input that you receive and how you process. Your feelings. And. Individuals who develop a secure attachment or what we refer to as type B, they expect protection and comfort from their caregivers because that is what their caregivers have provided them. And so they can integrate their thinking and feeling effectively. Two. To communicate what they're feeling and their level of distress, and then anticipate and expect. That. That parents will. Attend to their needs. So she gives. She gave a really good example of. Uh, hypothetical child, less colon. Charlie. So Charlie wakes up in the car and he's. Uh, hungry. So that's an internal feeling. Affect sensory information. And so he starts crying quite loudly. He's four months old. And. The mom is downstairs and she's playing with the older sibling. And so she shouts out. To Charlie. And she says, Is that okay. Charlie I'm coming. And because he has consistently. Associated the sound of her voice with. Her then. Approach in an offering comfort. The very fact that he heard hears her voice CA. Can have a deregulate in effect on his distress, in the anticipation that his needs will be met. So he has the internal feelings and he gets outside information and he can rely upon that. And then you can hear the first steps moving towards him. And then he's eventually picked up by his. Um, and he sees, and he smiles his mom and that then further regulation. And so. What he learns from that, what Charlie learns from that is the internal information is important because when you show that and when you express that. Then you receive comfort and protection. And so she gives the. She goes on to. To this example. Furthermore. And talked about when he's 17 years old. Charlie. He's grown up through childhood. He wants to go to university and he has an interview the following day, but his friends were inviting them out and they want him to go and play football. And he's kind of desperate together and play football with them. But he knows that this interview is a really important opportunity and would mean that he could. Get into university. And so what he has to do is be flexible and dampen down somewhat the effect, the effect is. The desire to go out and socialize and play with his friends. And rely a little bit more on thinking and cognition. So he might turn off the phone and put it to one side so that he doesn't have the sensory. Input. And then rely on the fact that he needs to, to practice. So that he can do well at this interview tomorrow. The following day, he does well with his interview and he comes out and he feels incredible and amazing. And so. What the benefit. Potentially she's. Trying to explain. And maybe I'm not doing a very good job of this who knows. Is. The type B. Strategy is. There's a degree of flexibility. And so they can use the effect in inappropriate situations, and then they can use the cognition and thinking inappropriate situations. So it's not necessarily that one's preferable to the other, or that that constantly integrated in a really balanced, neutral way. But there's a flexibility and. The individual has awareness of when to best use. The different approaches. And this is a massive, massive advantage. If you have access to. Both sources of information. And you're not biased towards preference in one over the other. So that's the, the type B strategy. Whereas. The type of a strategy, preferences, external and information. So cognitive and thinking. Over internal information. So they follow external rules and they comply with other people's feelings. Taipei. Develops in the context of a caregiver who is predictably unresponsive. Or predictably. Uh, Versive so back again. For this example. That's cool. Charlie again, Charlie wakes up and he's crying. Now if a parent is unresponsive, she may not. Attend to him. So he's waking up. He's hungry. And he starts crying. And the example that Becca gave the mum. As read a book recently, a parenting book and the parenting book is don't give in to the infant crying too readily. Because it will make a rod for you, you know, you'll make a rod for your own back and they won't develop any kind of self-sufficiency. So Charlie starts crying. And the carer in this situation feels torn. The books as I shouldn't go, but it doesn't feel right here in him. So upset. So. The car closes the door. And I mixed the sound and the sensory input of the child. And that seems to resolve the problem. She can't hear. Charlie crying any, any more? Then what he does is he cries. He got louder and now he's getting very distressed, very dysregulated. He's got, you know, his face is bright red. He's lying in the car. He's flailing around. And the noise begins to feel through the closed kitchen door. And so what she decides to do is to leave the kitchen and go out into the back garden and maybe hang up the washing. Because the noise is intolerable, and yet she wants to comply with the rule that she has about. If you give it to them, then now become too needy or too demand. And Charlie is frantically crying. And he then becomes absolutely exhausted. Falls asleep. The parent with the carer comes back into the house and he has nothing. And what does the carer. Uh, potentially conclude from that. It worked. And that reinforces the rule. It reinforces prioritize in. Uh, external information in this case, the information from the book and to ignore your own feelings and your own intuition. But in this process, what does Charlie learn? Charlie learns when he gets information, internal information about. Itself the display of that information and crying about it. Doesn't make it any better. So eventually he might. Learn that the display of his feelings. Um, a useful way to elicit a response. In addition to parents who are predictably response, unresponsive. There may be parents who are predictably rejecting or hostile. So Bob might, Charlie might wake up. Hungry and he's crying and the parent goes in and says, shut up. Can't stand it. And then. That distresses Charlie and he cries even louder. And the parent and the characters shut up even louder. Or some version of come back when you put a smile on your face or don't be so we can perfect it. And what Charlie might be learning in this instant is when he uses. He's internal information and displays his feelings. He actually anchored aggravates his parent. He gets, it makes it worse. Not better. So. Eventually. The children who have an unresponsive or a predictably unresponsive or predictably reject, and a hostile parent will learn to just dampen down their feelings because it doesn't yell all day positive, comforting, or reassuring response. And in fact, what they might also learn or realize is that when they. Don't display their feelings. That it brings their parent a little bit closer to them. Or it avoids them receive in a negative reaction. Now. This isn't. Uh, one category. You can have. Individuals or Tilden who were just slightly inhibitory. So they're like a little bit, um, Emotionally. Cool. And they don't, they're not too needy. And then you can kind of go further down where they've dumbed down all of their feelings, negative feelings, and then they look to compulsively caregive or comply with the expectations. Of the parent. And then you can go further down, even more inhibitory whereby. The relationships have been so fundamentally disappointing or rejecting that you begin to. Associate closeness with predictable danger or rejection. So you become highly self-reliant psychologically, then you can't trust that you can depend on people. And the main point. She, the Baca was emphasized and there's that actually these strategies are adaptive. That the infants. Ingenious way of. Finding a solution to a problem. Around the caregiving contexts that they find themselves in. None of this is deliberate or full four is often always unconscious. And not fall through. And that the development of the Taipei strategy can often lead to undemanding infants. And children and adults. And that can be reinforced. Socially. There's often this idea. Oh, your infant is so good. Didn't ever make any noise. And. Such a good baby and that can then get reinforced again within the educational system. And so they've learned to kind of dampen down their feelings and inhibit the display of their negative feelings. When she was talking about this. Aye. I was reminded of a. Uh, family work that I used to work with with both of the parents would use in. Heroin and crack cocaine and then quite violent relationship. And. Every time I would go and visit the infant. He would sit there kind of quietly, passively. And if I gave him positive attention, he would reciprocate. By smiling and appearing happy. Although. His eyes looked kind of glazed over. And it took me a while to. Recognize or appreciate the discrepancy between this happy smiley. Baby in the context off this highly dangerous. Caregiving context. And what I came to realize with that, he'd kind of dampened down his feelings in the face of. Parents who weren't available because of their own substance misuse problems. And, uh, their relationship issues and the conflictual nature of that. Now. The tie page strategy runs the risk of explosions of inhibited or forbid in negative effect. So if you inhibit, inhibit, inhibit, what you can run the risk of is sudden explosions of. Your hunger or a desire for comfort, which may manifest into sexualized. Behavior. Or. Yeah. And go or need for comfort. Or it could result in somatic symptoms that result in suppression of your emotions. Issues like eczema or headaches or IBS or asthma. If you're interested in the kind of psychosomatic. Manifestations of the inhibition of emotion. I would highly recommend Capitol Matty's. Book. I think it's called when the body says no. Where he examines a lot of the evidence and the literature around. How the psychosomatic conditions or somatic issues. Can be the manifestation of the inhibition of effect. And. They can be vulnerable to workaholism. Because work is a place where you can. Be completely distracted. And. Pretty occupied with performing out there and getting positive reinforcement for that. And yeah. Not have to be in relationship with the south or deprive yourself of becoming too close or intimate. If people. At your partner or your children, for example. And they can understand relationships intellectually, but they can lack emotional engagement so they can speak quite forcefully. And. Intellectually and cognitively about relationships, but often struggle to To develop intimacy, cultivating intimacy, and the use of drugs or alcohol. Um, Can be a way of dealing with. The sexual anxiety. And drugs and alcohol. If you imagine that. You're having to deal with your parents on availability throughout your childhood. Because of their substance misuse. What you're centrally blocking yourself off from is all of the feelings around the rejection, the, her sadness, the anger that they're not there for. You. Um, because the expression of those feelings. Does not yield a positive or reassuring response. And so when you return to lessons and your experiment in substances, like many of your friends are. You're going to have a different type of reaction potentially to the substance than somebody else. Who's had different set of experiences. It may be a tremendous relief to finally be. Disconnected and completely free the use of a substance from your feelings. And so that's how drug addiction can manifest as a result of the development of this strategy. And it's milder forms being slightly disconnected from your feelings can be really functional. And in some contexts, So. In the, um, presentation that Becca was given, she gave the example of, uh, Victoria Columbia, who was described by. One of the nurses as an, as a little Ray of sunshine. As a way of illustrating how some children can fall asleep, present in a positive way. To consider when disguise their underlying distress. And. There was this really powerful quote by. The man, the murder, Victoria, Columbia, where he said you could, you could be to. And she wouldn't cry. She could take the Beatons and pain, like Hani think. So that's a severe and extreme example, the degree to which children can shut themselves off emotionally from there. From their feelings. Now. The type C strategy. Sometimes referred to as an ambivalent strategy. Organizes around the opposite problem in the Taipei organizes around and. The development of the type C strategy organize is in the context of unpredictable care. And variable attunement. It's really hard in that context for the child. To know what to do. The child. The child's experience is that they kind of come in and out of that parent's awareness. And in the context of our predictability. The child learns that the display of emotion. Especially when done intensely. Can elicit the parents. Attention. And can in fact, make them more unpredictable. So there's a slight paradox in that. The child behaves and acts in an emotionally dysregulated or unpredictable way in an attempt to. Encourage the parent to be more predictable. And she gives the example of. Uh, parents saying to, if we go back to Charlie, four months old, maybe older than that four years old, where the parent goes, I'm just down to the shops. I'll be back in 10 minutes. But if you imagine. That in his experience. The mom has said that before, and then didn't come back. Maybe she got distracted or she went to the pub and didn't come back to the following day. Or maybe she. Didn't come back until an hour or two later, it's happened a few times. And so. How would, how would Charlie feel within that context? He would begin to feel incredibly anxious about the possibility of his. Parent. Leaving. And he would also learn to distrust. What is. Parents set. So language, isn't a reliable source of information. So Charlie might say, mum, please don't go. But that would be unlikely to change her behavior. So. Charlie really in that situation has never, ever optioned than to escalate by clinging onto a lag. But she might dismiss and say, don't be so silly. And then she might get angry and it kind of escalates. And this struggle. Unfold between the two of them. And so. Whereas the Taipei turns down that feelings. Type C. Strategies, they turn up their feelings. And within the kind of normative range is where the feelings are just. Slightly elevated in response to certain situations. As a way of illicit in attention or getting a reaction or getting. The needs map. And the more concern and strategies. Again, Like the Taipei, this isn't a categorical. Issue exists on a spectrum. And so. You have the, the mildly mildly. Mildly amplify and elevate in their emotional distress in order to elicit a reaction. But a more concerning strategy would be where they begin to use aggression or. Faint helplessness as a way of. Evoking sympathy or care to try and get a reaction from the, from the caregiver. And then when, when children or individuals become desperate, they might rely on more punitive and set up Def strategies. And so. This is where. You can really bigger begin to become unclear about when there's going to be danger. So you become hypervigilant and anxious around the intention of others. And so. The type C strategy. Can lead to. Attraction to groups, especially in adolescents. It, they can be attracted to cans, which offer a sense of belonging and connection. Where they push the boundaries and to the limit, and that can increase their feelings of safety and, and in vulnerabilities. If they're surrounded by. Others. And there's a group of them that increases their sense of power and control. In what they have otherwise failed. Uh, out of control one with very limited power. It can impair the development of that. Social relationships and self-advocacy. And the displays. Anger or aggression. Or vulnerability changes the behaviors of others. Now this isn't a conscious. Deliberate. Strategy it's often. And attempt to make the best situation. Make the best out of a, uh, difficult. Situation. So. The reason why it's important to think about. The various different strategies. There's a few reasons. One is. That. Children will often develop quite sophisticated strategies in the context of a wide variety of care giving context. And. One of the ideas that Crittendon talks about is. Change change, anxious attachment. Isn't the problem. Danger is the problem. Change the danger and not the child. So. When we're working with children and we think that they might be display in a compulsively inhibitory Taipei strategy, or they might be display in an aggressive helplessness type C strategy. The issue is not necessarily to change them because that strategy is what helps them. Dear one tolerate and cope with their experiences. But Robert too. Reduce the danger and support the parents so that the development and the strategy isn't as necessary. Is it. As it is. The ever. Key issue is that. When you begin to see the children developing the response to danger. You can then begin to realize that often a lot of the parents we work with. I have experienced significant danger, albeit in that childhood. And they've developed strategies to cope with the danger. And the adversity. For example, at first childhood experiences, domestic violence, substance misuse, poor mental health rejection, abandonment, poverty, et cetera. And they've been necessitate to develop these ways of coping and their childhood that allow them to cope and actually get a better version of the parent than they would otherwise. And this strategy gets. Embedded psychologically and unconscious level. And then is carried forward into adulthood. And that strategy that's carried forward into adulthood. Maybe the strategy that's now causing them the difficulties that's led to our involvement. For example. So. To give you two examples. It might be that there's a parent who were working with. Who is deeply distrustful and fearful about the availability of their partner as a result of that developmental experiences. And as a result of that, they resort to control. And coercion and occasionally violence. As a way of dealing with the feelings that the fear generates for them. And. It can be easy to adopt a morally condemn NAIT tree stance towards perpetrators of domestic abuse. But if we are to facilitate and to support them to change. We might want to look at what's the function of that behavior. How is that behavior? Making them feel safe? What problem? Is it solving for that and Optum. The problem that is solving is that underlying feelings and ways that they've been. Or needed to cope and their childhood experiences. Another example might be a parent who is completely emotionally detached and switched off. Potentially even depressed. And they're not. Incredibly or. Responsive. In fact, they may even be negligent, neglectful. And David pick up when the child is upset or distressed. And that might be. Because the way that they are to learn. To cope with that caregiving context was to switch off, was to be disconnected emotionally. Um, and what they haven't had throughout their lifetime. Is there anybody to amplifies or emotionally connect and relate to that? And so now they have a child. They don't have the ability or the capacity. To connect to the child. And so. The problem. That we see is, is neglect. And we see the. Deleterious or detrimental impact that it's having upon the child. And we cast judgment and we send the parent parenting courses. But if the fundamental problem is around. The development of strategies that they developed in their childhood, the cat. That is safe. Then we might be somewhat missing the mark in relation to what might help them. So there was a couple of points that she made in relation to the use of. Labeling. And back and talked about. Not not using. Labeling, for example, he is type out here is avoidant. He is. Aggressive or faint helplessness. Whatever the. Label might be. Because what we're really trying to do is move away from. Labels the often. Have inbuilt negative judgmental connotations. And try and understand the function of a person self-protective strategies. And that's really inviting us to think about. How does this. Behavior. Support and make them feel safe. And it might be that we're not going to be able to understand that unless we look and perfectly with the parent in relation to that developmental experiences. Attachment strategies can only be diagnosed using proven instruments. And Emily by qualified practitioners. So there's an invitation there towards. So. I think that's probably. Everything. I want to say. Oh, One more point. At the end. Becca referred to the work of ward at all. I think they wrote a paper on how to assess capacity to change. It's a massive DFE paper. And she was thinking about or explain and how we can help some parents. And one of the points that she made that I thought this was a really brilliant point, actually. Was part of our role as social workers is to develop. Deliver an intervention. That has proven efficacy. For resolving the problem that you've identified. And her argument was it's not good enough to turn up at court. And seek removal, even if evidentially that the child has been endangered. Unless there's obviously serious levels of endangerment. And management same in a word, serious levels of danger that warrants immediate removal. But the way that we've proven that we've sought to understand the problem that the parent is experiencing and facing. And provided an intervention that has a proven efficacy. And she talks about how often, much of the support that. We offer commonly for example. Parent education. Or short-term counseling. Is more beneficial for parents who have high levels. Of reflective function and who can think about their experiences and the way that this effect that. Uh, because they. They are quite low resource intense. Tense interventions. So send an apparent on a parenting course or six to. 12 week counseling program. Is probably going to be Insufficient in relation to the intensity of the problems. That the parent is experiencing. If they've had two. Organized self-protective strategies. Studies around. Chronic and pervasive, neglect and exposure to section views. It's unlikely that. Short-term counseling is going to help to resolve completely. Those experience. And what's much more. Likely is that the parent will need some form of treatment or psychological therapy. And she ended with a quote, which is quite. A nice, quiet, really, which is around different. If relationships. Uh, where things go wrong. Then relationships are where they're going to be per right. And this is why I really love the DMM is because. I do think it gives us an opportunity to. Think. Differently about the challenges that parents that we work with experience. And when we can think differently. We can approach and have different types of conversations with them. About their difficulties. And those different types of conversations might lead. lead us to think differently about The type of support that may May fundamentally Make a difference So i've no idea How is that episode is going to sound or whether it's going to be use. Useful or not I hope so because i've spent 45. Five minutes talking now So I'm getting to end it that Many thanks for listening to this episode I will leave Um, Links about rebecca hopkins And her organization independence. And Social work matters in case you're interested I probably in fact i almost certainly haven't done Uh, training any Justice really because her delivery is almost the opposite Of what mine is so i'm quite The whole. And monotone. And delivering information where she's much more engaging and participate. And Just a brilliant brilliant trainer So Again thanks for listening if you haven't already Then please do consider subscribing or sharing with your colleagues i'd really love it if If You would leave a comment Uh positive or negative or feedback is very welcome And finally if you have any questions please do get in touch I'll leave my email In the show notes For now thank you