“His rage was his worriment” Lewis Grassic Gibbon “Mr. Woodier, I have anger issues. My French teacher shouted at me. I swore at her and walked out.” Mairi seemed visibly shaken. The tone of her voice wasn’t defiant; it sounded more like a plea for help. The obvious remedy for such an outburst is a dose of anger management, or is it? When a young person’s anger is seen as a threat to others, the context and reasons for that anger can easily be overlooked. Do our cognitive-behavioural strategies even work, or do we risk increasing the experience of victimisation in some children’s lives? Schools may inadvertently pathologise anger instead of seeing how it can be a constructive and healing force. Mairi (not her real name) was in first year of high school. When I first met her she was only five years old, and she spent most of the school day sitting on her teacher’s lap or under a classroom table. Her behaviour seesawed between angry outbursts and emotional shutdown. When she came to me and told me about her outburst in French, I wondered how I could help her see that the reason for her anger wasn’t coming from some kind of psychological weakness or flaw. I can probably mark out my career by various failed attempts at addressing anger and aggression. Twenty years ago, I remember driving a minibus on Interstate 94 north of Chicago. We weren’t even out of the city limits and a fight broke out among the half dozen boys in the back. When in school, they were grouped in a class for what was called back then behaviourally disordered children. In other words, in a neighbourhood and school renowned for crime and gang violence, this merry band had been labelled the most violent and aggressive. We had practiced our anger management skills for weeks, but it was back to the drawing board for me. Anger management has become part of what Val Gillies calls the new orthodoxy of emotion 1. Uncontrolled emotionality is seen as a threat to learning, and pupils are taught how to abstract feelings in order to better manage them. Schools are expected to teach emotional and social skills. These things may sound admirable, until we look more closely. Gillies work in three inner city schools in London found that real issues around justice and power relations were obscured. Rather than using expressions of emotion to explore these issues, emotional responses like anger, outrage, or hurt were detached from the circumstances that provoked them. In addition, judgements of right and wrong left little room for teachers to engage with alternative moral frameworks without misinterpreting or pathologising them. Entirely missing was an understanding of the relational dynamics shaping the acting out of emotions. “The challenging behaviour we encountered was more often associated with social connectedness than its absence. Breeched social codes, personal loyalty and misplaced humour tended to drive confrontations” 2: 199. Back in Chicago, instead of focussing on anger management skills, I gave each boy instruction on a skill they could use on our next adventure. I taught one how to recognise snakes, another how to take photographs, and another how to cook on a camp stove. The time came for our next trip. This time we made it all the way to the Wisconsin River. Before we set out in our canoes, we went climbing on one of the bluffs along the river. As I describe what happened next, remember these were city kids, and they had never been out of their urban environment. Back in their neighbourhood, every day was about survival. Most had older brothers who were gang members. Threat was everywhere, and status and reputation for fighting meant everything. The first boy, Justin, short but muscular and bristling with bravado, stepped up to the cliff face. Half way up, he froze. Something was wrong. He was freaking out. The others shouted words of encouragement. “You can do it!” Looking back, I now realise that this was probably a turning point. From the moment this boy, the toughest in our group, experienced the encouragement of the others at the moment when he felt weak, the dynamics of our group changed. Instead of their energy going into fighting one another and testing one another’s strength, they began to work together.  I once had a teacher of educational philosophy who would leave the classroom in mid-sentence and re-enter having taken on the persona of a famous philosopher. It was always amusing, but it was also a great way to get us to use our imagination. Let us now imagine that Rousseau was also observing what happened that day on the banks of the Wisconsin River and allow him to enlighten us.
“You have forgotten there are two kinds of love. When you were trying to rationally explain why he should respect others, Justin only saw this as an attempt to control and frustrate him. This only added to the threat he had experienced in his childhood and his craving for dominance and prestige. This is what I refer to as amour propre. It displaced that other kind of passion, amour de soi, the innate concern to preserve one’s own existence and to have a fruitful life. Justin will need amour de soi if he is to have the strength to become a successful agent in his own recovery from the trauma in his childhood.” Rousseau continues, “When Justin froze on the cliff, he experienced, in a helpful way, the real limits of his powers and abilities. At that moment when he was vulnerable, he was freely given encouragement and recognition from his peers without having to dispossess others.” It is not only kids growing up in inner city neighbourhoods that experience imminent, ongoing malice and threat. My meetings with Mairi continued. I learned that despite her cheeky smile and Glaswegian swagger, she was easily shamed. I knew some of the details about her early childhood. Over the next few weeks, I was to learn more. Most of our conversations would begin by Mairi telling me about phone calls from her dad who was in prison. Something was weighing on her mind. I could imagine an unsuspecting teacher publicly reprimanding her and then being shocked and outraged when Mairi's anger erupted. I gave her time; I held back from giving advice or censoring her for her outbursts. The more I listened by expressing my curiosity and empathy, the more she shared and the more I understood her sense of shame and vulnerability. “When I was little, my mum would lock me in a room when she was taking drugs. My mum and dad would fight. Sometimes one of my mum’s friends would try to help me but she was a junkie as well.” I asked, “Have you ever felt like what happened to you was your own fault?” I was taken back by the force of her answer. “I always thought it was my fault.” Mairi told me she was worried about her dad coming out of prison. Her dad had been incarcerated because of what he had done to Mairi. Mairi told me she wanted to say to her dad that he would have to do better. I said, “I can’t tell you exactly what to say, but you show a lot of courage to be honest about these things.” Next week Mairi continued, “I told him on the phone that this is his last chance to be a parent to me. If he gets it wrong this time, I am going to cut him off. I don’t think he took me seriously; I asked my gran to tell him.” I commented: “It must have been really hard for you when you were little and your mum locked you in a room and your dad didn’t help you.” I wanted Mairi to experience my empathy at the time when she had felt most helpless and vulnerable. “Have you ever wondered if the anger you feel has something to do with what happened to you when you were little?” “Most of it.” Again, I was surprised by the force of her answer. “Perhaps being angry was the only way you could protect yourself. Maybe you needed to feel stronger when other people were not protecting you?” Mairi replied, “One boy was picking on me saying things. When he found out how angry I get, he stopped picking on me.” “So getting angry still helps you?” “It helps me get out my stress. I cry when I am angry.” Finally, I ventured some advice, “Rather than say you have anger issues, wouldn’t it be better to say you have issues with what happened to you when you were little?” It would be naive to think Mairi will never be angry again, especially when she is publicly shamed or made to feel weak. The issues around her anger are not fully resolved, but fixing her anger was never my intention. If I had tried to anger manage her, Mairi would have believed her anger was her problem and she needed to fix it. I gave her time so that together we could explore her feelings and thoughts about what happened, and I commended her whenever she expressed courage. I prompted her to think about context, but I tried not impose my preconceived ideas. Where she was most vulnerable, I expressed empathy. I rarely had to prompt Mairi, she told me when she wanted to talk and when she had enough. Mairi’s question: “Can we do something happier now?” was my cue to take out the UNO cards. Mairi has a much better chance of realising that she doesn’t need her anger anymore to protect herself. However, I think it is important to acknowledge that sometimes the anger young people struggle with can end in tragedy. A couple of years ago, BBC news flashed up on my TV screen the name and photo of a young man instantly recognisable to me. He was one of the boys who canoed with me down the Wisconsin river. In fact, Juan was the one in the group that I thought had the best chance of recovering from the trauma of growing up in the inner city of Chicago. Although he had a problem with fighting other boys, I never felt threatened. Rather, he had made some good choices; he had sought out relationships with adults who could offer him support and love. I listened to the details of another mass shooting. Juan had shot a doctor, a pharmacist, a police officer, and then himself. There were triggering circumstances, broken relationships, and perhaps a tendency to be impulsive. But it was still hard to understand why. Here was a young man who had given up on life, and that was profoundly sad and shocking. Caring for young people who suffer so deeply and sometimes cause great suffering in the lives of others raises deep and disturbing questions. How do these tragedies and the suffering of others affect us, and how can we continue to offer hopeful and sensitive care? I once asked a scientist working on a nuclear fusion project a question: “I bet it is hard to explain to someone like me what exactly you do?” He replied enthusiastically, “No, it’s easy. My work is like ‘balancing a pencil on it’s point.’” Seriously, how do we keep a balance between wanting to give up because our work seems futile and seeking to control every bad thing that can happen to a young person? How do we not become indifferent to suffering on the one hand and also avoid becoming unrealistic in our sense of responsibility for the lives of others? Unresolved or unbalanced, we either give up, or we make people our projects. We end up struggling with anxiety and feeling frustrated by our lack of control. I wonder if you have ever been in a situation like this? You have had an outstanding experience with a young person, and as they go home at the end of the day all you can think about is the chaos that the young person is going home to. Perhaps you have opened your home to a child and given them all the love you can give, but you know they are going back to a family where nothing much has changed. You agonise over your inability to really change things and end up asking “What’s the point?” We need to recover the possibility of ‘acting well,’ of doing the best we can in a given situation, whatever may become of it.3 Ultimately our motivation to keep on acting well in the face of suffering and chaos will probably depend on our personal values and deeply held beliefs. To those who prescribe simplistic solutions such as anger management, I recognise that there is a genuine desire to help. Having a solution helps us feel we know how to do our job, but there may be potentially harmful reasons for why we seek simple solutions to complex problems. Experiencing another person’s anger and aggression can alter the way we think. When relating to young people who have suffered maltreatment and interpersonal trauma, our thinking can become focussed solely on outcomes.4 We find ourselves acting rather than thinking, making rigid assumptions about a young person rather than recognising the nuances of their behaviour and the uncertainty of our own thinking. In addition, the very things that I want to change in you, if I am honest, I can probably recognise in my own life. For example, can we really say that road rage is different to another kind of aggression? Are we not all tempted to elevate our desire for recognition and respect to the point of aggressively putting others down? Based on his experiences of being imprisoned in the Soviet Gulag, Solzhenitsyn observed: “If only there were evil people somewhere insidiously committing evil deeds, and it were necessary only to separate them from the rest of us and destroy them. But the line dividing good and evil cuts through the heart of every human being.” 5 If I am honest about my own tendencies, should I not approach a young person in a more gentle and non-judgemental way? Doing so, I probably have the best chance of being able to challenge how they see the world, especially when their view of the world has been distorted by suffering caused by others. Keeping it real
References 1. Dent N. A Rousseau Dictionary. Oxford, UK: Blackwell; 1992. 2. Gilles V. Social and emotional pedagogies: critiquing the new orthodoxy of emotion in classroom behaviour management, British Journal of Sociology of Education. 2011; 32(2): 185-202. 3. O’Donovan O. Begotten or Made? Oxford, UK: Oxford University Press; 1984. 4. Bevington D, Fuggle P, Fonagy P, Target M, Asen E. Innovations in practice: Adolescent Mentalization-Based Integrative Therapy (AMBIT) – a new integrated approach to working with the most hard to reach adolescents with severe complex mental health needs. Child and Adolescent Mental Health. 2013; 18(1): 46 - 51. Available from: http://discovery.ucl.ac.uk/1385449/2/Fonagy_AMBIT_for_CAMH_finalSubmission.pdf [Accessed September, 2019]. 5. Solzhenitsyn A. The Gulag Archipelago 1918-1956: An Experiment in Literary Investigation [e-book]. Harvill Press: London; 2003 [cited 22/10/2019]. Copyright 2019, David Woodier. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact.
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 Each week I have cycled the eight miles to a house on the outskirts of town to meet with a very important 11-year-old pupil. I’ll call him James. One reason he is important is because is helping me see the lockdown through his eyes. Seven weeks ago on my first visit, James was reluctant to come out from his bedroom. He knew me from school, but he gave the impression I was intruding by coming to his home. To him, I was representative of an adult world that has let him down too often. When James finally emerged from the world of X Box, he looked more like a zombie blinking uncomfortably in the sunlight as he stepped out of his front door.
“Why don’t we go for a walk? You will have to keep your two meters distance from me.” Initially, this walk was just an excuse to check on him and remind him that he wasn’t forgotten. Now these walks have become routine; they have even taken on a name- a safe walk. I’m not sure our first walk was very safe. James suggested we go to a lake near his home. He wanted to show me the swans that were now flocking to the shore in hope of being fed. Suddenly he panicked as four or five swans surrounded us. “Come back!” I shouted as he vaulted the nearest fence. I tried my best not to collapse in laughter but played the hero and corralled the swans away. James gingerly reappeared, looking a bit embarrassed. He lives with his elderly gran, who has health problems and is bedridden some of the time. James is representative of one of Scotland’s more vulnerable youths. Even before the lockdown his attendance at school was spotty at best. His clothes were often smelly and his hair unkempt. His outward appearance spoke of neglect and his demeanour told of his sadness. Seven weeks later and when I arrive outside James’ house, thankfully less out of breath from the cycle ride than I was at the beginning of the lockdown. He meets me with a big smile, as I show him the skimming stones I have collected in my garden. He enthusiastically leads me down to the lake. We pass a swan sitting on its nest. James tells me he has fed the swan, but I notice he is also keeping his distance. I also notice his hair is longer and as if to make the point he pulls it down over his eyes. We laugh. We arrive at the small beach and he skims each stone, carefully counting how many times they bounce across the water. He watches a dog swimming out to fetch a stick and laments about his dog who won’t even put a paw in the water. I venture a more direct question. “How is your gran? Is she any better this week?” “She is okay,” is all he seems to want to say. I can’t tell from his answer if this is his way of not wanting to think about the seriousness of the current situation. I know from conversations with other young people that many are anxious. I could tell from the tone of voice of another of my pupils that he was deeply concerned he had not heard from his non-custodial father for two weeks. Even before the lockdown, many young people living in kinship care and foster care were already worried about the health of their family members and carers who are often elderly grandparents. For some, these fears have increased their isolation. I am surprised by how easily James seems to be engaging with me, so I ask another question about whether he misses school. He answers with a resounding, “No! I’m bored sometimes, but I don’t miss school.” A couple of weeks ago, his social worker persuaded him to attend the local school hub for children of key workers and vulnerable young people. He went for one day. “The teacher shouted at me. He said we shouldn’t be kicking a football.” Like the vast majority of so-called vulnerable young people in Scotland he didn’t go back. Why should he?’ His gran told me that no-one from the school had phoned to ask where he was when he didn’t show up the next day. I know there are teachers who are connecting with children and families by phone, by sending then a card - skimming stones in their own way, but James is not alone in his sense of being unnoticed or unwanted. School wasn’t the most rewarding experience before the lockdown and it will take a concerted effort to change some young people’s perception. I hear there are leaders in education meeting to talk about how we recover our schools. I wonder how many have been on a safe walk with an 11 year old. Some of the young people I see and talk to each week are happier not in school. One foster carer told me that her three children were much less stressed not having to go to school. If we have any hope of getting young people back to school, it will be because there is at least one relationship they value. When I say to James, “I better be getting home.” He asks me if I can come earlier next week and walk further with him around the lake. We end our time with a competition to see who can throw stones the furthest. Perhaps, as we think about going back to school, this will be a time to rethink how we relate to young people and re-imagine how education can help children see they are very important. They need to know, as we all do in order to learn, that they are safe, they are valued and belong. They need to enjoy being with us and us with them. We have an opportunity to recapture the fun and spontaneity children bring to life. They will play a vital part in our recovery as a society. Adapted from an article by David Woodier © 2020 David Woodier. Permission granted to reproduce for personal and educational use only. What was your first response when you realised the seriousness of the current threat from Covid 19? Did you phone an elderly parent, wonder if you should keep your child home from school, or did you find yourself wanting to escape to a remote spot in the Highlands? I think most of us found our attachment systems going into overdrive. We longed for a safe haven and at the same time to keep those we love safe. It is not easy, because in a moment of fear and crisis we may miss important opportunities to provide reassurance to others.
On one of our recent morning walks, my wife shared this story with me: “When I was a child living in Michigan, I remember the day when tornadoes came through our county. It was a long time ago and I don’t remember all the details, but I remember being very afraid when mom and dad told us to go down into the basement. That was the sensible thing to do, but I was still terrified until my dad took hold of me and put me on his knee. At that point I felt completely safe.” We walked on in silence; temporarily flooded with our own emotions. Finally, my wife commented, “You know a refuge isn’t really a place, it’s a relationship.” Before we talk about how we can be a safe haven to others, I think it is important to think more about how the attachment system manifests in adults compared to young children. When Mary Ainsworth devised the Strange Situation procedure, she found a powerful tool for observing how young children organise attachment behaviours. Ainsworth observed that when a toddler was separated and then reunited with his or her mother, there were clear patterns of behaviour. The child’s attachment behaviours, seeking proximity and contact with their mother, could be observed in real time. In older children and adults, the function of a safe haven and secure base becomes more internalised. How we think about attachment figures becomes more a state of mind, but no less real. Attachment in adults is not so much the sum of early experiences and our attachment history, but how we reflect on and make sense of those experiences, good and bad. John Bowlby suggested the link between early attachment experiences and adults’ attachment relationships is not fixed in stone (1). I think that presents a very hopeful picture. As adults we are not necessarily victims of our childhoods. We can still pass on a legacy of a secure attachment despite an imperfect past. It is more about how we resolve what has happened, put things into perspective (neither minimising past attachment-related experiences nor being preoccupied with attachment figures), and communicate our love though sensitively interpreting our children’s attachment signals (1). I think one of the best ways to help children internalise the sensitivity and availability of an attachment figure is by showing that we keep them in mind. I like to explain it like this: I know that several hundred miles away there is a lady, in her eighties now, who probably every day wonders what I, her son, am up to. Most of the time, I don’t even consciously think about my mother thinking about me, I just know it. Occasionally, and probably more often when I am worried or stressed, I phone her just to make sure. Being kept in mind helps me have a certain amount of confidence as I go out into the world. When growing up, it allowed me to function more independently. When there is a crisis, the thought of that person’s concern for me still provides comfort and a sense of safety and refuge. Now I am older, I still recognise the value of having a secure base and safe haven (2). What about the child who lacks that sense of being kept in mind? The foster carer of a teenage girl gave me a piece of good advice about her daughter: “When she withdraws and isolates herself, because she is afraid and anxious, adults tend to stop contacting her. She thinks that if she hasn’t seen you, you must have forgotten about her.” It was a penny-dropping moment. For one whole term, she refused to come to school. When I visited the house, she rarely came downstairs to see me, but I kept visiting. I wanted her to get a clear message: You are not forgotten. It must be incredibly hard to be a young person without that default way of thinking that the adults who care about you don’t forget you. It must be like living in a world where people fall off a precipice or somehow cease to exist. Keeping a person in mind often works in an unplanned way. I know of a young person who is adopted, and when his older brother moved away from home to study, he refused to talk about or even acknowledge his brother. One day, quite by chance, while visiting his brother with his parents, he noticed his photograph sitting on his older brother’s desk. There was a look of surprise and joy on the younger boy’s face when he saw this visible, tangible proof of his brother’s affection. Another adoptive parent remarked, “Even as adults I send postcards when I’m away, especially if I am visiting somewhere we have been together in the past, like a favourite ice cream shop.” At other times keeping in mind has to be more intentional. Some suggestions of how to do this may seem mundane and part of what most people do routinely in order to stay connected. However, the kind of children who need a clear message that they are not forgotten often seem most indifferent or even hostile to an adult’s interest. For other young people, circumstances like an unplanned move require adults to make an extra effort. Sending a postcard during a period of absence or remembering and commenting on a small detail a young person talked about doing over a half-term break can make a difference. As a teacher, occasionally I might ask a young person, “Do you mind if I keep that piece of work on my desk? Every time I walk past my desk, it will remind me of what we talked about today.” Even a visit to a home or children’s unit is not wasted: “That’s okay if they are still in bed, but could you tell them I was asking for them?” One of the key things I have noticed recently is how I need to know that I am being kept in mind. A phone call from a friend and an email from a loved one suddenly takes on special significance. Knowing that I am kept in mind also reminds me that in times of crisis, we all feel a need to seek a safe haven, but that refuge is not found in a place or an object, but primarily in a relationship with someone you know loves you. There are many metaphors we use to talk about refuge: shielding the vulnerable, standing on a rock, or a chick sheltering under the wings of its mother, but these metaphors stand for the qualities of a relationship with a person who is available and attentive, and whose love is faithful, committed, and protective. References 1. Van IJzendoorn M. Adult attachment representations, parental responsiveness, and infant attachment:A meta-analysis on the predictive validity of the adult attachment interview. Psychological Bulletin. 1995; 117(3): 387-340. 2. E. Grossman K.E.Grossman. Essentials when studying child-father attachment: A fundamental view on safe haven and secure base phenomena. Attachment and Human Development. 2019:1-6. © 2020 David Woodier. Permission granted to reproduce for personal and educational use only. Hello, my name is Claire. I live (currently very closely!) with my husband, adopted daughter and adopted cat. Living together in lockdown has meant we have all had to get used to living differently, not doing some things and trying new things. This blog is one of my new things – a different way to connect with others in this strange time.
I think ‘different’ will be our abiding memory of the pandemic for those of us not directly impacted by the terrible loss of family members or friends. Working and learning from home, the way the outside world looks and sounds, shopping, spending time with loved ones – all different. As an adoptive family we have always had to do things differently. And as such we have had to approach school and education differently (thankfully never quite like we are approaching it now!). As a teacher I refocused my knowledge development when I became a mum, on understanding how to advocate for pupils who have experienced significant relational traumas and losses in their lives. These pupils need a different approach to support them in their learning, Attachment Aware rather than the usual traditional approach mainly used in most schools. Relational interventions are necessary for these pupils to be in a position to thrive in school. Relational interventions will be necessary for all pupils to be in a position to thrive in school as a result of this pandemic. This collective, community trauma that we are all going through won’t end when the lockdown does. The return to school will be different from any other. Society is already thinking about how we recover and this is an opportunity for all of us who parent, teach or support these young people in other ways to share our knowledge and experience of what works for young people who have been through difficult experiences. This is a potential opportunity for us to influence education to ensure attachment principles are embedded within our schools to support all children to thrive. Schools will need to be different. Over the coming months I will use this blog to share ideas for how to support your young people to return to school as well as any potential opportunities for us to support schools to manage this transition. This will hopefully include positive developments in the education system focusing on how we restart relationships with all our vulnerable young people. Maybe different can be better? Claire First published in www.saia.org.uk/blog 2020 © Claire, Adoptive Parent and teacher Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact. In the spring of 2019, Scottish Attachment in Action met with a group of residential child care workers in Aberdeen. They enthusiastically shared how training in PACE (playfulness, acceptance, curiosity and empathy) and DDP (Dyadic Developmental Practice, Psychotherapy and Parenting) had transformed their relationships with young people. Staff members also talked about how they supported one another in order to stay connected with young people who sometimes presented very distressed behaviours. What is DDP? Dyadic Developmental Practice, Psychotherapy and Parenting (DDP)was developed by Dan Hughes as a therapeutic intervention for families who have fostered or adopted children with significant developmental trauma. These are children who have experienced maltreatment and disrupted attachments early in life. They often don’t feel safe with parents, struggle to form secure attachments, and may actively try to prevent their new carers becoming close to them. DDP was originally developed as a therapy, however, it now has a much broader application providing a set of principles and practices that can support networks, inform and enrich parenting, and support the child outside of the home, for example, in residential settings and school. www.ddpnetwork.org What is PACE? PACE (Playfulness, Acceptance, Curiosity and Empathy) is the core attitude of DDP. It is a way of thinking, feeling, communicating, and behaving that aims to help the child feel safe, learn to trust the care of adults, and to accept comfort and joy from parenting figures. Having a PACE-ful attitude can reduce the level of conflict, defensiveness and withdrawal that can be ever present in the lives of troubled children. Being PACE-ful enables the adult to see the needs and strengths that underlie distressed and challenging behaviour. It offers hope to child and adult alike. Why do I need the training? DDP helps a social worker repair a relationship with a young person “I did DDP level one training. It was four days and it was really good. I liked the way it was delivered by Fiona (SAIA Development Coordinator) and Edwina (Certified DDP Trainer). They offered real examples of how DDP can be implemented, and there were opportunities to think about our own practice.” “As a social worker, sometimes dealing with a young person in distress, I can fall into saviour mode. I want to do things for people rather than just sitting with them and holding that emotion with them.” “The training also allowed me to think about repairing relationships. For example, I was given the task of finding out about one young person’s experience of being in care. I was hopeful that I would get my task completed efficiently. As soon as he came down the stairs, I started speaking to him about his experiences in care. I forgot he doesn’t like being stigmatised or being looked after. It was first thing in the morning and all he wanted was to be left in peace. I was met with some resistance. I came away from that and thought about what the experience had been like for him. Later, I offered him a lift somewhere he needed to get to. I said I was sorry and I should have known that in the morning he was not keen on chatting to people. I acknowledged that his experience of being in care was unique. The discussion in the car continued, and he was much more open and engaged.” “Prior to the DDP training, I had read one of Dan Hughes’ books. Before the training, I was kind of doing it (his method) but never had the terms to name what I was doing. The training gave me a frame of reference, and I feel a lot more confident now. It has allowed me to support other staff members with their practice by helping them to explore the meaning behind those emotions rather than just giving factual responses or going into saviour mode.” DDP helps team members identify when they are struggling with blocked care 1 “As a staff team, we check in with each other to make sure we are as well as we can be. We were talking about how the children’s distressing behaviours can have an impact on us. If we are not taking care of ourselves and each other, this can impact on the way that we interact.” “Prior to having an understanding of DDP, there wasn’t a clear understanding of blocked care. It is a very hard job we do and we love it, but it is very difficult at the same time. When you find yourself in the position that you’re not enjoying that relationship anymore, it can be very disheartening. DDP has allowed us to gain an understanding of what is happening especially within your brain, the hormones, and the impact that has on your ability to care. We want to re-ignite the passion again for the young people that we care for. That is not easy because we don’t have those positive experiences of looking after the children when they were little. They have come to us after they have suffered traumatic early childhood experiences and their behaviours display that. We try to understand where they have come from, what this is actually telling us, and how we can work the best to support them and ourselves.” Reawakening compassion begins with understanding trauma “We have one young person who displays a really high level of emotional need and that’s incredibly draining on the whole staff team. We check in with each other and make sure we have regular discussions. In order to reawaken compassion, we have taken the timeline to team meetings. We go through it and look where a young person has come from and the trauma that they have experienced. We remind ourselves that the young person isn’t doing something because they won’t do it but because they can’t do it. We think about the unmet need within a young person’s developmental trajectory.” A young person responds to curiosity and empathy “What we realised is that this young person needs a high level of physical touch. We give her lots of cuddles, bedtime routines, bedtime stories, and washing her hair. There is a lot of time invested in nurturing.” “Also, she responds to us being curious about what has happened. Instead of responding immediately to behaviours, I use wondering aloud 2. If she can’t respond verbally, the young person can give a hand gesture, thumbs up or down.” “There is also a special place where she goes when she wants to speak to me. We haven’t seen as many of the distressed behaviours that we were seeing initially. There was a lot of physical aggression especially directed towards me and another colleague but that doesn’t exist anymore.” “I think what we have done is create a safe space for her and there is safety within our relationship as well. When she is very dysregulated, I let her know, ‘If you need this time then I can help you regulate.’ We will sit and hug. I used to struggle with sitting with the really distressed emotion; I would have jumped in and tried to fix it. Now I know I need to sit with it, we need to work through this, and we need to understand this. I think that really helps with her.” Sharing what works with a school builds a deeper understanding of behaviours “The school were really struggling with her behaviour and so we used the timeline. We had a meeting with the school, and we spoke about how we worked in a relational way. We took the timeline and spoke about the trauma and the neglect she’d experienced. It gave the people in the room a greater understanding. You could physically see the body language of the teachers and guidance staff changed in response to what they were hearing. You could almost feel the empathy in the room. Now we have this really good relationship with the school, and they are understanding these distressed behaviours.” PACE training changes mind-sets “The three-day PACE training was a really good refresher and a reminder of what I should be doing on a day-to-day basis. You naturally have your own values that you bring to the role, but sometimes you should leave them at the front door. We need to think about things with a PACE attitude, rather than defaulting into our normal view on things.” “I do outreach work with a young person who is coming up for 19 years old, but chronologically probably operates at a younger level. One of the principal things that I remind myself is the can’t not won’t principle. It is easy to say ,‘He’s nearly 19; he should be able to do x, y and z.’ I have to remind myself that although he’s 19, he can’t do a lot of things very well, like budgeting, managing appointments, and that kind of thing. It is the same with some of our other young people; it’s not that they won’t do things, it’s just that they can’t.” Seeing how PACE works in practice motivates staff “I get to see results. One young person, she doesn’t do physical touch a lot, but she asked me for a hug one day. I think she asked me because I work in a fairly open way with her and I have built up a really good relationship. I remember saying to a colleague, ‘That’s one of my best moments ever.’ People take for granted in day-to-day life that it is okay to ask for a hug, but when she asked me for a hug I thought, ‘Wow, that’s a moment!’” A no blame culture helps adults stay open and engaged “My supervisor and I reflect a lot on things that have happened; we are curious about things. We will look at how I have handled things, and we talk about how I am feeling. We had a situation last weekend where one of our young people, who had been doing a lot of alcohol and this affected his behaviour. He had gone out saying he was going to hurt himself, and I had to hold him to stop him from hurting himself. It was quite a traumatic event, but my supervisor talked through how I was feeling and how I was going to go forward with this young person. There’s never any blame and that helps me stay more open and engaged with a young person.” DDP helps staff stay in the moment with young people “Another thing I remember from the DDP training is the importance of always going with an open mind and not being judgemental. I really try to stay in the moment and think about how to match affect 3. When young person is feeling heightened, you can match their affect to help them co-regulate. The old calm down never really worked for them. If you can match their mood to kind of bring them down, I think that is really useful.” A PACE approach helps staff respond with more sensitivity “We put the PACE attitude into practice every day. We talk about a trauma-informed model, and PACE is a way to articulate that. I use curiosity with a young person to explore what is going on for them when they are distressed. When I have obviously got something wrong, I can say I am sorry for putting a young person in that position. I see young people being very responsive to that sort of dialogue. You are no longer telling them how they should feel, you’re actually having them tell you how they feel.” “Young people can better regulate because we are not seen as a threat. You are no longer threatening them with your ideas or your words. You are no longer in the position where a young person is distressed towards you, and they can see that you have not got distressed by their distress. It is an attuned way of responding.” Young people talk about the issues that are really important to them “I wanted to improve the lives of young people and do something different in our children’s homes. DDP is was a way to address trauma. It is about healing trauma instead of us just adopting a behaviourist approach, which does not work.” “It is creating a culture where we really listen to young people. Recently a young person told us, ‘There’s no food in this house!’” She was upset. “Before the DDP training, we would have responded by pointing out that there was food in the house. This time we thought about what she was really saying and why this young person was so angry. We worked through a process with the young person.” “About 40 minutes later she was saying, ‘All the staff are rubbish.’” “All the staff are rubbish! My goodness that must be really difficult for you!” I said to her. “By exploring her perspective and feelings, the young person was able to open up about what was really troubling her. She was blaming herself for something that had happened in her past. Before we would have just dismissed her with, ‘There is food in the cupboard.’” “It is really important that as a staff team we are able to keep ourselves contained and regulated because that enables us to hold on to and contain that anxiety for the young person. The end result was amazing. It had nothing to do with the food; it turned out it was about her feeling guilt over something that had happened in the past.” “Young people are getting the message that you get them, you want to understand them, and they are responding with more open communication and more trust.” “We have used that approach quite a few times with young people. Sometimes, they don’t want to actually speak. One young person used post-its and wrote, ‘Nope’ and held it up. Then we tried something else and he wrote, ‘Maybe.’” Do the young people know that you are using this new approach? “I don’t think they know, apart from one young person. She said these words, ‘Are you trying to therapeutic me?’” “It has been so gradual the kids are just lapping up the connections and the curiosity. Some young people might say they had noticed something was different. They are choosing to stay with us longer. We have less significant incidents, and our staff are not off with stress.” Residential managers notice the impact of the training “Members of the team have come back from the training very motivated and excited saying ‘light bulbs were going off in my head all four days.’” “We have embedded our ethos of care so that it is aligned with the principles of DDP and PACE and updated our policies and procedures so that they are clearly underpinned by relational/attachment-based practice.” “We now write our daily written records in a way that is respectful and non-judgemental of our young people.” “The way in which we work with families has changed in a way that helps us understand the family script and how this impacts on the young person. This also allows for direct family work that is trauma informed.” “Staff are able to de-escalate situations and do not resort to putative measures. However, we are also clear about what is not acceptable, and any risk-taking behaviours result in higher levels of supervision/safer care planning.” “DDP has given us an evidential baseline that explains our approach to other agencies within a variety of professional’s forums, including Police, Education, and Health Services. Sharing our approach with others encourages a holistic trauma informed understanding of the young person and their needs.” Further resources
1. Hughes, D.& Baylin, J. Brain-Based Parenting: The Neuroscience of Caregiving for Healthy Attachment. 2012: New York: Norton & Co. 2. Woodier D. Wondering aloud. Weblog. Available from: www.saia.org.uk/blog/wondering-aloud-building-support-for-young-people-who-are-in-crisis 3. Woodier D. Matching affect and why a dog is a man’s best friend. Weblog. Available from www.saia.org.uk/blog/matching-affect-and-why-dogs-are-a-mans-best-friend Please note that the PACE and DDP trainings were commissioned by Aberdeen City Council and were delivered within a partnership agreement Aberdeen City Council, Scottish Attachment in Action, and Edwina Grant (independent psychologist and certified DDP trainer). Attachment - 'a lasting psychological connectedness between human beings.' (John Bowlby) [download this article as a pdf] Introduction Scottish Attachment in Action’s conference this year (2019) demonstrates SAIA’s commitment to informing and promoting why attachment matters throughout the lifespan life – from cradle to grave we all have a fundamental need for human connection and love. Over the last twenty years understandings from attachment theory have been increasingly influential on the parenting and professional care of young children. It is now widely understood that infants and young children flourish when they have adults who can provide them with reliable comfort and protection and the opportunity for reciprocal joy and delight. These relationships provide a space where children can easily develop essential social and emotional skills such as self-regulation and emotional competence. These ideas have also been incorporated into central and local governmental policies. For older children whose early development has been compromised by the trauma of neglect or abuse the importance of using the therapeutic power and healing potential of new more positive attachment relationships has also become generally recognised. This focus on the importance of attachment relationships in childhood is welcome; in addition it would be Scottish Attachment In Action’s view that attachment theory has much to offer in understanding and improving the human experience more widely. This paper is intended to spark thoughts, raise questions and generate interest in the potential for adopting an attachment informed approach across many more areas of our lives. The healing power of relationships The cascading negative impact of adverse childhood experiences throughout life is now widely recognised but we need to avoid a fatalistic pessimism about this. The emerging evidence of the positive effects of using attachment focused parenting and attachment focused therapeutic approaches to support the recovery of traumatised children and young people offers hope for adults who still carry the emotional and social burdens of unbearable childhood pain. Counsellors, therapists, social workers, and health professionals have long understood the importance of the therapeutic relationships they develop however recognising their role as attachment figures may feel less comfortable or even inappropriate. There can be professional anxiety about creating dependence which perhaps fails to recognise that for some people their route to developing the capacity for interdependence may require a dependable experience of safety, predictability and comfort as well as reciprocity that can help repair trust and hope. The following case study illustrates the power of such healing relationships. Much of my work involves offering long-term therapy to adults with a background of trauma who often have, a background where a secure base was not formed in infancy/childhood; or where that healthy attachment was lost or broken. Central to the therapeutic relationship is making sense of those negative experiences with adult clients and offering the secure base they have been missing. Adults whose earliest needs have not been met usually come to counselling with a view that I will not or cannot meet their needs. They often have little expectation that I can help them begin to discover and learn how to meet their own needs. The building of trust between us takes a long time. Consistency in our work is essential. They need to know and learn to trust that I will be there when I say I will -that if I am to provide that secure base, then they are able to leave me (the therapy space) with the knowledge that I will be there when they return. Neil 1 (23) came to me struggling with being able to maintain romantic relationships. He found himself controlling, terrified of abandonment and loss, unable to trust, with very low self-worth and devastated by endings. His mother left the family home when he was two years old - his primary attachment figure left and did not return to him. His relationship with Dad suffered on many levels and did not provide the safety and security needed for secure attachment. He was a lonely, sad, confused child abandoned with the experience of no one being able or willing to meet his needs. Neil’s insecurity meant he desperately sought and clutched love and connection, yet struggled to receive it when it was offered. He also pushed people away with the same intensity with which he needed that love demonstrated to him. As an adult he believed he was unworthy of love, and was confused and distrusting when I showed him kindness or acceptance. Our therapy work was a long process over years of building up his trust in me and allowing me to be emotionally close to him. He gradually began to rely on me and to ask for my support, which was complemented with boundary setting to ensure he didn’t cling to me in a way which might overwhelm me and/or inhibit his growth in his ability to rely on himself too. Learning personal boundaries is an essential part of secure healthy relationships. Had he had that secure attachment in infancy, this would have been in place as an adult. This reparative relationship with me modelled to him the importance of being able to set basic guidelines of how you wish to be treated and how to respond to the wishes of people close to him. He often tested my commitment to him, he would say things to try to hurt me or push me away (often unconsciously). He was always desperate to be my “favourite client” – continually looking for me to confirm his worth. As part of our work and my commitment to him I took his story and our relationship to my counselling supervisor. Establishing a trusting attachment relationship with young people or adults who have not had a secure base can be difficult. It can be tricky, frustrating, tiring and at times feel hopeless. It can also tug at parts of your own attachment history which can exacerbate the difficulty in offering it to another. Supervision, self-care, support for yourself is crucial. Counselling is only one strand through which we as human beings try to form, repair, provide and receive healthy attachment relationships. Without wanting to do myself out of a job, my hope is that those working and living with young people who have not had a fair start in life are able to offer the safety and trust that can help those young people gain a secure base. The truth is, if young people are offered a secure attachment relationship there is less likelihood of them needing counselling and psychological services as adults. Human beings don’t want to be fixed, they are not broken. Instead, they want to find ways of being able to support themselves and to have an ability and willingness to seek support from others. Offering a secure base to help form a safe, connective relationship with self and others is arguably the greatest gift we can offer another. Written by Catherine Cooke. Accredited Therapist and Supervisor, and a Trustee of Scottish Attachment in Action 1 Not the client’s real name Outside the professional arena we also need to recognise the power of normal human love and relationships to reignite the possibility of belonging and reciprocity in people whose early experiences of people have been associated with mistrust or betrayal.
Attachment beyond childhood Our needs for comfort and protection do not disappear as we reach adulthood. Most of us have special people we turn to at moments of need – friends, partners or family members. Often such relationships are mutually supportive, we are attachment figures for each other. The dominant narrative within the UK, however, privileges the individual over the group and values independence over interdependence. This can leave people lonely and disconnected particularly at times of crisis. Attachment theory can help us recognise the importance of community and connection and the negative consequences for individuals and groups when these are lacking. Can we create societal and professional systems and structures that support the development of this type of community and connection? Cultural differences, life events, mental health issues , physical or intellectual difficulties may increase the vulnerability and neediness of any of us and this might make us more dependent on the emotional or physical support of those we trust whether on a permanent or temporary basis. Can we challenge assumptions that seeking help and connection in these circumstances somehow diminishes our worth? For many of us as we reach old age, increased physical frailty or cognitive decline will shift our relationships with our own children and a reversal of roles can take place where we find ourselves seeking comfort, care and protection from the same individuals we once cradled and soothed as infants. Once again the importance of very basic rhythms of life, consistency of relationship and soothing sensory experiences become key in insuring quality of life. There is a growing body of evidence that demonstrates that attachment-informed practice can have a similar transformational impact on the care of elderly people, whether within families or in professional settings, that it has had on our parenting and professional practice with children. Attachment in organisations The strongest influences on our children and young people, other than their families, come from the various educational environments they experience. From nursery to further education children are introduced to systems, structures and processes that powerfully affect their everyday lives and development. Educational organisations that recognise that learning is relational – we learn best from people we like and respect - and promote emotional health also support effective learning for all. Indeed for some children school is the safe base when home is not. As children progress through the educational system they move through environments that inevitably become increasingly less attachment-promoting. In nurseries children have their own key workers and within primary schools most of their time is still spent with a single teacher albeit in a much larger group. Once a young person moves to secondary school, however, they are likely to have a timetable that involves multiple changes of teachers, peers and places throughout their school day. In further and higher education most learning takes place either alone through self-study or in large classes Effectively children and young people become progressively less known and recognised as individuals. Many of these structural differences are the inevitable outcome of the different curricular demands at different stages of children’s education. An understanding of attachment theory has, however, allowed many schools to introduce processes, systems and structures that promote the importance of relationships and help teachers notice and recognise distress even when it is expressed through difficult behaviour. Such attachment-promoting schools provide an environment where children who have experienced adversity or trauma can be supported to recover but also where typically developing children are more likely to flourish and enjoy their learning and relationships. What would be necessary to create an educational system where such attachment informed practice would be the norm? As adults many of us spend a huge proportion of our lives in work settings and recognise that our emotional health and well- being can be profoundly affected by the way our working lives are structured and how well we are managed. Perhaps inevitably, authority structures and colleague relationships can mirror family experiences of rebelling against parents or being nurtured by them, as well as rivalry with siblings or enjoyment of the camaraderie and excitement shared with them. Where the importance of supportive relationships within organisations is recognised this can not only create greater productivity and less absences but also provides an emotionally healthy environment for all. An audit culture, short term or zero hour contracts, punitive targets, reputational anxieties and an increased focus on the digital sphere have all contributed to an environment in which work organisations have become less safe and containing places where relationships can be fractious rather than team-oriented. Where organisations have focused on creating a relational culture with processes and procedures that are congruent with this approach then employees are happier, staff retention improves and the primary task of the organisation is achieved. The basic responsibility of the caring industries is to provide care, support or help for people in some kind of need that is delivered through relationships with others. Yet even in these settings there can be little focus on the needs of workers for consistency, supportive relationships and emotional safety. Is it possible to, as the norm, create organisations that are attachment informed which will have benefits for employers and employees? Attachment to Place We tend to think of attachment as only relevant in personal relationships yet there is a growing literature about the importance of attachment to place. Similar factors influence our attachments to places as they do to people. The places we become attached to have been those where we have consistently experienced safety or comfort – this may be a house we have lived in or a school we attended. It may equally, however, be a place in the community where we could retreat when were sad or distressed and find soothing – a religious building, a library, a favourite outdoor space or the gym. Many of these places have the enduring quality of personal attachments – even when we have not visited them for a long time they have meaning. Many of us gain great pleasure from visiting childhood haunts many years later and are outraged if we discover they have disappeared or changed. This attachment to place underpins some of the campaigns to preserve buildings, outdoor places or institutions that are under threat because of new priorities or changing policies. Sometimes such closures can have powerful effects for individuals. Adults who grew up in children’s homes, for example, whose sense of their own narrative is already compromised may find it particularly difficult if their childhood homes have disappeared without trace –some even begin to doubt their own memories and experiences. Creative use of digital archiving and social media can help preserve attachment to place even when original buildings or places have disappeared or changed beyond recognition. Danger and distortion in attachment Finally, we maybe need to consider the potentially lethal implications of our collective failure to provide the political, social and emotional environment where individuals, groups and communities can feel included and experience positive attachment relationships. Human beings are social animals with a powerful drive to connect to others and feel a sense of belonging. If these opportunities do not exist within our families or communities and no compensatory or healing experiences are available then the hurt and excluded will find each other and may find their sense of connection or belonging in their shared rage or pain. In many cases this will fuel positive social change and the creation of communities of interest but it may also have destructive consequences. Gangs create strong bonds and give their members an illusory sense of safety and comfort. The genius of the Violence Reduction Unit’s approach to Glasgow’s gangs was that it recognised this function and worked to provide alternative more prosocial ways for young gang members to feel connected and to belong. Using an attachment perspective may help us to understand both the resurgence of terrorism and the poison of racism. Are there implications from an attachment perspective, for example, of adopting a seemingly deliberate policy to create a hostile environment for immigrants? Conclusion This paper is by no means an exhaustive account of the way that a better understanding of attachment could enhance professional practice and human relationships more widely. That was never its purpose. At Scottish Attachment in Action we want to encourage exploration, debate and challenge. We hope that our members and any other individuals and organisations interested in attachment will join in this discussion. Let us push at the boundaries! What would an attachment-informed prison system look like? Or an immigration service that recognised the meaning and importance of relationship for individuals, communities and society at large? How would attachment-minded politicians frame policy and law? It is our contention that any service, profession, community or business that involves connection with people would benefit from underpinning their work with an attachment –informed approach. What do you think? Written by Catherine Cooke and Judy Furnivall, SAIA Trustees, December 2019 [download this article as a pdf]  Why Attachment Matters Across the Lifespan. A summary of the Scottish Attachment in Action Annual Conference, 18th December 2019
Reflecting its vision of promoting attachment relationships throughout life, Scottish Attachment in Action’s 11th Annual Conference held in the Queen Elizabeth University Hospital, Why Attachment Matters Across the Lifespan, brought together an impressive range of speakers who provided a stimulating, reflective and often touching account of this important but perhaps rather overlooked area. Edwina Grant, SAIA’s chair introduced and welcomed each speaker to what is a new venue for SAIA events. Sir Professor Harry Burns, Professor of Global Public Health, University of Strathclyde started off the day by giving a characteristically thought provoking and humorous overview of the importance of consistent parenting. Always thoughtful and engaging and with his renowned firm grounding in science (“unless you have evidence all you have is opinion”), Sir Harry is never afraid to make a powerful social comment. He reminded us that the evidence is clear that the most successful societies are those with strong social bonds, connection and cohesion and gave a comprehensive overview of the evidence which supports this, as well as an insight into the motivation to improving the health of Scotland stemming from his early experience as a surgeon in Glasgow. Citing a range of data and scientific studies as well as the inspirational rectorial address by Jimmy Reid in the early 1970’s on alienation, described by the New York Times as the “the greatest speech since President Lincoln’s Gettysburg Address, Professor Burns provided a compelling and motivating call to the promotion of wellness through meaningful asset based support for and empowerment of families and reminded us that solutions emerge when we ask ‘what matters to you?’ The themes and insights of Sir Professor Harry Burns’ keynote address were echoed throughout this fascinating and inspiring day, with all speakers making links directly and indirectly with Sir Harry’s commentary. Ⓟ [view Sir Professor Harry Burns presentation] Scottish Attachment in Action’s patron Professor Helen Minnis, Child and Adolescent Psychiatry (Mental Health and Wellbeing), University of Glasgow gave us the benefit of her extensive professional and research experience on the topic of Getting a good early start: supporting attachment relationships in young children and stressed parents. Once again, we were treated to a comprehensive and accessible overview of a complex area. The Harvard Centre for the Developing Child was highlighted at the outset of Helen’s talk as a helpful source of information particularly for its use of metaphor such as ‘serve and return’ which will be a familiar term for many who work with infants. We were reminded by Helen that if we look across human populations, we recognise that we are adapted to cope with stress, that not all stress is ‘bad’ and that in fact stress responses are helpful in many situations where we are required to perform. The key to understanding human development lies in the understanding of what makes us resilient and adaptive. If we take an evolutionary perspective the quality of the ‘relationships within the pack’ play a vital role and help us to manage throughout life. Adults are programmed to respond to infants’ attachment behaviours but as we are aware there are sometimes barriers which affect this instinctive parental response and that in those circumstances, we need to address the neurodevelopmental issues of parents. Helen went on to describe the divergent developmental paths related to the interactions of temperament and parenting and reminded us that the range of ‘good enough’ parenting can be very wide and varied indeed. Working together to urgently support stressed parents is key, as are relationship focused interventions to support attachment relationships to remove barriers so that instinctive parenting can emerge. The importance of good formulation and helping the person to understand was emphasised. That deeper understanding, so eloquently described, is potentially very helpful in promoting that good formulation. Ⓟ [View Professor Helen Minnis presentation] Following the break and opportunity for networking, Dr Andrea Williams, Consultant Psychiatrist and Medical Psychotherapist, NHS Greater Glasgow and Clyde gave a very interesting presentation on the topic of Attachment Theory and personality disorder: how theory helps in the chaos. The focus of Andrea’s presentation was the work of the Personality and Homelessness Team which works across traditional boundaries to support a more coherent and attachment informed response to those with a diagnosis of personality disorder who find themselves homeless. The themes emerging from this work had resonance for many working to support particular ‘hard to serve’ groups and provided a compelling insight into the importance (and challenge) of taking a relational approach to the way we offer our services. The relevance of ‘doing with rather than to’ in all our services was amply demonstrated throughout Andrea’s presentation, as was the need to constantly learn and be open to shifts in ideas about what actually does help. The role of mentalising, the capacity to understand the mental state of self or others, was highlighted as an area compromised by high levels of stress arousal for both service users and service providers alike. Mentalising is a key element in social understanding and ability to adapt and is closely related to attachment experiences. An understanding of the activation of the attachment system under stress and the related difficulties of regulation of affect also underpin the approach to support for this often-stigmatised group. A recognition of the struggle for some to engage with supports led the team to reflect on the underlying dynamic of epistemic trust, the willingness to accept new information as trustworthy, relevant and generalisable, and its role in social learning and the capacity for change. The overwhelming experience of homelessness coupled with personality disorder can so readily lead to a loss of trust and deep suspicion of those offering help and support. Engagement is often messy, and the service needs to allow for a long intake period before any therapeutic support is even possible. The subtlety of developing trust and the necessity for ostensive cuing (early communicative cues closely allied to mentalising ability) was emphasised as key to the work of the team in engaging with service users and is a reflection from which many services could benefit. “If trust develops people can internalise knowledge and helpful things and take them into their world”. Following lunch and a further opportunity to network, visit the marketplace and bookstall, Jan Beattie, Executive Lead for People Development, Alzheimer Scotland provided a new and stimulating perspective in her presentation From childhood to later life: childhood experiences in dementia. Continuing the themes of the importance of attachment relationships and the way we deliver our services, Jan began by highlighting the importance of dementia as a global health priority but one in which there is no cure, and unlikely to be one around the corner. Many of us will be touched by dementia one way or another. An understanding of attachment can be very helpful in reframing some of the behaviour, distress and responses which can be part of the experience of dementia. It helps us to make sense of the drive to seek connections and the need to offer support which maintains connections. Secure attachment in childhood may lay a protective foundation which enables more effective coping and can be a protection against cognitive decline. However, 33% of people who receive a diagnosis do not go outside afterwards. This is often about a need to protect but clearly has a huge impact on opportunities for social connectedness. So, at a time of cognitive decline when social connection may be most needed, there is a significant risk of this being lost. The issue of lack of engagement and the ability to accept support also has an impact on the capacity to cope. Person centred planning taking account of what has been important has strong resonance with Sir Harry’s description of the importance of meaning making. Family support is key and family carers the most important resource. Walking alongside people through their experience of dementia and keeping connections until the end of life is what makes a difference. Jan ended with a telling and moving personal example from her own experience which gave real meaning to the significance of early relationships throughout life. Ⓟ [Read Jan Beattie's presentation] This fascinating conference closed with a presentation by Andy Lowndes, Deputy Chair and ‘The Music Detective’, Playlist for Life who took us through the work of The Music Detective, giving insight into the importance of music in connecting with important experiences in life. We all have the experience of connecting particular music with important events and feelings and Andy demonstrated this by involving the delegates in sharing some of this experience. As a former mental health nurse and academic, Andy’s interest in this area was piqued by the experience of Sally Magnusson in caring for her mother and the way in which music seemed to enable a connection with herself and with her family in a way that other senses could not reach. While Andy had seen this during his nursing career, he wanted to carry out some research; and so he did. There is a science base and a growing body of research on brain activity and listening to preferred music. Music is neurologically special, and Andy illustrated this through a series of compelling and touching video clips showing the responses of people affected by dementia when listening to music which had meaning for them. Andy works with families and carers to identify personally meaningful music to generate a soundtrack to the person’s life and generate the Playlist for Life which can help access important memories, feelings and experiences and bring comfort and soothing to those experiencing the losses associated with dementia. He encouraged us all to give developing a personal Playlist for Life some thought! 🌐 [Visit Playlist for Life] This innovative conference embodied Scottish Attachment in Action’s commitment to promoting attachment informed practice at all stages of life and was at the forefront of connecting the importance of relational approaches to service delivery throughout the lifespan. Grounded in science, and threaded through with warmth and humanity, this was a truly inspirational day. Alison MacDonald SAIA Trustee Lead officer for Health and Wellbeing within the Scottish Attainment Challenge in North Lanarkshire Thank you to Alison for this great summary of the day! When we talk about putting theory into practice, there is a risk that we think of support as something we do to children. Using our knowledge of how children develop secure attachments can help us learn how to attune to them. Expressing curiosity and empathy can be more effective when we learn how to match their affect. In addition to helping children co-regulate, this way of relating can build a special trust between adult and child that may open a door to learning. The link between trust and learning is often more visible in children and young people who have experienced maltreatment and disrupted attachments. The child who seems to assume the worst about our intentions towards them may also struggle to accept our help or advice. We often experience the young person who seems difficult to motivate or engage in learning as controlling or manipulative. The impression that these children are hard to reach and teach is probably linked to their difficulty feeling secure in relationships.  In the first year of an infant’s life, the parent’s or carer’s capacity to think about what is going on in the mind of the child allows curiosity and empathy about the child’s affect*. The carer provides the child with a kind of mirror image reflected in their parent’s or carer’s face and expression. The child manifests a mood or an emotion to a caregiver, who mirrors it in a display of understood affect. The infant who is crying and distressed sees sadness and distress in his caregiver’s face.
However, what adults usually do without even being aware of it, is mark or differentiate their display. For example, they may alternate a brief period of making a sad looking face with a soft smile, gentle voice, and rocking. This enables the child to recognise that the affect displayed by the caregiver is a representation of the child’s. This secondary representation allows a child to learn to calibrate and regulate his or her response rather than acting it out. 1,2 Many children who have been maltreated or who suffered disrupted attachments have not had enough experience with someone who can attune and connect with their affect. Yet, being able to experience a consistent, sensitive response from a parent or carer plays a vital role in helping children learn to regulate their emotions. How do we help children learn to regulate their emotions when they haven’t had these experiences early in life? How do we help them learn what it is like to have an adult who is trying to understand them and give meaning to their inner life and behaviour? In order to reach out to these children, teachers, parents, and carers have sometimes been encouraged to try matching the affect of the child or young person. This isn’t always straightforward, and I have seen mixed results. One teacher said to me, “I try to match his affect when he is upset, but his voice goes up too high.” Another asked, “How do I match his affect when his expression looks frozen or when he curls up in a ball?” I have also seen teachers amazed at the results when they figure out how to do this. “When I said to him, ‘I understand you must be really upset,’ he got even more angry. But when I said in a more animated voice, ‘I get it! No wonder you are upset if you think you were going to get the wrong answer,’ he calmed right down.” Success seems to depend on the child or young person being able to experience what it is like when an adult tries to understand him or her in a curious and empathetic way. It relies on an adult being able to notice the subtleties of a child’s expression and relate it to some underlying intention or meaning. This reflective capacity, often referred to as mentalizing, allows us to imagine the fears, desires, goals, hopes, and beliefs that underlies our own and others’ behaviours. Someone who is mentalizing is curious, accepts that their assumptions about a child’s behaviour may be wrong but wants to try anyway, is aware of the impact of emotion, and is able to see a humorous side of things. However, mentalizing is also a fragile process. It develops naturally, for example, from the interactions between members of a family, but it can be easily switched off when a child or adult feels threatened or shamed. Similarly, when an adult becomes too rigid in interpreting a child’s intentions, when an adult lacks empathy for a child, or even when an adult has lost joy in relating to a child, it may be very difficult to recover that mentalizing stance. What can we learn from the developmental processes, like mirroring, that can help us learn to match affect? The goal is not to present the child with a facsimile of their expression, but with a copy that is distinctive or marked. By matching the intensity and timing of a child’s affect -- for example, by matching the patterns of stress and intonation in the voice -- the adult demonstrates that understanding of the content of that emotion or mood. At the same time, the adult marks their display; for example, rather than shouting back at an angry child, the adult uses animated gestures. Sadness or disappointment can be matched by the tilt of the head or by an exaggerated sigh. Congruence but with a degree of differentiation allows the child to recognize the displayed affect as their own and not the adult’s. One experienced practitioner explained some of these features in these examples: “So, if a child says to me, angrily, 'I am so stupid!' my verbal response to match affect would be to say in an animated tone: That's so hard for you when you think you are stupid!” I would also match the intensity and pattern in the child’s expression with my body language and facial expression. Likewise, if a child was sad and said: ‘I am so stupid,’ I would say the same words, but my non-verbals would be less animated in intensity in order to match the energy of the child's statement.” The following steps may allow the child to get a sense of “you get me” and “you have understood me.” Although our goal is accurate mentalizing (giving the child the picture in my mind of what it is like to be them), we do not have to do this perfectly. It is important that the child experiences the process we use to correct our understanding.
I was in a meeting at a school and one of the teachers, in a light bulb moment, asked this question: “So you mean our job is to help him learn to relate to others rather than give him an education?” If I could go back and answer that question now, I would say something like, “Actually our job is to learn to relate to him first before we can expect him to relate to us.” Yes, relationships are vital to learning. They go hand in hand. It is just that we are used to teaching kids who have learned before they get to school that the knowledge adults have about the world is valuable. For other children, we need to be intentional about helping them learn to trust by giving them opportunities to experience what it is like to have an adult who mentalizes them. That experience of being understood is a key that unlocks learning. 3,4 This is a true story. Harry (not his real name), ten years old, sits at his desk with his head down. His teacher recognises something is wrong. She knows that the question Harry has been asked may have upset him: “Write about a character in a story who feels rejected.” She gently asks Harry, “Come outside with me.” The teacher has prepared herself for a moment like this. She says to Harry, “I can see that it is not easy for you to tell me what is wrong. I would like to do something a bit different. I am going to talk for you.” The teacher continues as if talking for Harry: “‘If I don’t answer my teacher when she asks me what is wrong, I’ll get in trouble. But I don’t know what’s wrong, and I don’t know how to tell you.’” As the teacher speaks her voice become more animated and she moves her hands in front of her like the two sides of a closed gate. She is trying to communicate the sense of frustration, of not knowing, that she imagines Harry is struggling with. Harry looks up and makes eye contact. Silent tears begin to spill down over his cheeks. The teacher pauses and then begins to talk about a time when she kept getting something wrong and didn’t know how to fix it. She begins to lighten the tone of her voice and Harry smiles. Later the teacher reflects on what happened. Was she able to match Harry’s affect? She can’t be sure, but she feels like there was a moment of recognition when Harry made eye contact with her. She thinks that Harry’s tears may have come from a sense of relief that someone could talk about him without making him feel ashamed. What is Harry learning? He is at the beginning; this is the first of many moments when his teacher can talk for him. Gradually, he will understand more about himself, he will see that the emotions that overwhelm him can be understood by his teacher and don’t overwhelm her. He can learn that it feels okay when another person helps you regulate your emotional response. The barriers and fears that cause him to back away from learning will seem less because he is learning to trust. Relating to young people using skills like matching affect allows us to communicate a deeper kind of understanding that can signal to a child that what I have to share with you is relevant and helpful. “If you can get what is in my mind, then I might be interested in what else is in your mind. Now I am interested in what else you have to say about what might work for people in my world”. 4 Just in case you think that the reference to dogs in the title was simply to get you to read this, some experts say that mentalizing is perhaps the most human of traits, and that the animals closest to being able to mentalize humans are dogs. Dog lovers probably already knew this, but It shows what a powerful advantage dogs gain by being able to notice the subtleties in expression of their human owners. How can dogs do this? Try hanging out with humans for several millennia: mentalizing is a great way to build companionship and have someone throw a stick for you. *Affect is often used as an umbrella term to include inner states that are relatively stable, such as an attitude toward a person and something shorter lived like a mood or an emotional response to a specific situation. It can also refer to something that child is not fully aware of and yet manifests in their expression or body language. If that doesn’t confuse you enough, try reading James Gross’ explanation in, “The future is so bright I gotta to wear shades” Emotion Review 2010: 2(3); 212-216 References: 1. Fonagy, P. What is mentalization? Available from: https://www.youtube.com/watch?v=OHw2QumRPrQ 2. Fonagy P. Gergely G. Jurist E. Target M. Affect regulation, mentalization, and the development of the self. 2002. 3. Fonagy P. Alison E. The role of mentalizing and epistemic trust in the therapeutic relationships. Psychotherapy. 2014: 51 (3): 372-380. 4. Bevington D. Epistemic trust for AMBIT. Available from: https://www.youtube.com/watch?v=ZBeEOkwLToM First published in www.saia.org.uk/blog 2019 © 2019 David Woodier, Inclusion Support Teacher. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact. Illustrations by Tom Donaldson www.etsy.com/shop/tomdonaldsonart Key Adults, Inclusion, and School Trips
Young people who struggle with the effects of insecure attachments, past neglect and abuse tend to be excluded because this seems an easier option than wrestling with the question of what kind of support is needed in order to make something like a school trip work. It is bad enough that these kinds of exclusions are probably discriminatory and unlawful, but my recent experience suggests that we may also miss out on the opportunity to learn important lessons about the kind of support that can benefit young people more generally. I recently heard a foster carer comment that one young person had not been on any school trips in the past four years. His behaviour in school was difficult and the head teacher decided this pupil (we’ll call him Matthew) had not merited the same opportunities as other children. I wondered how this deeply disaffected young person would respond were trips were not used as rewards for good behaviour, and if the school were more focused on giving him the kind of relational support he needed. Mathew’s teacher had consented to him coming on the trip only if I went along with him, but that seemed to be the full extent of any planning. The gym hall was full of anxious parents, hugs, last-minute instructions and excited children. These school children were about to embark on their week-long residential at an outdoor centre in the Highlands. Matthew, however, stood on his own. He lived in a children’s home, so had no parents there to wave him off. As the kids piled onto the bus, I noticed that everyone else had found someone to sit next to, except for Matthew. I wondered why no one had really thought about him. Why hadn’t one of the care workers from the home waited with him? Why hadn’t there been assigned seating on the bus? Surely Matthew wasn’t the only child worried about who would sit next to him? The next day, we put on wet-suits and headed for our first activity. I watched as Matthew, enthralled by his surroundings, listened to the instructor’s directions before we began our walk up the thickly wooded gorge. As we plunged into a very cold stream and climbed up our first small waterfall, I could see that he was thrilled. Matthew thrived on the sense of risk and the physicality of the experience. Afterwards, I thanked our instructor and explained a little more about Matthew’s background. The instructor replied, “This is just the kind of experience we want to give young people like Matthew. He is the kind of child that can benefit from what we have to offer.” The key to making these kinds of experiences work for all young people is to imagine how a child or young person will experience them. In addition, planning and preparation means thinking about the kind of relationships a young person has or lacks. Is there an adult who knows them well, who can spot the early signs that a child is anxious or upset? If the young person is struggling, is there an adult the young person can accept help from? If not, now is the time to think about helping a child experience that kind of relationship. I hear teachers point to lack of resources as a reason for not including some children. Much of what I saw on the trip with Matthew wasn’t about the need for extra resources, however. It was about giving him the support he needed and making better use of the support he already had. In addition, the things that particularly helped Matthew would also have benefited most, if not all, of the other children. On the back of my experiences and reflections, I have written a guide to school trips based on the requirements of the equality legislation, because it throws weight behind what should be good practice. See the ‘resources’ section of this website for a copy of the guide. First published in www.saia.org.uk/blog 2019 © 2019 David Woodier, Inclusion Support Teacher. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact. Why do some children find it more difficult to learn from being sanctioned for their behaviour? Do some children think differently? Is it something as fundamental as not being able to see the link between an action and its consequences, or is it more about misunderstanding other people’s intentions? When children learn early in life that other people’s motives are not always safe or trustworthy, we need a different approach to discipline. There is still a temptation, especially when under stress, that we default to a dogma that children should learn by facing the consequences of their actions. Consider first what happens when we assume children who have suffered abuse and neglect early in life can change their behaviour in response to being sanctioned. David was in a Primary 1 class. The nursery had flagged concerns that his language was delayed, and he found it impossible to listen to his teacher unless he was sitting on her lap. Observing him in class was rather like watching a runaway train. When he needed something, he would sprint across the room, knocking over other children left and right. His teacher explained, “We can’t have David running over other children. Do you think we should make him sit in the thinking chair?” A few weeks later, I met David’s parents. They both had learning difficulties. For the first months of his life, David had been completely neglected. I wondered how he had even survived. Expecting David to reflect on his behaviour while sitting in the thinking chair was unrealistic. What the teacher was expressing was probably her frustration that nothing seemed to get through to David, but what he needed was help at a developmentally fundamental level. In contrast, John was in his fourth year of high school. He had lived with his gran for most of his life but now she was too frail. John’s mother had died of an overdose and his dad was an alcoholic. School reminded John that he was different; he struggled in all his subjects and others made fun of his dishevelled appearance. I persuaded the school to let him try horse-riding.
On the first day of his lessons, I noticed John watching some of the horses as we drove into the farm. Usually full of bravado, he had become very quiet. He said to me, “I’m nay getting on that thing.”
“You need to get on,” was all I could think to say. Two years later, John was still riding each week. Occasionally, I would see the owner of the stables surreptitiously watching him. When John mounted his horse, there was an observable charge of energy flowing between boy and beast. John’s riding was now the only thing in his life that was not failing. The school sent me an email: “Unless John’s behaviours in school improve, we cannot let him go riding.” The teachers had cause to be concerned about John’s behaviours but even when we pleaded with them, they showed him no compassion. Compassion is not about showing pity, neither is it purely sentimentality. It understands that a young person does not always have to get what he deserves. Compassion sees his vulnerability and instead gives him what he needs as an individual. I could tell John knew something was wrong when his foster carer called him into the room. I tried to soften the blow, but John looked crushed when I told him the school’s decision. I’ll never forget his reaction: “I’m nay going back to school.” And he did not. John knew that his behaviour at school was a problem; what he lacked was the motivation to change. He must have felt the whole world was against him. A basic belief in a benevolent world is not the only thing children need in order to be able to learn from the consequences of their behaviour. A lot of complicated developmental stuff has to have happened. Even in the first twelve months, as Jean Piaget observed, infants, by acting on their environment, learn a huge amount about themselves and the world around them. But is there a limit to how much an infant can learn on their own? Imagine an infant who sees his favourite toy and extends his hand and fingers towards it. Can we assume the little chap can learn simply by his actions that he can have an effect on his world? Nearly three hundred years ago, David Hume, philosopher of the Scottish Enlightenment was not so sure, and philosophers are still arguing over his ideas. Much of what is happening around an infant is just coincidence; for example, the cat walks past and knocks over the same toy. Even if babies are really good “statistical inference machines”1,2 and can work out the correlation of two seemingly random events, they still cannot get to what Hume called “necessary connection.” We may have no way of grasping how our actions cause things to happen without the help of another person. As infants, we need an interpreter to help work out the consequences of our actions 3,4,5. Imagine the same infant who observes his mother reaching out for the same toy. He uses himself as a framework for understanding her actions. “Object-directed, grasping movements can be imbued with goal-directedness, because of the child’s own experience with these acts.”6 According to Usha Goswami, Cambridge Professor of Cognitive Developmental Neuroscience, the ‘’like me analogy” opens the door for the young child to learn about his own and other’s intentions. 6 Imagine one more scenario. This time our baby smiles at his mother, sublimely happy that he has found someone to share in his delight. She beams back, her smile not only communicating her own joy but also attributing her child’s smile with joyful, generous intentions. The infant has his first lesson in personal agency: “I can bring happiness to others.”7 As long as that child’s interpreter is reasonably reliable and attuned, he or she becomes the gateway for learning about another person’s mind and intentions. These are invaluable lessons that can serve him well. What kind of intentions will he attribute in the future to the teacher who gives him a detention? However, if he has grown up with a caregiver who has consistently misinterpreted his acts as apparently provocative, attributing the infant behaviours with a hostile bias, there is good evidence that the same child will attribute the neutral behaviours of others with similar hostile intent.7 We quickly see that there is a developmental pathway that can have serious consequences for how a child responds to his teachers. A lot has to happen in order for a child to accurately learn from the consequences of their actions. They need to be able to organise their behaviours around achieving a desired end. They need a sense of their personal agency: “I can bring about something good.” They need to have mastered the idea that other people have feelings like them and also act with similar kinds of intentions. (I am still working on that one.) They need to be able to regulate their emotions. Bessel Van Der Kolk concludes, “Predictability and continuity are critical for a child to develop a good sense of causality… .”8 Keeping it Real Part of the significant context for a young person is how their behaviour impacts you as a parent, carer, or teacher. These things can feel personal; they can elicit strong feelings of frustration, inadequacy, and being wronged. I have to remind myself that there is no short cut in helping a young person. These are lessons that take time and lots of patience. The skilful part is also about how we present opportunities to young people to reflect on their behaviour. Dan Hughes advises using consequences that logically and naturally follow on from a child’s behaviours.9 Teachers also have a critical role in helping, even if we have a hard time giving up our sticker charts. But methods based on rewards and sanctions can be modified. I once observed a teacher use a system of rewarding a boy who could become very anxious and dysregulated. She told him that he would need to earn twenty marbles to go on a class trip, but she added, “You will never lose a marble you have earned”. I had my doubts at first but in the end, I think it worked because she was sending him a strong message of reassurance. One secondary school struggled when a group foster home opened in the catchment area. The head teacher regularly suspended a couple of the young people. I suggested he should visit the house and express an interest in them. Kids who have faced a lifetime of rejection need to be reminded again and again that it is about their behaviour and not a rejection of them as a person. “You can’t fight in class, but this is your school and I want you back.” Young people, like John, are far more likely to learn from the consequences of their behaviours when we reduce their anxiety and compensate or mitigate for any sense of rejection with clear messages of acceptance. We live in a world where behaviours have consequences and young people look to adults to be competent and fair, but sometimes it seems that compassion is in short supply. We might do well to remember Shakespeare’s words that those who administer justice tempered with mercy are twice blessed. References (1) The infant brain. In our time [podcast on the Internet]. London: BBC; 2010 March 4. [cited 2018 March 28]. Available from: http://www.bbc.co.uk/programmes/b00r2cn4. (2) Sobel D, Kirkham N. Bayes nets and babies: infants’ developing statistical reasoning abilities and their representation of causal knowledge. Developmental Science. 2007; 10(3): 298-306. (3) Sobel D. Integrating top-down and bottom-up approaches to children’s causal inference. In: Johnson S, (ed.) Neoconstructivism: The new science of cognitive development. New York: Oxford University Press; 2010. p. 159-179. (4) Sakkalou E, Gattis M. Infants infer intentions from prosody. Cognitive Development. 2012; 27: 1-16. (5) Meltzoff A. Born to learn: what infants learn from watching us. In: Fox N, Leavitt L, Warhol J, (eds.) The role of early experience in infant development. Johnson and Johnson; 1999. p. 145-164. (6) Meltzoff, A. Imitation as a mechanism of social cognition: origins of empathy, theory of mind and the representation of action. In: Goswami E, (ed.) Blackwell Handbook of Childhood Cognitive Development. Oxford, UK: Blackwell; 2002. p. 6-25. (7) Goswami, U. Child psychology: a very short introduction. Oxford: Oxford University Press; 2014. (8) Van der Kolk, B. Developmental trauma disorder: toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals. 2005; 35 (5) 401-408. (9) Hughes, D. Adopting children with attachment problems. Child welfare. 1999; 78(5) 541-560. First published in www.saia.org.uk/blog 2019 © 2019 David Woodier, Support Teacher. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact. |
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Scottish Attachment In Action - Keeping it real
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Scottish Attachment in Action is a Scottish Charitable Incorporated Organisation (SCIO) OSCR registered No. SC045708
A: Suite 1, 213 Sandy Road, Renfrew PA4 0JY T: 07471 472703 E: admin@saia.org.uk
[Privacy Policy | Complaints | Contact us]