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.
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.
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!
Understanding Attachment Helps Teachers Build Resilience in Young People
Resilience can be one of those buzz words in education. It is easy to talk about but trying to help vulnerable young people become more resilient can be more difficult than we imagine.
You present a young person with a ‘once in a lifetime’ opportunity, for example, an outward-bound course. However, when the day comes and the bus is ready to leave, he is nowhere to be found.
You worked all year to prepare your class for the transition to high school. One of your pupils, from a difficult home situation, refuses to attend the new school after the first week.
Is it possible that we underestimate the vulnerability of some children because we don’t get how profoundly trauma* impacts young people? In addition, our view of resilience is so culturally conditioned that we think of resilience too much in terms of an individual’s strengths, rather than recognizing the importance of the relationships that surround a young person. A ‘stand on your own two feet,’ individualistic notion of resilience may be very unhelpful.
A recent phone call to a foster parent reminded me that in many cases building resilience in young people does not go to plan. Several years ago, I began a piece of work with a high schooler, David (not his real name). I carefully planned the activities based on what I understood about resilience, but I missed the importance of long term relationships.
David’s teachers in high school were pulling their hair out. He was restless in class, found it difficult to focus, and often acted like a clown. During my first meeting with him, I quickly realized here was a young man who wasn’t going to sit and listen to me. We needed to do something active together. After playing badminton with him several times, I could see another side to him. Behind his constant fidgeting and impish grin, he was kind, gentle, and eager to please. I began to think about how I could use my relationship with him to help him reintegrate in to his school. He needed an opportunity to experience real success in something that he saw as being worthwhile. He needed a challenge; I needed to stop losing at badminton.
Risk, resilience, and attachment
Education can have a positive impact on resiliency. For example, schools provide opportunities for children to achieve a sense of mastery, the feeling that comes from doing something well. Young people also have the opportunity to explore different social roles that can help them build a more pro-social identity (7). However, for young people like David school often reminds them of failure, and they too easily become cast in the role of a trouble-maker.
David was at risk long before he started school. He was probably exposed to alcohol while in his mother’s womb. When we add up all of the risk factors in a young person’s life things may look pretty bleak, but even then we can underestimate a young person’s vulnerability. We don’t realize that risk factors interact in a way that is not just a simple one plus one. A risk factor, such as an insecure attachment, can have a disproportionate influence on how a child is impacted by other traumatic experiences (1, 2).
To some degree, all children are vulnerable; they all need adults that can help restore a sense of safety and control in a sometimes chaotic world. In this way, a secure attachment between child and caregiver mitigates the effects of trauma. However, the opposite is also true. A child who is insecurely attached may be more easily overwhelmed and unable to develop some of the core competencies, such as the capacity to self-regulate emotional states, that will help protect him against future adversity (3).
The cascading effects of a child’s early attachment experiences may explain why some young people are knocked back so hard by the stress, for example, of moving to a new school. They are like the house built on sand.
Resilience can be defined as “reduced vulnerability to environmental risk experiences, the overcoming of stress or adversity, or a relatively good outcome despite risk experiences” (4). However, it is a relative not absolute quality, for some children, like David, even partial recovery of wellbeing and resilience is important (5).
Finally, in planning my work with David I was aware that building resilience is accomplished not by the removal of all risk and stress, but in the careful managing of these within a supportive relationship (6). In addition, the path to resiliency can begin in one small part of a person’s life, even from a single opportunity or turning point.
Building resiliency: David’s story
David looked nervous as we waited outside the office. The door opened and I introduced him to the head teacher of a local primary school. “David is good at sports and he likes children. Could he volunteer once a week in one of your PE classes?”
Over the next couple of months, I watched a slow transformation take place. David was more focused and ready to listen to correction when things were not going so well. I think it was something about how the younger children showed their delight in having David volunteer in class that helped him change. He was doing something that he could see other people appreciated and valued. He wanted it to work. At the end of his 15 weeks, David planned a dance competition for the children.
The turning point
As the day approached, I sensed David’s increasing anxiety. I noticed small changes in his mood and behaviour; he became increasingly restless when meeting with me. On the day of the competition, David disappeared. Finally, I found him sitting at the back of a room in his high school, slouched all the way under the desk, in a class that he wasn’t even enrolled in.
“David, listen to me. I won’t let you fail. If you get up in front of the kids today and you forget what to say. I will be right there and help you.”
This was the “turning point” and success at this moment depended on my ability to reassure him and whether he could trust me. Most children learn when they are very young that adults can be trusted to help them when they are anxious and fearful. They grow up experiencing, not perfect, but good enough, sensitive, attuned caregiving. Many vulnerable young people haven’t developed this basic kind of confidence. As teachers, it is where we can provide what Louise Bomber calls second chance learning (8). If we have done the work of building a relationship, a young person has the opportunity to learn something they missed earlier in their development.
The dance competition was a great success, and the pupils gave David a thank-you card. As he took the card, I watched the expression on his face. He laughed at the drawing the children had made of him, and read each of their names printed on the back of the card.
Later as we talked about his volunteer work, David could see how his decisions had contributed to its success. He found a sense of his own agency; he was able to bring about something positive in his life. His foster carer remarked, “He is taking more responsibility for himself. He was getting excluded and was depressed. He’s happier and is in school full-time.” David went on to apply to a local college to study sport’s coaching.
I wish I could end the story there. A few weeks ago, I spoke to David’s foster mum. She told me that after leaving school, he had gone back to his birth family, and he was now living as a drug addict.
It breaks my heart to think of David, now in his early twenties, alone and struggling with addiction. I prefer to remember him as the energetic 15-year old that wouldn’t sit still and beat me almost every time at badminton.
We must stop thinking about resilience as something we do to fix young people; it is not an event or an activity alone that makes the difference. In addition, the onus should not be on the young person to change but on the school, family, and community. Perhaps we should stop thinking about resilience in terms of the individual. We should be asking how resilient-building is our school? How do the relationships in a family that is fostering or adopting contribute to the child’s resilience?
We are only ever as resilient as we are connected to those who love and nurture us and that is as true for adults as it is for children.
* Relational trauma describes the experience of chronic and prolonged traumatic events, usually of an interpersonal nature, beginning in early childhood. These experiences usually occur within the child’s caregiving system and have profound developmental effects on a child (3). Typically, children feel overwhelmed and powerless, and often remain confused as to the role of adults more generally.
1. Luthar SS, Sawyer JA, Brown PJ. Conceptual issues in studies of resilience: past, present, and future research. Annals of New your Academy of Sciences. 2006;1094: 105-115.
2. Masten AS, Cicchetti D. Developmental cascades. Development and Psychopathology. 2010; 22: 491-495.
3. Van der Kolk BA. Developmental trauma disorder: towards a rational diagnosis for children with complex trauma histories. Available from: http://www.traumacenter.org/products/pdf_files/preprint_dev_trauma_disorder.pdf [Accessed December 2016].
4. Rutter M. (2006). Implications of resilience concepts for scientific understanding. Annals of New York Academy of Sciences. 2006; 1094: 1-12.
5. Shofield G, Beek M. Risk and resilience in long term foster care. British Journal of Social Work. 2005; 35: 1-19.
6. Woodier D. Building resilience in looked after young people: a moral values approach. British Journal of Guidance and Counseling. 2011; 39; 259-282.
7. Gilligan R. Promoting Resilience: Supporting Children and Young People who are in Care, Adopted or in Need. London: BAAF; 2009.
8. Bomber L. Inside I’m Hurting: Practical Strategies for Supporting Children With Attachment Difficulties in Schools. London: Worth Publishing; 2007.
First published within ‘Understanding attachment helps teachers build resilience in young people’ www.saia.org.uk/blog January 2017
© 2017 David Woodier, Support Teacher, Inclusion Base, North Lanarkshire. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact.
🔊 Why Attachment Matters [click to listen to audio file of this interview]
In the following interview between Professor Helen Minnis from the University of Glasgow and David Woodier a teacher, adoptive parent and blogger for Scottish Attachment in Action, Helen speaks about 'Why Attachment Matters' to her. Themes emerging from the interview may well resonate with those living and working with children and young people who’ve had an adverse start in life.
How do we give children the gift of a safe haven?
… I can’t help feel I have been gifted,
Lifted out of darkness,
Carried by angels to a safe place,
A haven with four windows,
And a single door,
The most beautiful place in all the world,
With the most beautiful people to welcome me, … 1
How do we create a world that is safe for children who have suffered abuse and neglect? How do we help them thrive in relationships? The words above are from a poem of a child who was adopted. The question for those of us who live and work with children who have suffered maltreatment is, how to put what we know about attachment into action. In the following interview, Professor Helen Minnis talks about her passion for helping children and young people. She discusses a range of issues, from teenagers to new therapeutic approaches, and from brain development to helping children cope with separation and loss.
When did your interest in attachment begin?
I wanted to do psychiatry, but before I wanted to do psychiatry, I wanted to travel. I spoke to the head of Child and Adolescent Psychiatry at the Maudsley Hospital. I said, “I am going to Guatemala for a year to work in an orphanage. What would you suggest I think about?” He said, “You should think about attachment and attachment disorders,” and he gave me the draft of the psychiatric classification system for attachment disorders. That was where my interest was born. That draft talked about children who had been abused and neglected being indiscriminately friendly on the one hand, and on the other hand, some of them being withdrawn and failing to seek comfort. I arrived at the orphanage and saw that right in front of my face. I was literally covered in children under five. I couldn’t walk forward until I peeled their little hands off. I became passionately interested in attachment.
Is Scotland a nurturing place to grow up? Are children able to build healthy attachments here?
It is all relative. In terms of encouraging the public to think about attachment the Scottish Government is quite far ahead. I remember a few years ago there were billboards, paid for by the Scottish Government, of a big sponge and the words: This is Your Baby’s Brain. I also think we realize we have some really big problems, and one of the big problems is the way we treat our teenagers. I think we ignore them; we don't give them eye contact; and we don’t give them a role in society. There are some major things we could do to make Scotland a more nurturing place, but it is great to live and work in a country where that’s what we are aiming for.
When did you first become involved with the work of Scottish Attachment in Action and why does an organization like Scottish Attachment in Action need to exist?
I was involved from day one. We had the Attachment Reference Group in Glasgow for colleagues from different disciplines to come along and discuss attachment. Edwina Grant heard about what we were doing, and we organized a day when we brainstormed about what Scottish Attachment in Action should look like. It was an incredibly exciting day, because we discovered that although we were from such different disciplines, we were really talking the same language. We realized was there was a need for a common language about attachment particularly across front line services that work with children including police, teachers, and nursery nurses. There was a role for both training and advocacy. I think Scottish Attachment in Action tries to sit in that space. It is always going to be needed, because getting people to think about young children is tricky. It is very hard for adults to put themselves in the mind of a child, because it is a long time since we were children. I think it is something that needs to be a daily struggle.
A number of years ago, you looked at the mental health of a group of adopted children living in Scotland. What effect does nurturing care and a stable family life have on children who were maltreated early in life?
It makes all the difference. Adopted parents have known that. I remember being sharply told off many years ago because I used the term “natural parents” which was an old term people used to use for birth parents, and someone said, “Adopted parents are natural parents, because they have done the nurturing.” That is so true. A child comes into the world with their genetic hand of cards, and what happens to that genetic hand of cards depends so much on the nurturing they receive from their family. From the study of epigenetics, for example, we know that the environment that surrounds the child can modify the DNA. Nurturing from parents is so crucial.
If we were to look inside a child’s brain, that of a child who suffered maltreatment early in life. What are some of differences nurturing care can make?
We don’t know more than we do know. The brain is like an unexplored landscape. One of the reasons I am in child and adolescent mental health is because we know less about the brain than we know about the universe. We know that the frontal temporal lobe of the brain, the sticky-out bit at the forehead, is bigger in humans. That’s because we need more in terms of planning and social interaction. Children who suffered early neglect and maltreatment sometimes have problems with some of the functions particularly associated with that part of the brain. Nurturing care can help children inhibit some of their emotional responses. Learning to plug into other special people by being part of a family and having the world interpreted for you by your parents, older siblings, and gran etc. is really important.
There are some children who seem to resist connecting with that nurturing care. Is there anything to understand about how children build attachments that could help us reach out to these children?
One of the things we have become more interested in is faulty signaling. This is when neglected children, because of their early experience of neglect, have learned to manage their own world so they habitually don't reach out to parents and carers. They fundamentally don’t understand that parents and carers are there to help you, support you, and comfort you when you are stressed. John Bowlby, who developed attachment theory, described how right across species it is a profound instinct to reach out to your carers when you are, for example, stressed, frightened, or have a tummy ache. It is actually a really small minority of abused and neglected children who don’t reach out. These children are then missing out on huge swathes of normal development. One of the really fantastic things is that in about ninety-nine times out of a hundred if neglected children are placed in loving families early in life that lack of signaling disappears quite quickly. However, there is a tiny minority of children in which it doesn’t melt away. I don’t know if that has something to do with the constitution of the children themselves or whether it has to do with not having the opportunity to be placed in a loving family soon enough. There is a tiny minority of children who, even in teenage years and adulthood, just don’t get that they should be reaching out.
I have noticed that some children with difficult starts in life -- children who don’t seem to respond well to the nurturing care of a foster carer or adoptive parent -- appear to ‘sort things out’ during adolescence. Is there something going on developmentally, a kind of re-wiring of the brain, that allows a young person to see things in a different way?
We know there are two rapid periods of brain development in life, the first few months and years of life and then again in adolescence. In adolescence the axons of the brain -- the long connections between your brain cells -- are being ‘cladded’ with myelin sheaths. It is a bit like cavity wall insulation. This is not something I am an expert on, but I have heard it used to explain why a child who is quite articulate at nine years old seems to almost lose the power of speech when they reach twelve. There is a lot going on in the brain that they are concentrating on. It is recognized that it is a time of opportunity because there is so much plasticity, so much of an opportunity for change and new development in the brain. One of the things that always gives me hope is that we now know you can develop new brain cells even in old age. The brain is different than other organs in the body. When you are born, your heart looks like it looks when you are an adult; it is just a small version of what it will be when you grow up. That is not true of the brain. When you are born and then again in adolescence, the brain has a huge amount of sculpting to be done. It is also worth remembering that some people heal and recover even later than that. I have personal stories of adoptive children who have left home at the age of sixteen and said, “I am never going to darken your door again.” Then they turn up later. I have a family friend whose son came back at his adoptive mum’s seventieth birthday party. He had been in prison and was covered in tattoos from head to toe. Now he is a loved member of the family again. So, although you are right that there are opportunities in teenager years, there are later opportunities as well.
You have been piloting something called the New Orleans Intervention Model in Glasgow. Could you say something about what makes this model different to services-as-usual for children and families?
There are two big differences. One, it is an infant mental health model. The other difference is that it offers treatment to birth families so that it is not just an assessment model. It was developed by Professors Charles Zeanah and Julie Larrieu from Tulane University in New Orleans. For a long time in New Orleans, every child who came into foster care under the age of five was offered this model. It offers standardized, attachment-based assessments in each of their caregiving relationships. They also do interviews and questionnaires with the birth parents about their own experience of attachment and caregiving, and refer the birth parents for help. For example, if they have problems with substance misuse or domestic violence. That process takes about three months, and then there is a period of intensive treatment with the aim of changing the birth family’s relationships so they can get the child home. But if it doesn’t work within a time limit, then the child is recommended for adoption.
Has any aspect of the study surprised you?
We have learned a lot about the nature of our systems here in Glasgow and about the ways in which we inadvertently cause delays for children. I think it has a lot to do with our difficulties as adults in putting ourselves in the mind of a child. There are so many places through a child’s journey where adults from all sorts of professional backgrounds could have thought, ‘This is not right for this child, and we need to move this forward,’ but we don’t. It has been a surprise at what kind of a perennial, entrenched problem that is.
Would there be a benefit in Scotland if we follow the example of some parts of the US where foster carers are also recruited to become prospective adopters?
One of the things we have become interested in through this project is the nature of foster care. Mary Dozier from Delaware has talked about commitment in foster care and whether the commitment comes from the length of a foster placement or from the freedom foster carers are given by their manager to fall in love with the child. In the United States, foster carers usually join the register as adopters. The philosophy behind that is that foster carers are supposed to be totally child centered, to love and commit to the child and potentially be the child’s forever parent. But if the birth parents get their life back on track, then the foster carers will have to relinquish that child. Some people say to me that it must be awful for the foster carer, but can you imagine that is generally what we do to children. The system in the United States allows the adult to take the hit rather than the child, and it seems to work well. Certainly in New Orleans it reduces delays. It means you are also not building in a loss for the child.
It is still a reality in the UK and in Scotland that children who are looked after are often moved around. They experience new foster parents, new schools, and new social workers. How do we help children who form multiple attachments? For example, should a child who is adopted visit their previous foster carers? Should a young person who is unexpectedly moved to a new school over the summer holidays have an opportunity to say goodbye to his teacher at his old school?
Those are examples of attachment in action. They are examples of being child centered. In a family where there has not been disruption through abuse and neglect and placement moves, that is what you would do for your child. For various reasons at the age of four, my daughter had to move, and we made a goodbye cake and we visited everyone. That is what you do because you nurture your children’s attachments. It is about nurturing children’s attachments and recognizing that secure attachments can come from surprising places. A child who has had a difficult early start may have a secure attachment with someone like their teacher, and that has got to be recognized.
Some people are concerned that contact, for example, with a previous foster carer, will prolong a child’s sense of loss and that it might make it more difficult for a child to form an attachment to a new family.
Probably the most important thing is to try and tune into the child. Try and understand that a child is likely to be grieving. Children go through bereavement processes in the same way that adults do. Relationships shift for children, and that is not a reason to pretend they don’t exist. Once a child is placed with a forever family, and the child understands that they are in a family who are committing to them for the rest of their lives, contact with a previous foster family can be very positive. This is very different than the situation where you have, for example, quite a damaged birth parent. I am not suggesting all birth parents are damaged. But if, for example, you had a birth parent where the experience for the child visiting the birth parent is really traumatic, then that needs to be thought about in a child-centered way. Difficult decisions have to be made. Children should not be allowed to see people who may have a negative effect on the child’s development.
Children with attachment difficulties often struggle to get the right kind of support in their schools. Can you talk about some of the reasons for this? Is it because children with attachment issues often present a variety of difficulties, and that makes it harder to identify that there may be an underlying attachment issue?
I think there is a lot in that. Identification is a problem. Particularly if they have attachment disorders, children with attachment issues nearly always have other problems. That is confusing, not just for teachers, but also for parents and clinicians as well. We know something we didn’t know fifteen years ago, if children or adolescents have one mental health problem, they are more likely to have others. We used to say, for example, if you have ADHD, then it can’t be anxiety. We know now that wasn’t sensible at all. Children with ADHD are at higher risk, for example, of having problems with autism or vice versa. Children who experienced early neglect and abuse are at higher risk than the general population of having other neurodevelopmental problems. This is some data we have found, and other people have found this, too: children who have had early neglect and abuse and have mental health problems often have complex neurodevelopmental problems. How these problems can be identified in school is really difficult. On the plus side, educational psychologists in Scotland are on the ball with this. I think they have led the way in thinking about attachment in schools and helping teaching staff think about attachment.
We are in the process of trying to develop something called the School Attachment Monitor, SAM. In the last six months, I have been working with Stephen Brewster and Allessandro Vinciarelli from Glasgow University School of Computing Science. SAM will be like a computerized version of the Manchester Child Attachment Story Task. If it works it will be automatically rated which means that it can be used in schools and we can look at the profile of attachment in children in the classroom.
I have heard carers, adoptive parents, and social workers express frustration with the mental health services available for young people in Scotland. Is there a mismatch between the needs of our children and what is offered to families? Is there something we can do about that?
Sometimes it is a problem of not recognizing the complexity of problems children experience when they have been maltreated. I have a lot of sympathy for my colleagues. Many do recognize the complexity, but I think we have all been on a really steep learning curve. We have done some research recently that suggested the direction of travel may not be what we thought it was. We know that a lot of ADHD has genetic causes, but I had always thought another route into ADHD was maltreatment. From some of the data we got recently, it is starting to look as though it might be the other way round. Children with some of these neurodevelopmental problems, in families that are already struggling, might be more likely to be maltreated. Therefore, in a sense, many maltreated children have a double whammy. This is new information for child and adolescent mental health services. In the past, we used to see children who had been maltreated and think that it is no wonder they have conduct problems, problems with behaviour. In fact, we should be thinking we really need to assess these children carefully. They may have genetic loading towards some neurodevelopmental problems that are going to make them more difficult to look after in the first place, not that there is ever an excuse to maltreat a child. The understanding of the complexity of these children hasn’t been there in our profession, but we are getting there. The other big issue is there are not enough of us. There are far too few child and adolescent mental health clinicians. Something parents could do is lobby. My clinical colleagues are genuinely overwhelmed.
You have been looking at the feasibility of DDP -- dyadic developmental psychotherapy2-- as a treatment for maltreated children in the UK. What is it about DDP compared to other approaches that makes it worthwhile considering the relatively high financial cost?
I think it’s worth considering, because it is different to existing psychotherapeutic interventions for children who have experienced abuse and neglect in that it promotes what Mary Dozier calls ‘a gentle challenge.’ Old-fashioned psychotherapy is very much led by the child; the child leads what happens in the room and the psychotherapist follows. That is sensible for the great majority of children, but if you have children that don’t signal their needs, that kind of child-centred approach is maybe not going to be successful. What I like about DDP and what gives it potential is the idea of PACE: playfulness, acceptance, curiosity and empathy. The PACE stance is a bit more gently challenging; you are not letting the child get away with hiding under the table and not engaging in therapy. In a playful, accepting and curious way, you are going to be saying, “The things that happened to you in the past are probably what’s making you sit under the table, but you have these good parents here who are ready to give you a good snuggle, so come and experience the love that’s available for you.” It's more directive in a gentle way. We also know from our research that therapists who are using it are very enthusiastic. So I think it has a lot of potential and needs a trial.
What are the barriers to seeing a wider availability of DDP in the UK?
One of the things the NHS should be proud of is that we carefully review the evidence base for those interventions. We haven’t yet got a robust evidence base for DDP. We need randomized, controlled trials if it is going to be commissioned.
Over the last ten years, there has been a resurgence of interest in attachment. Training on attachment is popular; it has almost become a buzzword. But are we really putting attachment into action?
I think so. It is a bit of a double-edged sword. I was at a meeting in England a couple of years ago with lots of social workers and academics. I think I was the only child and adolescent psychiatrist. People were saying, “All this early years stuff and attachment stuff; it is kind of flavor of the month.” I was thinking “Sorry!” So there are, in some circles, people who don’t see the importance of it. But again, that is one of the reasons I am happy to be living and working in Scotland because we have developed a shared language. Scottish Attachment in Action has to be patted on the back for that. There are other groups working towards a much more nurturing place to live. For example, it is wonderful that in education we now have this idea of, ‘How Nurturing is Our School?’ This is not some kind of soft option or some wishy-washy place. If we are nurturing children, they can thrive, and they can do well emotionally, behaviourally, and in their attainment.
But isn’t there a problem that attachment can remain too theoretical and abstract? Our understanding of attachment still does not make enough of a difference in how we make decisions; for example, in the way we work with a child who is being disruptive in school and being threatened with exclusion. Are we underestimating the difficulty of how to put what we know about attachment into practice?
There is a problem: attachment has been very laboratory based. The measures recommended for use in clinics are too cumbersome. For example, the gold standard measure for attachment in young infants is the Strange Situation Procedure3. I think that is probably the most important scientific advance in the twentieth century. However, it takes two or three people about twenty minutes to actually do it, and that is not including the set-up time and the hour and half to rate it. It is not feasible in the NHS. That is one of the reasons we are trying to develop better tools like SAM. We want to develop things that are quick and easy. In terms of intervening with children in schools and families, it is about trying to translate the learning from research into practice. Things like ‘How Nurturing is Our School’ are phenomenally important because teachers who understand the roots of children’s behaviours are going to change the ethos of the classroom. I wouldn’t underestimate the importance of talking about attachment. We have to keep harping on about it. This is not flavour of the month. Attachment is a fundamental instinct that allows children and young people to plug into what they need for their development, and there is a reciprocal caregiving instinct in adults to respond to that. That is the glue that holds our society together.
We welcome responses to the kinds of issues Helen raises in the interview. We plan to edit these responses and put them on the Scottish Attachment in Action website to give us a bigger picture of how we are putting attachment into action.
Following on from this interview, the next recording will be David speaking with our Chair of Trustee's, Edwina Grant.
1. Ruairi, Life Story Collection: Poems after Adoption About Life Before Foster Care. Leicester UK: Ruairi; 2012. A link is available from http://drawingtheidealself.co.uk/drawingtheidealself/Downloads.html
2. DDP stands for Dyadic Developmental Psychotherapy. It is a therapy and parenting approach that uses what we know about attachment and trauma to help children and families with their relationships. Further information is available from http://ddpnetwork.org/uk/
3. The Strange Situation Procedure was developed by Mary Ainsworth and is used to assess the attachment relationships between young children and their caregivers. The child is observed while strangers and caregivers.
“Many of the most intense emotions arise during the formation of attachment relationships. The formation of a bond is described as falling in love … ”
John Bowlby in The Making and Breaking of Affectional Bonds.
I had been standing in the kitchen nervously wiping down already clean counters, when my son shouted from the living room to tell me they had arrived. For me It was a huge occasion, I was about to meet the child I hoped would become my new daughter, but for her it was just a visit to another foster family who would be looking after her for a few days. Even as I anticipated her arrival, the roots of the love a mother has for a daughter were forming, but it wasn’t straightforward.
Social workers had been telling Katie since she was six that they were looking to find her a family. Five years later, after living with temporary foster carers, they were still looking. This visit would give us an opportunity to meet Katie and begin the process of becoming her permanent foster family.
As I reached the front door a small figure jumped out of the car looked up at me over the top of her glasses and with an expression I would come to know so well, shouted, ‘Hiya, I’m here!’ My heart melted and I just wanted to scoop her up and give her a huge hug but I restrained myself. With an overly formal handshake, I introduced myself.
‘I’m Katie,’ she said cheerfully, ‘and I saw a house with lions just before we got here.’ I couldn’t think where there was a house with lions nearby, but I didn’t get a chance to ask any more questions as Katie’s foster family was just behind her and there was a flurry of introductions.
The rest of the visit passed with our children, their children, and Katie running in and out the garden playing and the adults drinking coffee. I managed to prize Katie away from the fun to take her upstairs and show her the room she would be using. I was planning to give it a fresh coat of paint, and I wanted to find out her favourite colour. I couldn’t tell her but I wanted this room to be hers.
❝While we all know that simply loving a child is not enough, it is certainly the best place to begin. Without it a child simply cannot thrive.❞
Anyone who has ever given birth will tell you that one of the many worries that comes along with pregnancy is the fear, ‘Will I love my baby when I see him or her?’ Fortunately, most new parents fall in love instantly when they meet the wee one or at the very least over the first few hectic sleep deprived days and weeks of life. What is much less understood is the process of starting to love a child who is not part of your family by birth. Very little is written about falling in love with an adopted child and even less about loving a fostered child. It sometimes feels like that word is taboo and does not usually figure in the children’s reports given to the potential adopter or carer. Perhaps every report should have a section asking ‘Who loves this child and whom does the child love?’ While we all know that simply loving a child is not enough, it is certainly the best place to begin. Without it a child simply cannot thrive.
Looking back on my initial dealings with Katie, I am sure that the process of starting to love her began with that first ‘Hiya’ and grew stronger even while I was decorating her room. My husband could see what was happening and reminded me several times that this was early days and many things might still prevent her joining our family. Despite all his warnings, I couldn’t help myself. I was falling in love with her.
She has now lived with us for several months, she is very much part of the family and I love her wholeheartedly. I do not begin to understand all the biological and psychological processes that have made this happen but I am grateful for them. Over the last few months, this determined, stoical, and immensely practical child has taught me many things. Most importantly, she has taught me the value of allowing myself to love, and how to be aware of my surroundings. I now know that the house at the top of our road has large stone lions in the garden and I had never noticed them. She saw them on her first visit. I saw a little girl that needed the love of a family.
Our thanks to foster carer Jane for her guest blog this month - 'Keeping it real' with the ending of an attachment.
I was sitting at the edge of the hall watching the toddlers playing when it happened. A small child ran up to my boy, grabbed the car he was playing with and gave him a hefty shove that left him sprawled on the floor. As he let out a long wail and his eyes searched for me among the ranks of adults at the edge of the room I had an overwhelming urge to retaliate and make the other child suffer and feel as badly as my wee one did at that point. However being a rational woman in my early forties with all my inhibitions intact I contented myself with giving the offending child a filthy look as I scooped up my wee one and sat him on my knee to comfort him and his wounded pride. Less than a minute passed before he wriggled off my knee and headed back into the fray while I was aware that my heart was still racing and I needed to calm the mother tiger that was raging inside. Anyone who has ever spent any amount of time with groups of toddlers will know they are a tough unforgiving bunch where survival of the fittest is the name of the game and the adults are merely there to act as referees and mop the tears but even so I was surprised by the strength of my reaction and the level of distress I had just experienced.
❝...by then the damage had been done and our family was completely smitten with him.❞
All of this is a very normal reaction for a securely attached mother and child but I was not Andrew’s mum and he was never going to be my son. Although I had first brought him home from the hospital as a tiny, scrawny week old baby, I had always known he was not my own and I was going to be sharing the parenting with his biological parents until they reached a point where they could have him home for good. However by the day of the toddler group incident he had lived with our family for nearly 18 months and despite having contact with his parents at least 3 times every week we weren’t anywhere closer to him going home. On the other hand, he had spent a busy 18 months making himself very much at home in our family, our lives and our hearts.
It would be a full year later before his future would be decided and he would move to live with his new adoptive family but by then the damage had been done and our family was, to the last gran, completely smitten with him.
I have four birth children and the youngest was just 4 years old and still at nursery when we were approved as foster carers and Andrew made his noisy appearance in our lives. My older children were used to having younger ones around and Robbie, my youngest was more than happy not to be the baby of the family any longer as he was now a big boy who would be going to school after the summer. The kids were happy that I was now working from home and could pick them and whatever friends were available to play after school. I loved looking after him and my own brood without the pressures of work and deadlines and the morning commute. It was a win win for all of us.
But two and a half years in I really wasn’t sure we were doing the right thing. By then Andrew had not seen his birth parents for nearly a year and it had been our family who had been there for the birthdays, the Christmases, and the holidays. We had been the ones who had cheered the first steps and it was us who had sat at his cot side through long, scary nights in hospital with a respiratory infection. He called me 'mum' and my husband 'dad', not because we used those terms with him, but because the others in the house did and he was one of the group. Given all this, you won't be surprised to know that we were all dreading the day when we would say goodbye and he would start his new life with his new family. The week of introduction went really well and everyone hit it off from the beginning. Andrew seemed to accept what was happening and all the preparatory talk about meeting mummy and daddy and the cat all seemed to be paying off and he coped really well with all the changes of that week. It is fair to say that he coped better than I did but I hid my tears until after the kids were in bed and tried to keep the tone positive. The adoptive couple were great and could see how much we loved him and how much we would miss him and there was plenty of talk about meeting up after the summer holidays and continuing to play a peripheral but significant part in his life. It was exactly what we needed to hear and we clung to those words in the days and weeks after he left.
❝we all experienced grief, but without any of the space or understanding that normally accompanies a significant loss.❞
Sadly, as often happens we did not meet up after the summer and when I met his new mum for a prearranged coffee she told me that he never talked about us and that she was sure that he had forgotten us. This was hard to hear and would have been more devastating if I had not spoken to a social worker who had visited Andrew in his new house the week before and been told that he had been using our names when playing with some of his new toys. That was a difficult summer for us as a family, we all experienced grief but without any of the space or understanding that normally accompanies a significant loss. For my children it was the first time they had experienced a loss on this scale and they all grieved in their own ways but suffice to say it took a huge toll on us. I've often wondered how both Andrew and his adoptive parents were feeling over this time, and how he was making sense of what had happened to him.
The most frustrating part of the business however was the lack of understanding from the new supervising social worker who had been assigned to us that summer. She couldn’t understand why we were still talking about Andrew weeks after he had left, she told us to move on it, was our role as foster carers to hand children on. This might be true but I have talked to many foster carers who have prepared children for adoption and all have struggled to say goodbye. I know one foster carer who has seen over 30 wee ones leave her care and she describes it as as painful now as it always has been. Foster carers are taught about the importance of attachment, they work hard to help children and young people form positive warmly attached relationships but sadly no one tells us how to turn off those feelings at the end of a placement.
The system spends a lot of time and effort keeping children in touch with family who have let them down. My question is why do we put so little energy into keeping them in touch with those who have picked them up and helped them back onto their feet? Children who been brought up in a loving and caring families are then told that they are no longer allowed contact with everyone they know as it is will upset them or destabilise the new placement. We no longer keep children in hospital with very limited visits from their parents and I cannot imagine that the government would arrange to evacuate children to the country to live with strangers in these more enlightened times as was done during World War II. Wouldn't it be more helpful if we acknowledged the grief and loss experienced by everyone when it comes to moving children to their new families?
As parents of teenagers with attachment difficulties, we may need an extraordinary sensitivity and resilience to stay connected and engaged with our children. It is something we can’t do on our own, and yet finding help for adopted teenagers and for those who are in foster care can be difficult. We see our children struggling, but we can’t get others to recognize they need help. Sometimes help comes in an unusual form, even from a couple of rabbits.
Have you ever had an experience like this? “Mr. Woodier, what you are describing about your daughter* sounds like any other fifteen-year old.”
I feel a wave of despair wash over me. Perhaps this teacher is just trying to reassure me, but it has the opposite effect. My daughter is struggling. Why can’t the teachers hear what I am trying to say? I have been trying to get them to understand for years.
In my experience, parenting an adopted teenager is different. I have four children, and my youngest is adopted. All four of them experienced the teen years differently. Although they all faced challenges growing up, my adopted daughter’s struggles are more intense. She gets knocked back harder by failure and rejection.
One of the most important things I learned as a youth worker, teacher, and parent is the importance of staying connected, of not letting my children become alienated during those turbulent years.
But that’s not so easy because good parenting is a two-way thing. Dan Hughes and Jonathan Baylin, authors of Brain Based Parenting, describe this as a kind of reciprocal relationship, “When a mother and her infant feel mutual joy in each other’s presence, the infant experiences herself as capable of eliciting Mom’s joy, and the mother experiences herself as capable of eliciting her infant’s joy1.” Feeling I have helped my son with a problem or shared a joke with my daughter helps me stay positive, open, and engaged with my children especially when they are struggling. But too often, with my daughter, I am drawn into a conflict, and I am made to feel that I have nothing to offer.
In addition, when I was going through a difficult time with my sons, I could go back and remember what they were like before they became teenagers, the cute and cuddly years. But that is not so easy with my adopted daughter. It has never been easy for her to show love. There isn’t so much of a good ‘before teenager’ time to refer back to.
I try to imagine what life is like from my daughter’s perspective. She wants her friends to accept her, but she doesn’t want to stand out at school. She wants her parents to respect her as an adult, but she still hugs a teddy bear. She worries what the future will look like and whether she will pass her exams. She can’t stop thinking about a boy at school, but she lives in dread that he will find out she likes him. No wonder she seems stressed when she gets home from school.
So as a parent I have to work even harder to stay connected to my daughter. I don’t want her to feel alienated or alone. In order to do this, my daughter and I recently became bunny rabbit foster parents. (Yes, there is a charity in Scotland for homeless rabbits). The rabbits also come with strange names. I remember one particularly difficult day, and we were both upset. I said, “Come on. You hold Hey Diddle and I will hold Nuts in May.” We sat there in silence for a few minutes. As our stress levels dropped, we began to talk about the rabbits. The angry words were quickly forgotten and life looked more hopeful again.
Parenting my daughter takes every ounce of creativity, patience, and hopefulness I have and then some more. I hold on to every good moment because I know that somewhere in there is a young person who may just need a bit longer to sort out her life. When I get little back that helps me feel like I am a doing a good job as a parent, I need affirmation from friends and family.
So, on behalf of all those parents of troubled teenagers, we know you can’t fix everything, but don’t minimize what we are going through. We need as much help as we can get during this really important time in our children’s lives. Finally, I love my garden but if it helps me stay connected to a very special daughter, I am willing to share it with a couple of rabbits.
*My daughter has given me permission to publish these details. “Dad, none of my friends read your blog anyway.”
I am taking a break over the summer, but look for future blogs on why inclusion matters, how understanding attachment helps build resilience in young people, and an interview with Helen Minnis, Professor of Child and Adolescent Psychiatry at Glasgow University.
1. J. Baylin, and D. A. Hughes, Brain Based Parenting: The Neuroscience of Caregiving for Healthy Attachment (New York: W.W. Norton and Company, 2010).
Support teacher, North Lanarkshire
Helping children build secure attachments in the classroom can be lot harder than it looks. Attachment theory draws from many disciplines, and it is not easy to know where to start. In addition, teachers may wonder if all of this relationship stuff is part of their job description. Attunement is probably the best place to begin, but it takes know-how, time, and effort.
One of the key bits of work that allowed the theory of attachment to take off was the research of Mary Ainsworth. From her detailed observations of mothers and infants, she showed that infants become securely attached when their caregivers are in sync with them both physically and emotionally. This gives the child the experience of being met and understood. 
❝As a new teacher, I didn’t know where to start.❞
I learned the importance of attunement almost by chance in my first teaching job in Scotland. I wasn’t that anxious about meeting my new pupils, but maybe I should have been. I quickly found out that one ten-year-old boy in my class, David*, was in the midst of an emotional crisis. He had been placed recently with a foster carer, having suffered years of neglect and abuse from his mum.
I remember walking David back to class one day when he suddenly collapsed to the ground. It was as if his legs had been taken out from under him; he lay there sobbing. He had been looking forward to seeing his mum, but she hadn’t shown up again.
David’s difficulties in class were extremely challenging, and the only strategy I was given to help him was a point system in which he could earn or lose Golden Time (the Scottish equivalent of free time) each Friday. By Monday afternoon, David had already lost all of his Golden Time. When presented with work, he would tear it up and swear at me. When challenged, he would sometimes bite deeply into his arm or tear everything off the walls of the classroom. As a new teacher, I didn’t know where to start.
I remembered something from one of my lectures at university. Over the next two weeks, I wrote down descriptions of all of David’s challenging behaviours. I described his behaviours as if I was giving it to someone who had never met him. I focused on the detail of what each behaviour looked liked. For example, rather than saying, “He was disrespectful to adults,” I wrote, “He pointed his bum at me and smacked it!”
Little by little, David’s behaviour in school began to change. The meltdowns still came, but they didn’t last as long. I noticed when he was really upset, he didn’t want me to leave. After a couple of months, the head teacher came to me, “I am changing David’s risk assessment so he can go out of the school and play football with the team, as long as you go with him.”
What caused the improvement? Upon reflection, I realized that the only thing that had changed was something in me. I noticed that I could tell what kind of day David would have just by watching him walk into school in the morning. This awareness allowed me to fine-tune the work I was giving him. I made sure there was no mental maths on a day when he was anticipating a visit with his mum. I could tell when he was anxious or frightened.
❝Simply making observations was not enough.
I also had to learn to 'read' the behaviours
as cues in order to respond appropriately.❞
One day he came to me and said that the sink was broken in the toilets. Previously I would have ignored this and got on with the lesson, but I could see that it was causing him distress. He was pacing restlessly. He was worried that someone might get hurt. After that, each morning, before we began class, I would take him to look out the window, and reassure him that the plumbers that worked for Glasgow City Council were very good and would come soon. I also found myself feeling empathy towards him instead of being afraid of his anger and violent behaviour.
What made the difference in my classroom? David experienced what it was like to have an adult attuned to him. Mary Ainsworth defined this kind of sensitivity in the mothers she observed as, “the ability to perceive and to interpret accurately the signals and communications implicit in her infant’s behaviour, and given this understanding, to respond to them appropriately.” 
Simply making observations was not enough. I also had to learn to “read” the behaviours as cues in order to respond appropriately. I developed an awareness of David’s inner state, his thoughts and feelings, a mind-mindedness.
Attunement builds secure attachments when the supporting adult:
• Builds an extensive knowledge of a child through observation
• Is capable of perceiving things from the child’s point of view
• Responds in way that shows the adult is reading the behaviour as a “cue”
• Monitors the child’s response to ensure that the adult is reading the cue correctly
• Voices out loud what is going on in the child’s mind 
This isn’t something that only primary school teachers can learn to do. I remember when I was training to be a teacher, observing a teenager who looked like she was about to explode with anger. As the class approached the art room, the teacher was standing at the doorway. She was an older lady and small in stature. I remember thinking this could go badly. I held my breath.
As the rest of the class settled to work, the teacher, as if able to read some tell-tale signs, honed in on the one, angry teenager. She sat next to her and said in a quiet, chatty tone, “I was thinking about you and what you would need to finish your work. I have been saving these pens for you.” It was like watching a parent of a much younger child, arranging the materials on the desk and all the while chatting away. There was an almost palpable drop in the tension. I breathed again.
Becoming attuned is foundational in supporting a child with attachment difficulties. Many other kinds of support depend on at least one adult being able to “read” the young person. Attunement allows us to act quickly to help a child who is not coping, and to offer just the right kind of reassurance. Once we can read his or her cues, we can begin the work of helping a child become more self-aware and emotionally regulated. (This will be covered in more depth in a future blog.)
It is inevitable that there will be times when we get it wrong. We may miss a cue and leave the child feeling disconnected. However, having the sensitivity to repair the relationship is important; it is a vital part of the process of building secure attachments.
Over the years, I lost touch with David. However, seven years later, I was in a meeting with senior social workers and politicians from across Scotland. A group of young people presented a drama about the lives of looked after children. I couldn’t believe my eyes; there was David. Much taller and more confident, he performed flawlessly. Seeing David brought back some of my favourite memories of teaching: the look of surprise on his face and the sound of his laughter when I came into the classroom dressed up as a character from a story we were reading. I am grateful for David and all that he taught me.
* Names and identifying details have been changed to protect the privacy of individuals.
Better Practice by Building Attunement
1. Observe the young person and write detailed descriptions of their behaviours. Descriptions like, “He was disrespectful,” don't help us notice what the young person looks like. Our goal is to train ourselves to be able to recognize subtle differences in things like facial expression and tone of voice.
2. Don’t just observe behaviours that are challenging or distressed. Try to identify behaviours that show when he is settled, concentrating, happy, and relaxed. These are harder to notice because they may occur only infrequently.
3. Observe your own and others’ reactions to the young person. These can also be clues to how the child is feeling. As we become attuned to the young person, we will probably pick up on their feelings of rejection, shame, and hopelessness.
4. Prioritize those behaviours. Rather than which ones cause you most difficulty as a teacher, think about which behaviours make the young person more vulnerable. When I do this it helps me to have more empathy. I am not trying to change the young person because his behaviours make my life more difficult; rather, I need to think about how his behaviours are causing him to become isolated and cutting him off from the kinds of things that kids ought to be able to enjoy.
5. Use the questions in Louise Bomber’s book, Inside I’m Hurting. 
What makes his eyes sparkle?
What makes him fidget?
What makes him feel uncomfortable?
Which feelings does he try and avoid?
How does he cope with failure?
How does he respond to help?
What happens when there is tension of conflict in the room?
Edward Tronick’s ‘Still Face Experiment’ shows how sensitive children are to the loss of attunement: http://scienceblogs.com/thoughtfulanimal/2010/10/18/ed-tronick-and-the-still-face/
B.A. van der Kolk, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma (New York: Penguin, 2014), p. 107-124. In chapter seven, he explains the importance of emotional attunement and the benefits of secure attachments.
 B.A. van der Kolk, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma (New York: Penguin, 2014), p. 113.
 M. D. S. Ainsworth, S. M. Bell, and D. J. Stayton, “Infant–mother attachment and social development: Socialization as a product of reciprocal responsiveness to signals,” in The Introduction of the Child Into a Social World, ed. M. P. M. Richards. (London: Cambridge University Press,1974), 99-135.
 E. Meins, “Sensitive Attunement to Infants’ Internal States: Operationalizing the Construct of Mind-Mindedness,” Attachment & Human Development, 15:5-6, (2013): 524-544.
 L. M. Bomber, Inside I’m Hurting, Practical Strategies for Supporting Children with Attachment Difficulties in Schools. (London: Worth Publishing, 2007), p. 87.
(C) 2016, David Woodier. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact.
Support teacher, North Lanarkshire
How not to begin a lesson: understanding the behaviours of children with attachment difficulties
Sean* had been excluded from school and was sitting around in the children’s house. Although a bright kid, I was his only link to any formal education. Each week when we met, he had shown himself to be resourceful at finding something to control. Once when I read to him, I missed a word. Sean insisted that I re-read it from the beginning.
Sean showed signs of being traumatized by the chaotic experiences of growing up in a family in which there was domestic violence and drug abuse. I found it hard to imagine what it must have been like.
From an early age, Sean’s only survival strategy was probably his ability to predict what others were about to do and to manipulate the adults around him.
This time I had come prepared with what I thought would be an engaging activity. We would build a model eyeball and conduct some simple experiments.
Sean was hyper-vigilant. As I walked into the room, I felt his gaze scanning me from head to toe.
Right away he saw I was carrying something in my bag. As I took out the pieces of the model eyeball, he brought out his phone. “Here listen to this. There aren’t that many swear words.”
I tried to reengage him in the activity. “Haven’t you ever wondered how your eye works? I’ll help you build a model eyeball.”
❝Recognising what we don’t understand allows us to
take a different stance, one in which curiosity about
what underlies their behaviour replaces frustration.❞
Sean, who was already squirming on his chair, without warning threw up his arms and roared.
Sean was telling me that he could not tolerate the uncertainty of not knowing and not being in control.
My approach to introducing this activity was to assume that Sean, like most kids, would be motivated by curiosity, the thrill of discovering what makes something work. What I forgot was that Sean had never experienced the presence of a parent, a secure base who could moderate his anxiety when he was learning to explore his world as an infant. Sean’s roar was an expression of a primal defensive mechanism in the face of what felt like an overwhelming threat.
This example underlines several important principles for those of us who teach young people with attachment difficulties. First, we can’t always trust our own intuition about how children view learning.
Being able to recognize that some children’s beliefs, attitudes, and feelings are hard to discern sounds too obvious, but it is often overlooked. Recognizing what we don’t understand allows us to take a different stance, one in which curiosity about what underlies their behaviour replaces frustration.
Deep down, I believe Sean could discover that kind of inquisitiveness that propels most children to learn, but I needed to approach him differently. If I had realized that the underlying issues were more about trust and the need for control, then I could have allowed him some measure of control in the activity. “Sean, you have a choice today. You decide which to do the first, the maths quiz or a science project.”
In addition, we need to become intentional about 'learning' the child. For example, we should learn what the tell-tale signs are that he or she is not coping. We need to learn what works for each child, what helps them connect to or tolerate the presence of another human being. Sean enjoyed completing mental maths quizzes. The fact that the questions had straightforward answers and the quiz was timed probably gave him a sense of something predictable and controlled, and therefore safe.
Is part of our problem as teachers that we make too many assumptions about young people?
We make assumptions about their behaviour based on our own experience of life. Children with attachment difficulties need teachers who are more open-minded, who accept that there may be unexpected explanations for their behaviour. It is not a quick fix, but the curiosity and acceptance we give may be a starting point for some young people.
❝When I maintain that kind of curious stance,
I am better able to think about alternative
explanations for a young person’s behaviour.❞
Why it works:
Researchers know relatively little about the characteristics of teachers who are able to maintain supportive relationships with young people who have very challenging behaviours . However, we can learn some things from the research on parenting and attachment.
Parents who are able to raise kids who are securely attached tend to be better at mentalization.
This is the imaginative capacity to understand the kinds of beliefs, attitudes, and emotions that underlie one’s own and another person’s behaviour . Such parents are deeply interested in the thoughts and feelings of their children; they also recognize that their ability to truly know what is in their child’s mind is limited. They are good at perspective taking, understanding that their child may perceive shared experiences differently. As a result of this such parents, and maybe some teachers, are able to maintain what is called a curious stance. They resist the temptation of making assumptions about a young person’s behaviours.
Why this works for young people who have attachment difficulties is still, I think, a mystery.
Do young people feel less anxious? Do they sense a deeper commitment from such teachers?
Are teachers able to ‘learn’ the child and offer support before a young person becomes more agitated?
I know that when I maintain that kind of curious stance, I am better able to think about alternative explanations for a young person’s behaviour. That allows me to maintain empathy towards a child and reassure them when they feel overwhelmed and vulnerable.
* names and identifying details have been changed to protect the privacy of individuals.
Building Better Practice by Understanding Attachment
1. What kinds of behaviours in the classroom might be due to attachment difficulties and/or a history of abuse and neglect?
2. If you are teaching a young person with challenging behaviours, what assumptions are you making about what motivates their behaviour?
3. If you think about behaviour as a form of communication, what is he or she actually telling you?
4. How would an understanding of attachment and trauma change your practice? How would it change your priorities in the classroom?
1. Centre for Excellence for Looked After Children in Scotland. “Unit 06c: Understanding attachment, Helen Minnis: Mental health.” wecanandmustdobetter.org
This short video gives a succinct explanation of attachment
2. Centre for Excellence for Looked After Children in Scotland. “Unit 07a: Understanding trauma and loss, Helen Minnis: Trauma and neglect.” wecanandmustdobetter.org
This short video gives a succinct explanation of the trauma of neglect and abuse.
3. Geddes, H. (2006). Attachment in the Classroom: the links between children’s early experience, emotional well-being and performance in school. London: Worth Publishing.
Chapter 3 gives an outline of attachment theory and pages 76, 96, 114 include a summary of the impact insecure attachments can have on learning.
4. Geddes, H. & Hanko G. (2006) Behaviour and the Learning of Looked-After and Other Vulnerable Children. www.familieslink.co.uk/download/july07/Behaviour,%20attachment%20and%20communication.pdf
This paper looks at behaviour as a communication, attachment history and implications for behaviour and learning.
5. Golding, K. (2013). Observing Children with Attachment Difficulties in School: a Tool for Identifying and Supporting Emotional and Social Difficulities in Children Aged 5-11. London: Jessica Kingsley
Appendix 2 describes attachment theory and how children with insecure attachments may present in school.
6. Hertfordshire County Council. (2007). Working with Looked after or Adopted Children in School. CSF Publication 0046, Issue 1. www.hertsdirect.org/infobase/docs/pdfstore/csf0046.pdf
Check out the two-page poster that can help staff think about what might underly behaviours.
 Stacks, M. A., Wong, K., Dykehouse T. (2013). Teacher reflective functioning: a preliminary study of measurement and self-reported teaching behaviour. Reflective Practice: International and Multidisciplinary Perspectives, 14: 1-19.
 Ordway, M. R., Sadler, L. S., Dixon J., & Slade A. (2014). Parental reflective functioning: analysis and promotion of the concept for paediatric nursing. Journal of Clinical Nursing, 23: 3490-3500.
In my next article, I plan to share more about how understanding attachment helped me change my approach as a teacher...
(C) 2016, David Woodier. Permission granted to reproduce for personal and educational use only. Copyright notice must remain intact.
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