2. Attachment in the Earliest Moments Causes of Missed Attachment The Brian & Trauma Attachment-related Behaviors

3. Eyes, Face, Voice, Touch, & Movement Baby rests Caring response Baby and Parent Play Baby Cries Baby calms, trusts

4. Connection Break Repair Adapted from Levy & Orlans, 1998 Eyes, Face, Voice, Touch, & Movement

5. Baby learns to sooth and manage self Baby cries louder Baby rests Parent does not respond, or responds inconsistently Baby loses trust Baby cries Parent withdraws or responds with anger

6. Circumstantial – Premature birth – Painful or undiagnosed illness or injury – Sudden separation from primary caregiver Neglect and Abuse – Pre- and post- natal maltreatment – Significantly inadequate or pathological caregiving – Physical, emotional abandonment by caregiver – Multiple placements Parents’ Attachment History

7. Through age three, a child experienced neglect and/or abuse. The child changed primary caregiver(s) at least once. The child struggles with relationships. Negative Thinking Bad, unlovable, unsafe, lacking trust Negative Thinking Bad, unlovable, unsafe, lacking trust Lashing Out Anger to prove how unlovable, expecting rejection Lashing Out Anger to prove how unlovable, expecting rejection Adult Responds Shame Confirmed Adult Responds Shame Confirmed

8. How Memories Form:

10. Natural Chemical Baseline Baseline Traumatic Event Alarm Reaction Baseline

11. Traumatic Event Alarm Reaction Natural Chemical Baseline

12. AdultInfant

13. Trust & Mistrust Trust & Mistrust – Infancy (Birth – 2) Autonomy & Shame Autonomy & Shame Toddlerhood (2-4) Initiative & Guilt Early School Age (5-7)

14. Self-Regulation – Shrieking – Large reactions to minor events – Head banging – Aggression toward others – Frequently defies rules (oppositional) – Lack of impulse control – Self-destructive behaviors

15. Self-Regulation – Intensely demanding & clingy – Sleep problems – Soiling pants – Destruction of property – Abnormal eating habits – Stealing – Deceitful (lying, conning) – Cruelty to animals

16. Self-Regulation – Extreme difficulty with transitions – Hyperactive – Lethargic – Nonsense “arguments” – Hoarding – Inappropriate sexual conduct & attitudes – Controlling

17. Cognitive Functioning – Learning disorders – Language disorders

18. Affect and Mood – Not affectionate on adults’ terms – Intense displays of anger (rage) – Marked mood changes – Intensely sad, depressed or helpless – Inappropriate emotional responses – Unresponsive and/or resistive to caregiver attempts at soothing

19. Relatedness – Overly friendly with strangers (non-parents) – Fearful of adults – Does not like to be touched – Acts as bully – Bullied by others – Lack of eye contact for closeness – Lack of/unstable peer relationships – Cannot tolerate limits and external control

20. Physical – Poor hygiene – Chronic body tension – Accident prone – High pain tolerance – Overreaction to minor injury – Tactilely defensive

21. Play – Developmentally regressed play – Bizarre play themes – Consistency of anger/violence in play