1. Attachment What do we mean by attachment?

2. Bowlby’s Attachment Theory Bowlby generated a theory of attachment that has had enormous influence in contemporary developmental psychology According to Bowlby, infants are born with innate tendencies to seek direct contact with an adult (usually the mother). Bowlby said that attachment seeking is directed toward social contact with the mother, a desire for a loving relationship Over the years, the attachment theory has evolved

3. Kennell 1976 ‘An affectionate bond between two individuals that endures through space and time serves to join them emotionally’

4. Secure attachment Insecure attachment

5. How does attachment happen? The child’s needs are met Relief from discomfort Respond to child’s distresses Adult reaches out to the child, child responds Child and adult connect (reciprocity) Self esteem and self worth encouraged and developed.

6. Characteristics of secure attachment Baby Containment, reciprocity, responds to coos, smiles, body language, facial expressions, sooths and settles with care givers when upset. Toddler Seeks out adult in response to needs, feelings of safety and security, thrives with learning experiences, developing skills of interaction and socialisation School Age Experiences of predictability, knowledge and understanding of expectations of each other, develops a variation of communication skills, trust, responsive to ground rules Teenager Visibly confident, positive self esteem, ability to converse, ask and respond to instruction, awareness of safety, build on positive relationships.

7. If there is a secure attachment this will help the child to Attain his full intellectual potential Sort out what he perceives Think logically Develop social emotions – empathy Handle fear and worry Develop a conscience Become self reliant Cope with stress and frustration Develop future relationships Trust others Increase feelings of self worth (Vera I Fahlberg MD)

8. Insecure Attachment Avoidant Minimal or no warmth / greeting towards caregiver, makes little or no demands, no sign of pleasure with being with the adult, keeps away and moves away or mixes strategies of approach with avoidance, play is often inhibited, compliant self-sufficient. Disorganised Demanding and attention seeking, contradictory, behaviours can appear bizarre and extreme, stereotypical, and or fearful behaviours shown in adults presence, conflict, no peer relationships, poor impulse control. Ambivalent Unsure of adults intentions, hesitant to trust. Increase attachment behaviour, fretful, crying, clingy, lack of concentration, anger –need - conflict

9. Brain Development: Pre Birth The brain is actively responding to its environment from 2 months gestation

10. Brain Development: Post Birth First eight months of life brain stems are forming. The process during which each part of the brain takes on its particular functioning this goes on till the end of the first year Brain continues to develop till adolescence.

11. Baby’s first year Blood pressure, heart rate, body temperature Sleep, appetite Arousal, attachment, affiliation Motor regulation, sexual behaviour Concrete thought, abstract thought

12. Child’s first to second year Brain develops organisation of sensory stimuli into recognisable patterns Regulates motor activity Purposeful interaction with the world

13. Child’s first to fourth year Part of the brain called the limbic system forms Emotions, drive, behaviour and memory

14. Childhood & Adolescence Brain continues to develop Definition of personality, creativity, reason, humour, verbal competence, mathematical ability, artistic flair. Ability to integrate all of these into social relationships.

15. What are the barriers to healthy brain formation? Pre birth: injury to the developing foetus, toxic substances, drugs, alcohol, nicotine. pre natal malnutrition. The toxic effect of stress and trauma

16. What do we mean by Trauma ? ‘Intense fear, helplessness, loss of control, and fear of annihilation’ (Comprehensive Text Book of Psychiatry)

17. Physical affect of living in traumatic circumstances Positive attachment between child and carer does not happen, resulting in under development of the brain. The interconnections do not get made. Amygdale is the alarm centre of the brain Lays down a template of trauma Anything close to trauma triggers an alarm response Language centres in the cerebral cortex close down Full stress responses activates, flight fight or freeze Neurochemicals are released affecting the hippocampus Leads to distortions, memory distortions and lack of cohesive narrative of the trauma

18. Traumatised children check list Forgets large segments of childhood/Distorted memory Relative indifference to pain Unable to show empathy Unable to articulate / define effective states in regard to self and others/Deregulation of emotions Shows conflict and uneasiness in relation to intimacy/unable to trust/fear vulnerability and loss of control Re enactment of anger and aggression Self harm Self hypnosis, dissociation, depersonalisation Extreme emotional distancing Chronic sadness Persistent state of fear Denial in order to survive

19. As carers we can promote a positive environment for children in respite Provide activities suitable for the child’s age and stage of their development Baby – Feed using eye contact, facial expression and soothing language. If refusal to engage and baby turns it’s head away, use a mirror within the room for baby to focus on the image being seen. Use a sling for body contact often throughout the day, songs and rhyme’s using eye contact, touch and expressions. Toddler – Mirror action games, pretend face painting each other, fully clothed massage to reinforce positive touch, songs and rhymes using eye contact, actions and facial expressions, imaginative play. School age– Social stories, massage story on child’s back (mirror image) parallel play at colouring in / writing / language games, ways of giving children language to express feelings, imaginative play.