Fostering

Attachment

John Simmonds, Director of Policy, Research and Development at the British Association for Adoption and Fostering

What is attachment and why is it important?

Anybody who cares for young children cannot fail to notice their protest and distress at being separated from the adults they know and with whom they have an emotionally significant relationship. A small child’s protest at being separated is the best evidence you can get that they have an attachment relationship with that person. To become an attachment figure for a child results from their birth mother’s (although it may be the birth father or other family members) direct and sustained physical and emotional care of the child.

In 'normal’ development, this happens over the child’s first six or seven months. Although the exact way that this happens varies, the basic process is the same for all cultures in all parts of the world: specific adults make themselves available physically and emotionally to the baby, and from this developing intimacy arises a highly organised set of behaviours and feelings that are the attachment relationship. Each culture has evolved its own approach to this but the basic theme remains the same.

The purpose of a small child’s protest is to ensure that the attachment figure stays in close physical and emotional contact with the child when the child feels anxious or under threat. Small children do not have the physical or emotional resources to protect themselves or meet their needs. Attachment relationships therefore have a primary objective of ensuring the child’s survival. Making sure that an adult stays around who knows what you need and when you need it, and who can provide it, is an absolute necessity.

If the observable physical evidence of attachment behaviour is closeness to the attachment figure, the felt experience for the child is security, comfort and emotional warmth. The physical care of and interaction with the child is the most observable aspect of the attachment process, but the psychological processes are crucial and they are now known to have a direct impact on the developing brain. Attachment experiences can be thought of as core learning about the nature of relationships, some aspects of which are very resistant to change.

As children grow, it is clearly very important that they develop the capacity to tolerate separation from their attachment figures despite their protest. This will depend on the child’s confidence that the attachment figure will readily make themselves physically and emotionally available if the child should become confronted with a new or unusual event that they cannot manage. As the child develops, this confidence will become more pronounced and child will not only be able to tolerate longer periods of separation but their capacity to manage new events will become a source of excitement and learning. A young child’s distress at being left at a nursery for the first time will get easier as the days go by, so that for most children the anticipation will become a source of excitement although it may be tinged with trepidation if the child is feeling unwell or stressed by other events.

The processes underlying the development of attachment relationships, and research evidence of the longer-term impact of these relationships, have become a rich source for understanding child development. The have helped us understand that early relationship experiences are significant in the way that children come to think and feel about themselves and the way that they think and feel about other people. This also becomes the basis for the developing child’s (and later the adult’s) view of the world as interesting, exciting and responsive. An individual’s capacity to participate in cooperative, reciprocal, meaningful and intimate adult relationships will draw on these early experiences although inevitably they are reinforced or changed by new events. Relationships with friends, with partners, at work, with children of your own, depend on a number of factors. But the extent to which we can allow ourselves to engage with other people across a wide spectrum of activities will be influenced by the evolution of these early experiences over childhood and adolescence.

As attachment behaviour is rooted in the experience of seeking out a supportive attachment figure at times of stress, it is this dimension of subsequent relationships that is particularly important. Seeking out people we know and with whom we have an emotionally significant relationship at times of difficulty is something that most human beings do. The need for physical and emotional closeness with another human being when we feel stressed, frightened, overwhelmed, anxious or bereaved can be urgent at any age. The relief and comfort that can come from human contact when it is meaningful and works out well is obvious. It may literally be a matter of survival in some circumstances. In others, it may be a bridge to recovery from a difficult or traumatic event. This is so irrespective of age. Seeking the help and support of others is a life-long issue and an attachment framework helps us understand the processes that make it possible.

Patterns of attachment

Much of what is discussed above is readily observable in any family with small children, and the development of a method of measuring early attachment relationships in a controlled setting has helped to classify different patterns. The method involves exposing a small child to a number of three-minute episodes of separation from an attachment figure. Observations are then recorded of the child’s response to the separation and the reunion, and interaction with a stranger who comes into the room.

If the pattern described above were observed in the laboratory setting, this would be the basis for what is termed a 'secure’ pattern of attachment:

protest and distress at separation from attachment figure, leading to

seeking out the attachment figure on reunion, leading to

direct and appropriate levels of comfort and re-assurance from the attachment figure, which has the effect of

comforting the child, so that they can

resume playing with the toys in the room.

However, observations with some children and their attachment figures indicate a pattern that does not conform to this. It may be observed in any of the five sequences described above:

The child may not protest or show distress or show high levels of prolonged protest and distress.

The child may not seek out the attachment figure on reunion, or actively turn away from them.

The attachment figure may not comfort or reassure the child.

The child may not be comforted.

The child may not resume playing with the toys.

Careful observation and analysis of these sequences across large numbers of children have enabled researchers to classify patterns as follows:

A secure pattern where the child’s behaviour and emotion is organised to communicate the need for comfort and reassurance because the child has experienced and expects the attachment figure to respond sensitively and appropriately

An avoidant pattern where the child’s behaviour and emotion is organised not to communicate the need for comfort and reassurance because the child has learnt that the attachment figure is not likely to respond appropriately

An ambivalent pattern where the child’s behaviour is organised to have maximum impact on the attachment figure based on the child’s experience that the attachment figure inconsistently tunes in to the child’s emotional state and is experienced as insensitive and unavailable

A disorganised pattern where the child will have experienced the attachment figure as frightening, and perhaps a source of danger. The child will still try to turn to them for comfort; the act of doing so is full of physical and emotional risk so the child needs to try to protect itself at the same time.

There is now a large amount of research evidence about these patterns and in any given population the distribution will be about:

Secure pattern - 55%

Avoidant pattern - 23%

Ambivalent pattern - 8%

Disorganised pattern - 15%

To associate these patterns with normal and abnormal development is unhelpful. Instead, think of them as a child adapting to the relationship with their attachment figure and the circumstances they are in. Their physical and emotional behaviour is organised to get the best out of their attachment figure given their circumstances.

It is also important to remember that adults as attachment figures are also responding partly to their own personal history and partly to their social circumstances. Poverty and oppression do not make it easy to respond sensitively and attentively, although they do not preclude it for emotionally resilient adults.

What this suggests therefore is that rather than making judgements about normal and abnormal behaviour, the focus must be on maximising the opportunities for adults as attachment figures to learn how to understand consistently and respond sensitively and appropriately to children’s needs. While some people may respond readily to these opportunities, others may need specific programmes of work, including sustained professional help.

In some circumstances however, people may not be able to respond to such help at all. When this is the case, it is important not to underestimate the damaging consequences this will have for the child and the long-term impact this will have on their development. These are the circumstances where alternative plans for the child may need to be made.

Attachment and children - a summary

Babies and small children are developmentally dependant on the physical and emotional availability of the key adults who take care of them.

The intense and evolving relationship that results from this is key to the child’s trust of other people, their understanding of the nature of relationships and their feelings about themselves as valued, important and competent human beings.

Much of this process is 'natural’ although it takes considerable sustained physical and emotional energy, support from others and sometimes intervention when the adult/s find it a struggle.

When adults are not consistently and sensitively available to children as attachment figures, small children will develop psychological strategies to protect themselves. These strategies are necessary whether they are helpful or not. They are likely to have longer-term consequences for the child in the way that they make and sustain future relationships.

Where the unavailability of the attachment figure is severe because of factors such as significant substance misuse or mental health problems, the child’s need to protect himself or herself will become a powerful and dominant part of their identity.

When this happens, the child’s behaviour will demonstrate their fight for and need for a relationship that is enduring and meaningful, and at the same time their belief, based on experience, that this is never likely to happen.

Some children appear to give up on the idea that they will ever find something in other people that they find helpful. The emotional and behavioural strategies they use to protect themselves can also be strategies that put them most at risk of being rejected, being abused or developing serious mental health problems. These children are very difficult to help, and they are also very difficult to help as young people and adults.

Foster carers’ role

It will be clear from what has been written above that foster carers have a substantial and important role to play:

They will often be the first to see, hear and feel the protest and distress of the child who becomes 'looked after’.

They will need to comfort the child, try to make sense of what they feel and what they need and find ways of responding to this on an hourly and daily basis.

They will have to manage the daily separations involved in leaving one activity and going on the next, such as going to school, coming home from school, bedtime, bath time, and meal times. All of these activities may induce separation protest from the child.

They will need to introduce and establish a daily and weekly routine that the child comes to rely on as a source of security and predictability.

They will need to manage the process of reunion with birth parents and others on contact visits and the separation once the visit is over.

They will need to observe and feel the child’s patterns of responding to separation and reunion. This can be emotionally challenging, exhausting and upsetting.

They will need to understand how to make practical and emotional arrangements to ensure the child feels safe, is able to communicate and be listened to.

They may become a new attachment figure for the child, and this can happen irrespective of what is planned. It may also fail to happen where it is planned.

They will have the most direct experience of the child. What they think and experience will be very important to communicate to other professionals who may only have fleeting or intermittent contact.

Foster carers will need to understand:

the importance of the link between a child’s behaviour, emotions and development and their attachment relationships

the impact of attachment on children’s development from birth to adolescence.

the intensity and power of a small child in ordinary circumstances when they are 'in love’ with their attachment figures

that because a child does not show obvious feelings or behaviour at separation does not mean that the child does not feel it acutely

that some children, because of their early experiences, have very unpredictable and sometimes self-defeating strategies for getting help and support.

that what children learn from their early experiences may be very resistant to change irrespective of their skill, effort and commitment

how foster carers can develop a perspective on their own personal responses to separation and that inform their understanding of the child’s response

how to use information from professionals who have assessed the child and formed views about how to best help the child including the part that the foster carer can play

how to use photographs, objects, toys, play, discussion to help the child remember the people who are or were important

how to provide the child with a consistent daily routine

that even where children have been abused, they will have intense feelings towards their attachment figures and may still want to turn to them for comfort

that while most children come to have an attachment relationship with their birth mother and maybe birth father, other people may also become attachment figures, particularly grandparents or other family members

that children have many needs, which need to be thoroughly assessed, and the results shared with carers.

Social workers will need to:

understand the developmental importance of attachment relationships and their role in sustaining or re-creating them

understand the impact on children of separation and minimise this wherever possible

plan placement moves carefully including proper preparation of the child and the adults involved

help foster carers to understand and respond to the child’s separation protest and distress in a sensitive and thoughtful way

keep in close contact with foster carers to support them throughout the placement including listening when they talk about their own experiences of managing this

use foster carers’ observations of children’s separation protest and help-seeking strategies to inform assessments and make plans.