Saturday, September 4, 2010

Attachment Parenting in Foster and Adopted Children – Parenting to Help Heal Childhood Trauma

Parenting a child from an abusive background can be challenging, it requires parenting with a therapeutic point of view. That is to say parenting the child both in real time, and parenting with the specific intention of helping to heal the effects of trauma in the child’s history. You parent both the 10-year-old child of today, AND, for example, the child who at 5-years-old was traumatized by having been choked to unconsciousness over a period of years for having misspelled words on his tests. It’s unlikely that an abuser who is inflicting trauma on a child also sooths the child’s hurts and fears, so those hurts remain, no one cares for him, he doesn’t heal, you parent those hurts too, when they come up, and you have to be very tuned into the child in order to attend to him when they do.

Dr. Bruce Perry, a psychiatrist specializing in childhood trauma and author of the book “The Boy Who Was Raised As A Dog,” believes the child’s brain development is interrupted by trauma. The child’s body continues to mature, but the trauma halts the child’s emotional development at the point of the trauma, not completely, but in parts where the brain’s connections aren’t made via healthy secure attachment to parents, where a child isn’t held and comforted isn’t nurtured and loved. This has the effect of creating chaos in children from abusive or neglectful backgrounds. Think of the behavior of a baby or a toddler in a school age child and you begin to get the picture.

As the parent I have found it vital to keep in mind that a big part of my job is to help my child learn a new internal cause and effect dialogue. I’ve learned that brain development from birth to age five is foundational to our entire lives, and that healthy brain development requires consistent loving interpersonal relationships with others, primarily moms, but if the brain’s development is impaired in the early years, some areas can be improved, the brain’s connections can be healed to some extent, via loving interaction as a healing balm in the child’s life.

Generally speaking the earlier and more profound the abuse or neglect the more difficult it is for the child to heal, even with loving interpersonal relationships. Such are the difficulties of children institutionalized in orphanages or otherwise uncared for, not held, not played with, spoken to, rocked, touched, not nurtured, in a word, not mothered. The brain doesn’t develop as it should, and the child’s injuries are very real.

I’ve found two books particularly helpful in understanding brain development in early childhood. Each of these books focuses on the impact of trauma, abuse and neglect on developing children, but the information is both interesting and useful on a broader scale, especially for moms of young children. While I don’t believe it’s the author’s intent, each of these books makes the case for the value of motherhood in the strongest possible terms.

The first, mentioned earlier, is “The Boy Who Was Raised as a Dog,” by Bruce Perry. The second is “Building the Bonds of Attachment,” by Daniel Hughes. Dr. Perry’s book covers a series of case studies from his psychiatric practice working with abused and neglected children. His research focuses on the impact the child’s relational world has on his brain development. His cases involve children in whom the brain’s pathways are un-developed or under developed, and his work as a therapist focuses on interventions specifically designed for the parent to work with the child in these undeveloped areas. The idea is to parent the child at his developmental age rather than his chronological age under the premise that trauma interrupts brain development and the connections necessary for brain development didn’t happen as they would for a child who is parented by an attentive and attuned mother. Fortunately, some of these brain connections can be rewired, and Dr. Perry’s research suggests that attuned parenting, even in older children can help rebuild some of the brain’s missing connections.

Daniel Hughes book, Building the Bonds of Attachment is a fictional case study of one young girl. His narrative is based upon his work with children from abuse and neglect as well, and he walks the reader through this girl’s life from the time of her conception to her adoption as a school age child. The focus of his work is very similar to Dr. Perry, but less oriented toward explaining the development of the brain, and more focused toward the interrelatedness between parent and child, particularly from a therapeutic point of view. I have read and reread this book as we prepared to adopt an older child from foster care and again as we began to work through some of the issues that are a natural part of integrating an older child into our family. As I was seeking counseling for our family I was very specific in looking for a therapist with a background in Dr. Hughes methods. While there is some talking involved in this type of therapy, the focus is on the bond between parent and child rather than between therapist and patient. Dr. Hughes model is far broader than simply talking. It involves a lot of playfulness, touch, empathic listening, in short recognition of the child. Who the child is individually and what his life story is all about, and ultimately isn’t being know and loved by another one of the fondest desires of our human hearts? Ultimately isn’t this what Jesus offers us? Physical love, not just the words, but love in the whole messy business of daily living? He offers us his very body to eat for Pete’s sake, “You have given them bread from Heaven, containing in itself all delight”. But I digress.

All of this brain development business came home to me recently when I took our son to the eye doctor. We had been told that he had a “lazy” eye, and while he has glasses we’ve really only made him wear them when he’s driving. (We live in the country and well a kid needs to know how to drive on a farm don’t ya know.) When I asked specifically about his lazy eye the doctor told me that the eyes are making important connections with the brain in small children, and that if he had worn a patch over his stronger eye as a toddler his weaker eye would have been forced into making the connections in his brain and his vision would be equal in both eyes, but because he wasn’t his week eye is 20/400, or to put it another way he’s legally blind in one eye. The doctor told me that at his age it’s to late to go back and rewire the eye brain connection and that made me really sad, but I’m not sure I’m willing to accept his prognosis. If the brain can “re-wire” and make new connections via interpersonal relationships why couldn’t that work for an eye brain connection too. When I googled it up I found a study done in 2005 that showed improvements in 53% of children under the age of 12 who wore a patch to make the lazy eye work harder. Humm, I’m seeing a pirate in our future, maybe we’ll start calling him Patches. Poor kid.

Sts. Lucy and Odilia, please pray that Jesus heal my son’s eye completely. Amen.


Anonymous said...

Wonderful blog - thank you for sharing. About the eye, my daughter was diagnosed with this same condition at age 10 and was given a low chance of success, but we did eye drops to blur her good eye, and the patch at home. Her eye improved to the point of no longer needing glasses. It's absolutely worth a try! Good luck.

Katie said...

Very interesting post!

My 5 year old has to wear a "pirate patch" for an hour a day, she doesn't like it, but it does help her eyes!

Abigail said...

I'm now praying for better eye sight!