Adoption and Orphan Care in Poland – Part 2 of 2

First of all, happy Father’s Day to all. It is one of those “family” holidays I’ve avoided since losing my Casey. But I’m slowly emerging from the darkness, so that I can at least tolerate it. Life marches on, n’est pas?

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Now to Poland. I’ll start with a little travelogue because I’ve become fascinated with the country of my daughter’s birth. It is roughly the size and population of the State of California. It’s capital, Warsaw, sits at a latitude above Vancouver, Edmonton, Paris, London and Berlin, but south of Copenhagen, Oslo, Stockholm and Moscow. When we were there in 1991, it was suffering through a grueling transition from communism to capitalism, where the cost of living was roughly at parity with the West yet wages were stuck in the East. It was not a pretty picture.

Fast forward to 2013. Unemployment remains high at about 10%. It plans to join the Eurozone but still uses the Złoty. While much of Europe is mired in recession, Poland is growing, albeit modestly and, fortunately, it’s debt to GDP is a fairly benign 50%. So I’m rooting for Poland!

Onto orphan care. Some-of-Polands-thousands-of-war-orphans-at-the-Catholic-Orphanage-in-Lublin-on-September-11-1946-where-they-are-being-cared-for-by-the-Polish-Red-Cross.-Most-of-the-clothing-as-well-as-vitamins-and-medicines-are-provided-650x462After WWII, Poland was demolished and left with an estimated one million war orphans who made their way into the state Dom Dziecka system. Dom Dziecka (the c is soft) means “Children’s Home.” That’s where Casey ended up.

In the course of writing my book, I connected with a couple in Poland – Vic, a South African, and his Polish wife, a social worker named Joanna – who gave me an illuminating view of orphanage care in Poland. They run a charity called Agape-Trust.org. I encourage you to check them out.

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As we found in Mrągowo, the children’s basic needs were met – feeding, diapering and so on – but emotional needs were sorely lacking. In Casey’s orphanage I estimated that the orphan to caregiver ratio was roughly 10:1, not uncommon. What blew my mind, according to Vic, was that caregivers were trained NOT to bond with the children, even to the point of holding them face-away. It was considered unprofessional, much like a therapist-patient relationship. To make matters worse, as many as two thirds of the children in Casey’s orphanage were handicapped, so the caregivers’ top priority was protecting them from hurting themselves. The quiet ones, like Casey, were left on their own.

This system is changing, much like it did in the U.S. after WWII. Now with an estimated 25,000 orphans, the Dom Dzieckas are being phased out in favor of foster homes – smaller living units with better opportunities to form healthier relationships with caregivers. Foreign adoptions remain highly discouraged. Vic wrote to me recently about their work, something I always find fascinating. Here is his latest email.

We have registered our Polish charity, the Fundacja Dzieci w Rodzinie (Children in Families). We have been granted EU funds to run a series of workshops called “Creative Parents, creative Children.” This is aimed at disadvantaged families to help parents (mostly mothers) to broaden their vision and build self esteem.

Our focus is now on helping families in this area to prevent children ending up in the orphanage system. We still keep on with meetings for the orphanage children on Sunday afternoon/evening. Some of these children/teens will be the next generation of dysfunctional families. A few of the girls come out of the system already pregnant, and many are pregnant soon after leaving the system.

Unfortunately, young sociopath men have pathological radar that senses these vulnerable young women, and they have such low self esteem that they accept being abused. Even women with a good self esteem can be broken down if they are isolated from their family and friends by their abuser. These young women have no family worth that name and lack friends outside their depressive environment.

Lack of attachment is the primary reason we cannot connect properly with many of these children. Reading on your new website I found it very insightful the difference between bonding and attaching. We are hoping that we will be able to help some of these children, teens, and young adults about attachment with the help of animals.

We were given a couple of goats and bought a couple more. None of these goats were used to people. I tried to connect with these goats as an exercise by, as it turned out, attaching as opposed to bonding. It was done on the goats’ terms. It worked great, but of course these goats had been attached to their mothers, so I was building on something that was there already.

Well, we will see how this develops.

Good luck on finding a publisher. We will be praying for you.

Best regards,

Vic      

God bless you Vic and Joanna!

Adoption and Orphan Care In Poland – Part 1 of 2

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International adoptions have made headlines over the last few months with the cruel political gamesmanship going on in Russia right now. It’s nothing more than using orphaned children as pawns in a high stakes poker game with the United States.

A fellow adoption blogger in New York, Tina Traster, writes more extensively about the Russian ban on her blog, www.juliaandme.com. She and her husband adopted their daughter, Julia, from Siberia about a decade ago. If you are interested in this subject I urge you to visit her site.

I’d like to talk about Poland because that’s where we received Casey.

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Our international adoption journey began in 1990 when there were relatively few channels available – Latin America, South Korea and then Romania. Erika and I believed at the time that our adopted child would have a hard enough time with her identity and self-image – the standing in the checkout line at the Safeway test – so we figured Romania, a European country.

It was only by chance that we learned through the adoption grapevine that a couple in nearby New Haven, CT. (we were living outside of Hartford at the time) had adopted a 2-year-old girl from Poland. That seemed like nothing less than a moonshot to us. Erika was of Polish decent and still had family there. Thus became our journey to Poland, and the rest as they say is history.

International adoptions from Poland are very rare. During the first decade of this century, roughly 45,000 children were adopted from Russia and 69,000 from China. There were only about 1,000 from Poland. There are many reasons for this. First, by comparison to Russia or China, Poland’s population (some 30 million or so) is relatively small, about the size of Canada. It’s a deeply Catholic country with strict abortion laws. Children end up in the orphanage system for a variety of reasons – unwanted pregnancies, shame, a perceived handicap, family dysfunction, substance abuse, or even temporary room and board for some families financially strapped. Poland has worked very hard to find homes for children where they believe they belong – in Poland. Otherwise, they look beyond their borders. It was only through this loophole that we found Casey. She was perceived “special needs” because she was a weak preemie, but there was no data to back that up.

International adoptions have become a political hot potato with accusations of Westerners “stealing” children, bribing local officials with money. That wasn’t the case for us in Poland and for many, many other adoptive parents. But to be fair to all sides, these concerns are legitimate. After all, we’re supposed to be looking out for the best interest of the children. But that doesn’t sit well with an adoptive parent who’s bonded with nothing more than a photo of their (hopeful) child to be. Trust me, we’d been there. Midway through our process with Casey, we’d heard grumblings through our attorney in Warsaw that the Polish Parliament was considering putting the brakes on all foreign adoptions of Polish children. Erika and I went into an emotional meltdown, having bonded with Casey through just a photo and some fragments we’d heard about her. So I truly empathize with those adoptive parents of Russian children now caught in limbo. It’s a terrible place to be, as though your child and your hopes have died.

In Part 2 I’ll talk about what Poland is doing for its orphans.

Three Things I Learned About Adoptees That Surprised Me

Casey and DadBefore I get into this subject I want to acknowledge one writer who lamented my use of phrases like “adoptive” father and “adopted” child to describe myself and Casey, as opposed to simply “father” and “child.” She made a very good point. I use the “adoptive” qualifier here merely as a way to use key words and phrases to drive like minded folks to this blog. That’s all.

Never once did Erika, I or any of our family or friends ever refer to ourselves or Casey, or even think of ourselves, as anything other than a family like anyone else. As I’m sure any other adoptive parent would attest, it wasn’t a conscious effort to hide anything, but simply a matter of how we saw ourselves. There was never any second-guessing at any time over, “Gee, I wonder what it would’ve been like if we’d had a biological child.” Well, actually there was second-guessing. If we’d had a biological child, we never would have had Casey in our lives, a very chilling thought. She would’ve found another family – an American couple, or maybe British, French, German or Australian – for surely no one would’ve let this Polish beauty languish much longer in an orphanage.

But that’s speaking for us, not Casey. Being an adoptive parent is entirely different from being an adopted child. I always knew that Casey’s life experience had to be different from mine, so I never pretended to lump myself in the same boat with her. I just didn’t realize HOW different our respective boats were until after her death.

41492ZKA1YL._SY346_Nancy Newton Verrier, a prominent San Francisco Bay Area adoption therapist, adoptive mother and author of The Primal Wound, considered by many an adoption bible, provided astoundingly good – and painful – insight into the mind of an adoptee. Many of my thoughts come from her work and my interview with her.

So here are three things about adoptees that really surprised me.

imagesHuman babies (like Casey) are separated from their mothers at birth, yet puppies and kittens are allowed to bond with their mothers for several weeks before they’re allowed to be adopted from an animal shelter. In retrospect, this is so obvious, and yet it’s never discussed. Human babies are routinely separated from their mothers at birth, either heading to an adoptive family or an institution. How is it possible that we treat pets with more sensitivity than humans??

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Being loved by your adoptive parents is nothing compared to being abandoned by your birth parents. This too makes sense in retrospect. It’s that primal bond or attachment broken at birth that is not easily substituted by a replacement parent, no matter how loving and attuned they may be to the child’s needs. This leads to my third thing.

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It’s almost impossible for an adoptee to NOT think about their birth parents, at least on some level. I’ll explain by example. Despite our repeated prompts, Casey claimed never to have the slightest interest in knowing anything about her birth mother. Perhaps she thought of her as some kind of low-life loser. I’d heard this from other adoptees as well. We took Casey at her word. When I spoke to Dr. Ray Kinney, an adoptive father and therapist featured in the PBS series, This Emotional Life, about this, he asked, “Did you believe her?” It never occurred to me to even challenge her.

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In his book, Being Adopted, Dr. David Brodzinsky writes at length about the adoptee’s thoughts about the birth parents. In short, it’s almost impossible to have gone through such a traumatic separation and NOT think about the key people who brought life to you yet couldn’t keep you. Why not? After all, even homeless people cling to their children. And what if (like Casey) the birth mother had other children? Even if Casey had a charmed life in California, wouldn’t she wonder why it was her that her mother in rural Giżycko parted with and not the others? What was wrong with her? And sadly, I think that had to feed into her self-loathing, even in a way that Casey couldn’t understand.

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Unfortunately, for me this is now all speculation. 

What I’ve Heard From Other Parents

Before I get into this I want to emphasize two things: 1) I’m not a professional but a reasonably well educated layman and 2) I don’t paint all adoptees or other children who’ve suffered abuse or neglect with the same brush. I deal in degrees, nuance and probabilities.

There are many children who’ve overcome early deprivation to go on to lead very happy and productive lives. They have a healthy self-image and relationship with their families. But I do believe that their early experience leaves them more vulnerable to attachment related disorders and behaviors that can haunt them for years and rob them of the kind of fulfilling life they deserve. One professional I quote in my book believes that ALL adoptees should be treated as at-risk for attachment disorder and, at the very least, be evaluated by a trained professional early.

911While writing this book, I’d been continually frustrated in my efforts to shed a spotlight on attachment disorders with groups that would seem to be most interested – adoption groups. One foreign adoption coordinator essentially slammed the door in my face.

“I’ve facilitated many adoptions from foreign orphanages,” she wrote, “and I never had a problem with these children.” So either Erika and I were either unusually incompetent parents or we picked the rare short straw. Every other adoptee was well adjusted, happy and healthy. This opinion was echoed by one of this woman’s clients, whose adopted son had a similar early life to Casey’s. “So sorry for your loss,” his father wrote. “Our son is doing just fine.”

Could we really be that incompetent?

Then we connected with other adoptive parents whose stories mirrored ours and, I dare say, made our challenges with Casey seem like child’s play.

One mother wrote about her son delivered to an orphanage at five months old; he lived there for two years. His adoptive mother had unusual access to the orphanage, describing a clean, production line existence of almost ruthless efficiency. Bath time was like a car wash. Boys and girls – all under age five, lined up naked and crying – stepped into a tub where one caregiver soaped them up, one rinsed them down, one dried them off and another dressed them in pajamas. Potty training was a group activity with half nakedchildren learning the ropes while seated in a half circle on their potty seats. At mealtime, there weren’t enough hands to go around, so the kids learned to feed themselves. Though her son ate everything in front of him, he was nutritionally starved. When she offered him an apple, he ate everything, including the core, seeds and stem. At the time of her writing to me, he was an eight-year-old at the emotional level of a five-year-old. Though he had recovered from early developmental delays, he was still prone to meltdowns, anxiety attacks and struggles with self-esteem.

anger - 2A twenty-one year old girl I met with spoke about her birth to a prostitute; she believed her father was a client. She’d spent two and a half years in an orphanage before she was adopted. She was very close to her adoptive mother until middle school when she began to pull away, avoiding any kind of intimacy. In high school, their relationship deteriorated into screaming matches, power struggles and defiance. She remained externally stoic but admitted to low self-esteem that had led her to cutting, eating disorders, drugs and destructive relationships.

Another mother shared that her daughter was born to alcoholic parents, unschooled and neglected until she was placed for adoption at age seven. Her mother received her at age eleven with a range of challenges from growth deficiencies to language delays and learning disabilities. At the age of eighteen, she had the emotional maturity of a nine year old. Though delightful most of the time, her mother reported that the slightest provocation could send her daughter into a rage or sobbing fit. She could be sweet and charming to others but defiant and hateful to her mother. Left unsupervised, she was prone to risky behavior. She couldn’t be trusted on her own.

Yet another mother wrote that her son was given up shortly after birth, landing in a shabby orphanage that housed about two hundred fifty children. He was adopted at three and a half. There was no play area outside so the children remained indoors virtually twenty four-seven. With coal for heating expensive and scarce, it wasn’t unusual in the winter for the younger children to be confined to their cribs. Their diets consisted of lukewarm teas, soups, watery juice drinks, canned fruits and breads. Potty breaks amounted to sitting on chamber pots out in the open; diapers were non-existent. Years later at twenty-one, he was emotionally immature, prone to violent temper tantrums, depression and learning disabilities.

More stories emerged of teens and young adults suffering from early neglect. Depression, moodiness, self-mutilation, screaming fits, defiance and academic struggles were part of life. They left home and broke contact with their adoptive families. Job instability, unplanned pregnancies, suicide attempts and stints in disciplinary, rehab and psychiatric programs weren’t unusual.

The point of these vignettes is not to demonize foreign orphanages. Most do the best they can with woefully limited resources. Oftentimes their policies are well intentioned but misguided.

Despite the hardships of raising these children, their parents were clearly devoted to them. Through the chaos they’d found support. In numerous cases their children had been able to forge a life path with career aspirations, attending college and trade schools.

Most importantly, I never detected a sense of “buyer’s remorse,” although on extremely rare occasions there are “failed” adoptions. These parents had hope for their future. One mother, speaking about her troubled teenage daughter, echoed my own thoughts about Casey. “She has brought more love into my life than I ever thought possible.  She’s everything to me and I’ll do anything to protect her.”

Why Didn’t The Experts Catch It?

We sought answers from the experts, starting with Casey’s pediatrician, Dr. Johnston, when she was three. We went over her history in the orphanage, her astounding transformation from a quiet, weak, sickly infant to a spunky and spirited toddler. But the out-of-control tantrums and defiance worried us. What were we doing wrong?

Dr. Johnston couldn’t see any signs of trouble (perhaps Casey had worked her charms on the doctor). “Three-year-olds are still trying to get a handle on their emotions and are easily frustrated,” she said, “and Casey was a preemie. They tend to be hyper-sensitive.” She’d grow out of this. She was just a strong-willed child.

This same conversation played out over and over as we took Casey from one therapist to another – she was adorable but just strong willed. Spunky was a good thing! You just need to be tougher with her. Set boundaries. Be consistent.

Yeah, right.

Casey may have been playing all the therapists from the beginning until she announced that she wasn’t going back to therapy and we couldn’t make her. She was right. By then she was 15. We couldn’t slap ankle bracelets on her and throw her in the car. She said she’d call her lawyer if we did (as if).

Now in retrospect, I realize how right Casey had been all along. She called the therapists “idiots.” I’d call most of them ignorant, one professionally arrogant. They had all of the clues but ignored them, treating her instead like any other misbehaving kid without any understanding of where her behavior came from.

How could this have happened?

As I was to learn after Casey died, the effects of attachment disorders were known to a relatively small group of specialists, but they hadn’t made it into the mainstream. The Diagnostic and Statistical Manual of Mental Disorders (the diagnostic bible for therapists) covers hundreds of mental disorders but devotes a scant page or two to attachment. Interviews with adoption therapists revealed that attachment-related issues were given little if any coverage in master’s programs for social work, one prerequisite for therapeutic work.

Rutter_webIt wasn’t until the first wave of orphans from Romania and Russia had been studied over time that mental health experts began to understand the effects of early deprivation in children. One such study was the English and Romanian Adoptee Study in the 1990’s led by Professor Michael Rutter. It began to shed light on the devastating effects of abandonment and long-term institutionalization. According to this study (and much more I was to learn) Casey was at high risk for severe behavioral issues considering the dismal life she lived (despite the best of intentions) before we received her at 14 months. The fact that she was so “normal” most of the time is a testament to her will power, the “strong-will” that the clueless experts referred to.

Assessment! Assessment!

Write this on a blackboard 100 times.

Before I get into this subject, I need to acknowledge something personal. Today is May 3rd. My daughter Casey would’ve been 23 today. It’s one of the two toughest days of the year for me. I went to her memorial bench with her dog Igor to lay some tulips and a can of Diet Dr. Pepper, her favorite drink. Casey is the inspiration for this blog.

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Now back to assessment, and remember I speak as a layperson. This is the starting point for proper care. You can’t address the problem until you know what the problem is, whether it’s attachment, abuse, drugs, bipolar or any of the other hosts of disorders. So many times they all look alike, and often times confused with “normal” behavior.

Not one of the professionals we talked to about Casey suggested any kind of psychological assessment. It had to be a behavioral thing dealt with by discipline.

Hmm.

Ray_Kinney_2The importance of assessment struck me when I interviewed Dr. Ray Kinney, a Director and Staff Psychologist of Cornerstone Counseling in Wisconsin. I stumbled upon him while watching a PBS series called This Emotional Life where he was featured working with a teenage boy adopted from Russia. I was so moved by the program that I reached out to him online and he actually called me! We had a great hour-long conversation.

I learned that he and his wife were both therapists and parents of two adopted Russian children. As they tried to unravel their children’s unusual behaviors as professionals, it became their life work – helping others. This was a common theme I picked up from many of my interviewees – they were almost all adoptive parents or adoptees.

Dr. Kinney had spent over thirty-five years in clinical practice working with a wide range of abused and deprived children in the protective service and foster care systems. His cases numbered in the hundreds. He spoke to me not only about the importance of an accurate assessment but the ability to diagnose children who’d lived in orphanages beyond just attachment issues, a crucial prerequisite to determining an appropriate intervention strategy.

In addition to the effects of institutional deprivation, he claimed that these children might have also suffered abuse, malnutrition or in utero exposure to alcohol or drugs, any of which could have a profound impact on their ability to attach and trust. But an accurate diagnosis was too often compromised by the lack of training among mental health professionals. To the untrained eye, all of these disorders could look the same, resulting in inappropriate treatment.

He said: “All these things come together when you hold in your professional mind that you’re sitting with a child who has loss, deprivations, possible abuse, malnutrition, possible in utero exposure to alcohol or drugs, and how does that affect the child’s ability to attach and trust these parents?”

Hmm.

25 Signs Your Child May Have An Attachment Disorder

Trying to interpret behavioral signs in our children (or anyone for that manner) as a way of predicting potentially dangerous waters ahead can be an infuriating challenge for all but the most seasoned mental health professionals. That was certainly true for us.

Let’s face it. We as parents want our children to be “normal,” so we look for “normal” behavior, we see what we want to see, hear what we want to hear, don’t want to read anything unpleasant. We don’t want to believe that our children have a disorder that stigmatizes them. When Casey’s last therapist mentioned “attachment disorder” I locked onto the word “disorder” and rolled my eyes. Why did everyone have some convenient disorder?

To complicate matters further, many warning signs (whether for attachment issues, bipolar, suicidal tendencies, etc.) can look much like someone acting out in the moment – a toddler’s temper tantrum, a teenager’s defiance. I keep thinking about my friend – a prominent child psychiatrist – who lost his 17-year-old son to the Golden Gate Bridge. Like Casey, his son was set to graduate from high school and head off to an elite private college. If he couldn’t read the signs, how could I?

That doesn’t mean we shouldn’t try to be vigilant, no matter how imperfect the tools that we have to work with.

deborah_gray_00041_xwxvDeborah Grey is a prominent attachment therapist and author based in Seattle. In her 2002 book, Attaching in Adoption, she described a long list of common symptoms that cover the entire spectrum of attachment disorders:

1. Lack of impulse control, self-destructive behaviors, including cutting, eating disorder and other forms of self-harm. Intense displays of anger and rage.
2. Lack of trust in others.
3. Age-inappropriate emotional responses, like temper tantrums in teen years.
4. Marked mood swings.
5. Frequent defiance and opposition. No tolerance for limits or controls. Exploitative, manipulative, controlling, bossy.
6. Frequently sad, depressed, lonely, helpless.
7. Selectively superficial engagement and charm, such as being cool and unaffectionate to parents but charming or affectionate to others.
8. Destructive hyperactivity and destruction of property. Casey battered her bedroom door, stabbed her new IKEA desk with scissors and threw all of her keepsakes in the trash in a fit of rage.
9. Aggression toward others, particularly the parents. How many times had I heard Casey say “I hate you” or “I hate myself.”
10. Consistently irresponsible and forgetful.
11. Inappropriately demanding and clingy. This is a fairly common trait of many adoptees but we never saw it in Casey. She wanted (or claimed to want) independence.
12. Stealing, deceitfulness, lying, conning and manipulating.
13. Hoarding.
14. Inappropriate sexual conduct and attitudes.
15. Cruelty to animals.
16. Sleep disturbance.
17. Poor hygiene and cleanliness.
18. Preoccupation with fire, gore, evilness.
19. Persistent nonsense questions and incessant chatter.
20. Difficulty with novelty and change.
21. Lack of cause-and-effect thinking. Blames others for own mistakes.
22. Learning or language disorders.
23. Perception of self as victim.
24. Grandiose sense of self-importance.
25. Lack of purpose, spiritual faith or remorse (conscience).

Variations of Attachment

I refer to attachment disorders in the plural because they come in many forms and degrees. To confuse things further, reactive attachment disorder (RAD) and attachment disorder are often used interchangeably, at least to the layperson. In this post I’ll try to clarify things. Bear with me here.

Attachment disorder is a broad term used to describe mood, social and behavioral disorders arising from a failure to form normal attachments in early childhood.

Reactive attachment disorder (RAD) refers to a severe disorder affecting children characterized by markedly disturbed and developmentally inappropriate ways of relating socially in most contexts. It can take the form of a persistent failure to initiate or respond to most social interactions in a developmentally appropriate way.

Even after seeking clarification from interviews with experts, I failed to see much difference between the two, so I just stuck with the broad term attachment disorder to avoid confusion.

There are four main types of attachment:

1. Secure: The child uses its parents as a secure base from which to explore the world. If the parent leaves, the child becomes upset, but is happy and easily comforted when the parent returns.

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2. Anxious-ambivalent: The child explores little, preferring to remain close to the parents. He or she becomes highly upset when the parent leaves, and resists interaction with the parent upon his or her return.

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3. Anxious-avoidant: Similar to the anxious-resistant type, but the child does not appear to behave much differently around the parents than he or she would around strangers.

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4. Disorganized: For those children whose behavior cannot be described by the three main attachment types.

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There might even be a fifth type of attachment known as Oppositional Defiant Disorder, an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior.

What Is Attachment Disorder?

Casey Photos 1991-96_0032           Casey Photos 1991-96_0046

From that first night in Warsaw, we saw things in Casey that took us aback – the uncontrollable tantrums, primal-type screaming, near imperviousness to discipline and lack of coping skills, among other things that evolved as she grew older. But we saw them as nothing more than parenting and behavioral challenges because the vast majority of the time Casey was so absolutely delightful. These were mere distractions that could be dealt with by “proper” (i.e. strict) parenting and discipline.

How wrong we were and how little we knew!

Erika and I hadn’t even heard of the phrase “attachment disorder” until Casey’s third and last therapist brought it up in a debrief session to discuss her refusal to continue therapy. My initial reaction was dismissive – another convenient disorder, just like ADD, ADHD or OCD. Everybody has a disorder! But after getting so close to a proper – if possibly accidental – diagnosis, she veered off in a direction that she was convinced was at the root of Casey’s problems – pot. Indeed, Casey was a teenager who smoked pot just like I did, but that wasn’t the root cause of her problem. Without seeming blasé about teen drug use, I’ve never heard of pot smoking resulting in suicide. That’s straight out of the 1930’s movie Reefer Madness.

Attachment disorder was never again discussed, and the following year Casey was dead. When I revisited that phrase years later while writing my book, I was shocked. It explained everything.

So What Is Attachment Disorder (a/k/a reactive attachment disorder)?

hommedia.ashxThe disorder was an outgrowth of the work, beginning in the 1950’s, by British psychoanalyst, John Bowlby, considered by many the father of attachment theory. He was joined in his work by psychologist Mary Ainsworth. They believed that mental health and behavioral problems could be attributed to early childhood, suggesting that children come into the world biologically pre-programmed to form attachments with others, their form of survival. The main points of their theory are summarized below.

1. Though a child may have multiple attachments, she has an innate need for a primary bond to one main attachment figure, usually the mother. Any breakdown of this maternal attachment could lead to serious negative consequences. The child behaves in ways that elicit contact or proximity to the caregiver. When she experiences heightened arousal, she signals her caregiver (by crying, smiling, locomotion, etc.). Instinctively, caregivers, by creating a reciprocal pattern of interaction, instill in the child a sense of safety in her environment.

Mary-Ainsworth

2. A child should receive the continuous care of this single most important attachment figure for approximately the first two years of life. Bowlby claimed that mothering is almost useless if delayed until after two and a half to three years and, for most children, if delayed till after 12 months.

3. If the attachment figure is broken or disrupted during the critical two-year period the child can suffer irreversible long-term consequences, including delinquency, reduced intelligence, increased aggression, depression, affection-less psychopathy.

4. The child’s attachment relationship with their primary caregiver – the prototype for future relationships – leads to the development of an internal working model with three main features: (1) a model of others as being trustworthy, (2) a model of the self as valuable, and (3) a model of the self as effective when interacting with others.

Mother and Child watching each other

Mother and Child watching each other (Photo credit: Wikipedia)

Attachment disorders arise – simply put – when this primary attachment is broken or was never properly formed in those crucial first years of infancy. Wikipedia defines it broadly as a disorder of mood, behavior and social relationships arising from a failure to form normal attachments to primary care giving figures in early childhood, resulting in problematic social expectations and behaviors. Such a failure would result from unusual early experiences of neglect, abuse, abrupt separation from caregivers after about 6 months of age but before about three years of age, frequent change of caregivers or excessive numbers of caregivers, or lack of caregiver responsiveness to child communicative efforts.

We’ll discuss how attachment disorders can manifest in children in subsequent posts.