Book review
“Facilitating Developmental Attachment” by Hughes. A
The book shares facts, patterns, and cases of how to facilitate Attachment through play therapy. The book starts by defining different patterns of healthy and weak attachment to how parents, therapists, and children play a role in facilitating the attachment. Play therapy is an intense, directive, and empathic approach.
Attachment can either be healthy or weak, distinguished from the patterns that the child displays in the presence or absence of the attached figure. All the child development aspects (physical, emotional, behavioral, cognitive, social, and neurological) are affected by the quality of this relationship. The attachment develops from birth up to 4years of age. Attachments develop through six stages. The concrete attachment, Homeostasis, is from 0-3months, refers to sensory experiences (relax/Alert). The second stage is the personal attachment from 0-7months, which refers to a child’s joyful and personal experiences with his mother. The third stage is Somatopsychological Differentiation from 3 to 10months when the child focuses, initiates, and responds purposefully to one figure. The fourth stage is behavioral organization from 9 to 18 months when the child shows a wide range of feelings and behaviors in an organized manner and can separate within acceptable limits. The fifth stage is the representational capacity from 18 to 30 months; when the child gains symbolic attachments, his language develops to express his wishes, emotions, and intentions to his mother. In the final stage, representational Differentiation from 24 to 48 months, symbols gained previously are used to separate self from non-self when the child can realize that others have their own set goals. The author suggests that this relationship should be full of attunement and vitality and allow the child to experience separation and shame to integrate the autonomous self with good and evil (Hughes,1997).
If the attachment is weak, the child faces challenges in three areas of development. In cognitive development, the child faces a delay in language as a result of a few reciprocal experiences. In addition to failure to understand cause and effect. In emotional development, the child develops anxiety, a limited range of expressions, poor frustration tolerance, passiveness, and repetition. In interpersonal development, the child manifests manipulation, aggression, lack of discrimination, poor coordination, demanding, clinging, ambivalence, and withdrawal. Caregivers fail to provide a secure attachment due to many reasons. Lack of social experiences, disregard for the needed proximity by the mother, delay in regulating child’s emotions, less touching, talking, and playing with the child. In addition, caregivers fail when they interpret crying as deviant behavior and resort to punishment or bribes to discipline their child’s behavior instead of consequences (Hughes,1997).
The therapist needs to be direct with the child, aware of the severity of forming attachment and the age and duration of neglect or abuse. The therapists’ main objective is to encourage the child to go through these stages of attachment with his new caregiver. The best approach Hughes suggested is directive and empathic to avoid the child’s intentions to manipulate the therapist. The process should be done persistently, patiently, and playfully to move the child out of terror, rage, and despair. The child needs to feel safe to express his feelings with the therapist and the new caregiver. The therapist needs to embrace the child’s feelings and resistance actions, for example, if the child closes his eyes therapist whispers in his ears. The sessions focus on the emotional richness that the child did not form earlier, through structuring, challenging, intruding, and nurturing experiences. The therapist needs to recognize the sequence of attachment the child didn’t form, in order for the child to develop a healthy sequence of shame and reunion and not interpretive shame as rejection and humiliation (Hughes,1997).
The therapists differentiate and integrate the process to apply in the three different setups (past, present, and future); only then the child is able to understand and adapt to display different behaviors. For example, allow the child to express his anger and meet it with empathy; he will feel accepted and build trust and learn that discipline is toward the behavior, not his thoughts, and feelings. These interventions need to be intensive to all the reactions of forming new attachment, which consists of cognitive, emotional, physical, and behavioral experiences (Hughes,1997).
A therapist needs to be aware of many factors that can measure the severity of weak attachment, like duration of abuse, alternative caregivers, and if the trauma occurred during primary or practicing stages of attachment. These factors can support the therapist and the fostering parents to facilitate attachment faster through a directive, and empathic sequence through four areas; First, past, present, and future. Second, cognitive. Third, self-other duality. Last, is problem-solving skills. The therapeutic interventions vary from verbal directives, touching, psychodrama, confrontations, education, and paradoxical interventions. Therapists may need to ask the child to shout out loud “I am feeling mad” or sometimes copy the child. The aim is to keep the child engaged and minimize his resistance (Hughes,1997).
Parents’ intervention plays a crucial role in forming attachment; they must provide the child with a great deal of empathy while being firm and accepting his behaviors. Sometimes it is required to allow the child to regress. Though it takes longer time and effort from the parents and therapist but helps the child to catch up with attachments patterns according to (Hughes,1997).
In conclusion, maladaptive behavior can result from a weak attachment and treatment following Hughes’s instructions and experiences. Therapists using Hughes’s instructions and experiences supported many children to feel secure and balanced, reflecting on the child’s autonomy and behavior. Discipline through consequences is powerful tool parents can apply to avoid power conflict and harm to the attachment relationship (Hughes,1997).
Reference:
Hughes. A (1997) Facilitating Developmental Attachment. US: Roman & littlefield publishers, Inc.
