Have you ever wondered how the experiences you had as a baby shaped your personality as an adult? Can the patterns we form in relationships with our family be traced back to our angst-filled teen years, or did they start even earlier than that? The latest research tells us that experiences that occur even at that young age can permanently alter the structure and chemistry of the brain. What does this mean for families experiencing domestic violence?
We’ve talked before about the effects of domestic violence on children, and about the difficulties of parenting as a DV survivor. Lately we’ve been trying to think of ways to expand the services offered by our Child and Adolescent Therapy Program, which has historically served children between the ages of 3-18. Given what we know about the importance of experiences in infancy, we wanted to expand our services to children younger than 3, and their caregivers. We’re doing this through something called “Attachment Based Therapy,” which focuses on the bond between the child and caregiver, and how the trauma they have experienced can interfere with that bond.
Below, our Child and Adolescent Therapist Tiffany Clark talks about a conference she attended to learn more about this approach.
I recently went to a 10-day intensive training called The Circle of Security Approach to Assessment & Treatment, put on by Circle of Security. This training offered an overview of attachment based therapy as well as how to assess and treat those who could benefit from it. The first few days were spent covering basic attachment theory, which talks about how we are all relational beings, and how the degree to which we feel connected to our caregivers as infants makes a big difference in how we develop and move in the world. After that, the training quickly moved into applying what we had learned to case studies.
When I got there I was struck by how many other professionals are currently looking at the issue of infant-maternal health and the issue of attachment. I was also impressed by how easy it was to digest the material. I believe they designed it so it would be just as easy for the parents to learn about the subject as it is for professional therapists. I was also struck (yet not totally surprised) by the number of cases that fellow clinicians brought up that involved domestic violence.
The most interesting session I attended was one where we learned about assessing a caregiver’s “core sensitivities.” This means being able to recognize ways that a caregiver might be reacting to a child’s behavior and why. For example, if a toddler is showing signs of independence and wanting to explore the world, but their mom’s experiences have made her sensitive to separation or scared that the world is unsafe and feeling like the child needs to always be right with her, this type of assessment will shed light on that. It can help Mom realize that the child’s behavior is a normal stage of development and not a rejection, and help her develop an appropriate response to the signals her child is giving. When I ask the parent questions that reveal their state of mind more broadly, it helps us change our perspective from just looking at the child’s behavior in the moment as the problem. From there I can decide how to help.
I was struck by the lack of domestic violence knowledge among the other clinicians in the room. I was tempted to offer a “DV 101” session after one of the training days! It was interesting to hear the perspective of clinicians that are strictly child-centered in their approach versus our style which is more holistic and family-centered. Many of the other clinicians there came from child welfare agencies, trauma clinics, or some other place where their point of entry with a family is the child and the child’s behavior. Involving the parent or caregiver is one treatment option available to them, but at REACH we are often already working with the parent and aware of their trauma as well.
I am excited about the ways this training has already allowed me to expand my work with infants and caregivers. I’ve started using video-review as a part of the process, where after the initial intake I will record a free play session between the child and caregiver. This allows me to have some insight into the dynamics of the relationship. Who’s in control? Can the parent take cues from the child? How does the clean-up process go? Can the child regulate and self-soothe? Is the parent enjoying the child? Reviewing this with the parent gives me a way to highlight the good things I see and encourage them, as well as find things we want to work on. We’ll tape another session after a few months and be able to observe progress.
Special thanks to CHNA-18 for making it possible for us to attend this training!