When children are behaving in a reciprocal manner, they are open to learning. During the first two years of life, there are a number of opportunities for parents to teach children reciprocal behaviors. When toddlers test boundaries, they are still small enough to be picked up and placed out of harm's way. When they learn to crawl, and then to walk, mom and dad can coax them with lots of smiles and pizzazz. Children learn to trust that their needs will be taken care of. Eye contact, smiles, touch, and food are all part of the reciprocal bonding process.

On the surface, insisting on reciprocity can appear to be controlling and domineering. In fact, the reason for it is to enable the child to trust your authority and the environment.

Basic reciprocity consists of:

Coming when called
Sitting when asked
Respecting No
Going with a caretaker without complaining and arguing
Staying within set boundaries
Verbally responding to the existence of others

Attachment disordered children, for whatever reasons, did not have these opportunities, either because of abuse, neglect, chronic physical pain, or severe emotional problems (especially depression) in the mother. These children did not learn to trust that good things will happen. Hopefully we can give these children the chance to developmentally fill-in what they missed. This is accomplished through love, patience, and understanding on the part of adoptive/foster parents. The goal is to teach these children how to behave in a reciprocal manner. Because their bodies are larger, and they are more mobile, this can be a challenging course of action for adoptive/foster parents.

A starting place would be to have the child sit in a designated area (often called the "sitting spot"). The goal of sitting is not to degrade or control the child, but to teach the child self-control. In return, the adult must also engage in reciprocal behaviors, using appropriate verbal responses when asked a question or spoken to by the child. Modeling is a major piece of the reciprocity puzzle. We must mean what we say, and say what we mean. We must model what we are trying to teach the child. We must treat the child in a respectful and reciprocal manner if we wish the child to do the same with us.

During a two-week intensive, compliance with adult requests is stressed. Compliance is the beginning of reciprocity. The goal of therapeutic foster parents is not to bond with the child, but to help to create an opening in the child's wall of resistance so the child can attach to the adoptive/foster parents. In long-term care, a child is slowly weaned from strict compliance with the therapeutic parents so that the child can later attach to new parents. In either case, the primary goals are a healthy attachment relationship between parent(s) and child, and safety for the child and the community.

BOOK REVIEW

Life in the Trenches, by Paula Pickle

Living with a child with attachment disorder can be very stressful for families. Chronic stress changes families slowly and imperceptibly. Relationships are affected. Families need to become more aware of how stress is affecting them. Helping families to overcome the effects of chronic stress, and learn how to take care of themselves are the goals of this very helpful booklet. It's brief, but clear explanations of things families can do to help themselves survive the presence of an attachment disordered child will be greatly appreciated by many people. Get one for yourself, or for anyone you know who needs help to laugh and survive these very difficult children.

RESPITE RESOURCES

After a recent two-week intensive, creative placing parents found an excellent community resource for respite. They were unable to identify any families in their area who provided structured respite for their child, but they quickly asked their priest for ideas and he was happy to offer the area's convent. Their daughter, who is 15 and physically compliant, has spent several afternoons with the sisters, who fully appreciate her ability to work on specific projects. They provide a safe and structured environment, are pleased to have the free labor, and are not particularly involved in the psychological issues in her life. This is perfect!! Sandy's parents can trust that she will be given plenty of time to re-evaluate her choices and behaviors, while engaging in positive activities in a safe environment. It serves to de-escalate family battles, and serves the community at the same time (not to mention giving new meaning to the expression "get thee to a nunnery").

Any other creative ideas for respite/ relief care? Please write to us and share your ideas.

© The Attachment Center at Evergreen

Credits: Linda McKamey