Clark Baim, a psychodrama psychotherapist and co-director of training provider Change Point Ltd, has developed Community Care Inform Adults‘ guide to using attachment theory to work with adults.
Here, we outline some of the top tips from Baim’s guide to help social workers understand and use attachment theory in your work. Community Care Inform subscribers can read the full article here and also listen to a webinar on the topic.
Attachment theory will be a familiar concept for social workers who work with children; a model to understand how early experiences of care influence a child’s strategies for gaining protection and comfort. But it may be less well known that the theory can also be of use to practitioners who work with adults.
Attachment strategies aren’t just used in childhood, but continue across the whole course of a person’s life. So if social workers can understand the strategies an adult is using, and the behaviours that can result from this, they can make assessments and plans that are more likely to help the person make changes and access support.
- From birth, infants display a range of instinctive behaviours to signal when they are hungry, tired, cold or otherwise distressed. They will cry, cling and reach out to a protective person, such as a parent or carer – their attachment figure. So attachment refers to a number of related processes: staying safe, seeking comfort, regulating proximity to the attachment figure, and seeking predictability.
- Patterns of attachment develop within the context of thousands of everyday interactions between an infant and their attachment figure. The infant’s attachment behaviour is their best solution for obtaining protection and comfort. The way their attachment figure – a parent or carer – responds or, crucially, does not respond to the infant’s distress creates a template. This template then regulates how the infant recognises and responds to their own emotions, and how they interact with their attachment figure.
- Early attachment patterns become deeply embedded in the neural pathways of the brain and the central nervous system. So our attachment strategies from childhood can profoundly affect our ability in adulthood to regulate our emotions in relationships – especially intimate and sexual relationships. So an adult who was abused as a child may not realise they are being harmed when abused as an adult. Or they may even find some safety in the predictability of the abuse. If the situation is predictable, at least they can organise a strategy to survive within it – a strategy proven to work by the fact that it has kept them alive so far.
- Attachment behaviours are adaptive to the context they are developed in. In childhood, they are what helps keep the infant alive. But later in life, if an adult is still using these same strategies and behaviours, they can become maladaptive and harmful. For example, a child who compulsively complies with the demands of an abusive parent is just doing their best to survive; their compliant behaviour is keeping them alive. But if in adult life they continue using the compulsively compliant strategy, they can easily be abused or exploited in relationships.
- As social workers, we must never think that we are “treating” a strategy or set of behaviours. We must recognise the value that strategy had in keeping a person alive when they were facing significant dangers. Our role is to help them over-applying that strategy in adult life, while also helping them add different strategies to their repertoire.
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Really..a psychodrama psychotherapist ?!
When and where will this desire to frame all human experience in terms of ‘attachment theory’ end?
This makes a lot of sense I never realised I was doing this! Because of my own experiences of childhood abuse. Now I know this I can begin to access help to change these behaviours.
People have different personalities, capacities (if they have a disability for example that affects cognitive processing) life experiences and their perspectives will be forged by a combination of all these factors.
One perspective (ours) is not necessarily more valid than another (the person we see as having problems).
There are limits to our own knowledge and capacity.
Mal-adapted coping behaviours meet needs.
Recognising the ‘why of things’ and what these needs are is key to changing problem behaviours but blaming parenting sensitivity (usually by mothers) for an adult’s difficulties is unfair and misguided. It risks playing into a narrative of ‘blame’ and ‘rescue’ that meets the needs of the person doing the ‘rescuing’ rather than the needs of the person being ‘rescued’.
That is my perspective and arrived at as a result of my own life experience!
Unfortunately we continue to forget that people with mental capacity for their actions must be given the opportunity to accept responsibility for such actions and any consequences. Attachment theory is fine but it is just a theory. People are still responsible for their own safety and have to abide by certain common norms.
Similarly past abuse should never be an excuse for the unacceptable behaviour exhibited by some people with Personality Disorders. We should seek out and vigorously prosecute the abusers but the victim have no right to hold the rest of society responsible. They can blame the rules and the system in society that creates an atmosphere for abuse to go unpunished but the way to respond to this is to work to change the rules and the system not exhibit behaviour that wastes scarce resources and puts others, including health and social care staff at risk.
What’s not to like in this application of attachment theory ? The irritable replies may suggest it’s an explanation that fits sufficiently but not completely
There is no NICE guidance as far as I’m aware that recommends assessing the effect of ‘parental sensitivity’ when working with adults.
When working with children what’s not to like about attachment theory if you have a statutory responsibility to provide expensive support to children in need or looked after children?
There is not nearly enough of the expensive personalised support that neurodisabled or neglected children may need and what there is requires superhuman persistence to access.
Attachment theory instead turns the focus away from poor provision to poor quality of caregiving.
Parenting classes based around ‘increasing parental sensitivity’ can be rolled out relatively cheaply
All the better if an army of ‘ trained key workers, social care workers, personal advisers and post-adoption support social workers in the care system, as well as workers involved with children and young people on the edge of care’ can recognise and assess attachment difficulties and parenting quality, including sensitivity”
NICE guidance
https://www.nice.org.uk/guidance/ng26/resources/childrens-attachment-attachment-in-children-and-young-people-who-are-adopted-from-care-in-care-or-at-high-risk-of-going-into-care-1837335256261
So what’s not to like –unless of course like me, your autistic child must enter care because there are no appropriate services for him or for us in the community.