Attachment and the Secure Base System SelfConfidenceExploration Felt

Attachment and the Secure Base System

Self-Confidence/Exploration Felt security Secure Base Caregiver’s Signal detection Safe Haven Perceived Threat Attachment System Signaling Proximity Seeking

The Effects of Secure Base �Repeated Secure-base interactions create internalized models of relationships that are carried forward to new relationship experiences �What to expect �How to behave

Secure Base Effects �Powerful influence on Neurobiology �Emotion-Regulation and Sensory Integration �Language Development �Executive skills— � Shifting � Monitoring � Labeling � Problem-solving

Healthy Neurobiology �Three interrelated systems �Thinking �Feeling �Relating/communicating �Working together in an integrated, goal-directed, collaborative fashion

Attachment Problems �Attachment Problems—failures in the secure base system result: �Defensive, maladaptive relationship models �Neurobiological failure �Neurocognitive deficits—lagging skills in: � Thinking � Feeling � Relating/communicating

Disruptive Behavior Disorders Most commonly referral to community mental health centers Includes: Attention Deficit Hyperactivity Disorder Oppositional Defiant Disorder Conduct Disorder Copy Right: /Sibcy, 2005 gsibcy@Liberty. edu

Oppositional Defiant Disorder �Symptoms �Temper tantrums �Arguing with adults �Questioning rules �Active defiance and refusal to comply with rule �Deliberate attempts to annoy �Touch and easily annoyed �Anger and resentment �Mean and hateful when upset �Spiteful attitude and revenge seeking

Complex Oppositional Defiant Disorder �Define the problem: �Meets criteria for ODD, Plus �Executive skill dysfunction �Emotion dysregulation—anger plus other emotions �Relationship disturbances, which includes attachment system �Highly resistant to traditional parenting practices

Severe Mood Dysregulation (SMD) �Distinguished from Classic Bipolar Disorder in Children (episodic irritability) �Abnormal baseline mood: irritable, anger, and/or sadness, noticeable to others & present most of time �Hyperarousal: insomnia, physical restlessness, distractibility, racing thoughts or flight of ideas, pressured speech, intrusiveness �Increased reactivity to emotional stimuli (temper outburst) at least 3 x/week

Differences in anger expression �Hand-grenade –ADHD/ODD combo only �Hurricane—SMD or BPD

Sameroff’s three R’s of intervention �Re-education �Redefine �Remediate

Re-education The Pyramid Self-Control Self Control Problem Solving Cognitive Flexibility Language Processing/Mindsight Social Skills Emotion Regulation

Redefine Motivation vs Skills Motivation Skills

Motivation Yes Adaptive Maladaptive (Family System) Maladaptive SMD/BPD Maladaptive Family + CODD with SMD Skills No No

Unmet Expectations And Compliance Interactions Preventing explosions while enhancing secure-base and neuro-cognitive skill development

Goals: 1. 2. 3. Take parent concerns seriously Take child concerns seriously Reduce Challenging Behaviors, especially Reduce Melt. Downs � � � 4. 5. Destructive child’s nervous system Conditioned Emotional Responses (CERs) Reinforces insecure relationship models (attachment) Work on Neuro-Cognitive Skills—Whole Brain Child Improve Secure Base

Using the Whole Brain �Left-Right Hemisphere �Brain Stem �Limbic System �Avoid Amygdala Hijacking �Septal Rages �Prefrontal Cortex

Secure Base Effects �Powerful influence on Neurobiology �Emotion-Regulation and Sensory Integration �Language Development �Executive skills— � Frustration tolerance � Shifting � Monitoring � Labeling � Problem-solving

Three Pathways Pathway A—forcing concern Compliance Interaction Pathway B—Working on Pyramid Pathway C—temporarily dropping concern

Three Pathways Compliance Interactions �Pathway A—Force Adult Concern � Advantages � Disadvantages �Pathway B—Collaborative Problem Solving � Advantages � Disadvantages �Pathway C—Temporarily Dropping Concern � Advantages � Disadvantages

Collaborative Problem Solving: �E—empathy— �A—Assert— �R—Respect— --------------�I—Invite-�C—Collaboration—

Empathy & Validation �Listening and understanding child concerns �Helping child articulate concerns what the concern �Taking concerns seriously �Empathy is a reciprocal process, so you may try to empathize but if the child does not believe you understand then you have not empathized

Assert—with limits �Define Problem, expressing concern or expectation �Don’t mistake your solutions for concerns or expectation �Appeal to rules as important principles to follow �“You can be angry but you can’t do…”

Regulation—keeping it safe �Work at monitoring and managing your own emotion regulation—if too upset, go to pathway C �Non-contingent respect �Never use disrespect as a form of punishment �Avoid global, negative attributions �Remain warm—avoid triggering CER’s

Invite �asking child to generate possible solutions �Avoid forcing solutions �Think out loud

Collaboration �Working with child to come up with workable solutions �Help child use foresight and hindsight �Model flexibility �Model regulation �Model respect �Maintain warmth

Qualities of Good Solutions �Mutually satisfactory �Do-able �Durable

Back to the pathways �When to use A �When to use C �Different kinds of C’s, some are better than others �Two kinds of B’s �Emergence �Proactive—timing is everything

Parenting and Mentalization �The use parent-child interaction questionnaire �Describe situation: beginning, middle, end �Describe behavior �Interpretations �Actual outcome �Desired outcome �Question: did you get DO? �Why? �Remediation Phase

Engaging the Repair Cycle �Turning conflict into learning