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Promoting Attachment through Play Therapy

Review by Heather Stephenson, MS, CMHC 

parents and children attachment reportOn April 26th the UAPT held a training in Orem on the subject of Attachment. The presenters were Colette Dawson-Loveless, LCSW, RPT and Marilee Woolstenhulme,CSW from the Greenhouse Center in Pleasant Grove.  The presentation started with a quick review of John Bowlby’s contributions to attachment theory followed by the neurobiology of attachment.  Attendees of the conference learned that the first three years of a child’s life are critical as this is the window of time in which the neurons of the brain are organized. A parent’s role is important in a child’s life as they are an integral part in the child learning to regulate his or her emotions.

Next, attendees learned about Dr. Vera Fahlberg’s Arousal/Relaxation Cycle and how that fits in with the four different attachment styles. Dr. Fahlberg explained attachment like this: Every child has needs such as safety, belonging, and esteem. When these needs are not being met by a caregiver, the child becomes stressed. They express this stress in various different ways in an attempt to get their needs met. When the need is met the child is then able to relax. When this cycle happens that smoothly the child forms a secure attachment and learns how to trust. When the cycle is interrupted the child forms one of three insecure attachment styles: Ambivalent, Avoidant, or Disorganized.

An ambivalent attachment is associated by inconsistently available, responsive parents. These children display behaviors such as being easily frustrated, whiney, not easily consoled, unable to problem solve, flipping between anger and helplessness. An Avoidant attachment is associated with parents that are emotionally unavailable, imperceptive, unresponsive, and rejecting. These children display behaviors such as a lack of self-awareness, resistance to physical and emotional contact, low emotional affect, hostility, aggressiveness, little moral reasoning, and engage in inappropriate self-soothing. Lastly, a Disorganized attachment is associated with parents who are frightening, disorienting, and alarming. These children are generally fearful or extremely anxious, confused, dissociate, have extreme sensory sensitivities, are highly unpredictable, can behave in bizarre or animal like ways, and are more likely to self-harm.

These attachment styles can be integrated into Dr. Fahlberg’s cycle discussed previously.  A child with an ambivalent attachment is stuck in the stress of expressing his or her needs. This child is always expressing the need but it’s never met. A child with an avoidant attachment has learned that expressing needs gets him or her nowhere. Instead this child has learned to bypass expressing the need and learns to meet his or her own needs. Many times their attempts to self-sooth are destructive in nature (ie. drugs, sex, pornography, and other addictions).  A disorganized child moves around the cycle. It’s difficult to place them in any area as their behaviors are unpredictable and constantly changing.

The rest of the training focused on the “The Big Four” roles of parents: structure, challenge, engagement, and nurture.  Structure refers to a parent’s ability to set rules, guidelines, and boundaries for a child. Challenge refers to a parent’s ability to provide age appropriate challenges aimed at promoting growth and independence. Engagement refers to the parent’s ability to provide fun, stimulation, and excitement. Nurture is the parent’s ability to give a child comfort, calming, warmth, and tenderness.  As professionals it becomes our job to help parents, or other primary caregivers, to strengthen their attachments with their children by teaching them about “The Big Four,” and helping to facilitate activities to strengthen the areas that a parent may be struggling or deficit in. The interventions shared at the training all incorporated the five senses as a means to strengthen attachment. If you would like to learn more about attachment and helpful activities to use with your clients, check out Theraplay: Helping parents and children build better relationships through attachment based play by Phyllis Booth and Ann Jernberg.