The Impact of Trauma and Abuse on Children’s Attachment and Development. Laverne Antrobus 10.2.16

Neglect Neglect is the ongoing failure to meet a child’s basic needs and is the most common form of abuse. A child may be left hungry or dirty, without adequate clothing, shelter, supervision, medical or health care. A child may be put in danger or not protected from physical or emotional harm They may not get the love, care and attention they need from their parents

A child who is neglected will often suffer from other abuse as well A child who is neglected will often suffer from other abuse as well. Neglect is dangerous and can cause , long-term damage – even death.

Lack of basic nurturing can lead to serious psychological problems Neglect is difficult to spot…usually because it is often the absence of something rather than the presence and relies on an individuals judgement. Lack of basic nurturing can lead to serious psychological problems E.g. Romanian orphanages The original medical meaning of the word trauma is literally a piercing of the skin, and we might think of psychological trauma as piercing of a psychic skin or membrane.

These infants could spend up to 20 hours a day in their cots unattended. Many showed serious cognitive impairment – much of which persisted in later years Others engaged in stereotypical or self stimulatory/soothing behaviours. Early neglect has been shown to lead to considerable deficits in IQ, affect brain development and general emotional development

Parents Neglectful/problematic parenting – where parents do not see/are not able to interpret the signals from their children Or see the signs and assume nothing is needed from them or are simply unable to find/provide a response

Attachment types – how experience shapes behaviour and belief Secure: distressed by separation; accepts comfort; recovers equilibrium Insecure – avoidant / anxious: little distress on separation; ignores parent on return; watchful and inhibited in play Insecure- ambivalent / resistant: high levels of distress on separation; not comforted by reunion; alternates between anger and clinging; inhibited in play Disorganised – confused / disturbed behaviour including ‘freezing’ Models of attachment are subject to change over time Based on responses to Ainsworth’s Strange Situation, published in 1978. Measures attachment between children 12-24m and caregivers. Mary Ainsworth. Research on mother-baby dyads in Uganda and USA in 60s and 70s. Attachment ‘species specific’ not culturally. Mary Main – Disorganised category added later

The purpose of attachment The experience of security (emotional and physical) is the goal of the attachment system Attachment can be viewed as an evolutionary survival strategy The child who is secure in their dependence on their carer can take steps to independence , safe in the knowledge they can retreat to the ‘secure base’ of their carer This has parallels in the processes of learning and exploring. What risks can be taken? What errors can be tolerated? Attachment disordered / disturbed – huge preoccupation to child – hard to focus on ‘learning’ in broadest sense. Child may seek to confirm expectations of adults behaviour – act provocatively and seek sadistic or punitive response.

Effect of Abuse/Trauma High stress levels Difficulty focusing and concentrating Problems regulating emotions A hyper alertness/vigilance making it difficult to relax Victims of abuse with no safe adult to rely can be seen responding in number of different ways -identifying with the abuser -becoming violent

Others may retreat or take up a dissociative state Numb like state Inability to use their emotions and bodily reactions to guide them to know about dangerous situations

Case Study 5 year old Early life spent in an orphanage Very little care and stimulation Lack of control of psychological and emotional state Insecure Attachments Assessment over 3 months

Your thoughts… Did the experience of being cared for/thought about help Our hope was that if she continued to receive care in this way some new ways of relating/attaching might be possible Healthier brain structure as a result of better experiences? Thoughts/Questions?

References NSPCC website ‘Nurturing Natures’ by Graham Music Child Headed Households – children under attack –state of mind that they can find themselves in and the sense of fear in everyone Families who are living with and with the impact of HIV Aids Orphanage that we visit that has children who have Fetal Alcohol Syndrome