Presented by:Dr. Tami De Coteau, PhD

Licensed Clinical Psychologist

Office of Indian EducationMN Dept. of Education

Unique features of relationships of American Indians

parenting

American Indian Parenting Traditions

“A woman may give birth to many children. To all she gives food, care, and a place near her. To each she gives a portion of herself; to each she assigns a place in the household….A mother gives equally to all of her children, from first to last, from strong to weak. All are entitled to a place near her... Her gift does not diminish but increases and renews itself.”

- Basil Johnston

What is attachment? Interactive; Nonverbal communication

Attachment is a system in the brain that that develops to ensure infant safety and survival

The comfort, pleasure, and calm and balanced attuned interaction between the infant and caregiver creates a sense of safety within the infant

Secure attachment refers to the mutually attuned bond of trust between the primary caretaker and the child

Forms the basis for all future relationships; sense of self-worth; resilience to stress; ability to regulate own emotions; make sense of life; create meaningful connections with others

How does attachment form?Primary Intersubjectivity – Infant and parents discovery of

each other Person-to-Person relationship

Secondary Intersubjectivity – Infant’s discovery of the world (people, objects, and events) through experiencing the impact of the world on his parents

Person-to-Person-to-Object

Intersubjectivity – Awareness of shared perceptions and understandings that provide the foundation for social interaction

Intersubjectivity & AttunementShared Emotion

Infant feels receptive to and connected to his parent

He co-regulates his affective state with his parent’s affective state

He learns to regulate his own affective state

Intersubjectivity & Attunement Shared Attention & Shared Intention

Infant begins to reflect on his inner life of thought, affect and intention

Infant begins to reflect on the inner lives of his parents

He is able to co-create the meaning of the people, objects, and events in his life

Joint Attention

Joint Intention

How is attachment related to development?

Interactions with others (positive and negative) stimulates regions of the brain responsible for attachment

Communication patterns (verbal and nonverbal) influence the child’s mental process

Safe and secure communication is necessary to establish secure attachment

Establishes the basis on which the child will form relationships with others; his sense of security about exploring the world; his resilience to stress; his ability to balance his emotions, make sense of his life, and create meaningful interpersonal relationships in the future.

How does trauma and neglect affect the brain?

If the attachment region of the brain is not properly stimulated at the critical period of development, then that region and all other regions below and above it are affected 2005 Bruce Perry

The Human Brain

Activity Across Brain Regions

Brain Region Functions Critical Period

Experiences needed

Functional Maturity

Cortex Thinking, Planning,

Reasoning, Creativity, &

Sensory Integration

3 - 6 years Complex conversations,

social interactions,

exploration, safe, fed, secure

Adult

Limbic Emotion, Attachment Memory, &

Sensory Integration

1 - 4 years Complex movement, social

experience, narrative

Puberty

Diencephalon Sensory Motor & Sensory

Processing :

6 months - 2 years

Complex rhythmic

movement, simple narrative,

affection

Childhood

Brain Stem State Regulation & Sensory

Processing

In utero – 9 months

Rhythmic, patterned input,

engaged caregiving

Infancy

Brain Development Bottom Up – from primitive to most complex Brain development is sequential. More complex

systems are dependent on development of less complex systems.

For normal brain development to occur there must be specific patterns of activity at specific times during development = sensitive periods

Experiences (positive or negative) during sensitive periods organizes brain systems.

Therefore, trauma during early childhood can effect all future functional capabilities!

How does trauma and neglect affect attachment?Insecure attachments arise

from repeated experiences of failed emotional connection

Abuse; neglect; trauma; prolonged separation; multiple caregivers; maternal depression and/or substance addiction; lack of harmony between child and parent; inexperience mother with poor parenting skills

Insecure attachment is passed on from one generation to the next unless repair occurs

Insecure AttachmentAvoidant – Parent is unavailable or rejecting. Child adapts

by avoiding closeness and emotional connection

Ambivalent – Parents’ communication is inconsistent. The child cannot depend on the parent for attunement. He develops anxiety and feelings of insecurity

Disorganized – Child’s needs are ignored and parents behavior is a source of terror and disorientation. Child feels overwhelmed, frightened, and traumatized and attachment becomes disorganized and chaotic.Problems with regulation of emotions, social

communication, academic abilities, and severe emotional problems

How does attachment affect neurological state and vice versa?

Dysregulated Mother Dysregulated Infant

Depressed AnxiousStressedAvoids direct eye contactTunes outFrustration or anger

Up & down/unpredictable emotions

Cries Clench fistRigid body or arches backEyes shutShuts downAcceleration of the nervous

systemMixed withdrawn, clingy,

fearful

What is Reactive Attachment Disorder?

Mental Health Disorder; Severe Insecure Attachmentdefiance; manipulative or controlling patterns; little or no

conscience; frequent and intense anger outbursts; destructive to self, others, and property; gorging or hoarding food; and preoccupation with fire, blood, or violence

The child cannot form positive, lasting relationships

Often incorrectly diagnosed as several behavioral disturbance and ADHD

DSM 5“The prevalence of reactive attachment disorder is unknown, but the disorder is seen relatively rarely n clinical settings. The disorder has been found in young children exposed to severe neglect before being placed in foster care or raised in institutions. However, even in populations of severely neglected children, the disorder is uncommon, occurring in less than 10% of such children.”

How can attachment problems be repaired?Help the child & parent regulate their affect

Create safety

Focus on intersubjective experiences – shared emotion, shared attention, shared intention.

Provide empathy and curiosity

Respond to the child’s emotional needs

Provide structure and supervision

Restore harmony and order

Therapeutic Attachment Parentingby Daniel Hughes

P – PlayfulA – AcceptingC – CuriousE -Empathic

How can attachment problems be repaired?

CitationsKaren, R. 1998. Becoming Attached: First Relationships and How They

Shape Our Capacity to Love. Oxford Press, New York, NY. Perry, B. 2009. Examining Child Maltreatment Through a

Neurodevelopmental Lens: Clinical Applications of the Neurosequential Model of Therapeutics. Journal of Loss and Trauma, 14:240-255.

Trevarthen, Colwyn, & Kenneth J. Aitken. 2001. Infant Intersubjectivity: Research, Theory, and Clinical Applications. Journal of Child Psychology and Psychiatry 42, 3 – 48.