by Steve York

Think for a moment about holding an infant or small child. It could be your child, your grandchild, a niece, nephew, or neighbor. What was the experience like for you, an adult? You might have felt loved and needed. You may have felt strong and capable. Whatever you may have felt, most likely you felt "connected" to the child in some way. What do you suppose is the experience of the child? Feeling comforted and safe, nurtured and loved - somehow "connected" to the care giver.

Children who have been held regularly and have been otherwise nurtured by appropriate physical and verbal stimulation are able to trust, to love, and to form meaningful attachments to others. Conversely, children who are denied appropriate nurturing and who suffer abuse and neglect are often not able to form attachments to others and are at risk for developing Reactive Attachment Disorder.

Such children are unable to trust. They are generally oppositional and can be dangerous to themselves and others. These children are unable to give and receive affection in a healthy way. They lack cause and effect thinking and frequently do not develop a conscience. Being in control of everyone and everything is a learned survival technique and, as a result, they will not allow themselves to be parented.

It is a tragedy that some children will not receive the nurturing they need in the critical early months of life that helps them form attachments to others. But do we write such children off as lost causes? Can anything be done?

Attachment Therapy describes a wide range of therapeutic processes which may include inner child work, reparenting, cognitive restructuring, and psychodrama or role-play. Holding Therapy, as part of Attachment Therapy, describes a method of safe physical containment whereby the therapist cradles the child in his or her arms, much the same way you would hold a small infant. All of the primary components of bonding are present. These include: eye contact, touch, smiles, voice, and movement. This is designed to facilitate "connection" physically, verbally, visually, and emotionally between therapist and child. Some holding therapy also involves wrapping the child safely in a heavy blanket, rendering him/her totally helpless. The idea is to break down the child's learned defenses and recreate the feeling of security that a baby experiences with a nurturing, consistent caregiver. It also initiates the reprocessing of the infant bonding cycle which was interrupted for children with Reactive Attachment Disorder. It allows the child to safely release and receive help to resolve the emotional trauma which has prevented him/her from being able to develop trust and love and experience joy in life.

Holding Therapy is sometimes also mistakenly referred to as "rage reduction" therapy, which some believe is a limited description of what is accomplished through this therapeutic process. While reducing rage that a child might be feeling is a desirable and necessary outcome, not all Reactive Attachment Disorder children operate out of a state of rage. For those who do, this releasing process helps to clear away the "garbage" so they can begin to experience other feelings - sadness, fear, hurt, - that they have until now learned to ignore.

In most instances holding therapy takes place in a series of 2 - 3 hour intensive sessions occurring over the course of two weeks. The length of treatment depends on the severity of the child's disorder and his/her response to treatment. Parents are part of the treatment, often as participants with the therapist. Sometimes it is recommended that a child stay with therapeutic foster parents during these intensive sessions.

Holding therapy is not appropriate for every child with Reactive Attachment Disorder and decisions on whether to use this therapeutic method should be based on extensive evaluations with experienced professionals. There have been many encouraging results with holding therapy; however, it should be stressed that it is not a quick fix or a cure. It is the first step in changing the child's world. A combination of strong parenting skills, continued therapy, and solid relationships with other significant adult influences all contribute to the healing process.

The early months and years of a child's life are critical. But we must not turn our backs on those children who have suffered traumatic past experiences, believing them to be beyond repair. Children can heal, even older children. We at MARE hear countless success stories of children flourishing in loving permanent families. Of course there are struggles along the road, but let that not stop us from reaching out to the unattached child. Our future demands that we at least try.

Sources:

Attachments - newsletter of The Attachment Center of Evergreen, Inc.

1. "What We Do and Why We Do It," Fall 1995

2."The Evolution of Attachment Therapy," by Dianne Alfred and Gregory C. Keck, PhD., Spring/Summer 1996.

Don't Touch My Heart by Lynda Gianforte Mansfield & Christopher H. Waldmann, MA, LPC, copyright 1994 Pinon Press, Colorado Springs, CO 80935