Considering Attachment in
the Context of Adoption and
Foster Care
Douglas Goldsmith, Ph.D.
Executive Director
The Children’s Center
Special Thanks
Dr. David Oppenheim
University of Haifa
 Dr. Janine Wanlass
Westminster College

For their contributions and support on
conceptualizing issues around
attachment and permanency
Overview
Attachment Theory
 Internal Working Models
 Reflective Functioning
 Insightfulness
 Application to Permanency
 The Attachment Toolbox

Understanding Attachment
Attachment
Emotional bond with another person
 Behaviors promote proximity with one
perceived as older, stronger, and wiser
 Motivational system to seek proximity
 Enhances feelings of security
 Motivates baby to take action when
frightened

Attachment Theory

When I am close to my loved one I feel good,
when I am far away I am anxious, sad or
lonely
 Attachment is mediated by looking, hearing,
and holding
 When I’m held I feel warm, safe, and
comforted
 Results in a relaxed state so that one can,
again, begin to explore
Holmes (1993)
Attachment in Action
Behaviors shown by careseeker and
caregiver
 Aware of and seek each other out if
careseeker is in danger due to physical
separation, illness, or fright

Secure Attachment

The caregiver is perceived as a reliable
source of protection and comfort
Cooper, Hoffman, Marvin &Powell , 2000
Attachment Classifications

The strange situation
– Secure
65%
– Avoidant
20%
– Ambivalent
10%
– Disorganized 5-10% (80% maltreated)
Secure (B)
Uses mother as secure base
 Signs of missing mother
 Actively greets with smile or gesture
 Signals or seeks contact if upset
 Once comforted resumes exploration

Solomon & George (1999) p.291
Secure Attachment

“Attachment is mediated by looking,
hearing and holding: the sight of my
loved one lifts my soul, the sound of her
approach awakes pleasant anticipation.
To be held and to feel her skin against
mine makes me feel warm, safe and
comforted.”
Holmes (1993)
Avoidant (A)
Explores readily
 Little visible distress when left alone
 Upon reunion, looks away or actively
avoids
 May stiffen or lean away if picked up

Solomon & George (1999) p. 291
Ambivalent (C)
Distressed, fretful, passive
 Fails to explore
 Unsettled, distressed by separation
 Alternates bids for contact with signs of
angry rejection
 Fails to find comfort from the parent

Solomon & George (1999) p.291
Insecure Attachment
Intense love and dependency
 Fear of rejection
 Irritability
 Vigilance
 Punish their attachment figure for any
sign of abandonment

Insecure Attachment

The insecurely attached person is
saying:
“Cling as hard as you can to people –
they are likely to abandon you: hang
on to them and hurt them if they show
signs of going away, then they may be
less likely to do so.”
Holmes (1993)
Disorganized (D)
Behavior lacks an observable goal
 Look fearful
 Behavior is bizarre
 May try to leave after the reunion or
freeze

Attachment Behavioral
System
Attachment figure:
Near, responsive,
attuned
Felt security, love,
self-confidence
Playful, smiling,
Exploratory, sociable
Holmes (1993)
Attachment
Attachment is a reciprocal relationship
 The parent offers caregiving behavior
that matches the attachment behavior of
the child
 The child, using social referencing,
checks in with the mother “looking for
cues that sanction exploration or
withdrawal”

Holmes (1993)
Parenting

Overanxious Parent – inhibits child’s
exploratory behavior
– Child feels stifled or smothered

Neglectful Parent – inhibits exploration
by failing to provide secure base
– Child feels anxious or abandoned
Holmes (1993)
Attachment Problems
Bowlby
A severely hurt child fails to seek
comfort
 Signals that ordinarily activate
attachment behavior fail to do so
 System controlling attachment, and the
feelings and desires associated, is
rendered incapable of being aroused

Attachment From the Child’s
Point of View
How do children view their parents?
 How do children learn to think about
themselves as separate from their
parents?

Internal Working Model
Based on the child’s real-life experience
of day to day interactions with his
parents
 Reflects the images the parents have of
the child
 Images communicated by how each
parent treats the child and what each
parent says to the child

Impact of the Internal Working
Model
The model governs how children
feel toward each parent and about
themselves, how they expect to be
treated and how they plan their own
behavior toward their parent
Securely Attached Child

Internal Working Model
– Responsive, loving, reliable caregiver
– Self is worthy of love and attention
Holmes (1993)
Insecurely Attached Child
The world is dangerous
 Treat others with great caution
 Self is ineffective and unworthy of love
 These assumptions are stable and
enduring and terribly difficult to modify

Holmes (1993)
Video – Rosie’s Kids
Development of Relationships

“For a relationship between any two
individuals to proceed harmoniously
each must be aware of the other’s
point-of-view, his goals, feelings, and
intentions, and each must so adjust his
own behavior that some alignment of
goals is negotiated.
Development of Relationships

This requires that each should have
reasonably accurate models of self and
other which are regularly updated by
free communication between them. It is
here that the mothers of securely
attached children excel, and those of
the insecure are markedly deficient.”
Bowlby (1988) p. 131
Parenting
How do parent’s foster secure
attachment?
 What should we look for when we
observe parents?

Mothers of Secure Infants
Continuously monitor the infant’s state
 Accurately interpret the signal for
attention
 Act accordingly to meet the infant’s
needs

Mother’s of Anxious Infants
Monitor the infant’s state only
sporadically
 Inconsistently notice the infant’s signals
 May interpret the signal inappropriately
 Respond to the signal inappropriately,
or tardily

Ambivalently Attached Child
Shows overt aggression toward the
inconsistent mother
 “Don’t you dare do that again!” but has
to cling because he knows from
experience that she will.

Holmes (1993)
Avoidant Child
Outbursts of unprovoked aggression
 Needs to appease to the mother
because the child wants so badly to feel
close
 Fears she’ll rebuff him if needs are
revealed too openly; or if anger about
abandonment is shown too openly

Holmes (1993)
John: Seventeen Months
For Nine Days in a Nursery
James & Joyce Robertson
Phases of Response to
Separation

Protest
– Upset, confused, frightened by loss of mother
– Urgent desire to find mother
– Looks eagerly toward any sight, sound

Despair
– Increasing hopelessness
– Less active, withdrawn, apathetic
– Decreases demands on environment
Phases of Separation

Despair may be misinterpreted by presuming
that distress has decreased because the child
is settling in
 Detachment
– Makes the best of the situation by repressing
longing for mother
– When mother returns “he hardly seems to know
her”
– May appear to not need any mothering at all
John – The Follow-up

First Week
– Rejected his parents
– Won’t accept comfort or affection
– Won’t play
– Shuts self in room
– Cried a great deal
– Can’t cope with the slightest frustration
– Aggressive and destructive
Follow-Up

Second Week
– Undemanding
– No tantrums
– Plays alone – quietly
Follow-Up

Third Week
– Dramatic change
– Tantrums return
– Refuses food and loses weight
– Sleep is disrupted
– “Gulf” between parents and John
Follow-Up

One Month
– Relationship with mother improves
– Joyce visits and he regresses
• Refuses food and attention
– Three weeks later, second visit from Joyce
• Extreme disturbance for 5 days
• Includes aggression toward mother
Follow-Up

“Three years after his stay in the residential
nursery, when John was four and one half
years old, he was a handsome, lively boy
who gave much pleasure to his parents. But
there were two marked features which
troubled them. He was fearful of losing his
mother and got upset if she was not where he
thought she would be. And every few months
he had bouts of provocative aggression
against her which came out of the blue and
lasted for several days.”
Attachment:
The Parent’s Point of View
How does the parent’s past impact
attachment?
 How do we get in to the parent’s head?

Impact of Empathic Failure

“Whatever she fails to recognize in him he is
likely to fail to recognize in himself. In this
way, it is postulated, major parts of a child’s
developing personality can become split off
from, that is, out of communication with, those
parts of his personality that his mother
recognizes and responds to, which in some
cases include features of personality that she
is attributing to him wrongly.” Bowlby (1988) p.132
Reflective Function

“The reflective function refers to the
psychological processes underlying the
capacity to mentalize. . . mentalizing
refers to the capacity to perceive and
understand oneself and others’
behavior in terms of mental states, i.e.,
reflection.”

Fonagy, Steele, Steele & Target (1997)
Reflective Function
Allows the individual to make sense of
his or her own and others’
psychological experience, to enter into
another’s experience, to “read”
another’s mind
 Allows the child to make others’
behavior meaningful and predictable,
and permits him to respond adaptively


Slade (1999)
Reflective Function

The mother’s capacity to understand the
child’s mental states create the context for a
secure attachment relationship
 The mother is able to view the infant as
intentional
 Reflective functioning provides protection
against damaging effects of abuse and
trauma

Slade (1999)
Reflective Function

The capacity to tell a story that is affectively
believable
 The capacity to understand emotional
processes
 The ability to accurately understand ones
own and others behavior
 Slade (2002)
Dyadic Patterns

Marvin et al (2002)
Secure child – Autonomous Parent
– Easily approach and interact when distressed
– The reunion calms the child and facilitates
exploration
– Child can shift between exploration and using the
parent as a safe harbor with little anxiety
– Close attunement – disruptions easily repaired
Dyadic Patterns

Marvin et al (2002)
Insecure child – Dismissing Parent
– Both partners minimize intimate
attachment-caregiving interactions
– Miscue – I’m really more interested in
playing
– “Independence” is highly valued
– Overregulated affect, little emotional selfknowledge
Dyadic Patterns

Marvin et al (2002)
Insecure Child –
Ambivalent/Preoccupied Parent
– Both partners minimize independent
exploration
– Child is overly dependent on the parent
– Miscue – don’t explore, there really is
something to be anxious about
– Under-regulated affect
Dyadic Patterns

Marvin et al (2002)
Insecure, Disordered Child
Disorganized/ Insecure Parent
– Parent fears or becomes angry in response
to child’s attachment behavior and
abdicates caregiving
– Caregiver has unresolved trauma
– Role reversed relationship
Maternal Attributions

Fixed beliefs that the mother has about
the child – “beliefs that she perceives as
objective, accurate perceptions of the
child’s essence.”
Lieberman (2000)
Positive Maternal Attributions

“When a mother sees her child as the cutest,
most intelligent, most endearing being ever
created, she is summoning from the depths of
herself the capacity for ecstasy that allows
her to put up with the inevitably annoying,
exasperating, or simply tedious aspects of
raising a child.”
Lieberman (2000)
Maternal Attributions:
Protective Function
Child feels adored
 Allow child to cope with self-doubts and
feelings of despair
 Allow parent to better tolerate selfsacrifices that are integral to the
parenting process
Lieberman (2000)

Parental Insightfulness

“Parental empathic understanding
involves the capacity to see things from
the child’s point of view within a
balanced, accepting, and coherent
frame.”
Oppenheim (2000)
Balanced
Able to see experiences through their
child’s eyes and make attempts to
understand the underlying motives
 Talk openly about positive and negative
aspects
Oppenheim (1999)

One-sided
Preset conception of their child
 Difficulty staying focused on their child
and their relationship with the child
 Talk about their own feelings/issues

Oppenheim (1999)
Disengaged
Lack emotional involvement
 Minimally attempt to understand what’s
on their child’s mind
Oppenheim (1999)

Video
Foster Care and Permanency
How does foster placement effect
development?
 How do we assess relationships
between the children and their biological
as well as foster parents?
 How long in foster care is too long?
When can children still go home?

The Case of Sara
 Placed
for adoption upon discharge
from the hospital
 5 months of age legal adoption is
not completed
 Sara enjoys a loving relationship
with her parents
 The parent child relationship is
marked by reliable, emotionally
attuned, and responsive care
The Case of Sara
 Allegations
of neglect arise
 Sara is removed from the home at
the age of 10 months
The Case of Sara
Shelter home for four days
Second foster home for one week
Third foster home for eight
weeks
Adoptive home
The Case of Sara
 Upon
arrival to the adoptive home
Sara stares blankly, refuses social
interaction, and is oblivious to pain
after undergoing a medical
procedure
 Believing that Sara is available for
adoption her name is changed
The Case of Sara
 At
the age of 15 months Sara is
responding well to her new
environment
 First adoptive family hasn’t seen
her for 6 months and want her
returned to their care
The Case of Sara
Should she return?
 Who are the “psychological” parents?
 Does she remember her first adoptive
parents?
 She’s so young that she won’t
remember anything and can be returned
without distress
 Sara is a “resilient” child

The Case of Sara
The internal working model – viewing
the world through Sara’s eyes
 Assessing “risk”
 Could reunion reactivate feelings of
loss?
 Utilization of second adoptive parents
as a secure base
 Impact of no contact

Factors Favoring
Sara’s Return
Sara is a “resilient” child and can weather
more moves.
Sara needs to return to be able to resolve
her grief
As she gets older, Sara will long to be
with her first adoptive family
Sara should not have been removed in
the first place
Factors Against
Sara’s Return
Length of time away from her first family
without any contact
Her name change has impacted her
Internal Working Model
She now views her new family as her only
family and calls her new parents
“mama” and “dada”
Factors Against Sara’s Return
Sara clearly shows signs of a secure
attachment to her new parents
 A return could, in fact, be viewed by
Sara as traumatizing and as being
“ripped away” from her family
 Trauma could create a Reactive
Attachment Disorder

Factors Against the
Return of Sara

Comparing the future stability of the two
families
– First family is struggling with high levels of
stress and their relationship has been
negatively impacted and, largely ignored
– Second family has, and will likely,
withstand stressors
Implications for Caseworkers
Request relationship-based
assessments
 Understand children’s needs vs.
parental capacity for caregiving
 Develop specific recommendations
about what behaviors the parent needs
to develop to successfully parent this
particular child

Use of Supervised Visits
Used routinely but should be used for
extreme cases where abuse/neglect
even under supervision is of high risk
 Need to find ways to allow for more
contact with parents in a more natural
setting
 Therapeutic visits vs. supervised visits

Supervised Visits

Be mindful of the limits to interpretation
of the behaviors between the parent
and child
– Playfulness does not equal attachment

Stress following the visit is natural and
should not necessarily be interpreted to
mean that visits are experienced
negatively by the child
Observation of Parent-Child
Relationship
Observe proximity seeking behaviors – watch
eye contact and social relatedness
 Observe parental sensitivity and
insightfulness to child’s cues
 Who does child seek out when frustrated or
frightened
 Use doll play to assess attachment hierarchy

Assessment – Secure Base

Over the past two weeks can you think
of a time when your child was:
– Hurt?
– Frightened?
– Separated from you?
What did your child do?
 How did you respond?

Assessment of Parent’s
Point of View

Interview questions:
– Could you give me a thumbnail sketch of your
child?
– Tell me about a time in the past two weeks when
you and your child really clicked.
– Tell me about a time when you didn’t.
– What gives you the most joy in your relationship?
– What gives you the most pain?
– Where do you turn for emotional support?
Steele (2003)
Attachment Toolbox

Nurturing Relationships
– The “Ideal Grandma”
• Anticipating Needs
• Keeping the child in “mind”

Reading and responding to cues
 Emotional Regulation
– Proximity to the child
– Reassurance
– Emotional repairs - Time In
Time In
Stay close by to help the child calm
down
 Avoid processing until the child is
calm
 If child becomes aggressive distance
yourself while reassuring the child
that you’ll be available once the child
is calm

Attachment Toolbox

Managing anxiety
– Sleep Issues
– Appetite Issues
Encourage checking-in behaviors
 Providing structure and consistency
 Protecting the child from trauma
reminders
 Positive communication skills

Attachment Toolbox
Developmentally appropriate
expectations
 Managing parental stress

– Providing respite care
Treatment Options
Obtain comprehensive, relationshipbased assessments
 Supervised visits vs. Reunification
treatment
 Parent-child therapy
 Individual therapy
 Shelter vs. Residential treatment

Educating Parents
Parents need to understand children’s
histories to be on alert for trauma
reminders
 Be realistic about attachment issues but
recognize parent’s ability to hear the
concerns
 Encourage parents to seek treatment

Secure Base

“When a child is held in mind, the child
feels it, and knows it. There is a sense
of safety, of containment, and, most
important, existence in that other, which
has always seemed to me vital. . . It
seems to me that one of life’s greatest
privileges is just that – the experience of
being held in someone’s mind.”
Pawl (1995)