Attachment Therapy - Theoretical Principles

Theoretical Principles

Like a number of other alternative mental health treatments for children, attachment therapy is based on some assumptions that differ strongly from the theoretical foundations of other attachment based therapies. In contrast to traditional attachment theory, the theory of attachment described by attachment therapy proponents is that young children who experience adversity (including maltreatment, loss, separations, adoption, frequent changes in child care, colic or even frequent ear infections) become enraged at a very deep and primitive level. This results in a lack of ability to attach or to be genuinely affectionate to others. Suppressed or unconscious rage is theorized to prevent the child from forming bonds with caregivers and leads to behavior problems when the rage erupts into unchecked aggression. Such children are said to fail to develop a conscience, to not trust others, to seek control rather than closeness, to resist the authority of caregivers, and to engage in endless power struggles. They are seen as highly manipulative and as trying to avoid true attachments while simultaneously striving to control those around them through manipulation and superficial sociability. Such children are said to be at risk of becoming psychopaths who will go on to engage in very serious delinquent, criminal, and antisocial behaviors if left untreated. The tone in which the attributes of these children are described has been characterized as "demonizing".

Advocates of this treatment also believe that emotional attachment of a child to a caregiver begins during the prenatal period, during which the unborn child is aware of the mother's thoughts and emotions. If the mother is distressed by the pregnancy, especially if she considers abortion, the child responds with distress and anger that continue through postnatal life. If the child is separated from the mother after birth, no matter how early this occurs, the child again feels distress and rage that will block attachment to a foster or adoptive caregiver.

If the child has had a peaceful gestation, but after birth suffers pain or ungratified needs during the first year, attachment will again be blocked. If the child reaches the toddler period safely, but is not treated with strict authority during the second year, according to the so-called "attachment cycle", attachment problems will result. Failure of attachment results in a lengthy list of mood and behavior problems, but these may not be revealed until the child is much older. According to attachment therapist Elizabeth Randolph, attachment problems can be diagnosed even in an asymptomatic child through observation of the child's inability to crawl backward on command.

Critics say holding therapies have been promoted as "attachment" therapies, even though they are more antithetical to than consistent with attachment theory, and not based on attachment theory or research. Indeed they are considered incompatible. There are many ways in which holding therapy/attachment therapy contradicts Bowlby's attachment theory, e.g. attachment theory's fundamental and evidence-based statement that security is promoted by sensitivity. According to Mary Dozier "holding therapy does not emanate in any logical way from attachment theory or from attachment research".