I was reading an article online by Nancy Thomas called “What is Reactive Attachment Disorder” and find her pre – suppositions rather disturbing. Particularly, when she has no formal training in the assessment of attachment that I can discern from the attachment and child development experts in the field. When I reviewed the list of individual she has trained with, none of them that I was able to research had any formal training in the assessment of attachment quality of children. I may have to dig deeper with whom she has trained and with her trainers have trained with…
1) She presumes attachment is an “all or none” construct. This is a false. She claims on her site ” Attachment is defined as the affectional tie between two people. It begins with the bond between the infant and mother. This bond becomes internally representative of how the child will form relationships with the world. Bowlby stated “the initial relationship between self and others serves as blueprints for all future relationships.” (Bowlby, 1975)”
Her citation by Bowlby is now an outmoded concept. Attachment researchers such as Sroufe, Carlson, Waters, Marvin, Siegel, Soloman, Bretherton and others clearly state that that attachment occurs along a developmental path, and should one have an insecure form of attachment early on, this does not preclude them from developing a secure attachment over their early life or later life with a trusted and sensitive caregiver, spouse, or therapist. For example, let’s assume a mother depressed during the first year of an infants life but during the second year, receives and responds positively to treatment and becomes sensitively attuned to her child – the attachment security and quality can be developmentally altered onto a more secure path. “Blueprints” can be changed. Very, very, very rarely does a child lack an attachment relationship to any caregiver.
2) Her statement: Attachment Disorder is defined as the condition in which individuals have difficulty forming lasting relationships. This is false. This is clearly know as a “hasty generalization” in logic and a fallacy. She has taken a very complex topic as attachment and made an over generalization about it.
3) She then launches into a discussion of “non-attached”. This is very, very rare and false and evidence of all or none thinking. Research is clear that children who have experienced maltreatment can and do often have an attachment relationship with there caregiver. It is often a form of insecure attachment with evidence of what is usually an organized pattern having disruptions to it (known as disorganization). A more accurate reference is a “child with distorted attachment that initiate a maladaptive pathway…(Alan Sroufe, personal communication 9/20/11)
4) Children with “non-attachments” are doomed. This is false. The University of Minnesota has done extensive work with children in orphanages in Romania who exhibited “no attachment pattern” who are now exhibiting increasing security in their caregivers. This is very promising. And, again, lack of attachment to any caregiver is extremely, extremely rare. A more accurate reference is a “child with distorted attachment that initiate a maladaptive pathway…(Alan Sroufe, personal communication 9/20/11)
5) Attachment Disorder is accepted as a disorder by professionals with a clear definition and she describes the symptoms. This is false. There is and continues to much debate about the diagnoses of RAD and while progress is being made in the upcoming DSM-V; there remains much work to be done.
6) She lists “causes” of attachment “disorder.” Again, the pre-supposition of disorder is rather disturbing. Attachment is a description of the quality of the relationship and how well a child has confidence in his/her caregiver to meet his/her needs consistently and sensitivity. The list she provides are certainly correlated with forms of insecure attachment, however; to claim a cause is false. Also, children who exhibit secure attachment patterns can later develop an insecure pattern for various reasons: death of a parent, severe illness, divorce, etc. Patterns of attachment security/insecurity occurs over a lifetime.
What does this all mean…be careful what you read on the internet. Do your research. Be critical. Ask questions. My friend is an author and said, “Writing a book has made me an expert.” I appreciated his comment on this – but writing a book makes someone a writer, not an expert. Only proper knowledge and proper training and proper ongoing research and experience make someone an expert. Clearly, Nancy may have some thoughts and skills on parenting techniques that are helpful, but an attachment expert, she appears very misinformed regarding what attachment is and not. This is no fault of her own. It is a very misused and abused concepts among treatment professionals who lack specific training from experts in the field.
One more thing, she discusses her upcoming study on her effectiveness by reducing cortisol levels in parents proving her techniques work. The proper research based on her claims would be assessing the cortisol levels of the children and seeing if those are reduced combined with other measures of assessing attachment security in the children to determine their attachment security. After all, she claims on her website to “provide help for each wounded child….” See below for a direct pull from the site:
“We offer information on adoption / attachment and bonding issues, and Reactive Attachment Disorder (RAD) to families and professionals. We are also the official home of Families by Design providing educational materials and seminars.The goal of this site is to provide help for each wounded child with attachment disorder, PTSD (Post Traumatic Stress Disorder), ODD (Oppositional Defiant Disorder)….”
After receiving a posting, I reviewed this article. It appears that the pages that were cited from the Nancy Thomas website are no longer available. I am hoping that the site has been updated to reflect what is currently known from research. Research can provide us with sound information. It allows us to take what we know and make it into models that can hopefully help – as my mentor for the past two year, Dr. Bruce Perry states, “Essentially all models are wrong…but some are useful!”