How To Help Children Overcome Attachment Injuries

How To Help Children Overcome Attachment Injuries

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Summary

When a child's early bonding experiences with their parents goes wrong, the result can be extremely challenging behaviour in school, difficulties with social interaction and problems with emotional regulation.

In today's episode, our guest Catherine Young explains how to use her evidence-based M-MAT process (multi-modal attachment therapy) to heal the 'attachment injury' driving those behaviours and manage their emotions more successfully.

Important links:

M-MAT Attachment Therapy website: https://www.m-mat.org/

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Show notes / transcription

Catherine Young  0:00  

analogy would be say you were looking at walking styles and you put limping as a walking style. A person is limping, not because that's their natural style of walking but because they have some kind of injury or impairment. So similarly, an attachment style that's not healthy is due to some kind of injury or impairment. 


Simon Currigan  0:17  

Welcome to episode eight of the school behaviour secrets podcast and today we have an interview with Katherine young on the subject of supporting pupils with attachment difficulties. I'm here with my co host, Emma Shackleton. Hello, Emma. 


Emma Shackleton  1:09  

Hi there. 


Simon Currigan  1:10  

Emma, I've got a question on my mind. You're quite sporty. Have you ever had an injury that's held you back? 


Emma Shackleton  1:17  

 I was actually part of a roller derby team for a number of years. And that was a sport that I absolutely love. Roller Derby is a full contact sport like rugby on roller skates. Over the years I did suffer quite a few little bits of injuries, nothing as serious as a bone break. Thankfully, if your injury is not who bad and you can still train and compete. That's great. But it really does change your style and it affects your performance. And but Simon What has this all got to do with today's episode? 


Simon Currigan  1:48  

 Well, it's a very cheeky segue to our guest, Katherine young. She's got over 20 years experience of working with children with attachment difficulties, and she says that a child attachment style isn't fixed, but that it reflects an underlying attachment injury. And when that injury is healed, the child's free to move to a more constructive attachment style. He calls this process M-MAT: multimodal attachment therapy. And she's going to guide us through what that process looks like and how our students can benefit from it in the school.


Our guest today is Catherine Young, she's an author and trainer who's provided therapy to children and families for over 25 years, she's developed a new practical approach to helping kids where attachment is a significant issue. It's evidence based, and it's called M-MAT, multimodal attachment therapy. And Catherine, before we get going, I want to say that your book not only contains one of the best clearest descriptions of attachment therapy, but it's also super practical. I've heard lots of experts speak on the subject of attachment theory. But then when it comes to practical actions you can take to help address those issues. their answers are often very fuzzy, very imprecise, and your book is not like that at all. It gives us very clear instructions are very clear process to help children heal attachment injuries. So I'm very excited to have you on the podcast today to talk about your approach. Welcome to the show. 


Catherine Young  3:15  

Thank you. 


Simon Currigan  3:16  

So can we get started by asking what an attachment injury actually is? 


Catherine Young  3:22  

Sure, an attachment injury is an injury or impairment in that first primary relationship that a child has with their primary caregiver. 


Simon Currigan  3:32  

So how does a child receive an attachment injury? What happens to cause that injury? 


Catherine Young  3:37  

That's a really good question. First, we have to understand what attachment is how it develops, attachment is connection between a child and their primary caregiver, usually the mother and it develops through the interactions between the child and the parent, you know, the parent makes silly faces to the child, the child giggles the parent giggles back, there's sort of this reciprocal interaction happening. Alternately, the child is uncomfortable, they fuss the parent comes and helps them out. And so through these interactions, the child learns that there's someone there for them, they develop this connection to this person. And the parent also is developing a connection. It's not a one way process. It's a two way process. So how an attachment injury occurs is that this process gets disrupted somehow. And then the child does not develop this connection. The child and parent don't develop this healthy what we call secure attachment. And that can impact the child throughout their life. 


Simon Currigan  4:29  

What might cause that attachment to be disrupted during that process? 


Catherine Young  4:33  

Yeah, it really can be anything on the parents and or the child and that keeps them from interacting in that way. So for parents, significant substance abuse issues, or mental health issues could get in the way, and illness or depression can get in the way of that kind of interaction for the child. Also an illness or an injury or being in chronic pain, for some reason can disrupt their ability to develop that connection. 


Simon Currigan  4:58  

What difference does an attachment injury then make to a child emotions and behaviour as they develop?


Catherine Young  5:04  

Basically what's happened is the child has learned that the adults in their world are not a resource for them and every child needs an adult in the world to be a resource for them and to create safety for them. And if they don't have that, it creates a huge amount of anxiety, which can result in all kinds of behaviours, everything from real controlling behaviours. If the parents been very inconsistent in that early time, a child doesn't feel safe, they feel a need to control everything, to create a sense of safety for themselves. It also may inhibit them from looking to adults for help, they may act like adults don't even sort of exist in their world, they feel like they have to do it all themselves, which is a lot for childhood, no child should be in that position. Alternately, if one of the other ways an attachment injury might manifest is the child who kind of goes to anyone everyone looking for, you know, getting their needs met without really differentiating. One of the distinguishing characteristics of a healthy attachment is that the child distinguishes this person who I'm attached to who provides me safety and comfort is different from the other people in the world.


Simon Currigan  6:07  

When that process of bonding goes wrong. We've talked about how it affects the way they see adults, how does it affect when they reach school age? How does it affect how they see that peers?


Catherine Young  6:16  

Children with attachment injuries often manifest that in different ways, one way might be the bully, again, their sense of self is injured when the attachment injured. So they puff themselves up, they become the bully, you know, the one who's in charge and hurtful to others. So that's one possible way, another possible way with peers would be the one that who's the victim, they're used to being victimised they fall into that role with their peers, you know, peers then will tend to pick on them. Sometimes they'll go back and forth between the two, sometimes a child with an attachment injury they've given up on adults, but maybe now they're trying to create that attachment with peers. Unfortunately, that doesn't work very well, because you know, peers can't provide the stability, the maturity, all the things, the safety, all the things that a child actually needs. 


Simon Currigan  6:59  

In the book, you talk about attachment injuries, how does an attachment injury differ from an attachment style?


Catherine Young  7:06  

An attachment style is simply a pattern of interacting, it was developed years ago, through a particular situation with toddlers and parents, they kind of catalogued how children reacted in that situation. And they categorise those patterns of reacting as attachment styles. And attachment injury is what creates an insecure attachment style attachment styles are divided into secure attachment style and insecure attachment style. And if a child has an insecure attachment style, then they have had some kind of attachment injury. The analogy would be say you were looking at walking styles and you put limping as a walking style, a person is limping, not because that's their natural style of walking, but because they have some kind of injury or impairment. So similarly, an attachment style that's not healthy is due to some kind of injury or impairment. 


Simon Currigan  7:54  

The ultimate goal of M-MAT then is to address that underlying injury. 


Catherine Young  7:57  

Absolutely. Yep, that's exactly. 


Simon Currigan  8:00  

So you developed the M-MAT approach to supporting kids with attachment injuries, and M-MAT stands for multi modal attachment therapy. Now this podcast is mostly for teachers and school leaders and counsellors who work in schools and learning mentors. To them, the meaning of attachment therapy will be obvious, but to worse, what's a little less obvious is multimodal, can you go into what that part of the title means?


Catherine Young  8:22  

It's a blending of a variety of different therapy modalities. And I feel like it takes kind of the best of each and puts it together in a way that's very cohesive and comes together and really helps the child by stimulating different parts of the brain, but the cognitive piece, but then also more right brain kind of stuff through the play.


Simon Currigan  8:38  

What kind of age ranges does this process work with? 


Catherine Young  8:41  

It's geared towards five to 12 year olds, basically what we call latency age children, I have used it with teens and had clinicians that I supervised who worked with teens as well up to age 16, you know, some modifications. 


Simon Currigan  8:55  

Now interventions for attachment issues used in school, certainly in the UK, kind of often focused on a counsellor or a mentor working alongside a child in school, teaching them kind of attachment skills, in like in one to one sessions. But your approach works differently. Can you kind of explain how that approach works? 


Catherine Young  9:13  

Yeah, for sure. So by trying to teach attachment skills, you're you're trying to address the attachment style, but you're not really addressing the underlying injury in M-MAT, we, especially with the attachment based play, we kind of go back a little bit a child's allowed to regress and go to that place where that injury is in play is based on the earliest interactions between parents and children where you know, you make silly noises and the child responds everything from peekaboo to silly singing games and clapping games, those kinds of things that involve touch or eye contact or rhythm. Those are all some of the first kinds of interactions we have with our infants. And so every session starts at the beginning with that attachment based play. There's a lot of healing there and then we may move on later in the session to the talk part. 


We maybe work on skills building or looking at sort of restoring for the child, how they're viewing relationships. But that attachment base plays really a critical piece of of the M-MAT model. 


Simon Currigan  10:09  

And when you're running that play, these are sessions with parents trying to help the parent, undo that damage with a child, the therapist role is to help that connection rebuild.


Catherine Young  10:18  

When you're working with parents. And that's always the ideal is to have a parent in the room. With primary caregiver, you're working on repairing that relationship. And sometimes the parent may not be the one who damaged that relationship, it may be a relative placement, or it may be a foster adoptive placement. But nevertheless, the child is holding that image of relationship from their early relationships into this new relationship. And so it's trying to shift that for the child and to heal that.


Simon Currigan  10:46  

The attachment based play part of the session, like you said, like follow the leader and those kind of touch games, they're often games that traditionally using much younger children, when you have slightly older children, how do they react to those?


Catherine Young  10:58  

Well, interesting, I can't tell you the number of times when I first brought parents in, we've talked about this, and they'll be like, Oh, my child won't do that. And a lot of attachment injured children are sort of pseudo mature again, they kind of feel like they have to make their own way in the world. And they may appear like super independent, there may be some resistance, but it really feeds an inner need for them, they're almost looking for permission to go to that younger place. 


Simon Currigan  11:21  

I guess that makes sense. Because they're revisiting kind of activities that they missed out at a certain developmental stage, that they need to be able to integrate with other people with their parents and with their with their peers. So it makes sense that it would enjoy that because it would help them start to make sense of the world. How do parents react? 


Catherine Young  11:38  

Well, that's a very interesting question. They actually enjoy it as well. And and the fun part about it for the therapist is that you're engaging in this to you're modelling, you're providing sort of a buffer between parent and child, if there's been a lot of conflict, and you just make it fun, you laugh, you play you giggle, you'd be silly, sometimes the parent themselves, it's healing for them, even though that's not the target. 


Simon Currigan  12:00  

So that's the first part of a parent child M-MAT session, there's some attachment based play, the next part of the session is a bit more challenging. That's attachment talk, can you sort of talk us through what happens in that kind of middle part of the session?


Catherine Young  12:12  

The first time you do the actual talk piece with the parent and child, you do what I call the story of love, this is a really simple, easy intervention, that just kind of you're setting the tone for the therapy. It's where you talk to the parent and the child's in the room. But the child's listening, these children are very hyper vigilant, they're listening to everything that's going on. And as the parents tell me, I'm really curious, you know, do you remember the very first time you felt left room and then the parent then you know, responds, whatever is appropriate, baby, first time I saw their face, or it may be an adoptive parent or a relative caregiver, you're basically trying to create a new storyline in the attachment talk part. And this is kind of the first part of doing that. So you know, then you go well, okay, so I get that, you know, when babies are so cute, aren't they? You know, but what about like, if it's a toddler, you know, toddlers, they get into everything. They're kind of active, they're all over the place. Did you still love them then? And then of course, the parent responds, and then you move on to, you know, well, how about you know, now he's seven years old. Now, you know, to still love him then and you know, you just be curious and kind of playful with it. But then you want to project it into the future? Well, you know, but when he's a teenager, you know, he might decide to cut his hair funny, or, you know, strange clothes. Do you think you love them then? And so you move it into the future? You know, what, what about when he's an adult, he won't be your little baby anymore in the parents, oh, well, he's always my baby. Maybe someday he'll decide to have kids what if he has kids, those kids would be your grandchildren. And so you just are kind of creating the story of Okay, this is this love is forever. 


That's all you do your first talk session you have, the next step in the talk portion is to do what we call the attachment narrative. And this is where you're really helping the child restore their life. And you start with the child's birth, and you have the again, the parent and the child in the session, this actually works really well for teens as well, you know, you start with where were you born and the child contributes as much as they can, if they don't contribute anything, that's fine, too. You get the information from the parent, you just start talking about their life. And you start with from when they were born, were they born in a hospital, who they go home with, you go through and their strategies in the book for how to help that story become a healthy, adaptive story, as opposed to a story of, Oh, I was hurt, and I'm bad, you really want to change the story to Oh, something's happened. And I'm okay. And like I said in the book, there's a lot of different strategies for doing that. 


Simon Currigan  14:26  

When I looked through the book, I mean, there are lots of practical strategies in there. And basically, it seems to be you're leading the child and kind of a journey from I am not safe towards I am safe. And at one point, there's a suggestion that a parent or a caregiver makes an apology to a child, but the things that happened to them or for them not feeling safe. These are all quite strong actions. They're quite emotional conversations. What do you do if the child can't cope can't regulate you and those questions? How do they react to those?


Catherine Young  14:55  

First of all, by doing the attachment based play at the beginning and you won't really start the attachment narrative till you know that the child is cooperating with the attachment based play that is regulating in and of itself. And at the very end of the session, the closing piece is also regulating, also no demand is made of the child, when you're going through the story, and that gives them a little bit of space, they can sit back and listen if they want. Plus, the things that you're talking about are things that are already going through their head. And because you're framing it in such a more healthy way, often children get a strong sense of relief. Plus, you do not go into trauma into details. You talk about, you know, hard things happen, then you talk about what the child may have learned from that, and what's really true. So you're doing all this corrective work as you go. And, and that corrective work, it's really the underlying meaning that creates the biggest anxiety, I believe, for children. But if you're correcting that, as you go, children often experience actually a lot of relief, you do want to keep an eye on the child. And you know, you can always lighten up or backup if you do feel like they're getting triggered. 


Simon Currigan  16:04  

We do some work with kids who have experienced domestic violence. And it's amazing that you talk to parents, and they say it wasn't directed at them, but they still assume it's their fault. They assume they're responsible for everything that happens at a certain age. 


Catherine Young  16:16  

Yes.


Simon Currigan  16:16  

I was fascinated by the final section of M-MAT. It's where the child is fed by the parents and you go through some attachment based questions. And in the book, when you read it, it makes absolute sense. Can you talk about the purpose of the feeding? And then talk about what kind of questions you ask?


Catherine Young  16:32  

Yeah, well, the feeding is really very, very symbolic. As a therapist, usually with a parent's permission, you bring you know, little crackers, or some little treats that child likes and the parent literally feed them to the child. And you do that with the questions but it's very symbolic of I can take care of you and I can nurture you, it's one of the things about em mat is that it's really a lot about repetition. So this isn't something you do one session, and then you don't do anymore, you do it every single session. So over the weeks, it becomes ingrained, it becomes a pattern. Same with the attachment based play. Also, it's very grounding. I mean, food is grounding for all of us. But like you said, you know, if we've talked about some difficult things in the session, it's a good way to kind of get grounded back into our bodies and back into the present. 


Simon Currigan  17:13  

So we've got the other parents and child session where you can see the aim is to help the child understand the story of their lives, put right any mistakes they've made in terms of thinking errors, engage in attachment based activities to kind of rebuild the skills that they they never had in the first place and connect with the adult. I think that's really powerful. But also and M-MAT has parent only sessions. And can you talk a little about what the purpose of those are and how they're structured?


Catherine Young  17:40  

Yeah, the parents only sessions are much less structured than the parent child sessions, they're based on the needs of the parent, children with attachment injuries can be extremely challenging, because they may reject the parents attempts to help them they may even engage in behaviour that's specifically hurtful towards the parents. That session is, again is based on what you've assessed the needs of the parents are, do they need help? A lot of parents have found it really useful to come into the session and tell me you know, what happened this week in this particular incidents, and we can go over how what they could do, what they could have done different, you know how they could handle that. And they find that a lot more useful than going to, you know, sort of a generic parenting class. You also, though, want to work on making sure the parent has adequate supports in their life. 


Simon Currigan  18:24  

Every child and every family, obviously, have individual problems and issues. But how long does this sort of process take to have an impact? And what changes? Do you see at the end of the process? What kind of practical impact do you say? 


Catherine Young  18:36  

Yeah, really good question. You know, often, by the time they come to me, they've been through therapy for a number of years that maybe hasn't been effective. And I asked them to give me 10 weeks, 10 weeks of regular sessions, not the assessment sessions to really work with them and their child. And then at the end of that 10 weeks, you know, the attachment issues aren't going to be gone. But there should be enough of a shift that they can see progress. And that shift can be pretty subtle. Maybe now in the session, they're actually having fun together. Maybe it took four weeks for them to actually have fun in the attachment based play for the child to be really responsive to that maybe at home they're a little bit more responsive or or their tantrums are a little less intense, and how long the whole process will take. That, of course, depends on every situation, I think shortest has been maybe a total of six to nine months. Longest has been over a number of years, yet there's been progress, steady progress over those years. What we want to do in this therapy is to really shift them so that they can now access relationship as a resource, they can access their parents as a resource, and are no longer fearful of that connection. That's the goal.


Simon Currigan  19:45  

So that leads us neatly actually on to what happens when that parent or caregiver won't or can't engage with you in that process. You've got something called the M-MAT individual process. Can you explain how this differs from the process we've described so far? 


Catherine Young  19:59  

Yeah. With an individual, again, you don't have a parent in the room, the structure is really similar. You do do attachment based play, but you maintain certain boundaries with that, because you have to you're not, you're not trying to be the child's parent, but you still want to give the child that experience of play. One of the easiest ways is to think of what what would be appropriate peer to peer, you know, peer to peer would be clapping games, maybe to do follow the leader games, and then leave some of the more intimate ones like obviously holding and rocking a child and singing, you know, singing, some of the lullabies would not be appropriate or latency age child and a therapist. And that in of itself is helpful for the child, just having that experience is helpful for the child. 


At the next point, when you go through the attachment narrative in the same way you would with a parent in the room, because this child doesn't have that secure support this child is is kind of alone in the world. So you do some of the things that people do with child therapy Anyway, you use metaphor use stories, you talk about the story of the bunny, whose parents were always fighting, and then you do some corrective work within those stories, rather than directly talking about the child's story, again, for some of the reasons you mentioned earlier, you know, not wanting to trigger the child not wanting to also bring up their defences. And then I build in after that a little bit of the non directive play therapy, which I don't do at all in the parent child sessions. But this is where the child kind of leads the play. And then you end with some positive questions. Again, not as much relationship based as you would with the parent about successes and things like that. So they step out of the room with some some positive thoughts in their head. 


Simon Currigan  21:31  

Catherine, if you're a school leader right now, or a parent listening to this podcast, what's the first step you can take to start learning more about the process or helping kids with that process? 


Catherine Young  21:42  

Well, I think the first step would be to actually get the book, it's available on Amazon. It's called M-MAT, multimodal attachment therapy, healing attachment injuries in children and families, because that's where you'll really get the main gist of what this is all about. Also, for parents, I have just published a new book for parents specifically and other caregivers, which is understanding attachment injuries in children, and how to help a guide for parents and caregivers. And that has a lot of practical parenting strategies goes much more into the parenting piece of working with these children. So I think either of those would be a great resource for parents and for educational professionals. 


Simon Currigan  22:21  

And what we'll do is we'll drop a link to those in the shownotes. Finally, we ask this of all our guests, who's the key figure that's influenced you? Or what was the key book that you read, that had the biggest impact on your approach to working with children?


Catherine Young  22:36  

I think actually, there's two influences that kind of had the biggest impact for me. One was Dan Siegel, who anyone who knows he's big in the field of attachment and working with children, and I went to training quite a few years ago. And it was before he was really as well known as he is now and it really just got me thinking it was on attachment. And it really kind of started me off in this direction. And then the other one would be Theraplay, which is, is an attachment play based model of therapy, which also kind of brought me to the attachment based play and the importance of that my model is slightly different than theraplay. But But that was a big influence as well.


Simon Currigan  23:11  

Catherine, thank you for being on our podcast. I'm not on your payroll. But I think your book has done a brilliant job of joining the dots between theory and practice, in my opinion, and I think every school every SENCO, every counsel and every learning mentor should have a copy of this.


Catherine Young  23:24  

Well, thank you very much. And I appreciate the chance to talk about it.


Simon Currigan  23:28  

Wasn't that interesting? I like the optimism and practicality of it. And what I like about M-MAT is that it deals with the real problem the relationship between the child and the adult, which is the real issue rather than attempting to heal the problem rather than fix the symptom.


Emma Shackleton  23:42  

After listening to that, if you suspect that a child in your class is showing behaviours that might be consistent with attachment, we've got a free download called the SEN handbook that could really help. What the handbook does is helps you to link classroom behaviours with possible causes, like autism attachment, or ADHD. Now, this is not about making a diagnosis because as teachers, we're just not qualified to do that. But to get the ball rolling with the process of linking behaviours with possible causes, so that you can start to get the right help or the right professionals involved. It's a free download, go to our website, www.beaconschoolsupport.co.uk. Click on the free resources section near the top. And the link is also in the show notes.


Simon Currigan  24:31  

Early interventions, the keys to success there. Thanks for listening to today's show. Next week we're going to be answering the question, do gratitude diaries really help children build resilience? Do they actually work we'll be looking at the research and separating the science from the internet myth. So if you've been thinking about using gratitude journals with your students, or you're using them already, this will be especially valuable to you.


Emma Shackleton  24:55  

Finally, if you like what you've heard, and you don't want to miss the next episode, Open your podcasts app now and press the subscribe button that will tell your app to automatically download each and every new episode on a Tuesday. So it's sitting there waiting for you when you're ready to listen. Thank you for listening to school behaviour. Have a great week and we look forward to talking to you again in the next episode.


(This automated transcript may not be 100% accurate.)