Child-Centred Attachment Therapy

The CcAT Programme

Maggie Gall, Alexandra Maeja Raicar, Pauline Sear

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429911828
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This book describes the development of the Child-Centred Attachment Therapy (CcAT) model of working with children with attachment difficulties. The authors describe, in a vivid and accessible manner, the complexities involved in supporting parents in their struggles to respond positively to the needs of children who have been traumatised by their early experiences. After many years of working with a number of families with children who act out their hurt through difficult behaviours, the authors offer their insights to help both parents and professionals to understand and deal more effectively with such behaviours. The CcAT therapists give an impressive account of their belief in a therapeutic approach that focuses on attachment and protection as prerequisites for promoting healthy relationships.

CHAPTER ONE
The long-term impact of attachment difficulties on families

Introduction: learning from family stories

All carers and therapists—like the children, families and adults we work with—will have had to deal with key attachment, separation, and loss issues at some time or other in their lives. Many might have joined the caring professions in an unconscious attempt to rework their family scripts, heal from deep wounds of the past, or, as wounded healers, to try to understand or make reparation to others representing hurt children and other family figures from their childhood, as in “Emily’s story”, below.

It is likely that John Bowlby’s prodigious work, Attachment, Separation and Loss, was fuelled by his early life experiences. His sensitivity to the plight of young children separated from their parents, and his intuitive awareness of the importance of mourning, may have been deepened by his own unacknowledged loss at the age of four of his beloved nursemaid, Minnie, who had helped to care for him since birth.

Louis Cozolino (2006, p. 19) argues that therapeutic work requires the inclusion of our personal experience, which is just as important as scientific evidence. As therapists, we learn all the time from our clients, and we are likely to be more affected by certain stories that echo our own family narratives. Such stories tend to inform our therapy practice, consciously or not, and add to a rich and inexhaustible source of learning about the human condition and our varying reactions to it.

And so it was that, through my gradual learning about “Rose’s story”, below, I, too, came to realize the importance of openly acknowledging and mourning family losses, and the corrosive lifelong impact of family secrets on each and every member of that family. The power of this tragic story fuelled my own unconscious search for ways to help rebuild mother–child attachments.

* * *

Rose's story

Once upon a time, long, long ago, in a far-off land in Africa, there lived a young Indian, Tom, with his wife and their four small children. Tom’s mother had died in childbirth, and his father died when Tom was only twelve. An aunt in India grudgingly offered Tom a home until he was sixteen and thought to be old enough to make his own way in the world. Tom loved music and heard he could get a job as a pianist in Singapore, playing accompaniments to silent movies. So he worked in Singapore until “talking pictures” made him redundant there. Tom then travelled to be near relatives in a British colony in Africa, where he got a day job as a clerk and played music in the evenings.

Tom was now able to get married and start a family of his own at last. After living for several years in Africa, his young wife, Marie, longed to return to India and visit her family again. She was still grieving for their first-born daughter, Tina, who had been tragically killed in an accident. As an expatriate worker, Tom was allowed a paid passage back to India by ship once every five years, and eventually he and Marie thought they could afford to arrange a six-month holiday back home. The couple were so excited and busy preparing for weeks ahead that their two older children, Jenny and Peter, realized that this holiday would be different from the short trips the family sometimes took by railway to the coast.

After travelling by land and sea for almost two weeks, the family at last arrived at Marie’s parents’ home where they were all welcomed and the children made much of by relatives and friends. However, almost at once disaster struck. Marie suddenly became so dangerously ill that the doctors predicted she would soon die, and the children were gathered round her bed to say goodbye to her.

Jenny and Peter, only eight and five years old, were immediately sent away to live with different aunts, one in the north and one in the south, and so they could not meet. Three-year old Emily sensed that she, too, might be sent far away to live with strangers; she soon stopped walking and would only crawl, so that a worried Tom began to carry her around with him. The baby, Rose, was only seven months old and had fast become a great favourite with her grandparents, whom she learnt to call “Papa” and “Mama”. Emily and Rose were no longer allowed to see their mother, since her illness was contagious and it was feared that they might contract it.

Miraculously, Marie did not die, but she remained too ill and weak for the remainder of their holiday even to play with her children, especially Rose. The baby no longer seemed to know who her Mama was and so avoided going to Marie, who felt very hurt by this rejection. However, Emily had learnt to stay by Marie’s side, while Jenny and Peter were very glad to be brought back from their aunts to join their parents and little sisters again. The older children were now eager to return to their home in Africa.

The grandparents remained concerned that their daughter would not survive the long journey back, and they persuaded a reluctant Marie to leave Rose with them until she was strong enough again to carry her baby, already a year old. They reasoned that Tom could soon return to collect Rose, forgetting that he would not qualify for a paid passage to India for another five years.

No one knows how the parents explained this life-changing decision to the children, who never afterwards spoke about it, not even among themselves when grown up, until long after both Tom and Marie had died. Jenny loved her baby sister and did not understand why Rose was not returning with them to Africa. But she was shushed angrily by the adults whenever she tried to ask, and Jenny became afraid that she, too, might be left behind. She had not liked living with her aunt, who was very strict, while her cousins teased her for not speaking their language and for crying for her mother at night.

Peter remained silent about their leaving baby Rose behind. Being an only son, he was Marie’s favourite and he had greatly missed being with his mother for so many months. However, Peter was a placid child and he had got on well with his caretaker aunt and cousins.

Little Emily may not have understood what was happening, except that she was back with her beloved mother, who could only carry one child at a time, and that would now be her. So Emily clung tightly to Marie and to Tom, afraid that she too might get left behind like Rose, who always got all the grandparents’ and relatives’ attention for being so cute.

And how could baby Rose understand that, in her need to survive the sudden separation from her mother at seven months old by forming strong attachments to her grandparents, and in later turning away from a convalescing Marie, she was co-creating a tragic new history for herself and her family: one of lifetime abandonment and disrupted relationships.

Theirs was a long and tragic story, with lasting impact on each family member, who remained indelibly scarred, not only by their sudden separation from, and loss of, babv Rose, but even more by the parents’ inability ever to talk to the children truthfully about what had happened and why.

Five years later, when Tom obtained another paid passage by ship to travel back to India and reclaim his youngest daughter, the damage had already been done. He took with him Peter, now aged ten, as a companion for little Rose, but she was not used to sharing adult attention or treats. Jealous that their grandmother had begun to favour Peter, who was still a very placid child, Rose would tantrum and scratch and bite him. Her reputation as “a naughty child” preceded her return to Africa with Peter and Tom.

Marie soon began to dread Rose’s rejoining their family. The little girl gradually became a scapegoat for the parents’ early abandonment of her. Marie convinced herself that their “bad” little daughter was the reason that Tom became increasingly ill. He died when Rose was only twelve; this was another major and unacknowledged loss for her.

Neither Rose nor Marie trusted each other by then, or had any help to rebuild their long-disrupted attachment. Rose, at six years old, was expected simply to slot back into her birth family, who were by now complete strangers to her. Overnight, she lost her beloved grandparents, relatives, and friends, a country that had become home to her, its culture and even its language, since Tom forbade her to speak it at all. He had become anxious that this little daughter was already behind in her schooling and would not learn to speak English correctly, which he knew to be essential from his experience of being a foreigner in a British colony.

Years later, on returning to live and work in India as a young adult, Rose must have unconsciously remembered her father’s injunction to her as a child, for she never relearnt the mother tongue in which she had once been so fluent. Her now hesitant use of it and anglicized accent were a constant source of amusement to native speakers.

Growing up as a stranger to her own family, pretty little Rose sought comfort and attention from neighbours and family friends, who kept bringing round new clothes and gifts for her to her surprised and increasingly mortified parents. Naturally warm and nurturing, Marie felt branded as “a rejecting and abandoning mother”. In turn, she projected all her bad feelings about herself and anger at what had happened on to this youngest daughter, who, not surprisingly, became more and more difficult for Marie to manage or love. Rose’s constant lying was particularly hard for her mother to tolerate, given her own valuing of honesty. Their “negative interaction spiral” was never interrupted. Rose remained the bad, unwanted child and emotionally outside her family, even when living with them.

Marie became increasingly preoccupied with caring for Tom, whose health had greatly deteriorated. He died a few years later, leaving Peter, at sixteen, to provide for the family. Jenny had never forgiven her parents for their abandonment of baby Rose in India, and her unconscious blaming of Marie for this got in the way of their relationship from then on. After Tom died, Jenny left home to get married and she soon became pregnant and busy with her new family, determined never to abandon her own children.

Emily, at nine, had resented her little sister’s return to the family and displacement of herself as the favoured youngest child, since Rose was cleverer and prettier, and much admired by relatives and family friends in Africa, too. Emily retreated into a world of books and only gradually became aware that Rose and their mother did not get on at all. Marie still favoured Emily, to whom she confided her distrust of the little girl, so sowing the seeds of lifelong conflict between the two sisters. Emily, like Peter, was too loyal to their beloved mother to realize that not all Marie told them about Rose was true.

Instead, the family secret of these ongoing losses and how they came about was maintained by the parents. An unspoken injunction was placed on the children never ever to question what had happened. Peter’s deep love for, and loyalty to, his mother prevented him from ever admitting the truth, even to himself; he died relatively young from a corrosive bone disease.

So, poor Rose remained outside the family and unconsciously sought to emphasize her difference when growing up by speaking English with an affected American accent and using slang from the cowboy comics they read. She became more eccentric in her ways as she grew older, justifying Marie’s description of her as “odd” and “not quite right in her head”. By her early twenties, Rose had acquired a psychiatric label that stuck to her, making it even more difficult for her family to embrace her difference.

Rose returned to India on her own at nineteen, but now felt just as alien in her former homeland because of her independent thinking, western ways, and strange accent. She lived in various institutions thereafter, forever abandoned by her family.

* * *

I have chosen this particular family story to illustrate how easily attachments can be disrupted, and with such tragic results, even in a relatively normal family with kind and well-intentioned parents. This has been powerfully demonstrated in James and Joyce Robertson’s deeply poignant films, made in the 1950s, about the immediate and long-term impact of sudden separation and loss on two previously “securely attached” toddlers, “John” and “Laura” in A Two-Year-Old Goes to Hospital (1952).

It must be remembered that, in “Rose’s story”, Marie remained a loving and caring mother to Peter and Emily in particular, and that Rose must have been securely enough attached to Marie for those crucial first seven months of life to be able then to develop strong bonds with her grandparents, who became her substitute carers. However, Rose’s inability at a year old to reclaim a convalescing Marie as her primary attachment figure, and her mother’s felt rejection by Rose, sealed their fate. Neither had help thereafter to acknowledge and mourn their losses and rebuild their early attachment.

The unheard story of this “lost sister” divided the family forever; however, their scripted version was of being a loving and united family. As John Byng-Hall points out, “the family myth is the family’s consensus about which home truths cannot be told” (1995, p. 139, my emphasis). Anyone who challenges the truth of this myth is likely to be scapegoated, as Rose continued to be even as an adult.

Rose was neither neglected nor abused in infancy, but the impact of sudden separation from her very ill mother at seven months and the loss of her birth family at only a year old, followed by that of her grandparents at six years old, must have been more than her developing psyche could deal with, especially as she then became the unwitting scapegoat for all the family’s problems after her return to them in Africa.

Fifty years on, an early diagnosis of “attachment difficulties” might well have been made about a child such as Rose, given her behavioural problems as a result of the traumatic maternal and family losses she suffered in her first few years of life. Any therapeutic help for Rose and her family would have needed to address the painful truth of the ongoing losses for her as a child, and to work on rebuilding positive relationships with her parents and siblings to help them all to heal and move on as a family.

* * *

There is an intriguing counterpart to Rose’s story in that of her sister, Emily.

Emily's story

Emily must have learnt very early on from the family’s abandonment of baby Rose not to be openly rebellious. She readily accepted her father’s oft-repeated dictum: “A laughing child is a portrait of happiness.” Emily kept any sad, bad, mad feelings to herself and looked down on little Rose for not being able to do the sa...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• ACKNOWLEDGEMENTS
• Dedication
• ABOUT THE AUTHOR AND MAIN CONTRIBUTORS
• ABOUT CHILD-CENTRED ATTACHMENT THERAPY
• PREFACE
• CHAPTER ONE The long-term impact of attachment difficulties on families
• CHAPTER TWO Background to the development of CcAT: a programme for fostering mutual attachment between child and carer
• CHAPTER THREE From theory to practice: CcAT as a "working model"
• CHAPTER FOUR Phase 2 of the CcAT Programme (1996): brief evaluation of the pilot project: our learning from adoptive families
• CHAPTER FIVE Phase 3 of the CcAT Programme (1997-2007) CcAT as an independent attachment therapy with birth, extended, foster adoptive, and step-families: our further learning from families
• CHAPTER SIX Re-evaluating CcAT: its potential in child protection work
• CHAPTER SEVEN CcAT therapists' learning and users' perspectives; professionals' perspectives
• CHAPTER EIGHT A future for CcAT: spreading the word among professionals
• CHAPTER NINE Overall learning from CcAT: who can benefit
• Epilogue
• APPENDICES
• REFERENCES
• INDEX