Introduction
Childhood plays a critical role in developing personality and can significantly influence one’s choices and behaviors in adulthood. Evolutionarily, children were programmed to seek attachment with a stronger person who can provide appropriate care and support (Lai & Carr, 2018). Four primary attachment styles were described in the literature: secure, insecure-anxious, disorganized-disoriented, and insecure-avoidant (Broderick & Blewitt, 2020). Children with a secure attachment style are those who receive proper emotional support from their parents and have confidence in self-worth, seeking a response from their parents only at times of stress (Lai & Carr, 2018). Children with insecure-anxious attachment styles tend to constantly seek the caregiver’s attention (Lai & Carr, 2018). In contrast, insecure-avoidant types prefer to suppress security-seeking behavior (Lai & Carr, 2018). As the name suggests, disorganized-disoriented types can be willing to seek parent’s attention and avoid simultaneously (Broderick & Blewitt, 2020). This paper aims to present the case of a child with an insecure-avoidant attachment style. An insecure-avoidant behavior model may develop in children who experienced neglect and rejection from caregivers early in life, but cognitive behavioral therapy can improve their attachment style.
The Case: An Insecure-Avoidant Behavior
Lily is a two-year-old girl who was adopted by the Smiths when she was eighteen months old. Her biological mother was a twenty-year-old college dropout who committed suicide when Lily was about eleven months old. The girl’s parents describe her as an active and intelligent child, with clear speech and the ability to use a spoon and a fork. However, they are concerned about Lily’s apathy to other children and lack of affection for them. She received all immunizations for her age according to the schedule. The Smiths are not aware of her entire family history, but they were told that her biological father had illicit drug use disorder and her mother suffered from severe clinical depression. Lily does not have any significant developmental challenges except resistance to interact with peers. Indeed, learning and memory formation are exceptionally active in infancy; therefore, the child can form memories and abnormal methylation patterns in the brain due to adverse childhood experiences, affecting them later in life (Broderick & Blewitt, 2020). Since her biological parents abandoned Lily, the Smiths are now afraid that their daughter may have autism spectrum disorder.
Evaluation of the child revealed that she could communicate with others using 2-5 word-long sentences, maintain eye contact, understand questions, and do not show the signs of repetitive behavior. However, Lily does not express affection for her parents, does not cry when they leave the room and is not interested in playing with others when placed in the room with children. When asked why she does not play with them, she turns her back. It appears that the child developed an insecure-avoidant attachment style due to being neglected by her biological parents. Because Lily’s mother was clinically depressed and the father had a drug addiction, they probably did not express affection and sensitivity to their daughter. Unfortunately, she did not spend enough time with her new parents; thus, she has not yet developed a different attachment system. Still, neuroplasticity, which refers to the ability of the human brain to change and adapt, allows preventing adverse psychological consequences in the case of early intervention (Broderick & Blewitt, 2020). Therefore, finding the right approach for Lily’s attachment problem will improve communication between the daughter and her parents.
The main problem in this case is the development of insecure-avoidant attachment that resulted from a traumatic experience during the girl’s infancy. This experience is associated with parental neglect and her mother’s suicide. According to Lefmann and Combs-Orme (2013), the first year of life is related to rapid brain development. More than 40,000 synapses are formed every second during this period, indicating the absorption of information and learning (Lefmann and Combs-Orme, 2013). The period from birth to one year is critical for brain maturation because a child acquires new skills, learns about oneself and the surrounding world, and develops consciousness (Lefmann and Combs-Orme, 2013). The first year of life is also crucial because methylation patterns established in the brain in the first year of life can significantly impact the hormonal response to stress in adult life (Rasmussen & Storebø, 2020). Neuroplasticity gives some hope that the present intervention will help the girl unlearn some styles and habits of her adverse experience from early childhood and develop a healthy attachment style.
Early Development Intervention Analysis
Many people unconsciously continue to apply behavioral attachment styles developed early in childhood throughout their adult lives that often create obstacles in their socialization. The quality of interaction with the caregiver in infancy shapes neuronal pathways that remain relatively stable, making a child’s brain vulnerable to permanent alterations resulting from stress exposure (Maltese et al., 2017). For example, a traumatic childhood experience was found to cause an enlarged amygdala which subsequently shaped an emotionally sensitive personality type (Maltese et al., 2017). Another critical aspect of brain development and maturation that needs to be discussed is epigenetic changes, which alter gene expression caused by environmental factors (Rasmussen & Storebø, 2020). Specifically, adding a methyl group to DNA can silence gene expression (Rasmussen & Storebø, 2020). For instance, exposure to childhood trauma results in hypermethylation of the promoter region of the NR3C1 gene that leads to overactivation of the hypothalamic-pituitary axis (Rasmussen & Storebø, 2020). Epigenetic modifications are reversible under the right conditions, which sometimes should be maintained for a prolonged period for the desired change to occur. Therefore, early intervention into Lily’s development can prevent negative consequences and improve her attachment issues.
One of the possible interventions that can help in this case is cognitive-behavioral therapy. Therapy can reshape a patient’s attachment style through acceptance and effective communication (Slade & Holmes, 2019). Since Lily’s vocabulary is not equivalent to an adult one, establishing trusting relationships between the child and parents should be done through games in the therapist’s office (Broderick & Blewitt, 2020). Research shows that early intervention can help to change an attachment figure over time (Lai & Carr, 2018). The change can be initiated by establishing attachment between the child and therapist, providing emotional safety and unconditional acceptance (Slade & Holmes, 2019). Addressing the girl’s emotional pain by verbalizing her emotions can help Lily communicate and alter her dysfunctional attachment style (Broderick & Blewitt, 2020). This intervention may take a long time, but the outcome will be the child’s emotional recovery and transition to secure attachment behavior.
Possible Outcomes in Adulthood
Attachment models can affect children’s behavior later in life because of their impact on social adaptation. All traumatic events before age 5 seem to affect a child’s physical and emotional well-being regardless of further improvement in housing (Broderick & Blewitt, 2020). For example, children who had a secure attachment style but lived in a poor socioeconomic environment tend to be less susceptible to chronic inflammatory conditions than those who were mistreated by their parents (Broderick & Blewitt, 2020). Although an attachment style may change and children may become more socially adaptable, insensitive parenting style can be acquired by children rejected by their caregivers (Broderick & Blewitt, 2020). It appears that an insecure model of behavior can become second nature in affected people who may translate their anxious or avoidant attachment style to their future partners and children. Similarly, Lily, who has insecure-avoidant attachment, may become socially withdrawn and have difficulty with emotional expression later in life if left without the intervention.
Conclusion
To sum up, a child’s attachment model is mainly dependent on parenting style. An infant’s brain develops rapidly during the first year of life, allowing for faster learning of essential skills. However, the young brain is susceptible to environmental stress; thus, adverse childhood experiences can severely alter it. These changes may damage the physical and psychological well-being of the child. Four main attachment styles that develop as the result of the relationship between children and their caregivers were described in the literature. The presented case described the toddler with an insecure-avoidant behavioral model caused by insensitive parenting and traumatic childhood experience. Cognitive-behavioral therapy in the game form can help alleviate the negative consequences of neglect and rejection for this child. Finally, counseling is recommended in all insecure attachment cases to prevent the persistence of these issues in adulthood.
References
Broderick, P. C., & Blewitt, P. (2020). The life span: Human development for helping professionals (5th ed.). Pearson Education.
Lai, Y. H., & Carr, S. (2018). A critical exploration of child-parent attachment as a contextual construct. Behavioral Sciences, 8(12), 1-14.
Lefmann, T., & Combs-Orme, T. (2013). Early brain development for social work practice: Integrating neuroscience with Piaget’s theory of cognitive development. Journal of Human Behavior in the Social Environment, 23(5), 640–647.
Maltese, A., Gallai, B., Marotta, R., Lavano, F., Lavano, S. M., Tripi, G., Romano, P., D’oro, L., & Salerno, M. (2017). Neurosciences and attachment theory: A brief review. Acta Medica Mediterrania, 33, 1249-1255.
Rasmussen, P. D., & Storebø, O. J. (2020). Attachment and epigenetics: A scoping review of recent research and current knowledge. Psychological Reports, 124(2), 479-501. Web.
Slade, A., & Holmes, J. (2019). Attachment and psychotherapy. Current Opinion in Psychology, 25, 152-156.