Academic journal article Journal of Marital and Family Therapy

Family Attachment Narrative Therapy: Healing the Experience of Early Childhood Maltreatment

Academic journal article Journal of Marital and Family Therapy

Family Attachment Narrative Therapy: Healing the Experience of Early Childhood Maltreatment

Article excerpt

Based on attachment theory and research, Family Attachment Narrative Therapy is introduced as a new family therapy modality developed to heal the experience of early childhood maltreatment. Unresolved childhood trauma has been correlated with impaired and delayed cognitive, behavioral and emotional functioning. Gentle, soothing, nonprovocative and nonintrusive narratives told by parents provide an alternative restorative experience designed to shift and change the child's destructive internal working model. The result is improved functioning and the ability to accept nurturing and care in relationships that offer love and safety. A representative case example is used to illustrate theory, practice and outcome. Pre- and posttherapy assessment supports the claim of improved functioning.

Family Attachment Narrative Therapy was developed by the author to meet the challenge of providing effective treatment to the growing number of children who experience early childhood maltreatment. In the not-too-distant past, the prevailing assumption was that children were resilient, and, consequently, they would respond positively when life circumstances changed. We now realize that the problem is complex and that a change in circumstance must also involve changes in the way a child responds to adults that are able to provide care and protection (Fahlberg, 1991; Keck & Kupecky, 1995, 2002; Lieberman, 2003).

Each year in the United States, nearly one million children are determined to be victims of abuse and/or neglect, and it is likely that many more experience adversity that could be classified as maltreatment. In substantiated cases, more than 80% of the perpetrators were parents and 58% were mothers (U.S. Department of Health and Human Services, 2004).

Maltreatment by a parent can have a devastating effect on a child. Clinicians treating children with a history of disruptive attachment relationships, defined by neglect, abuse, or abandonment, frequently note significant behavioral, cognitive, and affective impairments (Greenberg, 1999). Identified areas of concerns include conscience development, impulse control, self-esteem, interpersonal relationships, and emotional stability. Cognitive problems can be observed in apparent deficits in logical and abstract thinking and difficulty in understanding cause-and-effect relations. Developmental lags may be evidenced in auditory processing, verbal expression, adaptive motor skills, and personal and social development (Fahlberg, 1991). Children who experience the chronic stress of neglect or abuse without a loving, attuned caregiver who can modulate their physiological arousal, thus providing a solution to their discomfort, seem to be impaired in their ability to achieve critical developmental transitions (Perry, Herman, van der Kolk, & Hoke, 1990).

A child's ability to separate from a traumatic past and move forward with a sense of purpose and a belief in a better future seems to be dependent on a close relationship with a supportive adult (Egeland, Carlson, & Sroufe, 1993; Sroufe, 1997). Unfortunately, the experience of maltreatment seems to prevent many children from trusting adults that could provide restorative care and protection. All children are born with the genetic predisposition to form strong attachments to their primary caregivers. However, if the child's early experience includes chronic abuse and neglect, the attachment process can be disturbed and negatively affect the child's ability to form healthy relationships in the future (Perry, 2001).

This conceptualization was first postulated in John Bowlby's Attachment Theory and his concept of an internal working model. Children inevitably form expectations of the behavior of others and themselves based on the responsiveness and accessibility of primary attachment figures (Bowlby, 1969/1982, 1973). This means that children approach new situations with a set of preconceptions, interpretive tendencies, and behavioral biases (Sroufe, Carlsonr, Levy, & Egeland, 1999). …

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