Involving parents in therapy
Infants are helpless when they are born. Their relationship with their primary adult caregiver is crucial to how the child's brain organises itself and how the child develops. They rely on their caregiver to meet their every need for food, comfort and nurture. When the caregiver is reliable and consistently meets the child's needs, the child develops a secure attachment to them.
When the early environment has been unsafe
Children who have experienced developmental trauma have learned that the world is not a safe place — and that adults who look after them cannot be relied on to meet their needs in a safe, consistent and nurturing way. Relationships have been unsafe or unpredictable, and so the child learns attachment strategies to protect themselves.
The adults who are trying to meet this child's needs may find that the child feels unable to trust them and (often unconsciously) rejects the support being offered — under-activation of their attachment system. A child can experience caring gestures as threatening, and become self-reliant and fiercely independent, resisting efforts to nurture and care for them.
Others may present as continually needing support and attention from their caregivers, doing increasingly dramatic things to ensure that those adults stay close and meet their needs. For some children, when the adult offers a response, that too can be rejected. This experience can be very difficult and bewildering for the caregiver — and can quietly chip away at their confidence in their ability to continue to meet the child's needs.
Developmental trauma happened in a relationship — impacting on the child's ability to accept nurturing care. Recovery from this trauma also needs to happen in relationship.
Why we work with the pair, not just the child
Caregiver-and-child therapeutic work such as Theraplay® and Dyadic Developmental Psychotherapy (DDP) are designed to support recovery within the relationship. Caregivers are helped to understand and make sense of their child's behaviour through a trauma-and-attachment lens, and supported to learn strategies for engaging with their child. Both models offer a therapeutic parenting aspect in addition to joint sessions with the child.
This is not because the caregiver has done something wrong. It is because the relationship is the medicine. The hour spent together in the therapy room is, at its best, a rehearsal — a place where new patterns can be tried, gently, with support — so that they can begin to be lived out in the ordinary moments of home.
If you'd like to talk
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Originally published by Sarah Lewis on LinkedIn, 5 June 2020.