The Networker- May/June 2012

You’re Not Alone!

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You’re Not Alone!

The Networker You’re Not Alone!

You’re Not Alone!

You’re Not Alone!

You’re Not Alone!

May/June 2012

In this Issue...

Attachment Disorder ...........1

Attachment Disorder - An Introduction

Piece of My Mind ................ 9

Lawrence B. Smith LCSW-C, LICSW

ATN News ......................... 10 Upcoming Events .............. 12

Attachment bonds:

Advocacy Retreat ...............13

An attachment bond contains all of the following elements:

Book Review...................... 14

The mission of the Attachment & Trauma Network (ATN) is to:

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Comfort and safety is sought within the relationship

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Desire for physical proximity to the attachment figure.

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Emotional distress in response to enforced separation.

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The attachment figure is a specific other person and is NOT interchangeable.

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Emotional significance as safety is established.

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Persistence across time and situations.

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Reciprocity and mutuality

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Develop gradually over time and underlie self and object constancy. Until constancy is achieved, the length of separations should be monitored so as not to overstretch the developing bond and tear it.

Attachment & development:

Promote healing of families through support, education and advocacy.

The quality of the initial attachment is enormously important, for it contours all subsequent development. A functional attachment relationship has been identified as playing a vital role in all of the following: 

The context for the neurological structuring of the right hemisphere of the brain and integration of right and left hemispheres

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Functioning of the neuroendocrine system: production of hormones and neurotransmitters

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Development of an integrated Internal Working Model (Continued on page 2)

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Regulation of: arousal level, reactivity to sensory input, motor activity, feelings, attention, and thinking

experiences with multiple potential attachment figures, is affected.

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Developing relationships with others / capacity for empathy

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Encouragement of exploration and learning vs. the management of anxiety

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Speech & language organization

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Practical reasoning and problem solving

An attachment bond is secure if an infant can reliably experience security / comfort / safety within it. This is critically dependent upon the infant perceiving the attachment figure as predictable, available, and competent. The overarching task of caretakers is to facilitate the child’s integrating of component parts into a cohesive whole. Research has identified the key ingredients to being a viable attachment figures are:

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Qualities of Attachment Figures:

Empathy or attunement can be defined as the ability to accurately perceive and reflect back the internal state of another.

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Communicate that they can mange situations (safety)

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Assist child to regulate arousal to prevent states of overarousal / fragmentation

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Responsiveness to crying / distress

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Carry out interactive repair as needed

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Memory functioning

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Ability to set effective limits in a practical manner

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Acquisition of a conscience

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Claim child as belonging with attachment figure

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Developing a sense of time as continuous and sequential

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Ongoing sense of curiosity

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Sense of humor

Resilience in the face of stress or novelty

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Well developed empathy or attunement skills. Without such external validation, a child’s ability to construct an internal model of the outside world (IWM), as well as a sense of the self as real, becomes impaired.

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Attachment at the Cellular Level: Recent research from the Tulane School of Medicine demonstrated the impact of institutional life at the cellular level. The focus was telomeres, which are strands of DNA attached to the chromosomes. Telomeres shorted with age and their length appears related to life span. The subjects were 100 Romanian children and what emerged was that the more time the children spent in an institutional setting during their first 4 years, the shorter were their telomeres. - Molecular Psychiatry. May 2011.

Empathy / Attunement: Empathy or attunement can be defined as the ability to accurately perceive and reflect back the internal state of another. One way to describe empathy is as a

Multiple attachments:

Children in institutions will attempt to form multiple attachments with their caretakers and typically select one caretaker to be the primary attachment figure

Contrary to popular mythology, infants are capable of more than one attachment. Multiple attachments are not equivalent, but are arranged in an internal hierarchy. The highest functioning infants have two working attachment bonds they can rely on. The quality of paternal, or other secondary attachments, primarily reflects the attachment skills of the relevant adult rather than a limitation in the infant’s capacity to form multiple attachments. Children in institutions will attempt to form multiple attachments with their caretakers and typically select one caretaker to be the primary attachment figure. To date, we have no research data to inform us as to how the Internal Working Model of infants and young children, exposed to conflicting

welcoming of feelings just exactly as they arrive without trying to change them, take anything away from them, add anything to them, fix them, or explain them. Being present to the child requires the adults to be aware of where they are placing their attention. It is easy to believe that one is reflecting the internal state of the child, when, in fact, the adult’s attention is focused on (Continued on page 3)

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wounded a child is, the more accurate must the empathy be to be soothing. In addition to empathic verbal content, adults should also be skilled at nonverbal empathy. This involves using voice qualities (e.g. loudness, inflection, rate of speech), bodily gestures, facial expressions, and physical proximity to communicate empathy with the AD child's internal state.

something internal to the adult. (Example: the child is feeling poorly about herself and says that she doesn’t believe her parents love her. A common and understandable adult response would be to offer reassurance to the child of the parents’ love.) This response comes from the adults’ distress that the child feels unloved and a desire to change that. Here the adult attention is focused on the adult’s desire to change how the child is feeling. As such, this may be a reassuring, sensitive response, but it is not an attuned one. A

Brain functioning:

There is a direct relationship between the security of attachment and the level of cortisol in the system

precisely attuned response would communicate that it is hard for the child to believe that her parents love her, and so she has a lot of hurt here- this is what the child herself has expressed. This response makes no attempt to shift how the child is feeling- it only describes, precisely, the feeling. One cannot accurately reflect something if one is trying to change it, as reassurance aims to do. Reassurance can even backfire as research has amply demonstrated. The reassurance can seem so far beyond believable to the recipient, that the reassurance only serves to reinforce how badly the recipient really does feel and can undermine the credibility of the one offering reassurance. Sensitive / reassuring, but misattuned responses, have more to do with the adults’ own reaction to what the child has expressed rather than to the content of the child’s expression itself. This is a very important distinction, for the more accurate the empathic comment, the more powerful its emotional impact; and the more deeply

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An infant’s brain makes 1000 new neuronal connections per minute. This pace of brain growth will never be seen again throughout the life span.

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The more a brain circuit is used, the more efficient and faster it becomes (uses less energy), the more information it can process, and the more flexible it is.

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The power of attention can alter brain structure by enhancing the brain circuits in use.

Etiology of AD: When the attachment process does not go well, it is almost never because of any single cause; but because of multiple influences interacting. A number of risk factors have been identified as increasing the probability of attachment difficulties: 

Intrauterine exposure to alcohol, drugs, and/or toxins.

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An early history of loss / abandonment.

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A history of multiple caretakers, and/or multiple changes in living location early in the child's life

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Emotional unavailability of primary caretaker.

When the attachment process does not go well, it is almost never because of any single cause; but because of multiple influences interacting. 

Physical and/or sexual abuse.

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Neglect.

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Chronically elevated cortisol levels.

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Failure to thrive.

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Chronic illness or pain.

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Sensory under- or over-reactivity that obstructs interaction with the environment.

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Significant parental mental health problems, particularly maternal depression in the first 2 years.

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Parental substance abuse.

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A history of harsh, overindulgent, extremely inconsistent, or chronically mis-attuned parenting.

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Chronic severe marital conflict / domestic violence.

Etiology: Cortisol Description: Cortisol is a steroidal hormone produced by the adrenal glands. Its primary functions are to increase blood sugar, aid metabolism, and suppress immune system functioning. It also decreases bone growth. Cortisol is released in response to stress or to insufficient blood levels. Cortisol levels vary on a predictable diurnal rhythm. Chronic stress or trauma can generate prolonged excessive cortisol.

caretaker response (Leach, 2010). Tactile deprivation produces increases in the circulating blood level of cortisol.

Elevated cortisol: Elevated levels of cortisol can have a range of damaging physiologic effects. Excessive cortisol erodes the myelin sheath that covers neurons, and this impairs the transmission of nerve impulses. It can damage the hippocampus, thereby impairing both long term memory and spatial navigation. On the other hand, elevated cortisol can facilitate neural workings in the amygdala which can lead to increased levels of fear and anxiety (Sapolsky, 2003).

Cortisol & animals: A few minutes of petting a dog lowers cortisol in both the human and the animal.

Progression of AD: AD develops over a span of time. In the face of early experiences of interactive dysregulation and a lack of emotional safety, infants and toddlers attempt to cope by presenting an array of attachment signals and behaviors to procure needed nurturance. Trial and error tends to guide this, and the overall result is a disorganized attachment style that is rather fluid. This disorganized style can appear as: 1) sequential or simultaneous approach/avoidance, 2) interrupted speech or movements, 3) poor coordination and stumbling primarily when the parent is present, or 4) rapid changes of affect. Without appropriate prior intervention, by age 6 this more fluid disorganized attachment style crystallizes into a more organized, rigidified attachment disorder, designed to control both the inner and outer worlds. Now the child will fall somewhere along the AD Spectrum. This underscores the value of early intervention with AD as with so many other things.- Lyons-Ruth. Psychiatric Clinics of North America. 2006.

There is a direct relationship between the security of attachment and the level of cortisol in the system.

Attachment & cortisol: There is a direct relationship between the security of attachment and the level of cortisol in the system. Securely attached infants do not show elevated cortisol in response to parental separation. This is not the case with infants who are insecurely attached or demonstrate disorganized attachment behaviors. Maternal depression in the first two years is the single best predictor of elevated cortisol levels at elementary school age. Orphanage reared children as well as neglected infants in families of origin both show a lack of the daily cortisol rhythms.

Prevalence of AD: The media tends to describe Attachment Disorder in children as “rare to extremely rare”, probably because the media’s focus is on the severest of cases. However, infant research and adult research using the Adult Attachment Interview (AAI), have identified the distribution of categories of attachment problems in the population as far more common: .

Emotional regulation: Crying infants left to cry without response leads to elevated cortisol levels that can reach a point capable of producing brain damage that can impair future learning capacity. It is not the crying per se that is the problem, but the lack of a regulating

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60% of adults are securely attached.

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25% of adults have an avoidant attachment style.

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10% of adults have an ambivalent attachment style.

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5% of adults have a disorganized attachment style.

central goal of AD children). Narcissistic disturbance refers not to a diagnostic category, but to a dimension of psychopathology (The AD Spectrum) that cuts across diagnostic entities, with the degree of narcissistic disturbance referring to the fragility of the self and its vulnerability to disintegration. And so in the end, narcissism comes down to a concept embracing regulatory and protective functions, and its disorder is dimensional rather than categorical. The exact same statement can be made about attachment and attachment disorder.- Robert Stolorow. International Journal of Psychoanalysis. 1975.

- Cassidy & Shaver. Handbook of Attachment. 2008 

50% of adults are securely attached.

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25% have an avoidant attachment style.

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20% have an anxious attachment style.

- Levine & Heller. The New Science of Adult Attachment. 2010.

True & False Self: The True Self (TS) emerges from sufficient synchronized experiences with the primary attachment figure. This facilitates faith in the external environment which lowers the need for self-protection. The TS houses real feeling, spontaneity, creativity and the sense of bodily aliveness. The False Self (FS), by contrast, begins with the initial attachment figure not coordinating with the infant’s signals, but instead ignoring them, misinterpreting them, overindulging them, or imposing the adult’s needs over them. The purpose of the FS is to protect the True Self (TS) from annihilation, primarily through exploitation by others. In this sense, the FS is a replacement attachment figure pursuing the primary goal of an attachment bond: safety. There is a spectrum of the TS being intermittently hidden to being completely hidden all the time. The FS is rigid in its workings and inhibits growth (IWM of AD). It houses intellectual activity while seeking to escape emotional and bodily experience. Living within the FS brings a sense of futility, deadness, and a feeling of not really existing. The emotional reactivity of the FS to perceived external threat should not be mistaken for the genuine feelings that belong to the TS. Real experience does not “stick” to the FS but flows through it like water through a sieve. This underlies the child’s lacking any sense of existence through time nor any internal sense of time as

The True Self (TS) emerges from sufficient synchronized experiences with the primary attachment figure.

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15% of infants from advantaged, low risk populations display disorganized attachment strategies.

- Lyons-Ruth. Psychiatric Clinics of North America. 2006.

Conceptual names: Narcissism: Much of what comes under the rubric of attachment disorder has been around for a long time, packaged in different terminology. Within the psychoanalytic tradition and its more recent iterations, object relations and self psychology, the concept of narcissism overlaps substantively with the attachment realm. Narcissism came to be defined as comprising those operations that function to regulate selfrepresentation and protect its stability. Narcissistic patterns such as fantasies of magical omnipotence, unlimited entitlement, bodily preoccupation, and an insatiable appetite for attention (all commonly seen in AD children) function as efforts to repair damage to the self-representation from early traumatic experiences (prevalent in the histories of AD children) and avoid its dissolution (annihilation anxiety). Narcissistic object choices are essentially substitutes for missing or malfunctioning skills for regulating the selfrepresentation. This plays out either as seeking mirroring of the fantasied grandiose self-image or seeking fusion with what is perceived to be an omnipotent object (patterns AD children frequently display). With the Grandiose Self, all unacceptable elements are dissociated and assigned to external objects which are then devalued. With the Idealized Object, all unacceptable elements are dissociated and buried within. In both cases, dissociation becomes a central feature of ongoing functioning with the goal being averting fragmentation and disintegration of the self (the

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a continuum. The deeper the split between the FS and the TS, the more the child demonstrates poor use of symbolism, significant restlessness, inability to concentrate, and a need to “collect” stimuli from external reality. The child’s “living-time” can then be filled with reacting to these stimuli.

The Attachment & Trauma Network (ATN) recognizes that each child's history and biology is unique to that child.

The FS is adept at taking in aspects of others (not true internalization) and weaving them into its pretense of being real- imitation is one of its skills. An organized FS can be very deceptive. The world sees the appearance of functioning and does not imagine the real internal distress that exists within the child. The world falls for the pretense, and the FS is seen as the whole child. This is extremely damaging to the child for it only enhances the sense of not really existing. Relative to the TS, the world being deceived by the FS is an ultimate act of misattunement. All this being said, the ultimate goal of the FS, is to find a way to give birth to the TS. Transitioning from the FS to the TS comes with a phase of extreme dependence, which the FS is likely to desperately fight (the worsening behavior that accompanies progress initially). Healing involves recognizing and communicating the child’s sense of not really existing- an act of attunement. On the other hand, the FS can collaborate for a long time with a clinician who mistakes the FS for the real client. D.W. Winnicott. Maturational Processes and the Facilitating Environment. 1960.

Because of this we believe there is no one therapy or parenting method that will benefit every child.

What works for one child may not work for another child.

Many children may benefit from a combination of different therapeutic parenting methods and trauma-sensitive, attachment-focused treatments.

We encourage parents to research different treatments and parenting methods in order to determine what will work best for their unique children.

Assessment and Diagnosis: Language and the Perception of Diagnostic Reality: There are several decades of research demonstrating the significant influence of language on perception. At the most basic level, all words are symbols, not real entities. However, it is easy to get too wedded to one’s language and conceptual terminology and start treating words as real objects. When this happens, the concepts can function as filters that obscure, or worse still, replace the reality of what is actually occurring in the moment. The client ends up getting dressed in a concept, and very valuable information, gets lost behind the label. Naming something is not the same as understanding it. Regardless of the concept attached, the clients remain the same. How they are functioning is still how they are functioning. So, the important question becomes, what difference does it make to the clinician to decide, “Is it this diagnosis or is it that diagnosis?” How does that decision impact treatment- for better, for worse, or not at all? And once we have decided, are we still curious about what’s happening in front of us or have we decided “we know”? But do we really know, or do we just think we know based on a “conceptual certainty”. Has the concept come to replace the reality of the client’s functioning?

www.attachtrauma.org Assessment: Attachment Disorder is a very complex entity. As such, trying to assess it in any single diagnostic appointment, as the current insurance-driven climate demands, is very prone to go astray. It is a disorder which manifests in the nuances of day to day life, and data on day to day functioning is therefore the most relevant. By definition, “day to day functioning” can’t be observed in a meeting or two, nor can it be captured by comprehensive testing procedures, all of which are still snapshots in time and place. There are several behavioral checklists for AD. However, as with other disorders, none of these checklists are diagnostically conclusive. In a comprehensive review of rating scales for Depression, Generalized Anxiety Disorder, Obsessive Compulsive Disorder, AD/HD, Bipolar Disorder, Schizophrenia, and Autism, the authors concluded: (Continued on page 7)

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Symptom specific rating scales should be employed with care. While they assess symptoms, they are not diagnostic measures. Use of these scales still requires clinical expertise and careful assessment to insure optimal outcomes.

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Generalized Anxiety Disorder

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Phobias

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Obsessive Compulsive Disorder

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Post Traumatic Stress Disorder

Hirschtritt & Bedoya. 2011.- The richest database for assessing AD is the information provided by parents, as they clearly have the most extensive data on daily functioning over time. This is supplemented by observations of parent-child interactions in therapy (just one reason parents need to be present in attachment work). Data provided by teachers is the next best source, though of considerably less value than parental input, given the differences in the relationships with the child.

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Dysthymic Disorder / Major Depression

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Bipolar Disorder

Because AD children present clinicians with such a diagnostic array of possibilities, these children are not so much misdiagnosed, as they are partially diagnosed. This is almost a guaranteed outcome of evaluations based on one or two sessions. One aspect of their functioning, typical of one of the above disorders, may catch a clinician's eye. The child is then given that diagnosis, and the larger Attachment Disorder picture gets lost as "the part is mistaken for the whole". Treatment is then based on the partial diagnosis, and this all but guarantees treatment failure.

Partial diagnosis: Because attachment impacts development in so many different ways, the symptomatic presentations of AD children can be found in all of the following current diagnostic categories: 

Attention Deficit Hyperactivity Disorder: Since attachment problems can disrupt neuroendocrine functioning, dopamine deficiencies can appear in both AD and AD/HD.

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Oppositional Defiant Disorder

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Conduct Disorder

The Future: DSM-5 Reactive Attachment Disorder (RAD)- DSM 4: RAD first appeared in DSM-3 in 1980, so it has a 30 year history. A primary objective of DSM-3 was to divide psychiatric disorders into separate categories that did not overlap. Given its complexity, RAD has never cooperated with this objective, and this likely (Continued on page 8)

ATN Board of Directors Julie Beem, Executive Director Denise Best, LMHC Tanya Bowers-Dean Stephanie Garde Ken Huey, Ph.D. Kelly Killian Jane Samuel Lorraine Schneider Larry Smith, LCSW, LICSW Nancy Spoolstra, Founder Janice Turber, M.Ed..

Sheri Verdonk

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contributes to its controversial reputation. Within the current DSM-4, RAD is listed as: 313.89: Reactive Attachment Disorder of Infancy or Early Childhood. There are two types:Inhibited and Disinhibited. The DSM-4 criteria are accurate as far as they go, but are too limited in scope in their description of inappropriate social relatedness and of the etiology of AD. The functioning of children with AD is far more complex than the criteria outlined in 313.89, and as a result, in terms of DSM-4, AD children are scattered across the diagnostic map.

increase in children being diagnosed with Bipolar Disorder during the last decade. This statistic is raising questions about the credibility of the psychiatric diagnostic process. Despite the possible change in diagnostic terminology, a frontline treatment for DMDD will remain the same as with Bipolar Disorder: second generation antipsychotics and mood stabilizers. The unacknowledged goal here is to capture some of the children currently in the bipolar category and remove them to another diagnostic class, thereby reducing the credibility-taxing explosion in the diagnosis of Bipolar Disorder. Curiously, nowhere in the formulation of DMDD is there any reference to attachment or trauma.

RAD and DSM 5: In the draft DSM-5, greater prominence has been given to the absence of seeking or experiencing comfort / protection in human relationships that lies at the center of AD. In addition, the onset has been lowered from age 5 to nine months, which is more in line with the origins of AD. These are plusses. On the minus side, the two types of RAD in DSM-4 have been split into two entirely different disorders: Reactive Attachment Disorder of Infancy or Early Childhood and Disinhibited Social Engagement Disorder (DSED).

November 6, 2011 Version 4.4 LAWRENCE B. SMITH LCSW-C, LICSW 9305 MINTWOOD STREET SILVER SPRING, MARYLAND 20901 Tel & Fax: 301.588.1933 E-mail: lbsmith@md.net Web: AttachmentDisorderMaryland.com

Symptomatic diagnoses: These diagnoses are based on a predominant symptom that typically cuts across multiple disorders, but has been extracted as a stand-alone disorder. They are not really disorders in and of themselves. Current examples of such diagnoses are: Oppositional Defiant Disorder, Conduct Disorder, Intermittent Explosive Disorder, and Generalized Anxiety Disorder. Such diagnoses erase the need for differential diagnosis and encourage progressively shallower clinical thinking. In the case of AD, wherein problems are often layered, symptomatic diagnoses skim off the surface problem while missing the deeper problems that are the real source of the surface problems. DSM-4 carries a number of symptomatic diagnoses, and DSM-5 appears to be expanding them. Because they carry no reference to underlying etiology, symptomatic diagnoses, are of minimal clinical utility, except as possible targets for psychopharmacological intervention.

ATN

Disruptive Mood Dysregulation Disorder (DMDD): This disorder has been proposed for DSM-5. It is a combination of two earlier proposed disorders: Severe Mood Dysregulation Disorder and Temper Dysregulation Disorder with Dysphoria. These proposed disorders, in turn, grew out of two areas of disagreement: 1) where aggression and labile affect both exist in a child, is this a “mood disorder” or a “disruptive disorder”, and 2) is Bipolar Disorder in children episodic as it is in adults, or chronic. The second question has taken on much importance as a result of the 40-fold

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Piece of My Mind chance that our kid is going to turn it around in his teens, graduate high school and go on to college.” Or there’s an “80% chance that she’s going to end up in jail” unless you can somehow get her to stop a particular action. Don’t we wish it were that easy to know not only what our impact was, but what we could do the “put right what once went wrong”?

Taking the Quantum Leap A frequent thread for our online support groups is “will things ever get better?”

Often the response back from the other parents in the trenches is a resounding “NO”. Well, when this thread appeared again recently and everyone’s responses were bleak, I started reflecting on how we know if “things” are getting better. In other words – Is there any hope when you’re not seeing progress in your child?

But since life’s not TV, we continue to muddle through feeling like we just leaped into a scenario for which we have no clue how to solve.

Julie Beem Many ATNers are parenting children whose problems are severe and longATN Executive Director The truth is that our children’s traumatic lasting. Their early childhood trauma, pasts, their attachment disorder, their sometimes coupled with other mental deep wounds do heal. Many have healed illnesses or disabilities, may impact their in dramatic ways, even more have healed in smaller lives in negative ways for the rest of their lives. For ways, and some will show very little sign of progress. parents, their children’s present day behaviors can Some will take into their adult years to show signs of quickly dash any possible hope. healing; others will make sudden changes for the better.

So what is our impact on our children? Can we heal Still others will progress and regress like a roller coaster them? Can we help them? Will things ever get better? for years. Some will need to hit rock bottom to make a As I pondered this today, an image popped into my head turn around, others will just turn it around. Those of of Al, the cigar-smoking hologram from Quantum Leap, you in the trenches reading this may be skeptically checking his probability calculator. You remember the asking “how does she know many of these kids heal?” show Quantum Leap, starting Scott Bakula as Sam, a Well, one way I know is that ATN has different members scientist who is lost in a time machine experiment gone now than we had two or three years ago. It’s an wrong and leaps throughout history into other people’s interesting phenomenon in that parents often decide to bodies to “put right what once went wrong.” So he let their membership lapse when one of two things have shows up in a situation only to spend each episode trying happened – either their child has needed to leave their to figure out how to right the wrongs and impact that home permanently, or more commonly, the child’s situation for the positive. And once that happens he behaviors have improved. This phenomenon is both “leaps” into another scenario. encouraging and discouraging to me, as the Executive Besides Sam, the only recurring character is Al, played Director. It’s encouraging because it signifies what we

by Dean Stockwell. Al appears to Sam to give him the all hope – that the therapies, therapeutic parenting and back story, which he apparently gets from his handheld all the tools do help and children and their families do device that not only knows why Sam has leaped into the find hope and healing. But it’s discouraging because in situation, but as events unfold also knows the our support groups we’re often left with only a few to tell probability of a positive or negative outcome based on these success stories and many who question “will things what Sam and others were doing in the moment. ever get better?”

Hmmm…parenting our children is VERY MUCH like The other way I know our children heal is to look at my having taken a Quantum Leap. But what makes it own daughter. She’s far from what anyone might call harder is that we don’t have ol’ Al, the hologram around “healed”. Yet looking back on where she used to be and to tell us that, based on all we’re doing, there’s a “90% (Continued on page 10)

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And even if she were not showing this positive progress, the whole experience has brought me, as her mom, to a totally different understanding of love, acceptance and relationship than I ever realized was possible. In many ways, the significant, positive change has been in me!

where we used to be as a family, the progress is huge.

While we’ve never found “a cure” for my daughter’s complex developmental trauma issues, we’ve tried many of the interventions out there. None were magic, but in aggregate, the slow, steady therapeutic parenting and all these interventions have brought her to a more positive place than we used to believe was possible. (I hear Al the hologram saying there’s an 80% chance that she’ll graduate high school and much higher probability that she won’t kill any family members while they sleep!)

So, when I see that roller coaster heading down, or hear another struggling parent ask “will things ever get better”, I can answer confidently that YES, things do get better…we get better. And together, as ATNers we help each other get better…everyday!

ATN News Great Non-Profits’ Children & Families Award. Help ATN become one of the top-rated charities for children & families. All it takes is a few minutes to write a review/testimonial about how ATN has helped your family. If we rate either 4 or 5 stars on your rating scale, it will help us get a “top-rated” designation. If we don’t rate that high, we especially want to hear from you about how to serve you better.

Here’s the link to submit a review: http://www.greatnonprofits.org/reviews/write/ attachment-trauma-network-inc/campaign:children-families-2012/. You have to sign up on their site before submitting the review. And the reviews must be submitted by June 30, 2012.

ATN will benefit from this exposure, especially because Greatnonprofits.org is connected with Guidestar, which is the leading way that donors and foundations find out about non-profits when they are issuing grants and funding. So your review about ATN could definitely help ATN grow!

Scholarships, Scholarships and More Scholarships. Thanks to generous donors, ATN now has a “scholarship fund” to help parents who are members or want to become members and are experiencing financial hardships. ATN’s scholarship policy allows individuals parenting a traumatized child or one with attachment disorder to apply for a scholarship to cover their annual individual dues ($35) for one year – no questions asked. The scholarship can only be used once.

We’re also accepting donations to the scholarship fund for those of you who would like to pay it forward. In fact, when you renew your membership, you’re able to donate an extra $5 to the fund. And others can donate in your honor – makes a great gift!

RAD Goes Hollywood. Two movies about Reactive Attachment Disorder made this year are now in limited release and will be shown in select cities across the U.S. in the coming months. The Boarder, a full-length feature film based on the book by Jane Ryan (www.theboardermovie.com), premiered on June 10 in Nebraska and will be shown next in Hagerstown, MD on August 25. Check their website for ticket information. My Name is Faith, a documentary about 13-year-old Faith taking healing steps, had its world premiere at the Hot Docs Film Festival in Toronto and has upcoming screenings in US locations starting in August. (www.mynameisfaith.com) ATN is excited about both of these movies and talking with the filmmakers about supporting their upcoming screenings as they move toward full distribution. Stay tuned for more…

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ATN Professional Member Directory These professionals believe in ATN’s mission and have joined us as Professional Members Ken Huey, Ph.D. CALO (Change Academy Lake of the Ozarks) Lake Ozark, MO ken@caloteens.com 573-365-2221

Denise Best, LMHC Adoption & Attachment Treatment Center of Iowa Iowa City, IA denisebest@mchsi.com http://www.aatcofiowa.com/ 319-430-4383 Matthew Bradley, MSW Beatitude House Waynesville, NC http://www.beatitudehouse.org/ 828-926-5591

Thomas Jahl, Headmaster Cono Christian School Walker, IA thomasjahl@mac.com http://www.cono.org/ 319-327-1085

Karen Buckwalter Chaddock 205 South 24th Street Quincy, IL 62301 kbuckwalter@chaddock.org 217-222-0034

Nina Jonio NeuroSolutions Gresham, OR nina@neurosolutions.org http://www.neurosolutions.org/ 206-910-6088

Gayle Clark, Executive Director Miracle Meadows School Rte 1, Box 565 Pennsboro, WV 26415 http://www.miraclemeadows.org/ 304-782-3630

Jennie Murdock, LCSW, LMT Lehi, UT Jenniem1951@gmail.com 435-668-3560 Lawrence Smith, LCSW Silver Spring, MD 301-558-1933 lbsmith@md.net

Shirley Crenshaw, MSW, LCSW Crenshaw, Inc. St. Louis, MO srcrenshaw@charter.net http://www.attachmenttrauma.com/index.html 314-374-4753

Janice Turber, M.Ed. Center for Attachment Resources & Enrichment (C.A.R.E.) Decatur, GA 404-371-4045 www.attachmentatlanta.org Therapists: Barbara S. Fisher, M.S. Janice Turber, M.Ed.

Lark Eshelman, Ph.D. Chestertown, MD lark@larkeshleman.com http://www.larkeshleman.com/index.php 410-778-4317

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Upcoming Events in the Attachment/Trauma World July 8-15, 2012 Yoga Adventure Vacation for Exhausted Parents Dr. Katharine Leslie http://www.brandnewdayconsulting.com/ Call Dr. Leslie for more info 336-376-8366

October 4-7, 2012 2012 EMDRIA Conference EMDR & Attachment: Healing Developmental Trauma October 4-7, 2012 Washington, DC http://2012emdriaconference.wordpress.com/about/

July 26-28, 2012—ATN will be there!

North American Council on Adoptable Children (NACAC) 38th Annual Conference Crystal City, VA http://www.nacac.org/conference/conference.html

Therapeutic Parenting for Adopted Children – Training Sessions Denise Best, LMHC http://www.aatcofiowa.com/Parent_Training.html Coming to a location near you throughout 2012: July 14 & 15 – Omaha, NE August 11 & 12 – Portland, OR August 18 & 19 – Seattle, WA September 8 & 9 – Denver, CO September 15 & 15 – Minneapolis, MN October 6 & 7 – Boston, MA (ATN will be there!)

October 13 & 14 – New York City, NY October 20 & 21 – Washington, DC November 3 & 4 – Atlanta, GA (ATN will be there!)

November 10 & 11 – Detroit, MI December 1 & 2 – Los Angeles, CA (ATN will be there!)

December 8 & 9 – San Francisco, CA

August 2-4, 2012 – ATN will be there!

Branson POWER Advocacy Intensive Nigliazzo Advocacy Center Branson, MO http://www.nigliazzoadvocacycenter.com/conferenceinformation.html August 25, 2012 The Boarder Premiere Hagerstown, MD www.theboardermovie.com September 19-22, 2012 – ATN will be there!

ATTACh: Understanding Attachment and the Effects of Developmental Trauma Baltimore, MD http://www.attach.org/2012-Baltimore/2012savethedate2.pdf

Contact us: ATN P.O. Box 154 Jefferson, MD 21755 1-888-656-9806

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Book Review Scared Sick: The Role of Childhood Trauma in Adult Disease Robin Karr-Morse with Meredith S. Wiley Frankly, Scared Sick: The Role of Childhood Trauma in Adult Disease scared me. What a great compilation of all the latest science about trauma and the impact it has on our health. It’s one thing to read that the CDC and the American Academy of Pediatrics recognizes early childhood trauma as a “major health crisis”. But it’s quite another to have someone lay out the details of the impacts of fear and anxiety on not only our brains but our entire bodies and the diseases that result directly from basic stress and from significant trauma.

and toddlers. And that this impact has always been overlooked when examining the diseases of adulthood – including cancer, diabetes and many chronic illnesses.

Karr-Morse also introduces the emerging science of “epigenetics” which is the science of external influences on our genetic make-up. It is the science of nature and nurture together – and nurture’s impact on genetics.

Because scientists are finding that our genes are actually, by design, sensitive to environmental influences, they are now able to apply this to behavioral health and issues such as addiction, depression, PTSD, Schizophrenia and Alzheimer’s.

Robin Karr-Morse makes a powerful case for the need to RECOGNIZE trauma’s impact and then to DO something about it. Scared Sick pulls together more documentation and statistics on the impact of trauma on a person’s health than I have seen in one place before. And the argument for preventing child abuse, neglect, exposure to drugs and alcohol…it’s all there, clearly presented. But this book goes farther. It clearly explains that FEAR, regardless of the cause (medical procedures, traumatic event, mother’s illness, etc.) shapes our biology prenatally and as infants

All this information both fascinated me, and made me very sad, knowing the incredible amount of trauma my daughter has endured and all the fearbased responses she has exhibited, and still does. As a mom I just kept thinking that it’s so unfair that early childhood trauma should not only make your life so emotionally and psychologically difficult, but now even your hope for a physically healthy life is diminished.

But the hope that’s laid out in this book for all children of trauma is what we (Continued on page 15)

Help Wanted: Book Reviewers.

If you or your child have read a good book related to adoption, attachment or trauma, write a review (250-400 words), include a link to where you found the book, and email to kelly@attachtrauma.org

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(Continued from page 14)

already know – ATTACHMENT! In the chapters on security and attachment, Karr-Morse talks a lot about state regulation and physical attunement – concepts very familiar to those treating and parenting children with attachment disorder (if they’re not familiar to you – you need to find an attachment/trauma therapist to work with who understands the importance of regulation and attunement.)

She then goes on to make a compelling case for social change, based on the role that trauma and fear play in drug abuse, chronic illnesses, mental illness and crime, and the gigantic cost to society. Scared Sick is far from a light summer read or even a “how-to” book of parenting skills. But it’s an incredibly valuable work for showing the world not only that early childhood trauma IS a public health crisis, but that there are things that can be done at any age to reduce the toll trauma has taken on our health.

Karr-Morse succinctly puts it this way, “It appears that when trauma is the problem, attachment is a key piece of the solution.” She also shows research on how regulation therapies and activities, such as movement, meditation and yoga, are making a healing difference for many.

If you’re feeling especially strong and curious, check out this trailer for the book which interviews the mother of a traumatized child: http://www.youtube.com/watch? v=uLF1jfWbj64

Don’t forget to renew your membership!

Individual (parent) memberships are $35 annually; Professional memberships are $75 annually.

You have four ways to join: 1.

Join online at www.attachtrauma.org. Click the Join button and use your credit card to renew your membership.

2.

Print the membership form available on the website and mail it to: ATN P.O. Box 164 Jefferson, MD 21755 along with your check or credit card information.

3.

Fax the completed membership form with credit card information to 1-888-656-9806 .

4.

Call Lorraine at 1-888-656-9806 and give her your card information over the phone.

Memberships make great gifts.

We have a scholarship program, so memberships can also be donated.

Scholarships are available for individual memberships.

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