Resilience

& Adult Attachment in Cases of Child Sexual Abuse

By Jane Gilgun & Wendy Anderson

Requires
Supportive networks of families, friends, community organizations, and helping systems Working alliances with service providers Competent service provision Optimism of service users and service providers that things can get better

Types of Adult Attachment Resolved/Secure: Family resilience is likely when the above conditions
are met.

Dismissive: Family resilience is possible when above conditions are met;

optimism often an issue; working alliance can be an issue as can supportive networks; parents must deal with own issues and do all they can for the sake of their children.

Preoccupied: Family resilience is possible when above conditions are met;

optimism often an issue; working alliance can be an issue as can supportive networks; parents must deal with own issues and do all they can for the sake of their children.

Disorganized: Family resilience is difficult to achieve; more likely as any of

the above four conditions are met and parents deal with own issues and do all they can for the sake of their children.
Children can recover from trauma and go on to live satisfying lives If they experience the safety of secure relationships Jane F. Gilgun, Ph.D., LICSW, is a professor and Wendy Anderson, MSW, is a Ph.D. student at the School of Social Work, University of Minnesota, Twin Cities.

Resilience & Adult Attachment in Cases of Child Sexual Abuse

By Jane Gilgun & Wendy Anderson University of Minnesota, Twin Cities, USA

Mothers of child survivors of sexual abuse are key to childrens recovery. Sexual abuse is a trauma for children. Research on attachment, trauma, and resilience shows that children can recover from trauma and go on to live satisfying lives if they have the safety of secure relationships and if parents in turn have the safety of secure relationships. Mothers and fathers, when either parent is not the person who abused children sexually, can provide this safety. Besides providing the safety of secure relationships, recovery from child sexual abuse involves other factors, which are called common factors in service outcomes. These factors are supportive networks of families, friends, community organizations, and helping systems; working alliances with service providers; competent service provision; and optimism of service users and service providers that things can get better. In order to be emotionally available to their children, parents require their own supportive relationships. It take a village to raise a child. It takes a village to help a child recover from child sexual abuse. If these factors are in place, in combination with parents who can provide the safety of secure relationships, children are likely to recover well from the effects of child sexual abuse. Children are said to be resilient when they have coped with, adapted to, and overcome the effects of child sexual abuse. When parents and children show these capacities, the family shows resilience. The issue for service providers is to assess family situation in terms of the factors associated with resilience and then to support parents sensitive responsiveness to their traumatized children. Providers can recommend a range of service options to parents and children. Effective services enhance relationships between parents and children. Ideas from attachment research can help service provides assess for whether parents have capacities to provide the safety children require to recover from sexual abuse. The research on which this poster is based interviewed mothers of survivors. In this handout, we focus on mothers, but the material can be tested for fit with fathers and other potential care providers. Service providers should also test findings for their fit with other mothers. In their on-going assessment, care providers pay attention not only to attachment issues, but also issues related to networks of other systems that affect children and families, to building working relationships with family members, and monitoring their own optimism and the optimism of service users. A key trait of effective practice is that service providers are sensitively responsive to parents and children.
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Developing effective strategies for action requires that service providers work cooperatively with parents, child survivors, and other family members and enlist connections with supportive services and personal networks. They continually monitor what is happening for families and themselves and adjust their actions accordingly. The following provides additional information on adult styles of attachment and their relationship to the recovery of children from child sexual abuse.

Two General Styles of Adult Attachment

There are two general styles of adult attachment. The first style is resolved/secure. The second style has three different types: dismissive, preoccupied and disorganized. Childrens styles of attachment typically mirror those of parents. Parents with resolved styles of attachment are most likely to provide their traumatized children with the safety of secure relationships and seek out various types of help, such as psychoeducation, self-help groups, therapy for the children and sometimes for themselves, among other helpful responses. They may at first be upset and even disoriented when they learn about the sexual abuse, but they grapple with their own trauma about the issues and focus on what children need. Parents with other styles of attachment may also provide children with the safety of secure relationships, but this may take them more time than parents who have resolved styles. They may require intensive therapy, self-help groups, and education about trauma and sexual abuse. What counts is their willingness to get this kind of help. If they refuse to take these steps, then service providers have to consult with others to make a plan for what to do to ensure that children have the safety of secure relationships that their parents cannot provide. This may mean petitions to the court and foster care. Four Types of Adult Attachment The following provides an overview of the four types of adult attachment. 1. Secure/Resolved Provide sensitive, attuned care for children Provide consistency and structure in family life Models and rewards prosocial behaviors for children Sets limits on inappropriate behaviors, explains why behaviors are inappropriate, and guides children toward behaving in appropriate, prosocial ways If they have experienced trauma, they acknowledge the trauma and its meanings and effects, and have dealt with it, usually through therapy and sometimes self-help groups Shows evidence of long-term, trusting, confidant relationships with others, beginning in childhood Has a good sense of who to trust and not to trust
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2. Dismissive Minimize childrens experiences of trauma Minimize the effects of their own traumas Downplay abuse as not a big deal or wont recognize the seriousness of what happened Unwilling to engage with service providers regarding childrens traumas and their own Are distant emotionally and over-regulate their own emotions May describe current relationships with parents and other family members as distant or cut-off, which sometimes is necessary for mental health but services providers should assess these relationships Their children may have avoidant attachment styles and do not seek them out for playful interactions or for comfort and help; children may have secure attachments with other persons, such as teachers, grandparents, other relatives, and friends 3. Preoccupied Self-centered: its all about me Unresolved/unattended trauma that they think about a lot May have mental health and chemical dependency issues related to unattended trauma Have difficulty regulating their own emotions, behaviors, and thoughts Have difficulty providing consistency, structure, and guidance to their children Unable to be sensitively attuned to their children; may be intrusive to children and disrespectful of childrens needs for a safe place where they can work through the effects of trauma without parental interference May parentify a child and expect child to take care of them May be overwhelmed by guilt and by what they did wrong instead of focusing on childrens well-being May think a lot about what their parents have done wrong or may idealize their parents Children do not seek out their parents for friendly interactions and for help and comfort; children typically have disorganized styles of attachment, although some may have secure attachments with other adults, such as teachers, grandparents, other relatives, and friends 3. Disorganized Behavior is random, dismissive, preoccupied, and sometimes agitated Have histories of complex trauma that they have not been able to deal with Often have issues with chemical dependency They may have diagnoses of persistent mental illnesses that they do not control well
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Childrens safety, well-being, and recovery comes first Children seek them out for general interactions and for comfort, although children may not tell even securely attached parents about the abuse because of fear perpetrators have instilled in them; children have secure styles of attachment

In conversations, especially when discussing sensitive issues, may lose may lose track of what they are saying or abruptly switch topics May provide grossly inadequate care to their children: abuse, neglect, abandonments with little or no understanding of the gravity of these behaviors May try to put up a front that things are perfect; may idealize current or past situations May respond with anger, lack of cooperation, or inconsistency when providers offer services Children do not seek them out for friendly interactions, comfort, or help; children may have secure attachments with other persons, such as teachers, grandparents, other relatives, and friends, but his more rare than in the other two styles of child attachments; children may develop reactive attachment disorders Implications for Practice: Guidelines for Intervention

The following are general guidelines for work with child survivors and their parents according to adults types of attachment. An overall goal is for service providers to foster child survivors secure relationships with other people. The ideal place to cultivate these relationships are with parents and siblings. Other secure relationships, however, are required for children and families to become resilient. These relationships can be with extended family members, friends of the family, members of self-help groups, and service providers. If parents are not able to provide the safety of secure relationships, this is a serious issue that service providers have to take seriously and consider petitions to the court for alternative child placements. Parents and children require emotional support, education about child sexual abuse, and safe places where they can work on repairing any breaks in their relationships. Children may also benefit from group work with other children who have had similar experiences. These goals and plans assume that competent services and service providers are available and that service providers and service users have working relationships. Service providers can be of great help when they offer experiences where children can experience their own competence. This involves helping children to engage in activities they enjoy and do well. Children in deep crisis and disorganized may require a lot of supportive work before they can engage activities they like. Sensitive assessments of childrens readiness is important. Since many reports of child sexual abuse are on families who live in poverty, service providers will include assessment of basic human needs such as food, clothing, shelter, and medical care as well as the other areas to assess. The following provides some ideas about what service providers may experience in their work with parents of survivors of child sexual abuse. Secure
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Dismissive May be shocked by allegations of child sexual abuse, but do not respond sensitively, even after time goes on; they also may not be shocked and are insensitive in their responses If they believe the children, they may say that the children are fine and everyone is fine If they dont believe the children, they will deny the sexual abuse happened and will be angry at the children and even blame children They may not see the sexual behaviors as abuse They or may not cooperate; they will probably resist services; if they do respond, their responses will be half-hearted and inconsistent They may refuse services for their own issues that interfere with their capacities for providing safety and security; they may not recognize that they have issues They may allow the alleged perpetrator to remain in the home and allow the children to go into alternative placements They may not keep children separated from alleged perpetrators Children may also resist services in order to please parents and to maintain a faade that everything is okay Preoccupied May be shocked by allegations of child sexual abuse; may believe the children but be so full of self-blame that they are not sensitive to the childrens need for safety and comfort They intrude upon the childrens experiences of the abuse that leaves little space for the children to have their own interpretations and understandings of the abuse They may not trust service providers sufficiently to engage in working relationships with them

Parents may be shocked by allegations of sexual abuse, but they believe the children, especially as the shock wears off Parents will probably cooperate; childrens cooperation depends upon the quality of childrens relationships with non-offending parents, siblings, and others; mothers and non-offending parents in general are not the only persons who influence childrens capacities to trust and to engage in services; the impact of the abuse itself can affect these capacities Parents will want supportive services for themselves and their children; they will seek the counsel and support of others, such as clergy, family members, and professionals They will do what it takes to ensure safety for their children, beginning with keeping alleged perpetrators away from the children Parents allow children to express whatever is true for them, including letting children know its ok to love perpetrators for the good things they did and dislike the sexually abusive behaviors Parents help children deal with other difficult issues such as when alleged perpetrators refuse to take responsibility for their behaviors and blame others, including the children

Disorganized They may be shocked by allegations of sexual abuse but be prepared for a range of responses; they may believe the children but maybe not; They have difficulties in forming working relationships with service providers because their thinking, emotions, and behaviors are so disorganized Its very difficult for them to respond sensitively to their children who have been sexually abused because their thinking, emotions, and behaviors are so disorganized; this adds to childrens confusion and disorganized thinking, feelings, and behaviors Their children typically have disorganized attachment styles which complicates their recovery from the effects of child sexual abuse Children may receive the diagnosis of reactive attachment disorder (RAD) Children may be placed out of home for their own safety May be engaged in services and visits sporadically and then disappear for long periods of time

Some cooperate and do what it takes to provide safety and security to their children and to themselves; this can take some time; they are likely to require a full range of treatments as discussed earlier They may at first act as if service providers will solve all of their problems and when this doesnt happen, they may experience distrust of providers to the point where they do stop cooperation

Discussion

Parents react in various ways to disclosures of child sexual abuse. Attachment theory can help identify promising and challenging adult responses. Other factors besides adult styles of attachment come into play in work with families. Adult attachments are fundamental, but other factors support parents capacities for providing the safety of secure relationships. Working relationships between service users and service providers are important, as are supportive relationships in several other systems, service provider competence, and service user and service provider optimism about their work together.

References & Further Reading

Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, N.J.: Erlbaum. Bell, S. M. (1970). The development of the concept of the object as related to infant-mother attachment. Child Development, 41, 291-311. Bell, S. M, & Ainsworth, M. D. S. (1972). Infant crying and maternal responsiveness. Child Development, 43, 1171-1190. Bretherton, I. (1992). The origins of attachment theory: John Bowlby and Mary Ainsworth. Developmental Psychology, 28, 759-775. Bowlby, J. (1969). Attachment and loss, Vol. 1: Attachment. New York: Basic Books; & Hogarth Press.
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Bowlby, J. (1973). Attachment and loss, Vol. 2: Separation: Anxiety & anger. New York: Basic Books. Bowlby, J. (1980). Attachment and loss, Vol. 3: Loss: Sadness & depression. New York: Basic Books. Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. London: Routledge. Cassidy J. & Shaver, P. R. (Eds.)(1999). Handbook of attachment: Theory, research, and clinical applications. New York: Guilford Press. Davies, D. (2011). Child development: A practitioner's guide, 3rd Edition. Guilford Press, New York, NY Hesse, E. (1999). The adult attachment interview: Historical and current perspectives. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 395: 433). New York: Guilford Press. Lieberman, A. F., & Pawl, 3. H. (1988). Clinical applications of attachment theory. In J. Belsky & T. Nezworski (Eds.), Clinical applications of attachment (pp. 327-351). Hilldale, NJ: Erlbaum. Main, M. & Solomon, J. (1986). Discovery of an insecure-disorganized/ disoriented attachment pattern. In T. B. Brazelton and M. W. Yogman, Affective development in infancy. Nowrood, NJ, Ablex Publishing. Main , M., & Goldwyn, R. (1998). Adult attachment classification system. Unpublished manuscript. University of California: Berkeley, CA. Sonkin, D. (2005). Attachment theory and psychotherapy. The California Therapist, 17(1), pp 68- 77. Internet Based Readings Gilgun, Jane F. (2010). Attachment and child development. Amazon Kindle Gilgun, Jane F. (2010). What is trauma? Amazon Kindle, scribd.com Gilgun, Jane F. (2011). Child sexual abuse: From harsh realities to hope. Amazon Kindle, iBooks, & scribd.com. Gilgun, Jane F. (2011). The NEATS: A child and family assessment. Amazon Kindle and scribd.com References for the Common Factors Model Cameron, Mark, & Elizabeth King Keenan (2010). The common factors model: Implications for transtheoretical clinical social work practice. Social Work, 55(1), 63-73. Drisko, James W. (2004). Common factors in psychotherapy outcome. Families in Society, 85 (1), 81-90.
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Lambert, M. (1992). Implications of outcome research for psychotherapy integration. In J. Norcross & J. Goldstein (Eds.), Handbook of psychotherapy integration (pp. 94-129) NY: Basic. Perlman, Helen Harris (1957). Social casework: A problem-solving process. Chicago: University of Chicago. Sprenkle, D. H., & Blow, A. J. (2004). Common factors and our sacred models. Journal of Marital and Family Therapy, 30(2), 113-129. Sprenkle, D. H., & Blow, A. J. (2004). Common factors are not islands-they work through models. Journal of Marital and Family Therapy, 30(2), 113-129. About the Authors Jane F. Gilgun, Ph.D., LICSW, is a professor and Wendy Anderson, MSW, is a PhD student, School of Social Work, University of Minnesota, Twin Cities, USA.