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Reactive Attachment Disorder By Kevin Perline One of the students I work with has been diagnosed with Reactive Attachment Disorder. The
student is a 15 year old male who was removed from his parents custody due to neglect and
abuse when he was 5. Since then he has been from one foster family to another. His behaviors
create situations that make the foster families essentially give him back to the system. In school
he initially presents as a pleasant helpful young man and is bright and articulate. Shortly after
creating friendships with peers he begins to sabotage those friendships by pushing their buttons
to the point were they are threatening harm to him at which he continues to taunt them. This
young man has been unable to identify the reasons for his behaviors and feels that he has no
control over his actions, “it just happens.”
This session began as a result of my having to intervene between this student and another who
had begun threatening him. Establishing rapport was easy as we have had a long- standing
relationship. I decided to use the Six Step Reframe with the first intention to elicit a better
understanding of what drives the pattern of behavior and then help the client develop alternative
behaviors to satisfy his positive intention. I should note that as I began this re-frame I deviated
from the traditional six steps for reasons you will see but would pull things back to the technique. I first asked the student if he was willing to take a leap of faith with me and try something funky
just for the fun of it. He said that he would. I then did some guided relaxation with the student
in order to help him be more focused and open. I then ask him to go inside and ask the following question “will that part of me that makes people
angry be willing to communicate with me consciously?” I also asked him to be aware of any
changes within his body that may occur in response to the question. Because this individual was very verbal I gave the option of having that part of him respond
either verbally or non-verbally (lifting his right hand for yes and his left hand for no). He went
inside and then responded by saying that it would prefer to talk. I then wanted to separate the positive intention from the behavior. I asked him to first thank that
part and then ask it if it was willing to share what it has been trying do when it engages in those
behaviors that make people angry. He went inside to ask the question and then responded “it
keeps me safe by keeping people from hurting me.” Before going further I had the need to ask
“keep people from hurting you how?” He responded “when I start to like people then they get
rid of me and send me to somebody else.” I then asked him to go inside and contact his creative part and ask it to generate alternative
behaviors that are just as good or better then making people angry at him to satisfy that part that
needs to keep him safe. At this point I asked him to have the part that keeps him safe signal us
that it has at least three new behaviors, which he did. I next asked the part that keeps him safe to accept the new choices and the responsibility for
generating the choices it felt it could be immediate, effective and available as a way to keep you
safe. At this point the students head dropped and there was a visible shift in his entire body. He
lifted his head and then with a much lower tonality and an intensity in his eyes and voice he said
“NO!” Well, this took us off the track but I was determined to see this through so I asked the
part that keeps him safe “what is preventing you from taking this responsibility?” That part
responded, “I need to stay strong.” I then asked if he could go inside and connect with his
creative part and ask the creative part if it could communicate with the strong part of him. He
responded “no.” I asked what prevented this? He responded that it was afraid of the strong part.
I then asked him to ask the strong part if it would be willing to share a piece of its strength with
the creative part. The strong part responded “no”. I asked if the strong part was afraid to share a
piece of itself. It said “no.” I then had him ask the strong part if it ever got tired having to
remain so strong. The strong part responded with a “yes.” I had him ask the strong part if it
trusted the creative part enough to share some its strength with his creative part so that his
creative part can also help keep him safe. The strong part said yes. I then had him ask the strong
part if it could now give a piece of that strength to the creative part, he responded “yes.” His
body had visibly become more relaxed as well as his voice. I then had him ask the creative part
if it felt stronger, “yes.” I then had him ask each part if they were now willing to help each other
a little more in keeping him safe. Both parts said yes. Back on track--I then asked him to ask the strong part again if it was willing to generate new
behaviors in appropriate contexts when its intention needs to be fulfilled, for the next week. I asked him to go inside and ask if there were any other parts that object to the negotiations that
have just taken place between his strong and creative parts. He responded “no” and his body
remained relaxed. I ended with a simple future-pace statement. There are many levels of work to do with this young man. We have had to revisit the Six Step
Reframe and I have done New Behavior Generator with him with some success. I can see other
techniques to include: Developing Self-Appreciation, Changing personal History, Re-Parenting,
Anchoring and adding a resource, Chaining anchors, etc. This is a child who truly has nothing; I
often wonder how he hasn’t simply died of a broken heart. |