Who Is the Hurt Child?

Parenting the Hurt Child : Helping Adoptive Families Heal and Grow
by Gregory C. Keck, Ph.D., Regina M. Kupecky, LSW

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Understanding the Attachment Cycle

For those who have read Adopting the Hurt Child or have a good understanding of attachment issues, this chapter - condensed, with permission, from our first book - will serve as a review. For those new to the topic, this will provide an introduction to the hurt child.

There is a common children's verse that says, "Sticks and stones may break my bones, but words will never hurt me." For the abused child, nothing could be further from the truth. While the effects of physical abuse usually heal over time, the psychological insults experienced by the child bring deep, long-lasting pain. These wounds fester within, creating ongoing difficulties for both the child and the adoptive family.

Many adoptive children did not experience early childhood trauma, neglect, or abuse. In these cases, the issues they face are common to all children and are supplemented by issues related directly to adoption. But for adoptive youngsters who lived through a difficult start, there is a range of developmental complications tied to the abuse, trauma, or neglect.

The problems that adoptive parents often see in their children are most likely the result of breaks in attachment that occur within the first three years of life. This condition is often diagnosed as Reactive Attachment Disorder, which impairs - and even cripples - a child's ability to trust and attach to other human beings.

Often mothers understand attachment issues before fathers do. This is because healthy children first attach to their mothers - beginning in the womb. Most adopted children blame the birth mothers for their abandonment, abuse, and/or neglect, and target adoptive mothers with their most negative behaviors.

At the beginning of Lara's assessment, her father said he thought his daughter was fine, and the problems were all in her mom's head. When Lara was in session, both parents watched on a video monitor from another room as the child manipulated, swore, lied, and tried to prove to the therapist that she was the boss. "Daddy's little girl" was showing her true colors, and her father admitted, "If I hadn't seen it, I wouldn't have believed it." Lara's mother was vindicated, her father was forgiven, and the family could begin to heal.

Attaching During The Critical Years

Most professionals who work with and study the process of bonding and attachment agree that a child's first eighteen to thirty-six months are of vital importance. In a healthy situation, this is the period within which the infant is exposed to love, nurturing, and life-sustaining care. It is the time when the bonding cycle is repeated over and over again:

• The child has a need.
• He expresses that need by crying, fussing, or otherwise raging.
• The need is gratified by a caregiver, who provides movement, eye contact, speech, warmth, and/or feeding.
• This gratification leads to the development of the child's trust in others. When abuse and neglect occur, they can interrupt the attachment cycle - leading to serious problems in the formation of the personality and most likely affecting him throughout adulthood. When the cycle is not completed and repeated, difficulties may arise in critical areas, such as
• 
  Social/behavioral development
• Cognitive development
• Emotional development
• Cause-and-effect thinking
• Conscience development
• Reciprocal relationships
• Parenting
• Accepting responsibility

Symptoms of Reactive Attachment Disorder

A child born into a dysfunctional environment that features abuse and neglect as overriding themes will not experience the attachment cycle with any predictability. As a result of this attachment interruption, he may exhibit many - or perhaps all - of the following symptoms:

• Superficially engaging and "charming" behavior
• Indiscriminate affection toward strangers
• Lack of affection with parents on their terms (not cuddly)
• Little eye contact with parents (on parental terms)
• Persistent nonsense questions and incessant chatter
• Inappropriate demanding and clingy behavior
• Lying about the obvious
• Stealing
• Destructive behavior to self, to others, and to material things (accident-prone)
• Abnormal eating patterns
• No impulse controls (frequently acts hyperactive)
• Lags in learning
• Abnormal speech patterns
• Poor peer relationships
• Lack of cause-and-effect thinking
• Lack of conscience
• Cruelty to animals
• Preoccupation with fire

When faced with these behaviors, the pain and heartache experienced by the adoptive parents cannot be underestimated, nor can the hope that comes with identifying this disorder. From identification comes treatment that can fill in the child's developmental gaps and allow him to grow to maturity.

Jason was removed from his neglectful birth mother when he was a year old and was placed in a very nurturing foster home before being adopted at age two and a half. By the time he was six, he was hitting and biting his adoptive mother and other authority figures. His past neglect - coupled with his unexpressed anger and sorrow over leaving his foster home - resulted in his becoming a very troubled child. Even though his history had few moves and much nurturing, he was still a child with unresolved loss issues that impacted his attachment.

Effects of Abuse and Neglect

Even before a child is born, the building blocks of development are being laid. During the critical nine months that the child is within his mother's womb, he must receive sufficient nutrition and be free of harmful drugs if he is to develop into a healthy baby.

Many of the children who hurt were born to mothers addicted to drugs and/or alcohol. These children can be viewed as life's earliest abuse victims, because prenatal maltreatment may have prevented some of their physiological systems from developing properly. Oftentimes they are not primed to attach to a caregiver. Impeded by immature neurological systems, they are often hypersensitive to all stimulation. They do not like light and may perceive any touch as pain. In fact, any child in chronic pain, even when nurtured by the most loving caregiver, may develop attachment disorder as the pain short-circuits his ability to attach.

Sadly, a baby born with fetal alcohol syndrome or with drug-induced problems is most often tended to by a substance-addicted mother who is incapable of providing even basic care. The infant's heightened sensitivity and irritability may set him up for further abuse or neglect, because the mother faces the added challenge of parenting a baby who is often fussy and upset.

Children placed into an orphanage shortly after birth receive little one-on-one care. No matter where in the world the orphanage is located, this early placement can affect a child's development and create attachment issues.

Whether the abuse and/or neglect occur in utero or after the child is born, the results may be similar. The attachment cycle breaks, and the likelihood of attachment disorder is great. Without the intervention of proper therapy, this emotional condition can create problems for a lifetime.

Mike was ten months old when he entered foster care as a fail-ure-to-thrive child. By the time he was adopted at the age of three, the physical traits of failure-to-thrive were gone. But his anger remained. He came to us at fifteen after multiple treatments, including counseling, anger management, day treatment, residential treatment, and in-home therapy. When we showed him a photograph of a failure-to-thrive child and explained where his anger came from and where it belonged, he began to change and join the family.

© 2002 NavPress. Used by permission of NavPress Publishing. All rights reserved.

About the Author

Gregory C. Keck, Ph.D., founded the Attachment and Bonding Center of Ohio, which specializes in the treatment of children and adolescents who have experienced developmental interruptions. In addition, he and his staff treat individuals and families who are faced with a variety of problems in the areas of adoption, attachment, substance abuse, sexual abuse, and adolescent difficulties.

Regina M. Kupecky, LSW, has worked in the adoption arena for over twenty-five years as an adoption placement worker. She is currently a co-therapist with Dr. Gregory C. Keck, Ph.D., at the Attachment and Bonding Center of Ohio. Mrs. Kupecky authored a resource guide, Siblings Are Family, Too, which is available through the Three Rivers Adoption Council in Pittsburgh, Pennsylvania. She has presented at local, national, and international conferences on a variety of adoption topics and holds a Master of Arts degree from John Carroll University.