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June 3, 2019 by Brighton & Hove Psychotherapy Leave a Comment

What is ‘Blocked Care’ as it applies to parenting?

The phenomenon of parental ‘blocked care’ is a term coined by Clinical Psychologists Dan Hughes and Jonathon Baylin and Psychiatrist Dan Siegal. It represents a central feature of the Dyadic Developmental Psychotherapy (DDP) approach to treating children and young people with a history of developmental trauma and attachment disruption.

Neuroscience research into the areas of attachment, trauma and neurobiological development, are teaching us that children’s brains are shaped on a neurological level by their earliest caregiving experiences. 

We now even know that an infant’s brain is primed, even in utero, to adapt to the type of care that it anticipates receiving from its primary caregivers in order to maximise its chances of survival. In other words, even in utero, infants are relational.

The Five Care Systems in parents

What is perhaps less known however, is that parents’ brains are also neurologically influenced by their experience of caring for their child – that the relationship is symbiotic. When things are going well, we now understand that five main areas or ‘care systems’ in the parental brain are optimally functioning. These are:

  1. The Approach System: The system that enables us to fall in love with our children, to crave to be with them and to become completely absorbed in them. This system is associated with the release of oxytocin (colloquially known as the ‘love hormone’).
  2. The Reward System: The system that enables mutual delight and attunement when a parent interacts with their child. This system is associated with the release of dopamine (the ‘addictive hormone’).
  3. The Child Reading System: The system that enables parents to positively interpret our child’s behaviours and motivations and to remain interested in their unique qualities.
  4. The Meaning-Making System: The system that enables parents to think positively and meaningfully about their relationship with their child.
  5. The Executive System: The system that enables us to physically care for our children.

For some parent-child dyads however, things do not go so well and one or more of these care systems do not operate optimally. For example, some parents may face unmanageable levels of stress whilst caring for their infants, which may be exacerbated by their own poorly developed care and emotional-regulation systems. 

Others may be offering reparative foster parenting to children who, owing to previous experiences of abusive or neglectful parenting, now fear, mistrust and reject the care they are being offered, which can be extremely painful for their new carers to bear.

The real risk when things go wrong however, is that parents may enter (chronic or acute) periods of ‘blocked care’. When this happens, the first four systems listed above start to shut down. The parent no longer experiences joy or fulfilment of being with their child. They do not get the rushes of oxytocin and dopamine that other parents get, and they do not seek to be with their child.

These parents also become much more likely to interpret their child’s behaviours and motivations from a negative perspective (e.g. “he is manipulating me” or “she is a spiteful child”) as well as their own relationship with the child (e.g. “I am a rubbish parent”).

In psysiological terms a stressed out parent is operating in ‘survival mode’. They are no longer able to remain open and engaged to the child’s emotional and developmental needs and are simply coping. The feedback system between child-parent-child has effectively shut down, or become ‘blocked’.

Without external support, the final care system – the executive system –  may also start to shut down. This is the point when we start to see abusive or neglectful parenting emerge where parents are physically unable to care for their child or children.

The growing evidence-base for blocked care highlights the crucial need for psycho-education, as well as early and non-judgmental support to parents and carers who are most vulnerable to it.

 References:

Hughes, D. & Baylin, J. (2012). Brain-Based Parenting: The Neuroscience of caregiving for healthy attachment. Norton

Hughes, D. & Baylin, J. (2016). The Neurobiology of Attachment-Focused Therapy: Enhancing Connection & Trust in the Treatment of Children & Adolescents. Norton

Siegal, D. & Hartzell, M. (2003). Parenting from the Inside Out. Tarcher/Penguin

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

Face to Face and Online Therapy Help Available Now

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Filed Under: Attachment, Brighton and Hove Psychotherapy, Families, Parenting, Psychotherapy Tagged With: child therapy, childhood developmental trauma, young people

March 4, 2019 by Brighton & Hove Psychotherapy Leave a Comment

The role of ‘attunement’ in relationships with babies and young children

Babies are not born with the neurological capacity to understand distress, or even to differentiate between discomfort and mortal danger. To ensure their survival therefore, babies are biologically programmed to communicate all forms of distress to their primary caregivers through very primitive means (e.g. crying, screaming and reaching out).

Under ideal circumstances, these ‘signals’ from the baby will elicit a sensitive (‘attuned’) response from their caregiver, whereby their caregiver will utilise their more developed brain in order to empathise with the infant’s distress, to soothe them and overtime, to give them words to better understand and communicate their distress. Repetition of this pattern over time, coupled with a deepening joy of the relationship, is not only the foundation for a secure attachment relationship, but the building blocks for other important skills such as developing empathy and emotional regulation.

When working well, attunement enables a child to feel truly understood, accepted and ‘felt’ by their caregiver. Inevitably however, “getting it right” all the time is not possible and sometimes signals will be missed or responded to incorrectly (‘mis-attunement’) – also known as a ‘relationship rupture’. Ruptures are normal and actually present opportunities for a child-carer relationship if the carer is able to repair the relationship appropriately. Indeed, it is estimated that for a secure attachment to develop, carers need to attune correctly around one third of the time (Hoghughi & Speight, 1998), which is reassuring!

Over the years, researchers have examined the importance of attunement on an infant’s mental health. This includes Ed Tronick’s (2007), ‘still face experiment’, which illustrates the distressing disintegration of a young child, whose parent temporarily stops responding to their cues (Youtube link). It also includes the work of Lynne Murray, who demonstrated that even warm responses to infants are not regulating unless they are exactly timed with their cues. This is important as for some parent-infant dyads, ruptures can be severe and chronically prevent the carer from being able to sensitively attune to their infant – ‘toxic mis-attunement’. This might occur when factors specific to the child get in the way of them being able to communicate their needs effectively (e.g. speech and language difficulties or neurodevelopmental difficulties), or when factors specific to the parent stop them being able to receive and process the child’s distress signals appropriately (e.g. mental health difficulties or substance misuse problems). There may also be external stressors impacting on the relationship (e.g. domestic violence or poverty). In these cases, it is imperative that mental health and social support services are proactively mobilised to offer early support to both the child and the carer.

Hoghughi, M. & Speight, A. (1998). Good enough parenting for all children – A strategy for a healthier society. Archives of Disease in Childhood, 78, 4, 293-296.

Murray, L. & Trevarthen, C. (1985). Emotional regulations of interactions between two-month-olds and their mothers. In T. M. Field & N. A. Fox (Eds.),Social perception in infants (pp. 177-197). Norwood,NJ: Ablex.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Child development, Families, Parenting, Relationships Tagged With: child therapy, family therapy, Mental Health, Relationship Counselling

August 6, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What is Sibling Rivalry? – Part 2

Over two blogs I have focussed on one area of sibling relationships, namely rivalry. In part 1, I looked at some aspects of sibling rivalry as they can surface in childhood. In part 2, I will suggest how these might impact on ongoing struggles in adult life, before suggesting ways in which problematic issues with rivalry can be helped.

Sibling Rivalry in Adulthood

Feelings of competition and rivalry are perfectly normal and to be expected in adulthood. However, when childhood rivalry has been particularly problematic and unresolved, this can shape and lead to intense struggles later in life. Below are some thoughts about sibling rivalry and adulthood.

An obvious impact is in relationships to competition. Difficulties might particularly arise at work, socially, in educational settings, or any other situation where competitive feelings are heightened. This might lead to over competitiveness at the expense of other experiences – for example friendship, fun, comradeship etc. The rivalrous person may be driven towards success, however, often these feelings just seem to cause paralysis, procrastination, and low-self-esteem, as the individual constantly measures themselves against others.

As siblings are the earliest relationships they become a kind of template for later relationships. If feelings have never really got beyond negative experiences of aggression and dislike, this can make it hard to establish positive, caring and cooperative adult relationships.

Siblings who hold onto intensely rivalrous feelings, may be unable to establish a good adult relationship with each other. They therefore lose out on what these uniquely close alliances can potentially offer.

Sometimes sibling rivalry that’s not overt in childhood later manifests in adulthood. This can often be triggered through a change in the family dynamic. The most common is the serious illness or death of one or both parents. In these circumstances, feelings of rivalry can intensify or, if latent, can suddenly manifest. This is particularly common if there are issues around sharing responsibility or care for the parent, or around inheritance.

Fair shares and mutual concerns

Dennis Brown, a group analyst, wrote a paper entitled ‘Fair shares and mutual concern: The role of sibling relationships’ (1998). He explored how these rivalrous battles with siblings belong to an early stage in the individual’s development and that in healthy childhood psychological growth there is a shift to a more cooperative position towards siblings and therefore later relationships.

Our relationships with our siblings are usually the earliest experiences of grappling with love and hate for our peers. It’s important that aggression, jealousy and rivalry can be countered by experiences of love, companionship, and affection. Achieving this in childhood helps this balance of positive and negative feelings in later relationships.

The potential for change

But if this change hasn’t taken place in childhood can anything be done in adulthood? Below are some suggestions of how to work towards resolving the more crippling preoccupations with ‘fair shares’ towards a greater feeling of ‘mutual concern’ for and with others.

One way forward is to try and develop an adult relationship with your adult sibling. Sometimes family members get stuck in a narrative belonging to the past. We carry the child templates of our siblings inside us without perhaps getting to know the adult version. This is particularly compounded if relationships don’t develop outside of the family environment, for example when siblings only ever see each other in the presence of the rest of the family, particularly parents.

During or after times when you find yourself preoccupied with doing better than others, or having painful feelings of inadequacy or exclusion, it can help to reflect on links between this experience and what you may have felt as a child in your family. This can help you step away and separate from those past dynamics, reminding you that this is no longer the actual situation you find yourself in.

I mentioned earlier that sibling rivalry can worsen or manifest after a major family dynamic change such as brought on by the illness or death of a parent. Sometimes the opposite shift can happen. For example, the loss of one or both parents, or other family events, can suddenly bring problems of historic rivalry between some siblings to a natural end.

The Role of Group Psychotherapy

Group psychotherapy is particularly helpful in working through the difficulties arising from unresolved sibling rivalry.

Being in a therapy group stirs feelings of rivalry for everyone in it. In this way, it tackles rivalry in a way that individual therapy (where you have all the attention to yourself) can’t. Bringing these feelings alive and to the foreground means they can be worked with head on in the safety of a therapeutic environment.

In a therapy group, members find that each other remind them of their siblings, some more obviously than others. This offers an opportunity for working through difficulties that they may have had growing up with actual siblings. Members can then develop the kind of affection and closeness with rivals that might not have felt possible growing up or since.

Group members often find that the group feels a bit like an alternative family. This gives the opportunity for everyone – including ‘only’ children – to have different kinds of ‘sibling’ experiences than those they grew up with.

Conclusion

Preoccupation with ‘fair shares’ is symptomatic of a world where we feel pitched against each other and encouraged to see ourselves as alone. These feelings can be particularly heightened if the conflicts of our earliest peer relationships have not been resolved. Psychotherapy and counselling give the opportunity to explore and understand these deep rooted and painful experiences and how they may continue to have impact. Psychotherapy groups emphasise our connectivity as human beings. This challenges the notion that we are on our own, offering a direct release from the paralysing grip of rivalrous conflicts, towards greater co-operation, affection, and ‘mutual concern’ in our relationships.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

Face to Face and Online Therapy Help Available Now

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Filed Under: Brighton and Hove Psychotherapy, Child development, Claire Barnes, Groups, Parenting Tagged With: group psychotherapy

July 30, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What is Sibling Rivalry? – Part 1

The importance and role of sibling rivalry

Siblings are the longest standing relationships in most of our lives. As we grow older they increasingly serve to keep a connection to our families of origin, reminding us of our parents and our younger selves. Most of us share genetic material and family histories with our siblings. They have a significant place in our origins and narratives and an important role in shaping us. We don’t choose our siblings in the way we do our friends and sexual partners but, in many ways, they are our closest peers.

Over two blogs I have focussed on one area of sibling relationships, namely rivalry. In part 1, I will look at some aspects of sibling rivalry as they can surface in childhood. In part 2, I will think about how these might impact ongoing struggles in adult life, before suggesting ways in which problematic issues with rivalry can be helped.

Sibling rivalry in childhood

Sibling rivalry is part of growing up. Children who have sibling/s share their parent’s love and attention and feelings of rivalry are naturally going to arise. While squabbling and fighting can disturb the family atmosphere, it is important that we are aware of these feelings and struggles are normal. These conflicts around competition are also ways in which young children prepare for managing later peer relationships.

However, feelings of rivalry can become particularly exacerbated for different reasons. For example, if there are unresolved difficulties in the parent’s relationship to competition and rivalry. Fighting between siblings that gets out of control or dominates the family can be often be traced back to some difficulty for one or both parents.

Other family dynamics may also play a part in complicating and exacerbating rivalry. Below are some examples where sibling rivalry might become heightened, and complex.

  • One example is when a parent is particularly enmeshed with one child. This means all other relationships, including other children, are pushed outside of this unhealthy coupling. This can create huge difficulties for everyone in the family and can heighten and complicate rivalrous feelings between the siblings.
  • A large age gap might mitigate rivalry in some ways but not in others. It may be particularly hard for the older sibling to allow or express jealousy or rivalrous feelings towards a much younger sister or brother. This younger sibling may be getting a kind of affection that the older brother or sister has had to relinquish but still misses.
  • The much younger sibling can feel the older one is closer to the parent/s as they’ve perhaps reached an age where they are being treated on more equal terms. This can also become bound up with the difference in capabilities due to age-difference. So, rivalry can feel linked with feelings of inadequacy.
  • Children who are born close in age may have had to share their mother’s/main caregiver’s attention and care as babies. Feelings of competition and rivalry may be experienced on a primal level – originating very early in life –  and this could make them particularly hard to articulate.
  • Children who have siblings with a disability or illness may feel ashamed and guilty for having negative feelings towards the sibling/s. This dynamic gets further compounded by the extra attention the sick or disabled sibling may well get from parents and others.
  • Harder still to express, manage, or even feel, is the rivalry and jealousy that might be felt towards a sibling who has died. In the psychotherapy field there is particular concern about children who may have been conceived to ‘replace’ a child who has died, and the very particular – often unconscious – pressures they come under.
  • Relationships and rivalry between half and step-siblings can sometimes be less intense if, for example, they do not live with each other. There will likely be a parent the child can claim as their own who is not shared biologically and emotionally. However, these half/step-sibling relationships can also feel complex and painful, as they are often bound up with parents’ separation and families splitting into ‘new’ and ‘old’.
  • One of the more unconscious ways families often manages rivalry is by assigning different roles and attributes amongst siblings. For example, the ‘clever’, ‘sporty’, ‘artistic’ ‘musical’ one; or ‘quiet’, ‘sociable’, ‘troubled’ etc. These might work to mitigate rivalry some of the time, in some families, and for some individuals. However, they can also stir up further complex feelings of rivalry, imbuing them with restrictive self-expectations and feelings of inadequacy.

Do only children have it easier?

Based on the accounts above we could think that the only child is the most fortunate. Certainly, ‘only’ children do not usually have to compete with early peer relationships for their parents’ love and attention and therefore avoid some of these more painful and destructive experiences of sibling rivalry. However, those who have grown up as only children often report a pervasive feeling of loneliness and isolation. Being the sole focus of parents’ love (and often therefore need) can feel very burdensome as a child and an adult. It is also no coincidence that only children often describe particularly acute difficulties starting nursery or school where they suddenly encounter the rough and tumble of peer relationships and rivalry.

The jostling and competing for space and attention that siblings engage with, prepare them for later experiences. However, it is important that children are also able to develop feelings of concern and companionship towards their siblings. In this way, the intense and more hateful feelings of rivalry can be moderated and managed. While feelings of sibling rivalry never fully go away they need to be resolved enough to establish healthy relationships with peers in adulthood.

In part 2, I will the potential impact of unresolved sibling rivalry in adulthood and look at ways of helping.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Child development, Claire Barnes, Parenting, Relationships Tagged With: sibling rivalry

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