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

The phenomenon of parental ‘blocked care’ is a term coined by eminent 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.

Advancements in the areas of attachment, trauma and neurobiological development, teach us that children’s brains are shaped on a neurological level by their earliest caregiving experiences. Indeed, we now 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. What is perhaps less known however, is that parents’ brains are also neurologically influenced by their experience of caring for their child. When things are going well, 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. Not surprisingly, this system is associated with the release of oxytocin (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. 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. They also become much more likely to interpret their child’s behaviours and motivations with a negative bias (e.g. “he is manipulating me” or “she is a spiteful child”) as well as their relationship with the child (e.g. “I am a rubbish parent”).

A stressed-out parent is in survival mode. They are no longer able to remain open and engaged to the child’s emotional and developmental needs. Rather, they are liable to become extremely rigid, defensive and behaviorally-focused in their approach to parenting. Sadly, however, without 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.

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

Dr Laura Tinkl is a Senior Chartered Clinical Psychologist, professionally accredited by both the Health and Social Care Professions Council (HCPC) and The British Psychological Society (BPS). Appointments can be made in the Lewes practice.