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Attachment and the Secure Base System Self-Confidence/Exploration Felt security Secure Base Caregiver’s Signal detection Perceived Threat Safe Haven Attachment System Signaling Proximity Seeking The Effects of Secure Base  Repeated Secure-base interactions create internalized models of relationships that are carried forward to new relationship experience experiences  What to expect  How to behave Secure Base Effects  Powerful influence on Neurobiology  Emotion-Regulation and Sensory Integration  Language Development  Executive skills—     Shifting Monitoring Labeling Problem-solving Healthy Neurobiology  Three interrelated systems  Thinking  Feeling  Relating/communicating  Working together in an integrated, goal-directed, collaborative fashion Attachment Problems  Attachment Problems—failures in the secure base system result:  Defensive, maladaptive relationship models  Neurobiological failure  Neurocognitive deficits—lagging skills in:    Thinking Feeling Relating/communicating Most commonly referral to community mental health centers Includes: Attention Deficit Hyperactivity Disorder Oppositional Defiant Disorder Conduct Disorder Copy Right: /Sibcy, 2005 gsibcy@Liberty.edu Oppositional Defiant Disorder  Symptoms  Temper tantrums  Arguing with adults  Questioning rules  Active defiance and refusal to comply with rule  Deliberate attempts to annoy  Touch and easily annoyed  Anger and resentment  Mean and hateful when upset  Spiteful attitude and revenge seeking Complex Oppositional Defiant Disorder  Define the problem:  Meets criteria for ODD, Plus  Executive skill dysfunction  Emotion dysregulation—anger plus other emotions  Relationship disturbances, which includes attachment system  Highly resistant to traditional parenting practices Severe Mood Dysregulation (SMD)  Distinguished from Classic Bipolar Disorder in Children (episodic irritability)  Abnormal baseline mood: irritable, anger, and/or sadness, noticeable to others & present most of time  Hyperarousal: insomnia, physical restlessness, distractibility, racing thoughts or flight of ideas, pressured speech, intrusiveness  Increased reactivity to emotional stimuli (temper outburst) at least 3x/week Differences in anger expression  Hand-grenade –ADHD/ODD combo only  Hurricane—SMD or BPD Sameroff’s three R’s of intervention  Re-education  Redefine  Remediate Re-education The Pyramid Self-Control Self Control Problem Solving Cognitive Flexibility Language Processing/Mindsight Social Skills Emotion Regulation Redefine Motivation vs Skills Motivation Skills Motivation Yes Yes Adaptive Maladaptive (Family System) Maladaptive SMD/BPD Maladaptive Family + CODD with SMD Skills No No Preventing explosions while enhancing secure-base and neuro-cognitive skill development Goals: Take parent concerns seriously Take child concerns seriously Reduce Challenging Behaviors, especially Reduce MeltDowns 1. 2. 3.    4. 5. Destructive child’s nervous system Conditioned Emotional Responses (CERs) Reinforces insecure relationship models (attachment) Work on Neuro-Cognitive Skills—Whole Brain Child Improve Secure Base Using the Whole Brain  Left-Right Hemisphere  Brain Stem  Limbic System  Avoid Amygdala Hijacking  Septal Rages  Prefrontal Cortex Secure Base Effects  Powerful influence on Neurobiology  Emotion-Regulation and Sensory Integration  Language Development  Executive skills—      Frustration tolerance Shifting Monitoring Labeling Problem-solving Three Pathways Pathway A—forcing concern Compliance Interaction Pathway B—Working on Pyramid Pathway C—temporarily dropping concern Three Pathways Compliance Interactions  Pathway A—Force Adult Concern   Advantages Disadvantages  Pathway B—Collaborative Problem Solving   Advantages Disadvantages  Pathway C—Temporarily Dropping Concern   Advantages Disadvantages Collaborative Problem Solving:  E—empathy—  A—Assert—  R—Respect— ---------------------------- I—Invite- C—Collaboration— Empathy & Validation  Listening and understanding child concerns  Helping child articulate concerns what the concern  Taking concerns seriously  Empathy is a reciprocal process, so you may try to empathize but if the child does not believe you understand then you have not empathized Assert—with limits  Define Problem, expressing concern or expectation  Don’t mistake your solutions for concerns or expectation  Appeal to rules as important principles to follow  “You can be angry but you can’t do…” Regulation—keeping it safe  Work at monitoring and managing your own emotion     regulation—if too upset, go to pathway C Non-contingent respect Never use disrespect as a form of punishment Avoid global, negative attributions Remain warm—avoid triggering CER’s Invite  asking child to generate possible solutions  Avoid forcing solutions  Think out loud Collaboration  Working with child to come up with workable      solutions Help child use foresight and hindsight Model flexibility Model regulation Model respect Maintain warmth Qualities of Good Solutions  Mutually satisfactory  Do-able  Durable Back to the pathways  When to use A  When to use C  Different kinds of C’s, some are better than others  Two kinds of B’s  Emergence  Proactive—timing is everything Parenting and Mentalization          The use parent-child interaction questionnaire Describe situation: beginning, middle, end Describe behavior Interpretations Actual outcome Desired outcome Question: did you get DO? Why? Remediation Phase Engaging the Repair Cycle  Turning conflict into learning