opening new possibilities for helping the growing number of stressed-out parents who are turned off to their own children. We’re two aging therapists who’ve worked with abused children and adolescents for many years and are keenly interested in the neurobiology of attachment. We met a few years ago, when we were asked to work with an agency that wanted to incorporate an attachment-based model in their treatment of highly stressed kids, teens, and their parents. This story of the new therapeutic path that emerged as a result of this collaboration starts, as so many do, with a failure.
There was one case at that time that Dan found particularly galling. He’d begun providing treatment for a young mother, Rebecca, and her 4-year-old son, Eric. The family doctor had described her as being a tense, discouraged mother, overwhelmed by the day-to-day responsibilities of caring for her son. Still, she’d seemed to want help for herself and her son, and agreed to see a therapist.
Yes, she said, when Dan did her intake; she was discouraged, all right—and frustrated! Eric was impossible! Why wouldn’t he just do what she asked? Why was everything a fight? Why wouldn’t he play by himself when she just wanted to relax? Why wouldn’t he eat? Sleep? The list of complaints seemed endless.
By contrast, Rebecca recalled how happy she’d been when he’d been an infant. He needed her! He loved her! She didn’t think that she’d ever felt as close to anyone as she’d felt to him. Certainly, she told Dan, she’d never felt close to her own parents. When they weren’t fighting with each other, they were finding reasons not to be home. Neither had much time for her: they often left her alone for hours, even at night. But after a while, she got used to it, she said with a shrug, and really didn’t mind anymore. Then one day she met Billy. He really wanted her, and sex with him made her feel loved. And then she had Eric, and she felt more love for another human being than she’d ever felt before.
But as he grew from a baby, who slept much of the time, into a toddler, he wasn’t always so rewarding to be with. He cried and flailed his arms and legs, resisting all her efforts to comfort him. This made her feel helpless, overwhelmed, angry, and stressed out. Her initial feelings began to fade, suppressed by her anger and a sense of being chained by parenthood to this small, ungrateful obligation. When Eric wanted her attention, she began to tune out, using her old childhood strategy of shutting out the world and numbing her feelings. Gradually, he stopped seeking her attention—which was just as well. She’d find reasons to drop him off at her mother’s home so she could have time by herself or with her friends. Eric didn’t seem to mind, but it puzzled Rebecca that her mother apparently enjoyed Eric more than she’d ever enjoyed her.
Dan was pleased and hopeful after his first few sessions with Rebecca. She demonstrated genuine sadness about her degenerating relationship with Eric, and she appeared to understand how being ignored by her own parents might have had something to do with her struggle to parent her son effectively. She was all attention when Dan told her that her son needed her attuned interactions, and that if she related with empathy while she set firm limits, he was likely to begin to cooperate with her and accept her authority.
However, she rarely seemed to put Dan’s suggestions into practice; she kept bringing in the same problems week after week. Dan began to feel disappointed and discouraged. Soon, she started saying resentfully that Dan’s ideas “weren’t working” as she grew even more frustrated with her son’s unimproved behavior. She hinted that maybe Dan’s advice was off-base—that he might be missing something and didn’t really understand Eric’s intensity. Furthermore, she began to suspect that Dan was beginning to be disappointed in her, even suggesting perhaps that she wasn’t trying hard enough. When she asked him one day if medication might be necessary for her boy, Dan’s frustration became clear to them both.
Finally, Dan asked why she’d reacted with so much anger instead of empathy when her son screamed at her. The tone of his voice conveyed his impatience with her, as did his message that, by now, she should’ve been responding to her son the way he’d tried to teach her. Dan began to dread his sessions with Rebecca, and after a couple more of these stalemated meetings, she stopped coming. Eric went back to live at her mother’s house, Rebecca went back to her defeated sense of resigned failure as a competent mother with a happy child, and Dan went back to looking for parents who’d appreciate what he could offer.
The Journey Begins
At about the same time that Rebecca stopped coming for her sessions with Dan, he and I began to explore together the practical, clinical implications of the interesting new brain research for the work we were already doing with traumatized children. We’re both steeped in the model of interpersonal neurobiology developed by Allan Schore and Daniel Siegel, and we felt we had a good grasp on the struggle that neglected and traumatized children faced in making the shift from mistrust to trust. We knew that attachment research clearly linked the development of secure attachment to the quality of caregiving kids receive—to connections with what Schore called a “psychobiologically attuned caregiver.” In short, we knew what these hurt kids needed from their caregivers: the ability to stay engaged and open with them, especially when the kids were “going defensive” and resisting the closeness they deeply needed but instinctively avoided.
As we focused more on the new perspectives that attachment theory and interpersonal neurobiology were opening up on failed cases like that of Rebecca, we began to look at parents in a different way. One morning, we had a shared epiphany: we finally realized what we’d “known” for a long time: parents’ brains work the same way that their children’s brains work! Just as a child has to feel safe to approach a caregiver, a parent has to feel safe to approach and trust a therapist. Parenting isn’t a cookbook activity for managing children’s behavior: it’s an ancient mammalian mind–heart process, which allows a caregiver to stay engaged and regulated enough to sustain the mind-to-mind, heart-to-heart connections that are vital for a child’s development. Parenting is rooted in openness and safety, not in survival-mode self-defense.
So, we wondered, what does it really take to be a sensitive, attuned caregiver and to sustain a parental state of mind through the thick and thin of childrearing? Why can some parents provide the warmth, openness, and empathy that help kids thrive, while others, despite having the best intentions, start to shut down and get defensive when their kids roll their eyes or sass them. What is parental openness, anyway, and how does a parent develop and sustain it? As we talked, the concept of parental blocked care came into focus as a shorthand way of describing the suppression of parents’ potential to nurture a child, especially if the child is slow to reciprocate warmth and love.
We realized, then, that just as our awareness of attachment and its neurobiological foundations informed our practice with children, understanding the neuropsychological foundations of caregiving would make us more effective therapists with their parents. First, we needed to learn what actually goes on in the parenting brain. Then, we needed to understand how stress affects the parenting brain and sometimes leads to blocked care. With a brain-based model of parenting and blocked care, we hoped to get better at helping stressed-out parents get unstuck and tap their potential for caregiving.