Book of the Month - The Neurobiology of Attachment-Focused Therapy

The Neurobiology of Attachment-Focused Therapy - Enhancing connection & trust in the treatment of children and adolescent
by Jonathan Baylin and Daniel A Hughes ​

The Neurobiology of Attachment-Focused Therapy - Enhancing connection & trust in the treatment of children and adolescent by Jonathan Baylin and Daniel A Hughes 

The focus of this book is set with a quote from Colwyn Trevarthan Emeritus Professor of Child Psychology and Psychobiology, University of Edinburgh.
“If we are to protect young children from harm …we will have to value more and give response to what children bring to human life-the eager spirit of their joyful projects beyond their seeking to survive.” 

How can therapists and caregivers help maltreated children recover what they were born with: the potential to experience the safety, comfort, and joy of having trustworthy, loving adults in their lives? 

In order to address this question this book shares the work of Dan Hughes and Jon Baylin in their development of a science based model of attachment focused therapy that links clinical interventions that are informed by an understanding of brain functioning on attachment and relationships. Thus Dyadic Developmental Psychotherapy (DDP) is linked to neurobiological processes.

Neuroscience shows that negative experiences lead to the development of a neural “alarm system” called the mid brain defence system linked to chronic defensiveness- the core of blocked trust.

The treatment is to target the mid brain alarm system – the part of the brain sensitised by pain suppression and chronic defensiveness evident in children who have developed blocked trust –the suppression of inherent relational needs due to poor care. 

The prefrontal cortex is activated in order to support new learning and move from mistrust to trust. This is done through techniques of reversal learning, fear extinction, memory reconsolidation, reflection, and reappraisal. The therapy ensure adults send messages of approachability and trustworthiness into child’s brain. i.e. not being defensive adults in order to ensure provision of comforting enjoyable experiences with adults. Safety is key in developing this trustworthy environment. 

Underpinning this approach are the key DDP elements of PACE – playfulness, acceptance, curiosity, empathy which are utilised by the therapist in work with children, parents and families. 

The content of the book is laid out in such a way that the reader is informed by the new science of attachment and the bio behavioural processes of trust, mistrust and trust building. This is rich and informative. The focus then leads on to the means of change in the brain functioning in order to bring about therapeutic intervention. There are summaries for some chapters (those providing theoretical background) which are an excellent learning aid. The chapters on intervention are very well illustrated with clinical examples which bring alive the approach as well as reminding the reader of the pain for the children and families involved. 

In drawing the book to a close the focus is directed to the future and the possible expansion of the DDP model looking at more processes to decrease chronic stress and defensiveness. 

The linking of the constantly developing information on brain functioning with attachment focused therapy is very successfully achieved in this book which will provide those working with children and families with potentially both an increased body of knowledge and an improved skill base.

​Ann Rooney
Consultant / Trainer