Book of the Month January 2018 - Building the Bonds of Attachment

Building the Bonds of Attachment: Awakening Love in Deeply Traumatised Children
(3rd Edition), Daniel A. Hughes PhD

This highly engaging and insightful book uses the story of Katie, a child at risk and then in foster care to explore the theory and application of Developmental Dyadic Psychotherapy (DDP), both in therapy in in therapeutic care.  Although the characters Hughes introduces us to (especially Katie) are an amalgam of real carers, children and Social Worker that Hughes and other practitioners have known over the years, they are believable.  The Inner World of “Katie” is well described, as is the seemingly endless patience of Jackie, Katie’s fourth foster mum.
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Through the narrative (novelistic) style, Hughes adopts, we get a revealing outline of blocked trust, blocked care, PACE in action and the process of PACEFUL parenting & therapeutic intervention.  Use of the Social Worker’s own developing relationship & parenting of his first child provides an opportunity for the reader to compare normal developmental pathways of relational styles, with the disordered reactions and thinking of Katie.

Each chapter is full of detailed descriptions of significant incidents followed by a reflective “commentary” section.  This allows the reader to refresh and summarise what has occurred, whilst checking their understanding of the trickier concepts and reviewing their own learning and development of ideas.

The introduction can be read alone as a helpful outline of attachment, why it is important and the role of therapy.  It also provides a helpful overview of the main aspects of attachment, and the important concepts that develop through early care, especially the role of attachment, empathy and intersubjectivity.  It provides a useful definition of trauma and the distinction between PTSD and developmental trauma.

At times the reader feels exhausted alongside the foster carers, especially Jackie, who are struggling to get it right for Katie and this is one of the books strengths – the ability to illustrate how difficult it can be to care for, and keep caring for highly traumatised children.  Although the outcome for Katie might be seen, by some, as too easy, for others it will be seen as an inevitable outcome of the hard work of therapeutic parenting where the aim is to build the bonds of attachment.  The reader never loses sight of wanting things to be better for Katie no matter how challenging she seems, because Hughes has drawn her character and the motivations for her behaviours so well.

Hughes skilfully outlines, through the examples he describes, the need for constant self-reflection on the part of therapeutic carers, including support to explore their own attachment history and the necessity of having access to the support of a therapist who is focused on the development of the relationship between carer and child.  By accompanying Jackie and Katie through their therapy sessions, the focus of the problem is shifted from a “within child” model (and the reader is given an example of this type of therapy in Katie’s first therapist) to a “within relationship” model.  By making the mind shift to seeing the problem located within relationship and knowing how they work, the message of this insightful, highly readable book is one of hope.  Things can change.  Children can be helped and healed.

Lesley Craig
Educational Psychologist
Clackmannanshire Educational Psychology Service.

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