​The Body keeps the Score – Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk, M.D      £21
 
What a wonderful book – authoritative, erudite, compassionate and beautifully written.

Dr Bessel van der Kolk combines the curiosity and analytical mind of the scientist with what Judith Herman calls, “the passion of the truth teller”, and the refreshingly humble outlook of a man in awe of his patients.

But a word of caution, this book is a challenge. Think twice if you are easily shocked, offended, or likely to wallow in guilt for doing what you believed to be best practice at the time. All we can ever do is our best and our best changes all the time, as van der Kolk himself has also had to acknowledge in his 30-year career.
 
To summarise the content I’m going to start in the middle of the book because it is here that van der Kolk makes the bold statement that developmental trauma is “the hidden epidemic” in society. As a trainer I talk to parents and teachers about attachment and trauma, many of whom think trauma is a fringe topic affecting a minority of children.  Van der Kolk would argue otherwise. He compares the (US) public health budget devoted to both heart health education and smoking cessation with the barely mentioned topic of childhood abuse, the cost of which exceeds cancer and heart disease in the USA.  To halve the rate of depression, drastically reduce alcoholism, IV drug use, domestic violence, suicide, prison admissions and improve workplace performance he believes we need to eradicate child abuse.
 
Even obesity comes in for a radical rethink. Diets, bariatric surgery even a sugar tax may look like a solution to a major health crisis, but for the trauma survivor society’s problem may actually be their solution, eg, being big may be a health risk in the long term, but for now being the biggest boy in class may be a way to feel safe from bullies, or being an overweight girl may stop unwanted sexual attention. Brace yourself for the research from one chief of medicine that most of his morbidly obese patients were survivors of child sexual abuse. Van der Kolk wants to get this “hidden epidemic” out in the open. When he asks, “how do you turn a newborn baby with all its promise and infinite capacities into a thirty-year-old homeless drunk?  He gets us to acknowledge how much relationship rather than genetics shapes development. So, while there may be a gene for alcoholism, for example, stressful experiences impact on genetic expression both in the womb and after birth.
 
Throughout the text van der Kolk gives us a glimpse of his own childhood and family traumas. He also tours the many dubious practices of the psychiatry profession over the course of his career, from the brutal to the inspired, focusing frequently on the profession’s more recent obsession with pharmaceuticals. Drugs such as Prozac transformed the lives of many depressed patients from the late 1980s onward, but in van der Kolk’s experience they did not work for war veterans with PTSD. The difficulty arose when medication was seen as the go to “fix it” for mental health problems rather than being part of a holistic treatment package. Drug benefits lay in their ability to dampen reactions not heal the illness. In the case of the half a million US children on antipsychotic drugs, medication has improved things for adults by making the children easier to control! Van der Kolk reports huge over prescribing in the children of low-income families and children in foster care. Shockingly, even thousands of under fives have been prescribed antipsychotics, reducing their aggression but also their motivation, playfulness, curiosity, general functioning and socialization.
 
Thankfully, amid the horror stories are accounts of the author’s inspirational teachers, such as the psychiatrist Elvin Semrad who discouraged him from relying too heavily on psychiatry text books and diagnostic labels which obscured his perceptions of real patients. Instead, he urged getting to know and respect the person while acknowledging that, “most human suffering is related to love and loss”. Teachers have also appeared in the form of patients such as Marilyn who told him his reassuring platitudes only made her more lonely and isolated because, “it confirms that nobody in the whole world will ever understand what it feels like to be me.”
 
Through his experience of working with patients Van der Kolk has  concluded that “all trauma is preverbal” whether it happens in infancy or adulthood. This doesn’t mean that it can’t be talked about but that talking rarely gets to the truth because it reactivates the experience of trauma in the body. Experiments with fMRI scans show that trauma activation stops the brain’s speech centre (Broca’s area in the cortex) from functioning. Consequently, the traumatised continue to live in isolated “speechless horror”. He questions accepted therapeutic practices in the light of what we now know from brain scans, research and experience and advocates alternatives such as yoga, EMDR, mindfulness and others that put trauma survivors back in touch with themselves.
  
There is so much in this book that cannot be summarised. I have only selected morsels to tempt and tantalise. In doing so, I feel that I have done it an injustice by missing out so much of the content on attachment, traumatic memory, the anatomy of survival, neuroscience and the numerous and varied paths to recovery. There is a huge focus on relationship and connectedness and our innate drive to be part of a tribe, which goes against the cultural norm of being an individual, competitive and self made. You have to read it to begin to grasp the breadth and depth of its reach but I’ll leave you with this summary by the author himself, “Trauma results in a fundamental reorganisation of the way the mind and brain manage perceptions… For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present. [We need] to think differently not only about the structure of the mind but also the processes by which it heals.”
 
Happy reading!
 
Reviewed by Sheila Lavery

THESE REVIEWS ORIGINALLY APPEARED ON THE SCOTTISH ADOPTION WEBSITE AND ARE REPRODUCED WITH PERMISSION

The Huge Bag of Worries tells the story of Jenny and her struggles with her increasing number of worries. Big worries, small worries, worries about all manner of things. No matter what Jenny tries to do, the worries just won’t go away and worse still, they keep growing...

Thankfully, help is at hand, in the shape of a kindly neighbour, who knows a thing or two about tackling a worry. Her words of wisdom and range of strategies soon help Jenny to lighten her load and finish up with a smile on her face!

This is a lovely children’s book, which would appeal particularly to those in the early years of primary school. It is enhanced by lively and witty illustrations, which help bring the story to life. The depiction of worries as furry creatures living in a bag also offers great creative options for working with children in a similar vein, to conceptualise and manage their own personal worries. The story has a reassuring message and the strategies offered by the neighbour are widely transferable and could be used by children again and again.

As a story, it stands alone as enjoyable read. For children struggling with worries on a range of levels, it is a terrific resource for supporting them to understand and manage these.

This months review comes from Naomi Head, a Senior Practitioner in the Placement Team.

THIS MONTH'S REVIEW IS A LITTLE DIFFERENT -
A POSTER AND PRACTICE NOTES FROM THE FAMILY PLACE
​
Using Theraplay to support transitions from fostering to adoption by Dr Vivien Norris and Sally Twigger.

Dr Norris begins the practice notes by stating “Although it is widely recognised that support over the transition from fostering to adoption is essential, many are uncertain how best to do this in practice”.

We recognise that transition is a complex process which carries with it many hopes and expectations for all involved.  It can be a tense and emotional time for the child the adopters, the foster carers and professionals.

Prospective adoptive parents will all have had their own particular journey to adoption, they will have attended preparation groups, have under taken an intensive home study , been to an approval panel and will have known the details of the child they have been matched with for a number of weeks, and will be desperate to meet and claim the child.  The adopters will want to begin to get to know the child to establish a relationship as soon as possible.  They may also feel nervous about being surrounded by other people who know the child well.  This can result in adopters feeling vulnerable and intimidated by an experienced foster carer who has effectively built up and managed a relationship with their child. 

The co-ordination process can be emotionally painful for foster carers who have cared for the child for a long time sometimes from birth.  Foster carers will have supported the child through some difficult experiences.  They will have integrated the child into their family and will have developed empathy for the child’s experience.  They will have supported the child to meet their developmental milestones and will have established rhythms’ and routines that the child will be familiar with.  Many foster carers can experience difficult feelings about the imminent separation from a child in their care.  This can be even more complicated and sensitive if the foster carers have previously expressed an interest in caring for the child on a permanent basis.

The workers have also known the child and supported the child through difficult and distressing times.  They will have contact with the birth family and will have facilitated family contact which is often fraught.  They will have been instrumental in removing birth parents parental rights and responsibilities and are invested in securing a good outcome for the child parents who will meet the child’s life long needs and offer the child an opportunity to heal, grow and develop.  In my experience everyone comes to co-ordination with hopes, dreams and high expectations, and it is possible to lose sight of the child’s needs when so many conflicting adult needs are at the forefront.

In her piece Dr Norris reminds us that children who are transitioning from one family to another, and who have a history of developmental trauma face complex difficulties.  They are likely to have a fragile sense of trust in adults and sensitivity to being triggered into a survival state, or to regress to earlier ways of relating which means they may move away from rather than towards their main attachment figure (the foster carer) at times of significant stress.  They are also likely to hide their fear and miscue; that is to give signals that they are fine and self-sufficient when they are feeling frightened.  In addition their capacity to think and make sense of what is happening to them is likely to be highly compromised and exacerbated by fear.  They may not be able to process and retain information or respond to logic and their sense of time may be distorted. Foster carers will often report that things have been explained clearly to a child but ‘they act as if they haven’t heard it’.  Alongside age related development and a child’s concept of time, children who are highly anxious may be able only to think in minutes or seconds and any discussion of the future beyond that may be meaningless.  This obviously presents challenges in terms of how to be of most help to children who are moving family.

The purpose of a transition is to move a child from their foster carers to their  adoptive parents.  This is usually achieved.  In my opinion that makes how we do the co-ordination even more important as we should be child focussed and protective of the child recognising their distress as described by Dr Norris.
The co-ordination plan focuses on practical arrangements but these arrangements should be put in place to support the child to transfer their sense of trust from his primary care giver to their adoptive parents. 
Dr Norris’s approach helps us to put the child in the centre and supports the child to make use of their main attachment figure.

With my colleagues I have put into practice Dr Norris’s approach to good effect. The use of theraplay in transition has made everyone more aware of the importance of transferring established loving ritual.  We are more conscious of need to know more about the child’s rhythms and to transfer these from the foster carer to the adopters. We are more conscious of putting in place a co-ordination plan aims minimise the trauma that the child will experience during the transition.  We want to know what soothes and what excites the child.  We pay greater attention to the continuity of the sensory environment and to the non verbal means of communication such as touch, play, music and transitional objects.

I have found the poster helpful, as it supports us to think about the impact of developmental trauma and the implication for the child when they are experiencing another move.  It is helpful to think about potential issues, the implications and goals that underpin the transition process.

This model recognises the foster carer as central in supporting the child throughout coordination and it is essential that they are well prepared for and well supported throughout this process.  Their social worker has a crucial role in relation to this and needs to be available to the foster carer during the co-ordination process.  Foster carers need to be enabled to undertake this piece of work and it is important that other departmental demands are kept to a minimum where possible (e.g. additional foster placements, LAC Reviews for the child).

As Dr Norris points out even children who are well prepared for moving placements can find the experience confusing and anxiety provoking.  This model recognises and accepts the child’s experience and helps us all to remain child focused throughout this difficult and challenging process.

I would recommend that all workers, foster carers and adopters read Dr Norris’s piece alongside her chapter in "Healing the Hidden Hurts".

Anne MacKenzie 
Senior Practitioner at City of Edinburgh Council

Keeping the Little Blighters Busy: 50 refreshingly different things to do with your kids before they're 12 3/4 by Claire Potter 

This is a great book to dip into for ideas on how to encourage play, and spend fun time with the children - or set them off and leave them to it!

​Bright and accessible, it gives a range of imaginative activities that cost little or nothing to set up and enjoy, and which are fun and exciting - it is not just another things to do with sticky-backed plastic sort of read.

In fact, it is brilliant book for parents who need more ideas on what to do with their kids and how to encourage imaginative playtime. It is aimed at ages 3-13, though the adults will have as much fun as the kids when joining in on many of the activities. 

The book is divided into sections making it easy to home in on the solution you need, or you can flip through it and pick up something that catches your eye - I particularly liked the “if you like this you could look at page…”  footnotes.

I found the suggestions imaginative but simple to set up, and applicable to all sorts of situations – rainy days at home, creative stuff in the garden, walks in the park or round the neighbourhood, new takes on Halloween and Christmas, all at low or no cost and generally easy to set up.  

The author also give a little bit of background as to how she came up with the idea, which rounds the book out. All in all it was an inspiring and warm hearted read, I will definitely be trying out a few of these activities with my 2 boys.

Ruth F, Adoptive parent

The Teacher’s Introduction to Attachment: Practical Essentials for Teachers, Carers and School Support Staff by Nicola Marshall

Teaching colleagues and school support staff are frequently in search of knowledge, understanding and skills to assist them in meeting the needs of some of our most vulnerable children- those who have experienced early developmental trauma. 

Within education circles some would argue that meeting the needs of this group of children presents one of the greatest challenges to fostering an inclusive education system and to realising the aspirations of Getting it Right for Every Child.

Nicola Marshall’s book is a helpful addition to the range of resources designed to support staff and carers to respond positively to the often complex challenges presented by children with attachment difficulties. 

She describes her book as a “down to earth, practical and accessible look at the world of attachment and trauma, particularly in educational settings” – and that is precisely what it is. 

While drawing on the work of many well-known writers and practitioners in the field, notably Dan Hughes, Bruce Perry, Kate Cairns and Louise Bomber amongst others, Marshall expresses the hope that the reader will find that her book comes from a real place of experience. The experience she refers to is that of being the parent of three adopted children, who she describes as being the reason for the book; having given her the inspiration to try to help others understand the impact of early trauma on children.

                 “The key to most things in life is awareness and understanding.
                   Once you have that the strategies are easier to find”. 

While there can be little doubt of the truth of this statement, many teachers may assert that while the understanding is essential, it is not sufficient, and that what is needed in schools is the means to implement practical effective strategies on a day to day basis. The fact that Nicola Marshall manages to cover both theory and practical strategy, and more importantly link them meaningfully in a relatively short 147 pages should add to the appeal of this book for busy school staff. 

The book is divided into four parts. Part 1 looks at theory and starts from the perspective of some of the puzzling behaviours and responses of traumatised children, acknowledging that we need to ‘take a step back’ and look at what may have happened in the lives of children before they came to school, to really understand the feelings behind the behaviours they present. This is a fundamentally important point, highlighting as it does that effective support for children needs to look beyond and behind behaviour. Teachers and other school staff frequently report that ‘traditional’ and often tried and tested approaches are simply not effective and this can lead to frustration and hopelessness for staff and children alike.

This section covers trauma, its meaning and causes as well as describing the attachment cycle, brain development, the consequences of disrupted attachment and attachment styles. Marshall acknowledges that there is more to say on this subject but her hope is that there is sufficient information in this to allow an understanding and that readers will be inspired to seek a greater depth of understanding through the references and resources provided. Although I have some reservations about describing attachment styles in a resource such as this, as it can reinforce the risk of tendencies to ‘classify’ and label children, there is enough in the later sections of this book to counter- balance any such propensity.  

Part 2 focuses on the Guiding Principles of working to support children. In this section the principles outlined are – Relationships over Programmes, Emotional Age over Chronological Age, Structure over Chaos, Time in over Time out and Sensory Less over Sensory More.  These sound principles for working with children who have experienced trauma and disrupted attachment are helpful for practitioners not only in thinking about the needs of children but also in providing a framework for considering the application of supportive approaches in their particular context and setting.  As such they are useful in helping staff and carers to begin to think about the practical application of strategies with the children they work with on a day to day basis. 

Part 3 goes on to focus specifically on areas of concern in an effort to deepen understanding of the needs of children and some strategies which may be of benefit. This is a practical and helpful overview of some of the main issues and builds effectively of the previous sections covering toxic shame, identity, empathy, trust, control and self-reliance, self-regulation, memory and organisation and changes and transition. Each chapter considers the possible underlying causes of concern, examines the implications for the child and his/her development, the signs that the particular area may be a difficulty for the child and focuses on what can be done to help. It manages to give greater insight into the complex and puzzling behaviours which can perplex (and sometimes defeat staff and carers) as well as offering advice about effective strategies to support children to overcome early adversity and settle to learn. 

Marshall provides examples and weaves some of her own experiences throughout.  This gives the book the flavour of what she describes as ‘heart knowledge as well as head knowledge’ and as such will resonate with those experiencing the challenges of living with or working with traumatised children.
The final section of the book picks up some of the areas not readily captured by the previous parts and looks at, for example, the important issues of secondary stress, communication and triggers.  

It also has a short section on rewards in school – an area that can be especially difficult within a whole school context. Marshall suggests that there is a need for a conceptual shift towards a relational approach which focuses on encouraging expression and integration in order to help a child feel safe, nurtured and good about themselves. She also makes some important points about expectations of change and the resilience and tenacity needed by staff and carers to stick with children in their journey to overcome early adverse experience.

In summary, Nicola Marshall’s book is an easy to read and helpful contribution to the burgeoning resource for school staff and carers in their efforts to help children who have experienced trauma and disrupted attachment to flourish; and as its cover attests, will be a welcome addition to any school’s staff library.

Alison MacDonald
Principal Educational Psychologist  

Yoga Games for Children. Fun and Fitness with Postures, Movements, and Breath
by Danielle Bersma & Marjoke Visscher

​
Namaste and welcome to our yoga games book review! 

I was ably assisted in this review by two small volunteers aged 4 and 7, who agreed (a TV bribe was admittedly involved) to test out the ‘yoga games’ from this book with me. 

The authors suggest working through a series of the games, beginning with breathing, then yoga postures and relaxation, providing a structure which is similar to that of an adult yoga class. The games are designed for children between 3 and 12 with age recommendations for each game. We managed 40 minutes in all, which was far longer than I would have anticipated, especially as early notices were mixed.

“Yoga’s not my thing, I don’t like it!”

We started with a few breathing exercises, the most popular of which was ‘Blowing Leaves’ which as the name suggests, encourages  awareness of the breath travelling in the body by blowing leaves around the room. A good storm ensued. We then tried ‘Animal Sounds’ and running around making a bee noise was also popular so we had a go at ‘Feeling Sounds Through the Back’ with the children sitting back-to-back and taking turns to try and to feel the resonance of one another’s singing or talking. Both declared they could hear the noises ‘in my ear’ so possibly this one needs some practice!

Moving on to poses, the  control needed for the ‘Cobra’ proved difficult, but more light-hearted exercises with suggestions to make the noise of a lion or make a funny face were met enthusiastically and we all especially enjoyed ‘The Sun Salutations for Children’ which included the instruction to ‘try to look silly’. A passing Granny was even successfully co-opted to this exercise. The sun salutations were great fun despite the clouds in the sky outside, and our 7 year old reviewer had learnt the sequence off by heart after a few turns.

Another surprising highlight was ‘Tree’ pose, which initially both children became very frustrated by. But with some gentle hand-holding for balance and a wee bit of patience they eventually really enjoyed gaining mastery of balancing on one leg. We needed a lie-down after all that work… The relaxation exercise ‘White Light’ was thoroughly resisted by the ever-fidgety 7 year old present, 

“I didn’t really enjoy that!”

But greatly enjoyed by Granny at the end of a long day and by our 4 year old reviewer who reported, 

“I actually did feel a white light in me!”

The book is simply laid out and easy to use and adapt to a range of situations and ages. It is primarily aimed at group-work or school settings but even with our very small group we still had a huge amount of laughs. The focus is very much on having fun and enjoying the movements. There are also lots of opportunities for children to talk about how the exercises feel and to develop physical and emotional self-awareness through them. Several games employ the cotton wool balls familiar from Theraplay® games, so these could easily be introduced with a Theraplay® game or two. Just choosing a few yoga games and having fun with them was a lovely way to spend a wet summer evening.

This months review comes from Ariane Critchley, a Senior Practitioner in Scottish Adoption's After Adoption team.

Review

The Bean Seed by Judith Bush & Robert Spottswood.

"The Bean Seed" by Judith Bush and Robert Spottswood, is a book I can relate to better than anything else I’ve read in my entire life.  
To those who haven’t yet read this book will think that sounds crazy – how can someone relate to a seed? 

If you take a moment to think about what a seed requires in order to grow into a strong, healthy plant, and compare it to the things a child needs to grow into a strong, healthy young adult, it is much the same thing, metaphorically speaking. 

Think of a seed that hasn’t been planted properly, with no soil and no water, left out in the sun, abused and neglected.  Now think of it not as a seed, but as a child.  Without blankets, food, water, nurture and care a child will do the same as the seed in this book.  They will start to believe that they are worthless.  That they don’t deserve the love and attention they so much desire, and that only way to survive is to take care of themselves.  They keep all their feelings inside so they don’t show weakness, they build walls so they don’t get hurt and they have developed the inability to trust that anyone else can or will look after them at this vulnerable time in their lives.

"The Bean Seed" is written in such a way that it is easy enough for a child to read with their parents as a bedtime story, or even on their own and while they may not understand it completely, they will relate with the little bean seed on some levels without really knowing it.  As the child matures and becomes more aware of the story and its meaning, it will be easier for them to comprehend as everything finally clicks in their mind.  The simplicity of it however does not mean that an adult will see it as too juvenile or think they will not be able to relate to a child's book.  It is set out with pictures and large text, and written in plain, easy to understand english, but the deeper metaphorical meaning of the book is what adults like myself will be able to take from the book, so don’t judge it by its cover. Sometimes because of the startling innocence and naivety of children’s books it allows the mind to understand things in a more profound way, there is no jargon or unnecessary complex words, just the truth written as if a child had written it themselves. 

I would definitely recommend this book to anyone, be it an adult, teen or child. For me this book was an eye opener because I had never fully been able to understand and come to terms with my feelings, and I couldn’t figure out why I don’t trust other people, why I feel the need to do things by myself, why I keep my feelings to myself and why I build so many walls.  "The Bean Seed" explains it all.  Children do these things to protect themselves, so they don’t get hurt again. It allows the reader to feel like they are not alone, that other people out there have been through a similar experience and that although the feelings they have are natural, it is okay to let go once in a while and let other people take care of you, that it’s okay to trust people again and that it is safe to grow into a strong, beautiful, healthy person that is valued and respected by those who love them. 

A beautiful story and absolutely worth a read. 

Foetal Alcohol Spectrum Disorders: Parenting a child with an invisible disability by Julia Brown and Dr Mary Mather

I am an adoptive parent of two children who have Foetal Alcohol Spectrum Disorders [FASD] and I would have welcomed this book as a valuable resource when they were first diagnosed.

Chapter 5 is excellent at discussing what does not work with FASD children before discussing what does work in Chapter 6 .

The main learning for parents is to develop and be able to be consistent in a daily routine and provide a structured supervised environment.

The following chapters concentrate on the problems FASD children have sensory processing, eating, temper tantrums and sleep or the lack of sleep.

It gives strategies on how to deal with the behaviours and communication and looks to education, social interactions and the move to independence.

The book highlights that everyone caring for a FASD child must accept there is no cure. This is lifelong disability, and one which must be managed and not solved.

My only slight criticism is that the interaction with the birth families and the emotional trauma they suffered before they came into care was not commented on.  Often these children have lived with their parents for a period of years and they need the opportunity to be nurtured and fill in these missing gaps and heal in their emotional life.

My two are now in their late teens, and the problems and need for care is ongoing as their inability to manage time and money continues.  There is a lack of services once they get past 18 and unawareness of adult social services regarding the lifelong needs of FASD Adults.

However difficult parenting these children can be, the rewards and fulfilment of the task is immense and one I am very glad I undertook.

I recommend this book to any adopters, foster carers and parents of Children with FASD.

Susannah MacKay

8 Keys to Building Your Best Relationships by Daniel A. Hughes

As a relationship counsellor, this book has impressed in the way it distils the roots and processes that so often lead to difficulties and conflict in relationships. It also offers insight and hope for relationships that can be very secure and fulfilling. 

Dan Hughes has translated theoretical concepts making them accessible to a wide audience, including the latest science behind relationships, making it a tool for husbands, wives, friends, lovers, professionals, business people, and parents. It would also add greatly to personal and social development curriculum within schools.

Personally I love models that break things down into smaller steps which build cohesive, integrated meaning. Dan does this really well and has combined his experience and understanding with lots of short case study examples and scenarios to make it easy to appreciate the relevance and importance of 
what he contributes here. As a reader already familiar with attachment theory I found the description of attachment styles much more easily understood and applicable to everyday life. 

Chapter and Key no 1 – Learn Why Attachment Matters lays out clearly the authority and standing of attachment theory, it’s usefulness and ultimately links the patterns of relating found in both children and adults to the behaviour that, when explained so insightfully, makes so much sense.

Key No 2 is - Know your Autobiography and be willing to rewrite it. In this chapter he leads the reader through 10 themes that help establish a stronger sense of who we are and the life factors that have contributed to it. Dan explains how re-experiencing the past can give new meaning and alter the influence these have on our present lives. A conclusion drawn is “….if you’ve been able to make sense of the events in your life – and the nature of your most influential relationships – and then develop a story that is organised and interwoven with different elements, you tend to be in the best position to develop healthy relationships.”

In Key no 3 the important areas of Brain and Biology are explored with reference to prominent researchers. Dan manages to craft explanations which make understanding concepts such as interpersonal neurobiology and social engagement remarkably easy. He gives everyday, credible examples to highlight his ideas which allow the reader to get a felt sense of what he attempts to explain.  It is becoming more and more accepted that neuroscience underpins attachment, and therefore relationships are a part of brain function. A key part of this chapter has to be a summary explanation of Dan’s signature PACE approach using Playfulness, Acceptance, Curiosity and Empathy, with poignant examples to support and lay a foundation for how this can and does work in supporting anyone experiencing relationship difficulties.

Key no 4 looks at Building your Reflective Capacity. Here you are invited to consider a range of questions designed to cultivate a conscious presence within relationships. What do relationships mean to me? What am I like in relationships? How do I reflect on others? These questions drill down into more specific questions which tease out what we might be looking for and expecting from our relationships. These questions are designed to increase our awareness of both what we might look for and what we ourselves bring to our relationships.

Key number 5 starts with an example of a young female professional who had difficulties managing her emotions within friendship. This introduces the reader to an interesting chapter called – Build Your Emotional Competence. Here again we get a chance to consider “the mind” and how neuroscience has brought greater understanding of emotions and the complexities of brain function. Dan goes on to explain the wider body systems including the links between our heart and gut which all play a part in felt experience. I found the differentiation between Shame and Guilt useful with great insights into how and why these emotions become established within our emotional self through our early experiences. Looking at how relationships develop provides a helpful way of considering the tensions which ebb and flow in relationships around conflicting emotions and the common causes that lie beneath. Practical exercises support the building of the three characteristics of emotional competence – Knowing what you feel, communicating your feelings and managing your feelings. 

To Master Effective Communication is Key number 6 which looks at reciprocity within the context of taking turns in communication. I like the way Dan describes the pre-requisites of effective communication as an ability to listen and more importantly the ability to stay open and engaged, avoiding defensiveness. This is again well illustrated by examples that help the reader appreciate the different patterns of communication that emerge as relationships grow and change. Developing capacities like saying what you mean and asking for what you want are considered to highlight some subtleties of more effective communication. I love the way the reader is invited to consider the influence of non verbal communication which so often leads to misunderstanding and conflict. Our voice and our physiology often let us down and the examples offered help to understand how this can lead to conflict but also be a very effective part on the solution.

In addressing the reparative work Key No 7 is aptly titled – Tinker and Repair. Accepting that even the healthiest of relationships have problems, and as human beings we will all make mistakes at some point, this chapter looks at what we do, and indeed how we might deal better, when problems arise. The reassurance given around mistakes helps the reader feel OK about personal challenges and experiences.  “People in relationships need to be able to repair whatever conflicts emerge if the relationships are to become truly meaningful and lasting.” Dan goes onto to point out that “Avoiding conflicts leads to a more polite but superficial relationship,” going on to explain what he feels are the fundamental points about relationship tinkering and repair. These are headlined as – Decide if the relationships is more important than the conflict, Remember the importance of the relationship, Remember that assigning blame is counterproductive, Don’t deny or avoid: Address the conflict, Don’t endlessly replay conflict, Remember that behaviour has more than one meaning, Address one conflict at a time and finally Mistakes happen: Say your sorry. Period. In summary our ability to tinker and repair is enhanced when our focus moves towards the opportunity to strengthen our relationships rather than to any risk to its durability when we experience conflicts.

The final Key and Chapter is titled Balance Autonomy with Intimacy. An autonomous attachment, as explained in previous chapters, provides both the safety and satisfaction that promotes balance in relationships. However, to feel fulfilled across your life, that wider awareness needs to reflect that “You are not a passive recipient of your life; you are active in creating it.” All of the work from the previous Keys comes together here to illustrate how knowing yourself and the impact of your story provides the platform for meaning and understanding which grows awareness. The example given in this chapter highlights how relationship difficulties develop. The autonomy which was a factor in the partner’s attraction is readily given up changing the rhythm and dynamics of the relationship beginning a cycle of dependency pushing the other away. The moral of this is that no person can be the source of another’s happiness. It is in the sharing of the uniqueness of two autonomous individuals that rich and fulfilling relationships thrive. This does not mean other relationships can’t last or don’t work but it highlights clearly that they will not be deep and fulfilling. 

In pulling the collection of 8 Keys together Dan has provided a valuable tool for building and maintaining balance in autonomy and intimacy within relationships. In claiming that “Your past relationships do not have to dictate your future relationships”, strategies are offered to increase the meaning of relationships in your life and exercises to help you establish how you may have contributed to past relationships and where you have made relationships difficult. A framework is offered for starting a journal, recording important features of yourself which can be used to promote and preserve your autonomy while allowing space for important relationships to develop and grow. This is further developed with a longer term use of a journal being used to compare and guide us towards sustainable healthy relationships. In the final paragraph Dan reminds us of the importance of being Playful, Accepting, Curious and Empathic to keep us on track with both our relationship with our self and our relationships with others. I thoroughly recommend this book.

Kevin Denvir
Relationship Counsellor

No-Drama Discipline: The whole brain way to calm chaos and nurture your child’s developing mind by Daniel J. Siegel, MD and Tina Payne Bryson, PhD  

As a trainer working in the area of attachment and trauma I spend my time talking to parents, teachers and other professionals about connecting with hurt children. While most people can see the need for attunement, empathy and forming positive relationships with insecurely attached children, the issue of discipline is invariably a stumbling block for many. We are so culturally conditioned to thinking about reinforcement as a way of increasing positive and reducing ‘bad’ behaviour that we struggle with the concept of relationship being more transformative than reinforcement. 

“Isn’t that rewarding bad behaviour?” “That’s mollycoddling!”, “How will they learn right from wrong?” are typical responses when you advocate ditching the time outs, star charts and punitive sanctions in favour of validating the feelings behind the behaviour to maintain regulation and encourage reflection. So I was delighted to review No Drama Discipline, which encourages parents to “avoid any discipline approach that is aggressive, inflicts pain, or creates fear or terror.” Readers familiar with Dan Hughes’ parenting attitude will probably have a few bells ringing by now and for me Dan Siegel is right up there with Dan Hughes in providing practical, straightforward and do-able parenting advice. In fact, there is a noticeable overlap between what Siegel, a neurobiologist, and Hughes, a dyadic developmental psychotherapist, advocate in parenting, namely connect with the child to correct the behaviour. Reassuringly, both Siegel and his co-author, psychotherapist, Tina Payne Bryson, are also parents.

So, before we even hit chapter 1, the authors ask us to forget all traditional concepts of discipline and open our minds to a different approach that will not only reap immediate rewards but also encourage children to become more reflective self-disciplined people in the long term. Interestingly, this is a book for all parents, not just those of us who are parenting traumatised children. It’s an example of how approaches, which work with the most difficult-to-parent children gradually, filter into the mainstream. 

Over the next six chapters and throughout the conclusion the authors take the reader on a journey from being a parent/carer/teacher who simply reacts to behaviour to a person who reflects on feelings and redirects the child to alternative ways of expression. They consider the 20 discipline mistakes even great parents make. Unsurprisingly, these include focusing too much on consequences instead of teaching and worrying about what other people think (who hasn’t been there?). Siegel references his famous hand model of the brain, which teaches children about their upstairs (cortex) and downstairs (mid and brainstem) parts of the brain and what it really means to flip your lid. He also discusses how we encourage what he has branded mindsight (empathy 
and reflection) in children. The book is peppered with simple, yet useful cartoons illustrating examples of good and not so good parenting responses and bursting with examples of what it means to be consistent yet flexible, validating rather than dismissive, and curious rather than lecturing, criticising or blaming. throughout it all, the authors are adamant that good discipline follows eight key principles: 
1. Discipline is essential. Children need clear, consistent boundaries
2. Effective discipline depends on a loving respectful adult – child relationship
3. Discipline means teach, not punish
4. We need to pay attention to the child’s feelings – misbehaving is usually about not handling big feelings very well.
5. Children need us most when they are behaving at their worst
6. We need to regulate children before they are ready to learn
7. We regulate through connecting and comforting
8. When children feel the comfort and connection they are more ready to take redirection.

It’s simple in essence, but it is hard to do this stuff all the time. Even the greatest parents get tired, hungry, ill, fed up and sick of it all and we tend to behave childishly when we don’t get our own needs met. Both authors acknowledge this and offer some examples of how they got it so horribly wrong with their own children. It’s brave of them to admit and there is a curious comfort in thinking, “hmm if Dan Siegel can lose his temper and swear I can’t be doing too badly.”

This is a book I would recommend for parents, carers, childminders, teachers, youth leaders, in fact anyone working with children and young people. It is authoritative, accessible, realistic and caring. Its not brilliantly written and it could probably be a bit shorter without losing anything of real value but as a book dedicated to discipline, its probably one of the best I’ve come across. 

Sheila Lavery

'Facilitating Meaningful Contact in Adoption and Fostering' by Louis Sydney and Elsie Price.

This is the first book I’ve read that tackles the issues involved in contact between adopted and foster children and their birth family. It considers the various forms of contact from direct contact, social media contact to occasional letterbox contact and even considers the impact on children where contact is not possible. It looks at the impact of contact on babies who are in foster care and who are involved in travelling to and from contact.  

The book starts with a consideration of the nature of contact today and in particular explores contact in the context of the, often, traumatic nature of children’s experiences prior to being accommodated. It looks at the neurological impact of early trauma and its impact on children’s ability to form attachments. The book stresses the importance of looking at contact in the context of children’s history and the way contact might impact children’s current attachment patterns and ways of managing. The authors are clear that contact should reflect children’s needs and be seen as an opportunity to help children repair from the impact of early traumatic experiences. The book’s use of case examples brings the points the authors want to emphasise alive; they demonstrate, in a practical way, how their views on contact can be put into practice.

Chapter two provides a clear explanation of the rationale for facilitating contact and clearly outlines how to prepare for and support such contact. This, for me, is essential reading for professionals considering how to manage contact in a way that is therapeutic for children. 

The book goes on to consider the impact of contact for babies and toddlers and invites readers to consider what contact does to babies and toddlers in terms of their attachments and ability to trust. The book goes on to consider ‘goodbye contact’ for children who are moving from temporary to permanent care. Given the potential for future contact through, for example, social media the authors suggest that the ‘goodbye contact’ should be renamed ‘goodbye for now contact’.

The book considers not only contact between children and their birth parents but also contact between siblings who are not living together. It considers the impact when children have different experiences; for example when children experience a disrupted placement. 

I would recommend this book as essential reading for all professionals working in the field of fostering and adoption. The book will also be helpful for foster carers and adopters who are involved in contact arrangements. It will help them consider the potential impact of contact arrangements and therefore assist parents in supporting their children. 

Christine Gordon
ADAPT Scotland

THESE REVIEWS ORIGINALLY APPEARED ON THE SCOTTISH ADOPTION WEBSITE AND ARE REPRODUCED WITH PERMISSION

The Confusing World of Brothers, Sisters and Adoption By Regina. M .Kupecky
 
This simple to read workbook is the 3rd in a series of workbooks based on 'The Adoption Club' , a fictional support club for adopted children aged 5-11. The book is intended  not only for social workers, counsellors or therapists working with children in this age bracket, but also for adoptive parents.

Being an adoptive parent myself, I was glad to see that it stretches to no more than 45 pages, and  as it's a simple read,I was able get through a first reading quite easily over a cup of coffee while my youngsters attended a sports club after school. 

Mrs Bright, the counselor at the Adoption Club, is the main character and she takes you through the social histories of the different children who attend the club. A wide range of children from different backgrounds and experiences are described in child friendly language and while the individual characters may not exactly match the particular children you are working with, they are general enough to find common similarities with the type of child likely to be encountered in any school or club settings today.

Each  character description  provides a follow up  section where feelings can be explored and questions recorded. Such as feelings of separation and loss of a sibling,  being an only child  or inheriting a new brother or sister and the emotional conflict that this brings.  I found that these exercises provide good story starters for my children who find it difficult to begin expressing their thoughts openly and  who find the security of talking through the personality of a third person reassuring.

As second timer newly adoptive dads we had a giggle when we read about the ups downs of having a new wee brother join the family.  It was reassuring  to think that the exhibited behaviours we are witnessing at home are no more than the normal readjustment interactions between two boys getting used to having to share time and space, and that our boys, much like those boys depicted at the club, are going through all this too. Its not only just us!

This book provides an easy to read set of activities which you can choose to work through with your child or young person or just to pick up from when relationships need to be explored a little further.  Failing that you could always all just sit down on the couch and watch an episode of Modern Family on the TV together!
 
-An Adoptive Dad.

Review

'Attachment in Common Sense and Doodles: A Practical Guide' (2013)
by Miriam Silver

With so many books about Attachment already available, Miriam Silver had a hard task in writing something different!  She achieves this, apparently effortlessly, with this well-written and accessible book, based both on theory and on her considerable experience as a clinician.

The book starts off perhaps a little tentatively, with well-known explanations and diagrams of attachment theory and a reminder about the need for not only children, but also adults, to have a safe base.  The author gives a helpful chapter on “why attachment matters” and the impact of poor early care.  Where she starts to into her own, however, is in providing opportunities for self-reflection, through small exercises which are interspersed throughout the book.  These exercises encourage us to reflect on our own attachment patterns, those of the children we care for or work with and the reciprocal impact.

As you delve further into this gem of a book, you find many insights into the behaviour of children with attachment difficulties and their carers’ reactions.  For example, in looking at the possibility that a “blow out” may create familiarity for a child, the author also reminds carers to be aware of their own physiological response: you can’t contain a child’s feelings if you are feeling angry yourself. The book could have stopped here but Miriam Silver bravely addresses the tendency for professionals to label children who come with challenging presentations and encourages us to think widely about the possible combination of organic and acquired difficulties.  

The second half of the book looks at parenting styles and the core qualities of the therapeutic parent, including Dan Hughes’ PLACE (Playful, Loving, Acceptance, Curious, Empathic).  The author addresses the deep shame which many children with traumatic pasts carry about themselves, their triggers from the past and how to help them to change the story which they have about themselves. This is a book which draws you in!  The language is very accessible and the text is accompanied by “doodles” drawn by Teg Landsell, which are very helpful.  

The book is intended for carers or professionals who are dealing with children who have been placed away from their birth parents after early trauma, neglect or abuse.  Miriam Silver’s objective was “provide a fresh approach… in an accessible form”.  In this she succeeds admirably and I commend this book wholeheartedly to foster carers, adoptive parents and to those working with them. 

*****  star rating   
Heather M Drysdale 
Systemic Psychotherapist/Adoption and Fostering Consultant

THESE REVIEWS ORIGINALLY APPEARED ON THE SCOTTISH ADOPTION WEBSITE AND ARE REPRODUCED WITH PERMISSION

Attachment in common sense and doodles - A Practical Guide by Miriam Silver

Of the many books on attachment theory, this must be one of the most accessible and relevant. Written in a lively, lucid, conversational style, Miriam Silver, a Consultant Clinical Psychologist, helps the reader develop their understanding of children who have experienced abuse, neglect and trauma and are no longer living with their birth family.

Teg Lansdell provides useful doodles highlighting ideas. Case studies and Reflection paragraphs, where the reader is encouraged to think about their own experiences ,adds a  personal dimension to the material.

A range of practical approaches are offered on how to help children feel safe, trust and become more open to the positive, healing care foster carers and adoptive parents hope to provide. There are references throughout for the reader to find out more about areas of interest.

The range of material in this book makes it relevant to a wide readership: parents and professionals, those new to attachment and those who are knowledgeable about it.

It’s a gem of a book!

Maureen Kinnell
Practice Manager

 Review

 ‘Holding on and hanging in’ (2010) by Lorna Miles 

I have just discovered this wonderful book by Lorna Miles, therapeutic foster carer. Interlaced with both the understanding and therapeutic PACE parenting (Dan Hughes model) of Wayne – a severely traumatised nine year old – it is wise, practical, poignant and playful.  

Lorna Miles takes the reader with her on her family’s  journey to support Wayne to start to grow and heal, and in telling the story she gives an honest account of the many challenges, frustrations, trials and tribulations.  

The book packs a punch with respect to the importance of the team around the family (social work, health and education) working together with a shared understand and a high level of support available.   

This is a great book for parents, carers and professionals.  As Dan Hughes says: 
‘This one story brings the theories, research, professional conferences and training to life.  And makes all the effort worthwhile’ 

Edwina Grant
Scottish Attachment in Action Committee Member
DDP Practitioner, Trainer & Consultant