Developmental Movement Consultants
The Brain Nanny©
Seattle, Washington

They take a great deal of our attention, yet sometimes we look at them and feel like there’s “no one home.” They need so much love, but it seems to wash off of them, as off the proverbial duck’s back. Traditional therapy has had to find new ways to deal with these children, who are described as “unbonded” or “attachment disordered.” They can become the bane of teachers and school counselors. As adults, some of them slip into our psychopathic or sociopathic criminal population. The current national sense of crisis about dealing with violent children (violence being one behavioral possibility of the unbonded child) makes it imperative that we take a deeper look at effective treatments for our unbonded children.

Among the effective treatments for this problem – one that is frequently over looked but could be a key to recovery for many children – is the Neurological Reorganization approach. This approach is also used to address head injuries, learning disabilities, and ADHD. Neurological Reorganization Therapy has been effectively used as part of a team treatment plan with children who are in therapy for bonding disorders.

Neurological Reorganization Therapy is a personalized program of neuromotor activities designed to fill in gaps in a child’s neurological development. Used in conjunction with cognitive behavioral, or feelings-based therapies, it can significantly speed up the recovery process and generally make recovery more complete. What are the behaviors that indicate a bonding/attachment disorder? Frequently the behaviors of the unbonded child appear paradoxical. The unattached child may be remote, or clingy or both. He may at times appear to be impervious to affection, unresponsive or even hostile. At other times, he may be loathe to leave his parent’s side, may insist on sleeping in or near the parent’s bed, or need reassurance throughout the night to sleep in his own bed.

A colleague, Susan Scott, previously of the N.W. Neurodevelopmental Training Center in Oregon, has made the following observation about children with attachment disorder: “This child may appear to lack empathy for others, or he may seem to be overly attentive to the feelings and wishes of others.

“The child’s teacher may comment, ‘he will hurt one of his classmates and then laugh about it.’ He may also go out of his way to appease the people around him. Both of these behaviors result because the child doesn’t have a way to know what others are feeling. In the first case, he cannot compare the hurt that this classmate is feeling to any event in his own experience and, therefore, has no empathy for the classmate. In the second case, it is his inability to know what those around him are feeling that causes him to feel the need to be conciliatory. They may be mad at him or may be pleased, but without a way to know, he must assume the worst and do whatever is in his power to prevent it.”

Paradoxes are common in the attachment disordered child, who can seem to be cruel or merciless, abusing other children or animals without understanding why this wrong. On the other hand, this child may, at the same time, be “socially promiscuous” (a phrase coined by Florence Scott, RN, which refers to a child who tries to win the favor and attention of almost everyone he meets as if he does not have clear idea of who his caretaker is). This child may have to be closely watched in public places, as he can be just as happy to walk off with a stranger as to stay with the family group. He may have no sense of his boundaries and climb into the laps of, or touch inappropriately, people he has just met. Over many years of working with these children, we have come to recognize the specific central nervous system issues that are associated with the behavior of the unattached child or adult.

I propose that the extent to which a child is able to feel pain appropriately is the extent to which that child has a capacity to be empathetic.
Almost universally, these patients have a disturbance in the functions of their pons level brain. This brain area, keenly alert to life-preserving information such as tactile sensations of heat, cold, pain and hunger, alerts us to threats to our life and person. This upper brain stem, pre-cortical, pre-logical, and pre-linguistic, is critical to our survival.

One of the functions of the pons is to alert us to pain, giving us information not only about ourselves, but also about others. I experience pain appropriately, and am fully aware of when I am hurt. It gives me a way to understand the experience of others. When I see someone who is injured, I am immediately able to empathize, because I know the experience of pain and how it affects me.

I propose that the extent to which a child is able to feel pain appropriately is the extent to which that child has a capacity to be empathetic. Is empathy solely a central nervous system function? Certainly not – psychological trauma, family of origin modeling, training in ethics or morality (or lack thereof), all play a part. However, if we do not have the capacity to feel, empathy is something as foreign to our experience as the color red is to the blind.

As a consequence of an inability to feel pain due to and under-active pons, we observe the child seeking out situations that provide needed stimulus to relieve numbness. Without critical information coming into the brain from the pons, a child may engage in high-risk behaviors such as jumping from high places, or perform life-threatening stunts, sometimes injuring themselves in the process, but ignoring the injury until it is “convenient” for them to take a break from their activity and deal with it.

Some children and adults will choose self-mutilation as a means to deal with the numbness they feel, resorting to cutting their skin with knives, razor blades, or broken glass. Others mutilate fingers and toes, cutting or chewing off fingernails or toenails, cuticles, calluses, until they bleed. Some have picked at scabs, creating larger wounds. Other clients, both children and adults, have pounded their heads into walls until they bled. Often adults with these behaviors (being more articulate than children) will report that they just wanted “to feel something…anything.” Clearly these clients feel cut off from the world for a very specific neurological reason. They do not feel, and in their attempt to feel they injure themselves or others. Clearly these children are, in many ways, unavailable. At the same time, a dysfunctional pons that is “working overtime” may cause the child to become hyper alert and anxious, perceiving as a threat stimuli that are not intense enough to be life-threatening. In a state of being constantly on guard, this child may appear paranoid, perceiving everything that is not a direct affirmation of that child as a criticism or a threat to their well-being.

Adults with a dysfunctional pons may feel isolated, alienated, or suicidal, as they tend to believe that there is no place for them in the world. In the extreme, they may become the “quiet loner” who values neither his own life nor the lives of others, who can take a life without remorse.
Because the pons in not a rational brain and does not have the capacity to speak, we often see what appears to be an unreachable substratum of despair that verbal, behavioral or emotion-based therapies do not appear to touch. ________________________________________

Another neurological component that affects bonding also occurs during the first seven months of life while the pons is organizing itself. Visually, at this stage of development, the child does not see in the same detail that adults see. Rather, they see in outline, their favorite outline being the human face: eyes, nose and mouth arranged in the specific pattern of human features.

A child at this stage will stare at another human face, whether family member or stranger, with the same loving intent gaze. This gazing period allows the child to bond with their species, even before they know the specific facial features of their own parents. The child knows that someone with these features is someone who will feed them, protect them from danger, and relieve their distress. In the second half of the first year, the child begins to visually distinguish his parents from strangers, and do more gazing into the face of family members.

For many children diagnosed with attachment disorder, there was little or no gazing into the eyes of another during these early months. Some of these children were in orphanages during this critical bonding period, with one caretaker for each dozen or more children, and no close holding and gazing time available. Children who are born affected by drugs or alcohol may not have the physical ability to go through this gazing phase, and may have a disruption in their bonding because of this unavailability. Both of these factors, the dysfunctional environment and the dysfunctional brain, can be significant barriers to bonding.

A child in neurodevelopmental therapy is screened for the physical ability to gaze, and is given activities to stimulate better visual processing and opportunities to spend time gazing at his caretaker.

When we address the challenges of a child with a pons-level injury, we must always remember that a dysfunction at this level leaves the child feeling abandoned, isolated, and fearful, without a clear way to express these feelings. Because the pons is not a rational brain and does not have the capacity to speak, we often see an unreachable substratum of despair that verbal, behavioral or emotion-based therapies do not appear to touch. Again, we are finding evidence that the unattached child is neurologically unavailable for bonding.

The question then arises, how do children become injured in such a way? The answers are multiple. A child may become injured anytime in the perinatal period from fetal exposure to drugs and alcohol, oxygen deprivation, or trauma in or exiting the birth canal. The brain can also be injured by specific illnesses, particularly those that cause high fevers or injuries such as a fall with a blow to the head, shaken baby syndrome, or drowning.

However, in many of our children, we see this disorder arise as a consequence of a separation from the mother during the first two years of life. Separations such as hospitalization or the child, adoption or foster care placements, time spent in an orphanage (as in the case of many international adoptions), abuse, abandonment, and neglect all interrupt the bonding process.

If, in addition, the child has been restricted in his movements during the first months of life due to hospitalization, surgery, casts or other lack of opportunity to have “floor time,” the resulting dysfunction can appear virtually untreatable. All the love, time, reasoning and reassurance in the world cannot restore this child’s emotional and neurological health until the neurological problems previously described are directly addressed.

In our work at Developmental Movement Consultants, we use a team approach to treating children who are diagnosed with attachment disorder. We perform an extensive evaluation for the child’s neurological organization, observing sensory and motor skills at seven developmental levels. From this Functional Neurological Profile we are then able to treat the lowest level of dysfunction, with daily programs of neuromotor activities. As that level becomes more organized, the program addresses the next level, then the next, until there is no longer evidence of a central nervous system factor in the child’s profile.

Throughout this process, we are in close touch with other therapists. This team approach is essential because feelings that have been previously unavailable often surface. This can be a very beneficial, but also very challenging phase, as the child is now more able to express his grief and anger. The child’s parents and psychotherapist, working in conjunction with the Neurological Organization Practitioner, support the journey through this new wilderness of emotions. It is essential that parents and therapists stay in close touch throughout this process, so that all therapy modes can be modified quickly to accommodate the powerful changes and deep emotions that emerge in the child.

If you are a parent of an unattached child, or a therapist working with children who do not seem to be moving quickly toward healing, it is an excellent choice to seek Neurological Organization treatment as soon as possible. The peace, security and happiness that will become available to the child as a result of this therapy can make him available for love, joy and a brighter future.

© Bette Lamont, 1998/2009