A hallmark of attachment disorder is lack of trust in caregivers and self. The child’s core belief (negative working model) about caregivers is “I cannot trust that caregivers will keep me safe, fulfill my needs, or love and value me.” The child’s core belief about self is: “I cannot trust that I will ever be safe; my needs are not valid; I do not trust that I am capable, lovable, or worthwhile.” Children with attachment disorder begin therapy not trusting the therapist, their current caregivers, or their ability to improve.
A salient developmental task of the first year of life is to develop basic trust in the context of a secure attachment relationship. Infants who are securely attached learn that helplessness and vulnerability are tolerable physical and emotional states. They trust their caregivers to provide safety, protection, and need fulfillment. The infant and toddler with insecure or disorganized attachment learn that helplessness and vulnerability are not tolerable states. Insufficient or nonexistent parental care results in a lack of trust and high levels of anxiety associated with helplessness. As development unfolds, the child becomes increasingly more angry, controlling, and oppositional, to defend against feelings of intense helplessness and vulnerability.
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