Angry & Rejecting: Attachment Disorder or Sensory Integration Issues?
Dear Dr. Laura,
I have concerns regarding my 22 month old son. He seems angry with me most of the time and resists physical touch. If we get close physically, most of the time he will hit me, bite me, kick me, pinch me. I feel as though my presence incites some kind of anger in him a lot of the time. If we lie in bed together and he gets close to me he will usually kick at me or hit at me. This has been going on for many months. If he hurts himself or gets angry at something unrelated to me he will come and hit at me. I cannot comfort him and have never been able to. When I call him to come to me he hardly ever does. When he sleeps in bed with me and my husband he usually turns away from me and goes and sleeps close to my husband. When he wakes up crying from sleeping and I go to get him he seems even more annoyed when he sees me sometimes. He is much more affectionate with my husband and much less aggressive with him. He is very happy when my husband returns from being away from him and much less so with me. I am a stay at home mother by the way and my husband works.
He had some gross motor and language delays but nothing drastic and has been diagnosed with some sensory integration issues, including touch, sound, vestibular, but nothing severe. He does seem much less laid back than other kids, more anxious and less happy.
I also feel very confused because at times he has seemed attached to me. He has cried for me when I leave him with other people, he calls for me when he does not see me sometimes or at times when someone he does not know interacts with him, he seems happy to see me at times, he has been affectionate to me on occasion. However, I have to say that these moments are not common.
He has recently gotten a sibling, and this has made matters worse in that he is even more aggressive towards me and seems to prefer his dad even more. I have always given my son lots of love, affection, positive responses, I try to be empathetic when disciplining him etc. Can attachment issues occur even if the mother does everything “right” per se?
There was a lot of trauma for me before his birth. My first baby had died only a year before and I had health issues etc. I am wondering if something like this could have affected him more than I realised, and depending on how much you believe babies are affected perhaps even before they are born.
Can things improve? What can I do to get a better connection with my son?
How painful to feel that your son is rejecting you! I am so glad you wrote to me. Even when parents "do everything right" things can go wrong for kids. Sometimes that is innate, as with the Sensory Integration issues you mention. Sometimes our own issues -- such as health issues or unresolved grief -- can affect our child even when we adore him and try hard to connect and do everything "right." And researchers are more and more coming to the conclusion that while kids are in utero, their development is deeply affected by their mother being under stress.
But I do think it is very possible for things to
improve and for you to have a better connection with your son.
First, let's consider whether it would be possible for the sensory issues you mention to be affecting your relationship with your son. You mention that he has "some gross motor and language delays but nothing drastic and has been diagnosed with some sensory issues, including touch, sound, vestibular, but nothing severe. He does seem much less laid back than other kids, more anxious and less happy." These issues may not have been diagnosed as severe, but could still be an early warning sign of sensory integration disorder, or sensory processing challenges. Other symptoms include motor coordination and speech delays, which you mention your son also has.
You also say
that he "resists physical touch" and that "If we lie in bed together
and he gets close to me he will usually kick at me or hit at me." It is possible that your son does have sensory issues that are getting in the
way of relating to you. Specifically, he may be exhibiting
symptoms of "touch sensitivity" or "tactile defensiveness," which cause
him to experience physical touch as painful or at least unpleasant. So
when you touch him, he lashes out.
As many as one in 20 kids has sensory integration challenges. Some kids only have a problem with touch, others also have issues with light, or with sound, or with food. Basically, the nervous system and brain aren't functioning quite right, and the child has a hard time integrating all the information from the nervous system. If these symptoms are very mild -- like freaking out if there are tags in his clothing or his socks don't feel right, but otherwise being ok -- these kids learn to manage and more or less outgrow their sensitivity. But other kids are more challenged and need help from an occupational therapist to better coordinate their nerve signals and brain.
I cannot, of course, diagnose this condition from an email. I suggest that you have your son evaluated by a Pediatric Occupational therapist who is trained in diagnosing sensory integration issues. Your pediatrician should be able to give you a referral. In addition to intervening in the clinic, your OT will also be able to teach you many things that you can do at home to help your son.
So why would sensory issues affect your relationship with your son? It is unfortunately not uncommon for kids with sensory integration issues to have disrupted attachments, because the usual bonding process of touch is disrupted. So in answer to your question, yes, parents can "do everything right" and still have an attachment issue with their child, if the normal attachment process has not been able to unfold because of sensory issues.
However, we must also consider that maybe the sensory issues aren't the problem at all, and the big issue here is attachment. Your loss of a child only a year before your son was born would be considered a risk factor for disrupted attachment. Even though you loved him and tried to "do everything right" it would be only human for you to have guarded your heart in your early interactions with your son. The foundations of attachment security are laid in the first year, and are built from interactions that are largely unconscious, simply the intimate back and forth of daily life. Mothers who have unresolved grief over a previous loss are naturally different in these interactions than other mothers.
That doesn't mean you are at fault, and it doesn't mean you can't dramatically improve the situation. Attachment disruptions can be healed. You are lucky that the normal age of the Oedipal stage is coming up, because you have a wonderful opportunity to reconnect with your son as he heads into his second year.
So what can you do?
1. Have your son evaluated for sensory integration issues by an OT who is experienced with this disorder. This is extremely important because touch is an essential part of bonding for humans. Intensive early intervention can definitely treat tactile defensiveness, if indeed that is what is going on with your son. You might find the book The Out of Sync Child by Carol Kranowitz, helpful in better understanding sensory issues.
2. Give yourself support. Feeling rejected by your child -- especially as he's in the terrible twos and acts out -- can be very tough. Make sure you have someone to talk to who can just accept your feelings without feeling the need to give you advice or solve your problems. Make sure you trust this person so that you can cry or rage and get these feelings off your chest. If you "stuff" them, you're more likely to take them out on your son.
3. Strengthen your bond with your son. Give the baby to your husband and spend as much time as possible with your son. Say to him "The baby is asleep and I am all yours for fifteen minutes. What would you like to do now for fifteen minutes together?" Focus your complete attention on him, shower him with your love, and let him take the lead. If negative feelings begin to come out, listen to him and stay calm. He is asking for your help.
At other times, if he can tolerate snuggling, great. You can also experiment with other kinds of touch that might work for him, such as rocking him like a baby when he's tired. If he still takes a bottle, by all means hold him and give him the bottle. You can also touch using games, like "This little piggy" or "Beep" in which you gently press his nose and say "beep" and then let him press your nose, and beep back.
You can find ways to let him express his anger safely and turn it into a bonding experience by having a fun pillow fight or letting him hit a pillow that you are holding. You can even bond with each other by doing something together that expresses aggression, such as hitting a punching bag together.
If he can't tolerate being touched, find other ways to connect. You can make a book of photos of him (some of which include you mothering him) and coo over them together. You can make eye contact with him as a way to connect, while you sing songs, play peek-a-boo, or throw a squishy ball back and forth together. Look for activities that are reciprocal to build the relationship. You might want to get Larry Cohen's book Playful Parenting. It's a terrific book on building bonds with kids by using play.
4. Help your son "discharge" his upset emotions that he is expressing as anger and irritability. I suggest that you spend a little time on the website Hand in Hand Parenting.org to read about kids and emotion. While I do talk about this here on the Aha! Parenting website, Hand in Hand goes into this in more detail, and I suspect your son has more significant pain to discharge than most kids. I suspect that under his anger at you he is very sad and scared.
Next time your son begins to express anger at you, don't take it personally. Instead, see it as a signal that he has big feelings he needs your help with. He wants desperately to heal these upsetting feelings. Your presence will allow him to release these tangled up feelings that are making him irritable and rejecting. Your helping him with these feelings by allowing him to be angry and aggressive, and accepting those feelings will automatically strengthen his trust in you and the bond you have with him.
Obviously, don't let him hit you. Instead, hold his hands firmly so he can't hit you, and let him struggle against you. He will sweat and kick and hit, and concentrate, and scream and cry. This could go on for half an hour, so just keep breathing, and stay calm yourself. If he struggles enough that you can't hold him, it's ok to let him go, your goal is not to "contain" him or to irritate him further by forcing physical contact, just to offer him connection so he feels safe to experience these upsetting feelings and let them out. Stay nearby and keep talking gently to him. Just say "I am right here, Honey. I know you have these big feelings. I will stay right here with you while you let them out." If he orders you to go away, take a couple of steps back and say "Ok, I will move a little away, Sweetie. But I am right here if you need me."
Basically, your goal is simply to stay present and allow your son to express his feelings. Under that anger is fear, and overwhelm, and pain. If your son gets a chance to discharge his emotions safely with you, he will get past the anger to the scary feelings underneath and let them out. Then, relieved and reconnected to you, he will relax into your arms. Not only will he become more pleasant, but he will feel closer to you because you have helped him through these feelings.
5. Don't ever use punishment. Your relationship with your son will be further eroded. Instead, use distraction, empathy, gentle guidance. There is a lot of free info on this website about how to parent positively without a need for punishment of any kind, including timeouts. Start here in the Positive Discipline section.
I wish you and your family all blessings. Please let me know how things unfold.