Using PACE to create loving attachments – An Interview with Kim S. Golding and Daniel A. Hughes

Kim S. Golding is a UK consultant clinical psychologist with a longstanding interest in parenting, and Daniel A. Hughes is a psychologist based in the USA who specialises in working with children and young people with trauma/attachment problems and their families.

In this interview, they tell us about using PACE (playfulness, acceptance, curiosity and empathy) to build secure attachments with troubled children – the subject of their new book, Creating Loving Attachments.

Please tell us a little bit about yourselves and what you do.

 Kim: I am a Clinical Psychologist and have been working within the NHS for the past 30 years. I have done a range of things during my career, but a common theme is working with parents who are struggling to parent successfully. I began my career working with parents of children with learning disabilities in Norwich, Norfolk. I took this interest with me when I moved to Oxford and began to work within the service for children with Down’s syndrome. Alongside this I supported families with children experiencing sleep difficulties and then became a member of a team supporting parents who were at risk of losing their children because of child protection concerns. During this time I also had my own two children and therefore got some first-hand parenting experience. This really highlighted to me how hard parenting successfully is. When my children were 3 and 6 years old I took a 6 year career break, whilst my husband changed jobs, and we all moved to Worcestershire. This gave me a chance to give more time to my own children and to get involved in their schooling. I joined the parent-teacher association and subsequently became a parent governor at the children’s junior school. I kept my hand in with psychology, however, with some teaching for the Open University, beginning a bit of a family tradition. Both my husband and now my son have followed me in working for the OU. I enjoyed my time out of Clinical Psychology, but I did not want to lose touch with the career I had worked so hard to get into. In 1998 I enrolled in a top-up doctorate course and also started to look for another clinical psychology post. I remained interested in working with children who had experienced abuse or neglect, and therefore was interested to hear about a project that was being developed in Worcestershire supporting looked-after children. I joined a very small team setting up this project and this has subsequently developed into a clinical leadership role in the Integrated Service for Looked-After and Adopted Children. Within this role I have been privileged to work with some fantastic foster carers, residential workers and adoptive parents. I have witnessed first-hand the challenges of helping children hurt within families learn to trust within families again. It has given me huge satisfaction to be able to support these parents and to see the children thrive in their care.

Alongside the development of my career as a Clinical Psychologist, I have always been a keen writer. As a child my parents kept my early stories. I think ‘The Magic Tree’ is still in my mother’s possession! My adolescent poetry is probably best forgotten, but when I had my own children I enjoyed making up stories for them, just as my father had done for me. We still remember the story tree where we used to sit on our way home from school on a summer afternoon for a story. Both my children, now young adults are writers: my son through his love of world-building through story and Dungeons and Dragons game-playing, and my daughter through her participation in ‘Nanowrimo’ (National Novel Writing Month in November) and by engaging in a creative writing degree. My own love of writing has joined forces with my love of psychology, as I now write to communicate psychology to others — although, as will be witnessed in this latest book, I still enjoy writing fiction, and will write the occasional story for the children I work with therapeutically.

Dan: I too am a Clinical Psychologist. One of my first positions involved initiating an intervention program for abused and neglected children. Using traditional methods of treatment I repeatedly failed in my efforts to make a difference in assisting these children and their families. I decided to focus more on working with children who were placed in foster care or who were adopted. Still struggling to offer helpful interventions, I began to study the field of attachment theory and research and to develop interventions that were congruent with that rich area of research.

Since then I developed a model of treatment, Dyadic Developmental Psychotherapy (DDP), with the goal of helping children who have great difficulty developing secure attachments to their caregivers to be able to do so, and to help their foster carers or adoptive parents to relate with them in ways that will facilitate their attachment security. I have since written many books describing this process, which have been written either for the parents – Attachment-Focused Parenting, Building the Bonds of Attachment, 2nd Ed. – or for their therapists or other professionals – Attachment Focused Family Therapy Workbook. I have also recently had published a book of poetry, It was that one moment, with the same content.

I now am busy training, supervising, and providing consultation for many therapists and agencies whose focus is both child abuse and neglect, but also the more general area of family therapy. My speaking engagements and trainings take me throughout the US, UK, Canada, and Australia primarily.

I am the proud and happy father of three daughters and one granddaughter. They have taught me a great deal about how to be a parent.

This book is for parents or carers of children with attachment difficulties. Why do these children need a different approach to parenting?

Kim: As all parents can testify, children who are emotionally secure with their parents will at times express themselves through challenging behaviour. The ‘terrible two’s and three’s’ is a common although perhaps misplaced expression for a normal stage of development in which children express their developing autonomy through tantrums and oppositional behaviour. Behavioural advice can be very helpful in helping parents to manage this sometimes challenging stage with their children. Some children, whether because of the unwitting reinforcement by the parent, or because of their own developmental challenges, will continue to exhibit these challenging behaviours as they grow older, placing additional strains on the family. Many sound parenting interventions have been developed to help parents of these children with broadly helpful results.

Children who have been hurt, rejected, neglected and/or experienced separation and loss of parents early in life do not have an emotionally secure base. For these children the social learning-based approaches are less helpful because they are centrally focused on behaviour, and therefore less focused on the building of trust and security with parents. These children therefore need a more tailored experience of parenting which leads them to develop more secure attachment relationships with their caregivers, whether they are a biological, adoptive, or foster parent or other kind of substitute parent. Attachment focused parenting combines the social learning ideas of traditional parenting interventions with ideas more centrally focused on building emotional security and helping children to heal from past trauma and loss. This parenting tends to focus on building security through higher levels of warm and empathic nurturing, greater attention to emotionally connecting with the child, and helping the child to experience love that is unconditional alongside the behavioural management that is always going to be a core part of parenting children.

Dan: I agree. Behavioural programs can be helpful when the child has an organised (and especially secure) attachment to his parents. When attachment patterns are disorganised, the child often experiences little positive meaning in his relationships with his caregivers, does not trust them, and is less likely to be open to learning from them their values, habits, and ways of experiencing the events of their lives. Changes in the parent-child relationship so that these factors do begin to emerge, need to precede any efforts to influence a child’s behaviours through reinforcement principles.

This book describes the ‘PACE’ parenting model. Can you tell us more about the model and how it works?

Kim: PACE is an attitude to help parents connect with the children they are caring for. Through a playful, highly accepting, curious and empathic approach the parents can more deeply connect with their child’s internal experience. This is modelled on the way that parents connect with their infants in healthy parent-child relationships, and is the foundation for healthy relationships and the development of attachment security.

Dan: We have found that the core qualities of playfulness, acceptance, curiosity, and empathy tend to develop trust and leave the child in an open and engaged state of mind, receptive to his parents’ guidance and love. We have also found that when parents are able to consistently maintain the attitude of PACE, they are able to relate with their child with greater patience and understanding regarding their child’s behaviour, and then be in a position to respond to it, rather than react to it.

One thing that stands out is the book’s positivity in contrast with many other parenting books’ focus on discipline and managing problems. Is this an important part of your approach?

Kim: Absolutely, we want to help parents have deeper, intersubjective relationships with their children which are deeply rewarding for both of them. Relationships which provide security for the child, and also an experience of deep connection with another are the foundation of healthy emotional development. This goes way beyond discipline and problem management. Our aim is to help parents and children have healthy, emotionally connected relationships within which children learn to adjust to societal expectations for their behaviour, whilst also developing a positive sense of self and the confidence to go forward in their life to make many more happy and connected relationships.

Dan: As Kim so well says, this positive, deeply rewarding relationship for both parent and child, is the foundation of effective teaching (discipline) without intense resistance and oppositional-defiant behaviours that we often see with children who have challenges secondary to attachment disorganization and relational trauma. Providing a positive context that is experienced as such by both parent and child, makes discipline a secondary, though important, part of parenting.

In the book, you describe how conventional behaviour management approaches to parenting can be problematic for children with attachment difficulties. Can you tell us how?

Kim: Children with attachment difficulties have experienced some difficult early experience within which they have developed core beliefs about themselves – for example, ‘I am bad’ or ‘I am not loveable’ – and about others – for example, ‘You will be unreliable’, ‘You will abandon me’ or ‘You will not love me’. These core beliefs are easily evoked during what are really quite typical parenting events; for example being asked to tidy away toys, being told to wait for attention, going off to school or to bed. The behaviours that these children demonstrate get mixed up with the core fears the children hold about themselves. Without careful thought, conventional behavioural strategies can reinforce these core fears further increasing insecurity and leading to increased challenging behaviour.

To take a simple example, time-out is a tried and tested way of helping a young child learn to manage his behaviour. Made famous in popular parenting programmes by the notion of the ‘naughty step’, the child is placed apart from the parent for a period of time. Imagine however how easily this can trigger those fears of ‘You do not love me’ and ‘You will abandon me’ when these fears are deeply held by a child. The child learns not that his behaviour is naughty, but that he is naughty – his behaviour and his sense of self is intertwined. This leads to increased distress which is difficult to communicate, and therefore is expressed in even more challenging behaviour.

Dan: When the child with attachment difficulties experiences discipline, he experiences it as a rejection of him, as a statement that he has failed, that he is bad, that he is unloved. These are features of shame, an emotion that makes it hard for a child to learn from the act of discipline. Shame is an inevitable consequence of a young child being abused or neglected by his parents – how else can he make sense of a world where the people who are supposed to keep him safe and support him when he is sad and frightened, are the same people who are hurting him in various ways.

Your approach highlights the importance of playfulness and curiosity, not just in children but also in their parents. Can you give us some tips to help parents to embrace playfulness?

Kim: I think the top tip with regard to playfulness is to embrace the playful moment. These are the moments that hold the relationships together, get us through the tough times and stay with us long after the moment has passed. Let me illustrate with a fond memory of my relationship with my son. At the time he was about seven or eight years old. Imagine this scene: I am in the bathroom and he is in his bedroom. I notice a spider in the bath. I want to rescue this spider, and look around for something that I can use to help it get safely outside again. Nearby is my son’s bath sponge, I pick it up and carefully entice the spider onto it. As I am walking out of the bathroom, carefully holding the sponge so I don’t lose the spider (yes a glass does work better, but bear with me!), my son emerges from his bedroom. He asks what I am doing and I tell him that I am taking the spider outside. He gives me a look that only children can give when they know their parent has finally lost it! The sponge was in the shape of a spider. From my son’s point of view, I was rescuing his bath sponge and taking it outside. We laughed so much when we finally understood our differing perspectives, and I still chuckle to myself when I think about this now. It is moments like these – spontaneous, joyful, fun and deeply connecting – that make parenting such a joy. They are deeply satisfying in the present, carry us along into our future, and become part of our shared past. Playfulness is the fabric of the relationship.

Dan: It might help a parent to embrace playfulness by remembering that those moments of spontaneous laughter, shared giggles, and smiling warmth are precious ways of communicating unconditional love, and helping the child to know deeply that he or she will always be in the parent’s mind and heart.

A number of the chapters in your book feature short children’s stories at the end. Can you tell us why these feature?

Kim: I have always enjoyed reading psychology books, but the ones that I hold most dear also bring an extra dimension to my reading pleasure. The authors write to entertain, to entice my interest as well as to educate. It is these books that I treasure and put down with reluctance. When writing this book, I very much wanted to give my readers a similar experience. I hope that this book is a satisfying read as well as a source of support and encouragement. To this end I wanted to include story-telling as an integral part of the way this book is written. Whether through narrative examples, use of literature or personal anecdotes, I hope the reader will find something to entertain as well as to educate. The short stories for children are another way of including this story-telling style. It provided us with an opportunity to re-visit key ideas from the section through the simple story and hopefully give the reader cause to smile at the same time.

Dan: Story-telling is at the core of how we learn, communicate, share and live as human beings. The academic definition of a securely attached adolescent and adult is that she or he has developed a coherent autobiographical narrative – a life story that one can accept, make sense of, and experience without shame or fear. As Kim said, our stories were not just for the children, but also for their carers.

Copyright © Jessica Kingsley Publishers 2012.