NPR - Emotional Training for Kids (and Why It Will Often Fail)

On my way into work yesterday morning, I was fortunate to catch this segment on NPR's Morning Edition, Emotional Training Helps Kids Fight Depression. First of all, I just want to say that I think this kind of education is crucial - emotionally intelligent adults are few and far between. The more emotional intelligence we can create in this culture, the more civil we will be with each other. So, be sure to go read it or listen to it - it's a good report.

BUT, and there is nearly always a but - there was one section of this that really caught my attention. Here it is (I've added emphasis to the kid's three different responses in this scenario):

In one session, he talks to the students about how "self-talk," the things you tell yourself, can lead to different feelings when disappointing things happen.

Brunzell hands each student a copy of the same cartoon strip. In the first picture, an angry coach is talking to a nervous player. The coach is pointing to a zero score, and he's unhappy.

Enlarge Courtesy of Jane Gillham, Lisa Jaycox and Karen Reivich

This thought-emotion worksheet helps teach kids how their reactions to a scenario can shape their feelings and how, to a degree, they can control these reactions. In this scenario, student Bryce Marcus has filled in the thought bubble with a positive way to interpret the situation.

This thought-emotion worksheet helps teach kids how their reactions to a scenario can shape their feelings and how, to a degree, they can control these reactions. In this scenario, student Bryce Marcus has filled in the thought bubble with a positive way to interpret the situation.

In the second box, there's a picture of the player. A thought bubble over his head is blank. The students' job is to fill the bubble with what they think the boy is thinking, and then indicate one of three possible emotions associated with the thoughts: sadness, anger, or "I feel OK."

Student Alicia Echavarriato shares her interpretation of the situation first. "What I wrote in my thought bubble is this: Why is the coach so mean? His screaming makes me want to cry ... I think I have a tear," she says. To her, the coach's anger feels like a personal attack, which would make her feel sad.

To Anthony Ortiz, the scenario evokes anger. In his thought bubble, he wrote, "Man we lost — we let the coach down."

Finding New Ways To Look At Challenging Situations

But here's another way to see the same scenario. In student Bryce Marcus' bubble, he has written, "The coach can be mad ... I'll do better next time."

Bryce's player didn't take the coach's anger too personally. And he realized the situation wasn't permanent.

"What I want you to understand," Brunzell tells the students, "is that coach was being very negative in this cartoon. But you have a lot more control over your feelings than you think." He wants them to see that there is a strong connection between their "self-talk" and the feelings that result.

The kids nod their heads and seem to get it. But carrying these lessons from hypothetical cartoons to real life takes a lot of practice.

Anthony says that just the other day, he missed what he says was an easy problem on a math test. "You just think you're stupid automatically," he says. "That's the first thought, but you have to fight that away."

He's learned to stop and think about the real facts. Overall, his grade is pretty good. And if he tried harder next time, he would probably do better.

The reason I wanted to highlight this part of the story is because I believe it reveals a deeper issue that cannot be addressed with a little cognitive behavioral therapy (CBT). What we see in these three different responses from three different children are major differences in attachment style.

Here is a summary of Bowlby's attachment theory (Collins, 1996):

Working Models of Attachment

Bowlby (1973, 1980, 1982) used the term working models to describe the internal representations that individuals develop of the world and of significant people within it, including the self. These representations take root in infancy and early childhood and are presumed to be largely determined by the caregiver's emotional availability and responsiveness to the child's needs (Bretherton, 1985; Sroufe & Waters, 1977). According to Main et al. (1985), a child's early working models are composed of schemata that represent his or her attempts to gain comfort and security. Over time, these specific experiences become abstracted into more generalized beliefs and expectations about the warmth and responsiveness of others and about the worthiness of the self. Once developed, these beliefs can be used to predict and interpret the behavior of others and to act in new situations without evaluating each one from the beginning.

Although each child's experiences, and hence working models, are unique, certain regularities have been observed in the nature and quality of infant–caretaker relations. On the basis of structured laboratory procedures and home observations, three distinct behavioral patterns or styles of infant attachment have been identified: secure, avoidant, and anxious–ambivalent (Ainsworth, Blehar, Waters, & Wall, 1978). These styles are closely associated with differences in caretaker warmth and responsiveness, and are thought to reflect differences in the psychological organization of the attachment system (for reviews of this literature, see Bretherton, 1985; Rothbard & Shaver, 1994). Indeed, Main et al. (1985) suggested that the three attachment styles are best understood as “terms referring to particular types of internal working models of relationships, models that direct not only feelings and behavior but also attention, memory, and cognition” (p. 67).

There are numerous studies of attachment style that suggest the importance of secure attachment in creating a healthy ability to handle emotions and challenges. Here is one definition of secure attachment, from the link above:

Children who are securely attached do not experience significant distress when separated from caregivers. When frightened, these children will seek comfort from the parent or caregiver. Contact initiated by a parent is readily accepted by securely attached children and they greet the return of a parent with positive behavior. While these children do not become exceptionally distressed by a parent's absence, they clearly prefer parents to strangers.

Parents of securely attached children tend to play more with their children. Additionally, these parents react more quickly to their children's needs and are generally more responsive to their children than the parents of insecurely attached children. Studies have shown that securely attached children are more empathetic during later stages of childhood. These children are also described as less disruptive, less aggressive, and more mature than children with ambivalent or avoidant attachment styles.

As adults, those who are securely attached tend to have trusting, long-term relationships. Other key characteristics of securely attached individuals include having high self-esteem, enjoying intimate relationships, seeking out social support, and an ability to share feelings with other people.

The research suggests that "people with a more secure attachment style were higher in self-worth, more confident in social situations, and more self-assertive. Secure adults also had more positive beliefs about the social world, viewing others as trustworthy, dependable, and altruistic" (Collins, 1996, para. 6).

In the NPR article, the only child who seemed to be securely attached was Bryce Marcus, who did not take the coaches anger on himself, but rather allowed the coach to be angry and took responsibility only for his own performance. Of the three children, he is the one who will likely grow up to be a healthy, emotionally intelligent adult.

Each of the other two kids took on the coaches anger in unhealthy ways. Alicia Echavarriato internalized the coaches anger and it made her want to cry. She and Anthony Ortiz, who felt that they had let the coach down, both demonstrate insecure attachment styles [there are several, including Ambivalent Attachment (only 7% to 15% of infants, characterized by clingy and over-dependent, stemming from maternal unavailability), Avoidant Attachment (children who might not reject attention from a parent, but neither do they seek out comfort or contact), and Disorganized Attachment (the child's actions and responses to caregivers are often a mix of behaviors, including avoidance or resistance, generally the children of a mother with borderline personality disorder, see Hobson, Patrick, Crandell, Garcia-Perez, & Lee, 2005)].

There is not enough information to suggest which form of insecure attachment the other two kids demonstrate, but the point is that they responded in an unhealthy manner. The problem, then, is that attachment styles are relatively stable over time without intervention, meaning that infant attachment styles often are found in adults as well (Hazan & Shaver, 1987, 1994; Shaver, Hazan, & Bradshaw, 1988).

While CBT therapy, as used in the NPR report, is all the rage in "evidence-based" therapy, it is not the best approach for repairing attachment failures (Liber et al, 2008). Those two children might learn some nice self-talk, but they are not likely to change their immediate emotional responses.

Fortunately, there are therapies that are designed to heal attachment failures, such as Relational Psychoanalysis (a form of attachment-based psychotherapy), Object relations theory, and Dyadic Developmental Psychotherapy (for children).

There is also evidence that a healthy adult intimate relationship can attachment failures from childhood, called "earned secure attachment" (Siegel, 2007, pg. 204-205 - see also Roisman, Padrón, Sroufe & Egeland, 2002). So even those of us who have had poor attachment experiences have hope for better functioning. But, unfortunately, CBT is not the best way to make that happen.


References:
Collins, N. (1996). Working models of attachment: implications for explanation, emotion and behavior. Journal Of Personality And Social Psychology, 71(4), 810-832. Retrieved from MEDLINE with Full Text database.

Hazan, C., & Shaver, P. R. (1994). Attachment as an organizational framework for research on close relationships. Psychological Inquiry, 5, 1–22.

Hobson, R. P., Patrick, M., Crandell, L., Garcia-Perez, R., & Lee, A. (2005) Personal
relatedness and attachment in infants of mothers with borderline personality disorder. Development and Psychopathology, 17, 329–347.

Liber, J., van Widenfelt, B., Goedhart, A., Utens, E., van der Leeden, A., Markus, M., et al. (2008). Parenting and parental anxiety and depression as predictors of treatment outcome for childhood anxiety disorders: has the role of fathers been underestimated?. Journal Of Clinical Child And Adolescent Psychology: The Official Journal For The Society Of Clinical Child And Adolescent Psychology, American Psychological Association, Division 53, 37(4), 747-758. Retrieved from MEDLINE with Full Text database.

Roisman, G., Padrón, E., Sroufe, L., & Egeland, B. (2002). Earned–Secure Attachment Status in Retrospect and Prospect. Child Development, 73(4), 1204-1219. Retrieved from Academic Search Complete database.

Shaver, P. R., Hazan, C., & Bradshaw, D. (1988). Love as attachment: The integration of three behavioral systems. In R. J.Sternberg & M. L.Barnes (Eds.), The psychology of love (pp. 68–99). New Haven, CT: Yale University Press.

Siegel, D. (2007) The Mindful Brain. NY: Norton.

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