Bringing an Attachment
Perspective Using CIRCLE
OF SECURITY Concepts to
Working with Women with
Postnatal Depression and
Anxiety
Mrs Anne Clifford
Dr Caroline Zanetti
WAPMH
Symposium
The Raphael Centre
SJGHC commissioned market research in 2001 as a
result of growing concern about the increase in perinatal
mental illness in the community.
The Raphael Centre opened at SJOGS in November 2002
followed by other Raphael Centres in other states.
This community based Perinatal & Infant Mental Health
service is situated adjacent to St John of God Hospital in
Subiaco.
This service is available to all families with Perinatal and
Infant Mental Health issues across the state.
Relationships are an
essential part of human
experience, and for the
infant, a crucial aspect
Donald Winnicott: the infant’s sense of self is built
substantially upon having the mother mirror back his
experience in a way that also gives him a sense of her
experience of him
Daniel Stern: mirroring occurs in terms of voice, affect
and movement
Colwyn Trevarthen: one’s sense of self emerges from
within an intersubjective experience
Attachment Theory
Human infants are born with the capacity to identify
and attach psychologically and emotionally to those
caregivers (usually the parents) who will keep them
safe as they learn about the world, and develop the
skills that enable the successful negotiation of life’s
challenges.
Attaching to a particular person means that the infant
will rely upon him or her to provide a safe haven
when discomfort or danger arises, and a secure base
for exploration at other times.
Attachment Theory
The tendency to seek and maintain the support of an
attachment figure is fundamental to human infant
behaviour.
Many things can promote, and interfere, with the
caregiver’s capacity to provide adequate support for
infants and small children.
WAPMH
Symposium
(Almost)
Everything I Need to Know About
Being a Parent
in 25 Words or Less
Always: Be BIGGER, STRONGER, WISER & KIND
Whenever Possible: Follow your child’s need
Whenever Necessary: Take charge
The Circle of Security graphic and formula appears
simple, but there are layers embedded within it:
layers involving children’s basic psychological and
emotional needs, child behaviour, parental capacity,
and parental patterns of psychological defence.
Circle of Security concepts
are woven into the Raphael
Centre: we use this model in
many aspects of our work.
Touching Base Group
Follows the Circle of Security Protocol (Cooper, Hoffman,
Powell, Marvin).
20 weeks with 6 mothers
Utilizes video footage from SSP.
Examines how the attachment relationship works at
different moments around the COS.
Allows parents to reflect on their difficulties with
parenting, as well as their strengths, in the context of a
non-blaming therapeutic relationship.
Original COS Protocol modified to add 4 partners’
sessions.
Pathways to Wellness Group
Content has a CBT framework but informed
throughout by attachment theory.
One session dedicated to discussion of the parent
child relationship using the COS as a model for
reflection on both current interactions and family of
origin relationships.
Dads session discusses the men’s relationship with
their partners & with their children using the COS.
Once the COS has been introduced all sessions
contain reference to Circle moments, & parents are
given opportunities to reflect on what they notice in
their children, & in themselves, as different needs
present during the day.
Baby Massage Group
Mothers with infants aged 5
weeks to 5 months.
4 sessions: 1 hour each week.
Maximum of 6 mothers &
infants.
Mothers may have a mood
disorder, or may just want to
become more relaxed &
confident with their babies.
Fathers can also attend
Being With…
At the heart of developing a secure attachment is the
knowledge that your caregiver is emotionally
available to ‘be with’ in during times of need.
Children need their parents’ support for comfort &
protection (and sometimes just to feel lovable).
They also need support when they are exploring the
world, and mastering new skills.
Creating the
Circle of Security
(Birth to 12 months)
Be with
me...
•
•
•
When I’m
feeling OK..
•
•
Delight in me as I fall in love
with your face
Watch over me as I turn to new
sights, sounds, and touches
Try to see the world through my
eyes and talk to me about it
Connect with me by matching my
voice, face, and movement
Wait for me when I look away to
keep from getting too revved up
Be with
me...
Protect me
Help me feel that you “get it” by
matching my emotions with your
voice, face and touch
Stay with me even when my
distress upsets you*
Wait for me when I look away,
so I can learn to use both you
and myself to calm down
Organise my feelings by sharing,
naming, and accepting them
without fear
When I’m feeling
upset
Always: be BIGGER, STRONGER, WISER, and KIND.
Whenever possible: follow my child’s need.
Whenever necessary: take charge.
© 2000 Cooper, Hoffman, Marvin & Powell
Enhancing the mother /infant
relationship using baby massage
Focus on:
Establishing an informal, warm, non-judgemental space
for mother & baby - providing the Hands on the Circle.
Enhancing sense of self as a mother, and building on the
attachment relationship she is establishing with her infant.
Observing the non-verbal expressions and responses of
the infant, and in particular, the interactions between
mother and infant.
Baby Massage Group
Two key concepts:
The quality of parent-infant interaction has a
powerful effect on infant development. In particular,
moments of intimate connection with the care giver
will determine the ultimate design of the baby’s
brain, and the nature and extent of the baby’s secure
attachment to the caregiver.
The tender touch of baby massage, and gentle
playfulness together will enhance the mother’s and
the infant’s experiences of being together in a
relationship.
Involved Dads group
Monthly information and support evening for new &
expectant fathers.
Facilitated by two male clinical psychologists.
Provides an overview of the Circle of Security and
encourages fathers to look at parenting from a
relationship based perspective.
Raphael Centre Crèche
An integral part of many of our programmes.
Led by an experienced, qualified childcare worker
who has attended a Circle of Security workshop.
Staffed by volunteers who are given training in Circle
of Security concepts through our in-service staff
development programme.
Minimum ratio of one staff member per 3 children.
Children are routinely assigned to the care of one
particular caregiver each week.
The experience of emotional
connection with other
human beings remains
important for our physical
and psychological wellbeing throughout our lives
The COS gives us a common
language for talking about
attachment needs of young
children with colleagues and
parents.
In particular we understand that:
All parents struggle.
It’s hard to give what we weren’t given.
Many parenting difficulties arise from unconscious
attempts to protect from emotionally painful
memories.
All parents have wisdom.
The love between parent and child is a powerful
force-one that can motivate parents to deal with their
pain in a different way.
Thank you
WAPMH
Symposium