Rachel,2 not yet 2 years old, stood looking at herself in thefull-length mirror, a frown slowly overtaking her face. Deepin her throat began a low, grumbling growl. As the growlgrew louder, she began hitting the side of her head and mov-ing slowly toward the mirror, her eyes glued to her ownimage. The growling became yelling, and she began slappingat herself in the mirror. I sat, stunned, unable to move orformulate a response. Her rage was palpable and deeply dis-turbing. Finally, I got up from my chair and went to her. Igot down on my knees, gently held her shoulders, lookedinto her eyes, and said, “Rachel, this is not your fault! Youare loveable and you are loved.”
A DISORGANIZED TODDLERIN FOSTER CARE:
Healing and Change From an AttachmentTheory Perspective1
JANET MANNThe Children’s Ark
MOLLY D. KRETCHMARGonzaga University
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This article focuses on the remarkable story of a deeplydisorganized child, Rachel, and her experience in fostercare with Janet and Paul Mann, founders of the Chil-dren’s Ark. Rachel and her mother were referred to theArk, an innovative intervention center for at-risk fami-lies, when Rachel was 10 months old. After 11 monthsat the Ark, Rachel was placed into foster care with theManns. On the basis of Janet Mann’s professionalimmersion in attachment theory, object relations theory,and especially the Circle of Security protocol (Cooper,Hoffman, Powell, & Marvin, 2005), Janet extracted 6 “principles” that guided her caregiving behavior withRachel. These principles included: (a) Communicatingthe message, “I am here and you are worth it”; (b) viewing negative behavior as needed; (c) readingcues and reinterpreting miscues; (d) “being with,” espe-cially during periods of intense emotion; (e) workingconsciously toward relationship repair when disruptionoccurs; and (f) developing awareness of one’s own stateof mind. This article explains and illustrates these princi-ples through Janet’s experiences with Rachel and pro-vides candid insight into what hurt children need forhealing and positive change.
abstract
This article presents a remarkable story of a deeply trau-matized child who, by great fortune, was placed into fostercare with Janet and Paul Mann, founders of the Children’sArk, Spokane, Washington (described below). Her story
1Portions of this paper have been presented at various training work-shops, including at Project Same Page, which was supported by the PaulAllen Foundation. We wish to thank Rachel and her family for allowingus to use examples from her experience with Janet to illustrate the princi-ples in this article. In addition to her family, Janet extends her gratitudeto her clinical colleagues, Sandra Powell and Kent Hoffman, who walkedthis journey with her, enriching the experience. The Circle of SecurityProject along with Janet’s work, interactions, and experiences with GlenCooper, Kent Hoffman, and Bert Powell drove and framed the principlesoutlined in this article.
Correspondence concerning this article should be addressed to Molly D. Kretchmar, Department of Psychology, Gonzaga University, 502E. Boone, Spokane, WA 99258-0054. E-mail: kretchmar@gonzaga.edu
2In order to protect the privacy and to respect the confidentiality ofthe child represented in this article, her name has been changed. Further,the child’s adoptive parents provided full consent to the use of her storyand read a complete draft of the manuscript prior to its submission inorder to confirm that they were comfortable with its contents.
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to them, about whether they are worthy of care, and soforth. Children with secure attachment histories have asense of trust toward others and feel the self-worth reflectedby the nurturing care they have received. In contrast, chil-dren with insecure histories are likely to view others as lessavailable and less trustworthy and to have internalized acompromised sense of self (Weinfield, Sroufe, Egeland, &Carlson, 1999). Of greatest concern are children with disor-ganized attachment strategies. These children typicallyhave caregivers who are either frightening or frightened,placing them in an irresolvable approach–avoidance bind;“the infant is presented with a paradox wherein the havenof safety is at once the source of the alarm” (Main & Hesse,1990, p. 180). Stemming from this paradox, researchersexpect that these children will carry forward highly dis-torted models of the self and of relationships; models char-acterized by deep mistrust, fear, rage, and possibly violence.Some theorists further speculate that disorganization is aprecursor to serious psychopathologies (Crittenden, 1995;see also Lyons-Ruth & Jacobvitz, 1999).
Children in the foster care system have likely sufferedmultiple attachment-related traumas, not the least of whichis parenting that is traumatic and frightening. It is likely,then, that many of these children have insecure and/or dis-organized attachment relationships (Schofield & Beek,2005). However, even when children have insecure and/ordisorganized attachment relationships with their parents,being separated from these primary caregivers adds anotherlayer of trauma (Charles & Matheson, 1990). For a youngchild, the very nature of separation is scary; even if whatthey had was abusive, it was at least familiar and perhapseven predictable. Children also have a remarkable capacity
demonstrates how a predictable environment and secure,loving care providers can foster change even when a childis profoundly disorganized, deeply mistrusting, and full ofrage toward herself and others. Along with their commit-ment to her, Rachel’s care providers’ solid understanding ofattachment theory and their ability to translate theory intopractice were central to the progress Rachel made. In thisarticle, we use Rachel’s story to illustrate principles of care-giving grounded in attachment theory that we hope willprovide insight to other care providers. This story is ulti-mately one of great hope, not only for this child but for thethousands of hurt children in foster care.
Attachment Theory and Foster Care“Attachment theory,” first developed by John Bowlby
(Bowlby, 1969/1982, 1973, 1980), asserts that children havea primary and essential need to be “in relationship” withtheir caregivers. To ensure our survival, our evolutionaryhistory prepared us to seek closeness or proximity to ourcaregivers, especially under conditions of threat or vulnera-bility (e.g., presence of a stranger, illness). When caregiversare available and welcoming, seeking proximity is easy andchildren’s feelings of safety and security are bolstered. Whencaregivers are unavailable (physically, emotionally, or both),inconsistent in their responsiveness, or frightening in someway (e.g., abusive), seeking closeness becomes more difficultand children’s feelings of security and safety are disrupted.
Bowlby (1969/1982) proposed that young childreninternalize “working models,” or representations aboutthemselves and others that are based on their early attach-ment experiences. These models form the basis for chil-dren’s expectations about how others are likely to respond
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to be connected to their caregivers, even their abusive ordepressed or addicted caregivers; this attachment is primaland visceral—built into our species to help ensure our sur-vival (Bowlby, 1969/1982). Removing a child, then, evenfor the child’s welfare, is likely to be deeply threatening anddisorganizing in and of itself. In addition, because the pre-sent foster care system cannot ensure permanent place-ments for children, many children experience multipleplacements, involving multiple separation and loss experi-ences, which only compound children’s deeply disturbedsense of self and other (Charles & Matheson, 1990).
The Children’s Ark: An Attachment-Oriented Solution
The Children’s Ark was founded in 1994 by Paul andJanet Mann, who then had over 6 years of foster care experi-ence and had provided care for over 40 children. The Chil-dren’s Ark began as a foster care residential program inwhich mothers who had lost custody of their children wereable to live, full time, with their children in a safe, struc-tured, therapeutic environment. The hope was to minimizethe separation experience between the parent and child(Kretchmar, Worsham, & Swenson, 2005; Worsham &Kretchmar, 1999). Presently, the Ark functions as an evalu-ation and intervention center that allows for daily andextended visitation between children placed in foster careand their parents. At the Ark, parents join their childreneach week day, retain the primary caregiving responsibilitiesunder the Ark staff’s supervision, and are required to worktoward improving their capacities for parenting and self-sufficiency. In addition to being with their children, parentsparticipate in educational programs and in the Circle ofSecurity, a group-based intervention in which parents learnabout their attachment relationships with their children andhow to enhance these relationships (Cooper et al., 2005;Marvin, Cooper, Hoffman, & Powell, 2002). Rachel and hermother joined the Ark when Rachel was 10 months old.
Rachel: A Teacher of Powerful LessonsRachel was born into a chaotic family environment in
which the abuse of her older siblings by her father hadalready attracted the attention of child protective services.With her father gone, Rachel remained under her mother’scare in an in-home dependency issued by the State ofWashington. When she was 10 months old, she and hermother were referred to the Children’s Ark for servicesafter Rachel was diagnosed with multiple delays and failureto thrive. Rachel and her mother participated in the Arkfor 11 months during which time the Ark staff becameincreasingly concerned about Rachel’s safety in the homeand the impact of Rachel’s home environment on herdevelopment. Rachel’s mother agreed to voluntarily placeRachel in foster care with Janet and Paul Mann.
Janet Mann became Rachel’s primary attachment fig-ure. In her journey with Janet, Rachel was a powerful
teacher about what all children, but especially hurt chil-dren, need to develop to their ultimate potential and aboutwhat even temporary care providers can do to begin to healthe pain of the child’s past. Janet, an experienced fosterparent well versed in attachment theory, had the wisdomto listen to Rachel and to see through Rachel’s compli-cated behavior to her vulnerability and tremendous need.It is in Janet’s words that we tell Rachel’s story:
After watching Rachel in the mirror, I was aware ofpondering somberly how wounded she was. It was certainlyclear to me that it was a dismal picture she carried in herhead about how the world worked, whether or not she wasvaluable, how she would be responded to, and whether shecould impact her world. Much of her rage seemed to beaimed at herself; somehow she carried the responsibility forthe misery in her life. What, as a temporary caregiver, couldI possibly do to help her?
I knew Rachel’s story, and I knew her family; so it wasnot hard to imagine how her picture had evolved. Rachellived with her mother and 2 older sisters. Her father, whohad sexually molested the older girls, had been court orderedout of the house. Her mother suffered from depression andwas fearful and ineffectual with the older girls. As a result,Rachel’s needs, even her most basic needs, often wentunmet or were delegated to the sisters. Life was chaotic,inconsistent, unpredictable, often frightening, and punctu-ated with violence.
When Rachel came to me she was an aggressive, anx-ious, and rage-filled little girl. Much of her aggression wasaimed at herself. On occasion she also demonstrated aggres-sion toward others. She often made aggressive sounding
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noises, like growling, and sometimes engaged in a nervous,haunting laugh, especially in response to an escalation in hercaregiver’s anger. Her activity level shifted easily into thefrantic/frenetic range and often was accompanied by clumsi-ness and defiance. She showed a blatant disregard for herown safety; engaging with frequency in danger seeking, or atleast “adult-grabbing” behavior. She manifested a generalanxiety, moving sometimes unpredictably into an exagger-ated fear and startle response. She was extremely hypervigi-lant, as well as hypersensitive to the mood and availability ofher caregiver. She demonstrated a very low tolerance forfrustration, accompanied by no expectation that help wasavailable. Occasionally, even a relatively minor frustrationcould lead to a rage response. Her behavior was controllingin many ways, especially around eating. She manifested ageneral inability to regulate her emotions. She was dismiss-ing of her own affect and resisted others’ attempts to comfortor soothe her. She was, in fact, resistant to relationship orany kind of intimacy at all and instead was extremely andcompulsively self-reliant.
Between her history and her behavior, I could constructa pretty clear picture of what she would expect in relation-ship with others, particularly with me as her new primarycaregiver. She would not expect me to meet even her mostbasic needs. She would expect me and her life to be unpre-dictable and chaotic. She would anticipate that I would beemotionally, and often physically, unavailable to her. Shewould assume that I could be either frightening or fright-ened; and that I would allow, and perhaps even engage in,violence and aggression. She would not expect me to haveany tolerance for affect or intimacy; she would expect to bealone in intense emotion. She would expect me to put myown needs above hers and to abandon her in many ways.
Conversely, I knew also how I wanted her to see me. Ifshe was to recover and function effectively in the world sheneeded to expect me to meet her needs, both physical andemotional. She needed to be able to count on reliability ofroutine and relationship. She needed me to be sensitive andavailable, and to be able to tolerate and validate her feelings.She needed to feel confident that I would support her explo-
ration and provide her with comfort and protection, and sheneeded to trust that repair was possible. These were loftygoals indeed; goals that I eventually learned to approach invery specific and conscious ways.
Rachel exhibited all of the signs of a highly disorga-nized child. The rage she directed at herself and occasion-ally at others would, without sensitive intervention, almostcertainly predict very troubling outcomes that are all toocommon among children in the foster care system (Rosen-field et al., 1997). Research and clinical accounts tell usthat foster children with disturbing behavior may elicitinsensitive, punitive care; may be moved repeatedly as aresult of their disruptive behavior; and are sometimesabused, again, in foster care homes (Kenrick, 2000; Rosen-field et al., 1997). It is not hard to imagine an otherwisewell-intended caregiver shutting down or lashing out inresponse to Rachel’s rage, which would only reinforceRachel’s disturbed models of self and other.
Janet understood Rachel’s rage and other troublingbehavior to indicate her profound insecurity and intensevulnerability, and, as noted above, Janet also identifiedwhat she wanted Rachel’s experience to become. Janet’sprofessional immersion in attachment theory, object rela-tions theory, and especially the Circle of Security protocol(Cooper et al., 2005; Marvin et al., 2002) intersected withher daily experience with Rachel and deeply influenced hercaregiving behavior. In conversation with several of herclinical colleagues, Janet extracted six “principles” that shefelt best explained her caregiving strategies. These princi-ples are powerful lessons about what all children, but espe-cially hurt children, need. In describing these principles, weuse Janet’s words as she tells more of Rachel’s story.
Principles
Principle 1: I AM HERE. YOU ARE WORTH IT.The first principle was to frame everything I did and every-thing I said with the message: I AM HERE. YOU AREWORTH IT. There are two things that secure childrenknow: that their caregiver is available should they needthem, and that they are worth it (J. Cassidy, personal com-munication, July 5, 2002). These were two of the thingsthat Rachel did not know. Starting with the day she stoodbefore the mirror attacking her reflection, I tried to wrapher entire life in the message: “You are loveable and you areloved.” First, I was religious about reliability of routine andrelationship, hoping to give her both a sense of securitythrough structure and a sense of belonging. Bath time, forinstance, was always at the same time and done in the sameway. I always followed the same order of things. We alwayssang the same songs and played the same games. And, mostimportantly, perhaps, we always followed the bath with thesame ritual: finding my husband wherever he was so that heand Rachel could have the conversation they had everynight in exactly the same way: “Did you take a bath?”
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“Bath.” “Are you all clean?” “Clean.” “Did you wash yourhair?” “Hair.” “What do you get now?” “BINKY!”
I filled Rachel’s day with as many routine and ritualexperiences as possible. I identified activities that she par-ticularly enjoyed (e.g., singing songs), and I set aside at leastone period of time a day to engage in them, no matter howdifficult the day may have been. Rachel’s life had includedfar too few of these “connecting moments,” and I wantedher to experience delight as a regular part of each day.
I believe that predictability became a lifeline for Rachel.If ever I doubted the importance of it to her emotional well-being, then she was sure to remind me. My faithful practicewas to carefully explain to Rachel everything that was goingto happen, especially if it was at all out of the ordinary rou-tine. One week about half way through Rachel’s stay withme, I went away for a weekend. She was, of course, dis-tressed and disorganized by my absence, and on Mondaymorning she was struggling mightily to get it back together.I took her down to The Children’s Ark with me, and as Isat down she went off to play. Suddenly I rememberedsomething I needed to do and so signaled a staff member towatch her and went upstairs. Apparently in my absence shecame back to where I had been sitting and noticed that Iwas gone. When I returned I sat in the same chair and asshe came around the corner and saw me sitting there again,she burst into heart-wrenching sobs. I was stunned. As herexperience became clear to me, however, it made sense. Ipicked her up and tried to soothe her while telling her thatI was sorry I had not told her what I was going to do, that itmust have scared her that I just disappeared when it wasgenerally my practice to tell her what was going to happennext. I told her that I understood also that it must havebeen particularly frightening for her right on the heels ofmy weekend away and that she must have felt abandonedagain. I had come to know that Rachel really needed herreality validated; to be seen, heard, and understood by mewere the beginnings of security for her. Like all children,Rachel needed at least one adult who “got it” about her.
Principle 2: BEHAVIOR AS NEED. The secondprinciple was to try always to view her “problem” behavioras the expression of a genuine need (Cooper et al., 2005).It is so easy to feel personally defied by the behaviors ofchildren like Rachel; to see them as somehow inherentlybad or flawed or even malicious; or, at the very least, to seethem as “acting out” to get attention. Instead, I came tosee that Rachel was simply engaged in an ongoing attemptto get her needs met. Some children, Rachel among them,have learned that they are generally not heard and thattheir needs will go unmet unless they can escalate their“adult-grabbing” behavior high enough that they cannotbe ignored. Seeing her behavior as the expression of a gen-uine need instead of “acting out,” allowed me as her care-giver to focus on ferreting out and meeting the need, ratherthan focusing on stopping the behavior.
One afternoon I was working late at the Children’sArk. Our clinical director, Sandra Powell, was watchingRachel in another area of the house. She reported thatRachel was playing happily one moment, and the next shewas racing around and around pulling magazines off tablesand knocking over lamps. Rather than responding nega-tively to the onset of the behavior, Sandra recognized it asthe expression of a genuine need (no matter how grace-lessly expressed) and responded instead to that. She pickedRachel up, held her in her lap, and said to her, “I bet youare missing Janet and wanting to go home. You do nothave to run around the room pulling magazines off thetable and knocking over lamps to tell us that, because I amhere. You can sit in my lap instead and tell me how muchyou miss Janet, and I will comfort you until she is here.”Rachel settled into Sandra, knowing in some way thateven if her particular need to have me was not going to bemet at this very moment, just having someone understandher was enough for now.
Principle 3: CUES AND MISCUES. As discussed inthe Circle of Security protocol (Cooper et al., 2005), notonly will children like Rachel speak louder through theirbehavior if their bids to have their needs met are not heard,but they will also learn to speak their caregiver’s specific,unique “language” in order to stay in proximity with theirsource of survival. Children who are generally seen, heard,and understood learn to “cue” their needs directly andanticipate that they will be met. When, as with Rachel,there are needs that a child’s caregiver is uncomfortablemeeting or fairly consistently fails to meet, that child willadjust her behavior accordingly to stay in at least theapproximation of relationship, and may “miscue” needs.Essentially, the Rachels of the world learn to “pretend” likethey do not need something because they have learned thatit will be difficult or impossible for the caregiver to meetthat need. My job with Rachel (and the third principle)was to be willing to override and say aloud miscues, to con-vince her that I was there and would meet her needs.
Rachel’s miscuing was so firmly entrenched that itseemed like she was not even aware that she had needs or at
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least any expectation that they could be met. In the begin-ning it felt like I was teaching her how to feel and how tocue. For example, several times she fell down hard enoughto draw blood. It never occurred to her to cry out, look for aresponsive other, or seek comfort. Under those circum-stances I would go to her and pick her up and say, “Oh, boy,that really looked like it hurt. Let’s go wash it off and find aBand-Aid. Let me hold you,” and so on.
Whenever I thought Rachelwas miscuing me, I tried to figureout what she really needed, whatwas really going on, and thenreflect aloud what I perceived herto be feeling or needing. It wasalways, of course, a guess; but I hadlittle to lose if I was wrong, and if Iwas right, I had a lot to gain.When I guessed right, I immedi-ately had Rachel’s attention.Sometimes that was enough to calm her down and regulateher. Other times I went on to move her to and throughintense, genuine, and appropriate emotion: an importantstep in healing. And the bonus always was that Rachel hadone more experience of someone “getting it” about her.
Toward the end of Rachel’s stay with me, her new(adoptive) family made several visits to my home. Duringtheir third visit, we were all sitting in the family room talk-ing and watching Rachel play. Her quality of play beganslowly to deteriorate until I thought she might disintegratecompletely. I picked her up and put her in my lap, facingme, and asked her what was going on. She first tried to tellme that she was fine and then that it was about a problemwith a toy; but I took a fairly safe guess and said to her, “Idon’t think that you are fine at all, or that it is about thetoy. I think that it is about those people sitting right overthere, and what their being here means.” Unfortunately,Rachel already had had one failed placement, so I was bet-ting that a family visiting had meaning for her. She frozeand looked deeply into my eyes. Then she looked over atthem and back at me and burst into tears. She then couldmove both into expressing her feelings freely and talkingabout them, while allowing me to comfort her. I had theopportunity to begin in earnest the conversation about hermove, to share with her my feelings about missing her, andto model for her new family how to help her grieve. All ofthis because of not letting a miscue go unchallenged.
Children like Rachel sometimes seem to regress tem-porarily, either in behavior or in skill level. Rather than aregression, I see this almost as a child “taking back” mis-cues; a way for them to say, “I didn’t get this need met, andI want it.” Rachel taught me many things, among them wasto understand regression as a sign of an unmet need. Oneday I was in the playroom with Rachel, watching televi-sion. Without initially attracting my attention, shebrought a baby bottle over to where I was sitting and posi-
tioned herself on my lap as if she were a tiny baby. Onceshe was fully in my lap, she looked into my eyes andhanded the bottle up to me and said, “You do it.” Some-what puzzled as to what she was up to, I did figure out thatshe wanted me to feed her the bottle…and so I did. After amoment she took the bottle out of her mouth and said,“Blankie too.” Then I understood. I got a blanket, wrappedher up and cuddled her, rocked her, and fed her the bottle
while affirming for her, “Youdidn’t get enough of this when youwere a little tiny baby, did you?”
Principle 4: “BEING WITH.”I realized quite early on that theonly way to get Rachel somewhereelse emotionally was to be with herwherever she was. Not only was itimportant for her to know she hadfeelings and to feel them, but it was
also important for her to feel met or held wherever she was.Wherever she was, I wanted her to feel validated, under-stood, and even joined. Because this was not the dance shehad learned as an infant and because she had learned toshut down her feelings very early on, I found myself actuallyactively encouraging these walks through intense emotion.Thus, the fourth principle became to be willing to “be with”her in intense emotion rather than trying to make it stop.
I had learned early in my relationship with Rachel thatwhen she was struggling internally with something that wasdifficult for her to manage, signals or cues became apparentif I was paying attention. Her play became less focused andher activity level more frantic and frenetic. She becamemore clumsy, almost as if losing control of her external beingas her internal being struggled. Often her posture with mebecame much more openly defiant. I always tried to catchthese signals so that I could go about helping her sort outwhat was going on. One particular evening I remember all ofthese signals happening one after the other, culminating inher standing on top of the coffee table, just a few feet fromme, with her hands on her hips, looking right at me. Aftertaking her down several times only to have her climb rightback up, I finally put her on my lap facing me, held herfirmly, against some resistance, and said to her: “I am goingto help you figure out what is going on. Looks like you needsome help. Looks like you are asking for help.” Then I tookmy best bet as to what was going on. In this case it was apretty good guess that she was emotionally disorganized by asudden and unpredictable increase in visits with her mother.So, I went on to say to her, “You saw Mom today; you haveseen Mom a lot this week. That is confusing. You don’tknow what to think. You want Mom, but she is never therefor you. It makes you sad. It makes you mad.” I let her knowthat it was okay to have whatever feelings she was experi-encing, that it was okay to let them out, and that I was therefor her and would go with her. As my own voice and emo-
Children have a remarkablecapacity to be connected to theircaregivers, even their abusive or
depressed or addicted caregivers;this attachment is primal and
visceral—built in to our species tohelp ensure our survival.
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tion intensified, so did hers, until she finally collapsed intomy arms in shuddering sobs that lasted that night for 40minutes. It is interesting to note that after these sessions,Rachel was always a different child. Her play became muchcalmer and more focused. She was less clumsy. She was notjust less defiant but usually became quite affectionate. Thatnight I got down on the floor because I knew she oftenreturned to me with affection. The experience had beenintense enough for me that I hadtears in my eyes as I sat andwatched her. She eventually cameback and sat in my lap facing me,looked up into my eyes, and slowlywiped away my tears.
Principle 5: REPAIR. Despitemy best efforts, there were timesthat I failed Rachel miserably,moments during which I disruptedour connection and challenged hertrust. As a general rule I like to consider disruptions in arelationship an opportunity to repair, the building blocks tointimacy (Siegel & Hartzell, 2003; Stern, 1985). Disruptionsin a relationship as fragile as ours, however, with a child forwhom trust is just emerging, can represent a major setback.
Rachel is a small child and came to me very thin. Whenshe was sick, she seemed to stop eating altogether, and thepounds just fell away. So, when she got pneumonia, lost herappetite, and started losing weight that winter, I was natu-rally very concerned. After several days had passed duringwhich it seemed to me she had eaten absolutely nothing,my concern turned to worry, then panic, and eventually tosomething that felt a lot like anger. After trying every trickof the trade and all of her favorite foods to no avail, I recallmaking something of a conscious decision not to show herhow angry I was becoming. To manage my own emotion,however, I chose instead to shut down, and I withdrewemotionally from her. I got her down from the highchair,moved with her to the playroom, and tried to move on. Ittook me a full 30 to 40 minutes, however, to regain myemotional balance; I recall not even being able to look ather during that period of time. I eventually rallied, but myreaction had apparently been enough for her to go to thatold familiar place of “You are not there for me…. I don’tneed you. I know how this works.” From that moment on itseemed that all we had gained was lost. Rachel went far, faraway, back to her old compulsively self-reliant self, and shedid it in very concrete and specific ways. By this time in ourrelationship when I came into the house or into the room,Rachel ran toward me with her arms in the air shouting,“Up, up.” Following this incident, she instead startedtoward me, but stopped abruptly a few feet away, turned herback to me, and walked away. She had also established arhythm of coming in to “touch base” with me when wewere in the same room together, then going out again. She
stopped coming in to touch me at all. She returned myfavor of gaze aversion and stopped looking at me or refer-encing me in any way as well. Every day felt like an eter-nity, and all the while I was working particularly hard torepair with her: giving her language to let her know that Iwas there for her; staying attentively focused on her hopingto catch and respond to her subtlest cue; and taking respon-sibility—out loud—for the disruption in the relationship.
Finally, after 3 long days, Rachelcame back. And she came back asconcretely and specifically as shehad gone away. She began comingall the way in and up into my armswhen I entered the house or theroom after an absence. Shereestablished her rhythm of com-ing in and touching when we werein a room together. On one occa-sion in particular, she came in,turned around, and leaned against
my legs, then picked up my hands and wrapped themaround her and held them there tightly. After her bath atthe end of the 3rd day, I got her out and stood her up on atowel on the floor as usual. I was used to having to keep atleast one hand on her at all times during bath time. Evenwhen she was fairly settled, she was a very energetic littlegirl and into everything. That night I remember beingaware of how still she seemed as I stood her on the floor,and I carefully took both hands off her and looked into hereyes. She stood motionless, returning my gaze, until she felltotally into my arms. I remember thinking that it verymuch felt as if she were saying to me, “I am going to trustthat this is different, that I can come back.” I identified asthe 5th principle as whenever possible to manage and/orcontain my own negative emotional state; and when it wasnot possible, to acknowledge that to Rachel and work withher to repair.
Principle 6: STATE OF MIND. There is some questionin my mind as to who benefited more from the 13 monthswe had together. My life changed in profound ways in rela-tionship with Rachel. She opened up my heart: both to newways of being and to very old painful wounds. She gave meaccess to parts of myself that I didn’t even know existedand shook my sense of myself to the very core. This was ofcourse not always an easy or comfortable process. Many ofher needs stirred in me intense emotion related to my ownhistory. As a trusted friend so wisely commented,
My hunch is that Rachel touches you in a place that is bothnew and very personal, that is, deeply “old.” Someone likeRachel is universal in her realness and her sacred good-ness—a realness that is rarely responded to with the kind ofsensitivity we require. I can’t imagine that you had the kindof attunement that you deserved at this “Rachel place” and
The Children’s Ark was founded in1994 by Paul and Janet Mann asa foster care residential programin which mothers who had lostcustody of their children wereable to live, full-time, with theirchildren in a safe, structured,
therapeutic environment.
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hence your availability to her brings up the grief and empti-ness of what you most needed (K. Hoffman, personal com-munication, October 7, 2002).
I couldn’t help but wonder about and try to track howmy own “stuff” was impacting my responses to her. Thus,the last principle: When struggles continued, reflect on myown experience with a trusted other, especially the impactof my state of mind as a caregiver.
ConclusionJanet and Paul Mann and their staff at the Children’s
Ark provide an example of the best of foster care. In particu-lar, Janet’s capacity to be a sensitive, responsive caregiver (asecure base); to be “in relationship” with a child, even whenthe relationship is temporary; to understand that the “badbehavior” of hurt children is a reflection of the child’s painand should be responded to with compassion rather thanpunishment; to be vigilant to miscues and aware of disrup-tions in the relationship; and to understand and reflect onher own vulnerabilities, have made her an exceptional fosterparent. She has also acknowledged that foster parenting canbe, and often is, difficult and painful and that foster parentsneed more support than they typically receive.
This purpose of this article was not to be prescriptivebut rather to share some insights about the process of pro-viding care to a deeply disorganized child, who we expect isnot unlike many children in foster care. We also hope thatthese ideas fuel further discussion about what can be doneto improve the foster care system and ultimately to im-prove the lives of the many hurt children who experiencefoster care.
Janet’s EpilogueAfter a long and carefully planned transition, Rachel is
now in her permanent home. Her new parents have showna stunning capacity to understand Rachel and her needs andthe courage and wisdom to help her complete her journey.Rachel is hard at work grieving all her losses and raging ather pain. She talks at a very young age and with amazingcompetence and heart-wrenching clarity about the agony ofher losses and the cost of the trauma she endured. She hasovercome an early diagnosis of multiple developmentaldelays and is at or above age in most developmental areas.She is a classic example of the emotional and developmentalimpact to children of environmental deprivation and rela-tional trauma. Fortunately, she is also a symbol of hope andtestimony to what a strong young human spirit and experi-encing relationship in a different way can accomplish. Herstruggle is far from over, but she is a survivor.
On a recent visit to see Rachel, I was struck by how farshe has come from that little girl raging at herself in the mir-ror. She came immediately to me and climbed into my lap.
She started with, “I miss you, Janet.” I told her that I missher too and that every morning I wake up and wonder whatshe is doing, what she is wearing, and what she is thinkingtoday. To each thing I mentioned, she responded, “I likethat, Janet.” Finally, she cuddled into my chest for whatseemed like a very long time; then sat up, looked clearly andsteadily into my eyes, and said, “That is my smell.” A
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