Tag Archives: Deenabandhu Trust

Healing the Attachment System

My observations in India – just as my much longer experience in El Salvador – have led me to question the idea that the way to heal attachment disorders is either by the establishment of a potentially secure attachment relationship through adoption or foster parenting, or through intensive and lengthy psychotherapy. That is not to say that I saw uniformly effective healing in either place, but just that I observed alternative healing methods that seemed to me to have promise.

In each children’s home, for example, there are multiple caregivers, at least one central parental figure, and (when all is going well) a secure environment. The secure environment is not only associated with the person of the caregiver but is also related to adequate food and shelter and freedom from threat. At Love and Hope, Rachel is the central parental figure, and the children also have important relationships with the tias and tios (female and male caregivers), the cook (as witnessed in the “papusa maker” video), and a social worker and psychologist on staff; the high caregiver-child ratio is one of the strengths of the home. At Deenabandhu, there are two central parental figures – Prajna and Prof. Jayadev – and the important continuity of one (the same) skilled and caring teacher throughout the early years of school. In addition to these strengths in each home there are the important relationships between and among the children – age mates and older-younger pairs. Perhaps the power of the peer relationships is enhanced by aspects of the culture; in El Salvador it is not uncommon to see a young boy carrying a baby on his hip. At any rate, the richness of the interpersonal environment offers many opportunities for finding security in a trusting relationship, contingent social interactions, and the subjective experience of caring and personal recognition.

It is important to recognize the apparently contradictory results of the Romanian orphanage studies that point to the dangers of early institutionalization and the need for a primary caregiving relationship such as through adoption or foster care (Zeanah et al, 2011, Fox et al, 2010). When viewing the films of the children in these orphanages, the caregivers appear to be surprisingly pleasant and sometimes engaging in friendly, even helpful, interactions with the children. The main problem, I guess, is the lack of contingency of caregiver responses, especially in infancy. That is, the children are fed without reference to their cues or initiatives, aggression in the free play situation is not responded to helpfully, and the caregivers do not play with the children. I guess I would suggest that the big difference I observed between what I saw in the films of the Romanian orphanages and what I saw at Love and Hope and Deenabandhu is greater personal involvement of the caregivers and the children so that relationships were encouraged, the children were known for who they were as little individuals, and there was a lot of interaction between caregivers and children – in play and in academic learning. This is related to the idea of “magic moments“, or “lost momentos magicos” of earlier posts.

I am reminded of Bruce Perry’s observations that traumatized children initially do better when allowed to seek out particular caregivers to fill specific personal needs – such as one caregiver to roughhouse with, another to provide food, another for comfort at times of emotional distress, another to help with homework. I am also reminded of Peter Fonagy’s therapeutic model of mentalization. That model avoids directly engaging the attachment system without simultaneously working on building reflective capacity that can guard against what one might call the “regressive pull” to intense destructive relationship patterns that were established in early childhood. Fonagy’s model was originally designed to treat adults with Borderline Personality Disorder, many of whom have experienced early trauma. However, it seems to me to be equally relevant to children – at least those with the cognitive capacity for mentalization – who cannot trust adult caregivers and cannot comfort or care for themselves. None of this means that developing a trusting and loving caregiving relationship with a single person is not healing. It is just to say that – at least now in my thinking – I am leaning towards the idea that there are multiple ways of healing the attachment system of children who have experienced trauma and severe neglect.

I hope my readers can make comments on this posting.

Bos K, Zeanah C, Fox N, Drury S, McLaughlin K, & Nelson C, Psychiatric outcomes in young children with a history of institutionalization, Harvard Review of Psychiatry, January/February, 2011, pp. 15-24; Fox S, Levitt P, & Nelson C, How the timing and quality of early experiences influences the development of brain architecture, Child Development, January/February, 2010, Vol. 81, Number 1, pp. 28-40).

Photograph by Ginger Gregory

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The Act of Serving

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As I consider these comforting rhythms of daily life, especially those involved in food preparation, I remember the video I have of Love and Hope that I call “The Papusa Maker”. Sarah Measures took the film, and she pointed out to me how much the little girl of 6-years old watching the cook make the papusas was learning. Of course, she was learning how to make papusas, but she was learning much more. She was learning “sequencing” by watching the cook as she moved through the specific acts involved in making papusas, in the same order, again and again. She was learning to tolerate frustration as she constrained her own activity. She was also learning about respecting boundaries as she observed an older boy flip one of the papusas, giving him instructions, but not attempting to do the job belonging to an older child until she herself was a big girl. In addition, she was most likely exercising her imagination, dreaming of herself as a “papuser maker”.

I then wondered what I could learn from my observations of meal preparation that I could bring back to my families in the U.S. It is hard to recreate a lengthy, methodical process of food preparation in the U.S., where busy multi-tasking two-career parents have a hard time even sitting down to “take out” with their children, let alone letting their children watch them prepare multiple courses from scratch. It does occur to me that the experience of a child watching an adult perform a meaningful sequence of repetitive acts in the context of a caring relationship offers a learning opportunity we rarely consider in the U.S. I am aware that one cannot transpose the features of one culture onto another, but I am hoping those reading this posting will send me some ideas about how parents in the U.S. can create for their children some of the comforting rhythms and learning of food preparation at Deenabandhu and Love and Hope.

This preparation takes hours, but the children have already risen before sunrise and eaten their gruel to assuage their hunger before their activities. They join us at breakfast after these are completed. The children sit on the floor and chant their prayer. Most of the children chant in an animated way but some stifle a yawn. Then one of the children designated as server, or one of the adults, serves all of us. The act of serving also has special meaning.

Prajna explained to me that the act of serving is an experience of giving, the expression of generosity; it communicates love and in that sense is self-enhancing. This belief was given special meaning by an experience I had with Prajna one evening at the girls’ dining hall.

Prajna and I walked to the girls’ residence to give them supper. An amazing sight ensued. We carried with us a metal container of the rice and vegetable meal the cooks had prepared. Prajna crouched in the middle of a circle of about 15 young girls with the container of food between her legs. Dipping her cupped hand into the food, she scooped out a round handful and ceremoniously place the ball of rice into the cupped hands of a waiting child. This was repeated for each child in the circle, Rajna adjusting her body position so that she was facing each child as she served her. When they were all served, Prajna asked, “Next?” and the girls eagerly extended their little hands. One after another she cupped her hand and served another ball of food to each waiting girl. It was the ceremony that was most impressive, including the face-to-face, social moment in which language and the face and the body were all engaged in a rhythmic, repetitive, perfectly contingent social activity. I thought that if this occurred on a weekly basis it would be essentially healing. I think it is what Bruce Perry talks about, and Peter Fonagy too.

photograph by Ginger Gregory

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India – Deenabandhu Trust: First Posting

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Ginger and I landed in Bangalore early Saturday morning. The first sight I had of India was twinkling lights in the dark from the plane. The airport is modern and clean. We made our way through passport control and customs with an extra security check after landing, similar to El Salvador. On the other side of customs we found the representative of the travel office, who located our driver. We got into his new taxi, and we were off for Chamarajanagar.

The driver said it would take us maximum of 4 hours to get there, but we started at 10 of 7:00 am and weren’t there by noon. Two reasons we were delayed were speed bumps – apparently every few yards, and also that we stopped for a “coffee break”. The Indian restaurant we stopped at served us a crispy brown pancake with a vegetable paste inside and two sauces. It was a cozy family type restaurant on a veranda with bamboo trees creeping into the seating area.

It took us a long time to even get out of the city of Bangalore, which seemed to go on and on forever. There were shops and people, but the cityscape was most remarkable for the large buildings that seemed half constructed, and gave a sad, forlorn quality to the scene. The poverty, manifested in small shacks and storefronts with dingy signs and flimsy construction, reminded me of El Salvador. In fact, except for the local writing on some of the signs (most were only in English) and the occasional Hindu god, it could be mistaken for El Salvador with one exception – the newer buildings though prematurely shabby were on a much larger scale.

In one charming observation from the car, I saw two school girls, dressed in neat white uniforms with navy scarves, facing each other and playing the clapping game that I have seen in the U.S. and at Love and Hope.

We drove through countryside with fields of rice and sugar cane, and then a city calling itself on a green sign”The City of Sugar”, after that, other cities, and then the big city of Mysore. After Mysore, the countryside became more beautiful. A lovely mountain range in the distance framed a green landscape, which up closer was made up of red dirt dotted with trees. We finally arrived in the small city of Chamarajanagar, which resembled the outskirts of San Salvador, or even a huge Nejapa, with its small, dilapidated shops and dusty dirt roads. One important distinction from a Salvadoran city was the bright colors of the women’s clothing. Even in the impoverished areas women wore magenta and chartreuse saris, lighting up the dusty dirt streets in a dramatic way. The driver got directions from some men on the corner and turned down a dirt road. Much later, we arrived at a pleasant cluster of recently constructed houses that were the Deenabandhu Trust buildings.

Prajna came out to meet us. She is a beautiful young woman who left a high paying job working at Cisco Industries to devote herself to orphanage work and began to work here full time. Now she is the primary administrator, along with the man she calls “Uncle”, G.S. Jayadev, the founder, who is in Bangalore at the moment with his ailing father. Professor Jayadev teaches zoology at a local university but has written many books on multiple subjects, and founded the first orphanage here twenty years ago. Prajna told us that the children at the home come from a variety of sources, though most of them are not actual orphans but rather are children of parents who cannot care for them for various reasons. Those reasons include extreme poverty, mental illness, incarceration, and single mothers working in the sex trade.

Our first introduction to the children was at lunch. The children in the “boys’” part of the home (occupied by boys, their caregivers, Prajna, and a small number of girls who live either with Prajna or with another woman caregiver who lives in a house in this section of the compound) were seated in a large empty room on mats, ready to eat. They were being served from large metal pots by some of the youngest boys whose current job was that of server. This job, I later learned, has special meaning here in that it is considered a gesture of giving, and in that sense, self enhancing. After being served, the children chanted a prayer. Just as I remembered from Love and Hope, the chanting of the prayer was animated and highly rhythmic. It seemed to organize the children both in their independent self-regulation and in their position as part of a well-regulated group. I mentioned this to Prajna, and she noted that before their lessons she leads them through a brief breathing exercise to help them prepare for studying. The meal was a delicious vegetarian meal of some kind of curry, chapatti, curd (yoghurt), and bananas grown by the children. The bananas were unblemished, ripe, and unusually sweet. After their meal, the children all take their big metal dishes and cups to the washing up room and wash them with water, then stack them in place in a large open rack with wooden slats.

Prajna told us that the two youngest children are 4-years old, a girl and a boy. The Trust dedicates itself to the care of these children until they – especially the girls, Prajna told us – were economically self-sufficient. Some of the children have gone on to high level study and training, but Prajna assured us that the Trust was satisfied if the children grew up to be independent, happy young adults in less high status employment. Prajna took us on a tour of the buildings that house both the 77 children who live at the orphanage, called the “ashram”. The boys live in several free-standing houses, with one house parent in each house. The 16 younger boys lived in one of the houses with one house mother. In the two other houses, 8 older boys lived with one housemother. The girls live in a new building that is a pride of the Trust. It is painted green and also obtains a significant amount of its electrical energy and heat from solar panels in the roof. An attractive, airy building, it includes multiple sleeping spaces and living spaces separated by internal staircases and corridors. Many of these passages are open to the air, so they are not only lit by sunlight, but they are cooled by breezes. Even in the winter, the temperature is warm by Boston standards, and the encircling mountain range drains the moisture in the air, so that it rarely if ever rains.

photograph by Ginger Gregory

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