Weekly Activity {Attachment Theory}

 4 questions 

1. What type of care giving might a child have received in order to respond with such rage and distrust?
2. While the article was written concerning foster care, what implication does it have for early care and learning settings?
3. What surprised you about the article?
4. What did you learn from the article?   What can you apply to your role as a caregiver?

Rachel,2 not yet 2 years old, stood looking at herself in the
full-length mirror, a frown slowly overtaking her face. Deep
in her throat began a low, grumbling growl. As the growl
grew louder, she began hitting the side of her head and mov-
ing slowly toward the mirror, her eyes glued to her own
image. The growling became yelling, and she began slapping
at herself in the mirror. I sat, stunned, unable to move or
formulate a response. Her rage was palpable and deeply dis-
turbing. Finally, I got up from my chair and went to her. I
got down on my knees, gently held her shoulders, looked
into her eyes, and said, “Rachel, this is not your fault! You
are loveable and you are loved.”

A DISORGANIZED TODDLER
IN FOSTER CARE:

Healing and Change From an Attachment
Theory Perspective1

JANET MANN
The Children’s Ark

MOLLY D. KRETCHMAR
Gonzaga University

ZERO TO THREE

May 2006

29

This article focuses on the remarkable story of a deeply
disorganized child, Rachel, and her experience in foster
care with Janet and Paul Mann, founders of the Chil-
dren’s Ark. Rachel and her mother were referred to the
Ark, an innovative intervention center for at-risk fami-
lies, when Rachel was 10 months old. After 11 months
at the Ark, Rachel was placed into foster care with the
Manns. On the basis of Janet Mann’s professional
immersion 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 with
Rachel. These principles included: (a) Communicating
the message, “I am here and you are worth it”;
(b) viewing negative behavior as needed; (c) reading
cues and reinterpreting miscues; (d) “being with,” espe-
cially during periods of intense emotion; (e) working
consciously toward relationship repair when disruption
occurs; and (f) developing awareness of one’s own state
of 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 for
healing and positive change.

abstract

This article presents a remarkable story of a deeply trau-
matized child who, by great fortune, was placed into foster
care with Janet and Paul Mann, founders of the Children’s
Ark, 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 Paul
Allen Foundation. We wish to thank Rachel and her family for allowing
us to use examples from her experience with Janet to illustrate the princi-
ples in this article. In addition to her family, Janet extends her gratitude
to her clinical colleagues, Sandra Powell and Kent Hoffman, who walked
this journey with her, enriching the experience. The Circle of Security
Project along with Janet’s work, interactions, and experiences with Glen
Cooper, Kent Hoffman, and Bert Powell drove and framed the principles
outlined in this article.

Correspondence concerning this article should be addressed to
Molly D. Kretchmar, Department of Psychology, Gonzaga University, 502
E. Boone, Spokane, WA 99258-0054. E-mail: kretchmar@gonzaga.edu

2In order to protect the privacy and to respect the confidentiality of
the child represented in this article, her name has been changed. Further,
the child’s adoptive parents provided full consent to the use of her story
and read a complete draft of the manuscript prior to its submission in
order to confirm that they were comfortable with its contents.

21382_Pg29-36 5/1/06 6:57 AM Page 29

mailto:permission@zerotothree.org

mailto:permission@zerotothree.org

ZERO TO THREE

May 2006

30

to them, about whether they are worthy of care, and so
forth. Children with secure attachment histories have a
sense of trust toward others and feel the self-worth reflected
by the nurturing care they have received. In contrast, chil-
dren with insecure histories are likely to view others as less
available and less trustworthy and to have internalized a
compromised sense of self (Weinfield, Sroufe, Egeland, &
Carlson, 1999). Of greatest concern are children with disor-
ganized attachment strategies. These children typically
have caregivers who are either frightening or frightened,
placing them in an irresolvable approach–avoidance bind;
“the infant is presented with a paradox wherein the haven
of safety is at once the source of the alarm” (Main & Hesse,
1990, p. 180). Stemming from this paradox, researchers
expect 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 a
precursor to serious psychopathologies (Crittenden, 1995;
see also Lyons-Ruth & Jacobvitz, 1999).

Children in the foster care system have likely suffered
multiple attachment-related traumas, not the least of which
is 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/or
disorganized attachment relationships with their parents,
being separated from these primary caregivers adds another
layer of trauma (Charles & Matheson, 1990). For a young
child, the very nature of separation is scary; even if what
they had was abusive, it was at least familiar and perhaps
even predictable. Children also have a remarkable capacity

demonstrates how a predictable environment and secure,
loving care providers can foster change even when a child
is profoundly disorganized, deeply mistrusting, and full of
rage toward herself and others. Along with their commit-
ment to her, Rachel’s care providers’ solid understanding of
attachment theory and their ability to translate theory into
practice were central to the progress Rachel made. In this
article, we use Rachel’s story to illustrate principles of care-
giving grounded in attachment theory that we hope will
provide insight to other care providers. This story is ulti-
mately one of great hope, not only for this child but for the
thousands 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 have
a primary and essential need to be “in relationship” with
their caregivers. To ensure our survival, our evolutionary
history prepared us to seek closeness or proximity to our
caregivers, especially under conditions of threat or vulnera-
bility (e.g., presence of a stranger, illness). When caregivers
are available and welcoming, seeking proximity is easy and
children’s feelings of safety and security are bolstered. When
caregivers are unavailable (physically, emotionally, or both),
inconsistent in their responsiveness, or frightening in some
way (e.g., abusive), seeking closeness becomes more difficult
and children’s feelings of security and safety are disrupted.

Bowlby (1969/1982) proposed that young children
internalize “working models,” or representations about
themselves 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

PH
O

T
O

: M
A

R
IL

Y
N

N
O

LT

21382_Pg29-36 5/1/06 6:57 AM Page 30

to be connected to their caregivers, even their abusive or
depressed or addicted caregivers; this attachment is primal
and visceral—built into our species to help ensure our sur-
vival (Bowlby, 1969/1982). Removing a child, then, even
for the child’s welfare, is likely to be deeply threatening and
disorganizing in and of itself. In addition, because the pre-
sent foster care system cannot ensure permanent place-
ments for children, many children experience multiple
placements, involving multiple separation and loss experi-
ences, which only compound children’s deeply disturbed
sense 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 and
Janet 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 in
which mothers who had lost custody of their children were
able to live, full time, with their children in a safe, struc-
tured, therapeutic environment. The hope was to minimize
the 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 and
extended visitation between children placed in foster care
and their parents. At the Ark, parents join their children
each week day, retain the primary caregiving responsibilities
under the Ark staff’s supervision, and are required to work
toward improving their capacities for parenting and self-
sufficiency. In addition to being with their children, parents
participate in educational programs and in the Circle of
Security, a group-based intervention in which parents learn
about their attachment relationships with their children and
how to enhance these relationships (Cooper et al., 2005;
Marvin, Cooper, Hoffman, & Powell, 2002). Rachel and her
mother joined the Ark when Rachel was 10 months old.

Rachel: A Teacher of Powerful Lessons
Rachel was born into a chaotic family environment in

which the abuse of her older siblings by her father had
already attracted the attention of child protective services.
With her father gone, Rachel remained under her mother’s
care in an in-home dependency issued by the State of
Washington. When she was 10 months old, she and her
mother were referred to the Children’s Ark for services
after Rachel was diagnosed with multiple delays and failure
to thrive. Rachel and her mother participated in the Ark
for 11 months during which time the Ark staff became
increasingly concerned about Rachel’s safety in the home
and the impact of Rachel’s home environment on her
development. Rachel’s mother agreed to voluntarily place
Rachel 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 about
what even temporary care providers can do to begin to heal
the pain of the child’s past. Janet, an experienced foster
parent well versed in attachment theory, had the wisdom
to 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 of
pondering somberly how wounded she was. It was certainly
clear to me that it was a dismal picture she carried in her
head about how the world worked, whether or not she was
valuable, how she would be responded to, and whether she
could impact her world. Much of her rage seemed to be
aimed at herself; somehow she carried the responsibility for
the misery in her life. What, as a temporary caregiver, could
I possibly do to help her?

I knew Rachel’s story, and I knew her family; so it was
not hard to imagine how her picture had evolved. Rachel
lived with her mother and 2 older sisters. Her father, who
had sexually molested the older girls, had been court ordered
out of the house. Her mother suffered from depression and
was fearful and ineffectual with the older girls. As a result,
Rachel’s needs, even her most basic needs, often went
unmet 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 was
aimed at herself. On occasion she also demonstrated aggres-
sion toward others. She often made aggressive sounding

ZERO TO THREE

May 2006

31

PH
O

T
O

: M
A

R
IL

Y
N

N
O

LT

21382_Pg29-36 5/1/06 6:57 AM Page 31

ZERO TO THREE

May 2006

32

noises, like growling, and sometimes engaged in a nervous,
haunting laugh, especially in response to an escalation in her
caregiver’s anger. Her activity level shifted easily into the
frantic/frenetic range and often was accompanied by clumsi-
ness and defiance. She showed a blatant disregard for her
own safety; engaging with frequency in danger seeking, or at
least “adult-grabbing” behavior. She manifested a general
anxiety, 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 of
her caregiver. She demonstrated a very low tolerance for
frustration, accompanied by no expectation that help was
available. Occasionally, even a relatively minor frustration
could lead to a rage response. Her behavior was controlling
in many ways, especially around eating. She manifested a
general inability to regulate her emotions. She was dismiss-
ing of her own affect and resisted others’ attempts to comfort
or soothe her. She was, in fact, resistant to relationship or
any kind of intimacy at all and instead was extremely and
compulsively self-reliant.

Between her history and her behavior, I could construct
a pretty clear picture of what she would expect in relation-
ship with others, particularly with me as her new primary
caregiver. She would not expect me to meet even her most
basic needs. She would expect me and her life to be unpre-
dictable and chaotic. She would anticipate that I would be
emotionally, and often physically, unavailable to her. She
would 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 have
any tolerance for affect or intimacy; she would expect to be
alone in intense emotion. She would expect me to put my
own needs above hers and to abandon her in many ways.

Conversely, I knew also how I wanted her to see me. If
she was to recover and function effectively in the world she
needed to expect me to meet her needs, both physical and
emotional. She needed to be able to count on reliability of
routine and relationship. She needed me to be sensitive and
available, 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 she
needed to trust that repair was possible. These were lofty
goals indeed; goals that I eventually learned to approach in
very 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, almost
certainly predict very troubling outcomes that are all too
common among children in the foster care system (Rosen-
field et al., 1997). Research and clinical accounts tell us
that foster children with disturbing behavior may elicit
insensitive, punitive care; may be moved repeatedly as a
result of their disruptive behavior; and are sometimes
abused, again, in foster care homes (Kenrick, 2000; Rosen-
field et al., 1997). It is not hard to imagine an otherwise
well-intended caregiver shutting down or lashing out in
response to Rachel’s rage, which would only reinforce
Rachel’s disturbed models of self and other.

Janet understood Rachel’s rage and other troubling
behavior to indicate her profound insecurity and intense
vulnerability, and, as noted above, Janet also identified
what she wanted Rachel’s experience to become. Janet’s
professional immersion in attachment theory, object rela-
tions theory, and especially the Circle of Security protocol
(Cooper et al., 2005; Marvin et al., 2002) intersected with
her daily experience with Rachel and deeply influenced her
caregiving behavior. In conversation with several of her
clinical colleagues, Janet extracted six “principles” that she
felt 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, we
use 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 ARE
WORTH IT. There are two things that secure children
know: that their caregiver is available should they need
them, and that they are worth it (J. Cassidy, personal com-
munication, July 5, 2002). These were two of the things
that Rachel did not know. Starting with the day she stood
before the mirror attacking her reflection, I tried to wrap
her entire life in the message: “You are loveable and you are
loved.” First, I was religious about reliability of routine and
relationship, hoping to give her both a sense of security
through structure and a sense of belonging. Bath time, for
instance, was always at the same time and done in the same
way. I always followed the same order of things. We always
sang the same songs and played the same games. And, most
importantly, perhaps, we always followed the bath with the
same ritual: finding my husband wherever he was so that he
and Rachel could have the conversation they had every
night in exactly the same way: “Did you take a bath?”

PH
O

T
O

: M
A

R
IL

Y
N

N
O

LT

21382_Pg29-36 5/1/06 6:57 AM Page 32

ZERO TO THREE

May 2006

33

“Bath.” “Are you all clean?” “Clean.” “Did you wash your
hair?” “Hair.” “What do you get now?” “BINKY!”

I filled Rachel’s day with as many routine and ritual
experiences as possible. I identified activities that she par-
ticularly enjoyed (e.g., singing songs), and I set aside at least
one period of time a day to engage in them, no matter how
difficult the day may have been. Rachel’s life had included
far too few of these “connecting moments,” and I wanted
her 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 practice
was to carefully explain to Rachel everything that was going
to happen, especially if it was at all out of the ordinary rou-
tine. One week about half way through Rachel’s stay with
me, I went away for a weekend. She was, of course, dis-
tressed and disorganized by my absence, and on Monday
morning she was struggling mightily to get it back together.
I took her down to The Children’s Ark with me, and as I
sat down she went off to play. Suddenly I remembered
something I needed to do and so signaled a staff member to
watch her and went upstairs. Apparently in my absence she
came back to where I had been sitting and noticed that I
was gone. When I returned I sat in the same chair and as
she came around the corner and saw me sitting there again,
she burst into heart-wrenching sobs. I was stunned. As her
experience became clear to me, however, it made sense. I
picked her up and tried to soothe her while telling her that
I was sorry I had not told her what I was going to do, that it
must have scared her that I just disappeared when it was
generally my practice to tell her what was going to happen
next. I told her that I understood also that it must have
been particularly frightening for her right on the heels of
my weekend away and that she must have felt abandoned
again. I had come to know that Rachel really needed her
reality validated; to be seen, heard, and understood by me
were 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 second
principle was to try always to view her “problem” behavior
as the expression of a genuine need (Cooper et al., 2005).
It is so easy to feel personally defied by the behaviors of
children like Rachel; to see them as somehow inherently
bad or flawed or even malicious; or, at the very least, to see
them as “acting out” to get attention. Instead, I came to
see that Rachel was simply engaged in an ongoing attempt
to get her needs met. Some children, Rachel among them,
have learned that they are generally not heard and that
their needs will go unmet unless they can escalate their
“adult-grabbing” behavior high enough that they cannot
be 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, rather
than focusing on stopping the behavior.

One afternoon I was working late at the Children’s
Ark. Our clinical director, Sandra Powell, was watching
Rachel in another area of the house. She reported that
Rachel was playing happily one moment, and the next she
was racing around and around pulling magazines off tables
and knocking over lamps. Rather than responding nega-
tively to the onset of the behavior, Sandra recognized it as
the expression of a genuine need (no matter how grace-
lessly expressed) and responded instead to that. She picked
Rachel up, held her in her lap, and said to her, “I bet you
are missing Janet and wanting to go home. You do not
have to run around the room pulling magazines off the
table and knocking over lamps to tell us that, because I am
here. You can sit in my lap instead and tell me how much
you miss Janet, and I will comfort you until she is here.”
Rachel settled into Sandra, knowing in some way that
even if her particular need to have me was not going to be
met at this very moment, just having someone understand
her was enough for now.

Principle 3: CUES AND MISCUES. As discussed in
the Circle of Security protocol (Cooper et al., 2005), not
only will children like Rachel speak louder through their
behavior 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 their
source of survival. Children who are generally seen, heard,
and understood learn to “cue” their needs directly and
anticipate that they will be met. When, as with Rachel,
there are needs that a child’s caregiver is uncomfortable
meeting or fairly consistently fails to meet, that child will
adjust her behavior accordingly to stay in at least the
approximation of relationship, and may “miscue” needs.
Essentially, the Rachels of the world learn to “pretend” like
they do not need something because they have learned that
it will be difficult or impossible for the caregiver to meet
that 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 it
seemed like she was not even aware that she had needs or at

PH
O

T
O

: M
A

R
IL

Y
N

N
O

LT

21382_Pg29-36 5/1/06 6:57 AM Page 33

ZERO TO THREE

May 2006

34

least any expectation that they could be met. In the begin-
ning it felt like I was teaching her how to feel and how to
cue. For example, several times she fell down hard enough
to draw blood. It never occurred to her to cry out, look for a
responsive 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 a
Band-Aid. Let me hold you,” and so on.

Whenever I thought Rachel
was miscuing me, I tried to figure
out what she really needed, what
was really going on, and then
reflect aloud what I perceived her
to be feeling or needing. It was
always, of course, a guess; but I had
little to lose if I was wrong, and if I
was 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 regulate
her. Other times I went on to move her to and through
intense, genuine, and appropriate emotion: an important
step in healing. And the bonus always was that Rachel had
one 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. During
their third visit, we were all sitting in the family room talk-
ing and watching Rachel play. Her quality of play began
slowly to deteriorate until I thought she might disintegrate
completely. I picked her up and put her in my lap, facing
me, and asked her what was going on. She first tried to tell
me that she was fine and then that it was about a problem
with a toy; but I took a fairly safe guess and said to her, “I
don’t think that you are fine at all, or that it is about the
toy. I think that it is about those people sitting right over
there, 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 froze
and looked deeply into my eyes. Then she looked over at
them and back at me and burst into tears. She then could
move both into expressing her feelings freely and talking
about them, while allowing me to comfort her. I had the
opportunity to begin in earnest the conversation about her
move, to share with her my feelings about missing her, and
to model for her new family how to help her grieve. All of
this 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 a
regression, I see this almost as a child “taking back” mis-
cues; a way for them to say, “I didn’t get this need met, and
I want it.” Rachel taught me many things, among them was
to understand regression as a sign of an unmet need. One
day I was in the playroom with Rachel, watching televi-
sion. Without initially attracting my attention, she
brought a baby bottle over to where I was sitting and posi-

tioned herself on my lap as if she were a tiny baby. Once
she was fully in my lap, she looked into my eyes and
handed the bottle up to me and said, “You do it.” Some-
what puzzled as to what she was up to, I did figure out that
she wanted me to feed her the bottle…and so I did. After a
moment she took the bottle out of her mouth and said,
“Blankie too.” Then I understood. I got a blanket, wrapped
her up and cuddled her, rocked her, and fed her the bottle

while affirming for her, “You
didn’t get enough of this when you
were a little tiny baby, did you?”

Principle 4: “BEING WITH.”
I realized quite early on that the
only way to get Rachel somewhere
else emotionally was to be with her
wherever she was. Not only was it
important for her to know she had
feelings 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 she
had learned as an infant and because she had learned to
shut down her feelings very early on, I found myself actually
actively 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 that
when she was struggling internally with something that was
difficult for her to manage, signals or cues became apparent
if I was paying attention. Her play became less focused and
her activity level more frantic and frenetic. She became
more clumsy, almost as if losing control of her external being
as her internal being struggled. Often her posture with me
became much more openly defiant. I always tried to catch
these signals so that I could go about helping her sort out
what was going on. One particular evening I remember all of
these signals happening one after the other, culminating in
her standing on top of the coffee table, just a few feet from
me, with her hands on her hips, looking right at me. After
taking her down several times only to have her climb right
back up, I finally put her on my lap facing me, held her
firmly, against some resistance, and said to her: “I am going
to help you figure out what is going on. Looks like you need
some help. Looks like you are asking for help.” Then I took
my best bet as to what was going on. In this case it was a
pretty good guess that she was emotionally disorganized by a
sudden and unpredictable increase in visits with her mother.
So, I went on to say to her, “You saw Mom today; you have
seen Mom a lot this week. That is confusing. You don’t
know what to think. You want Mom, but she is never there
for you. It makes you sad. It makes you mad.” I let her know
that it was okay to have whatever feelings she was experi-
encing, that it was okay to let them out, and that I was there
for her and would go with her. As my own voice and emo-

Children have a remarkable
capacity to be connected to their
caregivers, even their abusive or

depressed or addicted caregivers;
this attachment is primal and

visceral—built in to our species to
help ensure our survival.

21382_Pg29-36 5/1/06 6:57 AM Page 34

ZERO TO THREE

May 2006

35

tion intensified, so did hers, until she finally collapsed into
my arms in shuddering sobs that lasted that night for 40
minutes. It is interesting to note that after these sessions,
Rachel was always a different child. Her play became much
calmer and more focused. She was less clumsy. She was not
just less defiant but usually became quite affectionate. That
night I got down on the floor because I knew she often
returned to me with affection. The experience had been
intense enough for me that I had
tears in my eyes as I sat and
watched her. She eventually came
back and sat in my lap facing me,
looked up into my eyes, and slowly
wiped away my tears.

Principle 5: REPAIR. Despite
my best efforts, there were times
that I failed Rachel miserably,
moments during which I disrupted
our connection and challenged her
trust. As a general rule I like to consider disruptions in a
relationship an opportunity to repair, the building blocks to
intimacy (Siegel & Hartzell, 2003; Stern, 1985). Disruptions
in a relationship as fragile as ours, however, with a child for
whom trust is just emerging, can represent a major setback.

Rachel is a small child and came to me very thin. When
she was sick, she seemed to stop eating altogether, and the
pounds just fell away. So, when she got pneumonia, lost her
appetite, and started losing weight that winter, I was natu-
rally very concerned. After several days had passed during
which it seemed to me she had eaten absolutely nothing,
my concern turned to worry, then panic, and eventually to
something that felt a lot like anger. After trying every trick
of the trade and all of her favorite foods to no avail, I recall
making something of a conscious decision not to show her
how angry I was becoming. To manage my own emotion,
however, I chose instead to shut down, and I withdrew
emotionally from her. I got her down from the highchair,
moved with her to the playroom, and tried to move on. It
took me a full 30 to 40 minutes, however, to regain my
emotional balance; I recall not even being able to look at
her during that period of time. I eventually rallied, but my
reaction had apparently been enough for her to go to that
old familiar place of “You are not there for me…. I don’t
need you. I know how this works.” From that moment on it
seemed that all we had gained was lost. Rachel went far, far
away, back to her old compulsively self-reliant self, and she
did it in very concrete and specific ways. By this time in our
relationship 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 started
toward me, but stopped abruptly a few feet away, turned her
back to me, and walked away. She had also established a
rhythm of coming in to “touch base” with me when we
were in the same room together, then going out again. She

stopped coming in to touch me at all. She returned my
favor 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 to
repair with her: giving her language to let her know that I
was there for her; staying attentively focused on her hoping
to catch and respond to her subtlest cue; and taking respon-
sibility—out loud—for the disruption in the relationship.

Finally, after 3 long days, Rachel
came back. And she came back as
concretely and specifically as she
had gone away. She began coming
all the way in and up into my arms
when I entered the house or the
room after an absence. She
reestablished her rhythm of com-
ing in and touching when we were
in 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 them
around her and held them there tightly. After her bath at
the end of the 3rd day, I got her out and stood her up on a
towel on the floor as usual. I was used to having to keep at
least one hand on her at all times during bath time. Even
when she was fairly settled, she was a very energetic little
girl and into everything. That night I remember being
aware of how still she seemed as I stood her on the floor,
and I carefully took both hands off her and looked into her
eyes. She stood motionless, returning my gaze, until she fell
totally into my arms. I remember thinking that it very
much felt as if she were saying to me, “I am going to trust
that this is different, that I can come back.” I identified as
the 5th principle as whenever possible to manage and/or
contain my own negative emotional state; and when it was
not possible, to acknowledge that to Rachel and work with
her to repair.

Principle 6: STATE OF MIND. There is some question
in my mind as to who benefited more from the 13 months
we had together. My life changed in profound ways in rela-
tionship with Rachel. She opened up my heart: both to new
ways of being and to very old painful wounds. She gave me
access to parts of myself that I didn’t even know existed
and shook my sense of myself to the very core. This was of
course not always an easy or comfortable process. Many of
her needs stirred in me intense emotion related to my own
history. As a trusted friend so wisely commented,

My hunch is that Rachel touches you in a place that is both
new and very personal, that is, deeply “old.” Someone like
Rachel is universal in her realness and her sacred good-
ness—a realness that is rarely responded to with the kind of
sensitivity we require. I can’t imagine that you had the kind
of attunement that you deserved at this “Rachel place” and

The Children’s Ark was founded in
1994 by Paul and Janet Mann as
a foster care residential program
in which mothers who had lost
custody of their children were
able to live, full-time, with their
children in a safe, structured,

therapeutic environment.

21382_Pg29-36 5/1/06 6:57 AM Page 35

ZERO TO THREE

May 2006

36

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 how
my own “stuff” was impacting my responses to her. Thus,
the last principle: When struggles continued, reflect on my
own experience with a trusted other, especially the impact
of my state of mind as a caregiver.

Conclusion
Janet 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 (a
secure base); to be “in relationship” with a child, even when
the relationship is temporary; to understand that the “bad
behavior” of hurt children is a reflection of the child’s pain
and should be responded to with compassion rather than
punishment; to be vigilant to miscues and aware of disrup-
tions in the relationship; and to understand and reflect on
her own vulnerabilities, have made her an exceptional foster
parent. She has also acknowledged that foster parenting can
be, and often is, difficult and painful and that foster parents
need more support than they typically receive.

This purpose of this article was not to be prescriptive
but rather to share some insights about the process of pro-
viding care to a deeply disorganized child, who we expect is
not unlike many children in foster care. We also hope that
these ideas fuel further discussion about what can be done
to improve the foster care system and ultimately to im-
prove the lives of the many hurt children who experience
foster care.

Janet’s Epilogue
After a long and carefully planned transition, Rachel is

now in her permanent home. Her new parents have shown
a stunning capacity to understand Rachel and her needs and
the courage and wisdom to help her complete her journey.
Rachel is hard at work grieving all her losses and raging at
her pain. She talks at a very young age and with amazing
competence and heart-wrenching clarity about the agony of
her losses and the cost of the trauma she endured. She has
overcome an early diagnosis of multiple developmental
delays and is at or above age in most developmental areas.
She is a classic example of the emotional and developmental
impact to children of environmental deprivation and rela-
tional trauma. Fortunately, she is also a symbol of hope and
testimony to what a strong young human spirit and experi-
encing relationship in a different way can accomplish. Her
struggle is far from over, but she is a survivor.

On a recent visit to see Rachel, I was struck by how far
she 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 miss
her too and that every morning I wake up and wonder what
she is doing, what she is wearing, and what she is thinking
today. To each thing I mentioned, she responded, “I like
that, Janet.” Finally, she cuddled into my chest for what
seemed like a very long time; then sat up, looked clearly and
steadily into my eyes, and said, “That is my smell.” A

REFERENCES
Bowlby, J. (1969/1982). Attachment and loss: Vol. 1 Attachment. New

York: Basic Books.
Bowlby, J. (1973). Attachment and loss: Vol. 2 Separation. New York: Basic

Books.
Bowlby, J. (1980). Attachment and loss: Vol. 3 Loss. New York: Basic Books.
Charles, G., & Matheson, J. (1990). Children in foster care: Issues of sep-

aration and attachment. Community Alternatives: International Journal
of Family Care, 2, 37–49.

Cooper, G., Hoffman, K., Powell, B., & Marvin, R. (2005). The Circle of
Security intervention: Differential diagnosis and differential treat-
ment. In L. J. Berlin, Y. Ziv, L. Amaya-Jackson, & M. T. Greenberg
(Eds.), Enhancing early attachments: Theory, research, and intervention
(pp. 127–151). New York: Guilford Press.

Crittenden, P. M. (1995). Attachment and psychopathology. In S. Gold-
berg, R. Muir, & J. Kerr (Eds.), Attachment theory: Social,
developmental, and clinical perspectives (pp. 367–406). Hillsdale, NJ:
Analytic Press.

Kenrick, J. (2000). “Be a kid”: The traumatic impact of repeated separa-
tions on children who are fostered and adopted. Journal of Child
Psychotherapy, 26, 393–412.

Kretchmar, M. D., Worsham, N. L., & Swenson, N. (2005). Anna’s
story: A qualitative analysis of an at-risk mother’s experience in an
attachment-based foster care program. Attachment & Human Develop-
ment, 7, 31–49.

Lyons-Ruth, K., & Jacobvitz, D. (1999). Attachment disorganization:
Unresolved loss, relational violence, and lapses in behavioral and
attentional strategies. In J. Cassidy & P. R. Shaver (Eds.), Handbook of
attachment: Theory, research and clinical applications (pp. 520–554).
New York: Guilford Press.

Main, M., & Hesse, E. (1990). Parents’ unresolved traumatic experiences
are related to infant disorganized attachment status: Is frightened
and/or frightening parental behavior the linking mechanism? In
M. Greenberg, D. Cicchetti, & M. Cummings (Eds.), Attachment in the
preschool years: Theory, research, and intervention (pp. 161–182).
Chicago: University of Chicago Press.

Marvin, R., Cooper, G., Hoffman, K., & Powell, B. (2002). The Circle of
Security Project: Attachment-based intervention with caregiver-pre-
school child dyads. Attachment and Human Development, 4, 107–124.

Rosenfield, A. A., Pilowsky, D. J., Fine, P., Thorpe, M., Fein, E., Simms,
M. D., Halfon, N., et al. (1997). Foster care: An update. Journal of the
American Academy of Child and Adolescent Psychiatry, 36, 448–457.

Schofield, G., & Beek, M. (2005). Providing a secure base: Parenting
children in long-term foster family care. Attachment & Human Devel-
opment, 7, 3–25.

Siegel, D. J., & Hartzell, M. (2003). Parenting from the inside out: How a
deeper self-understanding can help you raise children who thrive. New
York: Tarcher/Putnum.

Stern, D. (1985). The interpersonal world of the infant. New York:
Basic Books

Weinfield, N. S., Sroufe, L. A., Egeland, B., & Carlson, E. (1999). The
nature of individual differences in infant-caregiver attachment. In
J. Cassidy, & P. R. Shaver (Eds.), Handbook of attachment: Theory,
research and clinical applications (pp. 68–88). New York: Guilford Press.

Worsham, N. L., & Kretchmar, M. D. (1999, April). The Children’s Ark:
A qualitative description of a model foster care program for children and
mothers at risk. Poster session presented at the biennial conference of
the Society for Research in Child Development, Albuquerque NM.

21382_Pg29-36 5/1/06 6:57 AM Page 36

1. c: Copyright 2006 ZERO TO THREE. To obtain permission to reproduce this article, please e-mail permission@zerotothree.org.