Building attachment from the bottom-up: Rhythms of engagement through sensory motor play

Attachment-building starts in the relationship between a newborn and a caregiver who meet skin-to-skin, eye-to-eye. Or does it begin there? Perhaps it is created, when the developing fetus is rocked in the womb as the mother moves through her world? Or when his heartbeat slows at the sound of her voice or of music? Perhaps when he kicks against the wall of the womb and the mother’s body provides resistance to his foot? Colwyn Trevarthen shows a film of a premature newborn chirping to call his momentarily distracted father back to the call-and-response they had established. A rhythm of engagement is established by the earliest hours of postnatal life.

The origins of rhythms of engagement are the sensory and motor activities of the caregiver and the intentional movement and communicative responses of the child. These earliest activities have vestibular, proprioceptive, tactile, and rhythmic components that provide rich nutrients for the rapidly developing central nervous system. But this is also the way a caregiver and child build an attachment.

Attachment, in psychological parlance, connotes the bond, or connection between the early caregiver and the child. When we have asked a caregiver or therapist whether they feel attached or not to a child, they invariably can identify moments of feeling connected and moments of disconnection with a child. A sense of connection is something one intuitively feels. But children and teens traumatized in the early years of life often suffer from a severe difficulty in sustaining connection with others and this gets labeled insecure or disorganized attachments, or in some cases, reactive attachment disorder.

For these children and teens, their rhythms of engagement were never securely established. For some, the caregiver has changed so many times, or been so absent that rhythms do not become rooted in the child’s body and mind. For others, the child’s earliest caregivers have alternated between engaging and frightening the child. This child gives signs of longing for connection, but disrupts the connection by fight, flight, and freeze responses, thereby confusing caregivers with their unpredictability. As Beatrice Beebe shows us in her microanalysis of mother-infant videotapes, these problems are already visible – and intuitively felt by viewers – in the responses of four-month-old infants to their mothers.

Therapists of these children are charged with operationalizing attachment. This means putting the theoretical construct into motion and creating new action patterns that children and caregivers can learn, embody, and enact many times together.

In our SMART work with children, youth, and families, we have focused our attention on building “rhythms of engagement” between child and caregiver that are grounded in sensory motor play as a way to develop, repair, or enhance attachment bonds. We named this therapeutic process attachment-building because it highlights the dynamic nature of full body mutual engagement between child and adult. Sensory motor play is the key to this process. This type of play does not start with language or symbolic thinking, but rather engages the full body as a bottom-up route to connection and communication.

The best way for you to understand how this works is to try it yourself. Here is a simple experiment to do with a partner.

This exercise demonstrates the elements of this sense of connection. In therapeutic work, the pattern of serve-and-return creates a rhythm of engagement in the body. This is a rhythm in connection – what Trevarthen called “playful duets of agency” (2009, p. 243) – for which a newborn is already available. And this sensory motor-based rhythm – through fully engaging the body – invariably changes the mood of participants to one filled with a sense of fun, laughter, enjoyment, and pleasure in each other’s company.

A starting point for families impacted by trauma is to remember to turn to such games when wishing to feel connected. Therapists can help by collaboratively creating new rhythms of engagement through sensory motor play with caregiver and child. The sense of connection that each person experiences is often the fuel needed to carry over these rich opportunities for attachment-building to home, and then on the shoulders of that sense of connection, the tougher issues can be faced.

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