Beacon Hill Training

“Where knowledge meets experience”

Attachment and Parenting

'Attachment theory' was first described by John Bowlby in 1969.   Basically a child attaches to its caregiver in order to survive.  

Attachment is the process of how a natural bond develops between child and carer.  Attachments are built between all those who care for a child from siblings or grandparents to the parent who cares most for a child.  Each attachment is important and each different from one another, there will be one person the child will have its principle attachment to, this would be the person who is there the majority of the time, such as the child’s mother or father.

Good ‘attachments’ are essential in normal child development and are the basis of how we function throughout our lives.   If only poor attachments exist, the outcomes can be hugely negative impacting upon all areas of an adult’s ability to function effectively.

At a more in depth level it is the process of how a child learns from there caregiver all the lessons they need to know, how to trust, how to form good relationships with others resilience and effective adult functioning.  It is the corner stone of effective and well-rounded adult functioning.  Attachments as a child are the basis for how people attach to others as an adult, the basis of their relationships and the underlying foundation of how a person attaches and parents their own children.  Quite simply it is enormous.

How attachments form

As attachments are built between a carer and a young child there is a whole host of behaviors and communication going on that most of us simply do not understand, mainly because it comes naturally to us to expect this normal behavior. 

Let’s look at some basic behaviors, for caring for a child’s physical needs the caregiver receives ‘rewards’ from the child such as a baby’s smile, eye contact or gurgle of happiness.  These are referred to as ‘signaling’ behaviors’, and these help build the attachment.  A carer may be seen to ‘coo’ and to smile, pull faces and to touch a child in response.  The child’s continued attention is the carer’s further ‘reward’.  Such ongoing communication further deepens the relationship the closeness and trust a child builds with their carer.

Likewise, crying and fretting will also bring a caregiver closer to the child as they meet their needs and care for them.  These are referred to as ‘protest’ behaviors.  As the child grows, the caregiver educates and aids the child to understand and to integrate into the world around them and to socialize with others.   The role of the parent is also crucial in the child developing empathy and understanding of the actions of others. 

As the child moves on into adolescence, the care becomes more complex as the child rejects parental advice or social ‘norms’ trying to find their own ways, however, it is the existing attachment and reliance to the care giver which anchors them to that family and to feel included within a safe place.  This ‘place of safety’ is what allows an older child to explore their environment as a younger child and to explore the world around them as a teenager.

Negative attachments

Just as positive reliable attachments produce a balanced and well-rounded adult so too will poor attachments result in a poorly functioning insecure adult.  

Typical behaviors:

  • Giving inconsistent care – may only give attention when they are more lucid
  • Reactions to needs can be unpredictable, may offer comfort or show anger
  • Lack of time playing / encouraging the child
  • Little time talking or interacting
  • Lack of focus on development
  • Lack of actual time spent with the child
  • Chaotic household, different people coming in at different times
  • Exposure to unknown people
  • Lack of supervision / leaving the child unsupervised
  • Ignoring the child’s crying / basic needs
  • Giving the child the view that they are unimportant

Parenting and resultant attachments can be broadly divided into four areas:

  • Secure
  • Avoidant
  • Ambivalent
  • Disorganized

To really simplify this ‘Secure’ attachments represent positive good parenting and good relationships trust and care.  The other end of the scale represents poor parenting with carers who provide inconsistent and often frightening levels of care.  The carer rarely shows love or affection.


The area of Attachment is so important in understanding how everyone functions from a child to how people function in relationships.  Understanding attachment is essential for any professional working with children, and adults.   It helps us see how issues have developed, how they can be addressed and gives people understanding of themselves, it really is the cornerstone of the work we all do. 

This is only a very basic outline of the basic principles of attachment, there is so much to learn, if you would like to know more these links may be useful to you:

So why do people do this?

There are many reasons why people would fabricate an illness, though the most common is that there is a ‘reward’ for the abuser.   The reward may be money, for example a parent is attempting to gain additional benefits etc by exaggerating illnesses.  This really isn’t uncommon.  There are often however more complex reasons.

Other ‘rewards’ for Fabricating illness are far subtler, let me explain.  All people feel better about themselves when given praise from professionals and family and friends.  For most of us it helps to know that other people understand what we are going through, or that our lives are hard. 

For the abuser, the praise from professionals such as Doctors, Nurses, Health workers, Teachers and even Social workers for being seen as a caring and nurturing parent is the ‘reward’.   People who abuse in this and a great many other ways are not simply ‘bad people’ but fall into ways of behaving and thinking, no one starts out ‘bad’.   For the abuser in Fabricated illness it may be that they are prone to think negatively about themselves, they could be depressed or that there is another underlying mental health condition.  In cases I have seen isolation from ‘normal’ adult society that being a parent sometimes entails does seem to be a factor, people are robbed of gaining self-worth through the normal means of work and socializing for example.

For example, a starting point may be the mother who feels isolated and depressed who feels better about herself and others when professional’s friends and family tell her she is a great parent, and caring fantastic mother.  

Like a lot of things, it is a slippery slope, no one starts out as an abuser.  People slowly fall into the role of ‘needing’ to be respected and thought well of for being a caring and focused parent, they slowly begin to crave this focus and regard and so begin to seek it out, becoming reliant on this support.  It is only a small step between seeking this focus and reward to begin to exaggerate issues to gain it. 

It is often the case that a carer begins to fabricate illness in a child when a child is already ill, or particularly when the child begins to get better and there is a risk that the carers ‘reward’ is about to disappear.  

Due to being exposed to this support and positive regard of others they find they need it to carry on feeling positive about themselves, it’s like a drug, a reliance on it has been created.   It is at this point that the carer begins to do things that would indicate the child’s illness is worse than it is, this may include:

  • Exaggerating symptoms
  • Telling professionals, the child is in pain / suffering when they are not
  • Creating a medical situation, for example cutting themselves and putting the blood in a child’s nappy, or adding salt to the child’s food to make the child ill

Children suffering this form of abuse have suffered unnecessary and often invasive medical treatment, harmful medication, unnecessary surgery and even died as a result.

Fabricating behavioral problems

Fabricating illness is usually just seen as fabricating medical illnesses, it is the case however that the same rewards and positive support and regard from professionals can be gained by fabricating a child’s behavioral difficulties also.

This is something I have seen throughout my career, yet is not something that is not recognized as fabricated illness generally.  Fabricating behavioral problems is just as damaging, stigmatizing and far reaching as fabricating medical problems, perhaps more so as it enters into a child’s beliefs about themselves.

What can professionals do?

It is so important that all professionals need to be made aware of Fabricated illness and the impact of the support they give.   They need to be aware of the dangers as well as the vulnerabilities of the people they work with.  Training in this area is sadly lacking, most professionals simply are not aware of this type of abuse, mainly because it is seen as rare, sadly it is an area of abuse that is not understood or identified, and is as such vastly under reported.  It happens all the time!

Professionals in all discipline’s need to be properly trained in this area, to be aware that the carer may get ‘addicted’ to the support they give and be mindful of the behaviors that can follow.

Comments? Questions?