Entropy Rules

Mindfulness Of Emotions:

Attachment Relationship Parenting Issues

    It has been historically difficult to create interventions that are effective at reducing child maltreatment risk in this population, who often live in circumstances including multiple cumulative risk factors (e.g., substance abuse, low socioeconomic status, partner abuse, low spousal support, etc.; Dawe & Harnett, 2007). In general, it appears that success with this population is more likely when parental mental health is a focus of treatment (e.g., Bakermans-Kranenburg et al., 2005). One such program that includes mindfulness is the Parents Under Pressure (PUP) program (Dawe, Harnett, Rendalls, & Staiger, 2003). A unique feature of this program is it includes mindfulness skills training to promote parental emotion regulation. An initial pilot study produced promising results, specifically clinically significant improvements in parental and parent-child relationship functioning and reductions in parental risk factors and risk behaviors (Dawe, Harnett, Rendalls, & Staiger, 2003). Next, a randomized controlled trial was conducted, which compared PUP to a brief parent training group and "standard care group" (Dawe & Harnett, 2007). Participation in PUP led to reduced child abuse potential, including reduced problematic parenting attitudes, as well as reduced child behavior problems. While the brief parent training group also led to reduced self-reported child abuse potential, it did not have the beneficial effects on family functioning observed in the PUP group. Individuals in the standard group demonstrated significant worsening of problems, in contrast (Dawe & Harnett, 2007).
    Mode Deactivation Therapy (MDT) is an empirically supported type of family therapy that incorporates mindfulness and acceptance for treating adolescents with behavioral problems and multiple mental health issues. Swart and Apsche (2014) found that Mode Deactivation Therapy was superior to Cognitive Behavior Therapy in reducing problem behaviors, especially internalized affective distress and reactive aggression, in a sample of male adolescents with histories of child maltreatment including physical abuse, sexual abuse, and neglect (Swart & Apsche, 2014). While MDT does not exclusively target parents, what this study illustrates is that mindfulness-based intervention can reduce risk factors in adolescents, who may lack emotion regulation skills in ways similar to adult survivors of child maltreatment.
    In a different study, Altmaier and Maloney (2007) tested the Mindful Parenting Program (MPP; Placone-Willey, 2002) in a small sample of White, recently divorced parents with preschool age children. The MPP is a program designed to increase parental mindfulness in the service of enhancing the parent-child relationship by replacing problematic interactions (e.g., parental actions characterized by withdrawal, anger, or criticism and humiliation directed at the child) with positive parenting. The 12-week program led to significant increases in parental self-reported state mindfulness. However, no changes reported or observed in the parent-child relationship were found. The authors speculate that this nonsignificant finding may be due to the short assessment period (Altmaier & Maloney, 2007). Alternatively, another interpretation is that within the highly stressful context of divorce, maintaining a consistent parent-child relationship (rather than a degradation of parent-child relationship quality) may be considered success.
    Mindfulness-based parenting interventions have also been found to yield positive effects in populations of parents of children with autism spectrum disorders (Cachia, Anderson, & Moore, 2015), ADHD (Van der Oord, Bogels, & Peignenburg, 2011), and developmental delays (Lewallen & Neece, 2015). While the literature on mindful parenting of children with ADHD or developmental delays may at first seem only tangentially related to the issue of mindful parenting to reduce intergenerational transmission of child maltreatment, it is still of interest to note that mindfulness-based interventions have been used successfully with parents who deal with highly stressful parenting contexts, which may resemble exceptionally high-stress parenting situations experienced by some adult survivors of child maltreatment. For example, parents and children with diagnoses such as ADHD often have disturbed relationships characterized by excessive parental stress, overreactivity, and negative attentional bias, which in turn has been shown to predict even more externalizing problems (Deault, 2010; Dumas, 2005; Johnston et al., 2002)
    Considered together, the burgeoning field of mindful parenting and the documented benefits of MBPIs suggest mindfulness may be a beneficial means of enhancing the attachment relationship (e.g., Medeiros et al., 2016). In particular, mindful parenting seems to predict better communication between parents and children (e.g., Lippold et al., 2015), and more effective parenting behavior (e.g., Parent et al., 2016), while other evidence illustrates that children with mindful parents enjoy better mental and behavioral health outcomes (e.g., Parent et al., 2016b).
    However, one of the main limitations of this entire body of research is that it largely ignores issues of early life adversity and current environmental risk. Excluding more parents with more complex mental health histories from studies investigating mindfulness and parenting may lead to more predictable data, but does a disservice by ignoring one of the most vulnerable populations that is in need of effective intervention. Given that child maltreatment is estimated to contribute enormously to public health costs, it is arguably even more important to begin to test MBPIs in high-risk samples that experience above average levels of risk factors with fewer resources to cope. The literatures to date on MBIs and MBPIs are promising, but it is essential to investigate its efficacy among adult survivors of child maltreatment, who were exposed to toxic stress during sensitive developmental periods, as this population may differ from the general population of parents in significant ways.
    Secondly, most cross-sectional studies on this topic fail to measure and account for exposure to formal mindfulness practice, and some MBPIs do not include any formal practice. This too is unfortunate since it limits our ability to discern the extent to which engagement with formal mindfulness meditation practice or other forms of MBIs can influence the development of better parenting over time. The information reviewed earlier in this manuscript describes how mindfulness, especially mindfulness meditation, has been linked to beneficial neurobiological, emotional, and cognitive effects. A logical next step is to study causal relationships between formal mindfulness practice and improvement of important neurobiological, emotional, and cognitive parenting capacities (e.g., enhanced neural connectivity, more effective emotion regulation, reduced impact of maladaptive schemata). Combined with an emphasis on multimethod study designs, this would represent advancement in the field, which has potentially over-relied on intercorrelating mindfulness self-report measures (e.g., parental trait mindfulness, mindfulness in co-parenting, mindful parenting as in the Parent et al., 2016a study), when such findings could simply represent common method variance. Thus, it is also recommended to begin to include other types of data as well (e.g., psychobiophysiological; behavioral observations).

⇲ About The Author

Robin Hertz, MA is currently in the process of completing a PhD in Clinical Psychology at the University of Oregon.