Dan Hughes: The “Magic Man”

November 4th, 2011

By Amber LeFevour LMFT, HCC Psychotherapist

During the last week of October, Chicago was graced with the presence of Dan Hughes, the creator of Dyadic Developmental Psychotherapy.  He spent an entire Sunday with parents, giving them a more in-depth look at his model, and how to use it every day with their children.  His expression of using the PACE model really brought the concepts alive and helped parents understand their children’s inner world so that they could respond in a way to further promote healing.

He then spent four days at the Theraplay Institute in Evanston to share his knowledge with therapists looking for a new way to reach the children they serve.  He gave a detailed explanation of Intersubjectivity, which is the core process of attachment formation in infancy.  He described the ways in which an infant responds to their mother, and vice-versa.  The consistent modeling of each other through facial expression and voice tone help to create the infant’s view of himself in the eyes of their mother, or primary attachment figure.  The infant comes to experience himself as loved and lovable, and thus creates a sense of self that displays confidence in self and empathy for others.

In some instances, this pattern does not occur, particularly when children experience orphanages, abuse, or neglect.  Multiple caregivers for infants in orphanages disrupt the consistency of experience, and leads to confusion about when or if the infant will have his needs met.  Abuse and neglect give the child an inner self of being unlovable or unwanted.  In all instances, the child creates a sense of shame about herself causing a retreat from the world or other caregivers.  Alternately, the child may be very clingy with caregivers, out of fear the child will not survive if the caregiver is out of site.  Often, children will vacillate between pushing their caregiver away and pulling them close, depending on the level of shame and fear they may be experiencing in the moment.

The issue of shame for many children who have experienced trauma in early childhood runs deep to the core of the child’s experience of himself as a human being.  This is his central frame of reference for who is he and how he acts.  Therefore, we experience children who act impulsively, are not concerned with external consequences, and have difficulty understanding and feeling how their behavior affects others.  This really drives home the purpose of Empathy in the PACE model.  During the four days of training with therapists, Dan Hughes really emphasized the role of empathy.  In fact, it seems that when empathy is active, the other pieces of the model seem to emerge more naturally.  When parents truly understand the child’s experience, they have a greater ability to offer acceptance.  And when parents are trying to express empathy for the experience and understand how the child feels, they will find that curiosity shows up, without judgment.  Playfulness becomes much easier with a child that parents do not experience as being manipulative.

To watch Dan Hughes use the model in therapy is absolutely enlightening.  He displays empathy and curiosity continually, and helps the child and parent feel as if they are finally understood.  He goes back to the initial attachment behavior that would be expected as an infant. He focuses on matching the tone of voice and the emotional charge of the child’s experience, as a mother does with an infant. If the child expresses anger, he raises his voice and mimics their behavior. If the child shows sadness and tears, Dan will lower his voice and join the child in that moment of sadness.  Meanwhile, he gives them words for their experience, so that they can start to have a verbal expression for their feelings and their sense of shame.  The child is then able to realize that they are feeling sadness because they were hurt, but that sadness is not the core of their person.  At times, Dan Hughes will also incorporate touch, as appropriate, to help create a deeper bond between the child and their attachment figure. In many of his videos showed to therapists, he had the family embracing the child in a nest of love, while the child cried about their story and their shame.

There is a clear distinction, however, between empathy and validation.  Many parents and therapists fear that if they express empathy for the child’s perspective, then the child may not understand that their behavior was wrong.  A common question is: “How can I portray empathy for her feelings, without letting her feel that the behavior was okay?”  Dan Hughes expressed empathy with key phrases that help put the focus on the feelings of the child and the experience of the child, rather than the outcome or the behaviors.  He said things such as, “Wow, that must have been hard for you.  It would be so hard to be teased by someone you thought was a friend.  You just wanted the teasing to stop, and hitting seemed to be the most effective method, because you’ve seen it work in the past.  I’m so sorry that you had to experience that.”  In this way, the parent has validated the feelings and the experience of the child, but has not condoned hitting.  As a consequence for the behavior, the parent will reinforce safety with the child, by suggesting that the child needs to stay close to them.  This also helps reinforce the attachment relationship with the parent, and lets the child know that the parent will keep them safe.  When the child is able to experience the parent as empathetic and still wanting to be around them, even after an unsafe behavior, they begin to recreate their sense of inner self, to believe that they are a lovable child.

Clearly, this process does not occur overnight.  Since a child’s brain is wired for attachment early in life, it may require a lot of reworking before the brain starts to rewire.  During this process, empathy seems to have such an important impact on the child to reduce his sense of shame and begin to experience himself in a new way.  This model can be very difficult at times, and it’s natural for a parent to feel as if they have screwed up or ‘lost it.’  In this case, Dan Hughes emphasizes the importance of repair.  Parents are only human, and dealing with a child with an attachment disturbance may be the hardest job on the planet.  No one can be expected to be on target all the time.  In fact, having these instances, and effectively repairing, teaches the child a very important lesson: it’s okay to screw up.  For children with intense shame, they will often feel as if they are screwing up, and they will lie about it, hide it, and try to get away with it at all costs.  This is most infuriating for parents, and seems to go against all logic.  Try to use PACE to really understand the child’s experience, rather than focusing on the behavior. And when that fails, as it will sometimes, be sure to follow up with an effective repair.

The Dyadic Developmental Psychotherapy model created by Dan Hughes seems to be one of the best available tools to help children with any sort of attachment disturbances.  After four days with him, the therapists walked out feeling as if empathy could save the world!  Truly, we could all use a little more empathy in our lives, so it makes perfect sense that our children would need it consistently and constantly.