Often when we think about teens smoking weed, we think of scenes like That Seventies Show, with kids enjoying the giddy side effects and having fun. There is another side to marijuana use though, and it isn’t often talked about in the media. Cannabinoid Hyperemesis Syndrome (CHS) is a condition that is brought on by using high potency THC over a long period of time. The syndrome causes severe nausea and vomiting, and often occurs within 1-5 years of chronic use.

The medical community is slow to acknowledge how rapidly this condition is becoming more and more common. Look on-line and you’ll find established medical centers using words like “rare” and “only after long periods of daily use.” However, what is happening in my practice is I am seeing prodromal phase of this condition with an increasing frequency.

People who suffer from this condition experience three phases of the illness: the Prodromal phase, the Hyperemetic phase, and the Recovery phase. The Prodromal phase is the stage in which symptoms of abdominal pain and nausea are uncomfortable and occur mostly in the morning. Ironically, those suffering in the early phase of the illness often use marijuana to try to curb the nausea, as it is known to abate nausea in many people who are suffering from ill effects of other conditions. Unfortunately, this use establishes a pattern of worsening symptoms. In the Hyperemetic phase, the abdominal pain and nausea become productive and manifest in repeated bouts of intense cyclical vomiting. During this time, the desire to eat and drink diminishes, causing weight loss and dehydration. Taking hot showers and baths help alleviate the symptoms temporarily, but if marijuana use continues, symptoms continue to worsen. The Recovery Phase occurs when marijuana use has stopped and is out of the system. It is then possible for the person to eat and drink normally. It may feel like normal life has finally resumed, this can last for many months, unless the person uses marijuana, at which point the symptoms can re-emerge and set the cycle into effect all over again.

It does seem like a strange reality that the very substance often used for alleviating nausea can cause this type of illness for some chronic pot users. Apparently, the difference lies in the area of the body being stimulated by marijuana use. People who get relief from nausea through marijuana use experience this relief due to the impact of the substance on the areas of the brain that effect nausea. For CHS sufferers, they are experiencing the impact of marijuana use on their digestive tract. Early on in marijuana use, brain receptors are more sensitive to THCs effects;  high levels of THC marijuana usage decreases the brain’s sensitivity to the THC effects, and this can result in greater sensitivity to the digestive effects of the substance (nausea and vomiting). And todays marijuana industry is selling legally and illegally THC strengths upwards of 50% - 90% THC.

Parents of teens who use marijuana frequently may notice digestive issues emerging in their kids. Having an awareness of CHS and the stages of the illness can help parents and kids monitor these symptoms and determine if the digestive upset is being caused by marijuana use or some other cause.

Teens are skeptical of parental input regarding marijuana use, particularly if they already know that their parents are not in agreement with their usage. Information about CHS can be shared with teens as a possible medical issue brought about by marijuana use. Informing them of symptoms to look out for (abdominal pain, nausea, vomiting) and offering to arrange a medical consult may empower them to look into the condition on their own or start to observe any trends related to their usage patterns. Initially, teens who are struggling with some of the symptoms may resist the idea that it could be CHS, since the only way to reverse the symptoms is to cease all use of marijuana. As with many other areas of parenting a teen, engaging in a power struggle about it is futile. Sharing information and expressing your care and concern may show your teen that, while you love them and want them to be healthy, you also understand that they need to come to terms with the possibility that their physical health is being impacted by marijuana use, and how disappointing that must feel for them. It can be challenging to strike a balance between trying to help them “fix” the problem and encouraging them to take a look at the facts and determine it for themselves; especially since we know that their prefrontal cortex is still developing process and they actually DO need our help to make decisions and think critically! Showing teens that their thoughts and opinions are important and encouraging them to consider their digestive symptoms and whether they could be related to marijuana use is a non-confrontational way to have the conversation and encourage self-reflection.

Many teens may under report their THC use to their doctor, and with child consent laws being what they are in many states (as low as 14) you as their parent may be in the dark about the level of information your child is providing their doctors. That said, as a proactive parent, it is worth sharing your concerns to your child’s doctor about the possibility of CHS, particularly as it is still not a commonly known condition, particularly in the prodromal phase. Don’t be afraid to bring this up to the care team. Often having a doctor support the possible diagnosis and share details with your teen directly can be impactful.

Lastly, the only definitive test for CHS is to stop smoking weed altogether. While on the one hand you might think, “great! Easy fix! My kid will get better immediately, “ the truths is these higher concentrations of THC are incredibly addictive, and take more than willpower to overcome. This is why so many of my clients end up needing residential care to help them to stop. Once they begin to see and feel healthy again, they have taken the most important first step to stem a very serious medical condition, not to mention the positive impact on drug-free brain development. It is a rough road, but there is hope and help.

If someone meets criteria for a condition, it seems as though it should be equally obvious in biological males and females, right?  A diagnosis is a diagnosis, after all. Data shows us that for Autism Spectrum Disorder (ASD) this is not the case. Older data indicates a diagnostic rate of 4:1, biological male to female, but it has since been recognized that females are underdiagnosed by practitioners due to many factors. The current autism ratio is now believed to be 3:4, male to female, with eighty percent of biological females being undiagnosed until over the age of 18. 

These startling statistics show us just how significant the disparity is between male and female diagnoses of ASD. One of the reasons for this discrepancy is the ways in which autism presents in the two biological genders. Autism symptoms can also be perceived differently for males and females by mental health practitioners. Diagnosis is not an exact science. Often conditions are misinterpreted as being something else, due to overlapping symptoms. Even with this factor being noted, the number of  women misdiagnosed is greater, with forty two percent initially misdiagnosed at least once. 

Black and Latino children are also less likely to get an early diagnosis of ASD compared to white children, delaying the intervention of helpful services. Given this combination of factors, black and Latino female children and adolescents are at greatest risk for having autism missed completely or diagnosis delayed. 

One reason ASD is diagnosed less frequently in biological females is due to masking. Females with Autism are better at masking communication and sociological symptoms of autism than males; this is partially due to the increased social pressures on females to fit into behavioral norms in our culture. 

Biological females are often overlooked for ASD diagnosis because symptoms present with greater intensity in males and are more likely to be noticed from a young age. Females often do not receive a diagnosis from an early age unless they also exhibit signs of an intellectual disability. Another factor that impacts the timeliness of an ASD diagnosis is the way biological females’ special interests are interpreted. Females with ASD often focus or on topics that are relatively mainstream, such as books, celebrities and animals, and these topics are often overlooked as clinically significant by evaluators as a result. 

The ways in which biological females inadvertently camouflage symptoms makes ASD tricky to diagnose, even with standardized measures. All testing relies on human interpretation, and symptoms vary significantly between males and females, as do cultural norms. These factors make an ASD diagnosis a complex matter for girls and female adolescents. As a result, a huge percentage of females with autism remain undiagnosed until far later in life. 

Culture also plays a role. Even details such as how questionnaires for parents are interpreted and responded to during the diagnostic process can impact whether people from varying cultures receive a diagnosis of ASD. This demonstrates that when it comes to autism, testing needs to be as diverse as the human population and should include a variety of validity screening options. Specific testing for varying cultures, genders and sociological factors should be considered to provide the most accurate results.

Early intervention has always been the benchmark for social skills training for people with ASD. When diagnosis of autism is delayed, as it often is for biological females and BIPOC (Black, Indigenous, People of Color) , social skills training is also delayed. This can result in challenging dynamics for undiagnosed kids in elementary through high school and a lot of time spent struggling that could have been devoted to social skills training and practice. 

Social skills training can provide kids with ASD a framework to interpret the behaviors of others and practice the skills that can help ease social interactions. This practice can help develop a sense of self-identity and connection with others that can dramatically shape the long-range quality of life for people with autism. As autism continues to be studied and interventions are improved to include cultural and gender factors, better results will emerge for all. 

​The answer to this question is no longer limited to the binary response of “male or female”. Our culture is shifting to be more inclusive of many gender variations, and this has been liberating for so many people of all ages who have felt misrepresented by the labels assigned to them. 

Teens and adolescents are embracing gender fluidity more than any other demographic. In a 2019 study of 8th, 9th and 11th grade students in Minnesota, 1.3% responded that they identify as transgender, genderqueer or genderfluid. While this number may seem relatively small, it becomes larger when you consider this as an average for this age group across the nation and the world. Gender fluidity is actively being discussed among teens and adolescents. It is part of a growing cultural awareness that will continue to be carried forward by their generation. So, how can parents help support and validate their kids who identify as transgender or gender fluid?

Parents may wonder if their teen or adolescent is just “going through a phase.” Some kids who are exploring their gender identity may find that they do, in fact, identify with the gender in which they were born. Some may find that they do not. It is important to remember that gender fluidity is not a new concept. Native American cultures, for example, have acknowledged two-spirit people long before it became part of the mainstream conversation. 

In many ways, we are catching up to the reality that binary gender identities, much like any other two-choice situation, simply does not work. Humans are far more complex and interesting than that. Your teen may be exploring gender identity and may determine that they identify as male, female, transgender, gender fluid, or non-binary. There are many gender types; it is not a matter of “choosing” one, as much as figuring out what resonates as truth. It’s also necessary to remember that gender and sexual preference are two separate factors. A person can identify with any gender and have a sexual preference for any gender as well; one does not automatically imply the other.

No one is born knowing all the terms relating to gender identity. For many parents who have only known about the male or female gender construct, this is new territory. It is understandable that you may not know the varying terminology or how to talk about gender fluidity. As you begin to talk with your teen about gender identity, be transparent about your limited knowledge of the topic and let them know that you want to learn. 

Many kids want to talk about their gender identity, or some of the thoughts and feelings they have about it but need to know that they are in a safe space where they will not be judged, mocked, or mistreated. By creating a safe space to talk about their gender and offering opportunities to teach you more about them, you are establishing yourself as a loving, non-judgmental parent who loves them unconditionally. This environment is optimal for any child and is particularly ideal for an adolescent or teen who identifies in a non-binary way. The American Psychological Association has published findings related to best practices in treating gender-questioning youth. Those findings indicate that transgender and non-binary youth who receive family acceptance suffer less depression and have lower rates of suicide and HIV risk behaviors.  The stakes are high for kids who are gender non-conforming. More than anything, they need the unconditional love and support of their parents. It could save their life. 

A good starting point for supporting an adolescent’s gender identity is to learn more about the use of varying gender-affirming pronouns. Do you identify with your gender assigned at birth? If so, your pronouns would be he/him/his or she/her/hers. People who identify as both male and female may use the pronouns they/them/theirs. The pronouns he/they or she/they can show that someone primarily identifies as a male or female but also resonates with the identification of the opposite sex. 

At first glance, it may seem like a simple pronoun would not matter much. But when you consider how many times in a single day someone uses a pronoun in reference to who you are, it is a very big deal, especially if you are being referred to by the wrong gender. Imagine if every time someone referred to you, they used the incorrect pronoun. Males who identify as male, would probably not want to be referred to as “she,” any more than a cis-gender female would want to be referred to as “he.” While it may be commonplace to use the gender assigned at birth as their pronoun, it may be uncomfortable or inaccurate based on their internal identification of gender. By asking people what their pronouns are, we are embracing their truth rather than an assumption. 

When transgender or non-binary adolescents begin to embrace their true pronouns and be more open about their gender identity, it is common for them to choose a name that suits them. Choosing your own name that resonates with your view of self is a powerful step. Regardless of whether a person makes the decision to legally change their name or simply uses it as a nickname, it is a statement of ownership and identity and should be supported as such. 

Some may fear that by supporting their teen in using a different name, that they are encouraging them to be genderfluid or transgender. Parents need to keep in mind that by supporting and embracing your child’s name choices and gender identification, you are validating them as a person who has autonomy and sending the message that you love them regardless of how they identify and what their name is. Part of successfully supporting a gender questioning teen is to be open to the journey with them and release your fears about needing control or maintaining status quo. 

Regardless of whether you support your adolescent in their gender exploration journey, or deny their experience, they will continue to internally navigate this question of gender. Many parents would rather have their teen be open and honest with them rather than dealing with it on their own without support. Try to be patient with your teen and with yourself as you learn more about gender identity. Ask questions, even if you are nervous or apprehensive. And if you are a supportive, loving parent of a transgender or questioning teen, give yourself a pat on the back for a parenting job well done. Part of raising a child successfully is to teach them self-acceptance and compassion for themselves and others. When we demonstrate that toward ourselves and our kids, we model that value system and make it easier for them to go out into this big world and thrive. 

Addiction and substance abuse are widespread problems in our culture, and often we become so invested in the discussion about the use of substances, we can overlook underlying factors, most commonly, trauma.  Studies have shown that 70 percent of those in treatment for substance abuse have had exposure to trauma. The relationship between addiction and trauma is significant, and as we explore the recovery process, trauma work is a necessity.

Dr. Gabor Mate, an expert on trauma, shares his perspective that we need to broaden our view of trauma, since every person has an individual interpretation of what is traumatic. He suggests we look at the Greek meaning of the word trauma, which is “wound.” We tend to think about trauma as a severe set of circumstances that are life-threatening or involve a risk of imminent harm. Dr. Mate suggests that, depending on the unique factors of an individual, including sensitivity levels, genetic makeup, and nurturing, trauma can mean many different things. When we think about trauma in this broader sense, it is easy to envision the many ways in which an individual may be inadvertently traumatized, even when their circumstances do not necessarily seem “that bad” from an outsider’s perspective.

Exploring addiction as a response to trauma makes so much sense. People turn to substances as an “attempt to solve a problem”. The aspects of substance use that make it appealing for trauma survivors are:

These compelling results of substance use become the perceived solution to the problems caused by trauma. Rather than “why is the person addicted,” we should ask ourselves, “why is this person in pain?”

When substance use disorder and trauma are treated simultaneously, the outcomes far exceed siloed treatment. No one knows this better than Patrick Devlin, psychotherapist, substance abuse counselor, and co-founder of Skyline Recovery in Bend, Oregon. Devlin and his team treat young adult men with addiction, and co-occurring trauma.

In his work with young adults, Patrick has seen how trauma affects the young adult mind. He states, “we know that trauma has a significant impact on the way a person sees themselves, their sense of safety, their relationship to their body, the comfort or lack thereof in their own skin, and their ability to tolerate or feel their own feelings. When you couple these impacts with the primary developmental task of adolescence as identity development (as opposed to adults that have a fully developed sense of self), this creates the conditions for deeply entrenched negative behavioral patterns, view of the world and low self-esteem.”

Though Patrick and his team at Skyline Recovery treat each teen as unique individuals and work on the specific needs of each person in the program, he notes that there are certain types of treatment that have been particularly helpful for those in recovery with trauma histories. One important aspect of treatment is family work, as Patrick explains that “addiction and substance use is a family issue and never exists in a vacuum.”

Devlin notes that increasing awareness and educating all family members about the systemic patterns is an important first step.  He also emphasizes the importance of family members getting needed supports such as therapy, siblings getting support at school, medication, and other resources. Because it is a family issue, Patrick says that each member of the family must be aware of their own needs and boundaries, take care of themselves and ask for help with it as needed. Decreasing patterns of co-dependency is an important step in families growing and becoming healthier, even if some family members continue to struggle.

Patrick recommends tried and true resources such as 12-step programs, mindfulness-based recovery programs and Al-Anon for families. He also suggests that parents and mentors educate themselves and help young people get connected to trauma-informed care. Devlin reminds us that, “you can lead a horse to water, but you can’t make them drink (although you can help make them thirsty by not enabling self-destructive patterns). There is a point in which you have to let go and give them the space to have their own journey. Also, to try to maintain a balance between support and detachment. Healthy detachment is an art that takes a lifetime to explore, but it is THE way to best support a person struggling with trauma and addiction.”

In terms of treatment for trauma, Patrick points to the growing body of evidence that talk-therapy is not as impactful as we would like. He also states, “addiction is not a rational problem but is largely emotional in nature and about dissociation.” Devlin advises that all types of therapy should be trauma-informed and support young people to be “in their bodies, and process feelings in a healthy way.” He suggests treatments such as somatic experiencing, attachment-informed psychotherapy, EMDR and Brainspotting. Patrick also shares that ego-states or “parts” work is helpful in working through trauma and addiction.

Patrick Devlin’s path toward helping others began with his own journey of trauma healing and recovery. He openly shares part of his story in the interview, stating, “I grew up in an environment where I was struggling with things that I didn’t have words for and the only solace I found was in substances. The groundwork was laid for me to fall into addiction and eventually lead me to the proverbial rock and a hard place that so many addicts encounter.” He further shared that he had a great deal of support and after several relapses was ready to get sober. “This led me toward being of service to other people suffering as part of my recovery and I quickly found that I loved the work and the power of people making profound changes in their lives. Now I am inspired by all my clients and feel so honored to be a part of peoples healing journey. I can’t imagine doing anything else.”

Patrick refers to the role of self-sabotage in mental health and recovery. He notes that Peter Levine, trauma expert, talks about the trauma repetition cycle and the ways people get stuck. The powerless feelings and sense of victimization people experience as a result of trauma can lead to an effort to exert control and regain personal power. Though the desire for self-actualization and autonomy is a healthy one, it can sometimes be misdirected into self-sabotage. Patrick has seen this pattern play out repeatedly over his years in the field of recovery. He suggests that families make an effort not to add shame to the person going through this type of regression, as this can reinforce the pattern. “The more shame an addict feels the more avoidant, dissociated, and unconscious they become. There is a difference between having boundaries as a loved one of an addict, detaching with love as they say in al-anon, and punishing them with your boundaries because you are angry that they regressed again.”

Trauma and addiction can be treated effectively with the right interventions. Understanding one’s pain and trauma, and the underlying thoughts, feelings and beliefs that have stemmed from it can help people in recovery heal. Trauma-informed care for substance use can help individuals and their families recover, reconnect, and heal.

Sometimes when people think of Obsessive Compulsive Disorder (OCD) they have a narrow view of what the condition involves. The average person may jump to the stereotypical excessive-handwashing version of OCD, or the person who obsessively checks the stove to make sure they turned off the burner. These are examples of how OCD can show up in people’s lives, but it doesn’t tell the whole story. 

Anyone who has this anxiety-based condition or has a loved one with OCD can attest to the varying ways it can present itself in thought, feeling and behavior. The hallmark of an OCD diagnosis is the presence of two components; obsessive thoughts that are distressing and repetitious, and compulsive urges to engage in behavior to reduce the stress. It’s not exactly a picnic in the park for teens with this condition, but it is manageable with the right type of treatment.

Obsessive Compulsive Disorder responds well to Cognitive Behavioral Therapy (CBT) because it helps teens dissect thoughts and feelings, while identifying ways to disrupt the urge to engage in the behaviors that can take up so much time and energy. Often the key to breaking up with OCD is learning how to tolerate the strong urges to act on distressing thought without giving in. 

​For teens who are struggling with this, it may sound impossible; the urge to engage in certain behaviors to reduce stress is powerful, but this is the avenue toward freedom. Think of it like a workout, or a training session for your thoughts and feelings. No one starts out running a 5K on their first day out jogging or benching 300 pounds their first visit to the gym. It’s all about learning the techniques and skills that can help you become an OCD Jedi Master. 

Cognitive Behavioral Therapy also helps teens sort out some of the underlying anxieties that drive OCD. Learning about triggers is a helpful way to recognize when symptoms may become more intense. Covid-19 may be a trigger for people who struggle with fears surrounding viruses or infectious illness, for example. For some this may manifest in excessive hand washing, overuse of hand sanitizer or other behaviors to reduce stress. 

It is important to remember that the compulsive behaviors of OCD are well beyond the range of typical precaution. Compulsive behaviors are time-consuming and/or disruptive to daily life. CBT can help teens determine where behaviors make the leap into being excessive or disruptive and then work on building tolerance to the distressing thoughts. Teens in treatment can learn to use coping strategies to manage thoughts and urges rather than giving in to them. Medications can also be useful for teens struggling with OCD, but it is crucial to engage in the therapeutic aspect of the work to build skills for managing it. Often CBT is sufficient, and no medications are needed.  

​Parents of kids with OCD are often flummoxed about how to help. The best thing a parent can do is offer empathy, support, and gentle reminders of coping skills when anxiety triggers are mounting. Remember that teens who are struggling with OCD are distressed by their thoughts and that is what drives the compulsive behaviors. It may be tempting to try to convince them that their thoughts are illogical or baseless, but this approach is likely to cause even more stress, which could increase symptoms. 

​Remember, your teen will build tolerance for varying thoughts and levels of distress in therapy and will learn to trust their minds with uncomfortable thoughts. Managing OCD is about learning how to keep perspective and recognize that thoughts are “only thoughts” and do not require excessive attention or action. When people with OCD learn to allow thoughts to enter and exit the mind like a passing breeze, it can alleviate a lot of stress and often symptoms begin to subside. Even when anxiety is causing some thoughts to get stuck, treatment can help teens recognize the familiar pattern and use skills learned in counseling to get through a difficult moment without giving in to a compulsive urge. 

Parents can also do some research to learn more about OCD and the ways it can affect teens. There are a variety of great resources available, including the McLean Hospital site and Peace of Mind. Both sites are helpful for parents to learn more about OCD and varying treatment methods. Teens will enjoy BeyondOCD.org Just for Teens site. 

Regardless of where you are on your journey with OCD, and whether you are a parent or a teen with the condition, relief is possible. When you use CBT tools and practice strategies, you can manage OCD and enjoy your life.

The way we connect with each other as humans influences every aspect of life, from our daily interactions with people around us to the health of our intimate relationships and view of ourselves.  Each of us has an attachment style that typically falls within four general categories: secure, avoidant, resistant, and disorganized.

The ways we attach to primary caregivers in early life is a predicting factor of our attachment style. As a “tabula rasa”, or blank slate with no conscious awareness or expectations, infants respond to the reactions of caregivers. Infants who learn that others are not likely to meet their needs consistently sometimes develop attachment problems during their lifespan. This can mean the difference between an infant who knows their needs will be met and one who learns that their needs are a burden or illicit hostility or unpredictable responses. Data from the Early Childhood Longitudinal Study indicates that out of 14,000 kids that participated, 40% had insecure attachment. If the challenges are profound enough and negatively impact a child’s life, it could indicate the presence of an Attachment Disorder, and may warrant mental health intervention. 

​Attachment Disorder is a diagnostic term used by mental health professionals that explains a range of emotional and behavioral symptoms related to an individual’s inability to establish trusting, loving relationships. In children, this may look like behavioral outbursts and attention seeking behaviors, resistance to connection with parents and others, or conversely, indiscriminate attachment and limited boundaries with others. 

​Often when we think of Attachment Disorder, we envision scenarios that may contribute to difficulty trusting others, such as negative early childhood experiences. While it is true that disordered attachment usually stems from early interactions, it is important to consider that some issues related to attachment are not as easily explained, and in some cases, it may feel like a complete mystery.

Parents who adopt are often provided with information about attachment issues prior to adopting, to help identify potential signs for early intervention. People who have adopted from infancy, however, may feel as though their child is protected from disordered attachment, since they have been the primary caregivers since day one. Even with adoption from infancy, attachment disorder can sometimes manifest, leaving adopted parents feeling confused, riddled with guilt, and deeply saddened about their child’s emotional suffering. 

​The ongoing study of the attachment process has shown that the way we connect with others and establish trust in human relationships is complex and deeply rooted. Attachment is influenced by a variety of factors, including but not limited to the way caregivers respond to infant needs. Babies who are adopted from birth can still have attachment problems unrelated to any experiences out of the womb. This phenomenon shows us that attachment is more than just having one’s needs met at crucial times in our lives. It also happens at the microscopic level, in utero, and is impacted by neurological and genetic factors that are beyond what we can control in an infant’s world. 

We have known that trauma changes our brains for decades, but the in-utero impact of trauma on the attachment of unborn babies is relatively new information. A 2017 study of maternal lifetimes stress, cortisol levels during pregnancy and infant reactivity showed significant findings. Mothers who have experienced a greater amount of traumatic experience during their lifespan are more likely to have infants with negative affective reactions. 

The maternal Hypothalamic-pituitary-adrenal-axis (HPAA) impacts infant and toddler affect, increasing the likelihood of distress, fear, and behavioral issues. The results of this study show that the impact of maternal stress over the lifespan influences maternal neurobiology and even impact the way unborn babies develop. These changes also compromise attachment wiring in the brain.  In short, attachment problems can become intergenerational and hard-wired, even when the infant is raised in a safe, loving home.  It is no one’s fault. Fortunately, there is help for addressing attachment issues.

Attachment disorder that is hard-wired may feel futile and hopeless to manage, but it can be addressed with the right tools and support. Professional therapists offer attachment therapy to parents and children as a means of helping to mend some of the barriers that can influence attachment. Early intervention is best, but older children can also benefit from attachment work. 

​Helping children and parents connect is the focus of attachment therapy, and it is done with careful planning and in consideration of the unique needs of specific families’ circumstances. Parents who have children struggling with attachment issues can experience growth, connection, and greater attachment with a little help.