Attachment Syndrome


Chapter 7:

"I can sit down with her on my own," she bites out, dropping into one of the uncomfortable chairs at the side of the room.

He bites his tongue and nods, sitting down next to her and placing Johanne's bag beside her feet. He quietly sets about doing the paperwork as she gnaws on her lip, her hands absently stroking Johanne's back. The baby, unlike the two of them, is blissfully asleep.

They managed to get an appointment with Dr. Frailey's recommended childhood psychologist, Alan Goldstein, for just after nap time. So Johanne is happily asleep in her mother's arms, while it looks like Beckett is about to worry herself into an early grave.

"Kate," he murmurs as he finishes off his contact information below hers under 'Emergency Contact.'

"What?" she snaps.

He stares at her. She's been testy all morning, jumping at him every time he's said anything un-baby related. She's twitchy, and even the two cups of good coffee he brought her haven't seemed to help.

"I can go, if it would be easier," he says timidly. He doesn't want to leave them alone for this. But Johanne isn't his, and it seems like he's not helping today.

"What?" she asks, her face falling open. "No, I don't—don't go," she says quietly, glancing around at the few other parents in the room.

"Okay," he says, nodding at her. "Okay. I'm gonna give the paperwork back, unless you want to add another contact."

"You put yourself down, right?" she asks him.

"Yeah."

"Then no. You'll call my Dad if they need him for something," she asserts.

He bobs his head, then stands and gives the receptionist the papers. He looks around as he walks back through the waiting room. Most of the children are much older than Johanne. A few play with blocks, others sit sullenly with their parents, looking as out of place as he feels in this office. It can't be easy to be in therapy as a little kid. At least Johanne doesn't know what's going on.

But Kate does. And she's as anxious as he's ever seen her—no trace of the stone-faced Detective to be seen. She's all mother today, and she is seriously uncomfortable.

"Why aren't you more jittery?" she demands as he sits down next to her.

"What?" he lets out, louder than expected. Johanne twitches in Kate's arms and they both wait, sighing when she settles back against her. "Sorry, what?" he adds, softer this time.

"You look so calm," she says, and it's obvious to him that she's not pleased with him for it.

"You can face down bullets without flinching," he replies.

"And that applies here how?"

"I have a parent poker face. You have a cop one."

She glares at him. "Seriously. You're going with poker face?"

"Do you want me to be anxious, because I can be. But if I'm coming in there, one of us should be calm, don't you think?"

"If—Castle why are you asking if you should be coming in? Of course you're coming," she says quickly. "Aren't you?" She meets his eyes for a moment, and he sees the total insecurity there.

"Of course I am," he agrees, reaching out to cover her hand on Johanne's back. "I just didn't…want to presume."

"Of all the times, you choose now to back off?" she whispers.

He smiles and pulls back, nodding. "Sorry."

She huffs but doesn't dislodge his hand. She wants him in there with her. Of course he wants to go in. He's incredibly attached to the little girl in her arms, and to her (but he won't think about that today). He just wasn't sure she'd want him there, what with all of the snapping and irritation he's seemed to incur today.

"You have her half of the time," Kate says, breaking him from his thoughts. "You know her almost as well as I do." He nods and bumps her shoulder with his. "Thanks for asking though."

He smiles. Of course he'd ask. Dogging her at the precinct is one thing. But this is her daughter. He's not sure he would appreciate his presence as much in her shoes.

"Johanne Beckett?"

They both turn at the sound. "Show time," he whispers, nodding to the assistant while Kate gently wakes Johanne.

The baby blinks up at her, but doesn't cry. "Hey girlie. We're gonna go have a talk with a nice…man," Kate tells her as she follows Castle to the patient hall.

He laughs quietly as they follow the assistant, a tall, kindly looking kid.

"What?" Kate mumbles, falling into step beside him.

"I don't think she knows what doctors are."

"The last time we went to one, psychiatric or otherwise, she keened for six hours," Kate grumbles.

"Right, my mistake," he says as they follow the kid into an office full of natural light and dark-wood furniture.

"Dr. Goldstein will be with you shortly," the young man tells them.

"Thank you," Kate says as he closes the door with a smile.

Castle sinks down into one of the two arm chairs across from the mahogany desk, watching as Kate hovers by the door with Johanne. After a moment, she seems to recover herself and sits down next to him, leaning Johanne away from her body.

"Did you have a good nap, sweetie?" she coos, smiling as Johanne turns to look at her at the sound of her voice. He watches their eyes connect for a moment before Johanne breaks the gaze and turns her head to look at the room.

It gives him hope. She may not stare them in the eye, but she does connect, if only briefly.

"She knows the sound of my voice," Kate says quietly.

"Mine too," he agrees.

"That's developmentally up to speed," Kate adds. "And she can support her neck. She even sits up with help, you know?"

"She's doing great," he says confidently. "This is just…to help her do greater."

"To help her do greater?" Kate repeats, looking over at him, amusement beneath her anxiety. "Really?"

"What? It would make a good children's book title. Story about the little hippo whose mother takes her to a nice elderly hippo so she can learn to trust her hippo teacher."

Kate cocks her head. "How's your book coming?"

He shrugs and she laughs just as the door opens.

"Hello Ms. Beckett. Mr. Castle," Dr. Goldstein says as he comes to stand at the side of the desk.

Castle stands and shakes his hand, steadying Johanne for Kate as she does the same. The man has kind eyes and a friendly smile. Castle can see how he'd be good as a children's therapist—tall but not too tall, kind looking, affable.

"And who is this?" Goldstein asks, reaching out to touch Johanne's hand as Kate turns her around to look at him.

"This is Johanne," Kate tells him, her voice light and easy. So she does have a baby poker face, just not in front of Castle. Interesting.

"Hi Johanne," the doctor says. Johanne doesn't seem to acknowledge her name, but does look at him for a brief moment, before trying to turn to look back out the window.

"We call her Josie," Castle adds. Johanne turns a little at his voice. "Don't we, bug?"

"And bug," Kate adds with a small laugh. "I—that one's my fault."

Dr. Goldstein laughs and sits down behind his desk, gesturing for them to take their seats as well.

"That seems like a good nickname to me," he says kindly. "Now, you indicated on her chart that she's having issues with eye contact?"

Kate nods, shooting Castle a grateful look, since he was the one filling out the paperwork.

"She doesn't make eye contact with anyone but me and Castle—me and Rick," she corrects. "And not for that long with either of us, really."

"You adopted her not long ago, is that correct?" Goldstein asks, looking between them.

"Oh," Kate lets out. "I—well, I adopted her. Castle's been…watching her during the day."

"While Kate's at work," Castle supplies.

"Ah. So you stay home with the baby, Mr. Castle."

"No," he says slowly. "I—ah, we're not together."

"Oh," the doctor says, surprised. "My mistake. I'm sorry."

"Happens." "People always do," they mumble together.

Goldstein chuckles and looks between them. "So, regardless of the…nature of your relationship, you spend equal time with Johanne? Separately and together?"

"Yes," Kate supplies. "And she's doing well, all things considered, but she just doesn't seem to…connect. I mean, she recognizes my voice, and Rick's, and she laughs, smiles, you know. But it's not—" Kate huffs and looks over at him.

Yeah, because he's going to do this better?

"She just seems detached," he tries. "I live with my daughter, who's seventeen, and my mother. And they're there a lot of the time when I have Josie, but she hasn't warmed up to them much. It's been three weeks of having her in my loft five days a week, sometimes more, depending on Kate's work schedule, and she still won't meet my daughter's eyes, won't cuddle with my mother."

"Does she cuddle with you?" Goldstein asks.

"I guess," Castle says slowly. "But not really. She lets me hold her, and she'll get cuddly when she's very tired, but otherwise, she doesn't really snuggle. She just…sits in my arms, or leans on me. It's not like it was with my daughter, who would kind of curl into me."

"She snuggles with me sometimes," Kate adds. "But not a lot. And only when she's had a really good day."

Goldstein nods and stands. "Could I hold her?"

"Of course," Kate says quickly, standing to hand Johanne over.

They watch as Goldstein walks back to his chair and sits, holding Johanne out so he can look at her. "Hi Josie," he says gently. "I'm Alan."

Johanne glances at him then looks away, squirming.

"She didn't warm up to any of the male doctors at the hospital in Haiti," Kate pipes up. "And she still cries when my dad holds her."

"She's not crying now," Castle observes. Johanne orients herself slightly toward his voice.

"But you're both here," Goldstein says easily. "Josie." Johanne doesn't look at him. He takes a hand and gives her stomach a tickle. She squeals them immediately quiets, peering at him, or just past him, Castle thinks.

"She does respond positively to touch," Goldstein tells them. "And you say she laughs and smiles?"

"Yes," Kate says, sitting on the edge of her chair now, hands clasped tightly in her lap.

"Mr. Castle, does she respond positively to you even when others are around?"

"Yes," he replies after a moment of thought. "Though, she's slower to laugh sometimes if she can see Alexis—my daughter. Slower still in front of my mother, actually."

"At whose home does she spend more of her time?" the doctor asks as he shifts Johanne in his arms, holding her close. Castle can see the tension in the baby's frame, the way she doesn't relax into the comforting embrace.

"I guess," Kate begins, looking over at Castle. "Yours?"

"Really?" he wonders.

"Well, she sleeps at home, but she's…asleep for most of that. Then we get ready and go to yours, then we usually hang there for her last bottle, and I take her home already asleep. And there are weekends, but I usually have to work at least one day."

"Huh. Yeah, mine, I guess," he agrees, a little startled to realize it. He hadn't thought it was so much time, really. But perhaps that's because Kate's gotten into the habit of hanging out when she comes to pick Johanne up, and he doesn't consider that time just his.

"Ms. Beckett, is Johanne as comfortable, in your opinion, when she's at home?"

Kate opens her mouth, then shuts it. "Usually," she says, contemplative. "But sometimes I think she's happier when we're at Castle's."

"See, I think she's more comfortable when I bring her home to you," Castle argues. "She's so happy to see you."

"But only when she's coming straight from you to me," Kate tells him. "If my dad has her, and I come home, she just huddles with me, doesn't really smile. But if you pass her off, she's all giggles."

Dr. Goldstein coughs and they turn back to him, sheepish. They hadn't really meant to…build theory in front of him.

"Based on what you've told me, what Johanne seems exhibit, in my opinion, are rather textbook early warning signs of Reactive Attachment Disorder. She's inhibited in her responses to most known caregivers, but is slowly warming to the two of you. I'll bet after she giggles she seems to withdraw."

Both he and Kate nod slowly. Reactive Attachment Disorder. God, that sounds bad. That sounds so bad.

"It's not an incredibly common disorder, but we do tend to see it in children who have experienced neglect, abuse, or trauma. How long was she at the clinic, Ms. Beckett? Do you know?"

Kate blows out a breath and rubs a hand over her temple. "A month, maybe two?" she offers. "Her mother was killed in a border dispute, and as far as I know, Johanne was dumped at the clinic almost immediately."

"Do you know if she was there when her mother was killed?" Goldstein asks, his voice soft.

Oh, God.

Kate goes sheet white, her mouth hanging open. Her face has him reaching across the small gap between the chairs to take her hand. Did Johanne see her mother killed?

"It's all right if you don't know," Goldstein assures her. "I just wonder. It would be easier to know the severity of the trauma if we knew what she'd experienced. Even so, at the age of perhaps a month and a half, she wouldn't have understood it. The lack of care following her mother's death, however—the abrupt disappearance of nurturing and care—that can have a lasting effect."

"It's fixable, though, right?" Castle manages as Kate squeezes his hand. "She can—she can learn to trust? I mean, she already does, a bit, right?"

Goldstein smiles at both of them, rubbing Johanne's back as the baby begins to fuss. "Very 'fixable,' Mr. Castle. You're already doing a great job of getting her acclimated to nurturing care. And as I said, I believe she's showing indicators, but it's hard to know for sure. She's quite young, so we can develop a plan to help her begin to trust, so when she gets old enough to form truly lasting attachments, she'll be able."

"She's too young to attach now?" Kate lets out.

"No," Goldstein says easily. "No. Obviously, she has preferences between caregivers, recognizes the two of you as her primary safe figures. But, developmentally, we believe children form true lasting attachments—clear cut attachments—at around eight months. However, without proper care, she might not form any attachments at all, and that can lead to a host of problems. What we want to do right now is build her trust and help her build her sense of security that can grow into attachment, so when she's old enough to, she'll be happy and healthy and able to trust and attach to people, yourselves included.

"In older children, and with more severe cases, I would recommend family therapy and perhaps even inpatient therapy. However," he says quickly as both Castle and Kate blanch, "in this case, I'll recommend home strategies and therapies to help her adjust and re-develop her trust and her understanding of her needs. She probably doesn't always cry when hungry, correct?"

"She usually does," Kate says quietly.

"Not always," Castle replies at the same time.

"That's understandable," Goldstein tells them as they look at each other, confused. "Ms. Beckett, you've had more contact with Johanne than Mr. Castle has, overall. And I'd be willing to bet that the nurses at the clinic were dominantly female, yes?" Kate nods. "So she understands feeding as a dominantly feminine need—a need of hers that women fill. When she cried, men never came to help her."

"But she does cry with me," Castle protests. "Just not all the time. Days when Kate's out later, she doesn't always cry when she should need a bottle at dinner."

Goldstein nods just as Johanne begins to whimper. "How about we pass her back to you, Ms. Beckett."

Kate nods and goes to stand up, but Goldstein shakes his head, coming around to hand her Johanne where she sits instead. He then moves to lean against the desk in front of them, looking between them with a smile as Kate coos at Johanne and Castle reaches over to smooth a hand over the girl's head.

"My first recommendation," Dr. Goldstein begins, bringing their attention back to him. "Is that you choose one home, and stick with it."

There's a short pause. "What?" Kate says inelegantly.

"Well, it seems to me that both of you provide the same level of care to Johanne. My usual recommendation for infants with his condition is to drastically limit the number of caregivers the child interacts with. Passing a child with a developing or full blown attachment disorder off to person after person can prevent the child from attaching to any one person, perpetuating the infant's belief that no one stays around, so there is no reason to trust each new person. The longer this keeps up as the child develops, the more ingrained the belief becomes."

"But—so that's your usual recommendation," Castle gets out, his head reeling. Choose one home? What does that even mean?

"But," Goldstein continues. "Mr. Castle has as much contact with Johanne as you do, Ms. Beckett, so it would be detrimental to suddenly deprive her of that contact, especially given her particular distrust in men."

Kate bobs her head, holding Johanne close. "So, what does that mean, exactly? She needs to see Castle every day? She does that already."

"But at the end of the day, Mr. Castle's gone. She still wakes in the middle of the night, doesn't she?" Goldstein asks gently.

"Yes," Kate admits.

"And Mr. Castle never comes at night when she cries. So, to her, it might make sense that Mr. Castle will never come when she cries."

"That's why she doesn't cry when it's dark out?" Castle asks, the bricks falling into place.

"Infants understand much more than we realize, and than they realize as well."

"And to fix that…Castle has to live with me?" Kate asks, looking up at the doctor in confusion—but not disgust, Castle realizes.

"I would recommend that the two of you simply spend a month or two with her. A leave of absence from work would be my first suggestion, but I realize that isn't always possible. It usually isn't, given this economy." Castle watches as Kate's eyes shutter, as she presses a kiss to her daughter's head. "That's not to say, Ms. Beckett, that she will not recover if you can't just take an extended absence. That is actually why I'm suggesting the two of you choose a home for the next few months. Six would be my best recommendation. That way, Johanne has stability. She'll develop an understanding of the day. Mommy sees her in the morning, Da—Mr. Castle sees her during the day, Mommy comes home at night, and both of you take care of her overnight."

They just stare at him. Is he really suggesting they…play house for six months?

"In addition to cohabitation, a schedule is very important. I would suggest you try and get her feedings onto as much of a clock as you can, with an infant, of course. Trips to the park, or outings should happen around the same time each day. Any time she spends with anyone else should be scheduled and regular. However, I would recommend that she not have any interim caregivers, and that you drastically limit the time she spends with anyone else."

"My daughter and my mother? They're—well, I don't know where we would stay," he trails off.

"The loft," Kate interjects. "Don't be stupid, Castle."

He just gapes at her while Goldstein laughs.

"Your daughter and mother can be around, but I would limit any physical contact they have with Johanne to less than an hour a day. Get her fully comfortable with the two of you, then begin to give the two of them, and your father, was it?" Kate nods. "And your father more time with her."

"For six months? No one should even hold her?" Kate lets out. "Doesn't that…isn't that counterproductive?"

"I would say after the first month, you should see great improvement in her relationship with both of you. After that, go by her comfort level. See how much she tolerates. She may even start to reach out for one of you if she feels unsafe. That's what we're hoping for—that she develops an attachment to you where she reaches for you when she's upset, when she's hurt, when she's scared. We want her to look to the two of you when she needs something, the way a baby should."

"The two of us," Kate repeats.

"I realize this is an unusual situation," Dr. Goldstein interjects. "And that you are not…together. And of course, if you feel it will ultimately be a detriment to have her become truly attached to Mr. Castle in this…capacity—"

"No," Kate says quickly. "No, she—Castle's great. It's just, this feels permanent?" she concludes, glancing over at Castle.

It basically sounds like he's about to become Johanne's father for all intents and purposes, for the foreseeable future, and beyond. How can he step back if he's the one she gets attached to—if he's who she learns to trust? He can't.

He doesn't want to step back.

"That's a big commitment that I can't just foist on you," Kate says.

"'Course you can," he says gruffly. "Told you. I'm your partner. I'm in this."

Goldstein observes them as they stare at each other, Castle hoping Kate can read the dedication in his eyes while he tries to figure out just what is making her eyes so full, so open.

"In terms of the day to day," Goldstein begins, waiting until they break their gaze and turn back to him. "I also recommend holding time."

"Holding time," Castle repeats.

"In the NICU, we call it kangaroo care, where a parent sits with the child, skin to skin, to help keep their body temperature up. Obviously, this isn't for Johanne's health, so-to-speak, but skin to skin contact can help an infant develop attachments. I'd recommend an hour of it with each of you, every day if possible. Just quiet time with you and the baby. Some mothers in particular enjoy holding time in a bath," he adds, giving Kate a smile.

Kate nods at him, bouncing Johanne gently when the girl sniffles. "Anything else?" she asks. "Sorry, I mean—is there more we should be doing?"

Goldstein gives her an understanding look. Castle likes this guy, even if he's just turned everything on its head.

"No, Ms. Beckett. I think that's basically it in terms of home care. I'd like to have you come in once a week, both of you, if possible, to get an update, so I can help with any problems that arise as you move forward. Therapy can be very helpful throughout this process, not just family therapy," he says, indicating the three of them.

Family?

"But personal therapy as well can help parents adjust to the challenges of helping their infant through this. It can also help shed light on any attachment issues either of you have had, so perhaps you can identify more with your—with the baby."

They stare at him, in shock and rather unable to come up with pleasantries.

He smiles at both of them. "I'll leave you two for a few minutes. See Angela on your way out to set another appointment, or a weekly, if you can plan ahead." They nod numbly. "For what it's worth, I think the two of you will do wonderfully by Johanne. You have already made a great deal of progress, and I have confidence you'll continue to do so."

"Thank you," Kate manages as the man stands and makes his way to the door.

"It was my pleasure, Ms. Beckett. Mr. Castle."

With that, he leaves, shutting the door behind him.

They sit in silence for at least a minute, Johanne's soft gurgles the only sound in the office.

"I—we," he tries, but closes his mouth, unsure of what to say. "You want to move to the loft?"

"Yes," comes her sure reply. He turns, surprised, and finds her looking down at Johanne. "I can't ask you to move in with me. You have a daughter too."

"I do," he agrees inanely.

"And you have all of her stuff there. You have a guest room. I don't."

"Right," he agrees, watching as she slowly looks over at him.

"Are you sure? Really sure?" she says softly. "'Cause I think this is the fight or flight moment, Rick."

That gets him.

It's now or never. He doesn't know if he's ever going to get the girl, so to speak—can't even consider it right now. Johanne is his number one priority, and for her, he'll do just about anything. And if the fates decide to give them an easy pass as well, he'll take it. But for right now, he can do this. He can make the right choice for the baby in her arms, for her daughter.

He stands and moves to kneel down in front of her, reaching up to stroke Johanne's back. The baby turns and gives him a glance before resting against Kate's chest.

"Wanna play house, Beckett?" he asks, pulling a binky out of the baby bag with his free hand.

She laughs, covering her mouth with a hand, her eyes shining. "Yeah, Castle. Okay. Let's play house."