Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective.

Florien Meulewaeter,Sarah S W De Pauw,Wouter Vanderplasschen

doi:10.3389/fpsyt.2019.00728

Abstract

Background: A growing body of research underlines that interpersonal trauma in childhood leads to heightened susceptibility for substance use disorders (SUDs) in later life. Little research has been conducted on parenting experiences of mothers in recovery from substance use, taking into account their own upbringing as a child and the potential aftermath of interpersonal childhood trauma. Methods: Through in-depth qualitative interviews, 23 mothers with SUDs reflected on parenting experiences and parent-child bonding, related to both their children and parents. Interviews were transcribed verbatim and data were analyzed adopting thematic analysis. Results: Throughout the narratives, consequences of trauma on mothers’ sense of self and its subsequent impact on parenting arose as salient themes. Five latent mechanisms of intergenerational trauma transmission were identified: 1) early interpersonal childhood trauma experiences in mothers; 2) trauma as a precursor of substance use; 3) substance use as a (self-fooling) enabler of parental functioning; 4) continued substance use impacting parental functioning; and 5) dysfunctional parental functioning and its relational impact upon offspring. Discussion: Findings suggest disruptive attachment can increase the vulnerability for SUDs on the one hand, but can be an expression of underlying trauma on the other, hence serving as a covert mechanism by which trauma can be transmitted across generations. Results indicate the need for preventive, attachment-based and trauma-sensitive interventions targeted at disruptive intergenerational patterns.

Highlights

Mental health problems are a common co-occurring condition in substance using populations [1], with growing research acknowledging the prevalence of post-traumatic stress disorders (PTSD) in individuals with substance use disorders (SUDs) [2,3,4,5,6]
The analysis showed an intricate link between early interpersonal trauma, attachment and addiction in the parenting narratives of mothers with SUDs, indicating the interrelatedness of these concepts
Five key mechanisms behind intergenerational trauma transmission were identified that contribute to disruptive attachment processes: 1) early interpersonal trauma experiences, 2) trauma as a precursor of substance use, 3) substance use as a enabler of parental functioning, 4) continued substance use impacting parental functioning, and 5) dysfunctional parental functioning and its relational impact upon offspring

Summary

Introduction

Mental health problems are a common co-occurring condition in substance using populations [1], with growing research acknowledging the prevalence of post-traumatic stress disorders (PTSD) in individuals with substance use disorders (SUDs) [2,3,4,5,6] This resulted in increased attention for integrated treatment to reduce both SUDs and PTSD symptoms [7,8,9,10,11]. Dugal and colleagues [27] indicate how dysfunctional early interpersonal encounters may shape dysfunctional interaction patterns to be repeated in subsequent relationships They further state that, in reaction to the perception that the other is insufficiently available to answer one’s own needs of love and protection, interpersonal trauma survivors generally present a hyperactivation of the attachment system. Little research has been conducted on parenting experiences of mothers in recovery from substance use, taking into account their own upbringing as a child and the potential aftermath of interpersonal childhood trauma

Methods

Results

Discussion

Conclusion