Chronic Relational Trauma Research Articles

Association between childhood maltreatment and attachment disorganization in young adulthood: The protective role of early mother-child interactions

BackgroundIndividuals who experience chronic relational trauma within the parent-child relationship are at risk of developing disorganized representations of attachment relationships in the form of Hostile-Helpless (HH) states of mind. While this association is well recognized theoretically, few studies to date have empirically tested predictors of HH states of mind. ObjectiveThe purpose of this study was to examine whether retrospective self-reports of maltreatment and the quality of mother-child affective communication assessed in childhood predict HH states of mind in young adulthood. MethodsThe sample was composed of 66 young adults from a low-income community sample, who had been taking part in a longitudinal project since they were preschoolers. ResultsResults indicate that childhood maltreatment experiences significantly predict HH states of mind and that the quality of mother-child affective communication serves a protective role in the association between childhood maltreatment severity and adult attachment disorganization. ConclusionThis study is one of the first to prospectively examine how the quality of mother-child affective communication in childhood relates to attachment disorganization in young adulthood. Our results highlight the importance of providing support to families in which the child is at risk of experiencing relational trauma, with a particular focus on improving the quality of parent-child interactions.

The Therapist’s Struggle to Hold Hope When All Seems Lost

ABSTRACT In our paper we discuss the therapeutic dilemma that arises when relational patterns and attachment bonding are based exclusively on positive transference. When the harmful absence of negative transference is overlooked, rage and aggression become sequestered in the unconscious field. It is also well understood in the broader psychoanalytic community that conflict and aggression, when experienced, acknowledged, and processed inside a safe therapeutic relationship, is a powerful antidote to helplessness and hopelessness. We also suggest that an overemphasis on the impact of trauma may run the risk of making it the “essence” of the therapy, unconsciously encouraging clients to feel nailed to their wounds, as if they have completely lost their capacity for self-agency. This is the story of Claire, a young woman with severe and chronic relational trauma with whom Adriano worked for six years. When both Adriano and Claire suffered a loss of faith and the therapy became stymied by its limitations in providing an answer to this dilemma, Adriano called upon the philosophy of Hegel, whose valuing of the restorative power of “tarrying” with despair gave him support and comfort as he struggled with his own helplessness and fear in the face of Claire’s abject darkness. As a footnote, we are happy to report that at the time of this paper’s publication, Claire is now a practising psychologist and has been married to her husband for three years.

Hostile-helpless states of mind: A scoping review of risk factors, correlates, and consequences.

Chronic relational trauma can lead to the formation of pervasively unintegrated attachment representations in adulthood, referred to as Hostile‐Helpless (HH) states of mind. Individuals with this type of attachment disorganization evidence conflicting evaluations of caregivers and have difficulty reflecting on their traumatic childhood experiences. This scoping review is the first to systematically integrate the results of all empirical studies on HH states of mind in an effort to highlight the scientific and clinical contributions of the concept and guide future research. Following Arksey and O'Malley's (2005) Methodological Framework, cross‐reference keywords were searched in three databases (PsycArticles, Psychology and Behavioral Sciences Collection, ProQuest). In total, 19 studies met inclusion criteria and were included in the synthesis. Results suggest that prevalence rates of HH states of mind increase as a function of adults' psychosocial risk status. Findings also reveal that the long‐term consequences of early trauma are greater in the presence of a HH state of mind, whereas the absence of a HH state of mind acts as a protective factor against the intergenerational transmission of maladaptation. Finally, results support the discriminant validity of the HH classification against other forms of attachment disorganization in adulthood. Research gaps and future research directions are discussed.

Facing the Music: Further Thoughts on Integrating Music into Psychotherapy

In this article, I respond to the insightful commentaries by Karen Riggs Skean (2019), by Richard Harrison (2019), and by Ben Adams (2019) on my hybrid case study of "James," a survivor of chronic relational trauma (Blimling, 2019). These commentaries have stimulated me to think further about the impact of music on my individual psychotherapy work, both with James and with subsequent clients, and specifically with regard to its impact on my approach to group psychotherapy work. In addition, these commentaries have raised particular issues that I respond to, including, (a) constructive criticism by Skean and Harrison regarding the potential further use of "metaprocessing" and the developments made in Accelerated Experiential Dynamic Psychotherapy (AEDP) since I completed the Case of James; (b) Skean’s perceptive point explaining how an individual therapist can take a personal passion—like music or literary writing or bicultural identity—and use it to enhance his or her enlivened presence in therapy with a client; and (c) Adams’ thesis that music and psychotherapy both have their origins in the shamanistic practices of our hunter-gatherer ancestors, suggesting that the combination of psychotherapy and music is a kind of return to our very roots.

The Case of "Rosa": Reflections on the Treatment of a Survivor of Relational Trauma

In this article, I respond to commentaries by Karen Riggs Skean (2018) and Shigeru Iwakabe (2018) on my presentation of the case of "Rosa," (Vigoda Gonzalez, 2018), a survivor of chronic relational trauma. In her insightful response, Riggs Skean (2018) elaborates on the interplay between language switching and the therapeutic frame, the suitability of Accelerated Experiential Dynamic Psychotherapy (AEDP; Fosha, 2000) for the treatment of trauma, and the short-term nature of the work with this particular client. Iwakabe (2018), an AEDP clinician and researcher, offers insights and reflections on the areas of language switching, emotional change process, and corrective emotional experiences, and poses evocative questions regarding the development of clinical skills relevant to affect-focused therapies. In the following response I consider these thoughtful commentaries and provide feedback with the hope to spur the dialogue regarding the flexible adaptation of treatment approaches to our clients’ psychological needs.

Moving Beyond “Sticks and Stones”: Chronic Psychological Trauma Predicts Posttraumatic Stress Symptoms

To date, trauma research has focused on the impact of physical trauma on posttraumatic stress (PTS) symptoms. Sometimes psychological trauma is measured with instances of physical trauma; however, less is known about solely psychological trauma. The current study addresses this by examining psychological trauma and PTS symptoms using the chronic relational trauma (CRT) model. The CRT model examines physical and possible concurrent psychological childhood, peer, and intimate partner trauma; however, psychological trauma alone has yet to be tested. A total of 232 female undergraduates (M age = 18.32, SD = 1.60) completed a series of questionnaires. Structural equation modeling indicated that childhood, peer, and intimate partner psychological trauma predict current PTS symptoms. Contributions of these findings are discussed.

La disorganizzazione dell'attaccamento spiega i sintomi post-traumatici nei bambini vittime di violenza intrafamiliare?

Child maltreatment is a chronic relational trauma with maladaptive outcomes in terms of both attachment of posttraumatic symptomatology. Many studies show that disorganized attachment is an important risk factor for the onset of externalizing, dissociative and PTSD symptoms. The Internal Working Models (IWM) of attachment disorganization could be a psychological mechanism key to understand the effect of child maltreatment on posttraumatic symptoms. The study aims to: 1) check for any differences in the IWM and posttraumatic symptomatology in a group of 47 of maltreated children and a group of 59 children from disadvantaged families; 2) explore, in maltreated children, if the disorganization mediates the association between type of violence and posttraumatic symptomatology. Results show that maltreated children have more severe maladaptive outcomes than the other group. Moreover, attachment disorganization is the only predictor of depressive symptoms; totally mediates the anger and dissociative symptoms; and partially mediates the anxiety and PTSD symptoms.

Somatopsychic Unconscious Processes and Their Involvement in Chronic Relational Trauma

In this paper the author introduces the concept of chronic relational trauma as a pervasive relational source of personal suffering intrinsic to pathological development in children and in family dysfunctional dynamics. Unconscious processes such as various forms of transference are the vehicle by which distortions, prejudices and abuses of power in dependency relationships are perpetrated and perpetuated. This paper details unconscious mechanisms such as projective identification, the somatopsychic dynamics of these mechanisms, and provides clinical examples of these dynamics at work. Dr. Tuccillo opens the analysis of transference to reveal it as a source of a legacy of transgenerational abuse; projective identification, a complex form of transference, is understood as a relational power mechanism that can distort and obstruct healthy growth of self-esteem, self-authenticity and self-value. Bioenergetic therapists can learn to recognize the operation of the distorting, pathological effects on the person, and his or her unconscious ability to continue a legacy of abuse of self and others through both analysis of transference dynamics somatically as well as psychologically. The author adds the passion born of more than thirty years of practice as a Bioenergetic therapist in appealing for a general raising of consciousness about chronic relational trauma and its effects. Awareness of these unconscious mechanisms experienced somatically and intrapsychically in the client and the therapist is key in working with and ameliorating core destructive issues in the personality, and in all spheres of human relating.

The role of trauma symptoms in the development of behavioral problems in maltreated preschoolers

Objective This study assessed the mediating role of trauma symptoms in the relation between child maltreatment and behavioral problems. It is based on the postulate that child maltreatment is a severe form of chronic relational trauma that has damaging consequences on the development of children's behavioral regulation. Method Participants were 34 maltreated and 64 non-maltreated children (mean age = 60 months; range: 46 to 72 months), all from economically disadvantaged families. Maltreated children were recruited from the Child Protection Agencies. Behavioral problems and trauma symptoms were evaluated by the preschool teacher with the Internalizing and the Externalizing scales of the Child Behavior Checklist—Teacher Report Form (CBCL-TRF) and the posttraumatic stress score of the Trauma Symptoms Checklist for Young Children respectively (TSCYC). Results Baron and Kenny's mediational procedure was conducted using structural equation modeling. Mediational analyses revealed that trauma symptoms fully mediated the association between maltreatment and both internalizing and externalizing behaviors. Conclusions Results were consistent with the literature on developmental trauma research and provide empirical support to the idea that trauma-related symptoms resulting from early maltreatment may constitute a mechanism in the development of psychosocial problems in preschoolers. Practice implications These findings underline the importance of understanding psychosocial maladjustment of maltreated children not only from the perspective of problematic behavior, but also by taking into account the traumatic reactions that might develop in response to chronic and intense stress associated with abuse and neglect.