Attachment Trauma Research Articles

Incarcerated Mothers: Trauma and Attachment Issues

ABSTRACTAlthough men comprise the largest portion of the prison population in the United States, the number of women in prison has increased more than 800% during the past three decades. More than 60% of these women are mothers of children under 18 years of age. There continues to be a gap in our knowledge base regarding mothers who are incarcerated. In this study, unresolved issues of trauma and attachment are explored for 28 incarcerated mothers involved with the child welfare system. Data were collected using the Trauma Attachment and Belief Scale (TABS) and the Adult Attachment Interview (AAI). Findings from the TABS revealed scores of average and high average in beliefs related to five need areas that are sensitive to the effects of traumatic experiences, namely self-safety, self-trust, self-esteem, self-intimacy, and self-control. Most participants were classified as disorganized/disoriented based on their narrative responses to questions from the AAI protocol. Implications for the results are discussed.

Neural Response during the Activation of the Attachment System in Patients with Borderline Personality Disorder: An fMRI Study.

Individuals with borderline personality disorder (BPD) are characterized by emotional instability, impaired emotion regulation and unresolved attachment patterns associated with abusive childhood experiences. We investigated the neural response during the activation of the attachment system in BPD patients compared to healthy controls using functional magnetic resonance imaging (fMRI). Eleven female patients with BPD without posttraumatic stress disorder (PTSD) and 17 healthy female controls matched for age and education were telling stories in the scanner in response to the Adult Attachment Projective Picture System (AAP), an eight-picture set assessment of adult attachment. The picture set includes theoretically-derived attachment scenes, such as separation, death, threat and potential abuse. The picture presentation order is designed to gradually increase the activation of the attachment system. Each picture stimulus was presented for 2 min. Analyses examine group differences in attachment classifications and neural activation patterns over the course of the task. Unresolved attachment was associated with increasing amygdala activation over the course of the attachment task in patients as well as controls. Unresolved controls, but not patients, showed activation in the right dorsolateral prefrontal cortex (DLPFC) and the rostral cingulate zone (RCZ). We interpret this as a neural signature of BPD patients’ inability to exert top-down control under conditions of attachment distress. These findings point to possible neural mechanisms for underlying affective dysregulation in BPD in the context of attachment trauma and fear.

Attachment Representations and Early Interactions in Drug Addicted Mothers: A Case Study of Four Women with Distinct Adult Attachment Interview Classifications.

Drug addiction is considered a major risk factor that can influence maternal functioning at multiple levels, leading to less optimal parental qualities and less positive interactive exchanges in mother-child dyads. Moreover, drug abusers often report negative or traumatic attachment representations regarding their own childhood. These representations might affect, to some extent, later relational and developmental outcomes of their children. This study explored whether the development of dyadic interactions in addicted women differed based on attachment status. The longitudinal ongoing of mother-child emotional exchanges was assessed among four mothers with four different attachment statuses (F-autonomous, E-preoccupied, Ds-dismissing, and U-unresolved/with losses). Attachment representations were assessed using the Adult Attachment Interview (George et al., 1985), while mother-child interactions were evaluated longitudinally during videotaped play sessions, through the Emotional Availability Scales (Biringen, 2008). As expected, the dyad with the autonomous mother showed better interactive functioning during play despite the condition of drug-abuse; the mother proved to be more affectively positive, sensitive, and responsive, while her baby showed a better organization of affects and behaviors. On the other side, insecure mothers seemed to experience more difficulties when interacting with their children showing inconsistency in the ability to perceive and respond to their babies' signals. Finally, children of insecure mothers showed less clear affects and signals. While differences between secure and insecure dyads appeared clear, differences between insecure patterns where less linear, suggesting a possible mediating role played by other factors. Clinical implications and suggestions for future research are discussed.

Treatment of Attachment Traumas in Postpartum Depression with Intensive Short-Term Dynamic Psychotherapy: Addressing the Self-Critical Personality

Intensive Short-term Dynamic Psychotherapy (ISTDP) is a treatment that has shown promise in addressing attachment ruptures that lie at the root of postpartum depression (PD). ISTDP can provide rapid symptom relief while also addressing the underlying maladaptive personality structures that cause and prolong PD. These vulnerabilities can include self-neglect, harshness toward the self and others, and difficulty regulating emotions. Research has shown that this self-critical personality style, usually resulting from having distant or harsh parenting, is highly correlated with PD. ISTDP directly addresses these self-critical patterns, commonly referred to in the psychodynamic literature as “superego pathology”. These patterns are thought to result from the identification with harsh caregivers. A woman may doubt her capacity as a caregiver, push away supports, minimize or ignore her feelings, project her fears and anger onto the baby, dismiss her instincts and idealize authority figures. If these tendencies are not addressed, a woman is likely to pass along these enduring patterns to her baby and future generations. Early, rapid, and effective psychotherapy treatments that address these underlying non-conscious defense mechanisms are essential in healing PD and ensuring a positive mother-infant bond. “If we want to shape the future, to truly improve the world, we have 1,000 days to do it, mother by mother, child by child. For what happens in those 1000 days through pregnancy to the second birthday determines to a large extend the course of a child’s life…”.

Bridging the trauma-adult attachment connection through somatic movement

This study shows how the inclusion of a developmental somatic movement approach to trauma can unveil and help integrate underlying patterns of attachment trauma and disorganization. It describes highlights of a clinical application combining movement observation and therapy with knowledge of adult attachment to address the post-traumatic symptoms of a 60-year-old man whose brush with death left him socially withdrawn, irritable, sleep deprived, and plagued by flashbacks. Methods included protocols from Sensorimotor Psychotherapy, Psycho-Physical Therapy, Developmental Somatic Psychotherapy, and Dynamic Embodiment Somatic Movement Therapy (BodyMind Centering; Laban Movement Analysis). The Adult Attachment Projective Picture System established unresolved attachment trauma; The Online Alexithymic Questionnaire revealed evidence of alexithymia; movement observation reflected the presence of unconscious and unintegrated developmental movement patterns. After 18 weeks, many symptoms were eliminated or reduced. The client reported a sense of resilience with greater ability to self-regulate under stress.

The negative Influence of adolescent's attachment trauma : mediating effect of victimization of school violence and moderating effect of conflict resolution strategy

본 연구의 목적은 청소년의 애착외상이 감정표현불능에 미치는 영향에서 학교폭력피해의 매개효과와 애착외상이 학교폭력피해에 미치는 영향에서 갈등해결전략의 조절효과를 확인하는 것이다. 이를 알아보기 위해 남녀 청소년 559명을 대상으로 애착외상척도, 학교폭력피해척도, 감정표현불능척도 및 갈등해결전략척도를 실시한 후 중다회귀분석을 통해 매개효과 및 조절효과를 검증하였다. 그 결과를 살펴보면 다음과 같다. 첫째, 애착외상은 감정표현불능과 학교폭력피해에 유의미한 영향을 미쳤다. 둘째, 애착외상이 감정표현불능에 영향을 주는데 있어 학교폭력피해가 완전 매개하는 것으로 나타났다. 셋째, 애착외상이 학교폭력 피해에 미치는 영향은 갈등해결전략의 수준에 따라 달랐는데 애착외상이 높은 경우, 공격형 및 회피형 갈등전략이 높은 집단이 낮은 집단에 비해 학교폭력피해가 높았으며, 애착외상이 낮은 집단에서는 차이가 없었다. 또한 애착외상이 높은 경우, 협력형 갈등전략을 사용할 경우 학교폭력 피해가 높은 반면 애착외상이 낮은 집단에서는 협력형 갈등전략을 사용할 경우 학교폭력피해가 가장 낮았다. 마지막으로 본 연구의 제한점과 후속 연구를 논의하였다.

Stressful Parental-Bonding Exaggerates the Functional and Emotional Disturbances of Primary Dysmenorrhea.

Some evidence suggests that women with primary dysmenorrhea (or painful period) often have traumatic experience with parental attachments, but the exact relationship is still unclear. This study aims to investigate associations between styles of the parental bonding and the detailed aspects of the disorder in Chinese university-student women. From university-student women, we have invited 50 primary dysmenorrhea patients and 111 healthy volunteers, to undergo tests of the Functional and Emotional Measure of Dysmenorrhea (FEMD), the Family Relationship Questionnaire (FRQ), and the visual analogue scale for the pain intensity experienced. Besides the high scores of the FEMD Functional and Emotional scales, the dysmenorrhea patients also scored significantly higher than the healthy controls on the FRQ scales of Paternal Dominance and Maternal Abuse. In patients, the FEMD Emotional scale was negatively predicted by the Paternal Freedom Release scale, and the FEMD Functional scale was positively predicted by the Maternal Dominance scale. Inappropriate parental bonding or chronic traumatic attachment styles have respective relationships with the functional and emotional disturbances experienced by the primary dysmenorrhea patients.

Being in Touch: Healing Developmental and Attachment Trauma at the Clay Field

Developmental trauma is a term that describes the impact of adverse childhood experiences that results in the loss of capacity to integrate sensory, emotional, cognitive and relational information into cohesive, trusting and safe lived experiences. Infants’ and children's brain, nervous systems and neural development are vulnerable to these traumas. Trauma is stored in the implicit memory and is manifest through body gestures, breath, body behaviours, sensory perceptions, emotions and thoughts. Play therapy, sand tray therapy and creative arts therapy are all offered as interventions for childhood trauma. Work at the Clay Field®, is a sensorimotor art therapy and differs from play, sand and visual arts therapy as it focuses on haptic perception, the use of the hands and touch as a tool of perception. Touch is one of the most fundamental human experiences and is the basis of secure attachment, linked to our earliest body memories. Work at the Clay Field® is grounded in theories of developmental psychology, object relations, sensorimotor therapy and haptic perception. Haptic object relations as skin sense, vestibular sense of balance and depth sense are presented as the underpinning principles of Work at the Clay Field®. Children from the age of 2 years old onwards are enabled through work at the Clay Field to satiate developmental needs, in particular those from the preverbal age of early infancy. They also can complete trauma-related fragmented or incomplete action cycles through safe touch and restore their developmental path.

Attachment representations of professionals − Influence on intervention and implications for clinical training and supervision

This study focuses on the attachment background of facilitators carrying out STEEP intervention, which may be a possible source of effectiveness variation. The attachment status of 161 professionals was assessed before STEEP training. 18 were followed up to evaluate the programme’s effectiveness regarding mother infant attachment. In the larger sample (n=161), 76% of trainees had insecure attachment representations. While attachment security had no impact on intervention efficacy, professionals with an unresolved attachment trauma were 4.4 times less effective than professionals with no unresolved attachment status. This study highlights the importance of including professional workers’ attachment status in intervention programs.

The ‘too muchness’ of excitement: Sexuality in light of excess, attachment and affect regulation

This paper brings together contemporary thinking about early attachment and affect regulation with our clinical and theoretical understanding of the problems of adult sexuality. In addition to recent theories of affect regulation and attachment, we incorporate Laplanche's idea of ‘excess’, which was an important transitional concept integrating real experience with fantasy in sexuality. We elaborate the idea of excess –‐ ‘too‐muchness’ –‐ to illuminate the early overwhelming of the psyche that affects the formation of sexuality. Linked to recent theoretical developments, this idea helps to grasp the relationship between sexual excitement and early affect regulation, showing how excitement becomes dangerous, thus impeding or distorting desire. The ‘too‐muchness’ of excitement recalls the experience of being a stimulated, overwhelmed, unsoothed child and influences later inability to tolerate sexual arousal and the excitement affect. A clinical case illustrates this connection between attachment trauma, anxiety about sexuality, as well as shameful experiences of gender identity as an area of trauma. We emphasize the importance of working through the terrors and desires of the mother–baby relationship as they emerge in the transference–countertransference in order to develop the ability to hold excitement and stimulation without experiencing the too‐much as the intolerable. This includes the working‐through of ruptures related to overstimulation as well as the delicate balance of attention to fantasy and intersubjective work in the transference.

Exploring Dissociation and Dissociative Identity Disorder: A Roundtable Discussion

In a lively and wide-ranging roundtable discussion, five seasoned clinicians versed in the treatment of dissociative disorders discuss the importance of recognizing dissociative phenomena: why they happen, how to recognize them, how to work with dissociation and Dissociative Identity Disorder. The panel emphasizes the point that dissociative processes are not exclusive to those suffering from an extreme dissociative disorder and can germinate from other experiences such as attachment trauma, for example. The case is made that dissociation has important implications for work with all patients, as it conveys a more experientially near conceptualization for a model of the mind.

Compulsive Masturbation Treated with Selective Serotonin Reuptake Inhibitors

Masturbation can be defined as a person's achieving sexual pleasure which usually results in orgasm by himself or herself (autoeroticism). Masturbation is a normal activity that is common in all stages of life from infancy to old age, but this viewpoint was not always accepted. Freud believed that neurasthenia was caused by excessive masturbation. In the early 1900s, masturbatory insanity was a common diagnosis in hospitals for the criminally insane in the United States. Masturbation is abnormal when it is the only type of sexual activity performed in adulthood, when its frequency indicates a compulsion or sexual dysfunction, or when it is consistently preferred to sex with a partner [1]. Compulsive masturbation does not have a distinct code in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition D.S.M.-V (2013) but can be classified as other specified sexual dysfunction [2]. The I.C.D.–10 classifications (W.H.O., 1992) ha ve a diagnostic category termed “excessive sexual desire” and compulsive masturbation may fall into this category [3]. Compulsive sexual behavior has been characterized as a behavioral addiction and an obsessive-compulsive spectrum disorder. It has been quantified using the statistic of total sexual outlet (number of orgasms/week). People with compulsive sexual behavior referred for treatment generally show a total sexual outlet of >7 [4]. Early psychological injury, from sexual abuse, physical abuse, exposure to violence, attachment trauma, or early sexualization, is at the root of sexually compulsive behavior [4,5]. Compulsive sexual behavior frequently has associated comorbidities of current mood disorders 33%, anxiety disorders 42% , substance disorders 29% and Personality disorders 46% [6,7]. Physical injury in compulsive masturbation is common. Patients with this disorder may masturbate 5-15 times a day and loneliness is felt keenly after an orgasm. This disorder can interfere in occupational, social, interpersonal, and intimacy functioning. Many different agents have been cited in case reports as helpful in treating compulsive sexual behavior: lithium, buspirone, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), atypical antipsychotics, naltrexone, and topiramate have all been reported to be helpful in treatment of sexual compulsivity [4].

Book ReviewsTreating Addictions With EMDR Therapy and the Stages of ChangeEMDR Toolbox: Theory and Treatment of Complex PTSD and DissociationNeurobiology and Treatment of Traumatic Dissociation: Toward an Embodied SelfTrauma-Attachment Tangle: Modifying EMDR to Help Children Resolve Trauma and Develop Loving RelationshipsDiagnosing and Treating Complex TraumaEMDR for the Next Generation: Healing Children and FamiliesBorderline Personality Disorder and EMDR TherapyThe Wounds Within:

Book ReviewsTreating Addictions With EMDR Therapy and the Stages of ChangeEMDR Toolbox: Theory and Treatment of Complex PTSD and DissociationNeurobiology and Treatment of Traumatic Dissociation: Toward an Embodied SelfTrauma-Attachment Tangle: Modifying EMDR to Help Children Resolve Trauma and Develop Loving RelationshipsDiagnosing and Treating Complex TraumaEMDR for the Next Generation: Healing Children and FamiliesBorderline Personality Disorder and EMDR TherapyThe Wounds Within:

Exploring the Attachment Narrative of a Professional Musician with Severe Performance Anxiety: A Case Report

The aim of this paper was to contribute to the further development of a coherent theory of music performance anxiety (MPA). Kenny (2011) proposed three forms of MPA – focal, MPA with social anxiety, and MPA with panic and depression. An attachment disorder was proposed as the underlying psychopathology for this third type of MPA. Accordingly, an open-ended in-depth assessment interview of a professional musician presenting with severe music performance anxiety that included panic attacks and depressed mood was analysed from an attachment theory perspective. We hypothesized that the musical performance setting re-triggers unprocessed feelings related to early attachment trauma, and that performance anxiety can be a manifestation of the emergence into consciousness of these powerful early feelings. As hypothesised, this musician suffered both early and current relational trauma that was expressed through particular symptomatology in his music performance anxiety. Failure to identify and treat underlying attachment disorders in severely anxious musicians may render other forms of treatment ineffective or short-lived.

The Texture of Traumatic Attachment: Presence and Ghostly Absence in Transgenerational Transmission

Work on the transgenerational transmission of trauma refers to unspoken stories across generations, but the actual mode of transmission has remained somewhat mysterious. Utilizing examples from her own life, the author illustrates how attachment patterns are a primary mode of transmission of trauma. When trauma revisits a person transgenerationally through dysregulated and disrupted attachment patterns, it is within the child’s empathic attunement and search for a parental bond that the mode of transmission can be found. This will become the texture of traumatic attachment: how it feels to this child to feel connected to the parent.

Stressful parental bonding exaggerate the functional and emotional disturbances of primary dysmenorrhea

BackgroundSome evidence suggests that women with primary dysmenorrhea (or painful period) often have traumatic experience with parental attachments, but the exact relationship between styles of the parental bonding and the detailed aspects of the disorder is unclear.MethodsFrom university-student women, we invited 50 primary dysmenorrhea patients and 111 healthy volunteers to undergo tests of the functional and emotional measure of dysmenorrhea (FEMD), the Family Relationship Questionnaire (FRQ), and the visual analog scale for the pain intensity experienced.ResultsBesides the high scores of the FEMD functional and emotional scales, the dysmenorrhea patients also scored significantly higher than the healthy controls on the FRQ scales of paternal dominance and maternal abuse. In patients, the FEMD Emotional scale was negatively predicted by the Paternal Freedom Release scale and the FEMD functional scale was positively predicted by the Maternal Dominance scale.ConclusionInappropriate parental bonding or chronic traumatic attachment styles have respective relationships with the functional and emotional disturbances experienced by the primary dysmenorrhea patients.

What does it mean to be a man? Psychosocial undercurrents in the voices of incarcerated (violent) Scottish teenage offenders

This article explores connections between social strain, constructions and practices of masculinity and the prevalence of violence among a white working-class male demographic. The study’s evidence-base is qualitative research conducted in Scotland. It utilized life history interviews with a clinically significant sample of 40 incarcerated young male offenders convicted of violent crimes. Family, school and peer group ‘pressures’ coloured these young men’s trajectories to persistent violent reoffending. Their language highlights attachment and betrayal issues. Masculinity associated with Scottish history is a resource within Scotland which may impact on contemporary practices of masculinity. The article’s dominant thesis is that the young men’s violence reflects immersion in traumatic life histories. The masculinized cultures they encounter are likely to produce violence and limit opportunities which could help ameliorate attachment trauma.

Vicarious resilience from attachment trauma: reflections of long-term therapy with marginalized young people

The concept of vicarious resilience captures the therapist's emotional growth occurring as a direct result of therapeutic engagement with traumatized clients. Three chronological case scenarios are presented for exploration of vicarious resilience in relation to attachment trauma. The purpose is to increase awareness and appreciation of the positive functions it serves for client mentalization, therapist skill and resilience factors for both parties. The reflective methodology considers the intrapsychic worlds of the client and the therapist and details how the therapist comes to experience the client's distressing projections. The potential for vicarious resilience begins from the outset of the therapist's actions of containment upon these projections. Advancing early ideas, it is advocated that vicarious resilience requires the therapist to have both the capacity and willingness to maintain a constant reflective stance.

Attachment, Recognition, and Secondary Trauma: Reply to Commentaries

This response first addresses the interimplication of attachment and recognition in couples work and reargues that disorganized attachment is the central dynamic underlying the emotional torment of failing relationships. In the second section, the author expands upon the secondary trauma that haunts the therapist who is trying to hold and contain the destructiveness that couples “on the brink” can enact.

Overcoming Powerlessness in the Clinical Exchange With Traumatized Patients

In this comment to Paolo Stramba-Badiale’s description of his clinical case, I argue that the therapist’s acknowledgment of feelings of powerlessness both in self and in the patient, without surrendering to them and without untimely attempting to overcome them, is a major factor of therapeutic change in the treatment of dissociative adults who had been chronically traumatized since early childhood. Consideration of the dynamic tension between the motivational system engaged in coping with environmental threats (freezing-fight-flight-feigned death) and the care-seeking (attachment) system provides the background for the argument, together with the knowledge of the controlling interpersonal strategies that typically follow, during childhood, infant attachment trauma.