The field of Attachment, Trauma & Neuroscience could be referred to as the holy trinity. One is scarcely mentioned without the other inextricably woven in. Understanding early developmental experience, self-regulation, and the ongoing impact of relationships on the brain and mental functions is the key to understanding the roots of resilience & risk, and prevention and intervention for trauma and attachment injuries (Dan Siegel, 2003).
In contemporary psychology the field of attachment has converged with many specialties, yielding illuminative contributions from neuroscience, interpersonal neurobiology, regulation theory, traumatology, psychosomatic medicine, and epigenetics to name a few. The body of work we are seeing today gives us a greater appreciation of past giants in the field, such as Freud & Jung and how trauma, including developmental trauma & disorganized attachment impact the brain.
New discoveries are changing the way we understand and treat trauma and the myriad of networks that we must integrate from the top down and the bottom up (Pat Ogden, 2006) to heal from trauma and attachment injuries. Healing trauma through attachment, mind, body & brain interventions, has never been more a science as well as an art, than today. Through the evolving and illuminate lens of attachment theory, we are led to the origin of our existence, “where there is still a continent to conquer” (Bowlby, 1969) and a place of healing.
From its origin seventy years ago to the present day, attachment theory has grown from a concept used primarily to describe the affectional bonds between infants and their mothers, to a broader concept, theorized to be influential throughout the entire life span (Bowlby, 1969/1982; Lopez & Gover, 1993). John Bowlby, considered the Father of Attachment Theory, was a British psychiatrist and psychoanalyst who challenged the Freudian view of development, claiming that it had focused too narrowly on the inner world of the child without considering the actual relational environment that shapes the earliest stages of human consciousness.
The concept of attachment in humans, and the behavior, cognitions and emotions associated across the lifespan related to attachment, are some of the most researched topics in contemporary psychology. Bowlby (1969/1982/, 1973, 1980) and Ainsworth et al.’s (1978) theoretical efforts produced one of the most prolific and creative lines of research in the 20th century that has extended into the 21st century (Cassidy & Shaver, 1999). This interest is not difficult to understand as survival of the human infant, physically and psychologically, is directly related to the attachment system. Humans have the longest period of dependency of all species known to man. Bowlby’s interest in the cognitive, emotional, and behavioral ties that bind humans together began with this astute observation (Bowlby, 1969/1982, 1973, 1980).
According to Schore (2003) the significance of Bowlby’s constructs resulted in an emphasis of the development of an interdisciplinary perspective in understanding the human being. Bowlby purported that collaborative knowledge from an array of sciences would yield a powerful model in studying developmental phenomena. This collaborative knowledge led to an explosion in attachment research from a spectrum of disciplines, including developmental biology, neurochemistry, developmental psychology and psychoanalysis, all sharing a common principle, “that the beginnings of living systems indelibly set the stage for every aspect of an organism’s internal and external functioning throughout the lifespan” (Schore, 2003, p.3).
John Bowlby’s ideas came from his observations and reflections about relationships between parents and their infant children. A good deal of his work was related to the study of behavior and emotional patterns that evolved as the result of long separations due to hospitalizations and other circumstances such as war and death. Bowlby started his publishing career with a paper on juvenile thieves in which he delved into their histories of abuse and neglect. Bowlby became increasingly concerned and curious about the various manifestations of pathology and of the misery and despair that lay behind masks of indifference and apparent callousness (Karen, 1994).
Bowlby observed that separations and losses, abuse and neglect had a disturbing impact on character formation. This initial study inspired Bowlby to accept an opportunity to do research on the problems and needs of homeless children initiated by the World Health Organization in Geneva, in 1948 (Bowlby, 1969/1982). These problems of homeless children were a major concern for postwar Europe.
Bowlby presented essential questions in such a way that his theoretical efforts facilitated designs of testable, experimental methodology, producing one of the most empirically grounded theories of human development (Mikulincer & Shaver, 2007).
Bowlby’s two most critical intellectual influences were Charles Darwin and Sigmund Freud. These influences are infused throughout Bowlby’s prolific works, facilitating descriptions of critical events in both the external and internal world of the human being by interweaving behavioral biology and psychoanalysis (Bowlby, 1973, 1980, 1969/1982). Bowlby concluded that the attachment system was designed primarily for the psychological and physical survival of the child, to protect the child from harm, as well as to provide a secure base from which the child could explore the environment (Bowlby, 1969/1982, 1973, 1980).
Bowlby posits that the individual’s cognitive appraisal of the availability and responsiveness of the primary caregiver, or lack thereof, is built up slowly during the years of infancy, childhood, and adolescence. Expectations are developed during these years and tend to persist relatively unchanged throughout the rest of life. These expectations are referred to as working models of self and others which are thought to represent an established cognitive system that becomes firmly established as he or she matures into adolescence and adulthood (Bretherton, 1992; Sroufe et al., 2005).
In Bowlby’s seminal trilogy, (1969/1982, 1973, 1980) he underscores “the central role of relationships in human development from the cradle to the grave” (Cassidy & Shaver, 1999, p. 89). Mental health is seen as intimately connected to relationships with attachment figures that provide emotional support and protection from birth to death. Bowlby (1973) states:
“For not only young children, it is now clear, but human beings of all ages are found to be at their happiest and to be able to deploy their talents to best advantage when they are confident that, standing behind them, there are one or more trusted persons who will come to their aid should difficulties arise. The person trusted provides a secure base from which his [or her] companion can operate.” (p. 359)
Attachment research has made considerable progress in illuminating how individual attachment organization contributes to various patterns of regulating emotions, cognitive processing, and personality development (Cassidy & Shaver, 1999). Attachment theory can legitimately claim to shine a light on people’s states of mind with regard to close relationships and how these relationships are experienced and handled under stressful conditions (Shemmings, 2004).
Attachment research has four phases, all inextricably linked with Bowlby’s (1969/1982/, 1973, 1980) attachment theory. The first, beginning with John Bowlby, calls attention to the attachment behavioral system as having primary and immediate functions as it relates to infant safety and survival. The second phase, by Ainsworth, Blehar, Waters, and Walls (1978), involves the development of the classifications of attachment categories. The third phase by Mary Main, described as revolutionary (1983) includes the examination of mental representational processes in older children, adolescents, and adults in which there are systematic relations between early attachment organization, personality development and later functioning. These processes are revealed in discourse, drawings, and narratives (Main & Solomon, 1996). The third phase of attachment research includes analysis of the Adult Attachment Interview (AAI) utilized for adolescents and adults, self-report measures of attachment styles, and Kaplan’s version of the Separation Anxiety Test. The research pertaining to attachment investigates its relation to human development throughout the lifespan. Mary Main described disorganized attachment in her research findings. The fourth phase of Attachment research involves the explosion of neuroscience, regulation theory (Alan Schore, 1994) & Interpersonal Neurobiology by Daniel Siegel, 2012) as well as tremendous contributions in the field of trauma and attachment by Bessel van der Kolk (2009).
The convergence of attachment theory and neurobiology has offered new ways of understanding how children and youths’ minds are shaped by the interaction of interpersonal experience and neurobiological processes. This convergence is described as interpersonal neurobiology. Interpersonal neurobiology sheds new light on how early experiences influence fundamental processes of memory, emotion, regulation of behavior and deepen our understanding of human experience and lends insight to the process of psychotherapy (Siegel, 2003).
Research supports that the sense of having a secure base is a crucial factor underlying emotions, cognitions, goals, and behaviors in interpersonal situations (Feeney, 1999). Studies over the last 20 years support that children show enduring traits and patterns that match Bowlby’s (1973) definitions of problematic attachment styles. These studies also support that children with secure attachment styles exhibit enduring traits.
Children with secure attachment are rated as more ego-resilient or flexible and adaptive, particularly in the face of frustration (Bleiberg, 2001). Sandler (1978), a British colleague of Anna Freud, suggests that childhood patterns of relationships were enacted in later relationships and eventually dominated behavior in all significant relationships, including, in due time, relationships with their own children.
Characteristics associated with secure parental attachment have been linked empirically with resiliency traits or adaptive social and psychological functioning across a variety of developmental periods (Kenny & Barton, 2002). In regard to the adolescent, secure parental attachments provide a source of security and support as the adolescent negotiates the transitions and challenges of this developmental period (Allen, Hauser, Eickholt, Bell, & O’Connor, 1994).
The idea of interpersonal relatedness and its effects on future development was influenced by the work of Harry Stack Sullivan (1953), who outlined relatedness from a developmental perspective. These stages of development begin with tenderness as an infant, attention for the toddler and intimacy for the adolescent, as they wish for a close loving relationship with another. For Sullivan, a failure to satisfy these relationships in any of the developmental phases resulted in significant problems in living (Prout & Brown, 1999)
Bowlby’s (1973) study of young children, and their responses to disruptions in attachment, illuminated the emotional dynamics of loss and separation, leading to a deeper understanding of later clinical problems. These difficulties included difficulty regulating emotional states and defensive strategies in which withdrawal and defensive detachment from others, or provocative self-destructive behavior, became primary interpersonal strategies in a person’s attempt to stay in relationship and manage overwhelming affect (Milkulincer, Shaver & Pereg, 2003). Fosha (2000) states these interpersonal strategies conveyed information which provided insight into the appraisal or expectations one has of others and the world around them. These expectations influence whether someone expects rejection from others or whether they expect comfort and understanding from others. This appraisal conveys information about how one experiences self in relation to and with others and, subsequently affects behavior.
Mahler (1972) describes the effect that pathological early relationships with the primary attachment figure may have on an individual, resulting in tendencies towards self-mutilative behavior or self-starvation in later childhood and adolescence. These maladaptive strategies of dealing with painful or overwhelming affect is viewed as a means to regulate internal states and to stay connected to others. Bleiberg (2001) discusses how these rigid strategies, in turn, often evoke responses from others that reinforce and confirm these adolescents’ appraisals of themselves and others, or their inner organization.
Mahler (1972) theorizes that children go through a series of developmental stages in which they internalize equilibrium-maintaining functions, initially performed exclusively by the primary caregiver. Derailment along this developmental pathway, due to any one of a myriad of problems in early attachments, causes serious problematic relational issues and diminishes the ability to regulate powerful emotions later in life.
In Pressman & Pressman’s (1997) book, The Narcissistic Family, the authors describe the insidious effects of emotional unavailability of the parent system on the children in an otherwise overtly healthy seeming family. The results include difficulties in interpersonal relations, intimacy and trust issues, with accompanying poor self-concepts, and concomitant dysfunctional emotional and behavioral reactions, such as distancing, dysphoria, bulimia, suspiciousness, feelings of emptiness and an inability to set boundaries.
Evidence reviewed from half a century of work on resilience has, as its first major finding, “Resilience rests, fundamentally, on relationships. The desire to belong is a basic human need, and positive connections with others lie at the very core of psychological development; strong, supportive relationships are critical for achieving and sustaining resilient adaptation” (Luthar, 2006, p.780).
Adolescence is one of the most significant transitional periods in an individual’s lifetime and a critical opportunity to intervene in a youth’s life as they are going through this transition. This transition, for many adolescents, is a chaotic and stressful period, which potentially leads to serious disorders (Howard & Medway, 2004). Much research in the field of developmental psychopathology has found that whether a child develops emotional and/or behavioral disturbances in the presence of stress and adversity is related in some way to an individual’s ability to regulate emotions (Schore, 2003).
According to research by Yates, Egeland, and Sroufe (2003) there is a complex interaction between early attachment and the development of the capacity for self-regulation. When an individual’s developmental history consists of supportive and available care, this facilitates early competence, adaptation, and the child’s development in general, including the ability to relate to others (Prince-Embury, 2006).
Studies related to resiliency examine both the role of the environment and its interaction with genes. The past decade has added this ecological level, that of gene-environment interactions, in conceptualizing human development and its reciprocal coactions which result in differential expression in the individual (Cicchetti & Valentino, 2006). Examining various aspects of development, advance understanding of both risk and protective factors that impede and foster healthy development, respectively. Bidirectional effects occur among components of the developmental system with varying expressions in the trajectory of normal development. The interactions of these effects, at each level of development, contribute to understanding the promotion of resiliency and psychopathology. Brain research opens new possibilities in working with children and youth by blending this knowledge with resilience science and teaching strategies that turn risk into resilience.
Given this growing body of evidence, the importance of attachment processes and its implications for healthy adjustment, prevention, prompt interventions and increased resilience are abundantly clear for their therapeutic merit. It is the relational environment that shapes the earliest stages of human consciousness and is of crucial adaptive importance. Clinical Programs targeting the development of healthy attachment are underscored as highly useful.
One of the most critical findings following years of research reveal that attachment lies at the crucible of human development and for which healing trauma and understanding pathways of risk and resilience is of paramount importance.
Cheryl Paulhus lives in Temple, Texas, has a private practice and is a Behavioral Health Clinical Director.
