Attachment style and the impact it has on trauma treatment

When I heard Psychiatrist, Bessel van der Kolk (author of the Body keeps the score) say in his Sydney workshop – “in order to heal the trauma, you have to heal the attachment style” – a lightbulb went off in my head and all my senses tuned in.

​It was that magical feeling, where you have no idea what the person is going to say next, yet you know and feel with every cell in your body, that it is going to be gold. And it was. 
 
Our attachment style is shaped and developed in early childhood, in response to our relationships with our caregivers, as our survival and safety depends on our caregivers. As babies, for the first few years of our lives, we are entirely dependent on our caregivers, and we already start bonding in the womb and subsequently from the second we are born. We depend on our caregivers for our physical needs: touch, eye contact, soothing voice, skin to skin, for our emotional needs: love, care, cues of safety, soothing and for our physiological needs: food, safe home, safe connection, regularity and predictability. This is a crucial point in time where our brain and nervous system develops exponentially – the biological need for healthy development is that we require safe relationships for our brain and nervous system to grow coherently – through connection, co-regulation, congruence, attunement, predictability and safety.

The attachment styles we received is critical in how we relate to others, how we show up in relationships, how we respond emotionally, how we view relationships and in particular, how it affects the quality and behaviors in our relationships. Simply put - the attachment style we have, often mirrors the dynamics we had with our caregivers in childhood. Attachment injuries happen in relation to people – they all occur in relationships - children may not have experienced abuse per se, but they have learned that their needs were not be met, perhaps because caregivers were not able to attune to the child’s needs, due to stress, worry, fears, work, mental health struggles, their own attachment issues or childhood trauma and this wounding has an effect on regulating their central nervous system and on their adult relationships. 

Secure Attachment Style
In the most favourable of circumstances, where a secure and stable attachment is formed, caregivers are emotionally present and attuned to baby’s needs. The child learns that their needs are met in a safe, consistent, attuned and coherent manner. Growing up, they learn that they can rely and trust on others to have their physical and emotional needs met, that they are not alone, and they are able to build secure attachments with loved ones, as their presence equals safety. Later in life they are able to form secure, loving relationships with others, they trust, (self) love, feel close to people, have healthy boundaries, and are not afraid of true intimacy and being emotionally available. Secure people need someone to respect their individuality and to walk with them in life, neither in a dependent or co-dependent way but in a healthy symbiotic balance. 

Insecure Attachment style
On the flip side - the child may perceive that their needs are not being met, that their caregivers are emotionally unavailable or unresponsive when they seek their attention, affection, or support. This can be due to, emotional neglect, traumatic event(s) or through shameful experiences. As a result, the child is unable to form a secure bond.

There are three types of insecure attachment:
Avoidant - People with avoidant attachment style tend to have trouble getting close to others or trusting others in relationships. They have a fear of intimacy. There is a distance in their relationships and friendships and they tend to be largely emotionally unavailable with a preference of being independent and relying on themselves. They tend to avoid intimacy or in-depth communication by pursuing work, (work alcoholic) hobbies and solitude. In their early childhood, their caregivers were emotionally disconnected and dismissive of their true needs. They may have been unresponsive and distant to the child’s basic needs of trust, safety, belonging, connection, allowing them to fully show up as themselves, leading the child to develop a (limiting) belief that their needs won’t get met. They tend to push people, intimacy and emotions away, particularly when they feel emotionally threatened or when people are getting too emotionally close.  Avoidant people need space and privacy.
 
Anxious - is marked by a deep fear of abandonment and rejection. Anxiously attached people tend to be very insecure about their relationships, often worrying that their partner will leave them. Their behaviour is associated with a neediness or clinginess and they can get very anxious when their partner doesn't call or text back straight away (so prevalent in today’s society). They are insatiable for validation, do I look nice, pretty etc, constantly feeling and expressing that their partner/friend doesn't care enough about them, wanting to spend all their time with them, knowing exactly where they are, with whom and for how long. They often express that they feel neglected, not enough of this or that. Anger, tears, arguments but also manipulation are common in order to have their needs met. In early childhood, their attachment style suffered some form of neglect, being uncared for, or perhaps even asked to leave to home. Caregivers were inconsistent and unpredictable with their affections and emotional availability – sometimes involved, sometimes distant and withdrawn. All these things led the child to develop an anxious attachment style coupled with various (limiting) beliefs that often drive their behaviour from the inside: I must have done something wrong, I cannot trust people, somebody is always better than me, people will always leave me. They are always seeking for validation in order to get their needs of trust, safety/security, feeling heard and self-esteem met.  
 
The remainder of the blog will focus on the 3rd insecure attachment style: the fearful avoidant aka disorganised attachment style and the need for differentiation between disorganised attachment and trauma.
 
Fearful-Avoidant aka Disorganised Attachment style
A disorganised attachment style is often a consequence of early childhood trauma including physical, emotional, sexual abuse and/or emotional neglect. This style arises when the child has reason to feel afraid of the care giver as their source of safety (care giver) becomes a source of fear. People with a disorganised attachment style experienced a chaotic, inconsistent and unpredictable parenting style. They may have gone through a somewhat fearful upbringing where they witnessed or experienced physical abuse from one parent to the other parent or to them personally, which was then followed by some form of emotional affection, to that parent or to them, whether it was through physical affection, praise, being bought or promised something, leading to mixed messages about love, pain and punishment – so often seen in abusive relationships and addiction. 

The child does not know what to expect, experiences inconsistency and chaos. The child does not know if or when their needs will be met and learn that they cannot rely on their caregivers to have their basic needs met. All these experiences leads the child to experience a deep sense of fear for its own safety, a lack of trust, a poor understanding of boundaries and a confusion in what a healthy relationship looks like, yet desperately wanting close connections. People with fearful-avoidant attachment both crave and deeply want intimacy, love, closeness and affection but also deeply want to avoid it, distance and distract themselves. This can often operate on a deep subconscious level. This affects how they engage in intimate relationships, often chaotic, being driven by subconscious deep unmet needs, with a distinct push and pull, self-sabotaging and paradox behaviour in an attempt to keep themselves safe, as their fears run so deep.
 
They often operate on a fight/fight or flee nervous system level (see stress blog), depending on whether they feel people are getting too close, encroaching on their space, or experience overwhelm due to a fear of abandonment. They do want relationships but they are afraid to let anyone in as they have a strong fear that the people who are closest to them, will hurt them. This can often lead to a self-filling prophecy due to their incongruent behaviour. They need consistency, safety and space. Disorganised attachment style is associated with a difficulty in regulating emotions, an increased risk for physical, mental or emotional abuse in relationships, increased psychological risks and sexual behaviour, and plays a role in addiction (addiction blog).
 
Single event Trauma vs Disorganised attachment
Disorganised attachment comes from childhood trauma. The distinction between a single event trauma and disorganised attachment is important because issues resulting from disorganised attachment trauma need a different approach than problems that result from a one off traumatic experience like an attack, assault, accident or another traumatic incident. 
 
The approach for a single traumatic event that ultimately changed your life in an instant, like an accident, the death of a loved one, illness, or an attack benefits from accessing and processing the memory of that event on a cognitive level but can also benefit from processing on a bodily level. EMDR is a good tool for processing on a mind level and Craniosacral therapy for mind and body -  some of my clients do it in conjunction. 
 
The approach for accumulated series of traumatic events in a disorganised attachment needs to focus on neural regulation of the disturbances in the nervous system and the brain, it needs to focus around dissociation, relationship to self and to others, emotional regulation, making the subconscious, conscious and needs to include a bottom up approach involving the senses, movement and expression. Talk therapy alone would be limited and several methods are needed on a neurophysiological level, including processing it through the body, integrating their imprinting with bodily experiences, feeling safe in their body, emotional regulation and embodiment, this means including the body as an access point to resource and to create safety through trauma informed bodywork like craniosacral therapy. 
 
Craniosacral therapy creates safety in the in-vironment of the body, recalibrates the nervous system, allowing any processes from the past to be safely completed in present time as it is processed through the body, literally coming out of the fight, flight or freeze, changing the physiology, repair attachment, accessing and processing the right – emotional side of the brain where trauma is stored and brain centres where sensory processing happens – which cannot be accessed through talk therapy alone and so much more (please see trauma blog)
 
Bottom line – Most trauma is interpersonal trauma – it occurs in the context with people and in relationships. How trauma is processed depends on the quality of the attachment relationship we received as it has implications and consequences for how we show up in life and on any physical, mental or emotional ailments we may have. Never too late and it can be restored. Be aware and repair.
 
“Make the unconscious, conscious otherwise it will drive your behaviour, direct you life and you will call it fate” – based on C. Jung

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