Child/Adolescent Attachment Trauma

WHAT IS ATTACHMENT/DEVELOPMENTAL TRAUMA?

Love and compassion are necessities, not luxuries. Without them humanity cannot survive.
Dalai Lama

Children have a biological instinct to attach; they have no choice.  And problems with attachment referred to as attachment-trauma, relational trauma (Dr. Laurel Parnell), or developmental trauma disorder (Dr. Bessel van der Kolk), can occur at any time during the early development of a child, including in the prenatal environment, due to a variety of circumstances. Pre-birth trauma can set the stage for an infant to have anxiety and difficulty connecting with others.  Throughout pregnancy, maternal emotional and physical messages are transmitted to the fetus.  When a pregnant woman becomes fearful or anxious, her heartbeat alters, reducing oxygen flow to the fetus, speeding up the fetal heart rate.  On a temporary basis, this is normal, and it begins to prepare the baby for the real world, as these mechanisms are necessary to help us in a life-threatening situation.   However, we are not designed to stay in high alert for long periods of time.  To develop as we are meant to, our bodies need to return to a state of calm again.

If overwhelming stress is a regular occurrence due to the circumstances of the pregnant mother’s life (difficult pregnancy, abandonment by the father or other support people, teen pregnancy, pregnancy as the result of rape, domestic violence, insecure living situation, etc.), this can cause a uterine environment in which the mothers’ frightened, anxious, depressed state raises her level of stress hormones, which creates a surge of adrenalin and cortisol in the fetus.  This is an uncomfortable state for the unborn child; and, because the brain is developing rapidly, this physiological distress will shape its sensitivity to potential threat, leading the developing child to find threat where it does not exist.  The baby will have a more reactive brain and be harder to soothe – which impacts the baby’s, and sometimes the parent’s/caregiver’s, ability to securely attach.

This is important information for biological as well as for adoptive and foster parents.  Even if raised in a home that is not chaotic and with parents who are emotionally attuned, the baby is still likely to be more easily upset and less responsive to being comforted which can be disruptive to the necessary bonding/attachment process.  Fast forward 3 years to a young child who finds it hard to play with others and form friendships, who lashes out or withdraws, gets easily overwhelmed by life in general and has dramatic, long-lasting outbursts, a child who struggles to stay focused and who does not sleep well; the list of challenges can be extensive.   Laurel Parnell, Ph.D., psychologist/researcher, uses the term relational trauma and describes this as “trauma that occurs in the context of a relationship – either something that happened or did not happen (e.g., neglect) to the client that has caused him or her harm” (emotional, physical, psychological).

In early infancy and childhood, attachment trauma may include:

• neglect or physical or sexual abuse by a parent/caregiver,
• the witnessing of domestic violence between parents/caregivers
• early painful injuries or medical illnesses and/or interventions that are perceived by young children as failure on the part of the parent to help or protect them
• loss through death, divorce, incarceration, abandonment, or
• removal from parents followed by foster care or orphanage care.

Children, whose early experiences were compromised by trauma typically grow up with difficulty self-regulating due to poor neurological integration, and an overactive limbic brain (the part of the brain where emotions reside).  They live, for the most part, in a state of hyper- or hypo-arousal, and they perceive a threatening world where they are unable to trust the people who are working so hard to care for them.

The U.S. Department of Health and Human Services (2012) data (calculated in 2011), indicates the highest rate of victimization of children takes place in the first year of life.  There was a time when that was considered better (than later trauma) because it meant that the early abuse was not consciously remembered.  However, according to research conducted by Dr. Dan Siegel, 2001; and Drs. van der Kolk & Fisler, 1992, it is now clear that although preverbal trauma is not recorded in the “explicit” memory system, which doesn’t begin until the 18^th month of life, the trauma memory is stored in an unprocessed form within the “implicit” (largely unconscious) memory system. This is a part of the brain that is not easily accessed through language-focused therapies like CBT, etc.

The traditional form of treatment for most emotional and psychological distress (adults as well as children) is a Cognitive-Behavioral Approach (CBT, TFCBT, DBT).  Most therapeutic approaches incorporate some CBT into treatment, but it is not necessarily the most effective way to treat emotional and psychological distress, especially those molded by negative early childhood experiences.  At A Place to Heal and Grow our preferred approach uses the EMDR-T (Eye Movement Desensitization and Reprocessing Therapy) and Internal Family Systems (IFS), EMDR-Informed IFS.

Resources

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