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Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate Honorary Lecturer for the University of Kent’s online Child Protection Centre

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Page 1: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Attachment Relationships, Trauma and Development

Alice Cook PhD StudentRoyal Holloway University

Family Assessment Practitioner ADAM Project Associate

Honorary Lecturer for the University of Kent’s online Child Protection Centre

Page 2: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Attachment Theory • Offers important message.

• Focus on relationships- reliable.

• Pioneers, John Bowlby, Mary Ainsworth and Mary Main.

• Babies intersubjectively interwined with carers.

• Bowlby- Infant feeding.

Page 3: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Understanding Universal Attachment Behaviours

All humans share a set of attachment behaviors comprising four components:

1. ‘secure base’, 2. ‘safe haven’, 3. ‘proximity-seeking’ 4. ‘separation-protest’.

Page 4: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• Whom do you like to spend time with?’ (proximity-seeking)

• ‘Whom do you miss most during separations?’ (separation-protest)

• ‘Whom do you feel you can always count on?’ (secure base)

• ‘Whom do you turn to for comfort when you're feeling down?’ (safe haven). (Hazan and Zeifman, 1994, quoted in Feeney and Noller, 1996

Page 5: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Emotion Regulation

• Attachment is the, ‘dyadic regulation of emotion’. (Sroufe 1996)

Page 6: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• Learn to draw effectively on external resources.

• Know the feeling of being comforted/contained.

• Parent attune with child's emotions.

• All attempts made by parent to provide comfort.

Page 7: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

She holds the infant with her hands, with her eyes, with her voice and smile. All of these holding experiences are opportunities for the infant to learn how to contain himself.

Brazelton, Kowslowski, and Main (1974

Page 8: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Attachment Styles

Secure• 60% • Toddlers (1-3)- Seek comfort when distressed

but settle relatively quickly when soothed. • Young Children (4-12)- Can form friendships

and be relied upon, can seek comfort from carers.

• Older Children (12+) form deeper reciprocal friendships still seek comfort from carers.

Page 9: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Parent • Comfortable with emotion within

relationships. • Able to seek support.• Aware and able to be safe haven and secure

base for child. • Focused on problem solving rather than just

reducing anxiety.

Page 10: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Insecure Avoidant• 40% (insecure)• Toddlers (1-3)- Do not seek comfort when

distressed, tend to mask or deny feelings. • Young Children (4-12)- Tend to have shallow

relationships with lots of friends; avoid emotional expression.

• Older Children (12+)- Tend to avoid intimate or close relationships. May immerse themselves in non-emoitional pastimes.

Page 11: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Parent • Prefer to avoid having or talking about

feelings.• Depend heavily on themselves and wont seek

support. • Stay distant from child to encourage

independence.• Tend to project unwanted traits onto their

child and others.

Page 12: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Insecure Ambivalent • Toddlers (1-3)- Can not be calmed easily after

experiencing anxiety or distress, may seem to want comfort but also resist.

• Young Children (4-12)- Tend to start forming very intense emotional friendships.

• Older Children (12+)- Find relationships of all kinds exciting but also confusing.

Page 13: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Parent • Tend to be overwhelmed by emotion in

relationships. • Prefer not to think in relationships and

parenting .• Over identify and cling to their children.• When facing problems, tend to focus on

reducing, ‘bad feelings’, rather than problem solving.

Page 14: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Summary of Insecure Attachment Styles

• Securely attached children know they can show their needs and feelings and won’t be rejected.

• Avoidantly attached children learn that bottling them up is what Mummy and/or Daddy seem to prefer.

• Ambivalently attached children end up unsure what to do when their attachment system is activated because, for example, they regularly get fed when their carer is hungry, not when they are.

Page 15: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Disorganised Attachment • Not an attachment pattern but fleeting

behaviours, that may be observed between child and carer.

• Indicative of significant maltreatment.• Frightened by haven of safety.• ‘Fear without solution’ (Mary Main)• Baby P.

Page 16: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

What do we mean by Trauma?

Trauma• Attachment based trauma.• Childhood incidences of severe abuse and

neglect.• Physical and/or psychological threats or

assault to a child’s physical integrity, sense of self, safety or survival.

Page 17: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• ‘Big T’ trauma, and ‘Small T’ trauma.

• ‘Big T’- sexual abuse, rape, physical abuse.

• ‘Small T’- neglect or a depressed or chronically mis-attuned carer.

• ‘Small T’ trauma can be just as destructive as ‘Big T’ trauma.

Page 18: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Unresolved

• Unable to process what has happened.

• Unable to, ‘come to terms with it’.

• Unable to make sense of it.

• Experiences remain unresolved.

Page 19: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Resolution

• Memories are integrated into their original context.

• Brain has filed and processed them correctly. • When unresolved- intrusive memories

flooding the persons conscious thoughts. • Uncontrollable flashbacks (sights, sounds and

smells)

Page 20: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Assessment of Trauma • Trauma inflicted by attachment figure.

• The age of the child.

• Length of the trauma.

• Severity of the trauma.

• Past and present attachment relationships.

Page 21: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

The Impact on the child

• Schema- ‘Unlovable’.

• Internalizing being bad provides a sense of power and control.

• The abused child will cling to this belief in his own badness because by becoming, ‘bad’ child can then make the objects of attachment ‘good’.

Page 22: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• Multiple, incompatible, incoherent representational model of the self and others.

• ‘The material for constructing an image of oneself is oneself alone’.

• Vulnerability- creates fragile, poorly symbolized, unmoderated sense of subjectivity.

• A self state where everything is directly experienced but difficult to regulate and potentially overwhelming.

Page 23: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• Severe emotional neglect- difficulty learning words for feelings.

- Adults can have difficulty in reading facial expressions.

• Lack of flexibility in thought patterns causes difficulty distinguishing what is thought and felt and what is experienced in reality.

Page 24: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

‘Traumatized individuals see and feel only their trauma, or they see and feel nothing at all; they are fixated on their traumas or somehow psychically absent’.

(Sykes and Wylie, 2004).

Page 25: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Mentalization/Reflective Function

• Mentalization-(mind-mindedness) Ability to recognise that others possess thoughts and

feelings that may differ from your own.

• Refective Function- Mentalization in the context of the attachment relationship. Parents capacity to recognise what their child is capable of

thinking and feeling and that their child may be experiencing things differently from them.

Page 26: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• If carer minimizes and misunderstands what the child thinks.

• Abusive- illogical and unpredictable.

• Causes random behaviour in the child, (eg DA)

• Poor circumstances to develop an interest in mental worlds of close and intimate relationships.

Page 27: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• Children flummoxed by what’s going on in other people’s minds.

• Little interest or enthusiasm.

• What's the point ????

• Huge implications for own parenting.

Page 28: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Emotional dysregulation• Abusive caregiver does not offer experience

of regulating babies emotions.

• Developmental impact.

• Infancy- self soothing.

• Adolescence and adulthood- unable to soothe ourselves in ways that are not destructive.

Page 29: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• Helplessness can lead to desire to want to control and dominate.

• Violence and aggression- ‘Trauma Organised System’ (Bentovim 1995)

• Creating an, ‘aura of violence, aggression and threat’.

• Victimisation is projected onto the other rather than being experienced by the self.

Page 30: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Dissociation

• ‘Psychically absent’.• Linked to past Unresolved Loss and Trauma. • Shutting down and disconnecting with the world.• Involuntarily. • Adaptive.

‘Nowhere to run and no one to turn to’, (Schore 2003).

Page 31: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate
Page 32: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

What’s needed?

‘‘If we are to truly effect change, we must provide high-risk families with what they need, first to heal and repair and then to grow and flourish”.

Slade et al (2005)

Page 33: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

• Collishaw (2007)- protective factors resulting in more resilient functioning.

• Developing competencies to make and maintain supportive interpersonal relationships was the most significant protective factor.

Page 34: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Two personality types

• Narcissistic/obsessive tendencies- ‘defensive pull not to attach to another’.

- ‘Defensive shell’, ward off feelings.

• Borderline/dependant tendencies- desire to seek and cling to an attachment figure,

- ‘ A surviving wish for intimacy’.

Page 35: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Supportive Relationship• Element of, ‘parental love’.

- Helps develop the capacity to take pleasure in another.

- Implications for parenting.

• Offer, ‘secure base’, ‘safe haven’.

• Emotional Scaffolding.

Page 36: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Always try to be:

• Available, loving, caring

• Interested, responsive

• Sensitive, accessible

• Co-operative, trustworthy

Page 37: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Aim never to be:

• Unavailable, unloving

• Uninterested, unresponsive

• Neglectful, hostile

• Rejecting, inaccessible

• Ignoring, untrustworthy

Page 38: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate
Page 39: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate
Page 40: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Final thought…

• Trauma lens’. (Van der Kolk et al 1996)

• Trauma victims- organise much of their lives around repetitive patterns of reliving and warding off traumatic memories, reminders, and affects.

Page 41: Attachment Relationships, Trauma and Development Alice Cook PhD Student Royal Holloway University Family Assessment Practitioner ADAM Project Associate

Questions

• adamproject.tiddlyspot.com (no ‘www’)-client

[email protected]