Interventions in the Attachment and Relationship Problems Trauma Can Cause
Julie De Wilde
Alfred Adler Graduate School
Much research has been done on the negative effects of trauma on attachment, which then has negative effects on relationships. Research more recently has focused on the positive post traumatic growth that can happen when clients receive safe, healthy attachment to a therapist they can trust. Research also includes the benefits to the client when a therapist includes important relationships in the therapeutic process.
Keywords: Trauma, Attachment, Relationships, Post Traumatic Growth.
Attachment and Relationships: Healing from Past Trauma
Much has been written about the correlation between early childhood trauma impacting attachment as well as the heatlh of future relationships. The emotion dysregulation that is caused by PTSD can result in personality disorders and many other mental illnesses. However, encouraging information is developing in the more recent research, showing instead how to build resilience in children so that they are protected from longer mental heatlh disorders that can arise from trauma. Factors that build resilience can protect form trauma and can create growth from trauma. Volgan and Bates, 2016, state that social support and attachment style significantly impact the long-term consequences of trauma and can aid in developing post traumatic growth.
Types of Support
According to Volgin and Bates, 2016, social support is divided into emotional support and instrumental support. They define emotional support as “comfort, caring, and affection,” (Volgin and Bates, 2016, p. 184); whereas, instrumental support involves “services, resources, problem-solving means, and tangible aid” (Volgin and Bates, 2016, p.184).
Comfort and caring can provide an environment where the stressed or traumatized person feels safe to process what happened, thus discontinuing their habit of avoiding thoughts and feelings of the trauma. They also then cease avoiding people, places, and activities associated with the trauma.
Instrumental Support. Many of the studies Volgin and Bates, 2016, reviewed showed evidence that instrumental support is helpful in alleviating symptoms of trauma and helping with post traumatic growth. It is thus important for therapists to ask in the diagnostic assessment what resources the person has for support. This can include supportive relationships, financial resources, time for processing, access to medications, adequate childcare, etc.
Healthy Attachment. What Vogin and Bates, 2016, found to be the most impactful on healing from PTSD and developing post traumatic growth or healthy cognitions is healthy attachment. This is because, without secure attachments, one will not or cannot trust that others will be there to support them as they process their traumas. Diamond, Russon, and Levy, 2016, take attachment research a step further when it comes to helping clients heal from trauma. They not only describe the therapist as the secure base who helps clients regain attachment to others and trust in themselves, but also describe how attachment family therapy can help clients heal from trauma. The therapist helps the family uncover traumas that have damaged trust in each other and then move towards more engaged and supportive family relationships. Diamond, Russon, and Levy state that when parents are emotionally present and available, children develop secure trust in others, develop self-confidence, and thus then learn to self-regulate their emotions. This then sets the tone for what they will expect from future relationships.
Secure Attachment. With secure attachment styles, people can initiate warmth socially and can receive comfort socially. They know they can trust stability of others in their lives. This stability contrasts the cognitive distortion that life is unpredictable, a common cognitive distortion of PTSD.
Anxious Attachment. Those who have anxious attachment worry that those they care about will not be emotionally available to them when they need support. They then pursue support with a sense of hypervigilance as a way of regulating their distress. In fact, Klest et al, 2019 state that chikdren who suffer abuse and neglect often develop insecure attachment. Kapeleris and Paivio, 2010, p.619, concur stating, “In the long term, these early experiences result in fear and negative expectations concerning relationships, especially intimate relationships”. They state further, “Childhood emotional abuse and neglect, in particular, are characterized by insecure attachment that persists into adulthood, and in turn, has been associated with relationship difficulties (Kapeleris and Paivio, 2010, p.620.”
Avoidant Attachment. Those with avoidant attachment, Volgin and Bates, 2016, strive for emotional distance in relationships. They tend to numb out when stressed and disconnect. This disconnect from others, from themselves, and from the present moment increases symptoms of PTSD (anhedonia, avoidance of triggers that remind them of trauma). Lassri et al, 2018 concluded that childhood trauma tends to make people self-critical, which the causes them to have adult relationships that are dysfunctional, reinforcing their belief that others do not like them. Therapists, therefore, need to educate their clients about the effects of trauma. If clients can see their interactions as arising from trauma, they can then begin to make different choices in the present and perhaps be more motivated to face their traumas (stop avoiding).
According to Volgin, and Bates, 2016, those with anxious or avoidant attachment styles report higher levels of PTSD. The question remains, did the attachment style cause a higher level of PTSD, or did the PTSD affect their attachment style, which then maintains the PTSD symptoms at their severity.
Through their own study, Volgin and Bates, 2016, p.188, concluded “for anxiously attached adults, lower levels of emotional and instrumental support exacerbated the impact of anxious attachment on distress leading to greater PTSD”. They however found no relationship between avoidant attachment styles and levels of distress following trauma.
Conclusion. While much research has been done on the long-term effects of trauma, newer research is showing promising results for healing via relationships that establish safe, respectful, trusting relationships. Therapists can play a large role in helping clients establish a healing relationship that challenges their current cognitive schemas about relationships and about the world. Therapists can also help clients recover from trauma by helping the current adult relationships the client has. As current relationships enter therapy and embrace a balance of openness and boundaries, as well as a safe, trusting relationship, clients begin to allow new schemas into their world view. The greater the number of safe relationships a client has, the more they can have the courage to face past trauma. Ceasing to avoid thoughts and feelings of past trauma eliminates yet another symptom of PTSD.
Diamond, Guy, Russon, Jody, and Levy, Suzanne. (2016). Attachment-Based Therapy: A Review of the Empirical Support. Family Process. Vol. 55, No 3, p. 595-610.
Kapeleris, Andrea R., and Paivio, Sandra C. (2010). Identity and Emotional Competence as Mediators of the Relationship between Childhood Psychological Maltreatment and Adult Love Relationships. Journal of Aggression, Maltreatment, and Trauma. Vol. 20, 617-635.
Klest, Bridget, Tamaian, Andreea, and Boughner, Emily. (2019). A Model Exploring the Relationship Between Betrayal Trauma and Health: The Roles of Mental Health, Attachment, Trust in Healthcrae Systems, and Nonadherence to Treatment. Psychological Trauma: Theory, Research, Practice, and Policy. Vol. 11, No. 6, p.656-662.
Lassri, Dana, Fongay, Peter, Luyten, Patrick, and Shahar, Golan. (2018). Undetected Scars? Self-Criticism, Attachment, and Romantic Relationships Among Otherwise Well-Functioning Childhood Sexual Abuse Survivors. Psychological Trauma, Theory, Research, Practice, and Policy. Vol. 10, No 1, p. 121-119.
Volgin, Rebekah and Bates, Glen. (2016). Attachment and Social Support as Predictors of Posttraumatic Stress and Posttraumatic Growth. Traumatology, Vol. 22, No 3, 184-191.