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CGTA Newsletter Article
THE TRAUMA-ATTACHMENT TANGLE:
Let’s Help Children and Parents Out of the Bind
by Joan Lovett, M.D., F.A.A.P.

Trauma causes loss of trust in self and others. The effects of trauma early in life can interfere with the development of loving, mutually satisfying relationships. Insecure attachment makes children more prone to trauma. This cycle of trauma and poor attachment can have profound detrimental effects throughout life. We clinicians can help peel off the layers of trauma, and we can help to stack sweet layers of trust.

Children who have experienced early trauma tend to believe that they are bad, that whatever went wrong is their fault (developmentally egocentric, young children believe that they are responsible for everything that happens), and they are filled with confusion, because they were overwhelmed by the traumatic events that happened to them. Shame, guilt, and confusion get in the way of forming healthy, loving, secure attachments, based on trust.

Usually, a single traumatic experience, in the context of secure healthy parenting, does not rupture the bonds of trust. Attachment issues typically arise from multiple, chronic trauma. Some traumatic experiences can be obvious, like adoption from a foreign country, physical or sexual abuse, loss of a parent, or natural disasters. Attachment problems can also develop in the more subtly destructive environment of narcissistic or depressed or substance involved parents. Sometimes even life saving care, as in a newborn intensive care nursery, can cause trauma that interferes with attachment. It can be slippery trying to figure out the causes and kinds of attachment problems. Even with a diagnosis, there are no proven treatments for specific kinds of attachment disorders.

In working with attachment issues, I find it useful to think in terms of cognitions. A child or adult who has difficulty relating to others may display behaviors that indicate negative beliefs like “I can’t trust anyone to meet my needs”,” I’m not safe unless I can anticipate and control everything that happens to me”, “I am bad and everything bad that happens is my fault”. To complicate matters, traumatized individuals often have conflicting beliefs, like “I can’t live without help” and “I don’t deserve help” They may have contradictory beliefs, such as “I have to have attention” and “It’s not safe to be seen.”

It is more helpful for a child who is safe and receiving adequate care to believe “I can trust people to take care of me,” I am safe now,” “I am good”, “What happened is not my fault.” “I deserve help.” These positive beliefs lead to more cooperative, mutually satisfying relationships that open the way for growth and development.

Adults who have experienced early trauma and subsequent problems with attachment have trouble developing and sustaining intimate relationships. It is difficult for them to relate to partners or to parent effectively. Adults with attachment issues usually lack healthy “inner parents” who believe in their worth and can encourage and guide them. Normal emotions and behaviors of others can easily trigger them into intense feelings and immature behaviors.

What does help children and adults who have had experiences that ruptured their trust in the world and who have been unable to develop close, reciprocal, loving relationships?

  1. Experiences of being safe for an extended period of time.
  2. EMDR to desensitize and reprocess upsetting memories.
  3. Development of healthy “inner parents” who nurture, encourage, and offer guidance.
  4. Children benefit from nurturing cuddle time with parents – and alternating bilateral stimulation to reinforce positive experiences of safety, care, tenderness, and attunement.
  5. Adults benefit from imagination exercises to help them experience nurturing.
  6. Children and adults need a cohesive life story that is developmentally appropriate and explains and reframes what happened to them and offers trauma resolution and hope for the future.
  7. EMDR to target confusion, so that uncertainty (necessary for approaching new experiences and learning) does not trigger anxiety.
  8. Grief work, to deal with loss and find ways to be loyal to more than one person or family.
  9. Creative opportunities for healing. Art, play therapy, drama, sandtray work can be used to express feelings, as well as provide targets for desensitizing and reprocessing traumatic experiences. Fortunately, children can resolve trauma even when EMDR is used to help the action figure, the baby doll, or the toy horse resolve a challenging situation.
  10. Work with parents (or refer them) to understand and desensitize their own triggers for reactivity. Children who are fearful, angry, needy, or sad need mature parents who can stay objective and help them contain their strong emotions.
  11. While the work of resolving trauma and developing trust can be slow, EMDR can facilitate the process. The rewards are sweet and well worth the effort.

Dr. Joan Lovett, F.A.A.P. is in private practice in Berkeley, California. She is an EMDR Institute Facilitator and EMDRIA Approved Consultant who has presented conferences nationally and internationally. Dr. Joan Lovett is author of “Small Wonders: Healing Childhood Trauma with EMDR” (Free Press, 1999) You may contact her at joanlovettmd@gmail.com to receive information about upcoming conferences or to arrange for phone consultation.