Developmental Trauma - Where Attachment Meets Trauma

Louise Godbold 2/19/1410:00 AM

Can this possibly be right?

A couple of weeks ago, I listened to one of the trauma 'greats' Dr. Bessel van der Kolk. He was humane and wise, and had us all enthralled for 7 hours straight. But in the middle of the flow of information that now occupies half a notebook, he said something that made me sit up.

He listed the set of symptoms we have come to associate with complex or 'developmental' trauma: inability to concentrate or to regulate feelings of anger, fear and anxiety; self-loathing; aggression and risk taking. Those are all attachment issues, he said, not trauma. Trauma symptoms are intrusive thoughts and nightmares, etc, and we know how to treat those (Eye Memory Desensitization and Reprocessing - EMDR, for example).

Wait! I looked around but everyone was bent over their notes or tucking into the breakfast pastries. Did he just say what I think he did?!

Let's dial back a bit. When a child does not receive consistent loving attention from their primary caregiver, the child develops an insecure attachment. So far so bad. The loving relationship provides the building blocks for brain development. In fact, Bessel (if I might be so familiar) told us that the strongest predictor for mental health was how loveable your mother finds you at 2 years old.

What happens to a child when their parent constantly flies into a rage? If the parent is shut down emotionally? (Watch the 'still face' experiment) If for long periods the parent is stressed or sick or has to go away? The attachment is in peril and if the child does not get the comfort they need those oxytocin receptors in the brain (see previous blog) don't get formed. Children or adults who don't respond to kindness and reassurance? Maybe that's because there is no mechanism to respond. And it makes perfect sense that without the fundamental feeling of being loved, a human being is not going to thrive.

So which is it? Does an insecure attachment lead to trauma symptoms? Or does trauma create the insecure attachment in the first place? Or is this new 'developmental trauma' (or the more general 'complex trauma') really a combination of two things that we have lumped together?

If so, do you see the implications? The Adverse Childhood Experiences Study (ACES) provided data that has created a great shift in our understanding of people with physical, mental and social problems, and has fueled the movement to become trauma-informed in our services... but what if we're focusing on the wrong thing? What if we should be focusing on attachment, at least as much as we are focusing on trauma?

At Echo Parenting & Education we have always focused on attachment and how nonviolence in child raising can create a safe, stable nurturing relationship between adult and child. Next week, we are convening a conference on developmental trauma "Changing the Paradigm: Trauma and the Developing Child" precisely because we have always seen this link between trauma and attachment. It was only because I was packed in with 400 therapists when I heard Bessel make the link too that I didn't do cartwheels (that, and because I was wearing a skirt). Nice to know that we are in the forefront of this thinking about developmental trauma, and not because we're psychologists or neurobiologists, but because 12 years ago our founder, Ruth Beaglehole, set up an agency that has 'an uncompromising view of what it is to love a child well'. Go Ruth! Go Echo! I think I might feel a cartwheel coming on...

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Kathy BrousMember

Thank you Lou!
Yes! Insecure Attachment causes trauma, not visa versa! Not only is your blog 300% correct but it’s what my book "Don't Try this at Home" documents at www.attachmentdisorderhealing.com/book.

    I'll have more details in my March 14 blog on Developmental Trauma next week.
    Dr. van der Kolk says it explicitly and at great length in his May 2013 Yale speech “Childhood Trauma, Affect Regulation, and Borderline,” which thanks to Jane Stevens I found on ACEsConnection. He is very clear, that the symptoms you list which we associate with developmental trauma (inability to concentrate, regulate, etc as in your blog) are all Attachment issues -- and he explains: these create trauma.
   It's a “new” concept of trauma so some refer to it as "trauma with a small t” – trauma ingrained in brain & visceral tissue as Bruce Perry explains, called developmental trauma for that reason.
     When Dr. van der Kolk said these symptoms are "not Trauma," he simply meant they are not "incident Trauma with a capital T” as in standard PTSD – as the establishment esp. the Pentagon has understood trauma. PTSD is trauma caused by discrete incidents. These can happen at any time in life (rape, violence, war zone trauma), need not be continuous and often have nothing to do with parenting per se. Van der Kolk explains this bias toward Big T Trauma in great detail in his Yale speech.

      Of course a parent who rapes or beats a child is also likely to give them broader insecure attachment and developmental trauma.
       But we can have plenty of life threatening insecure attachment and developmental trauma without ever having had a Big Incident Trauma at which one can point a finger. And THAT is a huge problem for being UN-seen. "Nobody beat me or raped me - what's wrong with me?"
   That's why developmental trauma which is caused by Attachment Disorder = insecure attachment is so insidious. Maybe 20-40% of our population goes through life never knowing they even have it. That’s why many of them go on to become leaders of industry and government and mess society up. That’s why Bessel has said half the Congress has attachment disorder.

3/6/141:18 AM

Joel AndresMember

Dear Louise,

Excellent post.

I am certainly not the expert, but it has always been my understanding that the two are interrelated. Though one who has a healthy attachment is most likely more resilient, and thereby able to recover more easily from trauma given the right interventions, most are not so lucky. What is also likely is that those who have not had healthy attachments are more likely to suffer from trauma because of their lack of resiliency. To me what is most important is not what we call it, but how we understand and treat it within the family, as the attachments within the family will undoubtedly influence the ability for family members to heal.

Best,

Joel Andres, MFT, JD

2/19/1410:01 PM

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