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Misattunement – The Invisible ACE


“I had a good childhood.  There was always food on the table and a roof over my head.  So why do I feel stuck all of the time?”    Do you wonder why you often feel unsatisfied in your relationships or why your professional life goes nowhere in spite of lots of effort?  Or why you never feel seen?  What if during your early years you experienced lots of misattunement? 

Huh? What's misattunement? Here’s an example.  I went to a very crowded garden show the other day and while looking at zinnias  I witnessed a mom with her 4 year old daughter.  Daughter says “Mom, I’m hungry.”  Mom quickly grabs the little girl’s arm and angrily says “You’re not hungry.  Let’s go.  You are always telling me you’re hungry.”  She then pulled the little girl behind her off into the crowd.  My heart broke for this child whose mother dismissively misattuned with her daughter’s very basic, physiological need for food.

 So what happens inside little ones who frequently experience this sort of misattunement?  They stop expressing their needs, learn to unconsciously reject their needs and then shut down and disconnect from their needs.  Dr. Laurence Heller, author of Healing Developmental Trauma says that children who experience this sort of deprivation give up their demand for caring and love.  They decide unconsciously that there’s no hope that their needs will be met.  Giving up becomes a common way they respond to stress. 

As such a child matures, she becomes used to living with these unmet physical and emotional needs. She develops survival strategies, like being really helpful to others and needing very little for herself.  She has an unconscious belief that her deepest needs don’t matter and that she doesn’t matter.  She may feel erased and empty, like she doesn’t exist.  When she risks expressing a need, she gives up easily if someone doesn’t respond.

For many of us the misattunement began in infanthood.  Picture this.  A mother feeds her baby who then falls asleep in her arms so Mom puts the baby down in her crib.  Then a little while later the baby starts crying.  The well-attuned mom goes to the baby and holds her until she falls back to sleep.  This mother is tuned into and responsive to both the physical and emotional needs of her baby.  Mom’s attunement helps the baby feel safe and secure so she can rest easily. When the baby signals distress, Mom responds with love and caring. 

 The misattuned caregiver might just let the child cry herself back to sleep.  No big deal on the surface, right?  In fact, parenting books advocated this for years.  But let’s go one layer deeper.  A baby can’t talk, so her only form of protest is crying.  When a baby cries and no one responds, she gets frustrated and cries louder.  If still no one responds to her frustration, she gives up and stops crying and eventually falls asleep.  The baby gives up, shuts down and disconnects from her distress because no one responds to it.  This misattunement interferes with the child’s sense of safety and fosters a sense of helplessness and hopelessness.

The Harvard Center on the Developing Child describes how this misattunement affects children’s brain architecture.  When caregivers consistently attune to a baby’s needs, neural networks are built in the brain that support the development of communication and social skills.  When there is consistent misattunement, a baby lives in a state of constant stress due to unmet needs creating significant emotional and physiological issues.  This is why I believe misattunement is an invisible ACE.

Here’s another example of misattunement that’s really prevalent in today’s culture. We misattune to our children’s’ capacity for stimulation.  In our hyper fast, loud world, we as adults can barely stand the endless packed schedules, traffic, and deadlines.  Many of us feel overwhelmed and exhausted by the fast pace and the constant stimulation and input in our lives.  We don’t attune to our own need for down time.  Now imagine the nervous system of the developing child.  Brad Kammer, Director of the NARM Training Institute, often talks about how we label children as “fussy” rather than getting curious about what’s going on inside the pre-verbal child who can’t simply say “this is all too much for me” or “I’m scared right now.” 

I feel antsy as I write about this because I was punished several times as a child for being “fussy” in loud, unfamiliar places.  My mother managed my behavior and misattuned with my emotional needs for safety and caring.  I learned to be a good girl.  As an adult I learned to endure situations well beyond what was good for me.  I often felt really stuck. Those are the survival strategies I unconsciously adopted in my family environment.  

Are any of these survival strategies familiar to you?  Do you pride yourself in needing as little as possible?  “Can I take care of that for you?”  “Whatever works for you.  I’m fine.”  “Sure, no problem.”  In rejecting our own needs we often chronically misattune to ourselves.  We don’t sleep when we need, we don’t rest when we need to and we don’t follow our hearts.

Many of us with these patterns go into the helping professions, putting our needs so far ahead of others’ that we burn out.  We can’t say no even when we know we are stressed to the max already.  We also tolerate disrespect from others.  As much as I wish these strategies just fall away when we become adults, they don’t.  These strategies continue into our adulthood until we get curious about them.

None of the Adverse Childhood Experiences questions specifically points to what I’ve described above and yet chronic emotional misattunement in childhood is an invisible ACE that can have devastating effects on our physical and emotional well-being later on.  We often feel unseen and really empty on the inside as well as chronically dissatisfied in spite of trying really hard to make things work.  If you resonate with any of this and you often feel stuck, I invite you to get curious about your relationship to your own needs.  What if underneath “I feel stuck” is actually “I need help” or “I need some nurturing.”  Consider if you are aware of your own needs and if you weigh them appropriately with those of others. 

If you feel disconnected from your own needs or you often feel unseen, maybe it’s time to get some help with this.  The NeuroAffective Relational Model (NARM) specifically helps people become aware of and unravel these old strategies so that we feel much more free, alive and at ease.  We learn to attune to ourselves so that we create the life we want while creating deeper connections with others.  You are not stuck with these patterns.  They are just patterns.  They are not you.  If this resonates, let’s talk.

Stay tuned for part two of this conversation about misattunement where I will talk about what happens inside us to all the frustration that builds up.

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I think another element to keep in account is that when you are deemed to be a fussy or high needs child that often signals there are other things at play. It would be easy to just assume the parent is callous or underperforming but children are all born different.

I see myself a lot in the description of the coping mechanism (overly helpful, etc.) and having become a mother myself and seeing a lot of the things my mother complained about in my son and having received a diagnosis of autism for myself (which includes sensory sensitivities and difficulties interpreting social cues) I think I'm starting to find the missing piece of the puzzle in that it really does take a village to raise a child, but not all of us have it, and some of us have a more difficult assignment than others.

Just a few weeks ago my friend came over with her two kids and I was amazed at how "easy" her second was completely unlike her first or my son: she barely ever cried, fell asleep really easily, when she did cry it wasn't the ear-splitting level her son and my son are able of and it made me think a lot about how difficult it has all been and still is and my capacity (or any human's capacity) to deal with requests and sound input.
In short: I wonder if you can throw in the mix the amount and "level" of requests different children make and the capacity of different mothers in the list: a child who makes 10 requests might see most of them fulfilled, whereas a child who makes 100 probably won't. Throw in each child's resilience levels and then you find that children with comparatively similar experiences or equally dedicated parents might have different outcomes and perceptions of how much their parents attuned to them.     

And of course, different sensory needs are much like a child's complexion and ability to withstand the sun: you can't blame them for it, but it's also worth being compassionate of their parents.                                                                                                                                                                                                                                                                     

Nancy as she grows, consider/remember neurofeedback... A lot of early experiences are encoded into the right brain as implicit learning -- 'truths' about life-- in the right brain.  Those are not easily overridden by rational/left brain lessons.  Sometimes modalities that work with the right brain are useful for these kids.  Neuroptimal is a form of neurofeedback that is one-size-fits-all and very helpful to calmness and self regulation.  It made a huge difference to the foster youth I mentor.


AS inattunement can be devastating, having you for a grandmother will have positive, lasting effects! It might not be something that's realized, yet, in her young life, but know that you are making a HUGE difference in her life. Keep up the good work!

Thank you. I am raising my granddaughter after trauma and loss. I see this in her and ask her to make a choice, let me know what she likes. Its so hard for her, yet she brushes the cat, the dog and feeds the chickens because they like it, need it. She’s so dear, people say. I worry. 

Before I learned of the ACE study, I had heard an Epidemiologist at [then Dartmouth, now] Geisel Medical School 'Grand Rounds' present: "52 % of Detroit Metropolitan Area Schoolchildren met the DSM-IV criteria for PTSD". Similar numbers have subsequently been reported in Philadelphia, Baltimore, Atlanta, and in June of 2018-at five charter schools in New Orleans.

The more recent types of 'ACEs' (Adverse Childhood..., and Adverse Community Experiences), which the World Health Organization's "WHO ACE International Questionnaire" attempts to consolidate, may address much of this, but this article [and comments, so far] recognizes one more possible factor with this issue of 'Misattunement'.

In spite of my ACE score of 6, I'm extremely grateful for a relevant 'Resilience Score' of 10: and my 'Extended Family' during my early formative years, and the proximity of 'A Whole Village' it takes to 'Raise a Child'... 

 (During one of my 'Community Organizing' jobs, I had a 'Shop Keeper' explain that the Shop Keepers and the Grandparents kept an eye on the neighborhood during the day, and they knew who was 'absent from school'..., and the working folks kept an eye on the shops and grandparents at night...---this occurred in the city where the local Police Department now has an 'ACEs' initiative, and it was noted in ACEsConnection.... [I'd even 'witnessed' some of these positive qualities in the Southeast Bronx of NYC in the early 1970's, in spite of the potential 'Adverse Community Experiences' that occurred there (85% of the housing was considered 'Substandard or Deteriorated', and the area reported 100,000 Heroin addicts...).

Hi Sarah,
Thanks for your comment.  I certainly did not mean to imply that any parent could possibly 100% attuned.  Not a chance for all kinds of reasons.  IMO development is compromised when the misattunement is chronic and there is no repair with the child.  Yes, I believe being able to hold the good and the not so good in our parents with compassion is essential in our healing and that comes organically when we really make contact with what's leftover inside us from our early experiences.


This crossed my inbox today -- thought it was pertinent to this discussion.  At ATN we often talk about "good enough" parenting - since no one can correctly meet the needs of their child 100% of the time.  This research is full of food for thought.

I can relate, both as a child who grew with (and still has) misattuned parents AND as a parent who has challenges attuning to my own children. I cringe, though, at the characterization you portray of the loving, well-attuned mother who can respond perfectly to her baby 100% of the time. This is not reality; there will always be times when a mother -- ANY mother -- is unable to attune to her children, whether for reasons related to her ACES or things in the current environment. I agree with Julie that misattunement seems more like a symptom of growing up with narcissistic, addicted, or emotionally/physically abusive or neglectful parents. By their very nature, those parents are incapable of providing the unconditional love and care their children are entitled to. I have to hope that my growing awareness of my reaction to my parents' misattunement, and the strides I've made to recognize those tendencies in myself, will begin to break the cycle for my children. But again, I am not perfect and never will be. I think compassion -- for ourselves and those who hurt us -- needs to figure large in whatever psychological/diagnostic "theory" we're going to use to understand the myriad ways we've been harmed or hurt in life, and how best to heal ourselves. I can only hope my children find that compassion one day too for any mistakes I've made, and for themselves.

Hi Carey,
Thanks!  Yes, indeed.  I love how you said that.

Yes, some people, kids and adults, who grow up in this do demand attention.  Dr. Heller, creator of the NeuroAffective Relational Model (NARM) says that when the misattunement is less severe, rather than being inhibited in expressing their needs, kids can be "can be very demanding of people in their lives while living with the continual feeling that there is never enough."


Great post! Perpetual invalidation is a a soul suck, especially for children.

Do some kids who grow up in this situation grow up to demand attention? 

Hi Harper,
Yes!  IMO, you just described one of the ways that misattunement contributes to a cascade of intergenerational trauma.  That's why I am so grateful that all of us are engaging around ACEs and related issues.  We can change this one interpersonal interaction at a time by really attuning to ourselves and those we interact with.


Hi Julie,
Thanks for your thoughtful comment.  I respectfully disagree with you about misattunement as an ACE.  If you want to dive into the theory, I encourage to read Peter Fonagy's 2002 book entitled Affect Regulation, Mentalization & the Developmental of the Self.  It's a dense and complex book and well worth the effort for anyone who wants to understand more about the importance of attunement and mirroring and their effects on secure attachment.


I really like what you have to say at the end...that these are just patterns, not you and they can be changed.  I think describing these as an ACE is a bit shaky, knowing what I know about attachment theory and that's about 65% of the population overall has a secure attachment, so 35% do not and yet this is not really "disordered attachment" just a vulnerability of developing your own avoidant/dismissive or anxious/clingy relationship style.  Yet research into those who have what attachment theorists call "earned secure" shows that those who are able to attune to themselves and become more healthy in their adult attachment style can truly become very strong relationally in attuning with others.  And that parents who misattune with their children can be taught, coached and supported into reading their children better - moving toward more healthy attachment.  So much of this depends on how many times this misattuned cycle repeats itself, how early and how chronic and what other early relationships are available.  At the severe end of this (extreme neglect) we're talking attachment disorders - where the child's very survival is dependent on NOT attaching to anyone and therefore they push away (shut down, fight, flee) any attempts at connection.  Fascinating thoughts - so glad to see that attunement/attachment are becoming part of the overall picture of helping to heal ACEs.

I totally agree that lack of attunement is an ACE and educate parents and others about this all the time in psychotherapy. So many people feel they had a "good" childhood, but I see signs of lack of attunement. Any parent who is "anxious" or "depressed" or "narcissistic" or has an addiction is going to be misattuned to a child, because they are over-focused on their own emotional needs. I write about the connection between insecure attachment and low self-worth or high shame intolerance. Parents who are, themselves, insecurely attached grow up to struggle learning to attach to their children and be emotionally present. That is because they are struggling with fears of inadequacy and shame. Anyone living in "fight-or-flight" is not going to be calm and able to engage in pro-social behaviors, such as child care. ....And the cycle continues because their child does not get their emotional needs met. 

Great article that really "hit home" when I felt the gut-punch-of-truth land for me.  I've been dancing around these feelings for a while and noticing their effects in my life but not understanding what was going on for me.  I'm thankful to finally understand their origins so I can start addressing them!  Awesome article that I'll definitely be sharing!

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