Posts from the ‘Attachment Theory’ Category

Apr 13

Healing Past Relational Trauma with Wholehearted Presence

The swirling busyness and restless energy settled and a profound stillness permeated the room, enveloping the group like a soft feather blanket. Sitting in silence and sensing the body was unfamiliar territory for most of the two-dozen workshop participants. After all, for many of them, the body had long-been associated with shame, self-judgment, discomfort, and trauma. Yet, there they were, courageously bringing compassionate awareness to their embodied experience, one moment at a time. Opening to the life that had been refused, again and again, until that moment.¹

This is a description of the first day of the first REAC²H workshop, which was conducted with a group of female survivors of childhood maltreatment. REAC²H is an acronym that stands for Restoring Embodied Awareness, Compassionate Connection, and Hope. It is an innovative approach to healing past relational trauma by cultivating present-moment awareness and self-compassion. The workshop was designed by Dr. Jon G. Caldwell, DO, PhD after years of research and clinical work in the fields of traumatology, attachment theory, affective neuroscience, and contemplative practices.

The REAC²H workshop was specifically designed to help individuals who have experienced “relational trauma”, which encompasses various kinds of emotional, physical, and sexual abuse that occur in the context of close relationships. Relational trauma has meaningful effects on the attachment system – an innate, biological system that facilitates interpersonal connection to adaptively shape human development. Thus, relational trauma and the resulting disturbances in attachment can have profound effects on a person’s developmental trajectory across the lifespan.

Apr 1

How We Relate Predicts How we Meditate: Attachment Style is Linked to Mindfulness

During a recent trip to Los Angeles California, I was aroused from early morning slumber by an eerie sensation of movement. As the veil of sleep was pulled from my mind, I gradually registered the meaning of the shaking bed beneath me and the groaning structures above me: earthquake! A shot of prickly energy ripped through my gut and landed in my chest, quickening my heart. Adrenaline sharpened my senses and time seemed to slow as I instinctively made my way to the patio door. I looked out onto the street, half expecting to see creviced sidewalks and toppling buildings. Instead I saw people nonchalantly walking their dogs and sipping their morning coffee.

Despite the apparent banality of the event for local Angelenos, the earthquake was a hot topic at the airport among people unaccustomed to earth-shaking awakenings. As I waited for my flight, I found myself listening to a conversation between two newly-acquainted women.

The first woman excitedly asked the other, “Did you feel the earthquake this morning?” Leaving no room for a response, she went on, “Wasn’t that something! I mean, have you ever experienced such a thing? I didn’t know what to do – I jumped up and ran around in my nightie like a chicken with its head cut-off!”

The second woman, pulling back a bit from the shared space, cocked an eyebrow and flatly replied, “Didn’t bother me much really. This is L.A. after all – comes with the territory I suppose.” Shifting in her seat uneasily she scanned the terminal while drumming her fingers on the chair’s armrest, “Have you seen a trash can?”

The first woman took hold of the other woman’s arm, causing her coffee to quiver and nearly spill, “I just kept thinking, ‘What will I do if this hotel comes down around me? How will people find me? What will my husband do without me? I mean, he can barely make spaghetti!”

The second woman slowly unhinged her arm from the first and with a shrug said, “I guess if it’s your time, it’s your time.” Slipping out of the chair (and the conversation), she stood up and wandered away while casting a comment over her shoulder, “Never a trash can when you need one.”

As a social scientist, I was fascinated by this exchange. You might be wondering what we can possibly glean from this brief conversation between two strangers? Well, I believe that their interaction can tell us something about their attachment tendencies and their capacity for mindfulness. As it turns out, these two constructs, attachment and mindfulness, are linked by how a person expresses and regulates emotion. Let me explain.

Mar 24

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Coming Home to Precious Presence

Over a decade ago, in the early stages of my own process of awakening, a colleague intuitively noticed that I was having a particularly difficult day and suggested that I “try to stay in the present moment”. My mind was reeling, my emotions were on overdrive, and I’m sure I was focused on some temporary, self-destructive fix. He caught my frantic, darting eyes with his and gently implored, “Just try to be right here, in this moment, just as it is… being present for our own experience can be pretty cool.”

Needless to say, I really didn’t understand what he was talking about. I had heard about “transpersonal meditation” and “being in the now”. But these phrases typically brought to mind images of bald guys in flowing robes chanting “Ooooommmm” in a remote hill-top monastery. These notions, naïve as they were, seemed to be completely at odds with my hectic, restless, and discontented existence at the time. I remember thinking, “Who has time for the present moment?!”

As I progressed in my self-reclamation journey, I began to recognize that my incessant running from the-here-and-now was associated with tremendous suffering. The constant busyness and perpetual mind-motion was probably meant to fill some void within myself. Yet, despite my frenetic void-filling behaviors, I still felt a lot of emptiness inside. Eventually, the pain of my situation was enough that I decided to try something different; I got curious about what I was running from and what it would be like to stay with my own experience.

I didn’t know it at the time, but this simple inquiry – “what is really here and can I be with it” – has been at the heart of various contemplative traditions for thousands of years. Within the traditions of Buddhism, a style of meditation practice known as vipassana involves training the mind to have greater awareness or insight of bodily sensations, thoughts, and emotions. Today, this type of practice is generally known as mindfulness and can be defined as “bringing attention to the present moment without judgment.” In recent decades, numerous scientific studies have shown that mindfulness techniques can improve relationships, health, and general wellbeing.

Feb 28

Recovering From Early Social Adversity: Valuable Lessons from Adopted Orphans

During my first meeting with Rebecca (as I will call her), I asked about her family history of mental and emotional difficulties, which can tell me something about her genetic susceptibilities, and about her early life experience with caregivers. These two elements of the evaluation often provide critical information about the unique way in which nature and nurture contribute to human development (see my previous article on this topic).

When I asked Rebecca these questions, an unforgettable look flashed across her face that was part shame and part longing as she explained to me that she was adopted and had no “valuable information” to offer on these topics. All she knew was that she had been adopted by an American family from a Romanian orphanage at the age of two. In fact, to her surprise, this little bit of information proved to be extremely valuable as we tried to better understand how her challenges in adulthood were related to her early childhood experiences. Read more

May 8

Attachment, Emotion Regulation, and Resiliency

Often, during the first week of treatment at The Meadows, people will skeptically inquire, “Do experiences in childhood really continue to affect my life as an adult?” While social scientists and mental health clinicians have been exploring this question for decades, other fields of science and medicine have been slow to recognize the effects of childhood adversity on adult health and wellbeing. However, this trend may be changing, in part due to a very influential study by a group of researchers at the Centers for Disease Control and Prevention that are examining the long-term effects of adverse childhood experiences (ACE) on various health outcomes in over 17,000 members of a managed healthcare organization in California.

In general, the results of the ACE study¹ show that adverse childhood experiences (e.g., abuse, neglect, abandonment) are relatively common and are associated with higher rates of early initiation of tobacco use and sexual activity, adolescent pregnancy, multiple sexual partners and STD’s, intimate partner violence, alcoholism, illicit drug use, depression, and suicide attempts. Of course, this resonates completely with our clinical experience and treatment model at The Meadows. However, these investigators also found that adverse childhood experiences are related to elevated rates of liver disease, autoimmune disease, chronic obstructive pulmonary disease, ischemic heart disease, and lower levels of health-related quality of life.

These compelling data suggest that childhood maltreatment is associated with a variety of mental, emotional, social, and physical health problems in adulthood. In fact, results such as these have led some people to elevate childhood maltreatment to the level of a “public health threat”. Yet, as indicated by the conceptual model used in the ACE study (see Figure 1), there are considerable gaps in our scientific understanding of the mechanisms and mediating pathways connecting adverse childhood experiences to the host of deleterious outcomes mentioned above.

Attachment theory has proven to be a useful framework for understanding how early relational experiences influence developmental pathways and adult functioning (see earlier article on attachment). Over fifty years ago, John Bowlby (the “father” of attachment theory) studied adverse childhood experiences in delinquent and homeless children and found that a warm, continuous, and secure attachment relationship between caregiver and child was of critical importance, not only because this biologically-driven bond enhances survival and reproductive fitness, but also because it establishes the foundation for successful social-emotional development and resiliency throughout the lifespan.

Mar 14

Attachment Theory in Action: Feeling Attachment Security in the Body

Several months ago, as I sat waiting to board a flight, my attention was captivated by an active toddler sitting (for the most part) on her mother’s lap. Beneath naturally curly locks of hair, her eyes, bright and curious, darted about the busy terminal, feasting on the smorgasbord of novel stimuli. When a scruffy-looking man passed by in a wheelchair and offered a gnarled hand to the young child, she fearfully buried her face in her mother’s loose-fitting sweater. The girl’s mother instinctively pulled her close and whispered softly in her ear while giving the grizzled man an apologetic smile. As the man pushed on, his course laugh still lingering in the air, the girl gingerly emerged from her safe, sweater-cocoon to survey the scene. Still within her mother’s secure embrace, the girl stood-up and ventured an inquisitive glance in the direction of the retreating man. Her fear had been down-regulated and she was able to explore the environment once again.

Interactions like this between a parent and child are repeated on a regular basis throughout early development. From the perspective of attachment theory, these dyadic experiences are the foundation for all social-emotional development. It is noteworthy that, from the earliest moments of life, attachment experiences are interactions between two minds and two bodies. As illustrated by the example above, the mother sensitively responded to the nonverbal intentions and emotions of the child by communicating safety and security through an embodied interaction with her child. In this way, attachment experiences, whether secure or insecure (as in the case of relational trauma and abuse), are incorporated into the body’s self-regulatory systems, and as a result, can play an important role in how the body reacts and responds in close relationships later in life.

This article is part of a series on attachment theory and relational trauma (see the first article for an overview) and is meant to illustrate how attachment theory can guide a therapeutic approach that incorporates working with emotions and the body. To ensure patient confidentiality and anonymity, the clinical example in this article is a fictional account based on many different patient histories and various treatment experiences. Although the following clinical information isn’t associated with one particular person, it is representative of many people who have experienced relational trauma. Read more

Jan 27

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Attachment Theory and the Developmental Consequences of Relational Trauma

As Humans, we are intensely social creatures. Close relationships with other people are often the source of our greatest joy in life, but they can also be associated with tremendous pain and suffering. Early relationships with caregivers, siblings, and extended family are not merely a static backdrop to a mechanistic unfolding of human development – these relational experiences have profound effects on biological and psychological processes, for better or for worse. We now know that children come into the world with sophisticated neurobiological systems that are keenly attuned to the social environment and in turn these systems are shaped by the social milieu. This means that the narrative of the early social experience is written into the biology of the developing child, or in other words, nurture actually becomes nature.

Unfortunately, overt forms of childhood abuse and neglect are all too common and can result in serious long-term physical and psychological consequences. In fact, large research studies have shown that adverse childhood experiences can lead to serious health risks, including many forms of chronic illness and even shortened length of life. However, it is increasingly recognized that covert forms of relational trauma and emotional abuse can also lead to deleterious outcomes, particularly in the area of social-emotional development.

While the term “relational trauma” often connotes overt forms of maltreatment such as physical and sexual abuse, it can also be used to describe covert forms of maltreatment such as abandonment, enmeshment, parent-child role reversal, verbal abuse, love-withdrawal, and many other forms of emotional abuse. Relational trauma can be difficult for children, caregivers and outside observers to recognize, which means it can persist throughout much of childhood and even into adulthood. For this reason, relational trauma can have insidious effects on development through persistent, maladaptive interaction patterns. These social interaction patterns occur while the brain is developing and can therefore shape the way that individuals think and feel about themselves, others, and the world around them.

Attachment theory is a very useful framework for understanding how differences in the quality of close interpersonal relationships, particularly parent-child bonds and adult romantic bonds, influence health and well-being throughout the lifespan. In the mid-nineteen hundreds, John Bowlby proposed that an attachment behavioral system evolved in humans (and other animals) because it improved the chances of offspring survival and successful reproduction by fostering proximity to caregivers, protection and safety, and sense of security for the developing child. Bowlby argued that a secure attachment relationship between a parent and child doesn’t lead to dependency, which was the contention of his psychoanalytic colleagues at the time, but instead creates a secure base for the child. In fact, he postulated that attachment security, and specifically a secure base, actually facilitates exploration and learning in childhood and ultimately leads to greater autonomy and social competence later in life. Read more