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Posts tagged ‘Adult Attachment’

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.

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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