What is Attachment Trauma?

Attachment trauma, an early form of relational trauma, occurs when there is some disruption in the healthy bond formation between a baby or child and his or her primary caregiver. Healthy attachment occurs when the caregiver provides comfort, affection, and basic needs on a regular basis and with consistency. Poor attachment, inappropriate responses to a baby’s distress, lack of affection, abusive behaviors, and the absence of the caregiver can all cause a traumatic experience for the child.

The consequences of attachment trauma can be far-reaching, because a positive caregiver-child bond helps to establish healthy development, self-confidence, self-regulation, and a pattern for developing other relationships. Trauma associated with this important bond can lead to a wide range of issues from poor social development to serious mental illness.

In psychology, attachment refers to the major social and relational connection a child makes, such as with a mother or father. The primary caregiver in a child’s life is usually who he or she attaches to, and this is most often the mother. It can also be a father, an older sibling, a grandparent, or another guardian, whoever spends the most time with the child and provides most of the caregiving.

The process of attachment begins early, in infancy. The process includes many elements of bonding between the baby and caregiver, including comfort, physical affection, meeting basic needs for survival, and development of a sense of self with respect to another person. How this process goes, and whether it is healthy, insufficient, or involves trauma, can significantly impact how a person relates to others throughout his or her life.

The theory of attachment in psychology outlines four different styles of attachment that a child develops with his or her primary caregiver. These styles can influence how an individual forms relationships later and whether they are largely successful or are riddled with conflict and problems.

• Secure. According to researchers, about 60 percent of people develop a secure style of attachment. These are people whose caregivers were loving and affectionate and responded appropriately and sensitively to distress in a baby or child. With secure attachment, a person will feel comfortable expressing emotions, are more self-confident in relationships, and are more likely to cope with negative situations and feelings in healthy ways.
• Avoidant. Avoidant, or dismissive avoidant, attachment occurs when the caregiver is not sensitive or reactive to distress in a child. That child is then more likely to avoid showing emotions or to turn to the caregiver for comfort. Later in life this person may be emotionally distant in relationships and unexpressive.
• Resistant. Also known as anxious or preoccupied attachment, resistant attachment is the result of a caregiver who is inconsistent or unpredictable with comfort and responsiveness to distress. The child may use strategies like neediness or extreme emotional responses to get the attention of the caregiver. As an adult, someone who formed this type of attachment may feel very insecure in relationships and may act needy and clingy, always looking for reassurance.
• Disorganized. A disorganized type of attachment occurs when a caregiver’s behaviors are in some way atypical or frightening. The child then has no clear strategy for seeking comfort or attention, and later in life this can lead to very tumultuous relationships.

Whether attachment proceeds in a healthy way or not, it influences later relationships. It is reflected in how a person identifies needs in relationships and how they try to get those needs met. It influences confidence, self-esteem, and choices of romantic partners. The healthiest and most complete type of attachment, which sets up a child for healthy development and positive relationships, is secure.

The other styles of attachment are not healthy and may be considered incomplete, because a secure attachment never developed. These can result in developmental problems, behavioral issues, emotional challenges, poor self-esteem, poor impulse control, difficulty trusting others, a lack of depth in relationships, impaired social functioning, and cognitive difficulties. These problems begin in childhood and may continue into adulthood if an individual does not learn to establish healthier patterns.

Trauma is often thought of as something dramatic, like abuse or assault, but it can also be more commonplace. Attachment trauma is considered to be a traumatic experience an infant or child has when a primary caregiver does not or cannot provide adequate care, affection, and comfort. When the caregiver ignores a baby’s distress, for instance, this can be a traumatic experience. The infant is crying and frightened, and the caregiver ignores the distress and provides no comfort. For an adult this may not seem traumatic, but to a baby or young child may be.

One or two incidents of poor attachment behaviors may not have a lasting impact, but when the caregiver consistently engages with the baby or young child in an inappropriate way, it can lead to lasting trauma. Trauma during attachment may also be more overt, such as physical or sexual abuse that is perpetrated by the caregiver. A child may experience other types of trauma, such as abuse by a non-caregiver or by witnessing violence, but it is only considered attachment trauma when it is a part of the relationship with a caregiver.

Attachment trauma can also be considered any situation in which there is a significant disruption in the formation of the attachment bond. For instance, when there is a separation from the caregiver, if he or she leaves or dies, it can be traumatic for the child. Other factors in the caregiver’s life that disrupt the bond, such as being abused, fighting with a spouse, or suffering from mental illness, can also cause attachment trauma in the baby.

Because healthy attachment is so important for all areas of a child’s development, and for his or her later relationships and functioning, attachment trauma can have a profound impact on an individual. Attachment trauma may cause a greater susceptibility to stress, difficulty regulating emotions, dependency, impulsive behaviors, social isolation, trouble sleeping, difficulty with attention, and mental illnesses.

The mental illnesses that a child who has experienced attachment trauma may be more vulnerable to are dissociative disorders, depression, and post-traumatic stress disorder. Dissociation is a state that children are particularly able to achieve, and they may use it involuntarily as a way to cope with trauma. Dissociative disorders include dissociative identity disorder, depersonalization or derealization disorder, and dissociative amnesia. When a child dissociates to cope, it makes them more vulnerable to developing these conditions later in life.

The issue of attachment trauma often does not come up until a child, adolescent, or adult is experiencing emotional, psychological, or behavioral issues and seeks help. Through therapy it may be determined that a person likely experienced attachment trauma. This is not a mental illness that has treatment guidelines, but it is an issue that often arises in therapy and can be addressed.

Trauma-focused therapy, for instance, can help an individual at any age learn to cope with past trauma and to overcome some of its consequences. Trauma-focused cognitive behavioral therapy can help a child or adult learn to be more aware of their negative thoughts and behavior patterns and how they relate to trauma. This kind of therapy teaches them how to change those patterns.

Eye movement desensitization and reprocessing is another type of therapy that can help a patient heal from trauma. It helps someone who suffers from traumatic experiences face painful memories and re-contextualize and move on from them. Family support and therapy can also be very useful in helping someone cope with past trauma and in establishing healthier and more supportive relationships.

Treating attachment trauma is complicated and highly individualized. It depends on the extent of the trauma and its repercussions. A person who experienced this kind of trauma is likely to meet the criteria for other mental illnesses or even substance use disorders. Treatment must include care for all of these to be most effective.

Because the repercussions of trauma are so serious and far-reaching, the best treatment plans are administered in a residential care setting. This allows the patient to fully explore all the consequences of past trauma and attachment issues and to focus on establishing healthy coping mechanisms and relationships. Residential care also gives patients access to a wide range of holistic treatments, including care for substance abuse and other mental illnesses, alternative therapies, healthy lifestyle management, and group support.

The trauma suffered during the important attachment period does not have to negatively impact a person forever. There are ways to overcome this trauma and to learn to establish a healthy sense of self, positive relationships, and better coping mechanisms. The outlook is good for those patients who commit to undergoing intensive, residential treatment.

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