Attachment is a foundational experience for children. Cairns (2002) refers to it as “formative” because it provides the models upon which children will base their views of self and others; attachment also shares an important function in the development of the young brain. What is attachment? Essentially, attachment describes the responsive relationship between an infant and its caregiver. It involves the appropriate and attuned responses of a caregiver to an infant’s needs; it provides the infant with a sense of security and competence. Through the caregiver, the infant learns how to regulate emotions. Later, a secure attachment will result in the confidence to explore the world and learn and grow. (Cairns, 2002).
Insecure attachment, therefore, results from caregiver behavior that is not supportive to the infant. The parent is unable to provide appropriate soothing, or does not interact with the child in a way that is interactive or attuned to his or her needs (Lieberman, 2004; Hipwell, et al, 2000). Parents who form insecure attachments with their children often have insecure adult style of attachment. Many parents of insecurely attached children are suffering from their own unresolved traumas (Cairns 2000; Liotti, 2004; Lyons-Ruth, Bronfman, & Parsons, 1999; Scheungel, Bakermans-Kranenburg, & Ijzendoorn, 1999). Insecurely attached children have been classified into three different subtypes: avoidant, anxious/ambivalent, and disorganized. The disorganized attachment style is most often linked to “fright without solution”, or the experience of the infant feeling scared or frightened by a caregiver’s behavior while at the same time feeling the desire for comfort and protection from the same person who is frightening them (Lieberman, 2004; Liotti, 2004; Lyons-Ruth, Bronfman, & Parsons, 1999; van der Kolk, 2005). Lyons-Ruth, et al (1999) also discuss the idea of “failure of repair.” Under this hypothesis, disorganized attachment results after neither anxious or avoidant attachment styles work to change parental responses. The child is left not knowing what to do. The authors’ other hypothesis is one of “competing strategies” in which parents might use conflicting parental attachment styles with their children – sometimes yelling, sometimes soothing, without any pattern.
Disorganized children frequently come from environments with high risk factors. Their parents are more likely to suffer from psychopathology or substance abuse (Lyons-Ruth, Bronfman, & Parsons, 1999). Impeded by their mental illness or chemical use, these parents are less able to interact with their children in ways that are meaningful or reciprocal (Hipwell, et al, 2000). The results for the children are often very devastating. Secure attachment has been found to be an important component of healthy brain development, while disorganized attachment hinders the development of important neural pathways, most notably in the right hemisphere of the brain (Cairns, 2000; Hinshaw-Fuselier, Boris, & Zeanah, 1999; Liotti, 2004; Schore, 2001).
It has been found that caregiver-induced trauma, otherwise known as “relational trauma”, alters the healthy development of socio-emotional functioning. Schore (2001) explains, “Early traumatic events that induce atypical patterns of neural activity interfere with the organization of cortical-limbic areas and compromise brain-mediated functions such as attachment, empathy and affect regulation” (p. 220). The stress connected to relational trauma alters the development of these areas of the brain, which has significant consequences. For example, the prefrontal cortex is unable to reach its full adult capacity (Cairns, 2002); this is the part of the brain where executive functioning, such as planning, impulse control, abstract thought, etc. occurs. The amygdala can also be affected, which causes changes in the formation of social bonds and regulation of emotions; Schore (2001) notes that these changes have even appeared to increase in magnitude over time.
A child affected by disorganized attachment and its resulting neurobiological challenges will have many different presenting issues. They will often respond inappropriately to stress because they have no good strategies for handling stress; they will use aggression, hyperactivity, dissociation, or other techniques as a way to deal with stressful situations (Cairns, 2002; Hinshaw-Fusellier, Boris, & Zeanah, 1999; van Der Kolk, 2005). They have difficulty developing trust, since the inner working model that they have developed is one in which they anticipate trauma; they often have a sense of shame, and have a difficult time distinguishing other feelings from those of shame (Cairns, 2002; van der Kolk, 2005). Disorganized children are often controlling, often with a great deal of anxiety; new experiences are frequently seen as threatening (Cairns, 2002; Liotti, 2004; van der Kolk, 2005). Most significantly perhaps, disorganized children have difficulty relating to others socially because of their lack of trust, empathy, and unmodulated affect (Cairns, 2002; Van der Kolk, 2005).
Unless disorganized children are able to receive intensive interventions that can change their inner working models and allow them to form secure attachments, the outlooks are grim. Disorganized children are at great risk for developing psychopathologies later in life, especially dissociative disorders or personality disorders such as Borderline Personality Disorder (Liotti, 2004).
References
Cairns, K. (2002). Attachment, trauma, and resilience: therapeutic caring for children. London, UK: British Association for Adoption and Fostering.
Hinshaw-Fuselier, S., Boris, N., & Zeanah, C.H. (1999). Reactive attachment disorder in maltreated twins. Infant Mental Health Journal, 20(1), 42-59.
Hipwell, A.E., Gossens, F.A., Melhuish, E.C., & Kumar, R. (2000). Severe maternal psychopathology and infant-mother attachment. Development and Psychopathology, 12, 157-175.
Lieberman, A.F. (2004). Traumatic stress and quality of attachment: reality and internalization in disorders of infant mental health. Infant Mental Health Journal, 25(4), 336-351.
Liotti, G., (2004). Trauma, dissociation, and disorganized attachment: three strands of a single braid. Psychotherapy: Theory, Research, Practice, Training, 41(4), 472-486.
Lyons-Ruth, K., Bronfman, E., & Parsons, E. (1999). Maternal frightened, frightening or atypical behavior and disorganized infant attachment patterns. Monographs of the Society for Research in Child Development, 64(3), 67-96.
Schuengel, C., Bakermans-Kranenburg, M.J., & Van Ijzendoorn, M.H. (1999). Frightening maternal behavior linking unresolved loss and disorganized attachment. Journal of Consulting and Clinical Psychology, 67(1), 54-63.
Schore, A.N. (2001) The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1-2), 201-269.
van der Kolk, B.A. (2005). Developmental trauma disorder: towards a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401-408.
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