Trauma, Attachment and Dissociation.

The three strands of understanding which are needed to inform effective evidence based approaches for children referred to residential care?

“Human beings of all ages are found to be at their happiest and to be able to deploy their talents to best advantage when they are confident that, standing behind them, there are one or more trusted persons who will come to their aid should difficulties arise”. John Bowlby (1973, p 359)

Another quote:

“Maintenance of proximity to caregivers increases the likelihood that the infant will be sheltered from exposure to the elements, defended against attacks”

Grand Central - The Brain

Genes provide, blueprints and basic framework of the brain, The Environment provides the shaping and finishing, They work in tandem, with genes providing the building blocks, and the environment acting like an on-the-job foreman, providing instructions for the final construction Sounds, sights, smell, touch like little carpenters - all can quickly change the architecture. Ronald Kotulak (1993)

“The Dyadic Dance”

The caregiver modulates the infants non-optimal states by calming the infant when arousal is too high and stimulating it when arousal is low. He or she is constantly attuned to and responding to the infants cues (Schore,2001)

This is the dyadic dance. The adult is the interactive regulator of arousal Modes of self-regulation Interactive regulation: involves the ability to utilise relationships to mitigate breaches in the window of tolerance and to either stimulate or calm oneself

Auto-regulation: is the ability to self regulate, independent of other people. It is the ability to calm oneself down when arousal arises to the upper limits of the window of tolerance or to stimulate oneself when arousal drops to the lower limits (Ogden, 2002)

Childhood Attachment Strategies

Secure attachment: infant shows clear preference for interactive regulation, but after being re-regulated by caregiver, is then able to self-regulate for short periods Anxious attachment (also referred to as Insecure - ambivalent): the infant anxiously seeks proximity to the caregiver, cannot auto-regulate without the caregiver and is not self soothed by reunion.

Avoidant attachment (also referred to as Insecure - avoidant): infant shows clear preference for self regulation, often actively avoiding interactive regulation and preferring books and toys to caregiver Disorganised attachment: infant has difficulty with both interactive and auto-regulation, exhibiting proximity-seeking coupled with freezing, distancing or avoidant behaviour

Disorganized Attachment

Secure attachment contributes to lifelong abilities to regulate emotional states. Even “anxious” and “avoidant” attachment styles allow for predictable ways of regulating arousal, using either interactive or auto-regulatory strategies.

Disorganized attachment status, on the other hand, interferes with the development of both auto and interactive regulatory abilities Disorganized attachment in children is correlated with maternal behaviour which is characterised as “frightening” or “frightened”. (Liotti, 1999) In studies of abuse and neglected children, disorganized attachment styles have been found in over 80% of maltreated children (Carlson et al, 1985; Ogawa, 1997)

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