Attachment and Trauma: The Fragmented Self

Attachment and Trauma: The Fragmented Self

Dianna Scholtes

Advances in the fields of trauma and attachment have demonstrated their intertwining nature,

their respective influences on infancy, development, psychological health and development

and associated clinical therapies. This paper presents an overview of psychoanalytic ideas of

attachment and trauma, specifically interpersonal trauma. It explains key concepts and

explores the historical, social and clinical contexts of how the models developed and evolved.

It looks at the effectiveness and strengths of the attachment model with reference to trauma

and its application to psychotherapy, specifically the role of the therapeutic alliance. It

presents the psychological impact of attachment trauma and the notion of the fragmented self. It

further evaluates professional limitations and challenges associated with working within

this therapeutic environment.

Attachment and Trauma 2

Attachment and Trauma: The Fragmented Self

There has been considerable erudition in the last two decades concerning the effect of

trauma and attachment on development (Hoehn, 2011). Without doubt, relics of attachment

trauma in childhood frequently affects individuals in elusive and moderately direct ways

which compromise functioning (Terr, 1990). The significance of the impact of attachment

and trauma is highlighted within this paper through exploration of the significance of trauma

within the caregiving system. The paper begins by providing an overview of both attachment

and trauma theory, specifically interpersonal trauma. It discusses important historical, social

and clinical concepts.

Research reveals that infants require a relationship with a parent/caregiver that is nurturing,

secure and safe and fosters development. The absence or disruption of such a relationship can

traumatise an individual, consequently making them incapable of connecting appropriately with

others. The destructive and disabling effect of traumatic experiences stemming from parental

neglect, abuse and/or violence can propel an individual into fractured versions of themselves,

forcing them to cope with the arduous task of adaptation (Gaffney,

2006; Herman, 1992). The following section provides a definition of attachment and provides a

review of the history of attachment theory, describing how the affectional bond affects

individuals from birth through to death.

The term ‘attachment’ is applied in describing the affective bond that cultivates between

an infant and their parent/caregiver (Goldberg, 2000). This bond is said to provide

the foundation for an infant’s development in which they learn to regulate emotions and

affective responses and form relationships with others (James, 1994; Schore, 2003). Fonagy

(2005) believes that such bonds have a huge impact on psychological health and

development, and that deficits in this area are responsible for most psychiatric disorders. Due

to the importance of security and distress in attachment processes parents/caregivers therefore


play a central role in the development and maintenance of an infant’s affect regulation

(Simpson & Rholes, 1994).

The history of attachment begins with Sigmund Freud - a man whose theories were

grounded in self and relational psychology, ego, object-relations and drive. Freud’s (1920)

psychoanalytic theory suggests that there are various stages of psychosexual development

which place an emphasis on attachment in infants. Freud believed that during the ‘oral stage,’

the main focus of attention is breastfeeding and providing the infant’s comfort needs. He

purported that the quality of nurturing received throughout this stage influenced the infant’s

resilience and trust in the world (McInerney & McInerney, 1998). John Bowlby (1979), who

furthered Freud’s findings stated that, “Freud not only insisted on the obvious fact that the

roots of our emotional life lie in infancy and early childhood, but also sought to explore in a

systematic way the connection between events of early years and the structure and function of

later personality” (p.1).

Bowlby formulated the basic principles of attachment theory which draw heavily on

ethological concepts. Bowlby built on these ethological concepts and developmental

psychology and made his official assertion of attachment theory in three seminal papers

which highlight the characteristics and development processes of bonds during early life

stages through to death. Bowlby’s theory is one of both normal socio-emotional development

and psychopathology, explaining that attachment processes are crucial to psychological well-

being and psychopathology (Egeland, 2004). Thus, this notion shifted psychodynamic

clinician’s to focus on early development as the root of all (Schore, 1997).

Bowlby (1979) believed that the initial attachments formed between the infant-

parent/caregiver have implications for one’s social development and underpin an individual’s

‘inner working model’ (IWM), which influences relationships across the lifespan. When an

attuned response is provided to the infant by a parent/caregiver the infant acquires a ‘felt


security’ thereby adapting an IWM encompassing mental representations in which an

individual understands themselves, their world and others (Bretherton, 1992; Schore, 2000).

Mary Ainsworth (1970) believed that these IWM arbitrate the infant’s capacity to

utilise the parent/caregiver as a ‘secure base’ in which the infant could explore new situations and

environments and know instinctively that the parent/caregiver would be available. Her

experimental procedure known as the ‘Strange Situation’ provided empirical evidence for

Bowlby’s theory of attachment which suggested that successful interaction between an infant and

their parent/caregiver has implications for later development of self-regulatory and social skills

(Bowlby, 1958, 1969, 1982). Ainsworth characterised three main attachment styles:

‘secure’; ‘insecure avoidant’; and ‘insecure ambivalent’. A fourth attachment style was

identified by Main and Solomon (1990) known as ‘disorganised’. All of these attachment

styles are said to be established by the end of the infant’s first year of life and are likely to

remain constant over the life course (Bretherton, 1992).

Attachment theory therefore provides a deeper understanding of the development of

psychotherapy and psychopathology. In the clinical context, research has observed that a high

number of individuals diagnosed with disorders of personality or mental health concerns are

insecurely attached; whilst those that have a disorganised attachment are strongly correlated with

later psychopathology (Goodwin, 2003).

Since its inception, attachment theory has “become the most powerful contemporary

account of social and emotional development available to science” (Steele, 2002, p. 518),

which is a prominent factor in the intervention, assessment and treatment of infants/children

and adults in any clinical setting. A number of evidence-based early intervention programs

for children are congruent or stem from Bowlby’s attachment theory: The Circle of Security

Child Parent Psychotherapy (Hoffman, Marvin, Cooper & Powell, 2006); Attachment and


Biobehavioral Catch-up (Dozier, Dozier & Manni, 2002); and Video Feedback Intervention to

promote positive parenting (Juffer, Bakermans-Kranenburg, van Ijzendoorn, 2007).

The expansion of research on attachment has further enhanced theoretical knowledge

and clinical applications of the theory, indicating that the attachment system continues

throughout life, undergoing crucial developmental changes. Hazan and Zeifman (1999), like

Freud (1920), purport that the affectional bond between the parent-child relationship and

adult relationships bears the same primary behavioural and emotional dynamics: security

seeking; separation; and proximity. Therefore, if the dictum that an affectional bond is a

primary defence against trauma generated psychotherapy what about the child who

experiences antithesis? The following section of the paper focuses on trauma, providing a

definition and an overview of the history.

The Australian Psychological Society (APS, 2014) depicts ‘trauma’ as a fear provoking or

stressful event which may cause psychological distress. The history of trauma is one that has seen

clinical and theoretical literature in psychoanalysis focus on manifestations of trauma. These

manifestations have been highlighted by the likes of Sigmund Freud, JeanMartin Charcot, Pierre

Janet, Josef Breuer, Jacques Lacan, Alfred Binet and Morton Prince, to name a few (Leys, 2000).

Trauma, for psychoanalysts like Khan (1963) implies a broader reaction to internal or

external impingements which generates varying levels of subjective distress. Khan’s

perception of trauma emphasises the psychological importance of occurrences that seldom enter

consciousness. Seemingly, the oxymoron of unrecognised trauma arises from the

infantile cognition of the child, thus limiting representational opportunities. Bromberg (1994)

however focusses on dissociation in relation to trauma. He conceptualises helplessness as an

occurrence in which the self of the individual is shattered.


Trauma, in recent years has resurged due to acts of terrorism, violence, natural

disasters and war. This interest has incited research and seen the development of clinical

procedures and diagnostic tools in relation to the impact of trauma on individuals and their

psychological functioning. Together with a heightened understanding of child abuse and

reporting protocols, researchers and clinicians have begun to examine the notion of

‘interpersonal trauma’ (Sanderson, 2009).

Bowlby (1973) viewed interpersonal trauma as an acute negative effect connected to

experiences of abuse and neglect. Such an event is regarded as interpersonal in nature and

correlates with a particular form of attachment, usually an avoidant, ambivalent or

disorganised attachment which is viewed as dysfunctional (Ainsworth & Bell, 1970; Main, et. al.,

1990). Allen (2001) suggests that interpersonal attachment trauma possesses more

pervasive effects than any other form of trauma. His theory reverberates ‘betrayal trauma’

proposed by Pamela Freyd (1996), a form of trauma which transpires within relational

environments where a caregiver violates the essential role expectations of protection and care

essentially severing affectional bonds.

The concept of interpersonal trauma evolved with a principal focus on the importance

of the mothering relationship with the developing child. Freud (1920) and Garland (1998)

purported that the mother provided a protective function for the child from damaging and

painful stimuli thus, Bowlby’s theory of attachment interconnects with interpersonal trauma

and allows us to spotlight what is damaging and what is protective in the developing child.

Researchers have identified several damaging disorders associated with interpersonal trauma

which include disorders of personality, schizophrenia, disorders of anxiety, dissociative

disorders, post-traumatic stress disorder, depressive disorders, self-harm, and dependency

(Sanderson, 2009).


Research suggests that serious attachment disruptions and trauma-related experiences often

coexist in the lives of infants. Both are viewed as threats to one’s survival. As

previously discussed trauma enfeebles attachments affecting individuals behaviourally,

biologically, socially and psychologically, as well as influencing an individual’s self-concept and

future relations (Badenoch, 2008). The overwhelming fear, anxiety and helplessness of

interpersonal attachment trauma stimulates post-traumatic stress reactions which have the ability

to fragment the self and alter personality (Sanderson, 2008).

Schore (1994) suggests that infants categorised as having a disorganised attachment

have difficulty in affect regulation, whilst Fonagy (1995) considered securely attached infants to

show mastery in affect regulation. Curnow (2007) asserts that anything which interrupts

the affectional bond may be experienced as trauma and generate disruptive behaviours. This

is in line with continuous research emphasising that traumatic events in childhood query

fundamental human relationships, contravening attachments and fragmenting the structure of

the psychological structures of self (Janoff-Bulman, 1985; Kohut, 1966).

In light of the literature presented it is essential to note that there are significant

contrasts amongst ‘secure attachment’ and ‘trauma attachment’. Secure attachment is

founded on love and enriches an individual’s development; whereas trauma attachment is

founded on terror and is potentially detrimental. Whilst infants perceive these relationships as a

necessity for survival, the dynamics of each scenario impact the development of the

individual very differently (James, 1994).

Therefore, exposure to trauma during infancy is believed to be a key causal dynamic in

the ontogenesis of psychopathology. Thus, a secure connection with a parent/caregiver is the

basis for cognitive and social development. When this connection fails the traumatised individual

loses their basic sense of self, eroding the structure of personality and often

developing a fragmented sense of identity (Herman, 1998; Kohut, 1966).


In clinical practice then, from an attachment trauma viewpoint, the symptoms and

behaviours of the client are recognised as unprocessed traumatic occurrences which have been

reproduced in implicit-procedural memories, as typified in a disordered, insecure IWM. These

unconscious memories shape the individual’s experience and appear in the

interpersonal structure, being communicated through narrative and expressional forms to the

therapist (Renn, 2012).

An important objective in psychotherapy in relation to attachment is the re-evaluation of

ineffective, antiquated IWM of self. Bromberg (1994) and Hughes (2011) purport that it is

essential to create a safe environment or ‘secure base’ to allow this re-evaluation of self to

occur. This core tenant of attachment theory is crucial in treating disorders of attachment

trauma, allowing clients to be open to new learning and exploration of self, in an attempt to

release affective elements of the client’s unresolved trauma. In treating clients with

attachment trauma several studies have identified that the therapeutic relationship itself is

fundamental in creating change. It is perhaps the most crucial evidence-based feature of the

therapeutic approach (Hughes, 2011).

Research demonstrates that the quality of the therapeutic relationship underpins effective

therapy, and is the foundation in which healing occurs. For such a relationship with clients with

attachment trauma allows for co-creation of dissociated experiences, encouraging identification of

mental states and influencing behaviours within several interpersonal contexts. According to

Renn (2012), this produces in the client a logical, safe and agentic self as antiquated IWM are

modified into new interpersonal models.

The augmentation of the client’s capacity to progressively systematise and assimilate

their fragmented self involves the healing of trauma misattunement in the client-therapist

relationship. Therefore, the therapist’s facilitating behaviours amalgamate with the client’s

creating a sense of safety in which the attachment relationship develops. This relationship


allows facilitation of a collaborative exploration of the client’s self-states, aiding the client to

develop an integrated sense of identity (Renn, 2012; Gingrich, 2013).

This paper has highlighted that attachment trauma creates impairments to one’s ability to

adapt and make meaningful connections with others. It illustrates that treating attachment trauma

requires knowledge and understanding of the dynamics of both attachment and trauma in order to

successfully integrate the concepts and develop a coherent treatment and

therapeutic experience (James, 1994).

Several evidence-based approaches to treatment of attachment trauma include: Childparent

Psychotherapy (Lieberman & van Horne, 2008), Patient-child Interaction Therapy (Eyberg,

1998), Trauma Focussed Cognitive Behavioural Therapy (Cohen, Mannarino & Deblinger,

2006), Sensorimotor Psychotherapy (Ogden, Minton & Pain, 2006), Dyadic

Development Psychotherapy (Hughes, 2003) to name a few.

Within all of these therapeutic practices it is imperative to note that numerous professional

challenges are implicated in working with individuals suffering from attachment trauma. These

challenges affect therapists across several dimensions. Therefore, it is

fundamental that therapists are equipped with sound knowledge and understanding of

attachment and interpersonal trauma and the psychological impact on both the client and

therapist. This involves focussed training in the dynamics and characteristics of trauma in relation

to attachment (Sanderson, 2009).

Considerable research has highlighted that therapists can become affected when treating

clients within this setting (McCann & Pearlman, 1989; Figley, 1995). This includes

being susceptible to an array of challenges and professional issues. Thus, it is important that

the therapist possess a developed sense of self-awareness. Self-awareness allows the therapist

to be mindful of the power and control dynamics of the therapeutic relationship in order to

minimise re-enactment. It also aids in noticing threats to the therapists well-being associated


with poor self-care, compassion fatigue, burn-out, vicarious trauma and/or secondary

traumatic stress (Sanderson, 2009; Figley, 1995).

Therapists in this setting are also likely to demonstrate a desire to want to ‘rescue’

their client. Such a process is counter-productive to the therapeutic process and is indicative

of transference and/or counter-transference (Sanderson, 2006). Thus, professional support

networks, training and peer and clinical supervision are critical to ensure the health and well-

being of the therapist to counteract working with clients in this therapeutic setting.

Attachment and trauma theory have undoubtedly modernised research highlighting

their interconnecting roles in psychological health, infancy and development. It is apparent in the

literature that attachment is the foundation for many trauma-centred therapies. More often than not

individuals presume that infants are not significantly affected by traumatic

occurrences. They believe that if the infant is too young to understand what is transpiring, then they

will not be affected by the event, or that the infant’s resilience will allow them to recover without

difficulty (Hughes, 2003).

The information presented throughout this paper has illustrated that this is not the

case. It has highlighted the notion that early attachments and the parent-child relationship are vital to

an infant’s capacity to acquire and develop emotional, cognitive and social skills. For an infant’s

first important relationships directly influence their developing brain forming a template for

attachment relationships into adulthood.

In summary, this paper has presented the key concepts of both attachment and trauma

theory with reference to their historical, social and clinical concepts. It has highlighted a form of

trauma known as interpersonal trauma and its connection with attachment, as well as

presenting the psychological impact and notion of the fragmented self. The paper evaluated

the strengths of attachment in treating trauma by highlighting the need to provide the client

with a safe and secure base.


It further evaluated the strength and crucial importance of the therapeutic relationship in

treating attachment trauma. Conversely, limitations in contemporary practice were

evaluated with a central focus on the well-being of the therapist, highlighting the challenging

nature of working within this therapeutic environment. To conclude, it is of fundamental

importance that appropriate evidence-based treatments are utilised by trained professional staff in

the treatment of individuals with attachment trauma disorders and that self-reflection and care are

just as imperative as the therapeutic alliance.


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Attachment and Trauma: The Fragmented Self

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