Understanding Maltreating Mothers: A Synthesis of Relational Trauma, Attachment Disorganization, Structural Dissociation of the Personality, and Experiential Avoidance

Abstract

Treatment options are limited for families in which the child has severe and intractable disturbances of emotion and behavior, in which there is suspected or confirmed maltreatment by the mother, and in which the mother has her own history of childhood neglect and abuse. This paper proposes a model for understanding maltreatment in mother-child dyads, drawing upon the developmental psychopathology, behavior, and trauma literatures. At the core of this model is the hypothesis that a mother's maltreating behavior arises from unconscious attempts to experientially avoid the reemergence of an attachment-related dissociative part of the personality that contains the distress arising from her own early experiences of attachment relationships. The implications of this model for therapy are considered.

Preventing intergenerational trauma transmission: A critical interpretive synthesis

“…Attachment is certainly recognised to be a component of relational trauma treatment (Pearlman & Courtois, ) but is often reflected upon within the therapy relationship or past relationships rather than in the context of any current dependents. The embedded nature of relational traumas is such that their full effects may not be realised until a similar relationship is engaged in (Amos et al, ), and while the relationship with a therapist or clinician forms an important space for this to occur, how to strengthen current attachment relationships beyond the clinical relationship is not widely discussed.…”

“…Relational trauma may include maltreatment, abuse and neglect experiences as well as serious and pervasive disruptions in caregiving as a consequence of parental mental illness, substance use or abrupt separation (D'Andrea, Ford, Stolbach, Spinazzola, & van der Kolk, ). Relational trauma can also refer directly to patterns of attachment interaction from parent to infant, characterised by conflicting signals, intrusive behaviours, withdrawing or antagonistic behaviours or a lack of soothing (Amos, Furber, & Segal, ). Adults who have experienced early childhood relational trauma are at increased risk of transmitting traumatic effects to their own infants through their attachment and interaction styles (Fraiberg, Adelson, & Shapiro, ).…”

Intensive Short-Term Dynamic Psychotherapy for Severe Music Performance Anxiety: Assessment, Process, and Outcome of Psychotherapy with a Professional Orchestral Musician

“…15 Over time, this pattern is automatically activated in any situation that has the potential to trigger the repressed feelings about the initial attachment rupture. 16 The anxiety generated by repressed emotion can manifest in one of four ways: (i) tension in the striated muscles of the body 1,17 ; (ii) smooth muscle anxiety that manifests as gastrointestinal symptoms such as nausea, hypertension, reflux, cramping, irritable bowel syndrome, and migraine 17,18 ; (iii) cognitive perceptual disruption that manifests as confusion, blanking out, tunnel vision, blurred vision, ringing or buzzing in the ears, and dizziness and fainting 4 ; and (iv) motor conversion, which results in unexplained weakness in the limbs. 19,20 In response to anxiety, defences are automatically activated.…”

Adult Exploration of Attachment Interview in Family Therapy

“…This includes information about how children ''need'' to be towards a parent and how parents act towards children, especially in responding to attachment related needs. For beginning parents, the behaviours of children resonate with and activate the child within the parent, setting off repeat patterns of response, reaction, care-giving and relating (Amos, Furber & Segal, 2011).…”