Centre of Knowledge

Recovery from Relational Wounds:

Attachment and Trauma Informed Practice

Rudy Gonzalez

Executive Director, Lighthouse Institute

What Do We Mean by Trauma?

A frightening or distressing event

resulting in a psychological wound or

injury

Resulting InDifficulty coping or functioning

normally following a particular event

or experience

3 Things Most Important to You

 

Single ComplexOne-off, out of the blue, time-limited Repetitive, prolonged, cumulative, chronic

Impersonal – natural disaster, accident Interpersonal, direct harm, exploitation, maltreatment

Out of context – coming from a stranger In the context of relationships, i.e. primary caregivers, significant others, responsible adult

No relationship to a person’s place in life Often occur at developmentally vulnerable times – early childhood or adolescence

Eg. Road accident, flooding, robbery E.g. Poverty, homelessness, incarceration, exposure to death/ violence

These examples are for illustrative purposes only and are not intended to minimise the effects of any trauma on an individual

Complex Trauma

Because of this timeless and unintegrated nature of traumatic

memories, victims remain embedded in the trauma as a

contemporary experience, instead of being able to accept it as

something belonging to the past.

Kolk & Newman (2007)

Theoretical Underpinnings of TIP

Attachment Theory

Object Relations Theory

Trauma Neurobiology

Psychological Wellness Theory

Attachment Theory - Bowlby

Bowlby used “attachment" to describe the affective bond that develops

between an infant and primary caregiver.

Attachment Theory

• Infants evolutionarily primed to form close and dependent bond with

primary caregiver

• Promotes healthy social & emotional development by:

Parental Responses → Patterns of Attachment → Internal Working Models

• Internal working models guide the individual's perceptions, emotions,

thoughts and expectations in later relationships.

Dyadic Emotional Regulation

Attachment is a form of dyadic emotional regulation.

Infants incapable of regulating own emotions and arousal.

Require assistance of caregiver.

As children become better at expressing their needs/ emotions, they learn self-regulation skills.

However, this dyadic regulation never entirely disappears. There is a time for both types (self and dyadic) throughout a person's life.

Object Relations Theory - Winnicott

• Prime motivational drive in humans is to form relationships with others

• Style of relationship that develops in infancy to early childhood becomes part of an internal blueprint or a learned way of relating to others

• Past relationships are replicated when we establish and maintain future relationships, which impact on our sense of identity

• People from traumatic relational environments may have difficulty in forming and maintaining constructive and healthy relationships

Object Seeking Behaviour

“It is as if in early childhood we create a script for a drama and then spent the rest of our lives seeking out others to play the parts. This does not mean the script cannot be changed. However, the more traumatic our early self-object relations, the more rigid and resistant to change we become” (Klee, 2009).

Projective Identification

In projective identification the person who is targeted with the projection begins to

behave, think, and feel in a way that is consistent with what is being projected into him

Projection Projective Identification

Wellness can only be achieved through the combined presence of personal, relational and collective wellbeing

Collective

RelationalPersonal

W

Impact of Trauma on Development

Once the cycle of trauma begins the effects begin to spiral. Rather than the trauma being a one-off event it becomes an expected occurrence. The person becomes highly anxious and is unable to switch off from this state. This then interferes with all aspects of their daily life and makes it difficult to do any of the ordinary things, like, having fun, relaxation and the enjoyment of any nurture that might be available. So the person becomes increasingly deprived of the experiences that are necessary for growth and to redress the imbalance.

Barton, Gonzalez & Tomlinson (2012)

An understanding of how the brain develops has significant implications for us in our work

with traumatised people. It is natural that we first of all relate to a person in a chronological

way. We see a middle aged person and we have normal expectations of a person that age.

However, if a person has been severely traumatised in early childhood their brain may not

have developed at a pace with their chronological age. If a person has been so

traumatised that the limbic and cortex parts of the brain are largely undeveloped, this

person may be functioning in many respects as a child.

Barton, Gonzalez & Tomlinson (2012)

Impact of Trauma on DevelopmentDevelopmental vs. Chronological Age

Impact of Trauma on Individuals

On-going exposure to traumatic

stress can impact all areas of

people’s lives including biological,

cognitive, and emotional

functioning; social interactions/

relationships; and identity

formation.

Guarino, Soares, Konnath, Clervil & Bassuk (2009).

Because people who have

experienced multiple traumas do not

relate to the world in the same way

as those who have not had these

experiences, they require services

and responses that are sensitive to

their experiences and needs.

Guarino, Soares, Konnath, Clervil & Bassuk (2009).

Impact of Trauma on Systems

A traumatised person may feel that a return to a chaotic and

abusive environment is inevitable. So rather than wait for it to

happen, they take control and try to provoke it to make things

feel more predictable.

Barton, Gonzalez & Tomlinson (2012)

Trauma Organised System

Activity

Client

Worker

Manager

CLIE

NT Feel unsafe

Angry/aggressiveHelplessHopelessHyperarousedFragmentedOverwhelmedConfusedDepressed

STAF

F Feel unsafeAngry/aggressiveHelplessHopelessHyperarousedFragmentedOverwhelmedConfusedDemoralised

ORG

ANIS

ATIO

N Is unsafePunitiveStuckMissionlessCrisis DrivenFragmentedOverwhelmedValuelessDirectionless

Parallel Process

Impact of Trauma on Organisations

A traumatised organisation, like a traumatised

person tends to repeat patterns of behaviour

in a way that prevents learning, growing, and

changing…and like individual trauma

survivors, systems find it very difficult to see

their own patterns.

Bentovim (1992)

Traumatic events and chronic stress

can produce a similar impact on

organisations. Without intending to do

so, without recognising it has

happened, entire systems can

become trauma-organised.

Bloom (2005)

The Flow of TraumaClient

Worker

Manager

What is Recovery from Complex Trauma?

 

The goal of therapy is to get children back on their developmental pathway

Anna Freud

Recovery is when the child has internalised the therapeutic process

Rudy Gonzalez

Organisational Trauma Informed Practice -Systems Recovery Process

• Therapeutic Relationships

• The Group

• Therapeutic Environment

• The Organisation

• The Community

Organisations As Therapeutic Settings

Organisation

Internalised by the client

Operations/ relationships

attuned to the therapeutic

task

Relationships, language,

communication, leadership and

authority = Environment

experienced by child

All staff role model a

healthy sense of

community

Variety of relationships

& circle of care

Provides a therapeutic

milieu

The Organisation as Therapist

The Community

Sense of community:

The feeling that one is part of a readily

available supportive and dependable structure.

Sense of community transcends individualism

in that to maintain such an interdependent

relationship one does for others what one

expects from others.

Sarason (1974)

Trauma Informed Practice

• Understanding trauma and its impact

• Culture of non violence

• Promoting safety

• Ensuring cultural competence

• Supporting consumer control, choice and autonomy

• Sharing power and governance

• Integrated care

• Healing occurs through relationships

• Those who care need to be cared for

• Recovery is possible

In Summary

Early relationships create an internal blueprint for future relationships

People from traumatic relational environments have difficulty in forming and maintaining constructive/healthy relationships

The script can be modified however the more traumatic our early self-object relations, the more resistant to change we become

Recovery is possible – the first tasks is to provide a safe, calm, and reliable environment

Trauma informed practice influences every aspect of our work and encompasses key conditions for recovery

Wellness is an ecological concept and can only be achieved through the combined presence of personal, relational and collective wellbeing

www.lighthouseinstitute.org.au