Adverse Childhood Experiences (ACEs) are traumatic events that happen early in life (childbirth to 18 years of age) that affect children while growing up, such as suffering maltreatment or living in a household affected by domestic violence, substance misuse or mental illness. Unlike single incident traumas, ACEs are often likely to last longer (or they may be repeated) and this can cause a child’s developing brain to become stuck in a physiological state of ‘threat’. When this happens, this stress may “toxic” to their psychological and emotional development, and in turn may affect their overall health.
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Adverse Childhood Experiences (ACE) Study
The Adverse Childhood Experiences (ACE) Study (by the USA’s Centre for Disease Control & Intervention & Kaiser Permanente) is one of the world’s largest investigations of the effects of childhood abuse, neglect and household challenges on later-life health and well-being.
Completed in the late 1990s, 17,000 Kaiser patients completed a 10-question questionnaire (below) regarding their childhood experiences, and their current health status and lifestyle behaviours. Their answers were compared against their medical histories, and researchers were able to calculate with a high degree of accuracy, the relationship between ACEs and the likelihood of later medical issues.
Results from the study were shockingly clear: Early adversity can many have lasting impacts, including having a strong association with risky behaviours, susceptibility to mental health and chronic health conditions. Sadly, ACEs have a dose–response relationship, meaning the more ACEs an individual is exposed to, the greater the likelihood their health will be negatively impacted. However, keep in mind, that the people surveyed in the ACEs study, were not necessarily people who were actively engaged in treatment.
We know that the more ACEs children experience, the more harm they can sustain over time. In fact, we know that adults who have experiences one or more ACEs are at a higher risk for depression, diabetes, cancers, heart disease and other health conditions during their lifetime. For adults who have more than 4 ACEs and who have not received adequate therapy, this can negatively affect longevity through the role of unhelpful coping behaviours and negative lifestyle factors.
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Examples of ACEs:
ACEs can increase risk of:
Child neglect (emotional, physical)
Parent or household mental illness
Parent or household substance use/alcoholism
Witnessing domestic violence
Having a parent or family member in jail
Parent separation or divorce
Death of a parent or sibling
Child abuse (emotional, physical, sexual)
Depression & other Mental Health issues
Alcoholism, Smoking
Teen pregnancy
Illicit drug use / Misuse of prescription drugs
Heart disease / Liver disease
Intimate partner violence
Sexually transmitted infections (STIs)
Suicide attempts / death by suicide
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We now know that the more ACEs children experience, the more harm they can sustain over time. In fact, we know that adults who have experienced one or more ACEs as a child are at higher risk of depression, cancer, heart disease, diabetes and other health conditions during their lifetime. For adults who have experienced over four or more ACEs and who have not received adequate therapy, this can even negatively affect longevity through the role of unhelpful coping behaviours and negative lifestyle factors.
Unfortunately, Parents who have experienced ACEs and who have not developed adaptive ways to resolve the complex and challenging impacts of these experiences, or who may have not have developed adaptive ways of coping with stress, are (sadly) statistically more likely to create environments – or have lifestyles – that place their offspring at risk of experiencing ACEs themselves. Often, this is how the cycle of inter-generational trauma continues.
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Below is an animation illustrating how ACEs develop and may be passed on intergenerationally:
The ACE Questionnaire:
To determine someone’s ACEs score, they answer the 10 Adverse Childhood Experiences questions relating to events prior to their eighteenth birthday:
Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or act in a way that made you afraid that you might be physically hurt?
Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Were your parents ever separated or divorced?
Was your parent or caretaker: Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
Was a household member depressed or mentally ill, or did a household member attempt suicide?
Did a household member go to prison?
Toxic Stress and ACEs
In addition to the hugely influential nature of the Attachment relationship between a parent and a child, ongoing adverse experiences (such as those listed above) can cause toxic levels of stress that sadly can negatively impact on both brain structure (i.e., the development of neural networks) and brain function (i.e., can alter a developing brain’s biochemistry and thus response to input).
Toxic stress happens when ACEs repeatedly trigger a child’s fight-flight-freeze system (our innate stress response governed by our sympathetic nervous system). It also occurs when emotions associated with coping (like anger, fear, frustration, shame, humiliation, anxiety) continue to trigger a stress response in the body and mind. This is commonplace in families where children are either punished for their emotional experiences, or parents who may lack the skills / awareness to navigate certain emotions themselves miss opportunities (cues) to settle and soothe their children.
With repeated exposure to high levels of stress (particularly in the absence of attachment safety), the accumulation of toxic stress can affect both skill and brain development. Living an a heightened state characteristic of perpetual fear (or the need to ensure safety) can effectively narrow our Window of Tolerance making us susceptible to chronic health conditions.
Hopefully it is becoming clearer to you that the devastating impact of toxic stress on a developing brain (and the resulting emotion-regulation and skill deficits people are left with) is not the fault of the individual. Rather, it is the outcome of not having a safe and secure development. This results in a child missing many important skills and experiences that build resilience, or a child’s brain being negatively affected in ways that can become pervasive in later life.
As we develop, particularly in the absence of supportive caregivers or healthy role models, toxic stress may also lead to less-than-ideal coping behaviours that may negatively affect our health. Over time and into adulthood, these coping behaviours can in turn cause health effects that can accumulate across a lifetime.
Summary of Key Findings from 17,000+ patients in the CDC-Kaiser Study
Due to the now well-documented effects of long-term toxic stress, the higher your ACE score the more likely you are to emerge from childhood with emotional and/or behavioural difficulties that can affect the rest of your life. In other words, the higher your ACE score the higher your statistical chance of suffering from a range of psychological and medical problems like chronic depression, cancer, or coronary heart disease.
Key findings from the ACEs study are summarized below:
The original study us available in full (via an external link) here.
Alarmingly, we now know that people who do not heal from their traumas are more likely to raise children who go on to have high ACE scores. In other words,
Untreated childhood trauma becomes a source of Intergenerational Trauma
Thankfully, although the effects of toxic stress can be profound, they can be significantly lessened by protective factors that build resilience and can buffer the effects of trauma. We know that safe, stable, and nurturing relationships can protect our brains and bodies from the harmful effects of stress and adversity.
We also know that healthy nutrition, regular exercise, restful sleep, practicing mindfulness, building social connections, and getting mental health support can all help decrease toxic stress hormones associated with ACEs and can improve health.
10 Important Things to Know About Adverse Childhood Experiences
Below is Part 1 of a hugely informative (but easy to follow) 5-Part video series by Dr. Colleen Bridger that explores the impacts of Adverse Childhood Experiences (ACEs) on a child’s developing brain and how trauma can influence both emotional and behavioural expression.
It presents eye-opening examples of ways trauma can shut down (or can activate) a child’s nervous system and how behavioural problems in children can be easily mistaken (and misdiagnosed) particularly when a narrow symptom-focus that overlooks the impacts of ACEs is used.
Click the following links for the remaining parts to this talk:Part 2 | Part 3 | Part 4 | Part 5.
Problems with ACEs Study: Correlation is NOT Causal
The ACEs Study is essentially a ‘snapshot’ of people who had adverse childhood experiences and where they were at later in their lives. It is not possible to infer direct causation from this research (i.e., it is an over simplification to say ‘ACEs cause later difficulties’). Similarly, the Study did not look at whether or not participants had received any treatment for their traumas (or what kind). We know that trauma-informed therapies (like EMDR Therapy) can greatly help people to ‘get past their past’ which is especially important for people who are affected by ACEs.
Also, keep in mind that ACE Questionnaire is very brief and it is not exhaustive (after all, it is only 10 questions…). Because of this, it does not list all possible adverse events that can happen within a family situation. We also know that Attachment issues between a parent and a childcan also have a huge impact on the emotional development and learning that a child can carry with them through adulthood. Equally – so too can events that occur outside the home (e.g. bullying at school).
However – and this is important – the ACE questions do not ask about any protective factors. For example, we know that having a healthy relationship with at least one caring adult or parent, who is emotionally attuned to your emotional and developmental needs can make up for a non-secure (or absent, or abusive) relationship with another caregiver / parent.
Indeed, not everyone who experiences one or more ACEs will go on to developing a serious mental health or medical issue. In fact, many adults who experience significant adversity in their childhood have gone on to have amazing lives full of adventures, achievements, and happy relationships and families. This is because although the effects of toxic stress can be profound, they can be significantly lessened by protective factors that build resilience and can buffer the effects of trauma.
Again, we know that these adults have identified that this resilience was helped by having at least one healthy, safe, caring relationship in their life. This is because safe, stable, and nurturing relationships can protect our brains and bodies from the harmful effects of stress and adversity.
A safe, stable, and nurturing relationship can come from a number of different people – for instance, a different parent, sibling, relative, teacher, mentor, therapist, or coach.
A safe, stable, and nurturing relationship for a developing child is:
An emotionally responsive and a supportive person in their life (Someone they can lean on)
Someone who views them as unique and interesting (Someone who is interested in them)
Someone who supports their ideas or dreams (Someone who believes in them)
If you are a survivor of childhood trauma, it is recommended that you find a trauma-informed psychologist who can provide a securely attached, emotionally corrective relationship in which you can process your past, learn the emotional regulation and relationship skills that you may have missed out on, so that you can learn to break the patterns of your upbringing.
Equally, if you are a parent who has experienced ACES or you are the parent of a child who has experienced ACEs, it is equally important to seek professional help to mitigate the effects of this trauma.
Summary
Adverse Childhood Experiences (ACEs) are traumatic events that happen early in life (childbirth to 18 years of age), such as suffering maltreatment or living in a household affected by domestic violence, substance misuse or mental illness.
ACEs may cause a child’s developing brain to become stuck in a physiological state of ‘threat’.
This may affect a child’s brain development, and psychological functioning and this may influence lifestyle behaviours that affect overall long-term health.
Parents who have experienced ACEs are (sadly) statistically more likely to create environments – or have lifestyles – that place their offspring at risk of experiencing ACEs themselves. Often, this is how the cycle of inter-generational trauma continues.
ACEs are not causal (and the questionnaire does not measure ‘protective factors’)
Although the effects of toxic stress can be profound, they can be significantly lessened by protectivefactors that build resilience and can buffer the effects of trauma.
With the appropriate help, adults who experience significant adversity in their childhood can go on to have amazing lives full of adventures, achievements, and happy relationships and families.
Safe, stable, and nurturing relationships can protect our brains and bodies from the harmful effects of stress and adversity.
Healthy nutrition, regular exercise, restful sleep, practicing mindfulness, building social connections, and getting mental health support can also help decrease toxic stress hormones associated with ACEs and can improve health.
I am a PhD Clinical Psychologist with over 15 years’ experience. My intentions are to help you to feel safe and respected, to collaborate with you to set clear treatment goals, and to facilitate an exploration of yourself and your situation in ways that regular conversations do not normally allow. Together, I hope we can discover constructive ways to improve your situation and your relationship with yourself and others.
My expertise and training draws from the latest evidenced-based ways to work with the mind, the body and all difficult emotions. My listening skills allow me to identify stuck patterns and unexpressed needs. I can help you to find new ways of responding to difficult situations, and I can help you to develop more resilience in the face of life’s challenges so you live with more meaning and purpose.
Medicare rebates are available for all Australians for up to 10 sessions each year with a GP referral and a mental health care plan. No matter where you live in Australia, Medicare rebates apply for all face-to-face and Telehealth consultations.
For immediate self-help, I have written practical articles containing tools to help you with a wide-range of topics. These articles are available here. If you are new to therapy, I recommend that you read this article to help you get the most out of therapy.
I look forward to working with you.
Dr Andreas Comninos
B.Psych (Hons), PhD (Clin Psych), MAPS, EMDRAA
PhD Clinical Psychologist
EMDRAA Accredited Practitioner
Psychology Board Approved Supervisor
Dr Andreas Comninos
PhD Clinical Psychologist
EMDRAA Accredited Practitioner
Psychology Board Approved Supervisor
B.Psych (Hons), PhD (ClinPsych), ACBS, MAPS
About me.
I am a PhD Clinical Psychologist with over 15 years’ experience. My intentions are to help you to feel safe and respected, to collaborate with you to set clear treatment goals, and to facilitate an exploration of yourself and your situation in ways that regular conversations do not normally allow. Together, I hope we can discover constructive ways to improve your situation and your relationship with yourself and others.
My expertise and training draws from the latest evidenced-based ways to work with the mind, the body and all difficult emotions. My listening skills allow me to identify stuck patterns and unexpressed needs. I can help you to find new ways of responding to difficult situations, and I can help you to develop more resilience in the face of life’s challenges so you can live with more meaning and purpose.
Medicare rebates are available for all Australians for up to 10 sessions each year with a GP referral and a mental health care plan. No matter where you live in Australia, Medicare rebates apply for all face-to-face and Telehealth consultations.
For immediate self-help, I have written practical articles containing tools to help you with a wide-range of topics. These articles are available here. If you are new to therapy, I recommend that you read this article to help you get the most out of therapy.
Attachment is an evolutionary model that explains how humans develop and function in relationships across the lifespan. Attachment science is one of the most researched areas in psychology. Its history spans over 60 years of research in humans alone, and many decades of research in animals prior (eg, from Lorenz’s observations of imprinting in newborn ducklings in the 1930s, to Harlow’s studies of the effects of maternal deprivation on infant primates in the 1950s).
Essentially, our ‘Attachment Style’ is formed in response to the emotional quality of the relationship provided to us by our primary caregivers. We know that early attachment experiences strongly influence human development in many key areas, including how our brains and immune systems develop, how we learn to self-regulate in response to both pleasant and unpleasant events, and how we learn to experience and communicate our emotions (and needs). As adults, our attachment experiences inform our perception and understanding of relationships and this heavily influences how we are likely to feel and behave in relationships, why we choose the partners we choose (and/or why we choose emotional distance from others).
This page aims to provide you with a deeper appreciation of how Attachment Styles develop and how they affect your current functioning. Early attachment experiences organize the internal worlds of us alland this influences the majority of our relationships (including our relationship with ourselves). Therefore, this a hugely important topic that deserves your time, attention, reflection and care.
Because neglect, parental inconsistency and a lack of love (experienced or perceived) can lead to long-term mental health problems as well as reductions in overall human potential and happiness, it is hugely important to learn about how our attachment experiences have shaped us, and for us to consider working towards healing our past attachment wounds. For many, there is truth to the anecdote: “We spend the first 15 years surviving living with our family and the rest of our lives healing from it”.
Not only do our attachment experiences shape how we are in relationships, they also extend to how we treat ourselves – this includes our ability to notice when we are suffering and also our response to our emotional needs (or why we may have learned to be insensitive to our emotional needs). This ‘responsiveness to Self’ (or a lack thereof such as when we are turning away from ourselves) is heavily influenced by what was (and often what was not – but should have been) taught to us by our primary attachment figures.
What is Attachment?
Our earliest attachments with parents or caregivers shape our abilities and expectations for relationships throughout life. The quality of our bond within these early relationships influences how our brain and immune system develops, how our sense of Self develops, and it also explains how we learned (or why did not learn) to regulate our emotions. The quality of our bond within these early attachment relationships also influences how we strive to satisfy our desire for closeness (vs independence), how we believe relationships work, and what we expect from our partners.
Attachment styles help explain how people respond differently when dealing with challenges of:
Uncertainty or distress
Strong emotions (negative and positive)
General setbacks (and how we relate to failure)
Understanding and communicating emotions (yours & the emotions of others)
Making ‘bids for emotional intimacy
Eliciting ‘care’ from others & responding to this care
Communicating expectations within a relationship
Identifying and communicating needs (your own and your partner’s)
Conflict & emotional disconnection
So, a person’s attachment style first forms in childhood, and then serves as a model for navigating life and relationships in adulthood.
How Attachment Develops
Early in life, humans are predisposed to focus on learning about other people’s reactions and how our behaviour can affect others. As infants, we are completely dependent on our caregivers for food, shelter and affection. As a survival mechanism, our brains have evolved to be very focused on establishing connection, whilst being highly sensitive to disconnection.
The effects of our early attachments with parents or caregivers can trigger a cascade of changes genetically, cognitively, socially, and physically which can have either positive or negative lifelong consequences.
Unsurprisingly, early attachment experiences affect our relationship with ourselves (how we view and relate to ourselves during moments of difficulty) and our relationships with others (the partners we choose – or avoid – and the interpersonal patterns that we keep repeating with all others).
Essentially, this is because the same motivational systems that gave rise to the close emotional bond between parents and their children is responsible for the bond that develops between adults in emotionally intimate relationships.
Although our early attachment experiences do not necessarily have to define us, they set us up with a ‘template for relating’ to Self and Others, which ultimately becomes either an asset or risk factor in terms of our resilience to stress. We now know from decades of research that early attachment experiences heavily influence an adult’s susceptibility to mental health difficulties.
The ‘Still Face’ Experiment
The infamous ‘still face’ experiment (developed by Dr Ed Tronick in the 1970’s) is a powerful demonstration of a child’s need for connection and how vulnerable we essentially all are to the emotional or non-emotional reactions of our primary caregivers. This experiment gives us insight into what it is like when connection does not occur.
Non-emotional reactions are a signal of ‘disconnection’, which triggers a range of instinctual behaviours in an infant. The ‘still face experiment’ illustrates the effects of perceived ’emotional disconnection’ and demonstrates how vulnerable we all are to emotional connection (and disconnection) from our primary caregivers, be they male or female.
Although the ‘still face’ may seem like a trivial example, as you may be able to appreciate, as a child develops there are many complex factors at play between them and their caregiver that will continue to shape and to ultimately teach a child about emotion regulation and self-soothing, how to connect emotionally, and how to elicit care (including a child’s experience and expectations of care as being ‘available and helpful’).
Father-infant responsiveness
Although the ‘mother-infant-bond’ is often cited as hugely important, we also know that the quality of a father’s bond and their emotional responsiveness is also hugely important to a developing child.
Notice how infants demonstrate the same connection-seeking behaviours to their fathers that the infants did with their mother in the previous video. Also, notice how these infants react just as strongly to their father’s ‘still’ face.
Again, understand that these connection-seeking behaviours and their associated reactions demonstrate an innate survival mechanism that is strongly influenced and shaped through parent-child interactions early in our lives. This ultimately informs how, when, why (and with whom) we seek (or avoid) connection as adults:
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Although these are just very brief demonstrations, imagine the longer-term effects – over many years – of repeated parental unresponsiveness on the emotional development of an infant. Clearly, over time this would affect a child’s sense of safety and being their sense of feeling ‘cared-for’ by that parent. They may also go on to develop extremely negative views about themselves (such as ‘I do not matter’ or ‘I am unlovable’).
Unsurprisingly, research has shown that children who have parents who are not responsive to their needs have more trouble trusting others, relating to others, and regulating their own emotions.
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Why do parents get it wrong?
Even for parents who want the best for their children, there are many reasons why they may struggle to be emotionally present in Secure Attachment ways with their children. For example, if you had a parent who was not responsive to your needs (was not Secure in their attachment style), or who may have even punished you for having certain emotions, you may struggle with knowing how to be Secure in your Attachment yourself. As a parent, you may have difficulties with emotion regulation or other emotional awareness ‘blind-spots’ that lead you to repeating behaviours similar to what you were exposed to with your own children.
At other times, parents lack the information about how attachment affects a child’s developing brain, or they may hold cultural (or outdated) beliefs about emotions and / or parenting that downplay the importance of maintaining an emotionally responsive connection with their children. Alternatively, some parents have strong dysfunctional beliefs about their own abilities (e.g., “I am a failure”) which can interfere with them being able to form a strong bond with their children. These are all common reasons why creating a Secure Attachment fails to occur.
On the other hand, there are also more complex challenges to developing Secure attachment. In households with children who are experiencing behavioural or other developmental difficulties, often parents become preoccupied with caring for that child to the detriment of the needs of other siblings. In households with divorce or a death of a parent there can be ruptures in the Attachment bond. In situations where there is domestic violence, it may be difficult (or unsafe) to show emotions. Unfortunately we know that people who were exposed to the following adverse childhood events (ACEs) can have difficulties with Attachment. Often these people had parents who were exposed to similar adverse events themselves (this is called intergenerational trauma).
We also know that drug and alcohol use can also negatively impact on emotional availability (and both intoxication and the resulting hangover can blunt emotional expression). Some parents have head injuries or other illnesses that make it difficult to show appropriate emotional reactions. Understandably, parents experiencing significant mental illnesses may also struggle to engage with their children in ways that cultivate a Secure Attachment bond.
However, there are also more common forms of disconnection that affect us all. Technology and ‘screen time’ has become a major part of our busy lives and nowadays it is not uncommon to see parents disconnecting from their children in the same ways that were demonstrated in the videos above, by simply using their phone.
For those who are interested, the following video captures what it is like for babies of parents who are immersed in their phones. Notice how absorption in a device triggers exactly the same response in a child as the parental complete non-responsiveness in the previous videos:
A Word of Caution !
Before you go down the road of using Attachment to blame or shame yourself (or your partner, if you are having relationship difficulties) please understand that: Attachment styles are ADAPTIVE behaviours from an earlier stage of life based on our upbringing. Although these behaviours may no longer serve us, they may be carried forward into adulthood. In other words, a child who is taught that relationships are untrustworthy or even frightening naturally learns to have SELF-PROTECTIVE behaviours in all of their relationships. This is not our fault – and it is completely understandable from a survival instinct perspective (after all, all humans are born completely dependent on their parents for food, shelter, nourishment, love and protection). However, as adults it is our responsibility to understand and heal from our childhood attachment conditioning, to help ourselves recognise that the past is affecting us and to provide ourselves with options (and the permission) to change and replace patterns that are no longer serving us.
Also, when considering your childhood attachment history, please keep in mind that parents do not necessarily have to be ‘highly abusive’ to have a negative effect on their children. Parents who are over-protective and intrusive, who are judgmental and have high expectations, or who are dismissive of a child’s thoughts and feelings can (over time) also cause a distrust of relationships – or even a distrust of a child’s own emotions – well into adulthood for that individual.
So in other words, if you learned in childhood that relationships are conditional, shaming, unstable, threatening, withdrawing or rejecting, it may cause you to be uncertain about relationships and this may lead to behaviours typical of the three non-secure attachment styles (anxious, avoidant, or disorganized behaviours). This is not your fault. These emotional reactions and their resulting protective behaviours are an understandable adaptive response to feeling insecure (or unsafe) in an important relationship during a critical stage of our development.
In other words, whereas being able to view attachment behaviours as ‘protective strategies from an earlier part of life that no longer serve us’ is crucial to our liberation, shaming or ridiculing ourselves (or our partner) for having attachment difficulties is probably doing nothing more than continuing to perpetuate the intergenerational toxicity that was handed down to us (or them) by caregivers. This is unlikely to result in freeing ourselves from these patterns and is more likely to continue to do further damage.
It is important to seek help for attachment difficulties. They are not easily resolved with self-help material alone. This is because attachment is relational, it involves your brain’s development and emotional learning in the context of interactions with others. There is learning, reflection, and healing that requires an emotionally-attuned and and emotionally-safe therapeutic environment, and there are skills that need to be honed and practiced interpersonally that cannot be mastered alone.
The Four Attachment Styles
The four attachment styles were born out of the seminal work of psychologists John Bowlby and Mary Ainsworth. In the 1950s, Bowlby proposed that attachment is the product of evolutionary processes and that infants are thus born with an innate drive to form attachments with caregivers. In the 1970s, Ainsworth developed a paradigm (the ‘Strange Situation’) to determine attachment security in children within the context of caregiver relationships. The ‘Strange Situation’ procedure involves series of eight interactions lasting approximately 3 minutes each, whereby a mother, child and stranger are introduced, separated and reunited. From this research, Ainsworth identified three main attachment styles (a fourth attachment style was later identified in the 1980s by psychologists Main and Solomon).
The four attachment styles consist of Secure Attachment and three Non-Secure Attachment Styles listed and described in detail with examples, below:
1) Secure
2) Anxious (aka Preoccupied)
3) Avoidant (aka Dismissive)
4) Disorganized
Secure Attachment:
Secure attachment is the ideal attachment style. Approximately 50-60% of adults have a Secure attachment style. A Secure attachment between a child and a caregiver forms when the caregiver is perceived as safe, predictable, consistent, and physically and emotionally available. The remainder of people develop one of three other attachment styles (Anxious, Avoidant or Disorganized, as discussed in the next section).
Secure attachments develop in the following ways: A securely attached infant believes her parent is safe, available, and responsive when she is in distress. Caregivers communicate these qualities the following ways: Facial expression, posture and tempo of body movement, tone of voice, physical proximity and tactile responsiveness, which together communicate a dependable, caring intention from the caregiver. (This is all pre-verbal information that an infant is constantly learning about and absorbing.) When a secure bond has been established, even the mere attention from or presence of a caregiver can help the infant to regulate distress.
As a result of a secure bond, even if the parent is not always available, the infant will learn to internalize these responses from their caregivers and they can draw on this internal representation to self-soothe and self-regulate during challenges or times of distress. As you can begin to see, this is essentially the origin of where we learn (or sadly where we fail to learn) emotional regulation.
Children with a secure attachment see their parent as a secure base from which they can venture out and independently explore the world. When a caregiver is emotionally responsive and strives to meet an infant’s emotional needs with consistency, the infant is taught to be emotionally responsive themselves. Thus, securely attached children grow into resilient, emotionally healthy adults who enjoy emotionally healthy relationships because they generally feel trusting and safe in those relationships.
In intimate relationships, a secure adult feels secure in their connection with their partner (even in their partner’s absence). This allows each partner to live their lives freely (which is called interdependence). Because a Secure individual is aware of and is able to respond in emotionally healthy ways to their own needs, this frees them up to be supportive at times when their partner feels distressed. Also, because a secure adult feels comfortable eliciting care from others, they are more likely to turn toward (vs shutting down or withdrawing from) their partner when they feel troubled.
In other words, an intimate relationship with a secure partner tends to be honest, open and equal, with both parties feeling independent, yet loving toward each other. Because of this, it is unsurprising that we find that compared to the other attachment styles, securely attached adults (and their partners) report feeling the highest levels of relationship satisfaction.
People with a secure attachment style:
Generally feel close to others and maintain positive, healthy relationships.
Feel comfortable with both emotional and physical intimacy, as well as with maintaining independence and personal space.
Communicate effectively and are adept at resolving conflicts as they arise, using open and honest dialogue.
Have fairly stable relationships, marked by mutual respect, trust, and understanding.
Generally trust their partner and believe in the reliability and consistency of their relationship.
Feel safe being vulnerable with their partner, sharing their thoughts, feelings, and needs without fear of judgment or rejection.
Exhibit a balanced approach to relationship dynamics, valuing both closeness and autonomy.
Are usually confident in expressing their emotions and can handle stress and challenges within the relationship constructively.
Maintain a healthy sense of self-worth and do not overly rely on their partner for validation or emotional support.
Tend to have a positive view of relationships and believe in their ability to overcome difficulties together.
An Example of Secure Attachment
A fantastic example of what Secure Attachment ‘looks like’ in the context of healthy (mutually secure) adult relationships is clearly evident in the (now) infamous “A Credo for My Relationships With Others“ by Clinical Psychologist Dr. Thomas Gordon. As you read through this Credo, I invite you to reflect upon whether you are achieving something like this within your important primary relationships (and if you are, reflect inwards about whether your are achieving this same harmony and respect internally – between the competing aspects of yourself):
“A CREDO FOR MY RELATIONSHIPS WITH OTHERS”
You and I are in a relationship which I value and want to keep. Yet each of us is a separate person with our own unique values and needs and the right to meet those needs.
So that we will better know and understand what each of us values and needs, let us always be open and honest in our communication.
When you are having problems meeting your needs, I will listen with genuine acceptance and understanding so as to facilitate your finding your own solutions instead of depending on mine. And I want you to be a listener for me when I need to find solutions to my problems.
At those times when your behavior interferes with what I must do to get my own needs met, I will tell you openly and honestly how your behavior affects me, trusting that you respect my needs and feelings enough to try to change the behavior that is unacceptable to me. Also, when some behavior of mine is unacceptable to you, I hope you will tell me openly and honestly so I can try to change my behavior.
And when we experience conflicts in our relationship, let us agree to resolve each conflict without either of us resorting to the use of power to win at the expense of the other’s losing. I respect your needs, but I also must respect my own. So let us always strive to search for a solution that will be acceptable to both of us. Your needs will be met, and so will mine—neither will lose, both will win.
In this way, you can continue to develop as a person through satisfying your needs, and so can I. Thus, ours can be a healthy relationship in which both of us can strive to become what we are capable of being. And we can continue to relate to each other with mutual respect, love and peace.
Dr. Thomas Gordon (1978)
Non-Secure Attachment Styles
Below are descriptions of Anxious, Avoidant, and Disorganized Attachment Styles, along with the difficulties individuals may face. It’s important to understand that professional help can be valuable in addressing these challenges. Therapy can assist individuals in understanding their attachment patterns, developing healthier ways to express their needs, and improving their ability to form secure and balanced relationships. Through therapy, individuals can achieve personal growth and enhance overall life satisfaction.
Anxious Attachment (aka Preoccupied):
Children who had parents who at times responded well to their needs, yet at other times, were not emotionally present or may have responded in hurtful or critical ways, grow up feeling insecure, uncertain of what treatment to expect.
In relationships, adults with an anxious attachment style find that they need a lot of reassurance and responsiveness. Unlike a securely attached person, those with an anxious attachment style may appear overly dependent on their relationships to feel okay. Certain interactions or events may trigger deep mistrust and they may regularly feel heightened anxiety about the stability of their relationships.
Even though anxiously attached individuals may feel desperate or insecure, more often than not, their behaviour exacerbates their own fears (via a feedback loop called a ‘self-fulfilling prophecy’). They may also interpret independent actions by their partner as affirmation of their fears. Worse, when they feel unsure of their partner’s feelings or feel insecure in their relationship, they may become clingy, demanding or possessive toward their partner.
Although these are simply attempts to protect the Self via seeking a sense of safety, reassurance and security, by clinging to their partner or by engaging in behaviours called ‘Protest Behaviours’ a person with an anxious attachment style may unwittingly push their partner away. For example, if (say) a partner starts socializing more with friends, they may think, “See? He doesn’t really love me. I was right not to trust him – Maybe there is someone else… This means he is going to leave me.” This may lead to (for instance) lots of reassurance seeking behaviours, such as calling, texting, or even stalking or reading a partner’s private messages. Alternatively, it may lead to hostility towards that partner, who often will not understand the context of the person’s behaviour, and this may drive them away – particularly if the partner has an avoidant attachment style (below).
People with an anxious attachment style:
Feel the need for lots of reassurance in a relationship.
Often report feeling overwhelmed or extremely anxious when they and a loved one disagree or argue.
Question their partner’s love, especially during times when their partner is away or not immediately responsive.
Feel threatened by their partner needing a break and may pursue them persistently until they receive the reassurance they seek.
May have a heightened sensitivity to perceived signs of rejection or abandonment, leading to intense emotional reactions.
Frequently worry about their partner’s commitment and may engage in behaviors to test or seek confirmation of their partner’s loyalty.
May experience difficulty with emotional regulation and rely heavily on their partner to manage their emotional state.
Often fear being alone and may struggle with feelings of inadequacy or unworthiness in the relationship.
Can become preoccupied with the relationship and may prioritize it over other aspects of their life, such as personal interests or friendships.
Individuals with an anxious attachment style may experience significant emotional instability, relationship difficulties, and a pervasive fear of abandonment. Their need for constant reassurance can lead to clinginess, conflicts, and low self-esteem, which negatively impacts overall life satisfaction. Therapy can be crucial in addressing these issues by helping individuals understand their attachment patterns, develop healthier coping strategies, improve communication skills, and enhance self-esteem. Engaging with a mental health professional can support personal growth and foster more secure and fulfilling relationships.
Avoidant Attachment (aka Dismissive):
Caregivers that were emotionally unavailable, absent, or unaware of their child’s emotional needs often raise children who develop an Avoidant attachment style. Perhaps crying was discouraged, or perhaps you were belittled for having emotional needs (vs being responded to with care, interest and warmth). As an adult, you may often feel uncomfortable with who you are or not know what you feel, and you may feel averse to situations in which you need to depend on someone, or be depended on by others.
A person with an avoidant attachment style lives in an ambivalent state, in which they are afraid of being both too close to and too distant from others. In relationships, they have fears of being abandoned but also struggle with being intimate. They may cling to their partner when they feel rejected, then feel trapped (or resentful, as though they will lose their sense of ‘Self’) if they become too emotionally intimate / close.
Often, in relationships, the avoidant style is attracted to the anxious style, and this sets off a push-pull between one partner (the anxious style) feeling unloved and the other partner (the avoidant style) feeling unable to meet the emotional demands of the other.
People with an avoidant attachment style:
Tend to value independence over emotional closeness and may rely excessively on themselves for emotional soothing or support (e.g., ‘Compulsive Self-Reliance’).
May suppress (numb), downplay, or struggle to share their deeper feelings with others.
May experience difficulty forming deep, meaningful relationships (e.g. due to a mild sense of ‘mistrust’).
Often feel awkward (or a strong urge to pull away) when a partner is seeking connection or is distressed.
Regularly feel emotionally removed from or separate from others (which can result in experiences of defectiveness or alienation).
May experience a strong desire to distance themselves from (rather than resolve) stressful situations or conflicts.
Are generally uncomfortable with identifying, feeling, or expressing their deeper emotions (they may be cut off in their awareness of their bodies and/or may be numb to what they truly feel).
May prefer fleeting, casual relationships to long-term intimate ones or may seek out partners who are equally independent (or who will maintain emotional distance).
Are often accused by their partners of being distant and closed off, rigid, and intolerant. In return, they may accuse their partners of being ‘too needy.’
If you have an Avoidant Attachment Style, it is important to respect and learn to communicate your needs for space in a relationship in ways that reassure your partner that both they and the relationship are safe. Effectively communicating these needs helps maintain healthy boundaries while providing reassurance.
To do this, first identify what you need and consider how you can reassure your partner. For example, you might say:
“This is not a reflection of how I feel about you—this is something that I need.”
Here’s an example of how to express your need for space using clear, empathetic, and reassuring language. This approach acknowledges your own needs while also being mindful of your partner’s feelings:
“I’m sorry, but I’m not feeling very communicative right now. Please understand that my need for space at the moment—like not texting or engaging as much—is not a reflection of how I feel about you. Would it be alright if I take some time for myself right now? I promise we’ll spend quality time together later.”
By framing your need for space clearly and warmly, you can help your partner understand that it’s about your personal needs rather than a response to them or the relationship. This approach fosters open communication and mutual understanding, which supports a healthier dynamic. Developing various ways to express your feelings and needs effectively reassures your partner, helping them feel secure in the relationship. When your partner feels this sense of security, they are more likely to respect your need for space. This mutual understanding allows you to enjoy freedom and security in the relationship, strengthening your connection without feeling the need to withdraw to ‘survive.’ In this way, both partners can maintain a balanced and fulfilling relationship.
Disorganized (unresolved) Attachment:
Disorganized attachment is a primary attachment style commonly observed in survivors of complex developmental trauma (cPTSD). This can occur when a caregiver is frightening, abusive, or behaves in highly inappropriate ways, or when a child’s fundamental needs and rights are violated. Such traumatic experiences can instill a deep sense of fear and confusion in a child, who is inherently dependent on their caregivers for nurturance, safety, shelter, and sustenance. This dependency creates an internal conflict: while the child needs their caregiver for basic needs, they may also perceive the caregiver as a source of threat or betrayal. This conflict can lead a child to believe that the abusive behavior is their own fault or that they should remain loyal due to the caregiver’s role as a parent.
As an adult, individuals with a disorganized attachment style may yearn for closeness but simultaneously fear it. They might avoid seeking out relationships because they perceive reliance on others as unsafe. When faced with opportunities for intimacy, they may experience an internal struggle and pull away, reflecting the deep-seated fears and confusion rooted in their early experiences.
The consequences of disorganized attachment can significantly impact life satisfaction. Individuals may struggle with chronic emotional instability, difficulties in forming and maintaining stable relationships, and a pervasive sense of mistrust or insecurity. These issues can lead to feelings of isolation, low self-esteem, and dissatisfaction with personal and professional aspects of life.
People with a disorganized attachment style:
May have had primary caregivers who were abusive (physically, emotionally, sexually, or through neglect).
Commonly report craving emotional intimacy, but also feel it is safer to be alone, experiencing conflicting desires for connection and self-protection.
May have had primary caregivers who alternated between showing love and being frightening or unpredictable, creating confusion about how to navigate relationships.
May experience Complex Trauma (cPTSD) due to prolonged exposure to adverse experiences during formative years.
Often have a deep mistrust of others, struggling to believe in the positive intentions of those around them.
May exhibit inconsistent or erratic behaviors in relationships, reflecting their internal conflict and confusion about attachment.
Often feel ambivalent about closeness, both yearning for and fearing emotional connection due to past trauma.
May experience difficulties with emotional regulation and find it challenging to maintain stable, trusting relationships.
May display a pattern of chaotic or tumultuous relationships, mirroring the unpredictability and instability experienced in childhood.
Can struggle with a sense of identity and self-worth, frequently questioning their value in relationships and feeling uncertain about how to meet their own emotional needs.
Professional help is often crucial for individuals with disorganized attachment to address these challenges. As with the other non-secure attachment styles, therapy can provide a safe space to explore and process past traumas, develop healthier relationship patterns, and build coping strategies. Therapeutic approaches such as trauma-focused therapies and attachment-informed therapies, can be particularly beneficial in helping individuals understand and modify their attachment patterns, improve emotional regulation, and enhance overall life satisfaction. Engaging with a mental health professional can support the healing process and facilitate the development of more secure and fulfilling relationships
Attachment & Emotion Regulation
Emotion regulation is the process by which we influence how we experience and express our feelings (which emotions we have, when we have them, and how they are expressed). Throughout our lives, emotion regulation is an important regulator of interpersonal relationships and in our relationship with ourselves.
The ability to regulate one’s emotions is taught in one’s earliest relationships. We are taught ‘how’ to feel (and we are often not taught how to feel) by our primary caregivers, and this becomes ingrained throughout childhood, and practiced throughout life. Thus, emotion regulation and quality of an infant’s attachment are closely linked.
In infants, patterns of emotion regulation are shaped and developed in direct response to experiences with their caregivers. Because an infant is dependent on a caregiver (e.g., for food, shelter, and protection), an infant’s emotional regulation serves the important function for the infant of maintaining a close relationship with the attachment figure. This ensures that the parent will remain close to the child and the child will thereby (hopefully) be protected. As was demonstrated in the “Still Face” videos above – this is a survival instinct (we are hard-wired to do this).
Therefore, it is easy to understand how infants of non-secure parents, who may experience repeated rejection, or hostility, may learn very quickly to minimize their own negative affect (i.e., by emotionally withdrawing or shutting down) in order to avoid the risk of further rejection. Often, infants internalise the voices of their parents – and this can lead to an internalisation of this response to self that persists into adulthood in the form of negative self-beliefs and/or self-criticism.
On the other hand, it is easy to understand how infants of mothers who have been relatively inconsistently available may maximize negative their affect in order to increase the likelihood of gaining the attention of a frequently unavailable caregiver. If this strategy succeeds, it becomes engrained through repetition as a natural response whenever faces with a similar situation. Clearly, this could result in difficulties with emotion regulation for the child that may persist into teenage years and adulthood.
Again, both of these patterns of emotion regulation are simply examples of primal attempts by the infant to remain in positive connection with the caregiver. When these patterns work, they are repeated and they become deeply learned emotional responses – ways that we may still strive to have our emotional needs met as adults.
The early experiences you had with your primary caregivers ALSO play a direct role in the development of your brain, which in turn influences your ability to regulate your emotions. Insecure or inconsistent styles of attachment result in the experience of feeling overwhelmed and unsafe in a child, which creates either Hyperarousal (being on high alert) or Hypoarousal (becoming numb) as means of protection. Left unaddressed, this can persist across the lifespan and can greatly affect adult relationships, including our relationship with ourselves.
Over time, these learned protective behaviours can reorganise a child’s brain during a particularly crucial stage of development (0-15 years) and this, in conjunction with either adverse childhood experiences, skills deficits, or maladaptive coping strategies, can lead to difficulties with emotion regulation in adults (such as a reduced Window of Tolerance, discussed in detail here). Essentially this is because through interacting with an infant in a very critical period of brain development (especially between 0 to 12mths) the mother begins to teach and shape how to down-regulate negative emotions but ALSO how to up-regulate positive emotions (such as joy, interest, excitement, which are important for play-states and the development of the dopaminergic-reward system).
This is essentially what we as adults are ultimately required to do for ourselves, in terms of regulating our emotions (by calmly activating and deactivating our arousal) in response to the full range of events and challenges that we experience. This is depicted in a simple way in the following diagram (taken from my Window of Tolerance article, discussed in detail here):
Moreover, we know that the broader the range of emotions a child learns to experience (and respond to), the broader the range of emotions the adult will be able to understand, experience, and respond to (and understand, experience, and respond to in others).
For these reasons, it follows that, whereas skills for emotional regulation may come significantly easier to those who have grown up with secure attachment, emotional regulation can be more difficult to learn for those who grew up with inconsistent, unavailable or abusive caregiving. Nevertheless, the good news is that we can learn to work with (and heal) our wounded attachment systems, and regarding improving our emotion regulation – this essentially involves developing a new set of skills, which can be learned.
Effects on Relationships
Although it is possible to have differing attachments with different people in our lives (e.g., you may simultaneously feel Secure in your attachment with a best friend, Anxious in your attachment with your boss, and Avoidant in relation to a pesky neighbour), we all have one primary attachment style. Each person tends to rely more on this one style than the other styles of relating.
In fact, this primary attachment style is so fundamental to how we process and make sense of the world that we even dream according to our primary attachment style. In one study, participants completed established measures of attachment to determine which attachment style best characterized them. Then, raters who were blind to the test results, listened to the participants’ recollections of dreams (listening carefully for themes, key people and the relationships between them). Amazingly, raters were able to correctly categorize participants’ attachment styles with a very high degree of accuracy, simply based on the content of their dreams (!). This result as been replicated in similar research.
In the area of intimate relationships, both male and female adults seeking long-term partners often identify qualities of responsiveness consistent with Secure Attachment caregiving (such as warmth, attentiveness, and sensitivity), as the “most attractive” qualities in potential partners. Yet, as you are probably aware, despite the attractiveness of these secure qualities, not all adults are paired with secure partners.
This is because it is common for people to find themselves in relationships with partners who confirm their existing attachment experiences regarding relationships, care, and love. In other words, as adults we are subconsciously drawn towards partners who replicate the attachment dynamics that we experienced as children – even when these dynamics are not helpful for us.(This is because our ancient brains are drawn to this ‘familiarity’ on a primal, subconscious level).
However, this need not be the case. If you are in a relationship that contains unhealthy attachment dynamics, you can become aware of them and work with your partner (or with a therapist) to improve and change unworkable patterns. Or, if the dynamic is truly dysfunctional and toxic, you can work towards terminating an unworkable relationship.
Alternatively, if you are not in an intimate relationship (or if you are not seeking one), understanding your Attachment style is still hugely important because it strongly influences how you relate to yourself and communicate with (and understand) others.
It’s Not Your Fault
As discussed earlier, there are many reasons a parent may struggle to be emotionally present with their children. For the most part, most parents try as best as they can to deal with the challenges of parenting with the emotional regulation skills that they have, many of which were passed onto them by their own parents.
Unfortunately, children of parents who lacked the capacity to understand how what they are doing was ultimately affecting their child’s psychological growth and well-being, will most likely be those who have the deepest attachment wounds (and challenges managing relationships, including their response to emotions and needs of the Self). This is because, as humans, we have built-in survival instincts. As infants, our attachment style was our best means of self-protection.
If you align with a “non-secure” attachment style, it is not because you did something wrong. Rather, your attachment style results from surviving your upbringing. In other words, a ‘non secure attachment style’ is a response to this period because it was how we learned to “balance out” the challenges of the caregiving provided to us. Any non-secure attachment style we may develop was the best way we to could cope with the difficulties of circumstances we were handed. In other words, our attachment experiences are not our fault (!). We did not choose our families, nor did we choose the difficult early childhood experiences we were exposed to.
No matter which attachment style you currently have, know that secure attachment is possible. Learning about attachment is a journey of healing, self-compassion, and moving towards a more secure attachment style that will ultimately lead to healthier, more rewarding relationships.
You can recover from your attachment wounds. You can learn to develop new ways to relate to yourself and to connect with others. Learning about attachment by reading this article (and some of the articles at the bottom of this page) marks the beginning of this journey…
Healing Your Attachment Wounds
We now know that the attachment style you developed as a child based on your relationship with a parent or early caregiver does not have to define your way of relating to yourself, or to those you love in your adult life. In fact, we know that healing our attachment wounds is possible through heathy, emotionally corrective relationships.
We know that healthy attachment to others is our primary protection against feelings of helplessness and meaninglessness. For instance, close, connected relationships can actually reduce anxiety and fear by easing our primal fear of abandonment. This is because strong, attached relationships reduce feelings of fear (threat activation) and help “calm the brain”.
Whereas emotional isolation is more dangerous for health than smoking or a lack of exercise (e.g., people who live alone experience three times as many strokes as those who are married), those who feel the safety of a comforting relationship actually are more resilient in life and can go out and take more risks. Quite simply, loving and being loved makes one stronger. Those who have trust in each other can turn to each other in times of distress and this creates even more emotional safety.
Emotionally corrective relationships can be intimate relationships that you may have with a trauma-aware emotionally supportive partner (or a close friend) who either has a secure attachment style or who has done a lot of this work in therapy themselves. This person may be willing to hold space for you while also holding you accountable, as you work through the pain of your past together in all the ways that this may emerge within the dynamics of your relationship. Again, these individuals are often people who have often already done the work of therapy and have done the work of breaking their attachment patterns. However, these relationships deserve to be cherished and they are not a complete substitute for working with a professional who is trained in helping people heal from attachment wounds.
Unfortunately, for people with complex attachment wounds, developing a secure relationship with the ‘right kind of person’ who is emotionally safe, knowledgeable, patient, unconditionally non-condemning and capable of providing a consistent secure base is a huge task, and there will likely be many hurdles along the way. Attachment patterns can be very challenging to understand and very resistant to change, and this can put significant strain on relationships. Again, working with a professional who is trained in helping people heal from attachment wounds is highly recommended.
Although self-help information can be useful, it is also important to seek help for attachment difficulties and not to rely on self-help material alone. This is because attachment is relational, it involves your brain’s development and emotional learning in the context of interactions with others. The learning, reflection, and healing that is needed to address issues of attachment require an emotionally-attuned and emotionally-safe therapeutic environment in which to do this work, and to practice interpersonal skills that cannot be mastered alone.
Developing Secure Attachment
Seen, Soothed, & Safe = Secure Attachment
Secure Attachment can be BEST summarized with the concept of: ‘Seen, Soothed, & Safe’. Although this idea was initially developed by Dr. Dan Sigel (Neuropsychiatrist, Researcher, and best-selling Author) to help simplify Attachment for parents seeking to understand, attune to, and provide for their child’s emotional and developmental needs, the concept of Seen, Soothed, & Safe can be applied to two further areas: How we as adults relate to others and more importantly, how we relate to (and care for) ourselves.
Seen
‘Seen’ means to acknowledge and understand the mind, and emotions of another. This involves showing interest, empathy and curiosity about the feelings, perspectives and needs of another and being supportive an responsive to the emotional worlds of another person (it is the opposite of a dismissive parenting style that ignores, invalidates, or belittles a child for having the feelings or reactions that they might be having). It also requires being able to remain ‘present’ with and attuned to another person. This is not simply about eye-contact; it is about any actions you can take that may communicate to another person that you ‘get it’ at a ‘feeling’ level – that you truly understand their emotional experience. Mindfulness skills, Active Listening skills, and checking that you have heard what someone is saying correctly, can greatly help with this.
Appling ‘Seen’ to Ourselves: This means developing awareness of our own internal worlds, being able to identify, understand, and take responsibility for working with our emotions. It also means identifying and understanding what we need, and being interested and willing to respond to meeting those needs. If this learning was not provided to us by our primary caregivers, this may require therapy and practice.
Soothed
‘Soothed’ means to provide a sense of comfort and calm to another when they are experiencing difficult emotions or situations, in order to help settle and soothe their nervous system, to provide emotional support, or to provide a ‘space’ to be with the difficulty that they may be experiencing. Soothing may be enhanced by the ways we use our voice (tone, speed, expression), and/or physical gestures like body language, eye-contact, hand holding, or hugging.
Applying ‘Soothed’ to Ourselves: Being able to comfort and care ourselves by responding to our needs with healthy self-care actions, that support, settle, and soothe our nervous systems are all hallmarks of being able to provide a sense of ‘soothed’ to ourselves when we are having difficulties. This may require the prior development and practice of self-regulation skills learned in either therapy or via useful self-help tools.
Safe
‘Safe’ means to provide a sense of emotional availability and/or protection to others which can be demonstrated in a variety of ways, such as via the aforementioned ‘Seen’ and ‘Soothed’ actions, by being ‘present’ and attuned to their inner worlds and demonstrating that you can be a stable and dependable figure during in times of distress. Other actions that cultivate a sense of ‘safe’ may include: Being able to provide emotional a ‘space’ for others where they feel accepted when experiencing their difficulty, by being reliably accountable for one’s actions where there is a contribution to the difficulty (i.e, taking appropriate responsibility to ‘right a wrong’), and checking-in on how another person is feeling in a reliable and a consistent way.
Applying ‘Safe’ to Ourselves: In addition to the skills required to feel we are ‘seen’ and can ‘soothe’ ourselves, being able to communicate through our intentions and our actions that we can care for ourselves in healthy ways (no matter what we may be feeling) can provide a deeper sense that we are ‘safe’ within ourselves. This is largely achieved by being able to respond to our inner worlds consistently with care, acceptance and compassion. This demonstrates to us that ‘it is OK’ to feel what we are feeling. Being proactively responsive to our emotions and our needs (which may include taking assertive actions to elicit care from others) and assertive communication skills are additional resources that can contribute to our sense of ‘safe’.
The video below summarizes the above concepts. Although it presents them as ‘4’ separate elements, they are essentially just 3 because: Seen + Safe + Soothed = Secure Attachment.
Individual Therapy
A skillful trauma-informed psychologist who has undertaken the appropriate training can offer you the experience of a healthy, emotionally corrective relationship. Such a therapeutic relationship has the potential to be an emotionally corrective relationship partly because it is the therapist’s job to be ethical, consistent, and to build in security while being fully present for their clients.
The goal of therapy in providing a secure attachment is to model healthy ways to relate to others and to provide a safe environment for you to learn to attend to and express your own feelings and needs, while also healing past wounds and practicing new skills. In this way, you can work towards developing more secure ways of relating to others, often referred to as ‘Earned Secure Attachment‘. With the support of your therapist, you will be able to begin to apply these new strengths outside therapy in relationships that matter to you such as with a partner, children and friends. This work can take time – but it can be done whether you are in an intimate relationship, or not.
In terms of using the emotionally corrective relationship of therapy to improve your relationship with yourself (which is also an important part of developing ‘earned secure attachment’), this may involve learning new ways of being able to soothe and support yourself when you are struggling or are experiencing a setback – these emotional skills will likely not have been made available to you as a child. For people with significant developmental traumas (such as attachment wounds or Adverse Childhood Events), therapies such as EMDR Therapy may be useful in helping you to remove the disturbance of painful memories so that you can put your past behind you, and create the relationships with yourself and others that you ultimately were unable to have.
If you are troubled by memories that disturb you, or if you are tired of being emotionally triggered by events, I recommend reading my page about EMDR Therapy.
Attachment-Focused Therapy for Couples (EFT)
The most well researched therapy for couples that makes use of attachment science is called Emotionally Focused Therapy (EFT) for Couples. EFT for Couples is a short-term therapy that is aims to improve attachment and bonding in adult relationships. EFT for Couples is about creating connection in close relationships. It helps couples to understand and express their emotional experience including their needs, feelings, thoughts, and behaviours.
EFT for Couples is acknowledged as the gold standard for empirically validated interventions in tested interventions for couples. This research shows large treatment effect sizes and impressively, stable results over time.
EFT is the only model of couple intervention that uses a systematic empirically validated model of adult bonding (attachment) as the basis for understanding and alleviating relationship problems. Developed over 30 years ago by Sue Johnson, EFT for Couples is essentially attachment science in a therapy. As has been discussed, attachment science views human beings as innately relational, social and wired for intimate bonding with others. The EFT model prioritizes emotions and emotional regulation as the key organizing agents in individual experiences and key relationship interactions.
Below is a short video explaining research that Sue Johnson and her team performed, involving brain scans of people in relationships who were treated with EFT for Couples. It demonstrates how developing a strong relationship bond can reduce feelings of fear (threat activation) and can help “soothe the threatened brain”.
EFT for Couples not only addresses factors such as relationship distress, intimacy, trust, and the forgiveness of injuries, but it also aims to influence and heal you and your partner’s attachment style.
Emotionally Focused Therapy (EFT) involves discussing specific incidents that may occur in your relationship, as a way to help each of you learn about your emotions and the behaviours that result from those incidents.
For example, your therapist may discuss your partner reminding you to take out the rubbish and how that makes you feel. Do you feel angry? What else might you feel? Are you ashamed because you forgot, so that makes you want to lash out in anger? Do you feel judged as “not good enough” by your partner and that makes you feel as if you disappointed her? Does this then make you want to pull away from her?
Goals of EFT for Couples:
To create a positive shift in partners interactional positions and patterns.
To foster the creation of a secure bond between partners.
To expand and re-organize key emotional responses and, in the process, the organization of self.
If you are in a relationship in distress, or you would like to improve your relationship in any way, I highly recommend learning more about the work of Sue Johnson and finding a psychologist who can offer EFT for Couples.
A more in-depth presentation about Attachment and EFT for Couples:
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Alternative Applications of Attachment Science: Consensual Non-Monogamy
Attachment science has traditionally focused on supporting monogamous relationships and improving parenting outcomes, often overlooking individuals who identify as polyamorous—those who form intimate relationships with multiple partners simultaneously.
For those pursuing consensual, conscious, and healthy polyamorous relationships (i.e., Consensual Non-Monogamy or CNM), finding resources to address attachment wounds, needs, and tendencies is challenging. This also involves being mindful of the attachment dynamics and impacts on multiple partners simultaneously.
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Jessica Fern’s Polysecure: Attachment, Trauma, and Consensual Nonmonogamy is a valuable resource that applies attachment theory to CNM relationships, aiming to help individuals and their partners achieve attachment security. However, many of the book’s suggestions for applying attachment research have not yet been empirically demonstrated in CNM relationships. This is likely due to the emerging nature of research in this area, which contemporary attachment researchers are still exploring. Nevertheless, the book is well-intended (and well-written), offering practical suggestions for those seeking to achieve attachment security in polyamorous relationships.
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Parents & Caregivers
If you are a parent whose childhood attachment experiences were less than ideal, or worse, perhaps you were exposed to significant traumas commonly referred to adverse childhood events (ACEs), I recommend that you engage in therapy with a clinical psychologist that is trauma-informed, and attachment aware (Please note: Sadly, not all psychologists are). Options for family therapy also abound.
It is also be important to invest in education. My recommendations are to undertake one (or both) of the following established and researched-backed programs:
An international program designed for parents and carers of children aged 0-12 years who want to strengthen the bonds with their children and would like support to help their children to build secure relationships. There is evidence that parents can in fact positively change a child’s insecure attachment style to ‘secure’ with COS training.
Collaborative and Proactive Solutions (CPS) training (external link)
CPS is an evidenced-based model of psychosocial treatment developed by Dr. Ross Greene, and described in his books Raising Human Beings, Lost at School, &The Explosive Child (another highly recommended ground-breaking approach to understanding and parenting children who frequently exhibit severe fits of temper and other significantly challenging behaviours).
Rather than focusing on kids’ challenging behaviours (and modifying them), CPS helps kids and caregivers solve the problems that are causing those behaviours. This problem solving is collaborative (vs unilateral) and proactive (vs reactive). Research continues to find that that the model is effective at not only solving problems and improving behaviour but also at enhancing adaptive communication and emotion regulation skills.
The Attachment Project is a (for profit) organisation that has useful Self-Help information for parents & caregivers (such as the specific link above) to help better understand how the different attachment styles develop in response to specific parenting strategies and styles. Their content is written by psychologists.
However, they offer an Attachment Style ‘quiz’ that is not a reputable diagnostic tool, nor is it empirically-validated (if you take this quiz, do so with ‘a grain of salt’). To their credit, the do state “The Attachment Project’s content and courses are for informational and educational purposes only. Our website and products are not intended to be a substitute for professional medical and/or psychological advice, diagnosis, or treatment.”
Summary:
Attachment science explains how humans develop and function in relationships across the lifespan.
Our ‘Attachment Style’ relates to the quality of our relationships with our primary caregivers.
Our earliest attachments with parents or caregivers shape our abilities and expectations for relationships throughout life. The quality of our bond within these early relationships influences how our sense of Self develops, what we expect from our partners, and how we believe relationships work.
Our early attachment experiences influence: How our brains developed; how we learned regulate our emotions in response to stress; and, how we relate to others and ourselves (including the partners we choose and how we believe relationships work, and we behave in relationships).
Attachment styles are not our fault (or our choosing). Rather, they emerge early in our lives and are the result of previously ADAPTIVE, self-protective (i.e., ‘survival’) behaviours, that we developed in response to our upbringing. These patterns are often carried forward into adulthood, even though the resulting effects on our relationships with ourselves and others may be compromised or may become ultimately unworkable.
Parents do not necessarily have to be highly abusive to have a negative effect on their children. Parents who are over-protective and intrusive, who are judgmental and have high expectations, or who are dismissive of a child’s thoughts and feelings can also cause a distrust of relationships – or even a distrust of a child’s own emotions – well into adulthood for that child.
Attachment in conjunction with adverse childhood experiences and other developmental deficits (resulting in difficulties with emotion regulation or maladaptive coping strategies), can lead to difficulties with emotion regulation in adults (such as a reduced Window of Tolerance).
Healing our attachment wounds is possible through a combination of learning, self-reflection, and heathy ’emotionally corrective relationships’ – this includes therapy with a trauma-informed, attachment aware therapist with whom you feel safe, understood and respected.
Although self-help information can be useful, there is a need for safe guided reflection and learning of interpersonal skills that cannot be mastered alone.
Because attachment is relational, we need an emotionally-attuned and emotionally-safe therapeutic environment in which to do this work. It involves working with our emotional understanding and responses in the context of interactions with others.
Therapies such as EMDR Therapy may be useful in helping you to remove the disturbance of painful memories so that you can put your past behind you, and create the relationships with yourself and others that you ultimately were unable to have. Regardless of the therapy ‘type’, ensure you seek the help of a therapist who is trauma-informed, and attachment aware.
Help for parents abounds in terms of individual and family therapy, and research-backed programs mentioned above in this article.
Couples with attachment difficulties are recommended to invest in therapy with a therapist who is trained in Emotionally Focused Therapy (EFT) for Couples. Based on attachment science, EFT is the gold standard for couples therapy a therapy. EFT for Couples not only addresses factors such as relationship distress, intimacy, trust, and the forgiveness of injuries, but it also aims to influence and heal you and your partner’s attachment style.
Understand that your attachment style may also affect how you engage in therapy. If you are receiving (or are planning to receive) therapy, I recommend reading the following article: How to get the most out of therapy.
I am a PhD Clinical Psychologist with over 15 years’ experience. My intentions are to help you to feel safe and respected, to collaborate with you to set clear treatment goals, and to facilitate an exploration of yourself and your situation in ways that regular conversations do not normally allow. Together, I hope we can discover constructive ways to improve your situation and your relationship with yourself and others.
My expertise and training draws from the latest evidenced-based ways to work with the mind, the body and all difficult emotions. My listening skills allow me to identify stuck patterns and unexpressed needs. I can help you to find new ways of responding to difficult situations, and I can help you to develop more resilience in the face of life’s challenges so you live with more meaning and purpose.
Medicare rebates are available for all Australians for up to 10 sessions each year with a GP referral and a mental health care plan. No matter where you live in Australia, Medicare rebates apply for all face-to-face and Telehealth consultations.
For immediate self-help, I have written practical articles containing tools to help you with a wide-range of topics. These articles are available here. If you are new to therapy, I recommend that you read this article to help you get the most out of therapy.
I look forward to working with you.
Dr Andreas Comninos
B.Psych (Hons), PhD (Clin Psych), MAPS, EMDRAA
PhD Clinical Psychologist
EMDRAA Accredited Practitioner
Psychology Board Approved Supervisor
Dr Andreas Comninos
PhD Clinical Psychologist
EMDRAA Accredited Practitioner
Psychology Board Approved Supervisor
B.Psych (Hons), PhD (ClinPsych), ACBS, MAPS
About me.
I am a PhD Clinical Psychologist with over 15 years’ experience. My intentions are to help you to feel safe and respected, to collaborate with you to set clear treatment goals, and to facilitate an exploration of yourself and your situation in ways that regular conversations do not normally allow. Together, I hope we can discover constructive ways to improve your situation and your relationship with yourself and others.
My expertise and training draws from the latest evidenced-based ways to work with the mind, the body and all difficult emotions. My listening skills allow me to identify stuck patterns and unexpressed needs. I can help you to find new ways of responding to difficult situations, and I can help you to develop more resilience in the face of life’s challenges so you can live with more meaning and purpose.
Medicare rebates are available for all Australians for up to 10 sessions each year with a GP referral and a mental health care plan. No matter where you live in Australia, Medicare rebates apply for all face-to-face and Telehealth consultations.
For immediate self-help, I have written practical articles containing tools to help you with a wide-range of topics. These articles are available here. If you are new to therapy, I recommend that you read this article to help you get the most out of therapy.