Latest / Inside The Consulting Room - Understanding the Child Behind the Behaviour / Attachment styles. Disorganized Attachment. When Love & Fear Are The Same.

Transcript

Attachment styles. Disorganized Attachment. When Love & Fear Are The Same. · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello, this is Kim Lee, child and adolescent psychotherapist.
• 0:05
  SPEAKER_00: And this is probably one of the most important episodes, if not the most important episode, in the series about attachment and attachment styles.
• 0:18
  SPEAKER_00: We've covered quite a lot so far, but this is probably one of the most complex, and it has to do with disorganized attachment.
• 0:28
  SPEAKER_00: Some of my observations come from direct experience of working with patients, only a few, who have this extraordinarily destructive attachment style.
• 0:46
  SPEAKER_00: Many years ago I learned of a some way called the Mulberry Bush School, which specializes in working with children who have significant attachment disorders, often as a consequence of severe trauma multiply experienced, and such children are chaotic beyond belief.
• 1:09
  SPEAKER_00: The Mulberry Bush School is probably one of the finest, if it's certainly the finest, in the UK in terms of working with such children.
• 1:18
  SPEAKER_00: It's a residential school, its work is highly specialized, and there is a documentary that I can point you towards entitled Hold Me Close, Let Me Go.
• 1:29
  SPEAKER_00: You can find this on YouTube and it's uploaded in different parts.
• 1:34
  SPEAKER_00: I should say some of it's very hard to watch, however, it gives you a very, very clear picture of the work of the school and the extreme forms of disorganized attachment behaviour.
• 1:54
  SPEAKER_00: When I first became aware of the Marbury Bush and the work of Barbara Docker Drysdale, its founder, I was strongly influenced, and I think that experience of learning about them and subsequently having periods of collaborative work with them.
• 2:14
  SPEAKER_00: Those things really did inform my thinking when I began working with children myself.
• 2:21
  SPEAKER_00: So I owe a great deal to them, but I would also say that some of the children you may see in the documentary, who I occasionally see in my consulting room, are very often referred to me because they've been considered to be suffering with attention deficit disorder or autistic spectrum disorder.
• 2:45
  SPEAKER_00: And very often I will think back to those early days of my work and certainly as a my work as a consultant in specialist units and think, no, this is disorganized attachment.
• 3:01
  SPEAKER_00: And nonetheless, the approaches required are still highly complex.
• 3:09
  SPEAKER_00: So in this episode, I want to try and talk through what this is about.
• 3:17
  SPEAKER_00: Essentially, it has to do with when love and fear become the same thing.
• 3:24
  SPEAKER_00: And there's perhaps no attachment style more painful to live with than disorganized attachment.
• 3:31
  SPEAKER_00: Not because it produces the greatest suffering necessarily, but because it creates the greatest confusion.
• 3:39
  SPEAKER_00: For the anxiously attached person, the fear is abandonment.
• 3:43
  SPEAKER_00: For the avoidantly attached person, the fear is dependence.
• 3:48
  SPEAKER_00: But for the disorganized individual, both fears exist simultaneously.
• 3:54
  SPEAKER_00: They desperately want connection, they desperately fear connection.
• 4:00
  SPEAKER_00: They long for intimacy and they fear intimacy.
• 4:04
  SPEAKER_00: They move towards people but then away from them.
• 4:07
  SPEAKER_00: And often spend years why relations wondering why relationships feel so difficult.
• 4:14
  SPEAKER_00: To understand why this happens, we have to return to childhood because disorganized attachment begins with a dilemma that no child should ever have to face.
• 4:23
  SPEAKER_00: And it's impossible.
• 4:25
  SPEAKER_00: Imagine being a child, and imagine that the person you most need in the world is also the person you fear.
• 4:35
  SPEAKER_00: The person who comforts you is also the person who terrifies you.
• 4:41
  SPEAKER_00: The person who protects you is also the source of danger.
• 4:46
  SPEAKER_00: The person you run towards is the same person you want to run away from.
• 4:52
  SPEAKER_00: The attachment system immediately encounters an impossible problem.
• 4:57
  SPEAKER_00: Whereas biology demands proximity, safety demands distance.
• 5:04
  SPEAKER_00: Neither solution works.
• 5:06
  SPEAKER_00: The child cannot simply stop needing the caregiver, but nor can they safely relax in the caregiver's presence.
• 5:15
  SPEAKER_00: The nervous system becomes trapped.
• 5:18
  SPEAKER_00: And because there is no coherent solution, a coherent attachment strategy never fully develops.
• 5:25
  SPEAKER_00: This is why we call it disorganized attachment.
• 5:29
  SPEAKER_00: It's the birth of contradiction.
• 5:32
  SPEAKER_00: As I said, anxious attachment is organized, avoidant attachment is organized.
• 5:37
  SPEAKER_00: Each has a strategy.
• 5:40
  SPEAKER_00: Disorganized attachment has no sable strategy at all.
• 5:44
  SPEAKER_00: Because the child learns that love and fear coexist, danger and comfort coexist, safety and threat coexist.
• 5:54
  SPEAKER_00: The result is psychological contradiction.
• 5:58
  SPEAKER_00: An internal state of catch 22.
• 6:03
  SPEAKER_00: And so the mind begins searching for ways to survive experiences that can't easily be understood.
• 6:10
  SPEAKER_00: So what happens inside the child?
• 6:13
  SPEAKER_00: Bear in mind, children need coherent realities.
• 6:17
  SPEAKER_00: They need to believe my mother loves me, my father protects me, my caregivers love and protect me, and the people I depend upon are safe.
• 6:27
  SPEAKER_00: But what happens when experience repeatedly contradicts those beliefs?
• 6:32
  SPEAKER_00: What happens when the parent genuinely loves the child but is also violent or emotionally unstable or frightening or addicted or traumatized themselves?
• 6:45
  SPEAKER_00: The child cannot simply abandon attachment, nor can they fully acknowledge danger.
• 6:52
  SPEAKER_00: So the mind begins separating these incompatible experiences, and this is where fragmentation occurs.
• 6:59
  SPEAKER_00: Because fragmentation is a necessary splitting up of parts of the self in order to survive.
• 7:06
  SPEAKER_00: It's not conscious, it's automatic.
• 7:12
  SPEAKER_00: Okay, now let's fast forward to adult relationships because childhood eventually becomes adulthood, but the attachment system remains, it doesn't change.
• 7:23
  SPEAKER_00: And this is where disorganized attachment often becomes most visible.
• 7:28
  SPEAKER_00: The tragedy is that the individual spends much of their life searching for precisely what they fear.
• 7:34
  SPEAKER_00: They want intimacy, they want closeness, they want somebody who finally feels safe.
• 7:40
  SPEAKER_00: But as soon as genuine closeness begins emerging, the attachment system activates.
• 7:46
  SPEAKER_00: Because closeness has never been associated exclusively with safety.
• 7:51
  SPEAKER_00: It's always been associated with danger.
• 7:54
  SPEAKER_00: And so relationships become profoundly confusing.
• 8:00
  SPEAKER_00: One of the most recognizable features of disorganized attachment is what we call the push-pull cycle.
• 8:06
  SPEAKER_00: The person pursues intimacy, they become emotionally open, they become trusting, allowing vulnerability and hope, then suddenly something changes.
• 8:18
  SPEAKER_00: The relationship becomes psychologically significant.
• 8:22
  SPEAKER_00: The possibility of dependency emerges.
• 8:26
  SPEAKER_00: The possibility of loss becomes real, and fear enters the system.
• 8:31
  SPEAKER_00: The same person who desperately wanted closeness now begins creating distance.
• 8:36
  SPEAKER_00: Not because they no longer care, but because caring itself has become frightening.
• 8:42
  SPEAKER_00: The closer they feel, the more vulnerable they become.
• 8:46
  SPEAKER_00: The more vulnerable they become, the more danger they must anticipate.
• 8:50
  SPEAKER_00: And so they withdraw or they destroy.
• 8:55
  SPEAKER_00: The testing that occurs in relationships like this includes repeatedly testing the relationships, perhaps, but almost always unconsciously, they may withdraw unexpectedly, create conflict, become emotionally unavailable, threaten separation, push people away, then watch carefully to see what happens.
• 9:18
  SPEAKER_00: Underneath all of this lies a simple question.
• 9:22
  SPEAKER_00: Will you leave me or perhaps will you hurt me if I trust you?
• 9:28
  SPEAKER_00: The problem is that repeated testing eventually damages even healthy relationships.
• 9:35
  SPEAKER_00: Relationships often feel overwhelmingly intense for individuals with disorganized attachment, and this is because every relationship contains more than one reality.
• 9:48
  SPEAKER_00: The current partner is present, but so are the original attachment fears.
• 9:53
  SPEAKER_00: The fear of abandonment, betrayal, and the longing for rescue, the expectation of danger.
• 10:01
  SPEAKER_00: Every relationship becomes psychologically crowded by the past.
• 10:07
  SPEAKER_00: And the present relationship begins carrying emotional burdens it was never responsible for creating.
• 10:14
  SPEAKER_00: And this brings us something to something deeper, which is about dissociation and survival.
• 10:22
  SPEAKER_00: One of the most common survival mechanisms associated with disorganized attachment is dissociation.
• 10:31
  SPEAKER_00: And it's often misunderstood.
• 10:32
  SPEAKER_00: It's not weakness, it's not attention seeking, it's not madness.
• 10:37
  SPEAKER_00: It's a kind of protective function.
• 10:40
  SPEAKER_00: When overwhelming experiences can't be psychologically integrated, the mind creates distance from them.
• 10:48
  SPEAKER_00: They may experience emotional numbness, feeling detached from themselves, feeling detached from reality, experiencing memory gaps, and fragmented emotional states, periods of disconnection.
• 11:04
  SPEAKER_00: And these are attempts by the nervous system to survive what feels psychologically unbearable.
• 11:12
  SPEAKER_00: The pathway towards identity fragmentation is something we need to be precise about.
• 11:19
  SPEAKER_00: Most people with disorganized attachments do not necessarily develop the difficulty or the illness we call dissociative identity disorder, which is an incredibly hard disorder to treat.
• 11:34
  SPEAKER_00: However, severe disorganized attachment is often present in the developmental histories of the individuals who later develop complex dissociative disorders.
• 11:46
  SPEAKER_00: Why?
• 11:47
  SPEAKER_00: Because the underlying psychological process is similar.
• 11:51
  SPEAKER_00: The child repeatedly experiences incompatible realities.
• 11:56
  SPEAKER_00: The mind struggles to hold them together, different emotional experiences become compartmentalized, and different self-states become separated.
• 12:08
  SPEAKER_00: Different realities become isolated from one another.
• 12:12
  SPEAKER_00: And at its most extreme, this fragmentation may become increasingly elaborate over time.
• 12:19
  SPEAKER_00: Not because the person is inventing different identities, but because the mind has developed different survival systems for different psychological realities.
• 12:30
  SPEAKER_00: And the origins are always protective.
• 12:33
  SPEAKER_00: The mind is attempting to survive experiences that exceed the child's ability to process them coherently.
• 12:43
  SPEAKER_00: So therefore, healthy relationships can feel unsafe.
• 12:47
  SPEAKER_00: And one of the saddest aspects of this attachment type is that healthy relationships often feel some unfamiliar, and predictability feels strange, consistency feels suspicious, reliability feels uncomfortable, and the nervous system has become organized around instability.
• 13:08
  SPEAKER_00: As a result, chaotic relationships may feel emotionally familiar, while the healthy ones may initially feel emotionally flat.
• 13:18
  SPEAKER_00: Not because they're less loving, it's because they do not activate the old attachment system in the same way.
• 13:26
  SPEAKER_00: Now we talk about healing.
• 13:30
  SPEAKER_00: When we get into any kind of attachment disorder, regardless of its type, we need our certainly as clinicians to understand how that's put together and where we need to do our work.
• 13:45
  SPEAKER_00: With the disorganized attachment style, this is very complex work.
• 13:51
  SPEAKER_00: A therapist is experienced both as someone who is caring, understands, does not provide judgment, who is endeavoring to form a healthy, trusting relationship, but at the same time, the therapist is a potential persecutor.
• 14:11
  SPEAKER_00: The therapist may cause pain.
• 14:13
  SPEAKER_00: The therapist may discharge the patient or punish the patient in some way because they're not responding quickly enough.
• 14:22
  SPEAKER_00: Now I say this from my own experience of working with such patients, but over time some of them gradually learn to hold the opposites, that somehow they manage to see that closeness and autonomy can coexist and that vulnerability and safety can exist within the same psychological reality.
• 14:47
  SPEAKER_00: And the goal isn't perfection, the goal is coherence, to become increasingly able to experience one's self as the whole person rather than a collection of disconnected survival states.
• 15:03
  SPEAKER_00: If you think of a jigsaw puzzle and the fragmentation before you put the pieces together, this gives you maybe an idea of what dissociative uh states are and what disorganized attachment looks like.
• 15:20
  SPEAKER_00: And the job of the job of the therapist, let's go back a bit.
• 15:26
  SPEAKER_00: If we put all the pieces of a jigsaw out, but we don't turn all the pieces over, those are the pieces that we don't understand and we don't we can't see until we turn them over.
• 15:36
  SPEAKER_00: The work of therapy is to gently and carefully turn the pieces over, because normally those will be experienced as intolerable.
• 15:48
  SPEAKER_00: And over time we put the pieces together and we make a picture.
• 15:52
  SPEAKER_00: And our task is to help the patient to be able to see the picture coherently and to tolerate it, knowing that sometimes under pressure the picture will not necessarily collapse but disconnect for a period.
• 16:06
  SPEAKER_00: It's incredibly forensic work.
• 16:11
  SPEAKER_00: And I think when one works with patients who have this degree of difficulty, we're looking at years, not months of work.
• 16:23
  SPEAKER_00: So I I'm I think I've I've probably given a clear enough view of how how difficult this is.
• 16:33
  SPEAKER_00: But I just want to remind everyone that at the center of disorganized attachment, there is usually a child who faced something no child should ever have to face.
• 16:44
  SPEAKER_00: And that is an attachment system that's trapped in contradiction.
• 16:49
  SPEAKER_00: A child trying to survive in a world where the source of safety and the source of danger become psychologically intertwined.
• 16:58
  SPEAKER_00: Many adults continue carrying that conflict long after childhood has ended.
• 17:04
  SPEAKER_00: The fragmentation, the confusion, the chaotic relationships, the fear of intimacy, fear of abandon, all of them originally served one purpose, and that was survival.
• 17:17
  SPEAKER_00: And perhaps the true healing or the integration begins when the adult finally is helped to realize that what once kept them alive doesn't have to determine how they live forever, because beneath the fear and confusion and fragmentation, there remains a human being searching for exactly what attachment was designed to provide from the very beginning.
• 17:44
  SPEAKER_00: Safety, a connection, in a relationship in which love no longer has to compete with fear.
• 17:52
  SPEAKER_00: I really do hope that this has been informing for you.
• 17:58
  SPEAKER_00: When I return in the next episode, I'll be looking at compulsive self reliance, compulsive caregiving, and compulsive care seeking.
• 18:11
  SPEAKER_00: Thank you for listening.