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Courtney Armstrong. Attachment Styles & Complex Trauma: from the archives · The Trauma Therapist

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Or today we even another episode from the archives with one of my incredible guests,
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enjoy or Welcome back to the Trauma Theraverist podcast. My name is Gaming
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Person. My mission is to help trauma therapist be their incredible selves, to
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be human, to be real, not just a clinician. I'm a big
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believer in who we are is more important than what we know, and this
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requires cultivating authenticity, genuineness, and vulnerability, and that requires intention. You
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can learn more about my courses and workshops by going to the Trauma Therapist project
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dot com. That's the Trauma Therapist Project dot com. Let's get started,
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light guys, Welcome back to the traumast podcast. I'm very excited to have
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back Courtney Armstrong. Courtney welcome, Thank you guy. I'm so glad to
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be here. So Courtney, as some of you will know, is a
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licensed professional counselor and nationally board certified Fellow in Clinical Hypnotherapy who specializes in grief
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and trauma recovery, with a career spending within two decades. She's the founder
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of the Institute for Trauma Informed Hypotherapy and developed her Trauma Informed Hypnotherapy approach after
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studying with numerous trauma experts and helping thousands of clients overcome trauma and grief.
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Courtney is the author, most recently, excuse me, of the book Rethinking
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Trauma Treatment, Attachment, Memory, Consolidation and Resilience, as well as the
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Therapeutic AHA and Transforming Traumatic Grief. In her twenty years of practice, she
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has helped thousands of clients recover from trauma and experienced deep personal transformation. All
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right, Courtney, very excited about Well, first of all, congratulations on
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the book and success in the book. You're like all over social media and
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I've been hearing a lot about it, so great back here. Thank you.
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It's just great. I love what you're doing as always, and I'm
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excited to help your listeners get some new ideas for things that they can do
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when helping their clients with attachment complex trauma and whatever else we decide we need
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to focus on today. So before before we do dive into that, give
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our listeners if you can just kind of like a brief nugget why this book?
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Why did you write this book and decide that this book needed to be
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written. Well, that's a great question because at the time, you know,
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I thought there's so many books out there on trauma. Do we really
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need another book on trauma? But I felt like there's been so many discoveries
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in the last just even ten years that have really changed how we treat traumas.
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As you were and I were in graduate school, and there wasn't really
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a book that I found that had pulled a lot of these things together in
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one So I wanted to create a book that kind of highlighted the most recent
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discoveries how that's changed how we're treating trauma we're much more effective at it,
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and have it in one place, so it could be kind of like an
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on the fly guide you could use no matter what model of traumatherapy you're trained
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in. I'm really interested in giving people tools that work across models, that
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looking at what models have in common. And this book also really focuses more
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on understanding your client's attachment style, because I think traumatherapy a lot of times
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we get the impression that's about reworking all those traumatic memories. But the more
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I have been in this field and the more research I dove into, I
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realized the Book of Trauma Treatment really goes back to the relationship and at the
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end, of treatment. I started surveying my clients and they would consistently tell
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me. When I asked them what was most helpful, they would say how
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you treated me. You know, they never really specifically named a technique or
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they didn't say, you know that memory reconsolidation or that. Although I do
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think all of those techniques we know about and use can help, it really
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still goes back to how they feel like their connection with you is. So
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they didn't say, you know, I'm so glad you you used Bessel Vinecock's
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intervention on page two hundred and twenty two. You just nailed that. They
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didn't say, that's hum. They didn't. I was so surprised. Yeah,
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I mean, you know, and of course, as you mentioned in
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the intro, you know, I'm trying in hypnosis is kind of my first
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love. So I do a lot of hypno therapy tools to help them with
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emotional regulation and even with memory reconsulidation, and they love it. But they
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they often didn't even mention that. They would keep going back to well,
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you were patient with me. You didn't push me to, you know,
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change too quickly. You validated that it was normal for me to feel some
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of the things that I was feeling, you know, right, right,
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yeah, I mean I'm just as you're saying that, it just feels so
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it just feels right. I mean, we need that. And when you
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think of people who've been impacted by trauma, that connection, that rapport,
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that relationship has in most instances have been ripped from them. Um. Okay,
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so let's let's dive in here. This this whole the concept, the
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idea of the topic, the subject of attachment styles. Is this a good
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place to start? I mean, yeah, okay, I'm gonna let you
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roll with it because there are a lot of questions I can ask you,
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but let's let's go. Okay, Well, here's what I started to realize.
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Number One. I started to realize that even when i'm I mean,
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I'm trained in a lot of models like you are, and so even um,
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you know, I like EMBR like some this thematic models like you're trained
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in, and I found, you know, it really just depended on the
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client. Like I found, I was using different tools for different clients.
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And then I started to think about what what made me choose this approach rather
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than that one for different clients, And I started to realize a lot of
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it boiled down to their attachment style. And even though I didn't always formally
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assess their attachment style, if we look at those four basic attachment styles,
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and I know it's really basic and that over time will probably expand how we
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think about attachment styles. But just for your audience, if we go back
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to those styles that Mary Ainsworth and Mary Maine Dude to Solomon identified secure attachment,
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avoided, dismissive attachment, anxious, preoccupied attachment, or ambivalent attachment,
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and then to disorganize or unresolved attachment styles. When we're dealing with trauma,
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especially developmental trauma and complex drama, they're almost always going to have those in
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secure attachment styles. And so the avoidance, you know, they're hard.
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The thing is they don't teach us this in graduate school, but they're hard
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to connect with. So your avoidance aren't going to like the touchy feely stuff.
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It takes a lot to even bring them into therapy because they've learned to
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cut off their feelings. They're compulsively self reliant. And we can get into
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a little bit more about each style at a moment, but so they're going
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to be the type that they needed. They like a lot of education first,
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a lot of me explaining why their nervous system was doing what it was
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doing to help them feel They really like to feel back in control of things,
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but you can even feel like you're jockeying for control in the session.
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But when I started to realize, oh, I'm just dealing with avoidant attachment
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instead of trying to label as resistance or narcissism, it began to make so
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much sense. It was so much easier to work with. Contrast that with
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anxious attachment. I found they just want to pour everything out. They just
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want somebody to listen to them. So they're going to be in some ways
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very different, even though they still they're going to trust real quickly or idealize
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you in the beginning and then suddenly get pulled back because they're like, oh
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gosh, I've revealed too much, because their experience in life has been you
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know, sometimes I get what I need emotionally from people, but at some
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point they're going to reject me or abandon me. So they're going to try
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to go them on really quickly, and then that rejection and abandonment fears stuff
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is going to pop up, and then they're going to start, you know,
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getting defensive with you. Are they're really sensitive to criticism or you find
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you know that they just want to use therapy to complain while you comfort them.
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You know. But again, some of these clients can look quite unquote
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waterline or histrionic. And then when I realized, you know what, it's
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just anxious attachment. I don't need to label it with anything else. I
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just need to realize that's where this is coming from. And when I started
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talking to them that way and said, you know, I can understand why
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why you would feel this way in relationships, and I would explain to them
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about attachment theory and how trauma could have impacted that for them, and they
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were like, oh my gosh, that makes so much sense and they felt
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less crazy, and I actually opened the door for us to begin to deal
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with some of those deeper issues for them without them getting so defensive. Yeah,
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I mean, thank you for going through that. And it's really helpful.
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I mean, you know, you said this is really basic, but
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I think it's so helpful to have it listed and clarify the way you did.
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You know, as you were talking, Courtney, I was thinking to
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myself that, you know, when I was seeing clients. Oftentimes it was
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for me to feel, you know, maybe this client was being resistant or
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whatnot, and for me to take that on myself in any number of ways,
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you know, either a knock on my self esteem or make me feel
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like I don't know what the heck I'm doing. But to hear you talk
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about this and to be aware of it, well, it's another thing.
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So how does a clinician therapist even begin to notice these things? Right?
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It's one thing to have them listed so neatly like you did, but it's
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another two. Okay, this is what's going on? Yeah, starting to
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pick up on it. You know, I made I'm going to tell your
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listeners, I made some little cheat sheets for myself that I would use in
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sessions that I'm giving them to you guys to because they really started to help
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me, like just hitting some of the highlights of traits that were generally presenting
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with different attachment styles. Then they do have formal attachment assessments and so you
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know, you guys can google adult Attachment inventory for examples. Kind of the
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classic. But it's twenty questions and even though they're really good questions, that
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takes about ninety minutes to administer that entire thing, and it's intense, Like
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I would not ask all of those questions in one session because it can really
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start to bring up some deep trauma for people. But you know, you
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can get ideas from that the AAI as well as there's another questionnaire like called
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the ecr R. The Emotional Closeness in Relationship Experiences, I think is what
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they call that. And I can even share link with the guy where where
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you and your clients can take that online. It'll score it and everything for
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you. So there's formal assessments like that, but just to give you guys
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some highlights, you know, I started to just you're not always going to
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have time to do those assessments. But what we've learned from the attachment research
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is just the way people answer questions about their family of origin help and gives
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you clues, or the way they talk about relationships. So the avoidant clients,
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what they learned early on is if I reach out for help. If
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you know, when they were babies, their experience was if I ask for
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help, I'm going to be ignored, rejected, or criticized. That was
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their perception. And keep in mind, I think a lot of parents don't
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mean to do that. They didn't mean to traumatize them. But what these
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children learn is, I'm just going to shut that down, do everything myself,
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not expect help from others if they got If they get help or ask
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for help, they feel ashamed immediately. So this is why when you start
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to work with them in treatment. First of all, they rarely come to
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therapy unless somebody's insisting they come, or they it's really bad they can't find
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fun and they're say depressed or anxious, or they've got an addiction or something.
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And you'll know because they'll just want to get down to business. They
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won't want to talk about their family of origin. They won't think that's relevant.
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When you ask them about it, they'll say it was fine. You
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know. They act like there's nothing to see here, and they're not trying
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to hide it. They really don't think there's anything to talk about. And
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it takes them a lot and realize, but you'll know because they'll kind of
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be dismissive of that. They'll be dismissive of you sometimes, like whenever you
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offer a suggestion, they'll either tell you like, yeah, I've tried that,
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that doesn't work, or they'll want to up you, like because they
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feel shame asking you for help or thinking I can't figure it out myself,
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like they always have to feel like I'm in control somehow and I'm not stupid.
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And so when you know that, or when you're picking up on that
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in a session, I think if you can begin to say, you know,
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something's happened in this person's life, it's made it hard for them to
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ask for or receive help. And this isn't personal, but I've got to
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learn how to dance with it right. And and if you confront it too
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early before you have some rapport, they'll cut and run, or if you
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push them to explore their feelings too quickly. And I know you. I
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don't want to go too far because I know that you've interviewed, like m
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Robert Muller on avoid and attachment. You've had a lot of people talk about
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attachment on your podcast. But I think what I want to bring to your
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listeners awareness is some quick ways you can kind of you can kind of suspect
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what could go went on and maybe you explore it further. Yeah this is
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really super helpful. Yeah, yeah, Okay, so anxious attachment, and
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you want to go there for a moment because I don't want to go too
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long on each one, but I want to give y'all some nuggets to take
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away. So anxious or ambivalent attachment, we call it preoccupied as adult because
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they're always preoccupied with the other person in relationships. Now I am a recovering
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anxious attachment style myself, So I'm going to tell you some things about us.
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We love therapy. So the book of your caseload if you especially if
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you're in private practice. These people tend to go to therapy. They love
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it because it's like it's a dream come true, someone validating you inconsistently.
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Because our experience was and my parents were not physically abusive to me, so
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I didn't have big tea trauma in that way. But because of a divorce
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and then their contentiousness after that divorce, and we got a lot of mixed
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messages, and being young, immature parents, they manipulated us and all this
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stuff. What I got is sometimes I was validated and supported by each hear
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and sometimes I was shamed or criticized for having needs or feelings, you know,
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And so what the message that they get is they start trying to assess
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the parents' mood or in any of their relationships, they're always focusing on what
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is that other person's mood that what do I need to tell that person to
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get them to accept me or approve of me, or love me, or
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to pay attention to me. And so when you come to therapy one,
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they're usually very engaging. If you ask them about their family of origin,
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they usually have tons of insight actually into it, like they can tell you
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very clearly what was wrong in their family and it's probably still going on,
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whatever the drama was. But they're usually going to be in therapy for current
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relationship or self esteem issues, and they're going to idealize you in the beginning
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because you're going to be validating them and you're going to understand them, and
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that's going to feel so good and you will feel like, you know,
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like there's a rapport building pretty quickly with them. However, they're very sense
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of the criticism. So when you start to begin to confront them about maybe
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something they could do differently in a relationship or you know, try to help
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them start to implement a new skill, they can suddenly feel like you're criticizing
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and rejecting them, and they'll either get angry with you or defensive or no
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show or or you know, try to get your love even more, try
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to get your approval even more. Like like I've had clients suddenly start bringing
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me, you know, coffee from Starbucks to the session because they think,
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oh, I gotta get back at our good graces. And so it's if
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you or it can look really manipulative, like borderline histrionic stuff like they start
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really acting out or getting really angry with you, or calling you on the
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weekends or you know, saying they're going to kill themselves, or they start
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to get better than suddenly they regress because they think you're going to discharge them.
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So if you realize this is coming from some old experiences where they and
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usually with these clients will start to explore where where does this feel familiar to
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you? Where you felt like things are going really good and then something felt
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like wait, something just shifted in this relationship. I don't feel so secure
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anymore. Yeah. Yeah, So let me ask you something, So,
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Courney, are you using this knowledge saying this last example you're talking about,
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are you using this knowledge as a as a doorway to begin to what talk
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about the trauma. Yes, yes, I use it as a doorway to
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begin to explore the root of whatever issue they're dealing with, which is usually
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some end resolved trauma. And I say that because most of the time these
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clients will not come to a saying I want to work on trauma. They
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come saying I have recurring anxiety or depression or substance issue or relationship issues,
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and we can give them some skill. I mean, I always want to
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stabilize the current problem, so I'm not going to jump into the trauma right
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away. First, I want to kind of build a report and stabilize the
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current issue. But then for long term relief or improvement, I have found
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exploring where did you learn this, Where did you learn this belief or this
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pattern, and how did it work for you in the past ultimately is what
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is going to give them long term resolution. And my clients experienced that too,
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as yours and many of our clients. They begin to realize, wow,
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I cannot believe how much this experience has affected my life, you know.
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But when they start to heal it, things, their self esteem starts
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to get better, they start to feel more confident about their ability to manage
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anxiety or depression or have healthier relationships, right, and even to name to
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name it, uh, to realize that because as you're talking, I'm really
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I think the reasons I'm smiling is because I mean, I'm like, oh
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my god, that's that's what that's me and I'm my god, I don't
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want to but that's that's. This is intense stuff because you're talking about how
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we were brought up and raised and like you said, oftentimes our parents are
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unaware of this and how screwed us up, right, right, But this
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is this is really just intense. And I love how you're talking about the
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importance of being able to identify. And I understand nothing is always in these
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neat little boxes, but what you're providing here or I think it's a really
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really good, good guideline here, So let's let's continue. Yeah, so
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yeah, thank you so much. The one that the next one I want
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to talk about is disorganized and resolved attachment because with severe trauma like severe abuse,
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severe physical abuse, or severe neglect, where you know, of course
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an attachment theory, this style evolves when you feel frightened of your caregiver and
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what the very person you're supposed to attached to for survival feels like the very
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person who threatens your survival the most. And maybe they didn't physically abuse the
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person, maybe the caregivers didn't, but it could just be an alcoholic parent
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that raged, or they abuse the spouse. And even if you were not
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abused physically as a child, just being in a household with that kind of
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scary violence can can create this or just just intense neglect where you just feel
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like there's nobody here really ensuring my safety. So what happens with these clients
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is and I would say, you know, the literature says that even though
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it's only five to ten percent of the population, the literature says it could
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be you know, as much as eighty percent of clients who've had childhood abuse
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and neglect like intense and what happens in the therapeutic relationship, And there's not
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as clear as a stereotype I could describe, But the hallmark I would say
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with these clients is they're suspicious and they will come to therapy because they often
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feel they often struggle with anxiety and depression, and they they often feel confused
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about their identity. They can shift, they can look d I D.
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But they're not always going to be dissociative identity disorder. But they can shift
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real quickly, like and say, there's a part of me that just gets
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so angry and rages and does things that I never thought I would do,
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like my parents, And then there's a part of me that's so like timid
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that'll just freeze and lock up, like what's happening? Guy? I started
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to realize and this I've really got a lot of this insight from Janina Fisher,
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who I know has been on your podcast, that they're shifting between survival
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modes, you know. So, like Janina Fisher says, we can think
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of parts in terms of there's a fight part, there's an attached part,
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there's a fear or flight part that wants to escape, there's a freeze part,
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there's a submit part. You know. So parts work can actually be
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really effective with these clients. So you know, whether you like internal family
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systems or you use another approach to parts work, I found that these clients
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can they often do felt very fragmented and that what we know now and what
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I also talk about in the book is developmentally we can explain that now with
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what we've understood from neuroscience, that they're if there's a lot of trauma before
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the age of eight, the way your brain's developed at that time will prevent
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them from creating like an explicit, coherent narrative or memory. They are more
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primitive association because usually that's how they had to cope, is to going to
24:48
free submit. So so for these clients that have more of a disorganized attachment
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style, you can feel them wanting to connect with you, but also being
24:57
very fearful or suspicious, and trust takes much longer to build with them.
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And I have found that generally they're they're cooperative in therapy, like they don't
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you don't feel like with the avoidant. It's more like there's a lot of
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pride and they kind of jockey for control that this client, you can still
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feel resistance, but it's more guarded out of fear and I'm not sure I
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can trust you yet. And they can also seem more fragile emotionally, but
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I will tell you they're strong. They're so they're tough as nails in another
25:37
way because they have lived through so much. And these clients, even though
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they will acknowledge trauma in their history. When you ask about it, they
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usually either don't want to talk about it because it's it's every They will say
25:53
things like, I don't want to talk about it because it'll start I'll start
25:56
having nightmares and it'll start bringing all that stuff up again, or they'll say
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I don't have clear memories, they're fragmented. So usually when we start,
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we need to do a more preparation with them in terms of how to help
26:11
them stay present and not relive the trauma. I've found, you know,
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before we get them to start talking about it, and in terms of building
26:21
rapport with them, I find they also do really well with education about what
26:26
their nervous system is doing or how the brain stores traumatic memories so they feel
26:30
less crazy and fragmented, and helping them understand, you know, even though
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it feels like different, even though it feels like mood swings are different parts
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of yourself. That makes sense, based on different survival strategies that work for
26:45
you at different times in your life. And and of course some people in
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this category will have the ID, will have dissociative identity disorder, and you
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know, you may not know that right away either, unless they because sometimes
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they don't realize it or they're not sure they can tell you. And I
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think that the message for us as therapists is that they need us to just
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be patient with them. They need to move slower in therapy. And so
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even though we might say, oh, gosh, I really want to help
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this person resolve these traumas I know it could really help them, they often
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aren't so eager to explore it and need us to pace with them a little
27:34
more before they're ready to get into it. And the other thing I've learned
27:38
from these clients is that the therapeutic relationship is definitely the most healing aspect for
27:47
them. These clients have consistently told me I've never had like a relationship with
27:52
a person that I felt like I could trust, or or when when I've
28:00
had like a misunderstanding with these clients, are made a therapeutic mistake, but
28:03
I hung in there for us to work through it, and even if they
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fired me, you know, um, they've often said, I never knew
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before that you could actually work through a conflict with somebody, and that was
28:18
Yeah, that's that's so amazing. I mean I know that, you know,
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people talk about that, but just to hear you talk about that,
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it is so it's so intense and it's so heavy, it's but at the
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same time it's just it's beautiful. It is. I mean, you know
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that I've learned so much from these survivors that I've worked with, and um
28:40
and also they like with that disorganized too. They can often feel so um
28:45
ensure of themselves and incompetent, but they usually have some They're usually super creative
28:52
and have some strengths. The other thing I've learned with them is I get
28:55
them to tell me something they're an expert at, so that we kind of
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level the plan filled. Sometimes they will be real submissive because they that's how
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they had to cope with a bees Like they see you as an authority figure
29:07
and they may, you know, have trouble make an eye contact. And
29:11
so I also try to find somewhere where I want them to tell me,
29:15
tell me something you're an expert at that I or here's something like one of
29:19
my clients built sail boats and like I said, that is fascinating, and
29:26
I said, bringing some pictures. I want to hear all about that,
29:30
just and that really finally opened her up where she had been so guarded and
29:36
quiet, and I've just she wanted to be there, but it was just
29:41
so hard for her to talk. And when I invited her to tell me
29:42
something she was an expert at, that really started to bring her out of
29:47
her shell. And yeah, let me just still remind everyone that I'm speaking
29:52
with Courtney Armstrong. Her most recent book is titled Rethinking Trauma, Treatment,
29:56
Attachment, Memory, Consolidation, and Resilience. Courtneyman, we can go on
30:04
and on and on. This is crazy. So the obviously the book,
30:10
what we're talking about here is the tip of the iceberg and the book.
30:15
But so who is this Who's this book for? Who's a target? Well?
30:19
I really see it as as appropriate from the beginning therapist to seasoned therapists.
30:26
The beginning therapist, I think it helps them feel like, here's a
30:32
lot of the basic tools that you need to be able to work with trauma
30:37
that you can refer to when you need a resource. In the memory reconsolidation
30:41
section, I give you ideas for working with different types of trauma, like
30:45
things that I've seen work with sexual trauma, childhood abuse. Is divided into
30:51
chapter on which trauma kind of trauma is combat trauma, attachment trauma. Because
30:57
one of the things I would hear when I would do workshops from young therapists
31:03
is well, I can't I don't know how to treat trauma yet, or
31:07
I have to go get training in this before I can do it. And
31:10
I thought, I didn't want people to feel that way, and I want
31:12
here's some things to get you started where you feel like you have some kind
31:15
of, you know, working knowledge of what to do. But in terms
31:22
of even more seasoned therapists, it really goes back to how to create a
31:27
corrective emotional experience in a session. And my intention is to not only give
31:33
you some new ideas, but also to validate for us that a lot of
31:40
what we do intuitively is probably right on the mark, like we get the
31:45
idea to do something or not to do something. And I wanted to validate
31:51
for a therapist that the neuroscience is actually supporting what we've intuitively known as therapists,
31:57
that the brain heals that the parts of the brain. What it is
32:04
now showing is that attachment provides the buffer, so that even if you've been
32:09
through trauma as a kid, if you had secure attachment with at least one
32:14
or two people. It will actually buffer some of the impact of the trauma
32:19
so that your brain can develop normally. And when I talk about that,
32:21
I mean development in terms of secure attachment helps you develop the networks you need
32:28
to know how to regulate your emotions, self soothed, feel like safe in
32:34
the world, like you matter and belong, that kind of stuff. And
32:37
we can now see on brain scans where kids who don't have that have trouble
32:45
with learning, memory, relationships, understanding people's intentions. So what happens is
32:52
because of neuroplasticity, we've learned that you can develop those areas. So it's
32:59
not like a lifelong sentence. If you've been through that as a young person,
33:02
you can recover that development in your brain and build those networks. But
33:07
it starts with having a secure attachment with somebody. And so I want you
33:14
to know, even as a therapist, when you don't feel like you're doing
33:15
you think, gosh, I don't know if I'm helping this person. I'm
33:20
just sitting here listening to them and trying to validate them as actually you are.
33:23
You're starting to model what it's secure attachment feels like and help and that
33:30
is, I'm not going to say you're going to reward their brain and what
33:32
but over time, that is beginning to help their brain develop those networks that
33:38
they didn't get their beginning to get the sense of what it. But in
33:44
the beginning it won't feel comfortable to them sometimes because they'll think they'll be suspicious,
33:49
like, why are you being so nice to me? What's on the
33:52
other end of this thing? You know? I think you know you're you're
33:57
talking about this, the important of creating rapport and providing correct most corrective experience.
34:04
I think that's a great topic for another podcast. Yeah, you know,
34:07
it's something seemingly so simple, right, like we we throw around that
34:13
that you know, we'll just build rapport. We're building rapport. But anyway,
34:16
we can talk about that later. Courtney. I want to thank you
34:20
so much for coming on here again. The book is rethinking trauma treatment,
34:23
attachment, memory, reconsolidation, and resilience. Where can people find you and
34:30
the book? Well, my new website is real world therapy dot com because
34:35
what I'm what I'm wanting to build over there is um resources for therapists like
34:40
how this looks in the real world, you know, and what to day
34:44
when it doesn't go as planned. So that's that's what we've got coming up
34:46
over there. But if you get to the real World Trauma Therapy UM,
34:51
you can download some cheat sheets about what we talked about today. If you
34:54
get to my resources and then click on Rethinking Trauma cheat sheets, I've got
35:00
cheat sheets for attachment style and how to work with memories, and and also
35:07
UM coupon code a twenty percent discount on the book. That packet you get
35:15
there at the back of it is a cupon from my publisher, Norton,
35:20
and you get twenty percent off free shipping on the book. So okay,
35:22
I'll have that linked up with the show notes page. And I also see
35:25
here that you offer consultation and coaching. Yeah, very very cool, Courtney.
35:31
Always a pleasure. I want to thank you so much for for inspiring
35:36
this podcast. Thank you so much. Thanks You've been such an inspiration to
35:39
me and all your listeners. So happy to happy to be here. All
35:45
right, Take care, take care,