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The role of the attachment theory in understanding “the need of family” owned by every child and in providing the right answer to this need


Purpose. This presentation raises from the following question: "Why disturbed attachments damage so strongly human growth so that children, when becoming adults, look for the same type of disturbed attachment and source of suffer they experienced and got to know in their biological family?".

The answer to this question considers the current neurobiological research on memory systems - this study awarded Eric Kandel in 2000 with the Nobel Prize in Physiology/medicine. Particularly, the answer here provided can be found in psychotherapy-applied clinical studies to demonstrate its scientific effectiveness.

Two clinical cases - we called them with the fictitious names "Erica & Nora" - are presented in parallel to gather differences and similarities.

The clinical study on these two cases is a qualitative one; the research design is an explorative one, since it aims at highlighting on the attachment theory, in particular on the value visits and removals from a mother's pathogen attachment disturb have for a child. The two patients described in the case report were both young woman under the age of 26 whose mothers are still alive and regularly visited by both of them.

Both patients attended a therapeutic program involving both cognitive therapy and Emrd. Combining CBT and Emrd is based on the fact that the Cochrane Database systematic revisions revealed in 2007 the cognitive-behavioural individual therapy, focused on trauma, and EMRD as the sole efficient psychological treatments for the cure of post-traumatic stress disturb at 2 to 5 months of follow-up.

At the admission Erica and Nora showed a post-traumatic stress disorder as well as a dramatically dysfunctional attachment and the need to recreate, within the therapeutic relationship, the same attachment relation experienced with their mothers. In these 2 cases mothers were characterized by their inability to grant their daughters safety enough to make them grow self-confident, able to establish safe attachment relationships. The neglect of Nora's mother as well as the high level of intrusion of Erica's mother explained the 2 women's symptoms: psychotic behaviour, self-harming, both physical and oral.

Clinical reports on Emrd sessions are the tool to qualitatively analyse the level of attachment in Erica's multiproblematic family and in Nora's non-emotional one. Since attachment styles are - according to Vittorio Guidano - the indicators of the unconscious schemes of emotional relationships responsible for the way people handle their relationships during their lives, Erica and Nora sought in their good relationship with their therapists the occasion to mend their life history in favour of their mothers rather than of themselves.

Key findings. As clearly stated by Bessel Van Der Kolk in their innovative studies on traumatic experiences neurobiology, post-traumatic stress disturbs are frozen in the central nervous system stressful sensorial memories, which actually stimulate inadequate if not completely dysfunctional behaviours. These memories, which are related to traumatic experiences, stimulate the cerebral domains responsible for highly intensive emotive responses; however, they disconnect those cerebral domains responsible for the integration between sensorial input and motorial output (hence causing helplessness) as well as for the modulation of physiological arousal and for the ability to express one's own experiences through spoken language (i.e. non-physical language).

The therapeutical work presented in these 2 cases focused on the acquisition of awareness of themselves, their needs as a child and a young woman, the ability or inability of their mother. Slowly but spontaneously, Erica and Nora understood the importance of their mothers and the need to "protect them" in order to have them not "destroyed" by psychotherapy. The recovery of happy memories on their mothers thus ensured Erica and Nora's recovery from their post-traumatic stress disturb. The whole recovery from symptoms happened for both women only after making peace with their mothers, justifying their "bad behaviour" and finding a likely and subjective explanation to attachment disturbs.

Results suggest that empowerment interventions shaped on each family's need can correct dysfunctional and pathogen attachment outcomes, preventing emotive breakdown and serious dysfunctions in children's growth. The attachment theory, indeed, indicates that it is simpler to intervene on an attachment style which subjectively reveals as a source of pain for one and his/her beloved, rather than getting into the habit of living with a new, strange/unknown, objectively "healthier" than theirs.

Regarding this, in Italy Alfredo Carlo Moro - judge in the Juvenilecourt - struggled more than once to make child removals from their birth family the last intervention to adopt after the failure of a series of empowerment actions personally designed according to the attachment style of each family's need.


Key references

Bisson J., Andrew M. (2007). Psychological treatment of post-traumatic stress disorder (PTSD), Cochrane Database Systematic Reviews, 18(3):CD003388.

Guidano V.F. (2001). El modelo cognitivo postracionalista. Hacia una reconceptualizaciòn teòrica y crìtica, Editorial Desclée De Brouwer, S.A.

Kandel E.R. (1999). Biology and the future of psychoanalysis: a new intellectual framework for psychiatry revisited, American Journal of Psychiatry, 156:505-524.

Van der Kolk B.A. (1994).The body keeps the score: memory and the evolving psychobiology of posttraumatic stress, Harvard Review of Psychiatry, 1(5):253-265.

Contacts: Elisa Pajusco, Centro di Terapia Cognitivo Comportamentale, viale Q. Sella 61 - 36100 Vicenza, E-mail: e.pajusco@vi.nettuno.it, Phone 340 2842645.

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