Trauma, Dissociation, and Disorganized Attachment: Three Strands of a Single Braid

2 The aim of this paper is to familiarize the reader with research findings and theoretical perspectives that suggest that disorganized attachment plays a central role in trauma-related disorders. It is proposed that the propensity to react to traumatic events with dissociation is related to disorganization of early attachment and its developmental sequelae. This conceptual framework has deep implications for the psychotherapeutic treatment of dissociative disorders, a topic that will be briefly addressed in the final section of this paper. Early attachment is studied and assessed through a standardized laboratory procedure (the Strange Situation: Ainsworth, 1982) where infants about 18 months old are observed during two brief episodes of separation from a caregiver, followed by two episodes of reunion. Three patterns of organized attachment behavior have been identified in infants: secure (the infant cries at separation and is quickly comforted at reunion), insecure-avoidant (the infant does not cry at separation, and actively avoids the caregiver on reunion) and insecure-ambivalent (the infant cries at separation, but is not easily comforted on reunion). Some infants are not able to organize their attachment behavior according to any unitary or coherent pattern: they are classified disorganized in their attachments. Research studies on adult attachment are based on the Adult Attachment Interview (AAI: see Hesse, 1999). The AAI is a standardized interview, developed by Mary Main and her collaborators, that explores adult individuals' autobiographical memories of past attachment relationships. A complex scoring system of the interview transcript allows for a reliable classification of the individual's state of mind concerning attachment relationships. Classification is based on the assessment of (1) deficits in metacognitive monitoring expressed as incoherence of memory, thought and discourse, and (2) different ways of organizing coherent states of mind concerning attachment. 3 The three main classes of coherent states of mind emerging from the AAI are called " autonomous " (related to secure attachment in children), " dismissing " (linked to insecure-avoidant attachment in children) and " preoccupied " (related to early insecure-ambivalent attachment). " Autonomous " interviews show coherent narratives, high levels of metacognitive monitoring (ongoing awareness that one's report of past memories should be made understandable to the interviewer) and freedom of thought in reporting memories of early attachment (i.e., both positive and emotionally negative memories are reported in a non-defensive manner). " Dismissing " interviews are characterized by idealization of the attachment figures, dismissing attitudes toward the importance of attachment …