Early Attachment Styles
Many researchers and clinicians refer to the four attachment styles of secure, ambivalent anxious, disorganized, and avoidant. These styles were identified through extensive observations of interactions between mothers and children and have been theorized as possible building blocks to a person’s development and well-being. The research base is substantive enough that Van Izendoorn and Bakermans-Kranenburg (1997), almost two decades ago, concluded, “Intergenerational transmission of attachment should be considered an established fact” (p. 163). Nevertheless, environmental support could influence the development of secure attachment, while a lack of it could facilitate insecure attachment when disruption of the family system or loss occurs (Raby et al., 2015). According to Lehner and Yehuda (2018), “Trauma can profoundly affect parenting, especially trauma that included the loss of family members. Offspring have described overprotection by parents, but also numbness, distance, and neglect” (p. 25). Therefore, the dynamics in families with parents who are trauma survivors need to be looked at from a relational perspective.
The connection between insecure attachment and TGT was demonstrated by Bar-On et al. (1998), who took three studies on TGT and looked at them from an attachment perspective. These TGT studies (quantitative and qualitative) on Holocaust survivors (from the Netherlands, Canada, and Israel) were re-examined through the lens of attachment. The issues of “attachment, separation, and loss” are seen as concepts influencing insecure-ambivalent attachment and the “observed preoccupation” with issues about separation and parents’ well-being (p. 316). Another concept that is reinterpreted is the notion of the conspiracy silence seen from the lens of disorganized attachment and continuous cumulative contextual support. Loss and trauma studies have been correlated with “disorganized infant-mother attachment relationship,” which are both experiences common to Holocaust survivors (p. 319). The authors explained that TGT and disorganized attachment correlate because parents are a source of distress and also a source of security. Parent overprotection and exaggerated response “unintentionally transmitted disorganizing messages of imminent danger” (p. 333). Authors tried to use studies that had a different methodology and different countries of origin in order to triangulate the common findings (Bar-On et al., 1998). One important part of the discussion is the fact that unresolved trauma and loss of an attachment figure caused parents to be emotionally dysregulated.
Similarly, Baider (2000) noticed that 2G trust in social support and resilience could be short-lived and disrupted later in life. Avoidant attachment and intrusive thoughts could be triggered by a life threat (Baider, 2000). In a study with cancer patients (Baider, 2000) who were 2G of survivors of the Holocaust, the presence of their mothers and spouses was correlated with increased distress. Participants were recruited from three hospitals in Israel, eight months to eight years after they first were diagnosed with breast cancer. Survivors of the Holocaust were defined as Jews that had been in a “concentration camp, forced labor camp, or extermination camp in Europe during World War II” (p. 905). The offspring of one or two survivors were recruited, while those whose parents were not in the Holocaust were in the control group. Researchers conducted a semi-structured interview with 106 2G participants and 102 participants in a comparison group (Baider, 2000). All participants completed three self-report questionnaires. The Brief Symptom Inventory was used to measure psychological distress, the Impact of Event Scale was used for suggesting psychological problems, and the Mental Adjustment scale was used to measure how patients were coping with cancer. The first two scales showed statistical significant difference where the Brief Symptom Inventory showed grand severity index (M = 66, SD = 7.4) higher than with comparison group (M = 54, SD = 7.8) with t = 11.76, p < 0.0001, and the Impact Event Scale in 2G had intrusion and avoidance (M = 16.9, SD = 8.9; M = 20.6, SD = 10), higher than control group (M = 8.1, SD = 6.8; M = 8.4, SD = 6.6) with t = 8.02, p = <0.0001; t = 10.41, p = < 0.0001. Authors speculated the reasons why these results were found, including that preoccupation with being a burden and causing more distress to mothers who were survivors, caused higher avoidance of support.
The issue of enmeshment and lack of individuation seen in 2G of Holocaust survivors have been described as a possible cultural dynamic. In order to clarify this dynamic as a possible transgenerational event, Kretchmar and Jacobvitz (2002) searched to understand how boundary patterns and attachment might be being transmitted across generations. By recruiting mostly white women, from middle-class families (N = 55), researchers documented attachment observation with infants at 6, 9, 18 months. All participants were recruited through birth announcements or had a history of participating in previous research with one of the authors. Participants were 87% white, 94 % married, and ranged from 21 to 41 years old (M = 29), 48 % had some college and 68% had a full or part-time job. There were 24 female and 35 male infants. Kretchmar and Jacobvitz (2002) used current relationships and assessment of memories of past relationships to gauge current relationships with grandmother and infants. This study correlated mothers internalized memories of relationship strategies with their mom and if that influenced how their interaction and attachment to their own infant. This study was able to find some important correlations between the mother-child relationship when it came to boundaries and attachment transmission (Kretchmar & Jacobvitz, 2002). Nevertheless, it is important to remember that self-report can often be biased and based on mood. Most importantly, “the predicted relationships between memories of overprotection, both patterns of boundaries disturbances (disengagement and entanglement), and less optimal caregiving did not emerge” (p. 364). Authors discussed that a disengaged parent trying to look engaged could look intrusive, while being disengaged might actually show a certain healthier approach to cope with a difficult parent. On the opposite spectrum neediness through entanglement and resistant attachment seemed similar, where there was hypervigilance on separation and resistance in reunification. The authors concluded that “helping parents to resolve both past and present issues with their own parents will assist them in establishing more optimal relationship dynamics with their own children” (p. 369).
According to Wallin (2007), our lives “revolve around intimate attachments” (p.1). The development of working models of a secure base so that an individual can go explore the world and feel safe is the base of attachment theory and how it applies to healing in psychotherapy. According to Wallin, children with a history of secure attachment show “greater self-esteem, emotional health and ego resilience, positive affect, initiative, social competence, and concentration” (p.23). Also, Wallin (2007) wrote about the flexibility of the parent allowing flexibility to the offspring which allowed improvisation to attune to the needs of the child. Important elements of a secure attachment include safety and co-regulation of emotions. Once a parent can help soothe a child, this child gains confidence in their ability to thrive without being overwhelmed by their own experiences of life. This learning of self soothing and regulation of one’s own feelings have been described through mirroring of parent and child as well as witnessing play (Wallin, 2007). Wallin describes attachment theory as a building block to understanding the multiple dimensions of the self, including the emotional self, the somatic self, and the representational self, the reflective self, and the mindful self, all selves experience and shapes one’s life.
In a longitudinal study, it became clear that attachment style is passed down as an ancestral legacy (Hautamäki et al., 2010). Thirty-two families of a mother, father, and maternal grandmother were followed during the last trimester of pregnancy. The theoretical framework supported the continuation of attachment styles when there was environmental stability (Hautamäki et al., 2010). While discontinuity of attachment has been related to environmental change, when mothers and grandmothers with secure attachment had 100% likability their infants also had a secure attachment. Eighty-six percent of avoidant attachment continued from the dynamic of mother and grandmother. There was a continuation for secure attachment and insecure-avoidant across generations but a reversal reaction to the ambivalent attachment to disorganized attachment and vice-versa. Difficulties with external validity included homogenous culture and economical status in the sample with no diverse demographic data (Hautamäki et al., 2010).
Bradley et al. (2013) examined the family environment effect on the oxytocin receptor gene. PTSD histories, childhood family environments (CFE), resilience, positive affect measurement, and DNA saliva extracts were used as measurements in a sample of 971 African Americans (69.7% female, Mage= 34.84, SD = 8.83). There was an expected positive correlation found between resilience and positive CFE, as well as between positive affect and positive CFE, and a negative correlation between resilience and positive affect with “childhood maltreatment and other traumatic experiences” (p. 5). There was no evidence of a shift in genotype correlated with resilience, and only one out of three genes were less likely to correlate with resilience. It seems that genes did matter without considering the family environment and that genes seemed to be altered by parents’ experiences with trauma and possibly passed down to their offspring (Bradley et al., 2013). Therefore, the family environment could trigger TGT in the next generation.
Felsen (2018), an expert in the field, explained that intergenerational and intragenerational family interactions are essential parts of identity formation in 2G and 3G individuals. He explained that family ruptures due to sibling relational dysfunction might be created by parents’ trauma. The transmission of historical trauma affects how siblings fulfill their obligation to “parental needs and relational expectancies” (p. 440). When one sibling felt that the other sibling caused pain to the parent, intense negative feelings were created between them. These dynamics seemed to resurface as the parents aged and became more dependent (Felsen, 2018). These conflicts and ruptures between siblings created even further family disruption in the third generation. The “mission to take care of the parents” was manifested in both siblings but from different points of view, acting as the “good child” or the “problem child” (p. 439). Felsen (2018) proposed that this rupture is a re-enactment from the traumatic loss that happened during the Holocaust, where there was no more extended family. Felsen also proposed that this late onset of TGT occurred when there was a lack of social support, which seemed to be provoked by the family ruptures, including sibling dynamics. In general, part of the difficulty of studying TGT and its treatment is that it has many components relating to the family of origin, social environment, and biology that can affect the psychological health of 2G and 3G (Felsen, 2018).
In a study on intergenerational transmission of trauma with mothers from Japan, Okawara and Paulsen (2018) proposed that memories of one’s attachment trauma would surface if guided to attend to the somatic sensation felt when irritated with one’s child. Okawara and Paulsen (2018) suggested that attachment-related trauma is held as implicit memory and, therefore, sometimes only triggered in adult life. According to the authors, when the negative effect from children triggers visceral unpleasant somatic sensations in mothers, caregivers might become irritated and feel oppressed by their child’s emotions. In these situations, the mother might ignore the feeling or respond to their child’s every demand in order to stop the unpleasant sensations (Okawara & Paulsen, 2018). The child, in turn, might respond by detaching, protesting, or entering into despair, behaviors that correlate with insecure attachment patterns of avoidant, resistant-ambivalent, and disorganized-disoriented. The authors further speculated that this early distress could “predict a greater amygdala volume in adulthood” (Okawara & Paulsen, 2018, p. 145). Thus, dysregulation of mothers and hyperarousal of their sympathetic nervous systems is thought to underlie the intergenerational transmission of maltreatment to the child.
In Okawara and Paulsen’s (2018) study, they used three sessions of eye movement desensitization and reprocessing (EMDR) to target intergenerational transmission. The first session was similar in both case studies: They asked the mother to hold a body sensation of a memory of being triggered by her child and to give them a number from zero to 10 to represent their level of distress. As part of preparing for the following sessions, they asked the mother to find a safe state, remember a good moment with their child, and self-tap on each side of her arm. Through two case studies, Okawara and Paulsen (2018) described how, in the next two sessions, each mother recovered memory from childhood in which their own negative emotion was not soothed by caregivers. By recalling these events, the trauma was desensitized and stopped being reenacted with their own children. These case studies were conducted in a culture where enmeshment is considered the norm and, according to the authors, the two mothers were happily married, well-adjusted, and loved their children. These factors limit transferability and, as case studies, they lack empirical rigor. Nevertheless, the use of thick description allows for a detailed worth further exploring.
Mikulincer and Shaver (2019) explained secure attachment as confidence and optimism in times of need where the person feels lovable and competent while believing that others are supportive and responsive. After reviewing many studies, they found that people who came from secure attachment had better emotional regulation and were able to express and communicate their feelings, problem solve, and re-construct and reappraise a situation without distortion. On the other hand, Mikulincer and Shaver (2019) explained that individuals with histories of avoidant attachment prevented noticing their own emotions by suppressing thoughts and memories or revealing emotions. Furthermore, individuals with histories of anxiety attachment perceived mostly negative emotions as congruent to attachment needs, creating and “amplifying a cycle of distress,” being hypervigilant, and at the same time holding a “counter-phobic orientation toward threatening situations or making self-defeating decisions” (p. 7). These theoretical underpinnings of attachment styles facilitate the understanding of the studies reviewed here.
A recent publication of unpublished papers from John Bowlby, the pioneer of attachment theory, illustrated his thought process on building an inner working model of one’s relationship with a caregiver (Duschinsky & White, 2020). Bowlby (1962) explained that guilt is present when there is a denial of hate and the promise of love. Because one fails to do what they promised to another, they betray their ideal self. This impossible ideal self and promise to caregiver might create the base for guilt and insecure attachment. Bowlby (1962a) explained that this process could create self-punishment tendencies: displaced anger towards self, anger towards the introjected object or parent, and third, the desire to be forgiven and atoned through punishing his or herself from a sense of guilt. These inner mechanisms are processes of disconnection from social support and support seeking. Bowlby (1962b) explained that this detachment and inner oppression comes as a defense from a traumatic loss of an attachment figure. Even though Bowlby wrote these papers in the 1960s, it is a radical shift of thinking that held its publication at bay until this year (Duschinsky & White, 2020).
Keeping attachment style legacy in mind when treating vulnerable populations with TGT might help interrupt traumatic transmission from one generation to another. The research on attachment style clarifies the transgenerational and epigenetics aspects of parent and caregiver influence on their offspring as an ancestral legacy issue. It showed that offspring of parents with trauma might develop insecure attachment characteristics later in life when confronted with a life-threatening situation (Felsen, 2018). Attachment styles can affect one’s well-being and capacity to self-regulate, connect with others and one’s environment. When a parent is being triggered by their child, this might indicate transgenerational trauma (Okawara and Paulsen, 2018). The insecure attachment might be seen in relationships with people and places, and it might be felt in the body and in family dynamics.