HJNO Sep/Oct 2024

SEXUAL VIOLENCE 22 SEP / OCT 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS   ❝ … our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well- being … 1 Human Bonds Humans are social by nature. We yearn to make connections and form long-lasting relationships. A handful of our relationships will be life-long, deep, and intimate. The bonds we make in our childhood with our parents play an integral role in the bonds we make as adults. 2 While less com- mon, relationships later in life can influence the bonds we make as well. 3 Depending on a cho- sen professional field, someone may devote their time to those who are working on insecure attachment styles and the issues that make those attachments insecure. Working on such personal issues promotes the healing opportunity for more trust and intimacy in relationships in the future for the client. This healing opportunity is valu- able for those who have experienced insecure attachment and trauma bonding. 2 However, the work is difficult and can take a toll on the mental healthcare provider. 4 Connection is not hard for everyone. For those who spent their formative years in the care of a person or persons who met their needs, a secure attachment style is formed. 2,5 Secure attachment comes easily to such people because positive behaviors demonstrating the responsible man- agement of emotions were displayed during the child’s developing years. People in successful relationships, or healthy relationships, can retain their autonomy and manage their responses to the things they cannot control with navigable levels of restraint and a narrative of understanding. Having such relationships modeled by adults for a devel- oping child teaches the child how to be secure in self-identity and respond to a changing world. 5 Connecting deeply and forming lasting intimate relationships is not easy for everyone. When a child grows up in an environment where they are expected to be independent, fend for themselves, are reprimanded for depending on caregivers, and/or have had their needs responded to slowly, if at all, the formation of healthy bonds becomes harder to realize. 5 When there is abuse or an environment of oppression in general, there is a development of a dysfunctional bonding style. 2,5 Bonding and Attachment Bonding styles and attachment theory are frameworks that illustrate the complex interplay between individual and relationship-level pro- cesses, and how personal relationships form and function. 2,5 John Bowlby, the preeminent scholar on attachment theory, emphasized the importance of, and the expectation relating to, depictions of attachment security — depictions that, when pos- itive, enable an individual to cope constructively with stressful life situations, to maintain emotional stability and self-esteem, and to contribute con- structively to mutually satisfying intimate relation- ships. When the behaviors are negative, they set the stage for possible lifelong insecure attach- ment dysfunctions. 2,6,7,8,9,10 While Bowlby claimed that attachment systems were most important in early life, when survival is the highest priority, he also noted that attach- ment systems are active across a person’s life span and present themselves in one’s thoughts and behaviors related to proximity-seeking behav- iors in times of need. 2,10 Attachment Strategies and Attachment Styles Bowlby asserted that infants are born with a full repertoire of attachment behaviors designed, by evolution, to assure needs are met by supportive attachment givers: to protect them from danger and to help them to develop strategies that are beneficial to a full, well-lived life, with fulfilling relationships. 9 Bowlby described crucial differ- ences in attachment system functioning. 6 Differ- ences are derived from early relationships and reactions to survival skills developed while seek- ing support in times of need and the process to internalize those reactions. Attachment figures that are available, sensitive, and supportive cul- tivate and promote a sense of security and con- nection in the person being caretaken. However, the converse is also true; when the attachment giver is not reliably available and supportive, and a sense of security is not attained consistently, self-regulation is harder to develop for the per- son being caretaken, and secondary attachment Not long ago, I sat down with my friend Gen- evieve Oswald and discussed trauma bonds and how they interact within relationships. Our dis- cussion arose from a reflection of how traumatic events impact relationships. Relationships are affected as the trauma is happening and long into the future. In my own life, in a very short time period, I had a near-death experience, endured the death of my brother in a shipwreck in Alaska, then a miscarriage with my first wife, followed by her cancer diagnosis, and her death two years later, only to be followed by the death of our two daughters (ages 6 and 9) along with my mother- in-law in an automobile accident. After these sig- nificant traumas, I found myself deeply embed- ded in relationships that were categorically trauma bonds and difficult to navigate as well as depart. Bessel A. van der Kolk writes in The Body Keeps the Score : ❝ Trauma, whether it is the result of some- thing done to you or something you your- self have done, almost always makes it difficult to engage in intimate relation- ships. After you have experienced some- thing so unspeakable, how do you learn to trust yourself or anyone else again? Or, conversely, how can you surrender to an intimate relationship after you have been brutally violated? 1 After an intense therapeutic journey — and an overhaul of my emotional, physical, mental, and spiritual pillars of health — I find myself in a healthy marriage of 22 years and a personal and professional life in behavioral health that gives me purpose, happiness, and a true sense of belong- ing. In our conversation, Oswald and I — she as a yoga instructor, business owner, and city council- woman and myself as a psychotherapist, business owner, and founder of a grief and trauma center — agreed this topic needed to be studied, writ- ten about, and circulated so that more and more people in the caregiving field and in general are able to understand and navigate the difficult jour- ney of healing and reintegrating back into rela- tionships after a traumatic event has happened, or been retriggered, personally and as a provider. Healing can happen, especially if people are aware and conscious of what is happening to their best ability. Again, from Bessel van der Kolk: