HJNO Sep/Oct 2024

HEALTHCARE JOURNAL OF NEW ORLEANS I  SEP / OCT 2024 23 and successful social and personal adaptation. 5 Such interactions and representations of attach- ment security promote relationship quality and counters, or renders unnecessary, defensive and ego-driven motives that may otherwise distort perception and lead to misunderstandings, con- flict, and even violence with relationship partners. 2 Subconsciously, and sometimes consciously, we expect our partners to function as our primary caregivers did. Because of our expectations, we also act in ways we would have behaved with our primary caregivers; anticipating our misgivings will become our reality. 3 Although an individual's attachment style is typically perceived as a con- sistent approach to relationships, it is, in fact, a product of various cognitive and emotional fac- tors as well as specific memories and schemas tied to different contexts and relationships. While attachment orientations are initially formed in relationships with caregivers during childhood, Bowlby states that meaningful interactions with relationship partners in adulthood have the poten- tial to change an individual's working attachment model, shifting them from one attachment style to another. 9 This is worth noting more than once. Attachment styles can change. Negative Attachment as a Result of Sexual Assault Noting that attachment styles can change is especially important if an insecure attachment style is developed in the presence of sexual abuse endured as a child or an adult. The United strategies characterized by anxiety and avoidance are developed. 2,5 When a person’s attachment fig- ures are not reliably available and supportive, a sense of security is not attained by the person in need of security, worries about one’s social value and others’ intentions are created, and strategies of affect regulation other than proximity seeking are established. Ample evidence shows that rela- tionships with attachment figures who are unavail- able, unresponsive, or abusive do interfere with the development of a secure attachment style and, instead, result in insecure attachment styles in children. 2,11,12 According to Bowlby, there are four types of attachment styles; secure, avoidant (dismissive or anxious-avoidant in children), anxious (pre-occu- pied or anxious-ambivalent in children), and dis- organized (fearful-avoidant in children). 9,10 Bowlby states that avoidant, anxious, and disorganized are considered insecure attachment styles. Attachment in Adulthood Early childhood traumas have long-term reper- cussions. Following psychoanalytic theory and attachment theory, the fundamental hypothesis proposes that the relationship between a child and their mother is an exemplar for, or influence on, future romantic relationships. 2,5,6,13 More recent attachment research dives into the symptomology of attachment as well as attachment orientations and the patterns of relational expectations, emo- tions, and behaviors that result from internalizing a particular history of attachment experiences in adults. 2,5 Adult symptomologies of attachment dis- orders corroborate with neglect as well as abuse during childhood as predictors. 5 Avoidance as a symptom is the demonstration of a person’s dis- trust in relationship partners’ good will and their defensive striving to maintain behavioral inde- pendence and emotional distance. The extent of a person's worry about a partner's availability in times of need, as reflected in the anxiety dimen- sion, is partially influenced by the individual's self- doubts about their own worthiness. 2 Interactions with secure attachment figures as a child play a significant role in fostering a sta- ble and secure attachment as an adult, leading to essential components of healthy personality development, positive psychological well-being, Nations defines sexual violence as “any sexual act, attempt to obtain a sexual act, or other act directed against a person’s sexuality using coer- cion, by any person regardless of their relation- ship to the victim, in any setting. It includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part or object, attempted rape, unwanted sexual touching, and other non-con- tact forms.” Burt defined rape as the psychologi- cal extension of a dominant-submissive sex-role stereotyped culture, suggesting that sociocultural attitudes toward women, rape, and rapists can predict sexual violence. 14 Rape is a widespread issue in all societies, affecting individuals of all social backgrounds. Studies suggest that 59% of women have been victims of sexual abuse by their partners at some point in their lives. 15 In the book Far from the Tree , Andrew Solo- mon writes, ❝ Despite these enormous strides, rape often remains invisible. Our warnings to our daughters caution them against get- ting into a car with a stranger or going home with a man they meet in a bar, but 80 percent of rapes are committed by someone the victim knows. More than half of rape victims in the United States are under eighteen, and nearly a quar- ter of them—an eighth of the total—are under twelve. Rape is often habitual in abusive relationships and violent mar- riages. Impoverished women who depend on men for survival feel less volition over their own bodies. The Centers for Dis- ease Control have asserted that rape is ‘one of the most underreported crimes’ and estimate that only 10 to 20 percent of sexual assaults are reported. 16 The cliché but widely held belief that sexual violence is provoked by a scantily clad, seduc- tively attractive woman out alone at night is a stereotype and myth that helps to hide the facts about acquaintance rape, rape convictions, and rape culture. 14,17,18,19,20 While rape does not always involve life-threatening physical violence, it is most often committed by someone known to the victim. Such knowledge begs the questions, “Why didn’t she run away?” and, “Why didn’t she say ❝ Ample evidence shows that relationships with attachment figures who are unavailable, unresponsive, or abusive do interfere with the development of a secure attachment style and, instead, result in insecure attachment styles in children. ❞