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Cited by 45Psychoanalysis and Psychopathology ResearchAttachment and Relationship DynamicsMaternal Mental Health During Pregnancy and Postpartum

Unresolved trauma and reorganization in mothers: Attachment and neuroscience perspectives

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Iyengar, Udita, Rajhans, Purva, Fonagy, Peter, Strathearn, Lane, Kim, Sohye·2019·Frontiers in Psychology
DOI 10.3389/fpsyg.2019.00110PMC PMC6363675
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Abstract

The onset of motherhood is characterized by significant psychological and neurobiological changes. These changes equip the mother to care for her new child. Although rewarding, motherhood is also an inherently stressful period, more so for mothers with unresolved trauma. Past research has looked at how unresolved trauma can hamper a mother's caregiving response toward her infant, which further affects the development of secure attachment in her own infant. The Dynamic Maturational Model of Attachment and Adaptation (DMM) has introduced a unique concept of "attachment reorganization" which can be described as a process whereby individuals with unresolved trauma are transitioning toward attachment security based on their enhanced understanding of past and present experiences. Preliminary results from one of our previous studies have shown that, among mothers with unresolved trauma, mothers who themselves demonstrated "reorganizing attachment" toward security, had infants with secure attachment, thereby indicating the potential to halt the intergenerational transmission of insecure attachment. While this concept is of great clinical relevance, further research is required to assess the benefits of attachment reorganization as a protective factor and its positive implications for child development. Thus, the aim of the current review is to expand on the concept of attachment reorganization in mothers with unresolved trauma from both attachment and neuroscience perspectives. To that effect, we will first review the literature on the transition to motherhood from attachment and neuroscience perspectives. Second, we will use attachment and neuroscience approaches to address deviations from normative experiences during motherhood with a specific focus on the role of a mother's unresolved trauma. Lastly, we will expand on the concept of reorganization and the promise this concept holds in resolving or halting the intergenerational transmission of trauma from mothers to their children.

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  • Among individuals with SUDs, traumatic attachments can be replaced by healthier, human attachments of various sorts.

    “Also among individuals with SUDs, traumatic attachments can be replaced by healthier, human attachments of various sorts (117, 118).”

    From Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective (2019) · cites this paper as [118]

    The Clinical Examples of Reorganization section describes a mother with SUD and unresolved trauma who is reorganizing toward secure attachment, supporting the possibility of attachment change. The paper frames this as a change in attachment strategy, particularly in the mother–infant context; it does not say that traumatic attachments are replaced by healthier human relationships of various sorts. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Mothers with a history of trauma can transition towards secure attachment, based on their enhanced understanding of past and present experiences.

    “Iyengar and colleagues (118) indicated that mothers with a history of trauma can transition towards secure attachment, based on their enhanced understanding of past and present experiences.”

    From Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective (2019) · cites this paper as [118]

  • Attachment representations are not permanent and can evolve across the lifespan.

    “Notwithstanding the persistent impact of insecure attachment throughout the lifespan, a growing body of research emphasizes that attachment representations are not permanent and can evolve across the lifespan (118).”

    From Mothering, Substance Use Disorders and Intergenerational Trauma Transmission: An Attachment-Based Perspective (2019) · cites this paper as [118]

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Research works printed but not linked: 54

  1. Ainsworth M. D. S. Blehar M. C. Waters E. (1978). Patterns of Attachment: A Psychological Study of the Strange Situation. Hove: Psychology Press.
  2. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Arlington, TX: American Psychiatric Pub 10.1176/appi.books.9780890425596 · DOI · Paper page
  3. Barone L. (2003). Developmental protective and risk factors in borderline personality disorder: a study using the adult attachment interview. Attach. Hum. Dev. 5 64– 77. 10.1080/1461673031000078634 12745829 · DOI
  4. Bowlby J. (1972). Attachment: Attachment and Loss. Vol. 1. London: Penguin Books.
  5. Bowlby J. (1973). Attachment and Loss: Separation, Vol. 2 New York, NY: Basic Books
  6. Bowlby J. (1980). Attachment and Loss: Loss, Vol. 3 New York, NY: Basic Books
  7. Cicchetti D. Toth S. L. (1999). The development of depression in children and adolescents. Am. Psychol. 53 221– 241. 10.1037/0003-066X.53.2.221 9491749 · DOI
  8. Crittenden P. M. (1992). Children’s strategies for coping with adverse home environments: an interpretation using attachment theory. Child Abuse Neglect 16 329– 343. 10.1016/0145-2134(92)90043-Q 1617468 · DOI
  9. Crittenden P. M. (1995). Attachment and risk for psychopathology: the early years. J. Dev. Behav. Pediatr. 16(3 Suppl.), S12– S16. 10.1097/00004703-199506001-00004 7560126 · DOI
  10. Crittenden P. M. (1997). “Toward an integrative theory of trauma: a dynamic-maturation approach,” in Rochester Symposium on Developmental Psychopathology Vol. 8 eds Cicchetti D. Toth S. L. (Rochester, NY: University of Rochester Press), 33– 84.
  11. Crittenden P. M. (2000). “A dynamic-maturational approach to continuity and change in pattern of attachment,” in The Organization of Attachment Relationships: Maturation, Culture, and Context, eds Crittenden P. M. Claussen A. H. (New York, NY: Cambridge University Press), 343– 357.
  12. Crittenden P. M. (2006). A dynamic-maturational model of attachment. Aust. N. Z. J. Fam. Ther. 27 105– 115. 10.1002/j.1467-8438.2006.tb00704.x · DOI
  13. Crittenden P. M. (2017). Raising Parents: Attachment, Representation, and Treatment. Abingdon: Routledge 10.4324/9781315726069 · DOI
  14. Dube S. R. Felitti V. J. Dong M. Chapman D. P. Giles W. H. Anda R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics 111 564– 572. 10.1542/peds.111.3.564 12612237 · DOI · Paper page
  15. Easterbrooks M. A. Biesecker G. Lyons-Ruth K. (2000). Infancy predictors of emotional availability in middle childhood: the roles of attachment security and maternal depressive symptomatology. Attach. Hum. Dev. 2 170– 187. 10.1080/14616730050085545 11707909 · DOI
  16. Ensink K. Berthelot N. Bernazzani O. Normandin L. Fonagy P. (2014). Another step closer to measuring the ghosts in the nursery: preliminary validation of the Trauma reflective functioning scale. Front. Psychol. 5: 1471. 10.3389/fpsyg.2014.01471 25566146 PMC4269108 · DOI · Paper page
  17. Fonagy P. (2002). Affect Regulation, Mentalization, and the Development of the Self. New York, NY: Other Press.
  18. Fonagy P. Leigh T. Steele M. Steele H. Kennedy R. Mattoon G. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. J. Consult. Clin. Psychol. 64 22– 31. 10.1037/0022-006X.64.1.22 8907081 · DOI
  19. Fonagy P. Steele M. Steele H. Moran G. S. Higgitt A. C. (1991b). The capacity for understanding mental states: the reflective self in parent and child and its significance for security of attachment. Infant Ment. Health J. 12 201– 218. 10.1002/1097-0355(199123)12:3<201::AID-IMHJ2280120307>3.0.CO;2-7 · DOI
  20. Fonagy P. Steele M. Steele H. Leigh T. Kennedy R. Mattoon G. (1995). “The predictive validity of mary main’s adult attachment interview: a psychoanalytic and developmental perspective on the transgenerational transmission of attachment and borderline states,” in Attachment Theory: Social, Developmental and Clinical Perspectives, eds Goldberg S. Muir R. Kerr J. (Hillsdale, NJ: The Analytic Press), 233– 278.
  21. Fraiberg S. Adelson E. Shapiro V. (1975). Ghosts in the nursery. J. Am. Acad. Child Psychiatry 14 387– 421. 10.1016/S0002-7138(09)61442-4 1141566 · DOI · Paper page
  22. Hoekzema E. Barba-Müller E. Pozzobon C. Picado M. Lucco F. García-García D. (2017). Pregnancy leads to long-lasting changes in human brain structure. Nat. Neurosci. 20 287– 296. 10.1038/nn.4458 27991897 · DOI · Paper page
  23. Insel T. R. Young L. J. (2001). The neurobiology of attachment. Nat. Rev. Neurosci. 2 129– 136. 10.1038/35053579 11252992 · DOI · Paper page
  24. Jacobsen L. K. Southwick S. M. Kosten T. R. (2001). Substance use disorders in patients with posttraumatic stress disorder: a review of the literature. Am. J. Psychiatry 158 1184– 1190. 10.1176/appi.ajp.158.8.1184 11481147 · DOI
  25. Kim P. Strathearn L. Swain J. E. (2016). The maternal brain and its plasticity in humans. Horm. Behav. 77 113– 123. 10.1016/j.yhbeh.2015.08.001 26268151 PMC4724473 · DOI · Paper page
  26. Kim S. Fonagy P. Allen J. Strathearn L. (2014). Mothers’ unresolved trauma blunts amygdala response to infant distress. Soc. Neurosci. 9 352– 363. 10.1080/17470919.2014.896287 24635646 PMC4260525 · DOI
  27. Kim S. Iyengar U. Mayes L. C. Potenza M. N. Rutherford H. J. Strathearn L. (2017). Mothers with substance addictions show reduced reward responses when viewing their own infant’s face. Hum. Brain Mapp. 38 5421– 5439. 10.1002/hbm.23731 28746733 PMC5763911 · DOI · Paper page
  28. Koenigsberg H. W. Siever L. J. Lee H. Pizzarello S. New A. S. Goodman M. (2009). Neural correlates of emotion processing in borderline personality disorder. Psychiatry Res. Neuroimaging 172 192– 199. 10.1016/j.pscychresns.2008.07.010 19394205 PMC4153735 · DOI
  29. Landa S. Duschinsky R. (2013). Crittenden’s dynamic–maturational model of attachment and adaptation. Rev. Gen. Psychol. 17: 326 10.1037/a0032102 · DOI
  30. Lanius R. A. Bluhm R. Lanius U. Pain C. (2006). A review of neuroimaging studies in PTSD: heterogeneity of response to symptom provocation. J. Psychiatr. Res. 40 709– 729. 10.1016/j.jpsychires.2005.07.007 16214172 · DOI · Paper page
  31. Lanius R. A. Williamson P. C. Bluhm R. L. Densmore M. Boksman K. Neufeld R. W. (2005). Functional connectivity of dissociative responses in posttraumatic stress disorder: a functional magnetic resonance imaging investigation. Biol. Psychiatry 57 873– 884. 10.1016/j.biopsych.2005.01.011 15820708 · DOI · Paper page
  32. Montague P. R. Lohrenz T. (2007). To detect and correct: norm violations and their enforcement. Neuron 56 14– 18. 10.1016/j.neuron.2007.09.020 17920011 · DOI
  33. Najavits L. M. Walsh M. (2012). Dissociation, PTSD, and substance abuse: an empirical study. J. Trauma Dissociation 13 115– 126. 10.1080/15299732.2011.608781 22211445 PMC3341607 · DOI
  34. Pearson J. L. Cohn D. A. Cowan P. A. Cowan C. P. (1994). Earned-and continuous-security in adult attachment: relation to depressive symptomatology and parenting style. Dev. Psychopathol. 6 359– 373. 10.1017/S0954579400004636 · DOI
  35. Perry B. D. Pollard R. A. Blakley T. L. Baker W. L. Vigilante D. (1995). Childhood trauma, the neurobiology of adaptation, and “use-dependent” development of the brain: how “states” become “traits”. Infant Ment. Health J. 16 271– 291. 10.1002/1097-0355(199524)16:4<271::AID-IMHJ2280160404>3.0.CO;2-B · DOI
  36. Protopopescu X. Pan H. Tuescher O. Cloitre M. Goldstein M. Engelien W. (2005). Differential time courses and specificity of amygdala activity in posttraumatic stress disorder subjects and normal control subjects. Biol. Psychiatry 57 464– 473. 10.1016/j.biopsych.2004.12.026 15737660 · DOI
  37. Rauch S. L. Whalen P. J. Shin L. M. Mcinerney S. C. Macklin M. L. Lasko N. B. (2000). Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study. Biol. Psychiatry 47 769– 776. 10.1016/S0006-3223(00)00828-3 10812035 · DOI · Paper page
  38. Riem M. M. Bakermans-Kranenburg M. J. van IJzendoorn M. H. Out D. Rombouts S. A. (2012). Attachment in the brain: adult attachment representations predict amygdala and behavioral responses to infant crying. Attach. Hum. Dev. 14 533– 551. 10.1080/14616734.2012.727252 23106177 · DOI · Paper page
  39. Rodning C. Beckwith L. Howard J. (1991). Quality of attachment and home environments in children prenatally exposed to PCP and cocaine. Dev. Psychopathol. 3 351– 366. 10.1017/S0954579400007562 · DOI
  40. Roisman G. I. Padrón E. Sroufe L. A. Egeland B. (2002). Earned–secure attachment status in retrospect and prospect. Child Dev. 73 1204– 1219. 10.1111/1467-8624.00467 12146743 · DOI
  41. Schore A. N. (1997). Early organization of the nonlinear right brain and development of a predisposition to psychiatric disorders. Dev. Psychopathol. 9 595– 631. 10.1017/S0954579497001363 9448998 · DOI
  42. Schurz M. Radua J. Aichhorn M. Richlan F. Perner J. (2014). Fractionating theory of mind: a meta-analysis of functional brain imaging studies. Neurosci. Biobehav. Rev. 42 9– 34. 10.1016/j.neubiorev.2014.01.009 24486722 · DOI · Paper page
  43. Shah P. E. Fonagy P. Strathearn L. (2010). Is attachment transmitted across generations? The plot thickens. Clin. Child Psychol. Psychiatry 15 329– 345. 10.1177/1359104510365449 20603421 PMC3060612 · DOI
  44. Siegel D. J. (1999). The Developing Mind: How Relationships and the Brain Interact to Shape Who We are. New York, NY: The Guilford Press.
  45. Sieswerda S. Arntz A. Mertens I. Vertommen S. (2007). Hypervigilance in patients with borderline personality disorder: specificity, automaticity, and predictors. Behav. Res. Ther. 45 1011– 1024. 10.1016/j.brat.2006.07.012 17045566 · DOI
  46. Sroufe L. A. (2005). Attachment and development: a prospective, longitudinal study from birth to adulthood. Attach. Hum. Dev. 7 349– 367. 10.1080/14616730500365928 16332580 · DOI · Paper page
  47. Swain J. E. Ho S.-H. S. (2017). Neuroendocrine mechanisms for parental sensitivity: overview, recent advances and future directions. Curr. Opin. Psychol. 15 105– 110. 10.1016/j.copsyc.2017.02.027 28813249 PMC7195810 · DOI
  48. Swain J. E. Kim P. Spicer J. Ho S. Dayton C. J. Elmadih A. (2014). Approaching the biology of human parental attachment: brain imaging, oxytocin and coordinated assessments of mothers and fathers. Brain Res. 1580 78– 101. 10.1016/j.brainres.2014.03.007 24637261 PMC4157077 · DOI · Paper page
  49. Swain J. E. Lorberbaum J. P. Kose S. Strathearn L. (2007). Brain basis of early parent-infant interactions: psychology, physiology, and in vivo functional neuroimaging studies. J. Child Psychol. Psychiatry 48 262– 287. 10.1111/j.1469-7610.2007.01731.x 17355399 PMC4318551 · DOI · Paper page
  50. Watson S. Chilton R. Fairchild H. Whewell P. (2006). Association between childhood trauma and dissociation among patients with borderline personality disorder. Aust. N. Z. J. Psychiatry 40 478– 481. 10.1080/j.1440-1614.2006.01825.x 16683975 · DOI · Paper page
  51. Williams L. Kemp A. Felmingham K. Barton M. Olivieri G. Peduto A. (2006a). Trauma modulates amygdala and medial prefrontal responses to consciously attended fear. Neuroimage 29 347– 404. 16216534
  52. Winnicott D. W. (1956). “Primary maternal preoccupation,” in The Maternal Lineage: Identification, Desire, and Transgenerational Issues, ed. Mariotti P. (New York, NY: Routledge/Taylor & Francis Group), 59– 66.
  53. Winnicott D. W. (1960). The theory of the parent-infant relationship. Int. J. Psycho Anal. 41: 585. 13785877
  54. Winnicott D. W. (ed.) (1965). “1960 Ego distortion in terms of true and false self,” in The Maturational Processes and the Facilitating Environment (Madison, CT: International Universities Press).

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Authors
Iyengar, U., Rajhans, P., Fonagy, P., Strathearn, L., & Kim, S.
Affiliations
  • King's College London (GB)
  • University of Iowa (US)
  • Baylor College of Medicine (US)
Corresponding author
Iyengar, Udita
ORCID
Venue
Frontiers in Psychology
Publisher
Frontiers Media SA
Published
2019-01-30
Volume
10
Pages
110-110
ISSN
1664-1078 (ISSN-L)
DOI
10.3389/fpsyg.2019.00110
PMC
PMC6363675
OpenAlex
W2913728055
Cited by
45
References
13
Citations by year
2026: 6 · 2025: 8 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 12 · 2020: 4 · 2019: 4
FWCI
0.91
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Iowa Research Online (The University of Iowa) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion, other-oa)
Funders
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD065819)
  • National Institute on Drug Abuse (R01 DA026437)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
unresolved trauma, motherhood, transition to motherhood, secure attachment, intergenerational trauma, maternal care, infant development, attachment security

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