An Attachment Perspective on Trauma, Loss, and Resilience

The NYU Silver School of Social Work's Division of Lifelong Learning hosted the second annual attachment theory conference on March 7 with Drs. Miriam and Howard Steele, associate professors at the New School for Social Research. The Steeles demonstrated how attachment theory enriches theoretical conceptualizations of social work, enhances clinical practice, and assists in making both clinical and policy decisions. They also elucidated how the tenor of one's earliest attachments to caregivers may provide a template for the quality of ensuing development, relationships, and even productivity across the lifespan.

The day began with introductions from Dean Lynn Videka and Professor Jeane Anastas, who discussed the Steeles' 20-year history with the London Parent-Child Project, where they have established the strong connection between psychoanalytic, object relations, and attachment theory. Anastas also briefly addressed the Steeles' endorsement of a modern, multidisciplinary conception of and approach to the original precepts of attachment theory, which positions secure attachment to caregivers as the scaffolding for affect regulation across the lifespan. The day's three presentations -- all of which involved attendees in Q&A sessions -- included powerful case and video presentations to illustrate clinical applications of conceptual points.

In the day's first presentation, entitled "Attachment Representation and Emotion Regulation-A Twenty-Year Longitudinal Study," Howard Steele spoke about the striking concordance between parents' representations of their own attachment history and their infant's attachment status, using two seminal instruments respectively: the Adult Attachment Interview (AAI) and the "Strange Situation Procedure" (SSP). He discussed various clinical uses of the AAI, the importance of fathers' contributions to attachment, how parents help young children recognize and regulate their emotions, and how secure and insecure attachment may contribute to different mental health outcomes.

In the second presentation, "Changing Attachment Representations in Traumatized Children," Miriam Steele focused on the salience of attachment theory for foster care. Attachment-based assessments can serve as a "window into the internal world" of both foster children and prospective foster parents and can identify experiences of separation, loss, and trauma. She reviewed a powerful study using the AAI, which illustrated the negative influence of foster mothers' unresolved loss and trauma on their experiences of parenting as well as on children's attachment style and eventual use of avoidant defensive strategies. Finally, Miriam Steele pointed out the astuteness of social workers making placement recommendations. Skilled social workers were able to determine which prospective foster parents may be inappropriate to care for the most traumatized children, thereby supporting the use of attachment-informed assessment to assist with foster care decisions.

In the third presentation, "Defining Therapeutic Action: Attachment-Based Intervention with High Risk Families" the Steeles discussed an attachment-based intervention designed for high-risk, multi-problem families. The Center for Babies and Toddlers at the Children's Evaluation and Rehabilitation Center (CERC) at Albert Einstein College of Medicine assists very high-risk parents who have experienced extensive interpersonal trauma, the corollaries of substance abuse, and both community and domestic violence. In the CERC, attachment status, mental health, and nervous system activation of mothers and infants are determined prior to interventions, reflecting a multidisciplinary approach increasingly utilized in attachment work. Cost-effective groups provide these often-isolated mothers with emotional support and corroboration of their experiences. Mother-infant individual psychotherapy is conducted through assessment of videotaped interactions, a cutting-edge approach to fostering rapid change in parent's behavior in the highest risk dyads.

Throughout their presentations on attachment theory, the Steeles also addressed one of today's greatest challenges -- how to start leveling the playing field for the most compromised parents and children by recognizing the influence of both trauma and resilience in their earliest relationships.