Basic Assumptions for Working with Traumatized Family Members with Attachment Problems

Last week I attended the New Hampshire Infant Mental Health Conference.  The primary focus of the conference was evaluating for and treating trauma in children.  Cassie Yackley, Psy.D. of the Dartmouth Trauma Intervention Research Center adapted and presented the following from Dan Hughes’ Basic Assumptions for Parenting and Treating Traumatized, Attachment-Resistant Children.  I thought it would be valuable to post here.

Whenever you are working with a parent or child who has suffered trauma remember:

1.      They are doing the best they can.

2.      They want to improve.

3.      Their life, as it is not, is “a living hell.”

4.      They try to be safe by controlling everything in their environment.

5.      They try to be safe by avoiding everything that is stressful and painful.

6.      Their “attacks” reflect a fear of your motives for the nurturing and support you provide.

7.      Poor affect regulation, fragment thinking, a pervasive sense of shame, inability to trust, and lack of behavioral controls inhibit them from being able to have the relationships they desire.

8.      For them to change, they will need you to accept, comfort, and teach them.

9.      You will need to validate their sense of self (and family) while teaching them important developmental skills.

10.  You will need to understand their developmental stage and adjust your expectations to match so that they will have success, not failure.  Your physical and psychological presence are the foundation of your comforting and teaching them.

11.  Under stressful emotional conditions, they will regress and revert to basic, solitary defenses that they have used to survive.

12.  They will have to work hard to learn how to live well.  You cannot do the work for them, nor can you save them. You can comfort and teach them.

13.  You will need support and consultation from trusted others if you are to be able to successfully comfort and teach them.  You will make mistakes and will need to face these, learn from them, and continue.