1. Resilience & Adult Attachment
in Cases of Child Trauma
Jane F. Gilgun, Ph.D., LICSW
Gwendolyn Anderson, MSW
This online learning module has been developed under the auspices of: Federal Title IV-E Funding, Minnesota Department of Human Services (Contract
#439481), The Center for Advanced Studies in Child Welfare at the School of Social Work in the College of Education and Human Development

2. Topics
• ACE: Incidence of Trauma
• Definitions of Trauma
• Diagnostic Criteria
• Adult Attachment, Self-Regulation, & Trauma
• Neurobiology of Trauma

3. Adverse Childhood Experiences (ACE)
• 17,337 adult HMO members
• 11.0% reported having been emotionally abused as a child,
• 30.1% reported physical abuse,
• 19.9% sexual abuse;
• 23.5% reported being exposed to
• family alcohol abuse,
• 18.8% to mental illness,
• 12.5% witnessed their mothers being
• battered and
• 4.9% reported family drug abuse.

4. PRINCIPLES OF NEURODEVELOPMENT
• Disproportional influences of early childhood
experiences
• Secure attachments protect from and
heal following stress, distress, and trauma.

5. Plasticity (Use Dependent
Development)
• If the patterns or incoming neural activity
are regulated, synchronous, patterned, and
of ‘‘normal’’ intensity,
– the higher areas will organize in healthier
ways;
• If the patterns are extreme, dysregulated,
and asynchronous,
– the higher areas will organize to reflect these
abnormal patterns.

6. Effects of Early
Infancy & Childhood Experiences
• “organizing, sensitive brain of an infant or
young child is more malleable to experience
than a mature brain” (Perry, 2009, p. 245).
• Thus, the effects of abuse, neglect, and other
traumas may have more of an impact on a
young brain than a mature brain.

7. General Definition of Trauma
• A General Definition
– event that is life-threatening or psychologically devastating
to the point where persons’ capacities to cope are
overwhelmed.
– Directly experienced, witnessed, or have knowledge of
• When activated, fear is primary emotion
• Prefrontal cortex is “shut down”
• Low road responses are activated
– Fight, flight, fear, or self-regulation
– To recover,
• Children require the safety of secure relations
• Support to deal directly with the effects of the trauma

8. General Definition
of Complex Trauma
Complex trauma
– a series of difficult life events
– that interfere with attachment relationships
– and that threaten healthy development in a
range of domains,
• including emotional, cognitive, language,
sexual, physical, social, and physical

9. Sexual
Abuse Physical
Complex
Trauma
Abuse
Witnessing Rape &
Physical Assault of
Mother
Emotional
Abuse &
Physical Abuse
Emotional
Neglect
Educational
Neglect
Physical &
Medical
Neglect

10. PTSD—DSM-IV
A: Exposure to a traumatic event
B: Persistent re-experiencing
C: Persistent avoidance and emotional numbing
D: Persistent symptoms of increased arousal not
present before
E: Duration of symptoms for more than 1 month
F: Significant impairment

11. PTSD—DSM-5
A: Exposure to a traumatic event: actual or threatened death, serious
injury sexual violence
B: Intrusion Symptoms
C: Persistent avoidance and emotional numbing
D: Negative alterations in cognitions and mood that are associated with
the traumatic event
E. Trauma-related alterations in arousal and reactivity that began or
worsened after the traumatic event (
F. Persistence of symptoms (in Criteria B, C, D and E) for more than
one month
G. Significant symptom-related distress or functional impairment
H. Not due to medication, substance or illness

12. PTSD
• PTSD diagnosis is not developmentally sensitive
• does not adequately describe the impact of exposure
to childhood trauma on the developing child.
– Developmental delays
– Regressions
• across a broad spectrum, including cognitive,
• language, motor, and social skills

13. Developmental Trauma Disorder
A. Exposure
B. Affective & Physiological Dysregulation
C. Attentional & Behavioral Dysregulation
D. Self & Relational Dysregulation
D. PTSD Symptoms
F. Functional Impairment

14. Recovery from Trauma
• Parents can provide the secure relationships children require to
recover.
• Assess children’s attachment relationships.
– Degrees of self-regulation & conditions under which it occurs
– Degrees of dysregulation & conditions under which it occurs
– Parents a secure base?
– Do children explore environemnt?
• Secure relationships are key. These relationships not only are those
between parents and children but between parents, children, other family members,
service providers, and others who interact with children and families.

15. Assessment for Resources & Risks
• Did Trauma Occur?
– Nature of the trauma
• Attachment Relationships
– Protective or Risk?—ask this throughout
• Family Relationships
• Family’s Connections
– Extended family
– Friends, neighors
– Community organizations
• Religious organizations
• Civic organizations

16. Definition of Infant
Mental Health
• Infant: child age 0-3
• Developing capacity of children regarding emotions
– Experience them
– Regulate them
– Express them
• Form close interpersonal relationships
• Explore the environment and learn
Synonym: healthy social & emotional development

17. The Job of Non-Specialists
• Assessment
– of trauma
• Nature and situation; identify triggers
– of attachment relationships
– capacities for self regulation
– capacities for exploration
• Be Secure Bases and Safe Havens
• Knowledge of Resources Including
– Knowledge of Who are Competent Specialists
• Working as therapists with child and family trauma requires a
great deal of training and supervision

18. Importance of Secure Relationships
• Research on attachment,
trauma, and resilience
shows that children can
recover from trauma and go
on to live satisfying lives if
they have the safety of
secure relationships and if
parents in turn have the
safety of secure
relationships.

19. Notes on Adult Attachment
• Adult attachments with children take place in a
web of other relationships
– These other relationships include
• Spousal relationships
• Relationships with other family members, friends,
neighbors, and anyone else who may influence
family relationships
• Relationships with service providers
• Adults’ own attachment & developmental histories

20. Family Relationships & Social Networks
• Service providers can assess
whether families have
formal or informal
supportive networks
• Supportive social networks
are essential for both parents
and children in recovery
from trauma.

21. Effects of Adverse Childhood
Experiences
• Adverse childhood experiences in the
absence of protective processes affect
brain development and thus children’s
development
• the power of healthy relationships
to protect from and heal following stress,
distress, and trauma.

22. Services
• Most children who have adverse experiences do not
receive services
– Many do well because of naturally occurring
protective processes
• Safety of secure relationships
• Opportunities to process effects of the adversities
– Brain development will be effected but unlikely to
be debilitating
• Most children in care do not receive services.
– What do you think is going to happen to the
children??

23. Relevance of Ideas
About Resilience
• Factors Associated with Improved Functioning
– Children with
• relational stability
• multiple positive, healthy adults invested in their lives
improve;
• Factors Associated with Lack of Improved Functioning
– children with
• multiple transitions,
• chaotic and unpredictable family relationships,
• Relational poverty.
• Remember: Resilience is relational

24. Relevance of Ideas
About Resilience
• Factors Associated with Improved Functioning
– Children with
• relational stability
• multiple positive, healthy adults invested in their lives
improve;
• Factors Associated with Lack of Improved Functioning
– children with
• multiple transitions,
• chaotic and unpredictable family relationships,
• Relational poverty.
• Remember: Resilience is relational

25. Working Relationships
with Service Providers
• Establishing a working relationship between
families and service providers can be
challenging
• Requires sensitivity and responsive care by
service providers
• Building a working relationship may
enhance optimism that things will get better

26. Meeting Basic Human Needs
• Families may need
assistance with meeting
basic needs.
• When these needs are met,
parents will be better able to
concentrate on maintaining
secure relationships

27. Resilience
• Children are said to be
resilient when they have
coped with, adapted to, and
overcome the effects of
trauma..
• Secure relationships and
service provision that
provide safe places to work
thought the effects trauma
contributes to resilience in
children.

28. General Styles of Adult Attachment

29. Characteristics of Secure/Resolved
Adult Attachment
• Provide sensitive, attuned
care for children
• Provide consistency and
structure in family life
• Models and rewards
prosocial behaviors for
children
• Sets limits on inappropriate
behaviors, explains why
behaviors are inappropriate
• If they have experienced
trauma, they acknowledge
the trauma and its meanings
and effects
• Shows evidence of long-term,
trusting, confidant
relationships with others
• Children’s safety, well-being,
and recovery comes
first
• They know it’s not all about
themselves but it is about
their children
• Children seek them out for
general interactions and
comfort
• Children may not tell
securely attached parents
about the abuse

30. Characteristics of Preoccupied
Adult Attachment
• Self-centered: “it’s all about
me”
• Unresolved/unattended
trauma that they think about
a lot
• Possible mental health &
chemical dependency issues
related to past trauma
• Have difficulty regulating
their own emotions,
behaviors, and thoughts
• Have difficulty providing
consistency, structure, and
guidance to their children
• Unable to be sensitively
attuned to their children
• May be overwhelmed by
guilt and by what they did
wrong instead of focusing
on children’s well-being
• May think a lot about what
their parents have done
wrong or idealize their
parents
• Children usually don’t seek
out parents for friendly
interactions and for help and
comfort

31. Characteristics of Dismissive Adult Attachment
• Minimize children’s
experiences of trauma &
effects of own traumas
• Downplay abuse as “not a
big deal” or won’t recognize
the seriousness of what
happened
• Unwilling to engage with
service providers regarding
children’s traumas & their
own
• Are distant emotionally and
over-regulate their own
emotions
• May describe current
relationships with parents
and other family members
as distant or cut-off, which
sometimes is necessary for
mental health but services
providers should assess
these relationships
• Their children may have
avoidant attachment styles
and do not seek them out for
playful interactions or for
comfort and help

32. Characteristics of Disorganized
Adult Attachment
• Behaviors are random, dismissive,
preoccupied, and sometimes
agitated
• Have histories of complex trauma
that they have not been able to
deal with
• Often have issues with chemical
dependency
• They may have diagnoses of
persistent mental illnesses that
isn’t controlled well
• In conversations, especially when
discussing sensitive issues, they
may lose track of what they are
saying or abruptly switch topics
• May provide grossly inadequate
care to their children: abuse,
neglect, abandonments with little
or no understanding of the gravity
of these behaviors
• May try to put up a front that
things are perfect; may idealize
situations
• May respond with anger, lack of
cooperation, & inconsistency
when offered services
• Children do not seek them out for
friendly interactions, comfort, or
help

33. Immediate Reactions
• Dysregulation
• Children respond according
– to inner working models of previous experiences
– Developmental levels
• Children exposed to DV & other traumas
– High risk for physical aggression
• History of secure attachments
– Trauma itself may result in disorganized behaviors
– No apparent reactions but they come later (Ian)

34. Typical Reactions to Child Sexual Abuse by Adult
Attachment Style
The following section provides some ideas about what service
providers can expect in their work with parents of survivors
of child sexual abuse for each style of adult attachment

35. Typical Reactions of Adults
Who Show Secure/Resolved Styles of Attachment
• Parents may be shocked by disclosures of child trauma,
but they believe the children.
• Parents seek the help of service providers for themselves
and their children.
• They do what it takes to ensure safety for their children.
– This includes seeking services for themselves.
• Parents allow children to express whatever is true for
them.
• Parents help children deal with other difficult issues.

36. Typical Reactions of Adults
Who Show Preoccupied Styles
of Attachment
• May be shocked by allegations of child trauma.
• They intrude upon the children’s experiences of the
abuse.
• They may not trust service providers.
• Some cooperate and do what it takes to provide safety
and security to their children and to themselves.
• They may at first act as if service providers will solve
all of their problems.

37. Typical Reactions When Adults
Show Dismissive Styles of Attachment
• May be shocked by allegations of child trauma, but do
not respond sensitively.
• They may deny the abuse occurred or minimize its
effects on children.
• They may not recognize that they have issues that
require attention.
• They may allow the alleged perpetrator to remain in
the home.
• Children may also resist services.

38. Typical Reactions of Adults
Who Show Disorganized Styles of Attachment
• Typically are the agents of the trauma
• Adults respond in many different and often contradictory ways
• They have difficulties in forming working relationships with
service providers
• They rarely respond sensitively to their children.
• Their children typically have disorganized attachment styles.
• Children may receive the diagnosis of reactive attachment
disorder (RAD) or disinhibited social engagement disorder.
• Children may be placed out of home for their own safety.
• May be engaged in services and visits sporadically and then
disappear for long periods of time.

39. Case Examples
• In the next few slides, we will present case examples of
parental responses to child sexual abuse, one of many types of
trauma that children experience.
• These case examples are from research on survivors and
mothers of survivors of child sexual abuse.
• These responses are categorized by adult attachment styles.
• After each example is provided, you will have time to reflect
on which type of attachment style is being displayed. The
correct answer will be provided after the reflection.
• The case examples of adult attachment may not be in the same
order as they have been presented so far in this training.

40. Pat
Her mother’s boyfriend raped Pat when she was 15. In the next
slide, she describes her mother’s reactions to her disclosure of the
abuse.

41. Pat (continued)
“I wasn’t going to say anything to
anybody because he had threatened
me…..When I did get home… I saw
him in the hall. I realized I couldn’t
stay there in the same building with
him. I went and stayed with my
girlfriend. I told her mother. …. When
I walked through the door she knew
what had happened. I stayed with her a
couple days before I told my mom.
She didn’t believe me. Of course she
went and she confronted Rick (not his
real name). He told her that I seduced
him. Then she gave him my
motorcycle... so he could get away.”

42. Reflection
• Take a moment to write down which type of adult attachment
Pat’s mother is portraying.
• What elements of Pat’s story made you decide on this style of
adult attachment?

43. Reflection
• Take a moment to write down which type of adult attachment
Pat’s mother is portraying.
• What elements of Pat’s story made you decide on this style of
adult attachment?
Pat’s story is an example of dismissive adult attachment

44. Alice
Alice found out her husband had been sexually abusing her two
daughters. She immediately left her husband and moved to a
shelter. She eventually divorced her husband.
She sought sex abuse counseling for her girls and supportive
counseling for herself. Her ex-husband never took responsibility
for the abuse.

45. Alice (continued)
“I knew it instinctively, that once I
picked up that phone and called
Child Protection that I’d probably
lose my house, the car, my friends,
my church, everything. I would
lose everything. And I thought, is it
worth it? You better damn well
believe it’s worth it. I will not have
my kid be molested. I would rather
be on the street poor, and have my
freedom. And I know that better
than anybody. And to me, that’s
worth it, if she doesn’t have to be
molested anymore. I’d rather have
it that way.”

46. Reflection
• Take a moment to write down which type of adult attachment
Alice showed.
• What elements of Alice’s story made you decide on this style
of adult attachment?

47. Reflection
• Take a moment to write down which type of adult attachment
Alice showed.
• What elements of Alice’s story made you decide on this style
of adult attachment?
Alice’s story is an example of secure/resolved adult
attachment

48. Donna
Donna has a history of untreated child sexual abuse, substance
abuse, and mental health issues. Her older children sexually
abused the younger children. Donna does not understand that
these sexual behaviors were abusive. Three out of 4 children
were removed from her care and a judge is about to decide
whether to remove the remaining child, who is the oldest. She
presents her story in confusing and jumbled way.
When you read her statement, see if she makes any sense to you.

49. Donna (continued)
“We had a fire in 2005, and so we were stuck in a
hotel room. The kids were going swimming. They
came back, and they were horsing around naked,
because, there are only two showers at a time, and I
was trying to find a place to live, and, you know, we
had to talk about boundaries. And it was certainly not
something I condoned, but I didn’t think it was—I
mean we just lost—the fire was primarily in the kids’
floor. They just lost everything they had, and if they
were going to find some self-comfort in their bodies, I
was kind of ok with that….I think the charges that—as
I understand them, are that, when I was pregnant with
Sam, I explained the birds and the bees to Emma, and
she became very curious from that talk and sexualized
Jake. So. Most of the system says that can’t be
possible. But I don’t think they take into consideration
that not only was I pregnant, but then I was pregnant
with twins, and then I was pregnant with a dead twin.”

50. Reflection
• Take a moment to write down which type of adult attachment
Donna is portraying.
• What elements of Donna’s story made you decide on this style
of adult attachment?

51. Joy
Joy has a history of child sexual abuse, drug addiction and was
diagnosed with depression. Upon disclosure of the abuse,
she lost custody of her daughter.
At first, Joy showed disorganized attachment. Eventually,
however, she began to become more attuned to her daughter,
went into treatment, and got sober. Through treatment, she
learned to deal with the effects of her own sexual abuse and other
traumas.
After successful treatment and counseling, Joy and her daughter
have reunited.

52. Joy (continued)
“When you think that you’re protecting your
child from that, because it happened to you
and you want to prevent that to happen to her.
I was so down on myself that I allowed that
to happen to my daughter. It feels like I was
just being selfish, only thinking about getting
high and stuff, you know, with this person. I
was like, wow, you know, all this stuff that I
was hearing, and graphic details and stuff. I
don’t even like to even talk about that. I was
confused. I didn’t know what to do. I didn’t
want to deal with the problem. I stayed high
for at least a month before I went into
treatment. I didn’t think about getting help or
therapy. I thought I don’t need it.”

53. Reflection
• Take a moment to write down which type of adult attachment
Joy is portraying.
• What elements of Joy’s story made you decide on this style of
adult attachment?

54. General Guidelines for Intervention
• Engage families in services
that meet basic human needs
such as for safety, food,
clothing, housing, and
medical care, including
mental health & cd care
• Offer emotional support,
education about child sexual
abuse, and safe places
where children & parents
can work on repairing their
relationships
• Foster child survivors’
secure relationships with
other people.
• Offer opportunities for
children to experience
competence. Teach them
self-regulation skills.
Children in crisis require
affirmation and supportive
work before they can
engage in activities in which
they have competence.

55. Working with Parents
Who Have Secure/Resolved Styles of Attachment
• Secure/resolved parents are more likely to cooperate and want
supportive services than parents with other styles of
attachment.
• Helpful referrals include individual and family counseling by a
provider trained in sexual abuse-specific treatment and who
also can provide psychoeducation about sexual abuse.
• Assess families as to whether they can meet basic human
needs.
• Provide opportunities for children to experience competence
through helping them engage in activities they enjoy.

56. Working with Parents
Who Have Preoccupied Styles of Attachment
• Parents may need additional supportive services to address
past trauma, mental health issues, or substance abuse issues
before they can provide a secure relationship with their
children.
• Assistance with basic needs
• Counseling referrals for children and family members &
opportunities for children to experience competence in
activities

57. Working with Parents
Who Have Dismissive Styles of Attachment
• Service providers need to be sensitive to the issues parents may have
when parents cannot be sensitively attuned to their children.
• Service providers require sensitive persistence in order to form
working relationships with parents with dismissive styles of
attachment.
• Eventually, parents may engage in treatment to deal with their own
issues.
• When possible, service providers should encourage parents to allow
their children to engage in treatment and psychoeducation, as well
as to form relationships with other people and to engage in activities
they enjoy.
• Be alert to the possibility that children in the family may be sexually
abusing other children.

58. Working with Parents
Who Have Disorganized Styles of Attachment
• These parents have difficulty forming relationships with most
other people.
• It is difficult for service providers to form working
relationships with them. They will need a lot of time from
service providers to build trust.
• Service providers may build some trust by helping parents to
address basic needs.
• They may allow their children to receive a full gamut of
services, but refuse services for themselves unless court
ordered. Typically, they have experienced extensive trauma
and have not experienced the safety of secure relationships
where they can work through the effects of trauma.

59. Some Final Points
• Parents with secure/resolved styles of adult attachment typically
require few services because they do whatever it takes to keep
their children safe.
• Some parents with the other three styles of attachment may
eventually respond to services when service providers
themselves are sensitively attuned to them and can therefore
form relationships with them.
• Service providers must themselves provide services that show
they they are trustworthy, consistent, sensitively attuned, and
willing to go the extra mile for the sake of children and their
families.

60. Some Final Points (Cont’d)
• Some parents are unable to respond to services because of their
own unattended histories of trauma. They have rarely if ever
experienced the safety of secure relationships.
• Service providers work as well as they can with parents and do
whatever they can to provide children with the safety of secure
relationships through being trustworthy themselves and through
seeking opportunities where children can deal with their trauma
and engage in activities where they experience their own
competence.

61. Recovery and Safety in Secure Relationships

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