Page 22 - PIECES OF THE PUZZLE Eline Vissia

CHAPTER 1
study indicate that neglect and verbal violence in childhood are the traumatic experiences most closely associated with the development of dissociative disorders and symptoms in adulthood (Dutra et al. 2009). Disorganized attachment plays a central role in trauma-related disorders. It has been suggested that the propensity to react to traumatic events with dissociation is related to disorganization of early attachment and its developmental sequelae (Liotti 2004). It is hypothesized that early disorganized attachment is the first step in many developmental pathways that lead to increased vulnerability to dissociative disorders and dissociative reactions to later traumas in the face of traumatic experiences during childhood and adolescence (Liotti 1992).
The attachment system, although more often active during infancy and childhood, is operant throughout an individual’s life and powerfully activated during and after any experience of fear and of physical or psychological pain (Liotti 2004). A need to cope with a traumatic stressor activates the attachment system. Disorganization of attachment closely mimics the collapse of the integrative functions of consciousness that characterize any dissociative experience, and may be the first instance of dissociative reactions during life (Liotti 2004). Treatment of dissociative patients with developmental trauma disorders is complex and must be based on a multi-phase program, where the first goal is to overcome relational and arousal modulation difficulties (Cloitre et al. 2011, Courtois, Ford 2009).
Closely related concepts
Traumatic experiences, attachment dynamics and dissociative reactions seem to be intertwined, like three threads woven into a single strand (Liotti 2004). This strand may extend into developmental pathways leading, in the presence of later traumas, to complex forms of posttraumatic stress disorder, dissociative disorders and borderline personality disorder. Early childhood trauma-related consequences and to neglect or attachment related problems often co-exist (Draijer 2003, Courtois, Ford 2009). Traumatic experiences in children are often inflicted by people they depend on and who should protect them. Not only do children develop posttraumatic stress symptoms accordingly, also severe problems in affect regulation and social relationships might emerge (Draijer, Langeland 2009). It has been indicated that dissociation, although trauma-related, is neglect-related as well (Draijer, Langeland 1999). In particular, maternal dysfunction was found to be related to
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