When a person experiences trauma, there’s one key factor that can play an important role in whether or not PTSD symptoms develop – and that’s secure attachment.
But what happens when someone has never had a connection to a secure attachment figure? How can we help our client build the feelings of safety that are so vital to healing from trauma?
In the video clip below, Pat Ogden, PhD and Ruth Lanius, MD, PhD highlight the importance of repairing attachment. Ruth also offers a useful strategy that can help clients rebuild secure attachment.
Take a look – it’s about 4 minutes.
For more on the neurobiology of attachment, please check out the Treating Trauma Master Series.
Now I’d like to hear from you. How will you use these ideas in your work with clients? Please leave a comment below.
When I worked in a women’s prison we offered comfort kits in our offices and classrooms. One day I stumbled on some rabbit furs in a store and noticed how much it soothed me to touch the fur ( as a child I was very attached to my kitty but have an allergic husband). I bought a number of fur pelts for use at the prison where there is no access to live animals and even human touch is limited. These items reportedly brought comfort to many prisoners during counselling sessions and in classrooms.
Does anybody have any idea, if PTSD can be healed over online sessions?
Of course it can. Using the computer, video call you can correspond with patient/client as easily as can be. I have found that it takes a few minutes to become comfortable with each other but once session begins it’s fine.
I read your article. It was an amazing sharing. Would you inform the full name of MDMA?
Thank you
In my first year of veterinary school, one of my favorite professors reminded us of the Human-Animal Bond. He reminded us that as we are caring for the pet, we have to remember that for some people the bond with their pet is the only experience they have of unconditional love. That for some people, love from other people is problematic and conditional. Yet as human beings, we NEED sources of unconditional love. And our pets can supply that. Therefore it was our duty as veterinarians to protect that bond to the best of our ability.
How helpful that the veterinary professors shared that wisdom with his students.
I have used adjunctive forms with some clients; art, music, drama. These can be used both in the therapy office or outside of the office. In addition, I had one client who only felt safe at the edge of the ocean so we had our therapy session there.
One of my patients was from the war-torn former Yugoslavia. He had no family in the States, and no other close relationships. I asked him to bring in photos of all his close family members. We set the pictures in a circle of chairs and did family therapy. It was very (positively) emotional, and very helpful.
Joel Block, Ph.D.
One of my clients is an only child, her mother was a single mother and she was an alchoholic, the mother killed herself and she had no one to rely on, she came to see me looking for help…..my objective was to help her feel safe and not alone……we worked for over a year and I am glad to tell you she is doing fine, she is married and have two children. We continue being in touch
Thank you for this video. I work with young ? children (4yrs and up) and many have already experienced a lack of secure attachments with many of those they love.
I provide a safe place for them to be for one hour, a schedule they can depend on weekly, A fun (therapeutic) play activity
Letting them be in control of our game (in healthy ways) as they are so out of control of so much of their lives , and I work on TF CBT and emotion identification.
If it is safe I work on the relationship w that parent and my client (divorce) , helping them understand each other.
Caregivers are afraid to let s child be in control , but it is healthy ( ie from what they wear to what they want to eat ….you can take out two outfits and let them make the final choice, etc.. so you are really in control but set it up like they are in control. Let them make the final choices.
When I use Play as my conduit to learning their stresses/trauma, I follow their lead.
Children experiencing trauma (divorce to abuse to loss of nuclear family/foster care) need a sense of empowerment. We as therapists can assist in this process..
Excellent pieces of information concerning working with clients with PTSD. Secure attachment through animals is really therapeutic. Thank you for all this valuable content!
Thanks for your good work! I agree, animals are wonderful to work with someone who does not have strong attachment to humans. Not only can you work with the persons Animal, but I work with a therapy dog partner, who is wonderful and intuitive. He knows when to come close, closer, and when to sit quietly by emanating care and love. Sometimes a client will just reach out and touch and the dog. Or sometimes just feel his care.
For those of us who have been severely manipulated by kindness, it could take years of connecting with a cat to see progress. What worked for me was MDMA-assisted psychotherapy.
Healing shouldn’t have to be so hard.
Cats do their own thing. No good for attachment healing. Although the purring is said to have a healing effect. Cats are good to prevent TIAs. Dogs give unconditional love, when treated right and not abused prior, being an adoptive dog. Preferably the pup at 8 weeks, preferably have a garden, do not walk the pup outside to meet other puppies, form a strong attachment with owner and other dogs already part of the tribe. But bear in mind to raise a pup, suffering the most severe attachment order can be too much for initially it is a lot of giving and the pup attaches to you as its mother. I now have a 6 months old, raised on a farm, not inside the house. Difficult to housetrain. My females i could put in nappies but a with a male those do not work. Got a good gentleman’s wrap and put human incontinence material inside. Cheap and working solution. I found it hard to get into my brain that him wanting to be near is him doting on me and does not come from neediness, having been Codependent with humans throughout my life.
I read your article. It was an amazing sharing. Would you inform the full name of MDMA?
Thank you
A few years ago we made our domestic violence shelter “pet-friendly”, enabling women to bring their pets into shelter with them. The positive effect this has had for the clients is clearly visible. As one staff put it “having her dog in her lap made it easier for [the client] to say hard things”. Their attachments to those around them they trusted may have been damaged, but if we nurture whatever connection they have been able to maintain with their pet, and use it, it seems to help them move beyond that damage.
I worked for ten years with poor, unwanted and homeless children and abandoned, neglected and abused horses. Both benefited as the children gained a sense of empathy, relationship and connection to the animals; disaffected children learned that they could have some sense of agency by helping out with and training the horses and the horses gained by being properly cared for finally. One severely epileptic 3 year old has never had another seizure since sitting on an old nag of a horse for 20 minutes. He is now 9. I think we seriously underestimate the power of a relationship with animals when it comes to attachment issues and trauma.
We have a dog that will come into the session with the clients permission. Lilly the dog is a great help with those very insecure attachment particularly with disorganised attachment. She seems to know how much contact the client needs and will often lie down at their feet for the whole session. I have some other stories of dogs assisting particularly in the family constellations work that I do. I would like to share those perhaps at another time. Thankyou for this reminder.
I connect to my clients with my horses and dogs for therapy
The post about pets and attachment has, I think, helped me to clarify what was only a foggy understanding before. I started being sexually abused when I was turning nine. We had pets at home, but I think the real attachment I had and that helped me a lot was to my little sister who was then about three. Sadly, I suspect my need of her may not have been good for her. We are friends 50 years later, but she keeps her distance.
We are a non-profit offering free support to anyone who doesn’t have a therapist, insurance or afford a life coach, etc. Free national conference calls for support, zoom events, free support groups in person. We have a call list of over 100 people that they can call 24/7 to get support. Having a community with community family holiday and everyday events has been a key element to accelerating their progress versus seeing a therapist once a week. Every day interaction with loving people practicing unconditional love…after about a year 90 percent of people’s lives change dramatically with all the Family type support and getting held at every event and every group. Sharon Winningham, Founder Loving-groups.org All volunteer community We are in 7 cities and virtual to all.
Sharon,
I would like more information on your programs you describe here – I was not able to find any of the free national services at the link above, but I certainly can see how beneficial (and much needed) this could be – Thank you!
As a childbirth educator, I have a client who used her newborn baby as a way of establishing attachment after a traumatic birth experience. It was soothing way for her to “work through the trauma” that they both had experienced together.
Hello.
I find that symptoms following trauma do not always present until some time later.
This could be weeks to years, as was the case with me.
As a practitioner I have seen clients with trauma that have manifested over time.
Rarely have I heard of symptoms appearing shortly after the event.
What is needed is stat intervention following any type of trauma, especially younger clients.
I find this highly interesting.
Keep it the good work.good food for thought.
Dr.Dave.
Yes, yes and yes…
Yes, to this theory . I agree that Loving attatchments are so very important. I deal with a girl/woman 71 years of age who has been through various traumatic experiences and never really had those loving attatchments to help her through them. Now at this age it is very difficult for her to trust anyone and change those old ways of thinking. Of course her situation is much more difficult because she is Autistic and mentally delayed on top of it. She has made some progress but each day is a new adventure in dealing with her thought life. I am at a loss sometimes as how to handle her. There are no pat answers and no easy fixes for her. Or me.
I work as a school social worker and often bring my three year old golden retriever dog into my office. Ruby has been coming since she was a puppy and she is a source of comfort and a transitional object enabling students to talk more openly and freely while brushing her, hugging her or even taking her for a walk or run with her in the woods and on the school grounds. Sometimes just throwing a tennis ball and letting the student release their pent up anger and/ or aggression is another role that Ruby helps students with.
Visualisations with kind eyes exercise have also helped a lot. I also Recommend messages, ask the client to develop deep contact with the self as a person while looking at the image in the mirror. Engaging with different parts that show up during this exercise and holding these parts without judgements.
We hold people in our laps with certified “holders” who hold them like a baby everyday so that they can begin to feel safe though having a lot of oxytocin in their body. Over time they can feel more social and begin to step out into our social events. Likened to reparenting slowly.
Where is the article about what the leading hospital is doing? Please email that article to me! Thanks! (love the series, btw!)
I have a very intuitive mare who helps people process what ever emotions they need to process. I will give the client a bucket of grooming tools so they can touch her with a purpose, and without fail they begin talking to her, crying and hugging her. She will tuck them into her chest with her head and hug them back. People who have been nonverbal, or severely affected have come out of sessions with her talking and smiling. She was a rescue from physical and emotional trauma herself. This is how she gives back.
Wow, this really touched me very deeply. What a wonderful soul to be with, so much healing power. Thank you for sharing, still wiping my eyes…
In the 20th century Hanscarl Leuner (Germany) developed the psychodynamic method of Guided Affective Imagery. Today it is known as Kathathym Imaginative Psychotherapy (KIP). It delivers a stepped approach of the trauma, starting with the imagination of a save and protected place, where someone is able to find himself well. Helpers can also be imagined. In succession of several sessions the pt will be asked to imagine the different aspects belonging to the traumatic event, i.e. affect, the subjective representations and in the end the event itself.
It is a very soft method because every aspect is encrypted in imagery as much as the psyche of the pt needs it .
I use active imagery In chronic as well as in acute situation of trauma. The method is very well developed in areas where people speak the German language. I am a retired psychiatrist living in Holland, but still teaching and supervising this approach at the Stichting Symbooldrama (shortly changed in the Association of KIP).
Thanks for the Treating Trauma Master Series!
Piet
GI is a well-researched treatment for PTSD in US as well. Bellaruth Naprastek has written about why and how it works. She also has created many scripts, recorded them and made available online.
I’ve worked with trauma for 40 years and now teach assessment and holistic treatment of it.
GI is effective, available and inexpensive. All traumatized individuals can do it and benefit as it’s a right brain approach, what is indicated.
I have at times brought my dog into therapy sessions. Once when I was working with a woman rigid with grief my dog slowly walked over to her and licked her leg. The tears then began to freely flow. A better intervention than I could give.
“You can find out what the’re doing and why “ is what you say pertaining to a major leading hospital. So I “click here” as told, and get NOTHING about it. It’s so misleading and not the first time your site has done this. Please change and give more of the information you lead people to expect. Thank you
I have worked asking clients to see (image) their inner child, whatever age arises naturally in their imaging. Then I ask them to “see” the specifics of the child, how their hair is worn, how they are dressed in their image. Them I move deeper and ask them if they can ‘see’ the child’s face…and then what does that child need right now in the present moment. If they can see the child and what they need, I ask the clt to say a few sentences to the child: 1.) I love giving you attention. 2.) I love listening to you.
This is usually a powerful exercise for the adult, bringing tears, tenderness and emotional attachment towards the child. It’s a way of forming an ‘attachment’ with one’s own self and reparenting an inner child. I want to credit Keith Mar and Kathleen Baggarly MFT’s in Santa BArbara Ca who I first learned a version of this technique from. Very powerful.
Unless…your family is judgemental, critical, and will use this opportunity to say: “I told you so.”
It is amazing. The same as my opinion. They (animals) are beautiful people. They love their owners whatever they are
Thankyou for reminding us of the safe connection to animals. I lost my cat who I had for 9 years. As a therapist, this cat was my co-therapist and often my clients bonded with the cat when they weren’t feeling safe. The cat seemed to “know” when to physically get close to the client and when to keep a distance. When the cat passed, my clients expressed grief over his absence in our sessions.
I also went through my own epiphany when he died. I realized how strong our bond was and realized that he was the first being I felt mutual unconditional love with for such a long period of time!! When I was healing from a major loss, his fur was all I could meditate on as anything else was too acute and too painful.
I still visualize him and imagine his smell or the feel of his fur when I am feeling vulnerable.
What a beautiful story, Mara.
What if the victim has an attachment but rejects care from the caregiver. My experience is that it is a very long healing process, very challenging and takes a great deal of patience from the family. Never give up is the lesson.
Horses are other animals who are extremely sensitive and valuable partners for working with trauma to develop attachment and security.
Thank you once again for your continued educational support. Love the idea if using animals to facilitate an emotional attachment. Animals are a huge part of healing from trauma.
Thank you for all your educational and training efforts. I am benefitting daily as are my clients! Thank you!
We’ve used animals with sexually abused people and war victims. We have two dogs and consider them to be assistant therapists in that sense.
What do you do for someone who has adverse reactions to animals? In other words, an individual who is not particularly interested in animals or has no desire in pets whatsoever.
Using an animal as a way for someone to feel closeness is great idea for those who do not have a secure attachment
I want to be worked up at the VA for Vietnam PTSD but they are so dam complicated i am repulsed by their bureaucracy.i wish there were a professional,private one,who specializes in this sort of thing even paid to help a vet navigate the system to get that work up?
my army buddy from the same company i was in the same dates ,has got good treatment from a Calif VA included in this is both of us having exposure exposure to agent orange hes has clinical,physical very definable illnesses and I have had psychiatric problems years after i was discharged.
There may be mind-body psychotherapists (not sure what the correct term is) in your area. Years ago when I started working through my body to heal from PTSD I had a really hard time finding a way to do it. However, I Googled yesterday and was surprised to find that there are now many people who do mental health treatment through the body. I suggest you Google for your area. Good luck.
Raymond, I am not a veteran but I had to deal with extreme PTSD symptoms because of violent abuse. I have benefited from a therapy called Emotional Freedom Technique (EFT). A friend of mine who is a veteran of Vietnam recommended EFT to me highly. He told me about “Vets Stress Project” which is totally free to veterans and has reports of great success helping vets. You can get all the info at “stressproject.org”. There is also a newsletter to sign up for at the site and a phone number to get immediate help. I thank you so much for serving our country, Raymond. I wish you success and peace.
For an entire year I rocked one of my clients. She found it almost impossible to talk about her early childhood. We did a lot of Hakomi work around the difficulty of verbalizing, without going into the details of her experiences. At some point I asked her if she would like to do some bodywork and she lit up – as I observed her body on the table, rocking came to mind. I asked her if she would like that and to my surprise she said yes. So for a year, she would come in, we would gently touch on whatever she brought and then for about 45 minutes I would rock her, starting with her feet and gradually going up the body, gently rocking her from side to side. I was astounded by the difference this made. She opened up, asked for hugs, was able to talk far more about her childhood. We processed quite a bit before she felt she was ready to try things without therapy.
I have worked for 16 yrs with a client with poor attachment and she bonded very strongly to her cat. However, the cat passed away in August and my client is really struggling – to function, to keep getting swept away from grief. This cat was the only love she’s ever felt and now she is alone. It’s very challenging, but she is still here and comes weekly and very gradually can begin to share, but managing the cutting and “I have no reason to be on the planet” is challenging to say the least. I rely on the strength of our long term therapeutic alliance….
I work on many levels such as energy sending the person positive energy and letting him/her know that I will be there no matter what. I know first hand about this from coming into the world where my parents had try to abort me. I developed an attachment with my dad but he was mostly working away and made myself sick to get attention from my mother. I have overcome these issues through getting help and training. I am grateful for more learning, thank you
Dealing with children who feared dogs, I was helped by my then Rhodesian Ridgeback pet dog. This dog was traumatised and made fearful of humans and was a great example to my fearful clients. A lesson to show them how to make friends with my dog (who was so fearful of them), allowed further talk about how we could ascertain if a dog was friendly or not and how to deal with dogs in any situation. Animals are a great way to both give and receive love. Some great work has been done with some prison inmates in this regard, also in nursing homes.
I am registered in the Master Series, but the example with the animal as a way for secure attachment was very meaningful. I am proposing a presentation to veterinarians about Vicarious Trauma and prevention. As professionals they are exposed to trauma of having to euthanize their patients, and the grief of the owners and themselves. Do you know of some specific examples to do with vets? My concentration as an Art Therapist is on educating about trauma and prevention with the use of my resilience puzzle technique which I developed, including mindfulness practices.
Would appreciate any suggestions.
My daughter is a vet and she has her own pets and a husband and baby of course who she sees and connects with daily. I see how this can help but the day in and day out of having to euthanize and having pet owner who don’t care about their animals is difficult.
What is your resilience puzzle technique?
I have treated adult survivirs of sexual assault as children in small support groups.(5 or 6 people.)As trust developed , which for some took quite a while, we began to see sharing and healing.
Not sure this counts in this particular discussion since these people already suffered from PTSD in some cases.
I think it’s a great example, Gale. As a survivor of CSA it took a long time to find out there are many, many of us and therefore we are not alone. Thought we were alone, but now know better. I tend to trust fellow survivors as soon as they ‘come out.’ We understand something that is hard for others to deal with or ‘get.’ Thank you for working w small groups and posting.
Growing up with an unpredictable and harsh caregiver has made me cautious in developing close relationships. I have thrown myself completely into intimate relationships only to find they are unsustainable. I believe that restoring a sense of self compassion and trust is the best road for me to travel. I am learning to give myself what I never got. It is a long, slow process.
Thank you for offering your videos on this subject with such incredible expertise.
I have been a Clinical Counsellor for 5 years and have found that helping to restore client’s sense of self compassion is heightened greatly by fostering/cultivating connections with a pet. As a way of learning to/familiarizing oneself with loving/caring for another living being, traumatized clients can, over time, learn to/permit themselves to offer the same sort of care/warmth/support to themselves.
Barriers and obstacles to doing so are to be expected: that makes sense, as they have long had to form protective armour when in the presence of supposedly caring others. Bonding/connecting with a warm/fuzzy/accepting friend can activate self compassion centres in the brain/release oxytocin.
In short, learning to be compassionate toward another being can show the client that not only is this kind of love/support/care possible, they can (safely) offer it to themselves, too.
Recently I had to take over the care of my mother’s eight year old cat after Mum had a stroke. The cat very soon after, decided to sneak into my therapy room. My clients did not mind and I began to notice that people who were very anxious, seemed to attract the cat and he would rub himself against their legs first of all, and they responded. Then he would jump up on the couch and let them stroke him. It is wonderful to observe them relaxing, absentmindedly stroking him as they open up. It has been an interesting and delightful experience having him as a “regular” now in the therapy room. It is also interesting to note that he knows when to stay away from some clients preferring instead to sleep on a nearby chair.
I have an empathy cat. If I’m watching, say, Call the Midwife, he can sense me crying from across the apartment and will come give me a hug.
I think guided imagery is a really powerful resource, allowing the client to visualise what feels good and safe to them.
TREES! And all of the non-animal world (the primary caregiver of every one of us). This of course has reciprocal benefits.
Yes, I second this. Staring off into the undulating valleys and ridges of trees in the hills or mountains, can cultivate a sense of open-spaciousness. It is restoring to accept the simply beauty of nature in its pristine presence. Human nature, in all of its flora and fauna, should be easier to accept securely with the former stabilization in view.
I agree with using the natural world for emotional healing also. Have taught many people to place a hand on a tree trunk, and notice how at first they might feel the pulse of their heart beat. After only a few moments, they can feel the pulse change to a wave coming to them from the tree. Laying on the grass, also has a vibrational frequency that calms the mind somehow