Corrective Attachment Environment

Can this ontogenetic process be recreated over the course of a psychotherapeutic relationship? … The treatment of early right hemispheric attachment pathology involves the socioaffective experience-dependent development in the patient of an internalized image of the therapist that counters the one generated in interactions with an early ‘psychotoxic’ mother.

Schore argues that the therapeutic relationship can neurobiologically re-enact early attachment formation, providing a corrective internalized object that repairs right-hemispheric structural deficits originating in traumagenic caregiving.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994thesis

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If we are inherently weak or severely damaged by trauma then we must rely on therapists to be our good attachment figures. The relationship with the therapist is supposed to help us dev[elop]… This myth of environmental dependency dominates our learning theories and our educational system, underestimates clients, pulls for unnecessary dependence, and overburdens therapists.

Schwartz critically interrogates the corrective reparenting model, contending that its premise of environmental dependency systematically underestimates client resources and distorts the therapeutic frame.

Schwartz, Richard C, Internal Family Systems Therapy, 1995thesis

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Understanding how self-regulatory capacities are formed through early attachment relationships is helpful to therapists, who also provide a similar relational context in which dysreg[ulation is addressed].

Ogden frames the therapy relationship as a structural analogue to the original attachment dyad, providing a relational context that can restore self-regulatory capacities disrupted by early traumagenic environments.

Ogden, Pat, Trauma and the Body: A Sensorimotor Approach to Psychotherapy, 2006thesis

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The name given to this state of affairs is deprivation. This is the point of origin of the antisocial tendency, and here begins that which takes hold of the child whenever he or she feels hopeful, and compels activity that is antisocial until someone acknowledges and attempts to correct the failure of the environment.

Winnicott identifies environmental failure—specifically deprivation following sufficient provision—as the clinical origin demanding corrective environmental response, laying the conceptual groundwork for what later becomes the corrective attachment environment.

Winnicott, Donald, The Maturational Processes and the Facilitating Environment, 1965thesis

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While the therapist’s Self may need to be a primary attachment figure for the clients’ parts for a while, this is only until the client’s parts are willing to let the client’s Self take the lead.

Schwartz concedes a provisional role for the therapist as attachment figure while insisting this is a transitional, not constitutive, function—limiting the corrective environment’s scope to a scaffold toward internal self-leadership.

Schwartz, Richard C, Internal Family Systems Therapy, 1995supporting

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The therapy alliance was deepened and strengthened… the therapeutic alliance takes on added significance with addicts and alcoholics since many of them enter treatm[ent with severe attachment deficits].

Flores demonstrates through clinical narrative how the therapeutic alliance functions as a corrective attachment environment for addicted populations whose developmental histories are marked by relational failure.

Flores, Philip J., Addiction as an Attachment Disorder, 2004supporting

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Is it the secure base of this relationship and the ‘new beginning’ which provide the main vehicle of cure, or are interpretations and the insight they produce the crucial factors?

Holmes situates the corrective attachment environment debate within the classic psychoanalytic tension between relational provision and insight, asking whether the secure therapeutic base is itself curative.

Bowlby, John, John Bowlby and Attachment Theory (Makers of Modern, 2014supporting

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The treatment of impaired right brain affect regulation calls for a greater focus on the powerful nonverbal influences on the communications of primitive affects in the psychotherapeutic relationship.

Schore specifies that the corrective attachment environment must operate primarily through nonverbal, right-hemisphere-to-right-hemisphere channels, mirroring the pre-symbolic register of original attachment transactions.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994supporting

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Traumatogenic environments that produce disorganized-disoriented attachment behaviors in children typically include both neglect and abuse… inadequate stimulation, insufficient mirroring, and a lack of responsiveness by the caregiver accompany neglect.

Ogden delineates the specific relational failures—neglect, mis-attunement, absence of mirroring—that a corrective attachment environment must remediate in traumatized clients.

Ogden, Pat, Trauma and the Body: A Sensorimotor Approach to Psychotherapy, 2006supporting

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When the attachment figure is also a threat to the child, two systems with conflicting goals are activated simultaneously or sequentially: the attachment system, whose goal is to seek proximity, and the defense systems, whose goal is to protect.

Ogden articulates the disorganized attachment dilemma that corrective therapeutic environments must resolve: restoring the attachment system’s function when prior attachment figures were simultaneously threatening.

Ogden, Pat, Sensorimotor Psychotherapy Interventions for Trauma and, 2015supporting

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A person’s current relationships — the support available from family, friends, and neighbours — are also important as a source of buffering against the impact of stress.

Holmes extends the corrective environment concept beyond the consulting room, positioning current social relationships as ongoing corrective attachment provisions that modify psychiatric vulnerability.

Bowlby, John, John Bowlby and Attachment Theory (Makers of Modern, 2014supporting

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Greenspan refers to growth-promoting and growth-inhibiting environments influencing the ontogeny of homeostatic self-regulatory and attachment systems.

Schore, drawing on Greenspan, establishes the developmental logic undergirding corrective attachment environments: early environmental quality directly shapes the ontogeny of regulatory and attachment systems, implying therapeutic environments can reinitiate arrested growth.

Schore, Allan N., Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994supporting

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If she knows she must be away too long she will have to change from a mother into a therapist in order to turn the child back into a state in which he takes the mother for granted again.

Winnicott’s formulation, cited by Holmes, prefigures the corrective attachment idea by describing the mother adopting a quasi-therapeutic function to repair the sequelae of unavoidable separation.

Bowlby, John, John Bowlby and Attachment Theory (Makers of Modern, 2014aside

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Deprived of the capacity for symbolic representation of their unhappiness, and therefore the opportunity for emotional processing or transcendence, the traumatised child resorts to projective identification in which the intolerable feelings of excitation and pain are ‘evacuated’ into those to whom he or she is attached.

Holmes describes the projective dynamics that corrective attachment environments must contain, identifying how unmirrored trauma is evacuated into attachment figures including the therapist.

Bowlby, John, John Bowlby and Attachment Theory (Makers of Modern, 2014aside

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