Trauma, Attachment, and Self-Care: What Everyone Should Know
November 12th, 2021 | 17 min read
Trauma. Once a word that solely referred to a physical wound, it is now far more popularly discussed with regards to psychological wounds. One can read dozens of books about trauma and find countless memes floating around discussing it, but there seems to be a lot of suspect advice out there. Even worse, it seems that trauma discourse is being used to reconceive our entire psychological, religious, social, and political milieus in a therapeutic manner—a manner which, of course, can then only be cared for by professionals. This is just the latest iteration in a process going back over a century which has used psychology to make sense of the modern world and (at best) aid religion in the care for the soul or (at worst) supplant religion’s care for individual souls entirely. There is a lot of discussion around trauma from churches and other Christians that, in conjunction with narratives around deconstructing one’s faith, threatens to accelerate the process of apostasy for many.
At this point, one could look at the process of medicalization that has consumed Western society (and much of the rest of the world) and the obsession with a therapeutic approach and decide to dig one’s heels in against it. From this perspective, talk of trauma and attachment is namby-pamby nonsense that creates diseases out of the usual slings and arrows of misfortune that we all experience and coddles people until they have become triggered pill-swallowers who weaponize their trauma to political ends. On the other hand, an uncritical embrace of the therapeutic language that is all the rage in the fields of counseling and psychiatry is tempting, albeit to an entirely different group of Christians. The discoveries and developments over the past few decades offer tremendous insights that are able to describe a number of important dynamics in the lives of people who suffer and may be able to help find a path out of that suffering.
As you might have guessed from the framing of this previous paragraph, I think there is a middle path that both sides could journey together in the middle. There is a great deal of wisdom to be found in contemporary psychological research that adds specificity to things that poets and philosophers have known for a long time, but there is also a danger to allowing trauma discourse — especially in its basest forms that most people will encounter — to set the terms of our discussions. This essay, in recapitulating what I think are the most important aspects of that wisdom, will be primarily for people who are unfamiliar with these contemporary insights. Along the way, I will add observations that will no doubt be offensive to those who think those insights are the greatest thing for Christianity since the bound codex, and I hope those readers will find this essay helpful in its challenges.
My basic theses are as follows:
- Our most intimate relationships shape our patterns of relating to others throughout our lives, so Christians must understand how attachments can be disordered and how memories are formed.
- Trauma is something that affects many people a little and a few people a lot, so Christians should understand how trauma can affect people in profound and frustrating ways.
- Dysfunctional, sinful, dangerous, or addictive patterns of living and relating are common responses to trauma or attachment disorders; it is very difficult to change these patterns if the underlying causes are not adequately addressed.
- Popular misunderstandings of self-care are dangerous, so Christians should embrace a set of practices that truly care for the self.
- The best defense against the real danger of over-professionalization and over-medicalization is the judicious use of professionals and medicine.
What is attachment and why does it matter?
The word “attachment” as used in contemporary psychological research more or less describes the process of how our most important relationships form (or malform) us. From the time that we are born, all human beings learn to experience the world through our caregivers. We are meant, in God’s pattern of families, to experience reliable care, intimate contact, and genuine love through relationships with our parents and other family members.
When this process happens as God intends it, we grow in trust and one’s conception of one’s self is secure. Our brains are constantly taking in what is happening around us, processing potential threats when they arise, storing memories as key events take place, and integrating our relationships with others into our self-understanding. Most of these key events take place with other people and our minds develop through shared experiences. Under ideal circumstances, children develop into adults through the power of secure, loving relationships and as adults we continue to maintain the complex systems of our mind through learning and ongoing relationships. This is attachment as it is meant to be: we construct meaning from our experiences and discern how new experiences fit into what we already know and understand.
However, when attachment is not secure, all sorts of unhealthy patterns can develop. One need only read in the book of Genesis to see what comes of families where love is earned rather than freely received, where the closest relationships lack trust, and where one has to protect oneself in order to be safe. The current model of attachment defines four different “attachment styles.” The first one is secure (as described above). The second is “anxious-ambivalent,” in which love and care were only intermittently given and thus a child who fears losing the love of another can grow up into an adult who is emotionally dependent on others. The third is “avoidant,” in which love and care were completely inaccessible in a meaningful way, leading to an aversion to all intimate relationships for lack of the interior knowledge of such relationships. The fourth is “disordered,” in which love and care alternated with intense fear or harm, leading to an all-over-the-place pattern of dealing with life — alternately withdrawn, needy, or explosively violent.
These descriptions are helpful to consider because people can learn patterns of relating to others that they repeat in childhood, adolescence, and adulthood. Because one’s own self-understanding as fundamentally loveable or unloveable is shaped by our most intimate relationships in our most formative years, we should recognize how ingrained such self-understandings can be. Whether it is a pastor counseling an adult, a volunteer working with youth, or a parent training up their child, it is critical to understand that one learns as a child how to love. This is entirely compatible with what Christians understand about habit and virtue: if we want to develop the habits of love that reflect who God created us to be, we must recognize that this is a process that can be disrupted and must be learned (or re-learned after un-learning bad habits) over time.
Learning involves memory. We must forget the conception of memory working like a library in which books are shelved or a computer calling up files in different directories; some memories are simply retrieved but for the most part memory is more like rapids in a river, a continuous readjustment of the processes of our mind in light of new stimuli. This, of course, also involves our self-understanding and our view of the world around us. As very young children, this meaning-making and memory-organizing is primarily a function of the right brain and its spatial-emotional processing, but as people grow older they incorporate their left brain and its logical, linguistic functions into their self-understanding and comprehension of the world. Our understanding of ourselves evolves to become more and more complex over time, integrating both implicit memory and explicit memory into a web of narratives that gives stability to our inner lives, structures our relationships with other people, and helps us to deal with new challenges as they arise. Memory, self-understanding, and relating to the world are all stories that we are constantly telling — and re-telling — ourselves.
It may be argued that spiritual attachment to God happens in a similar manner, but I do not think this is the case. God’s relationship to human beings is far more complex and infinite than that of a child to their caregiver, and because God has the freedom to relate to His children that no human parents ever can or should, we should not over-interpret these ideas theologically. As Karl Barth observed, we learn about fatherhood from God and not about God from fatherhood.
No one escapes adversity in their life, of course, and having secure attachment helps many people experience traumatizing events without permanent disruption. Community rituals, close relationships, and internal resources of resilience help people who experience severe loss or frightening events to integrate these traumas into their personal history and self-understanding. Those with strong relationships with others and a history of secure attachment often have a greater capacity to absorb stressors while maintaining the complex system of their minds and disadvantages than those without these relationships.
Throughout history, people all over the world have used all sorts of means to collectively deal with trauma: art and ritual chief among them. Part of the current obsession with trauma is undoubtedly our cultural abandonment of the social structures that facilitated healing from trauma and our technological power to eliminate suffering from many aspects of our lives. However, just because there have always been ways of dealing with trauma does not always mean that it was dealt with well. The Iliad and the story of Dinah from Genesis 33, for example, are among the earliest examples of trauma weaponized to political ends. Part of the task for the people of God in our time is to be a place where people who have no other way to deal with trauma can be safely cared for.
Part of why attachment and memory are critical for understanding trauma is the power that trauma has to disrupt the aforementioned ongoing processes of meaning-making, self-understanding, and relating to the world — especially when it happens in children. When acute threats arise, our lower brain systems designed by God to protect us from danger activate our sympathetic nervous system to engage in the “flight-fight-freeze” response that gears our bodies towards fleeing danger, fighting back, or freezing. Imagine if you saw a bear approach you in the woods. Your sympathetic nervous system would immediately fill your bloodstream with adrenaline and other stress hormones your body needs in order to either flee, fight back, or freeze. The lattermost option, which animals use by “playing dead” to deter predators, is most commonly used when flight or fight is not an option. In human beings, freezing often looks like disassociation — sometimes, for example, victims of rape or molestation will describe their trauma as though they were watching it from the ceiling.
These systems, designed to help us deal with crises and emergencies, override the more complex functions of our higher brain described above for the sake of immediate survival. This is often useful in the immediate context of danger, but intense, prolonged, or repeated trauma can make these short-term brain functions more dominant over the higher functions responsible for the ongoing organization of our mind as a complex system. Trauma can also link these lower sympathetic functions to specific stimuli (images, sounds, or smells) that trigger flashbacks with reactivation of the same sympathetic response and its attendant stress hormones. Perhaps the best popular book about trauma, The Body Keeps the Score, refers to this phenomenon: psychological and physical trauma is absorbed by our physical selves in ways that do not seem very rational to a Cartesian mind.
Trauma also does not have to involve physical danger or abuse; many studies have demonstrated that neglect of genuine physical and emotional needs can be just as devastating, especially when these are long-term. Betrayal and psychological abuse can also be traumatic. Think of a woman who comes home one day to see her husband being led out in handcuffs for possession of child pornography: She has suffered in just a few moments a devastating trauma that will likely take years to recover from. Or consider a pastor who is constantly undercut by a smooth-talking and power-hungry member of his elder board; years of having one’s words twisted and reputation sullied by a fellow Christian with power can inflict the same sort of damage. Having a parent who is addicted to alcohol or other substances is a well-recognized trauma.
When the complex neural circuitry required for the processes of memory and self-reflection is interrupted by trauma, it is possible for any of these systems to stop working as they ought. The resulting collapse in meaning can ripple through one’s entire life, impairing the complex system of the mind and its constant processes of perception, differentiation, and integration that make up our self-understanding. We are constantly “reading” the world around us and the people near us through all of our senses and constructing meaning based on what we observe; impairing the higher brain functions through trauma makes the construction of meaning more difficult, or, for some people, nearly impossible on their own.
Trauma can also disrupt the formation of memory, which is an extraordinarily controversial issue. Because disassociation and denial are such powerful recourses for victims who feel completely helpless before, during, or after a traumatic event, it is certainly possible for someone to forget a traumatic event or only remember bits and pieces. On the other hand, it is also possible to deceive oneself and others, and it is best to let the appropriate authorities who are trained in such matters decide whether or not a claim is fabricated.
As with an attachment disorder, the habits of mind caused by trauma, once formed, are rarely remedied with a little encouragement and some Biblical truth. Biblical truth can form the basis of one’s recovery, but other elements are crucial to healing from trauma: establishing safety, remembering & grieving, and restoring relationships. If someone has been profoundly affected by trauma, it will be very difficult for that person to live in a healthy way until they have been through these steps.
- Establishing Safety: A person who has been traumatized needs to feel safe before they can process their trauma. Very often, this means that they need to be able to trust that they won’t be rejected, dismissed, degraded, or avoided should they make themselves vulnerable to a spouse, pastor, counselor, or friend by telling their entire story. It can be easy to neglect this step because sometimes people who want to help think that “tough love” or “a stern dose of reality” is necessary, but “tough love” is rarely helpful in this manner. Oftentimes, accepting a person back with gentleness after they have done something self-destructive (not indefinitely) can communicate God’s patient love to them in a way that they have not experienced before.
- Remembering and Grieving: This is a stage where the person who has been traumatized processes what they have been through to the best of their ability. This usually does not happen all at once — often someone will tell bits and pieces of their story or process a little, wait to see if the person they’re processing with is trustworthy and accepting, and then proceed. It is not the responsibility of the person who is listening to determine the truth of what is being spoken, but rather to affirm the pain that the person who is speaking feels and encourage them to construct a narrative that will allow them to move on in the future.
- Restoring Relationships: In most cases, people who have been severely traumatized need help to restore normal, healthy ways of relating and living. Once they are not in a constant state of wariness or numbness, as is often the case, they can put much more effort into unlearning maladaptive behaviors and practicing habits that bring them joy, life, and connection. Someone may always bear the physical or psychological scars of trauma, but through the work of the Holy Spirit and the love of friends, anyone can and should be able to have joyful relationships with others..
Listening and coming alongside someone in their suffering are the primary roles of anyone trying to help someone who has been traumatized. This may not feel like much, but you might be surprised at how many people report that they have never had anyone willing to do just that. Our model here is Simon of Cyrene, who did for Christ in His greatest trauma what many of us are called to do for a season in the lives of others.
I want to emphasize that these are steps which do not require specialized or professional training, because if every severely traumatized person required professional help to get better, then millions of people would be condemned to suffer. Many people walk and have walked through these steps, perhaps unknowingly, with loving friends or Alcoholics Anonymous groups. However, the more profound the trauma and its effects, the more likely someone could benefit from seeing a professional who is experienced in helping those who suffer. When there is a mental illness involved that would benefit from medication (and many do, although some do not), a professional is also required.
While this problem is not nearly as prevalent, I would argue on the other hand that over-medicalizing common experiences and reading trauma into things that peers experienced as positive is, in general, harmful. All of us remember some things differently with the passage of time; sometimes you might even find something you wrote or recorded from years ago that you consider differently. In the context of church life, one can find many people who are deconstructing their faith looking back on earlier memories with a far different perspective than they had at the time. While I begrudge no one their perspective, we would all do well to keep in mind that whatever place you are in life will shape the way that you think about the past, and certain features may loom larger or feel smaller — perhaps in disproportionate ways.
At its best, “self-care” simply refers to the habits of mind, body, and spirit that allow us to live as God wants us to live. Our bodies are meant to move around, eat good food, and rest; our souls are meant to connect to God and to others in ways that bless us and them. Such habits are crucial for normal life, but all the more so for those who have been afflicted as previously described. Sleep, nutrition, recreation, intimacy, Sabbath — all of these things are God’s design for self-care.
Unfortunately, in our strange times, memes about trauma and self-care have become vehicles for conspicuous consumption and unhealthy indulgence. The “wine mom” trope is a perfect example: it suggests that taking care of oneself involves self-medication with a substance that is dangerous in excess. Endless social media scrolling, substances indulged to the point of intoxication, binge-watching, buying things you don’t need, or overeating are all bad things from the perspective of self-care. Yet because these things temporarily numb the feelings of sorrow, despair, anxiety, pain, powerlessness, or anger that we feel, there is a demonic lie that tells us that we deserve to use these things to feel good. (Of course, most or all of these things can be enjoyed in moderation, and there’s another demon whose job is to help you constantly redefine moderation.)
It should be no surprise, then, that addiction and other unhealthy behaviors are frequent features of the lives of those who have been traumatized. One of the most profound discoveries in health from the past several years is that of ACES (adverse childhood events), which found that children who experienced multiple childhood traumas were far more likely to engage in unhealthy behaviors as they grew older, increasing their risk of death and disability, but were also more likely to die from cardiovascular disease even if they didn’t engage in those behaviors. One of the first investigators of this effect was a doctor working in an obesity clinic who realized that every woman he worked with reported a history of sexual abuse. Some reported that the larger they got, the safer they felt because they received less predatory attention. Sometimes trauma kicks off self-perpetuating cycles of self-destructive behavior that hurt the victim over and over again in devastating ways.
These are perhaps the most difficult people to be and work with: they have been wounded by others, they wound themselves, and they are liable to wound others. The most obvious and distressed of these can be found in prisons and homeless shelters, where God’s people often can be found ministering His love (yet rarely enough of them). But there’s a spectrum: you almost certainly know someone who seems fine or even very successful from the outside yet self-medicates their pain with pornography, substances, gambling, Netflix, or some other addiction. Churches and ministries that forsake healthy boundaries and don’t ensure their workers practice true self-care are more or less environments designed to create the latter, so beware.
The care of addiction specifically is a subject all of its own that I have written about in greater detail elsewhere. I have since found the best one-sentence summary of addiction from Matthew Crawford: “Precisely because our brains are so plastic and formable, the grooves that we wear into them through repeated behavior may become deep enough that they function like walls.”
For now, it is important to note that unresolved attachment disorders or trauma often initiate or sustain addictions, thus addressing those issues in some manner is almost always a crucial part of addiction recovery. Furthermore, one has to believe that the walls we’ve worn into our minds can be climbed and broken down, but this always takes time and rarely does one climb up a wall without falling back down a few times.
I wrote the previous 3500 words because I want Christians to read them. I want Christians to read them because I want them to understand how ancient wisdom and contemporary science have a lot to say about attachment and trauma. I have already mentioned The Body Keeps the Score by Bessel van der Kulk; Serene Jones’ Trauma and Grace has an excellent chapter on Calvin and the Psalms that brings a rich theological perspective and Diane Langberg’s Suffering and the Heart of God is probably the best practical manual that expounds on what I’ve described above.
The world is full of traumatized people, inside and outside of the Church, and there are approaches inside and outside of the Church that make it worse. Simplistic insistences to trust God and “get over it” can be stumbling blocks to people, just as diagnosing yourself via memes and medicating yourself via Amazon can make things much worse. Sometimes professionals are helpful; in contexts where they are easily available I think that often they at least manage to provide a structure and a path for healing, if one is willing to walk down it. The goal of trauma healing is, ultimately, to be able to have joyful relationships with others and freedom from crippling or self-destructive habits, and a lot of different things will get different people to that goal. All of us need to take care of ourselves as God meant for us to and be people that others can rely on to be with them as they carry their burdens and heal their wounds.
Enjoy the article? Pay the writer.
Matthew Loftus teaches and practices Family Medicine in Baltimore and East Africa. His work has been featured in Christianity Today, Comment, & First Things and he is a regular contributor for Christ and Pop Culture. You can learn more about his work and writing at www.MatthewAndMaggie.org