A Brief Detour (pt 4/6)

On this journey to understand and heal Romantic Relationship Addiction - RRA/ Love Addiction -LA, the roles of trauma and early attachment have been a major focus. It’s true that these factors influence romantic relationships in adulthood. In many, if not most, cases, our earliest primary caregivers inform the trajectory of our lives.  Attachment Theory is one of many tools to help us understand the origins of our relational patterns.

Aaannnnd like any other “theory”, Attachment Theory has its limitations.  Pop culture “Attachment Style” quizzes don’t offer adequate insight or the nuance required to encompass a lifetime of unique and dynamic relationships.

People are complicated and exist in a kaleidoscope of context. Culture, economics, family composition, race, gender, ability, etc., are just a few of the factors that impact someone’s reality.

Practitioners who fully ascribe to Attachment Theory usually consider it “universal”.  In my opinion and experience, Attachment Theory is far more narrow. The theory assumes a Westernized, patriarchal, 20th- and 21st-century context as the norm.

This excludes a variety of cultural approaches to raising children and connecting with the community. In Japan, children are often raised to prioritize early self-sufficiency and community cohesion.  In the US, allowing children certain levels of autonomy can be considered neglectful. What constitutes a “normal childhood and healthy development” can have different and meaningful interpretations.  (Rothbaum et al., 2000)

Attachment Theory, like other common mental health theories and models, has a tendency to pathologize trauma responses. A growing body of mental health professionals is rightfully questioning whether the existing mental health medical model does more harm than good.  Dr. Jessica Taylor and Jaimi Shriver’s new book, Indicative Trauma Impact Model: A non-diagnostic, trauma-informed guide to emotions, thoughts, and behavior, offers expansive (and user-friendly) insight into the limitations of common mental health diagnostics and treatments.

The text lays out the growing number of mental health disorders in the DSM (Diagnostic and Statistical Manual) with each subsequent version.  The original DSM (1952) had 128 while the DSM-5 (2013) has 541 mental disorders. (Taylor & Shrive, 2023 p 20). Taylor and Shiver go on to assert that Biological/ Medical, Cognitive Behavioral, and Social Models (as well as the integrative Biopsychosocial model) all fall short in identifying trauma as the overarching cause of individuals’ mental and emotional responses. Trauma Informed Theory goes along way to alleviate the victim blaming and all too common misogyny that precedes some mental health diagnosis. 

***It’s important to note that Dr. Taylor and Ms. Shiver are based in the UK, which has a nationalized health care system. The US and UK have differing health standards, approaches to, and funding for care.  Ex: In the US, you must (in almost all circumstances) have a mental health diagnosis for insurance to cover and or reimburse for mental health treatment.  A formal diagnosis is not required if an individual pays for therapy as private pay.*** 

I share all of the former to transparently express: All of this “ish” is theoretical. I have tremendous respect for my colleagues, professors, and the true pioneers in mental health and social services. As a society, we have and continue to make strides in understanding the importance of mental health.

And at the same time, we simply don’t know what we don’t know.  Nor do we know what we may have already lost. Are there new languages, tools, and approaches for supporting emotional and mental well-being since the days of our parents and grandparents? Yes, more than likely. But it requires considerable hubris to posit we’ve reached the pinnacle of humanity’s understanding of and approach to mental health.

As a Black Woman and descendant of enslaved Africans in America, I often wonder about the mental, spiritual, and emotional well-being of my pre-colonial ancestors. I often imagine they flourished. I’m ever curious about their deep connection to nature and harmonious wisdom. Did these foster thriving connections and relationships with relative ease?  Maybe when community was valued over the great and mighty capitalism, maybe mental health as a stand-alone construct, wasn’t a necessary … but I digress.  

Am I noting the theoretical limitations of the field of mental health to dissuade individuals from seeking care and support?  Quite the opposite.  My aim is to help people cultivate a more expansive and liberating understanding of mental, emotional, and physical wellness. As we continue to learn and grow, it’s imperative to be honest about what we may be outgrowing. We also need to be circumspect about the role and intention of those who have the power to “define” what “normal”, “ evidence-based, “appropriate,” and “healthy”  entail. Narrow definitions of such terms have a history of harming the most vulnerable and marginalized.

A given theory, diagnosis, or cluster of common symptoms should only be used as an adaptable tool. These tools need to support the most appropriate care and facilitate healing. Mental health theories work best when used in pursuit of catching up with the amazing human mind and its potential. Our innate ability to heal and the beautiful neuroplasticity of our brains allow us to create new paths for rewarding and reciprocal connections with ourselves and others.

Rothbaum, F., Weisz , J., Pott, M., Miyake, K., & Morelli, G. (2000, October). Attachment and Culture: Security in the United States and Japan. Harvard.edu. https://weiszlab.fas.harvard.edu/files/jweisz/files/rothbaum_et_al_2000_j_ch_fam_studies.pdf

Taylor, J., & Shrive, J. (2023). Indicative trauma impact manual: Itim for professionals: A non-diagnostic, trauma-informed guide to emotion, thought, and behaviour. VictimFocus.