1. Early experiences and current contexts together better predict psychopathology than either alone. While early experiences do not solely cause later problems, they play a special role in shaping subsequent experiences. 2. Foundations from early experiences add to current contexts in predicting issues, and troubled children with positive early foundations are more likely to recover than those without. Conversely, children with histories of anxious attachment who function well in childhood are more likely to have problems in adolescence or adulthood. 3. Memory is fallible and what actually happened may differ from perceptions; the perspective of the child is important to consider.

1. L. Alan Sroufe

2. Assessments of early experience and current contexts
together always predict psychopathology better
than either alone.
Early experience does not directly or solely cause later
problems, yet has a special role through framing
of subsequent experience.
Foundations add to current contexts in predicting
pathology and that troubled children having
positive early foundations are more likely to
recover than troubled children who do not. The
Obversely, children with histories of anxious
attachment who are functioning well in middle
childhood are more likely to have problems in
adolescence or adulthood than are other well-
functioning children.

3. We become who we see reflected in the
mirrors of our parents’ eyes…?
Developmental perspective
ED controversy - Temperament, genetic
predisposition vs. blaming mothers
Mike Rechtien, MA
Primary Therapist
Castlewood Treatment Center, St. Louis, MO

4. Something unusual:
• Sensory integration difficulties
• Emotional dysregulation
• Highly sensitive/reactive
• Excessive caretaking or
• Overly controlling

5. What actually happened?
Memory is fallible
Poisonous pedagogy (A. Miller) as
good parenting
The perspective of the child
We can predict attachment of unborn
child with 80% accuracy
Correlation of Strange Situation
behaviors with narratives of adults

6. Connection between CNSs
Mirror neurons
1 second delay
Intertwined
Mentalizing/Reflective Function –
Allen/Fonagy
Contingent Communication - Seigel
Safe Haven – Bowlby

7. 1. the ability to reflect on one's
internal emotional experience
2. make sense of it
and at the same time…
3. reflect on the mind of another
“Mentalizing” (Fonagy, 2001, 2002)

8. 1. Secure - high coherence, evidence for what
they say, succinct but complete, relevant to
the topic of conversation, clear and orderly
2. Dismissing – idealized, or derogatory about
attachment (avoidant)
3. Preoccupied – angrily, passively or fearfully
(ambivalent)
4. Unresolved in relation to loss or abuse
(disorganized)

9. Her interest was in the coherence of the narrative.
Rather than focusing on the individual’s story,
she looked at the structure of the story – what the
person allows themselves to know, feel, and
remember in telling the story. Breaks in the story,
disruptions, inconsistencies, contradictions,
lapses, irrelevancies, and shifts are important,
relevant and diagnostic, as they are
linguistic efforts to manage
that which is not regulated in experience or
memory.

10. Disorganized (U/d) adult subjects exhibited
performance issues on frontal lobe tasks,
especially working memory tasks.
Suggests that too much stress is placed on
working memory when a speaker attempts to
simultaneously recall and discuss a frightening
experience.
Anne Rifkin (2005)
U/d subjects are scored so due to lapses in the
monitoring of discourse or reason.

11. 1. Quality – truthfulness (internal
consistency)
2. Quantity – succinct but complete
3. Relation – relevant to the discourse
4. Manner – clear and orderly

12. Maybe ED is more about attachment than food.
Clients relationship with food is a lot like their
relationships with people.
In times of stress it substitutes for people.
Social Anxiety treatment doesn’t take.
Behavioral therapies don’t work in the long run.
What if the client’s relationship with food is a re-
enactment of early attachment disruptions with a
transitional object that can be controlled and is
always accessible?

13. The parent’s coherence of narrative
on the AAI
Shows capacity of the adult to make sense of
the mind of self and capacity to detect
child’s behavior and see implicated mind
(behind the behavior) and respond in a
timely and effective manner

15. Attachment relationships are defined
by emotional vulnerability
Child’s experience of parental behaviors:
Rejection – child goes to parent with tender
emotions and is turned away
Neglect – parent physically available but
emotionally unavailable
Involving/Role Reversal – child’s attachment
is used for the parent’s gain
Loving – an active dedication to the
development of the child as an individual

16. U/d – Disorganized in attachment, unresolved
concerning loss or trauma
E – Preoccupied in attachment
Ds – Dismissive of attachment
CC – Cannot Classify - Uses opposing (E and Ds)
attachment strategies
F- Secure (almost nonexistent)

17. AAIs of complex trauma clients look a lot like
AAIs of our “perfect family” clients.
Attachment trauma – small “t” trauma?
Disruption of attunement that contributes to
sensory integration issues
ED as a disorder of intimacy vs. a disorder of
eating
Study patterns of attachment and design
treatments accordingly

18.  Values attachment and regards attachment
experiences as influential
 Acknowledge need for others
 Freely explore thoughts and feelings
 Remember childhood events clearly
 At ease with their own imperfections
 Don’t idealize family or have involving anger
 And produce secure infants!!
J. Allen, 2001

19.  Infant not capable of emotion regulation
(i.e. need assistance from the caregiver)
 Early attachment development overlaps
with SIGNIFICANT neurological
development
 Research has shown a high correlation
between caregiver’s attachment strategy
and infant attachment strategy (80%)
 Attachment is central to the capacity to
regulate emotions

20.  When a caregiver reads the verbal and non-
verbal cues of the child and reflects them
back, the child sees him or herself through
their interaction with the attachment figure.
 It is through this attunement and
contingent communication process that the
seeds of the developing self are planted and
realized.
Fonagy (2001, 2002)

21.  “During infancy and childhood, working
models are thought to be somewhat flexible
and responsive to changes in the
environment.
 However, as the child grows older, working
models become established and the child is
more likely to assimilate new experiences
into the existing model.”
Leveridge, Stoltenberg, and Beeseley (2005)

22.  Thoroughly resolve Loss and Trauma - state
dependent memory work (IFS, EMDR,
Hypnotherapy), cognitive processing,
narrative work, expressive work
 Contextualizing attachment environment
and its importance – “T squared” Neglect,
Rejection, Involving Behavior, Role Reversal,
witnessing terrifying events
 Reduce Idealization to deal with self blame

23.  Reduce family enmeshment and expose
family secrets, legacy burdens
 Expose preoccupied anger seen through
projection and criticism
 Establishing a coherent narrative regarding
one’s life
 Self agency – action as opposed to reaction

24. L. Alan Sroufe