Understanding Maltreating Mothers: A Synthesis of Relational Trauma, Attachment Disorganization, Structural Dissociation of the Personality, and Experiential Avoidance

Abstract

Treatment options are limited for families in which the child has severe and intractable disturbances of emotion and behavior, in which there is suspected or confirmed maltreatment by the mother, and in which the mother has her own history of childhood neglect and abuse. This paper proposes a model for understanding maltreatment in mother–child dyads, drawing upon the developmental psychopathology, behavior, and trauma literatures. At the core of this model is the hypothesis that a mother's maltreating behavior arises from unconscious attempts to experientially avoid the reemergence of an attachment-related dissociative part of the personality that contains the distress arising from her own early experiences of attachment relationships. The implications of this model for therapy are considered.

Keywords:

• relational trauma
• attachment disorganization
• experiential avoidance
• exposure
• response prevention
• interpersonal trauma
• structural dissociation

Acknowledgments

The authors would like to thank Mrs. Heather Chambers and Mrs. Ann Kasprzak for their inspirational clinical work that drives them to learn more about this population and the three anonymous reviewers for their generous and insightful comments.