Intergenerational Processes, Attachment and Unexplained Medical Symptoms

Abstract

Children organise self-protectively in response to anxiety-provoking or dangerous parental behaviours. When children's self-protective responses are extreme and persist over time, they may come to the attention of health professionals in the guise of emotional, behavioural or somatic symptoms. A parallel phenomenon is that harmful parental behaviours may be embedded in the emotional processes of the intergenerational family unit, reflecting the parents' own experiences of comfort and danger, as well as the particular manner in which these experiences have been integrated into the parents' current functioning. Using a case study of a three-year-old girl with medically unexplained urinary retention, the article explores how information about attachment relationships and unresolved parental loss or trauma can inform our understanding of implicit, anxiety-driven processes within the family, and to facilitate family interventions and symptom alleviation. The case shows that the Dynamic-Maturational Model of attachment has significant applications in the areas of family therapy theory and practice, psychosomatic medicine and consult-liaison psychiatry.