Sanctuary for Attachment-Broken People

Trauma-informed care has become of interest across the nation. The interest emerged from an increased understanding of trauma’s effects on individual health and wellbeing, including the first massive study of adverse childhood experiences (ACES) among a California sample of white, middle-class elderly patients. The higher one’s scores on ACES measures, the worse one’s health outcomes in adulthood (Felitti & Anda, 2005).

Dr. Sandra Bloom has been a leader in trauma-informed healing. She situates human development in secure attachment, calling it an “operating system for human beings” (Bloom, 2014, p. 58). But when trauma or other forms of toxic stress take place in childhood, it’s like a computer virus in the development of the child’s psychobiology. The child’s development gets thwarted or twisted in such a way that it requires intervention healing—or else the individual’s trajectory for the future carries and spreads the virus on to others and to subsequent generations. Bloom identifies the virus as violence.

Noting that many of the providers in helping cultures (e.g., social workers, therapists, nurses, and their assistants) themselves experienced childhood toxic stress, Bloom developed an attachment-based, trauma-informed approach to organizational culture.

She spells out how secure attachment fosters multiple capacities vital for living a good life: feelings of safety and security, emotional management, developmentally appropriate learning, reciprocal (serve and return) communication, participation in relational networks, fair play (reciprocity and justice), and capacities to deal with change and loss.

What happens when secure attachment does not take place, when attachment is disrupted?

Bloom writes:

“When the child has a less than optimal attachment experience as a result of exposure to trauma, adversity, neglect, and other conditions of toxic stress, the damage to the normal development of body, brain, mind, and soul can be extensive, but may have differential effects across different kinds of abilities, at different ages, in different people, even those within the same families. The people who come into any kind of caregiving setting, therefore, are likely not to have simple problems but instead have very complex, interrelated problems that are often related to inadequate integration of complex brain functions.” (Bloom, 2014, p. 64)

Here are some of those potential problems:

• Lack of safety and trust, and chronic hyperarousal (threat reactivity)
• Lack of emotional management (and susceptibility to pathological adaptions for self-control)
• Learning problems (in every aspect of development)
• Alexithymia—failure to communicate emotions (and tendency to act out emotions instead)
• Abusive power relationships (victim and/or bully)
• Injustice and narcissism (leading, e.g., to a preoccupation with vengeance)
• Failure to grieve and resistance to change
• Inability to imagine a different future

There are many adults who will have one or more of the challenges listed above. If workplaces do not help address the trauma, they may be susceptible to similar challenges:

• Chronic stress and ongoing lack of safety and trust, fostering greater reactivity among workers
• Poor emotional management among workers leading to escalation of conflicts
• Organizational learning disabilities, dissociation and amnesia, leading to, for example, short-sighted decision making
• Organizational miscommunication, conflict and alexithymia, leading to chronic unsolved issues and conflict
• Authoritarianism, learned helplessness, and silenced dissent, leading to compounded errors

Bloom proposes creating a sanctuary with the Sanctuary Model.

“Creating Sanctuary” means sharing “the experience of creating and maintaining physical, psychological, social, and moral safety within a social environment” (Bloom, 2014, p. 73). This requires (1) a shared knowledge base about trauma and human development, (2) shared values, (3) shared language, and (4) shared practice—the four pillars of the Sanctuary Model.

Shared values include the following commitments:

• Nonviolence
• Emotional intelligence
• Commitment to social learning
• Open communication
• Democracy
• Social responsibility (concern for the common good)

Shared language and share practice are encompassed by S.E.L.F., a “nonlinear, cognitive-behavioral, psychoeducational approach for facilitating movement through the Sanctuary Commitments—regardless of whether we are talking about individual client, family, or staff problems, or whole organizational dilemmas.” (p. 78)

S is for safety—physical, psychological, social, and moral.

E is for emotional management.

L is for loss, recognizing that all change involves loss and that working through loss is a process.

F is for future—envisioning a better one.

It takes several years to integrate the approach in an organization. Organizations can get trained in the Sanctuary Model and must be certified to use the name. There are books about the approach listed below.

Attachment Essential Reads

"Baby Reindeer" and the Psychology of Attachment

Swinging With Attachment Styles

Many of Bloom's insights can be applied in our individual and family lives and hopefully help us move toward eradicating the violence virus among us.

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