Gender, Attachment and Trauma

By Megbarker @megbarkerpsych

Today I was stoked to be asked to be part of an online conference at The Bowlby Centre therapist training institute. The event focused on gender, hence inviting me to speak. My conversation with Jane Czyzselska kicked off the day with the aim of providing attendees with a bit of a gender 101, prior to more in depth conversations around gender and attachment through the rest of the day.

Initially I had some reticence around my involvement because, while I know plenty about gender, I'm no expert on attachment theory, which is the therapeutic approach that The Bowlby Centre focuses on. I learnt about it back in my psychology degree and taught the basics of it as a psych lecturer, but never went much further than that. My own psychotherapy training was existential, so I drew on other theories for understanding how people tick.

While I'm always happy to do gender 101, having written Gender: A Graphic Guide with that aim, I felt like I wanted to do more than that here: to find some ways to weave gender and attachment together. While all therapists need to be mindful of gender diversity, aware of their own gender, and practice affirmatively, I wanted to explore what attachment therapists, in particular, might gain from exploring gender in depth.

Attachment

Fortunately, in the weeks leading up to the event I realised that I have actually been engaging deeply with attachment understandings over the past couple of years, just without always naming it as such. During my deep dive into trauma many of the authors I've been reading have been informed by attachment theory, in addition to more recent understandings of trauma. In fact it could be argued that John Bowlby was one of the first theorists and practitioners to highlight what we now call developmental trauma which is when - for whatever reason - parents are unable to regulate their children's emotions and to help them get to the point of being able to self-regulate.

My most recent trauma read - Nurturing Resilence by Kathy Kain and Stephen Terrell - sets out the somatic experiencing approach to working with trauma. This, along with sensorimotor psychotherapy, is one of the main embodied trauma approaches, and it is grounded in the attachment theory of John Bowlby and Mary Ainsworth. So I now have a greater appreciation for how what I've been working with is, in fact, all about attachment.

One way of understanding the plural work that I've been doing throughout lockdown is as a journey towards what's called ' earned secure attachment'. This is the sense that if we did not have secure attachment - and the eventual capacity to emotionally regulate - as kids, we can develop this as adults. It relates to Pete Walker - and others' - idea that we can reparent ourselves, and be reparented by committee (therapists, groups, and/or friends with whom we practice securely attached relationships and coregulation of emotions).

The rest of this post will begin with a brief overview of attachment theory, in case you aren't familiar with it, explaining why it's useful to explore it alongside gender (and sexuality, and relationship style). I'll then include my answers to the questions which Jane and I explored in our conversation at the conference.


What does attachment theory say?

I was fascinated to read in Kathy and Stephen's book that Bowlby was spurred into his work by his own experiences as a kid. He was mostly cared for by a nanny when he was a child, and she left when he was four years old, which devastated him. He was then sent to boarding school when he was seven, which he grew to believe were detrimental for children's well-being: something born out by much subsequent research and therapeutic work on boarding school syndrome.

It was useful to read that, right from the start, links were made between attachment style and the wider cultural norms around how kids were treated. Bowlby also worked closely with boys who'd been arrested for criminal behaviour. I'd previously assumed attachment theory to be quite an individualistic approach: locating our struggles purely in early childhood experience.

This linked, for me, to Gabor Maté 's more recent work on trauma. Maté argues that current cultural norms of child-rearing result in the high levels of developmental trauma and troubled attachment that we see, and that we should be addressing these at a structural and systemic level, not just the level of individuals or families. He suggests that the pressures on parents in the culturally normative forms of nuclear families, under neoliberal capitalism and economic crisis, mean that most are simply unable to provide secure attachment and the kind of emotional regulation that their children need.

Parents need far more practical and emotional support themselves in order to raise kids in ways that meet their emotional and relational needs. However, our culture has moved far away from models of extended families and sustainable communities of care which might provide this. One consequence of the current system is that many kids end up looking to peers (and, perhaps later, partners) to meet unmet early attachment needs, who are ill-equipped to do so, and often act in retraumatising ways.

Attachment theory argues that children need a safe haven with their caregiver/s: a caring, protective space they can return to to be soothed when they are stressed. They need a secure base: a stable attachment relationship with one consistently available caregiver which provides a template for their later relationships in life. Over time the child becomes more and more able to move away from this secure base. It is the knowledge that they can move away and come back that means that they gradually develop the capacity to be more independent and look after themselves and their own emotions in the way they were looked after in their secure base.

Bowlby's colleague Mary Ainsworth developed attachment theory in her research with infants who were left alone with a stranger by their caregiver. She found that those who did not have this kind of 'secure attachment' developed different forms of 'insecure attachment'. An 'anxious-ambivalent' attachment is where the child is highly distressed without their caregiver and may be either angry or helpless when they return. An 'anxious avoidant' attachment is where they avoid or ignore their caregiver and don't show distress at them leaving, or much reaction to them returning. 'Disorganised attachment' was added by Mary Main and relates to more inconsistent attachment behaviour.

Later theories mapped these attachment styles onto adult relationship behaviours, delineating between secure attachment (flexible, good at connection and at discerning nourishing from risky relationships) and insecure forms of attachment including: 'anxious preoccupied' (needy and dependent), 'dismissive-avoidant' (independent and not wanting intimacy), and 'fearful avoidant' (desiring close connection and finding it very difficult).

So both attachment theory, and the more recent trauma theories which develop it, propose that a key role of caregivers is to regulate the child's emotional state, meaning that the child can learn how to do so themselves long term. This means learning how to calm ourselves in times of heightened emotions such as fear, sadness, anger, and frustration. Coregulation is when caregivers attune to how their child is feeling, and engage in back and forth interaction to understand - and meet - their needs, soothing them when stressful events occur.

If we are met in such a way we learn how to soothe and calm ourselves when tough things happen and our bodies go into more reactive modes (self-regulation). We'll also find it easier to form good connections and to reach out to them when we need to. Without such an early 'secure attachment' we're likely to be overwhelmed by tough events and emotions, to engage in survival strategies to avoid them, and we may well struggle to discern nourishing from risky relationships, and to reach out to others when we need support.

Attachment theory already clearly understands that our relationships are utterly interwoven with our mental health. Mental health struggles are rooted in our early relationships because this is where we learn to be okay with ourselves and our feelings, or where we get the message that we - and our feelings - are fundamentally not okay. Mental health difficulties like addiction, anxiety, and depression can be understood in terms of survival strategies which we develop to deal with otherwise overwhelming emotions. Also our current relationship experiences are utterly interwoven with our relationship with ourselves and our emotions. Problems in those relationships - due to our attachment and emotional capacity - can easily retraumatise us, replicating those early dynamics, and reinforcing our negative experience and understanding of ourselves.

Here are a few initial thoughts about why it's useful to think about attachment alongside gender, sexuality, and relationship diversity. I'll go into more detail on all of these in the rest of the post.

Cultural norms

First, the culturally normative way of doing relationships and families, which is linked to attachment struggles and developmental trauma, relies on a certain - interlinked - understanding of gender, sex, and relationships. The model of a heternormative romantic/sexual couple meeting all each others' needs and forming a nuclear family is actually relatively recent and culturally specific. It relies on a binary understanding of 'opposite' genders where men are breadwinner-protectors and women are caring-nurturers, which developed in a capitalist context that relied on women working unpaid in the home and reproducing the workforce. Many of the strains on relationships today can be located in the cultural ideal of getting all your needs met in one person (best friend, co-parent, hot lover, etc.) as well as in an economic system where most people in such relationships are under huge financial stress and having to work long hours in addition to partnering and parenting, or face poverty.

Doing it differently

Relatedly, many people are now doing gender, sex, and relationships in different ways to this cultural norm, all of which may afford some possibilities to relate differently with ourselves and others. For example, Jessica Fern's recent book Polysecure: Attachment, Trauma, and Consensual Non-monogamyexplores the ways in which forms of consensual monogamy may open up different attachment possibilities. Different ways of relating may work better for different attachment styles, or may enable more secure ways of relating and attaching.

Likewise those who are intentionally addressing or shifting their ways of doing their gender, and/or their sexuality, may also move in the direction of greater emotional regulation and/or more secure attachments. Consider how entwined gender is with emotional expression, and how stepping outside of the culturally normative way of doing romantic/sexual relationships may offer possibilities of slowing down and/or prioritising different kinds of relating which may be more stable and secure.

Similar things apply

It also occurred to me that many of the things that I often emphasise about gender, sexuality, and relationships also apply to attachment.

These days most attachment theorists and therapists emphasise that attachment style is not fixed from birth, but that we can experience ourselves in different attachment styles in different relationships, for example, or 'earn' a secure attachment through therapeutic work and self reflective practices. Similarly, although once understood as fixed and singular, gender, sexuality, and relationship style are all fluid and plural. They may shift over time and/or be different in different relationships.

The trauma/attachment literature emphasises that attachment is biopsychosocial. Our way of attaching comes from a complex mix of the wider cultural way of doing child-reading (social), how that played out in our particular family (psycho), and how early attachment experience became engraved on our bodyminds or nervous systems (bio). Similarly, gender, sexuality and relationship style are all biopsychosocial.

All are interwoven

Finally, we can question the fact that our current culture separates out gender, sexuality, relationship style, and mental health as if these are discrete things. Many cultures, and historical times, would not separate out gender, sexuality, and spirituality - for example - seeing all these things as utterly interwoven. In the same way that we might usefully question our current normative way of doing relationships and family, we might recognise that regarding gender, sexuality, relationship styles, and mental health struggles as fixed identities that we have is a relatively new phenomenon, and possibly not a very helpful one.

Moving on to gender 101, let's define some useful basic terms first - because lots of therapists are worried about getting it wrong...

I think it's important to recognise that reality. Laurie Penny wrote that 'the way we think about gender is moving so fast you can feel the breeze in your hair'. This is fraught terrain for many people. I'm always reminded of what Simone de Beauvoir wrote about how threatening it can be for mothers to see their daughters doing gender in different - more liberated ways - than were available to them, and how they may try to stop that. We see a lot that kind of thing playing out intergenerationally. There are all kinds of deep fears, losses and shames in play when relating across generations and genders: all kinds of reasons why people may want others to support - and not challenge - their gender worldview. Perhaps it gives them a sense of safety, of knowing who the 'good guys' and 'bad guys' are, and which side they are on, for example.

This is why I always emphasise, first and foremost, that therapists reflect deeply on their own experience of gender and how it has impacted their lives. As with all other intersecting aspects of identity and experience (e.g. disability, race, class, sexuality, age), we really need to feel how it operates within us, and through us, if we're to work with other people around it.

What ARE some the terms therapists need to be aware of?

I would say it's useful to recognise the multiple different aspects of gender. So gender identity is whether you identify as man, woman or non-binary, for example. Gender expression is how you present your gender in terms of appearance, clothes, voice, etc. Gender experience is your lived experience of your gender. Gender roles are the roles you take on in life and how they relate to gender: father, feminist, waitress, widower, etc. Then there is how your gender is read by other people. There may be more or less match between identity, expression, experience, role, and how others read your gender, for different people.

In terms of gender status people are generally divided into cis and trans. Cis - or cisgender - people remain in the gender that they were assumed to be by those around them at birth. Trans people shift from that in some way. Trans can be seen as a big umbrella encompassing trans women, trans men, and non-binary people. And non-binary can be seen as another big umbrella encompassing all the people who are a gender other than male or female. For example they may be both genders, or between genders, a further gender, no gender, or move between multiple gender positions. Of course the category of cis is also a big umbrella encompassing many different cis masculinities and femininities.

People often associate trans with social transition (changing names, clothes, pronouns, etc.) and medical transition (taking hormones and having surgeries). It's important to point out both that many cis people engage in social and medical gender transitions, and that many trans people do not. Think about name changes for choice, or at marriage, for example, or the huge gender-related shifts that can come with menopause, retirement, or treatment for prostate or breast cancer. I personally prefer a sense that we - as therapists and medical practitioners - should be helping all people to come to a congruent and comfortable place with their gender, regardless of whether they would be categorised - or see themselves - as cis or trans.

We often think of trans people as a small minority of people, when we're focused on social and medical transition. However, Daphna Joel's research has found that over a third of people experience themselves as being to some extent 'the other gender, both genders, or neither gender'.

Historically, many psychanalysts have conflated gender, biology and sexuality, and when it comes to trans, non-binary and folks with variations in sex characteristics, some still do - so can you explain the difference and the way they interact?

Intersex people, or people with diverse sex characteristics (DSD) have bodies which are difficult to categorise in the current western binary sex model. Historically medics have intervened with those bodies in order to attempt to make them conform to a binary, and heterosexual, norm (i.e. penises and vaginas of a certain length). Activists and practitioners are increasingly speaking out against this and encouraging more consensual practices.

It's important to know that what we think of as biological sex - as well as gender - is diverse. What are we talking about when we talk about sex? Is it chromosomes? Level of circulating hormones? Bodily features like genitals, breasts, or hairiness? Or is it brain structure and capacity? On all of these levels humans are actually diverse rather than binary.

Many biologists now prefer to talk about sex/gender rather than separating these out, because it's really impossible to disentangle the biological, the psychological, and the social. Personally I find the concept of 'biopsychosocial' very useful here. Gender is biopsychosocial for all of us meaning that we can't tease apart these three elements. All are in play and all influence each other. For example, what we now know about neuroplasticity and endocrinology suggests that the ways in which we learn gendered behaviours - from the world around us - shifts our brain and body patterns. So, as well as the way our brain and body are - from our early years - shaping how people read our gender and how we experience it, the ways in which we are read, and experience our gender, also shape our brain and body.

When we think about all the different elements of sex (chromosomes, hormones, body shape and size, brain structure and function) and all the elements of gender (identity, expression, experience, role, etc.) we can see how the concept of the snowflake might actually be a useful one, because with all of the different elements, all changing over time, we each end up with a pretty unique sex/gender. If we add in sexuality - which is about way more than just the gender we are and the gender we're attracted to - we have even more diversity and uniqueness.

Virginia Goldener notes that historically psychoanalysts have considered working towards and/or achieving a stable gender identity as an indicator of a successful outcome - and that this is neither possible nor desirable. Consistency around gender identity is for many a cis myth or as Goldener suggests, a pathology. Do you agree?

I'm really grateful to you for putting me onto the Goldener paper and I like a lot of what it says. I do completely agree with her argument that 'gender coherence, consistency, conformity, and identity are culturally mandated normative ideals that (therapy) has absorbed uncritically'. Really we only have to look back through time and around the world today to see the truth of this. The current binary opposite understanding of gender is very recent, and it is utterly interwoven with heteronormativity and family structure under this particular form of capitalism.

There have been many places and times where gender was not seen as binary or opposite, where very different characteristics were associated with different genders, where there were multiple genders, and/or where gender wasn't considered an important feature of a person, or separable from other aspects of their personhood. It's certainly highly ethnocentric to believe that binary gender in the way our culture currently understands it is any kind of universal truth.

Goldener takes her argument further to suggest that adhering to a consistent gender could be seen as a pathology. She comes close to my view here as well. In my BACP GSRD resource I highlight the strong links between trying to conform with rigid ideals of masculinity and femininity and significant mental health struggles. Think about rates of suicide and addiction amongst men, for example, or body images issues which are highly normative among women, or the kinds of depression and anxiety associated with women basing their identites around being-for-others, as de Beauvoir put it. This is why I always say that therapists should be talking about gender with all clients, not just gender non-normative ones. In fact gender expansive and creative folk are perhaps more likely to have already dealt with this stuff.

Goldener makes the argument that people come to a consistent gender by disowning anything about themselves that doesn't fit with the ideological pressures of gender coherence. Think about the ways in which masculinity is defined by anything that isn't feminine, for example, and how boys and men are encouraged to repudiate any 'feminine' feelings, appearances, desires, etc. This argument fits nicely with my understanding of plural selves - drawn from various therapeutic approaches. This is the idea that we are all plural, rather than singular, but have to disown, or split off, aspects of ourselves in order to survive in our families, communities, and wider culture. I think it's useful to see gender as part of this.

I also found Goldener's use of double binds very compelling. This is the sense that we receive confusing and contradictory messages - in families, communities, and culture - about gender which take a huge toll on mental health. Goldener gives the example of such contradictions in a woman's family gender story: 'Mom didn't stand up to Dad, and she was always silently angry and depressed. But whenever I was argumentative, she would say I was 'too masculine' and no man would ever want me.' So the woman faces the contradiction that if she does femininity like her Mom she will suffer as she did, but if she does it differently she faces rejection by her Mom and potentially by all men. We might also think about school messages that men need to be successful but also not show any interest in studies, or cultural messages that women must be empowered and desiring, while still seeing their worth as bound up in appearance and being in a relationship with a man.

Goldener ends by saying that a more critical therapeutic tradition 'could promote resistance to the normative construction of gender polarities and hierarchies by documenting how the exploitation of gender distinctions in the inevitable struggle for power in society and in domestic life produces untenable relationship binds and unbridgeable psychic splits, which damage the human spirit in all of us and in the next generation.' This understanding of cultural gender as a form of intergenerational trauma comes close to my own sense of things, and that of my co-author, Alex Iantaffi, who recently published the book Gender Trauma.

Currently people are expected to remain in the same gender throughout their lives. There is still a moral panic and 'debate' over people who do not, and trans people are expected to promise to remain in the same gender forever once they have transitioned. There is a huge sense that people should be consistent in their gender, despite the fact that everybody clearly experiences and expresses their gender in very different ways over time, from being a child, through a teenager, adult, and older person, and as cultural gender norms also shift radically over the course of their lives.

I think we need to shift this whole sense that gender, sexuality, or self fixity and consistency is something to be aimed at, or somehow superior over flexibility and fluidity. All of these things can - and do - shift over long periods of our lives, and we also experience and express them very differently in different situations and relationships. Think about how you behave with the store clerk, a loved one, and a child, for example, or how you feel at this conference, out for a drink, or last thing at night.

One note of caution I would add here though is that we don't flip the binary such that we privilege fluidity over fixity and regard that as, in some way, superior. Most of us experience some aspects of our selves, our gender, our sexuality, and more, as relatively stable, and other aspects as more changeable. I'd like us to get to the point where all of this could be equally respected and supported as somebody's lived experience of themselves, rather than there being attempts to fix what is fluid, or to change what is stable.

Trainings often fairly uncritically reproduce cis and heteronormative value systems - so that the lens through which we're taught in the psychanalytic or psychodynamic model is often devoid of exposing how systemic structural issues impact on clients. Why is it important for us to explore gender with all clients, not just with those where it might seem an obvious issue, such as trans and gender expansive clients?

It's very troubling to me how little most therapy trainings include considerations of social structures and cultural messages when we know these things are hugely impactful on people's emotional well-being, and cannot be disentangled from individual life experiences. There's a real danger in therapy that we reinforce a sense that mental health should be understood and addressed purely at the level of the individual and their interpersonal relationships, when it's the wider societal systems and structures that are the problem in so many ways.

So yes I would say that heteronormativity and gender norms impact all clients, not just trans and gender expansive ones, and that it's a vital part of the picture to unpack with clients who may not have considered normativity and how much it is part of their distress. Just to give a few more examples to the ones I've given already, the NATSAL survey finds that over half of people consider themselves to be sexually dysfunctional in some way. Clearly the issue here is with the narrow cultural view of what counts as (hetero) sex rather than half of individuals having this individual problem of sexual dysfunction. Few men manage to resist the cultural messages that they mustn't show vulnerability or seek support, and we know the toll this takes in terms of their impact both on others and on themselves.

It's very important that therapists are able to mirror, accurately, people's sense of their own gender, given that many people will have experiences of only certain aspects of their gender being affirmed by those around them, if that.

In your writing on gender you say that we can't really understand gender without taking an intersectional perspective. What does that mean, and how might we work with clients in this way?

Intersectionality is an idea from the Black feminist Kimberlé Crenshaw to capture how we are all impacted by multiple axes of oppression, and how these intersect. An example that I like to give was when I did a bisexuality training in a workplace context. People there were sharing their thoughts on being out as bi. A couple of white bi women said that it felt like an accepting environment to them. Some black women shared that there was no way that they would be out as bi there. They were already sexualised and harassed as black women, and to be openly bi would exacerbate that to intolerable levels. Here we see the intersection of the treatment of black women as hypersexual - and their bodies as the property of others - with the understanding of bisexuality as promiscuous and available to all. This creates a unique experience for black bi women which neither white bi women, or straight black women, had.

I think intersectionality is hugely important in therapy with all clients, because we have to understand how our clients are uniquely positioned in relation to these axes of oppression to have a full sense of their experience. To give another gender example, the experience of considering embarking on a trans journey is very different depending on age (a teenager versus a 50 year old), disability (having to downplay disabilities to access trans services and vice versa), sexuality (whether transitioning will involve you now being read as gay, for example), and race (whether transitioning will involve you now being read as a race/gender combination who is seen as dangerous and/or subject to violence, for example).

Your co-author, Alex Iantaffi, just published a book called Gender Trauma. How might we see gender as a form of historical, intergenerational, and/or developmental trauma? What are the implications of this for trauma-informed therapists?

Alex's book is a must read for all therapists I would say. Although the focus is on gender it takes this intersectional view whereby all of those axes of oppression can be seen as having a traumatising impact. I find this understanding of trauma useful: that it is historical, cultural and intergenerational, as well as being developmental and/or resulting from specific traumatic experiences over our lives.

Alex points out that gender is a form of historical trauma in the ways that attempts have been made to eradicate certain genders through settler colonialism. We could also consider the ways in which white western understandings of gender and sexuality have been imposed on colonised countries, and the ongoing legacy of this, and the gendered sexual violence that was involved in slavery. All of these historical forms of gender trauma pass down through the generations, and linger in damaging myths, norms, and stereotypes.

Gender can be seen as a form of intergenerational trauma in the way that gendered ways of behaving are passed down through families - the kind of thing that Goldener was referring to. Gender reveal parties could be seen as a recent example whereby kids are assumed to be all kinds of things because of their genitals, even prior to birth. Consider the impact of this on intersex kids, on gender expansive kids, and on all kids who don't entirely conform to the ideals of genders their famlies expect, or who might not if such rigid expectations were not imposed from so young.

When it comes to developmental trauma, we could wonder about the gendered ways in which babies and children are treated in relation to their emotions, from a very young age. Developmental trauma occurs when kids aren't soothed when overwhelmed, or supported to learn how to emotionally regulate themselves. I think we could see this, for example, when boys are punished for expressing emotions other than anger, or when girls are expected to care for others' emotional states, even as infants. I was so struck by the documentary No More Boys and Girls, where 7 year old boys could not come up with words for any emotions other than anger, and all the kids agreed that boys were 'better' and that girls' main aspiration in life should be to be 'pretty'.

Much of your writing these days is about plural selves and parts work. How does this concept relate to gender, and to attachment, and what are the implications for potentially working with all clients as plurally gendered?

For me personally, it was my journeys with sexuality and gender which eventually led me to an understanding of plurality. Initially I was aware of having several different sets of sexual desires, and enjoying sex or play the most when I could sink fully into one of these different headspaces. Then I had a sense of being non-binary, which could enable me to hold the feeling that I was masculine and man without letting go of a sense of knowing that I was also feminine and woman. These explorations eventually led to a realisation that I have a vivid experience of multiple parts, who certainly have different gender expressions and sexual - or asexual - desires, but who are about much more than that.

In terms of parts work I'm weaving together the work of people like John Rowan, Hal and Sidra Stone, Richard Schwartz, and Janina Fisher, as well as what I'm learning with people within plural communities. My sense is that everybody - to some extent - disowns parts of themselves and foregrounds other parts, in order to conform to their family, community, and culture, for example. Significant developmental trauma is not what causes people to be plural, but it does seem to result in more significant splits between the parts, such that some are inaccessible, unknown, or dissociated from.

My own experience is that I created a pretty well functioning feminine self in my teenage years, in order to survive. I experienced myself as purely that self for many years, but often with a confusing sense of incongruence that this person who was all about fitting in, helping others, and being independent, fairly regularly made it their business to tell uncomfortable truths in public, suddenly leapt into relationships and communities, or became overwhelmed by shame and fear when tough stuff happened.

So, for me, plurality is entirely interwoven with gender and with attachment, given that other parts of me hold gender-related behaviours, attachment styles, emotions, and survival strategies, which were too dangerous for me to hold or express as a child. It was confronting, for example, to realise that there's certainly a needy 'anxious preoccupied' part when I would probably have checked towards the avoidant end of the attachment spectrum. It's also been helpful, and painful, to finally be in touch with a 'fight' survival strategy that was almost entirely turned in against myself for much of my life.

With a plural understanding we could usefully explore how gender, attachment styles and emotional experience are highly interrelated. For example, boys are generally encouraged culturally to be at the avoidant end of the spectrum and to express feelings in the form of anger, disowning more dependent attachment styles or fearful feelings. Similarly girls are still generally encouraged to be highly relationally oriented, even dependent, and to express emotions as distress rather than anger. These things do not come together for all people, of course, given our specific family systems and life trajectories, but they are bound to be linked to some extent in terms of what we disown and foreground in ourselves in order to survive.

In addition to bringing all parts forward, and to improving communication within the system, I find the concept of earned secure attachment extremely helpful here. For me this is the idea of creating and developing inner parents, or containing parts, who can hold and hear disowned or traumatised parts, building trusting relationships with them which can - over time - enable them to feel safe-enough in the world, and to grow from the traumatised places they have been stuck in.

For me the vital thing is what Bonnie Badenoch calls 'radical inclusivity', Janina Fisher 'no part gets left behind', or Richard Schwartz 'no bad parts'. It's about welcoming, befriending, and forming loving relationships with, and between, all aspects of all parts of ourselves. The aim is not a kind of integrated singularity - the cultural norm - nor is it reaching that sense of consistency that Goldener warns against, whether on gender or attachment style or anything else. Rather it's about helping all parts to be in the world, to bring everything that they have been holding and to share it, and to continue to grow and become, as a vital part of both inner and outer systems.

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Plural tag: This post was by James.