애착외상(attachment trauma)의 이해와 치료적 함의 = Understanding and Therapeutic Implications of Attachment Trauma

다국어 초록 (Multilingual Abstract)

This study focused on the attachment trauma which manifests in a relationship between parent and children in complex trauma and reviewed the effect of attachment trauma on personality change of children and adult’s mental health. We found key psychological mechanisms that cause symptom formation and social maladjustment beyond fragmentary relationship between attachment trauma and symptom. There were 'collapse of attachment system', 'failure of emotion management', 'dissociation', and 'impairment of self-system'. We also studied the most prominent therapeutic approaches for attachment trauma and identified the core therapeutic mechanism of each system and common therapeutic factors among the therapeutic approaches. The core therapeutic mechanisms we identified were 'psychological education for attachment trauma', 'building working alliance', 'cognitive reformation', 'expression and management of emotion', and the common therapeutic factors were 'restoration of mentalization' and 'reinforcement of attachment relationship'. Based on such findings, this study discussed implications of therapeutic interventions and adaptation for children who experience attachment trauma and its survivors.

국문 초록 (Abstract)

본 연구는 복합외상 중 아동기에 부모 혹은 양육자와의 관계에서 발생하는 애착외상에 관심을 갖고 애착외상이 아동의 성격변화 및 성인기 정신건강에 미치는 영향 및 치료에 대해 검토하였다. 애착외상과 증상 간 단편적인 관계를 넘어서 증상형성과 사회부적응 을 초래하게 되는 핵심적인 심리적 기제를 확인하였는데, ‘애착체계의 붕괴’, ‘정서관리 의 실패’, ‘해리’, ‘자기체계의 손상’이었다. 또한, 애착외상의 치료접근들을 개관하여 각 치료법의 핵심적인 치료기제와 공통적인 치료과정을 살펴보았다. 핵심적인 치료기제는 ‘인지재구성’, ‘애착관계의 강화’, ‘정신화 능력의 강화’, ‘정서표현 및 조절’이었고, 공통 된 치료과정은 안정, 외상 처리, 일상생활의 적용이었다. 애착외상 치료법 개관을 바탕 으로 외상 처리, 재건, 성장 단계의 통합적 치료모형과 통합적 애착외상 치료 프로그램 을 제안하였다. 이를 토대로 현재 애착외상을 경험하고 있는 아동들과 애착외상 경험자 들의 치료개입과 적응에 대한 시사점을 논의하였다

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