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Attachment Relationships Shape Pain-Signaling Behavior
The Journal of Pain, 06/26/09

Kozlowska K - This article reviews recent advances in our understanding of child development as articulated by contemporary attachment theory - in particular, the dynamic-maturational model (DMM) - and discusses their implications for interpreting human pain, pain-signaling behavior, and medically unexplained pain. The development of the experience of pain, along with ways of signaling pain, is tied to familial relationships generally and, in particular, to the manner in which attachment relationships shape the infant's behavior and physiology, thereby regulating the experience of pain. In explaining how the child's early attachment relationships produce individual differences in the way that she learns to experience and signal pain, the article provides an innovative perspective that is helpful in understanding the wide variations in patients' experience and presentation of pain, in elaborating formulations of medically unexplained pain, and in planning treatment. More broadly, the article suggests a variety of hypotheses for further empirical testing.