The Psychopathological Domains of Attachment Trauma: A Commentary

The contribution by Farina & Schimmenti (2025) highlights the impact of childhood maltreatment on adult health. Deep Brain Reorienting (DBR), a neurophenomenological approach, proposes that attachment traumas derive from two primary experiences: shock and pain. Shock, often pre-affective, precedes emotions such as fear or anger and can take different forms (implosive, impact). When it dissipates, a deep pain emerges, linked to loneliness, rejection, and existential emptiness. DBR aims to slow down the shock-pain-affect sequence, separating its components to reduce emotional overload and promote regulation. This allows pathological beliefs of unworthiness to be reworked and contradictory attachment patterns to be addressed. The therapy also addresses dissociative symptoms, differentiated into supracortical, intracortical, neurochemical, and structural forms, reducing fragmentation of the self. In conclusion, DBR hypothesizes that attachment traumas result from alterations in midbrain mechanisms of orientation and affective regulation, compromising attachment development, mentalization, and self-esteem.