The Somatic Foundations of Attachment

The Forming Body

I write about somatics, trauma, attachment, and the physical architecture of being human. This is where I think through the questions that orient my work: How do we become who we are? What does it cost to survive? And what becomes possible when survival is no longer the only goal? Weekly essays for practitioners and seekers who want substance over comfort.

Most practitioner training in attachment starts with the four styles. Secure, anxious, avoidant, disorganized. You learn the behavioral markers, the origin stories in early caregiving, the adult manifestations in romantic partnerships and therapeutic relationships. The categories are useful as descriptive shorthand, and they give new clinicians a way to begin noticing patterns they might otherwise miss. But they describe outcomes. They tell you where the river deposited its sediment. They tell you very little about the current itself, or about the geological event that shaped the riverbed in the first place.

The geological event is the body in its earliest formation. Not the body as a vehicle for the mind, not the body as the thing that carries the brain to therapy, but the body as the living process through which every relational capacity is organized before the infant has anything resembling a self to reflect on. The primitive reflexes, the postural transitions, the first experiments in reaching and grasping and pulling, the organization of breath in the presence and absence of a regulating other. All of this precedes language by months or years, and it precedes cognition by even longer, and it constitutes the actual substrate upon which what we later call “attachment style” is built.

I have been working with this substrate for thirteen years, and training practitioners to work with it for the last six, and what I keep encountering is a gap. The gap between the neuroscience, which is increasingly clear about the body’s primacy in relational development, and the clinical training, which still tends to treat attachment as a psychological phenomenon that happens to have somatic correlates. The order is reversed. The somatic process is primary. The psychology is what emerges from it.

Closing that gap has been the central project of our Attachment and Somatics training. What follows is not a summary of the course. It is an attempt to trace the thread that runs through several decades of research and clinical observation, across multiple lineages, and to show where these lineages converge on something that I believe has significant implications for how we work with relational wounding.

Bonnie Bainbridge Cohen has been studying the developmental foundations of human movement since the early 1970s, and her Body-Mind Centering work represents one of the most detailed maps we have of what happens in the body during the first year of life. She identified sixteen sequential movement patterns, which she calls the Basic Neurocellular Patterns, that trace the organism’s development from the most primitive cellular breathing (the expansion and contraction that occurs in every cell, corresponding to single-celled organisms) through navel radiation, mouthing, spinal movement, and eventually to the complex contralateral patterns that make walking possible.

What Bainbridge Cohen demonstrated through decades of hands-on work with infants and adults is that these patterns are not merely physical milestones that a child passes through on the way to locomotion. Each pattern establishes a particular relationship between the organism and its environment. Cellular breathing establishes the pulsatory ground of being, the most basic oscillation between expansion and contraction that will later underlie every capacity for contact and withdrawal. Navel radiation establishes the relationship between center and periphery, between the core of the self and the reaching limbs. Homologous movement (both arms together, both legs together) differentiates the upper body from the lower, establishing the vertical plane. Homolateral movement differentiates right from left. Contralateral movement integrates all of these into the diagonal, three-dimensional coordination that mature functioning requires.

And within each vertebrate pattern, Bainbridge Cohen identified a specific sequence: yield, push, reach, pull. This sequence is not incidental. Yield is the body’s capacity to release weight into support, to trust what is beneath it. Push is the capacity to extend away from that support, to differentiate, to say “here I am” through muscular effort against the ground. Reach is extension toward something desired. Pull is the act of bringing what is desired closer. Each of these micro-movements is simultaneously a motor event and a relational event, because the infant is performing them in the field of the caregiver’s body, and the caregiver’s response to each movement teaches the infant something about what is possible between self and other.

This is the level at which attachment is being organized. Not in the infant’s cognition, which barely exists. Not in the infant’s emotions, which are still undifferentiated states of arousal and quieting. In the body’s movement, in the reflexive and then increasingly voluntary negotiation of weight, contact, effort, and orientation toward another living system.

Sally Goddard Blythe’s research at the Institute for Neuro-Physiological Psychology provides the clinical evidence for what happens when this process is disrupted. She has spent over thirty years studying the role of primitive reflexes in development, and her central finding is that these reflexes, the Moro, the ATNR, the TLR, the grasp, the rooting, are designed to be integrated during the first year of life, gradually replaced by more mature postural reflexes that allow for the development of voluntary motor control, balance, coordination, and the capacity to be still and attentive.

When they are not integrated, when they persist beyond their developmental window, the consequences are measurable and pervasive. A retained Moro reflex keeps the organism in a chronic state of startle readiness, because the brainstem-level alarm system that should have been superseded by more nuanced threat-assessment is still running as the dominant program. A retained Asymmetric Tonic Neck Reflex interferes with hand-eye coordination, midline crossing, and the visual tracking necessary for reading. A retained Symmetric Tonic Neck Reflex disrupts the coordination between the upper and lower body, affecting posture, the capacity to sit still, and the ability to adjust visual focus between different distances.

Goddard Blythe located these reflexes in the brainstem, the most primitive part of the brain, and she located the postural reflexes that should replace them in the midbrain, where alertness and attentional capacity are mediated. When the transition from one to the other does not complete, the organism remains organized around survival-level processing. It cannot fully attend, fully orient, fully settle into the environment, because the foundational level of its nervous system has not finished its own developmental task.

What makes this relevant to attachment is the question of what allows the integration to occur. The reflexes do not integrate in a vacuum. They integrate through movement, and that movement occurs in a relational context. The infant is being held, carried, rocked, fed, placed on surfaces that invite particular kinds of effort. The caregiver’s body is the environment in which the brainstem completes its work. The quality of that holding, its consistency, its rhythm, its capacity to contain the infant’s distress without either collapsing under it or rigidifying against it, directly shapes whether the primitive reflexes give way to more mature organization or whether they persist as the body’s default operating system.

Ruella Frank saw this from the other end, from the adult therapy room. Since the mid-1970s, she has been studying the way that infant developmental movements show up in the present-moment behavior of adult clients, in their gestures, their postural shifts, the way they lean toward or withdraw from the therapist, the micro-movements of the hands and the feet and the spine that occur beneath conscious awareness but that carry enormous information about where the developmental sequence completed and where it was interrupted.

Her Developmental Somatic Psychotherapy, which she developed within a gestalt therapy framework and which has been informed by her background in dance, bodywork, and the movement theories of developmental psychologists like Esther Thelen, provides a language for reading these movements and working with them clinically. Frank demonstrated that when an adult client reaches toward the therapist and then pulls the hand back, or when the shoulders brace at the moment of receiving something wanted, or when the body cannot settle its weight into the chair, these are not random behaviors or personality quirks. They are the present-tense expression of a developmental movement that was interrupted in the original relational context and that remains incomplete in the tissue.

Frank’s phrase, which has stayed with me, is that “the smallest clues in our own movements can be discovered and disclosed such that the deeper themes of life come to the foreground.” She trained therapists to attend first to their own bodily responses within the session, to notice what arises in their own yield and push and reach, because the therapeutic field is co-created. What the therapist feels in their own body is not private data. It is a movement of the field, emerging from the relational situation between two nervous systems in contact.

This is phenomenological work in the truest sense. It does not interpret the body’s movements from outside. It describes what is actually occurring, in real time, at the level of lived experience, and it trusts that the description itself opens something. That precision of attention is, in my experience, one of the most significant clinical capacities a somatic practitioner can develop.

Pat Ogden arrives at a similar conclusion through a different theoretical lineage. Her Sensorimotor Psychotherapy, which draws on Hakomi, neuroscience, polyvagal theory, and interpersonal neurobiology, places the “somatic narrative” at the center of clinical attention. Gesture, posture, prosody, facial expression, eye gaze, movement. Ogden’s argument is that this narrative communicates what the verbal narrative often cannot, because it operates at the level of procedural learning, the kind of learning that is encoded in the body’s habitual patterns and that cannot be accessed through declarative, verbal, top-down processing alone.

She uses the term “action tendencies” to describe the body’s habitual relational strategies. A healthy infant develops action tendencies that serve the attachment system, proximity-seeking, orientation toward the caregiver, reaching for contact, pulling the caregiver closer. When early experience is adverse, when the environment is unpredictable or threatening or simply insufficiently present, the body develops compensatory action tendencies that may have been adaptive in the original context but that become the source of enormous suffering when they persist into adult relationships. The body organized toward self-reliance may have difficulty receiving. The body organized toward vigilant proximity may have difficulty with separateness. The body organized in the confusion of a disorganized attachment, where the caregiver was both the source of comfort and the source of threat, may oscillate between approach and withdrawal in a way that makes stable contact with anyone nearly impossible.

Ogden’s contribution, alongside Frank’s, is the clinical demonstration that these action tendencies live below conscious awareness, below narrative, below the reach of most talk-based modalities. The body has to learn something different through the body. Through new experience, offered slowly enough and with enough relational attunement that the procedural learning can begin to revise itself.

Bruce Perry provides the neuroscience that makes all of this legible at the level of brain architecture. His Neurosequential Model, developed over thirty years of research with traumatized and maltreated children, is organized around a single structural principle: the brain develops sequentially, from the bottom up, and each successive level depends on the integrity of the level beneath it.

The brainstem, which governs respiration, heart rate, body temperature, and the primitive survival reflexes, develops first, primarily in utero and in the earliest weeks of postnatal life. The diencephalon and cerebellum follow, mediating motor regulation, sensory integration, and arousal modulation. The limbic system, which governs emotion, social bonding, attachment, and relational memory, develops next. And the cortex, the seat of language, abstraction, self-reflection, planning, and the kind of insight that therapy traditionally aims to produce, develops last, with the prefrontal cortex not reaching full maturation until the mid-twenties.

This sequence has implications that most clinical training has not yet fully absorbed. If the brainstem is disorganized by early adverse experience, everything built on top of it will be compromised, because the foundation is compromised. You cannot build stable emotional regulation on an unstable sensory-motor base. You cannot build coherent self-reflection on unstable emotional regulation. The hierarchy is structural, not optional.

Perry’s clinical principle follows: regulate, then relate, then reason. You reach the brainstem through patterned, repetitive, rhythmic somatosensory experience. Walking, rocking, drumming, swimming, breathing. Activities that speak the brainstem’s own language. Only when the brainstem is sufficiently regulated can the limbic system come online enough for relational engagement to produce its reward. And only when relational engagement is stable enough can cortical processing, the domain of insight and narrative restructuring, do its work.

Perry describes what happens when this sequence is violated, when we try to reason with a nervous system that is in a survival state. The cortex goes offline first. Then the limbic system follows. The organism is left operating from the brainstem and diencephalon alone, the most primitive neural architecture, responding to stimuli with the only tools available at that level: fight, flight, freeze, or dissociation. Offering cognitive behavioral strategies to a nervous system in this state is, in Perry’s framing, a fantasy. The hardware required to process the intervention is not currently running.

Stanley Keleman was working with the body’s formative processes decades before the neuroscience confirmed what he was observing in his clinical practice. His Formative Psychology, developed from the late 1950s onward, begins with the premise that the body is not a fixed structure but an ongoing process of forming. A series of anatomical shapes that are continually being organized and reorganized in response to what the organism encounters across the lifespan. The shapes that emerge in early development, the particular way the musculature organizes around the skeleton, the relationship between the ribs and the diaphragm, the habitual tonus of the jaw and the shoulders and the pelvic floor, these are not merely physical characteristics. They are the embodied record of what the organism learned about the world in the conditions under which it was formed.

Keleman’s phrase was “feeling follows form.” This reverses the assumption embedded in most psychotherapy, which is that emotional insight produces bodily change. (This was also later stated by Deb Dana as “story follows state”.) Keleman demonstrated that the direction can run the other way, that changing the anatomical organization produces shifts in emotional experience as a direct physiological event. His methodology, which he called voluntary muscular effort, involved the intentional intensification and de-intensification of habitual patterns, so that the person could come to know, through their own kinesthetic experience, the shape they had organized around and the other shapes available to them.

For attachment work, this is not abstract philosophy. The body that was compressed by chronic fear has a particular somatic organization, dense, held in, the breath shallow, the shoulders drawn forward, the diaphragm braced. The body that was formed in neglect has a different organization, collapsed, under-toned, the structure lacking the internal support that comes from having been adequately held. The body that was formed in chaotic or disorganized caregiving may oscillate between these, or may hold both simultaneously in different regions of the body. These organizations are readable. They are trackable. And they can be worked with, not through insight about them, but through the direct, embodied experience of forming something different at the tissue level.

When I look across these five lineages, Bainbridge Cohen, Goddard Blythe, Frank, Ogden, Perry, and when I add Keleman’s formative understanding to the picture, I see something that I think the field has been assembling for decades without fully articulating. They are all describing the same phenomenon from different vantage points. They are all saying that attachment is organized in the body before it is organized in the mind. That the substrate of relational capacity is sensorimotor, reflexive, postural, and formative before it is psychological. That the patterns laid down in early development persist as the body’s default relational operating system, running beneath awareness, beneath narrative, beneath the reach of insight alone. And that reaching these patterns requires meeting the body at the level where the patterns live.

This convergence is what we built our training on. Not because we originated these ideas. Because the field was producing a coherent picture across multiple disciplines and lineages that had not yet been fully integrated into something a working practitioner could use in a session. The Neurosequential Model tells you that the brain develops from the bottom up and that intervention must follow the same sequence. Body-Mind Centering tells you what the developmental movement patterns are and how they organize relational capacity. Goddard Blythe’s research tells you what happens when primitive reflexes are retained and the foundation remains immature. Frank tells you how to read the developmental movements as they appear in the present-moment behavior of an adult client. Ogden tells you how to track the action tendencies and their disruptions. Keleman tells you that the body’s organization is its psychology and that changing the form changes the experience.

What we added was the synthesis. Not a new theory layered on top, but a clinical framework that brings these streams into dialogue and translates them into a set of somatic markers, readable signals at the level of the body, that a practitioner can track in real time. Where the breath restricts. Where the postural organization braces or collapses. How the nervous system responds to proximity, to contact, to the moment when you invite the client to extend toward something they need. What happens in the practitioner’s own body as the client’s patterns activate the relational field between them.

This is the work that changes couples, that shifts relational dynamics in ways that talk therapy alone often cannot reach. Not because we teach clients a theory of developmental movement. We don’t. The framework is a meta-level understanding that the practitioner holds, and that holding shapes the kinds of activities we construct, the kinds of contact we offer, the pace and the rhythm and the quality of presence we bring. The client’s body responds to what is being offered. And over time, in conditions of sufficient safety and consistency, the tissue begins to reorganize around something other than what it learned in the original formation.

Trauma happens in the body. Attachment is organized in the body. And the revision of both, when it is possible, happens in the body, in the presence of another body that can be trusted. Every lineage I have cited here points to the same conclusion. The question for practitioners is whether our training has prepared us to work at that level, or whether we are still trying to reason with a nervous system that needs, first, to be met on its own terms.

This is the first in a series exploring the somatic foundations of relational life. The next piece will examine what happens between bodies in clinical space, the territory of proximity, contact, and the practitioner’s nervous system as an instrument of change.

The Somara Community – The free public-facing home of the practitioner network. Curated somatic resources, weekly teachings, and a global community of practitioners. No cost, no commitment.

The Collective – A monthly membership for practitioners building a somatic culture. Four live experiential somatic practice classes per month with expert faculty and rotating global guest teachers, plus lifetime access to all recordings and the full resource library. $57/month or $470/year.

Foundations of Trauma + Somatics – A self-paced mini-course in the foundations of trauma and somatics. Nervous system literacy, somatic awareness, and trauma-informed principles. One-time payment for lifetime access. $299, plus a $750 discount on the T+S training once completed.

If you have a question or topic you’d like me to explore, leave a comment below. I read them all, and they shape what I write.

Thank you for bringing your attention here. In a world that pulls us constantly toward distraction, your presence matters.