Prolonged ruptured attachment syndrome (PRAS) – A fate worse than trauma or grief

This paper introduces Prolonged Ruptured Attachment Syndrome (PRAS), a newly conceptualised framework for understanding a form of psychological distress that extends beyond conventional notions of grief and trauma. PRAS is characterised by an unresolved emotional state arising from attachments that are neither entirely severed nor fully intact. Unlike traditional grief and trauma models, which assume the possibility of adaptation or healing over time, PRAS addresses the psychological impact of attachments that remain in a state of indeterminate rupture, leaving individuals unable to process their pain or find closure. Drawing on the bio-psycho-social model, this paper situates PRAS as a universal phenomenon that underscores the fundamental human need for secure attachments. PRAS manifests through key dimensions, including loss, helplessness, fear, and persistent anxiety. We argue that PRAS adds a critical perspective to existing grief and trauma theories by accounting for the unique harm caused by unresolved and prolonged disruptions to attachment. Case examples illustrate the potential clinical application of PRAS, emphasising its relevance in contexts such as refugee experiences, alienated parents, and families of missing persons. By formally defining PRAS, we aim to broaden psychological understanding and provide a lens for addressing this previously unclassified but widespread source of human suffering. Recognising PRAS within mental health science and practice offers an opportunity to develop more compassionate and targeted responses to individuals grappling with the enduring pain of ruptured attachments.