Adult Attachment Patterns in a Treatment Context

Relationship and narrative

Sarah Daniel

• Editorial: Routledge
• Año: 2014
• ISBN:
  9781317622598
• Edición: 1
• Categoría: Psicología
• Categoría: Psicoterapia

Attachment theory posits that the need for attachment is a life-long phenomenon that becomes especially relevant in times of crisis or trauma. When adults experience illness, accidents, assaults, psychological difficulties or losses, their attachment-behavioural systems are activated, motivating them to seek help and support from family and friends and/or from helping professionals. However, the resulting request for help is affected and shaped by earlier experiences regarding the support and trustworthiness of attachment figures. Can others be trusted? Is it safe to show vulnerability? How should one behave to increase the likelihood of receiving the help needed?

Adult Attachment Patterns in a Treatment Context provides an integrated introduction to the subject of adult attachment. Research into adult attachment patterns offers professional helpers a theoretically sound insight into the dynamics underlying a range of client behaviours, including some of the more puzzling and frustrating behaviours such as denying obvious pain or continually pushing the professional for more personal involvement. Sarah Daniel shows how applying knowledge of attachment patterns to treatment settings will improve the way in which professionals engage with clients and the organization of treatments. This book will be relevant to a range of helping professionals such as psychotherapists, psychologists and social workers, both in practice and in training.

Part I

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Adult attachment patterns and treatment relationships

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Chapter 1

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Adult attachment patterns

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Attachment theory is a psychological theory originating in the work of British psychiatrist John Bowlby in the mid-twentieth century. In his central three-volume work, Attachment and Loss, he considered what proximity to consistent caregivers means to a child’s development, as well as the psychological effects of loss or separation from caregivers (Bowlby, 1969, 1973, 1980). Bowlby’s theory has since been extended and elaborated by a number of researchers throughout the world and attachment theory continues to be a field of rapid growth.

The aim of this chapter is to provide a general introduction to attachment theory and more specifically to adult attachment patterns. The chapter will not provide an exhaustive account of attachment theory and the connected research, and the description of research in children’s attachment will be kept to a general level. The purpose of the chapter is to provide an account of attachment and adult attachment patterns detailed enough to form the background knowledge necessary for the book’s second and third parts, in which specific attachment patterns are discussed in a treatment context. A number of the properties of adult attachment patterns introduced in this chapter will be discussed in greater depth in the book’s second part, where each pattern is described individually.

Theoretical and historical roots: attachment in childhood

In the wake of the Second World War, many children had lost their parents or been separated from them for longer periods of time. The World Health Organization therefore asked the child psychiatrist Bowlby to draw up a report of the implications that separation and loss had for children’s mental health. Attachment theory emerged from Bowlby’s efforts to gain a theoretical understanding of the powerful reactions he and his colleagues observed in children separated from their parents for prolonged periods of time – for example, in connection with hospitalization.

The children underwent a sequence of different reactions, first protesting violently and restlessly searching for their absent parents. Usually a phase of despair and despondent whimpering followed, which then eventually gave way to an emotional ‘disconnection’, where the children appeared to give up recovering the relationship with their parents. At this point the children no longer reacted with joy when reunited with their parents, but reacted instead with seemingly ‘flat’ indifference (Bowlby, 1973, Kobak and Madsen, 2008).

The evolutionary basis of attachment

In order to understand the significance of children’s emotional ties to their parents, Bowlby turned to evolutionary psychology. Evolutionary psychology is concerned with the roots of different psychological phenomena in the evolutionary history of humans. In contrast to the dominant view at the time – that children become attached to their parents because they provide them with food – Bowlby claimed (1969) that the impulse to attach to caregivers is an expression of a primary inborn motivational system, which is directly related to the survival of mankind. Children thus enter the world with an instinctive drive to attach to caregivers; a need which is just as powerful as the need for food or sleep.

Compared to most baby animals, the human child is extremely helpless and depends on long-term protection and care from adults in order to survive. The inborn behavioural and motivational system – the attachment system – serves to ensure that infants stay in continual physical proximity to adults who will take care of them. The need for attachment is so basic that a child will also become attached to ‘caregivers’ who are not caring at all, but are on the contrary rejecting or even violent, as long as these are the dominant adults in the child’s life.

According to Bowlby (1969) the attachment system functions as a ‘cybernetic’, that is, a goal-oriented system similar to a thermostat. The goal of the system is the security provided by physical closeness to the caregiver. In safe situations, when the child is lively and in good form, the attachment system is on standby, and the child is busy exploring the world. However, if there are signs of danger – for example, if surroundings are unfamiliar, if strangers are present, or if the child is unwell or has been hurt – the attachment system is activated and the child will draw closer to the caregiver or start crying to summon the caregiver. Once the child has had sufficient contact with the caregiver and no longer feels threatened or insecure, the attachment behaviour is interrupted and the child calms down. All parents will recognize this small ‘drama’, which is repeated every day and innumerable times throughout the life of a small child; it is not damaging to the child, but an inevitable part of any childhood.

However, something that is damaging to small children is prolonged periods of time without regular contact with one or more consistent caregivers. Children who grow up in institutions where staff constantly changes may thus develop serious mental and emotional problems even if they never experience lack of food or physical care (Rutter, 2008). Loss or prolonged separation from caregivers similarly has significant psychological consequences and, for example, increases the risk of depression later in life (Kobak and Madsen, 2008). Presently, we are seeing a rapid expansion of our knowledge about the significance of attachment relationships for the early development of children’s brains, and about how experiences in attachment relationships can affect future development, also on a neurobiological level (Polan and Hofer, 2008).

Ainsworth’s Strange Situation and individual differences

Although Bowlby’s ideas about the significance of attachment for psychological development were based on his experiences from clinical work and observation, he was very much a theorist. Today attachment theory is strongly associated with an empirical research tradition due to Bowlby’s fruitful collaboration with the Canadian-American psychologist Mary Ainsworth. Ainsworth set out to study how attachment between children and parents took place in practice and she conducted thorough observational studies of infants and mothers in both Uganda and USA.

To observe the attachment system in action in a controlled environment, she invented the so-called Strange Situation, which is the most important method for examining attachment patterns between children of the age of 1 and their caregivers (Ainsworth et al., 1978). The Strange Situation is conducted in a laboratory room, which is fitted out with different exciting toys, and involves two short separations and reunions between child and caregiver. During the first separation, the child is alone in the room with a stranger, and during the second separation the child is completely alone (Solomon and George, 2008).

In her studies, Ainsworth focused on the attachment relationship between child and mother. On the basis of attachment theory as it was formulated at that time, she expected that all children not subjected to long-term separation from their mothers would behave in the same way in the Strange Situation: they would become anxious due to the unfamiliar situation and stranger, but be soothed by their mother. They would protest when their mother left, but calm down once she returned. However, it turned out that the children reacted to the separation from, and reunion with, their mothers in markedly different ways (Ainsworth et al., 1978).

More than half of the children reacted as Ainsworth expected them to. Another group was not visibly worried by the situation, did not protest when the mother left and ignored her when she returned. Finally, one group was greatly agitated even while the mother was still in the room, protested violently when she left, and reacted ambivalently, alternating between clinging to her and angrily rejecting her when she returned. These ways of reacting were considered expressions of three different patterns of attachment, one of which was secure and two of which constituted different types of insecurity. As already mentioned, the first pattern made up more than half of the children Ainsworth observed, and was termed secure attachment. The second pattern was termed avoidant attachment, and the third pattern was termed ambivalent attachment. Ainsworth’s work thus constituted the starting point for the extensive research since carried out in attachment patterns or individual differences in the quality of attachment.

Attachment patterns and caregiving environment

Based on her detailed home observations of children and their mothers, Ainsworth was able to relate the children’s reactions in the Strange Situation to specific patterns in the children’s everyday interaction with their mothers (Ainsworth et al., 1978). The securely attached children’s mothers were attentive to their signals and were quick to react with comfort and care when the children displayed a need for this. The mothers of avoidant children emphasized independence and were dismissive when their children sought comfort. The ambivalent children’s mothers were more unpredictable: at times they were warm and caring; at other times, absent or preoccupied with their own concerns.

The correlation between sensitive response to children’s attachment behaviour and secure attachment in children has later been confirmed by a large number of studies (Belsky and Fearon, 2008, De Wolff and van Ijzendoorn, 1997). Furthermore, studies following children who were observed in the Strange Situation study at the age of 1 have indicated that secure attachment is related to a number of positive emotional and social competences later in life, while insecure attachment involves a risk of developing problems later on (Thompson, 2008). However, it is important to bear in mind that insecure attachment is not ‘abnormal’ or pathological. Up to half of all children in middle-class families without any particular problems are insecurely attached. Nor is insecure attachment synonymous with what is termed ‘attachment disorders’ in child psychiatry diagnostics, which is a much more rare and serious phenomenon (DeKlyen and Greenberg, 2008).

According to attachment theory, secure, avoidant, and ambivalent attachment in children are all the result of a relevant adjustment to the family environment into which children are born. To express and regulate attachment needs, children ‘select’ the strategy that provides the greatest possible degree of security and support in relation to their particular caregivers (Main, 1995, Weinfield et al., 2008). If caregivers are available and responsive to attachment signals, it is most appropriate for children to express attachment needs clearly and straightforwardly. If caregivers emphasize independence and reject children when they cry and desire proximity, the children learn to suppress tears and turn attention away from attachment needs. In this way, the children are better able to maintain proximity to their caregivers and thus gain a certain degree of security. If caregivers are available and responsive at times, but at other times are not, children become hypervigilant of signs indicating the caregivers’ state of mind and learn to exaggerate the expression of attachment needs to ensure their attention.

Although insecure attachment patterns may be considered as children’s appropriate adjustment to their social environment, these patterns do, however, involve a number of costs for these children compared to children with secure attachment patterns. In the child’s first year, and later, there is a close relationship between the attachment system and the exploration system, which is the inborn behavioural system that prompts the child to explore surroundings and learn new things. The child is only capable of exploring surroundings if he or she feels safe – that is, if the child’s attachment system is not activated (Ainsworth et al., 1978).

The attachment system of the ambivalently attached child, who is constantly in doubt as to whether the caregiver is available for comfort if needed, is overactive. This means that the child struggles to find peace to play and learn. In contrast, the avoidantly attached child strives to deactivate the attachment system. However, this can only be done by turning attention away from one’s own feelings and the interpersonal interaction with the caregiver. The avoidant strategy results in a reduced capacity to identify and describe feelings and in not learning to rely on other people when experiencing hard times. Although the avoidant child is more free to explore the surroundings than the ambivalent child, keeping the attachment system ‘at bay’ requires great effort, and is done at the expense of attention to feelings and relationships (Main, 1995).

Organized and disorganized attachment

Common to all three attachment patterns mentioned so far is the fact that they form an organized and coherent ‘strategy’ for managing the attachment system. Whereas secure attachment represents the most flexible regulation of the attachment system, avoidant attachment is connected with a systematic deactivation of the attachment system, while ambivalent attachment is connected with a systematic hyperactivation of the attachment system.

However, by closely studying video recordings of the Strange Situation, one of Ainsworth’s students, the American psychologist Mary Main, noticed that one group of children could not be clearly classified according to the three organized patterns (Main and Solomon, 1986). These children exhibited changing or contradictory strategies or a complete collapse of strategies when facing the Strange Situation. For example, some approached the caregiver when reunited, but would simultaneously turn their heads away. Others would simply sit rocking back and forth or remain completely motionless. Main and her colleagues described these types of behaviours as an expression of a fourth attachment pattern, disorganized attachment, which is especially frequent among children who have been subjected to abuse or serious neglect.

Later research has shown that children with disorganized attachment patterns often find their caregivers frightening, either because their behaviour towards the child is hostile or inappropriate, or because the caregivers themselves were traumatized and therefore become overwhelmed and incapable of supporting the child when needed (Lyons-Ruth and Jacobvitz, 2008). This creates an unsolvable dilemma for the child. The child’s attachment system urges the child to seek comfort from caregivers when scared. However, if the caregiver is simultaneously the source of fear, the child experiences irreconcilable impulses to simultaneously approach and withdraw from the caregiver.

Like the ‘organized’ insecure attachment patterns,...