ATTACHMENT THEORY.pptx
- 3. Ainsworth, 1973; Bowlby’ 1969 • Attachment is a deep and enduring emotional bond that connects one person to another across time and space Laura Berk • Attachment is a strong, affectionate tie we have with special people in our lives that lead us to experience pleasure when we interact with them and to be comforted by nearness in times of stress Bowlby • “To say a child that he is attached to, or has an attachment to, someone means that he is strongly disposed to seek proximity to and contact with that individual and to do so in certain, specified conditions.”
- 4. Origin of Attachment theory • According to ethological theory, infants and babies are biologically predisposed to become attached to others. • John Bowlby (child psychiatrist and psychoanalyst) wrote a pamphlet on homeless and orphaned children of WW2 after which he formulated Attachment theory and published it in, “The Nature of the Child’s Tie to His Mother” (1958) • An experiment performed by Harlow & Zimmerman (1959) showed that developing a close bond doesn’t depend on hunger satisfaction, but comfort. • During 1970s, Mary Ainsworth (developmental psychologist) worked on Attachment theory • Attachment theory was extended to adult relationships by Cindy Hazen and Phillip Shaver in 1980s. Today’s work on Attachment theory is based on work of both Bowlby and Ainsworth.
- 5. Bowlby’s Attachment theory Babies seek proximity to mother and react with anxiety to separation from her. (Bowlby, 1973) It’s emotional: negative emotional influences later life if attachment is not formed within critical time period The central theme of attachment theory is that mothers who are available and responsive to their infant's needs establish a sense of security If child experiences love and affection, the child sees itself as worthy of love and attention
- 6. Bowlby’s Attachment theory It is innate It has critical time period to develop, birth to 3 years Develops internal working model of world, i.e., cognitive schemas Forms the basis of future relationships Any disturbance in forming attachment leads to disturbance in later stages of development and leads to psychopathologies
- 7. Bowlby’s Attachment theory Important in terms of social, cognitive, and emotional development Attachment behaviors appear to be universal across cultures Psychological connectedness (Bowlby, 1969) Has evolutionary context : caregiver provides safety and security. Enhances chances of survival (Bowlby, 1958) Doesn’t have to be reciprocal
- 10. Phases of Attachment formation 1 Pre-attachment phase (Birth to 6 weeks) 2 Attachment in making phase (6 weeks to 6-8 months) 3 Clear-cut Attachment phase (6-8 months to 18-24 months) 4 Formation of reciprocal relationship (18-24 months and so on)
- 11. Pre- Attachment Attachment in making Clear-cut Attachment Formation of reciprocal relationship Innate signals by babies to caregivers (smile, crying) Difference in response by babies to familiar adult and stranger Evident attachment to familiar caregivers Reciprocates the relationships formed with primary caregivers Closeness of the adults comforts child Develops “Sense of Trust” Child shows distress when primary caregiver leaves Negotiation using requests and persuasion Not yet attached, all adults are same Still doesn’t protest being left with some other adult Response varies from child to child, but separation protest exists here Dependency low, confidence on caregiver’s accessibility high No fear of strangers No fear of strangers Stranger Anxiety Separation anxiety declines
- 12. Phases of Maternal Separation Protest Despair Detachment distress at separation attempt to regain contact with caregiver by crying loudly throwing oneself around Quiet stage in which child is in “mourning” and is withdrawn. Intermittent or monotonous crying may occur Child shows interest in the environment. It is a phase of recovery. When caregiver returns, the child may show no interest in them.
- 14. Ainsworth & Bell (1971) Type of Attachment Description Caregivers behavior Secure • Distressed when mother left • Positive & happy when mother returned •Avoidant of stranger when alone but friendly when mother present Will use the mother as a safe base to explore their environment Sensitive & responsive primary care Insecure Avoidant • No sign of distress by mother’s absence • Showed little interest when she returned • Infant okay with stranger and plays normally when stranger is present • Stranger will be treated similar to the mother (does not seek contact). • Mother & stranger are able to comfort infant equally well Caregiver insensitive or not interested in children. Rejecting caregiver
- 15. Ainsworth & Bell (1971) Type of Attachment Description Caregiver’s Behavior Insecure Resistant • Intensely distressed when mother left • Apparent fear of stranger – and avoids stranger • Clinginess mixed with rejection on return may approach mother but may resist contact (or even push her away) • Fear of exploration (insecure behaviour) and cries more Inconsistent and poor maternal availability. These children cannot depend on their mother (or caregiver) to be there when the child is in need Disorganized •No consistent way of dealing with the stress •Shows contradictory and confused behavior Child is neglected or abused.
- 17. Factors promoting Insecure Attachment Abandonment/ Deprivation in 1st 2 years Abusive, Neglecting, Erratic parents Child’s own temperament Stressful family situations
- 18. Bowlby’s 44 thieves Aim: To investigate the effects of maternal deprivation on children in order to see whether delinquents have suffered deprivation. According to the Maternal Deprivation Hypothesis, serious effects on its intellectual, social and emotional development. Bowlby interviewed 44 adolescents who were referred to a child protection program in London because of stealing- He interviewed the parents from both groups to state whether their children had experienced separation during the critical period and for how long Findings: More than half of the juvenile thieves had been separated from their mothers for longer than 6 months during their first five years. 'affectionless psychopathy”
- 19. WHAT HAPPENS IF CHILD FACES AVOIDANCE OR TRAUMA?
- 20. A child reared in a severely deprived setting will not experience factors such as •access to adequate nutrition, sensory and cognitive stimulation, •loving caregivers •linguistic input fMRI scans found •worse on a simple verbal memory test •less hippocampus activity. •Also exhibited specific PTSD symptoms. •They also had problems remembering the trauma •felt isolated •had impaired emotions Rutter, 2001: (continued) Age of adoption as a major factor •the older when child left orphanage, more problems
- 21. IMPORTANCE OF ATTACHMENT THEORY in Psychiatry/ Psychology…..
- 22. Focuses on healthy interpersonal relationships Attachment styles in childhood manifests in LATER STAGES OF LIFE, and relationships formed. Quality of care can change, but Internal working model stays same. Impacts physiological development of BRAIN Develops lovability and worthiness of SELF; loved, effective, autonomous, competent self Focuses on Cultural differences Prolonged Separation: Key features of psychopathology includes affectionless, anti-social tendencies, and stealing Relational Diasthesis Model: Attachment predisposes an individual to further trauma (Karlen Ruth) Oedipal conflicts as a result of insecure attachment (Morris Eagle)
- 23. Three prototypical pathologies of narrative capacity (Jeremy Holmes), •Clinging to rigid stories (dismissing) •Feeling overwhelmed by un-storied experiences (preoccupied) •Inability to find strong narrative to contain traumatic pain (preoccupied) Romantic love could be conceptualized as an attachment process and that how one views and approaches romantic relationships might be an outgrowth of previous attachment experiences (Hazan & Shaver, 1987). The majority of studies that have examined the association between attachment and psychiatric disorders have been cross- sectional
- 24. A better understanding of the etiology of psychiatric disorders, especially from an interpersonal perspective. Externalizing psychopathology (which might involve acting-out behaviors, e.g. eating disorders) is hypothesized to be associated with minimizing (or deactivating) strategies, whereas Internalizing psychopathology (such as depression, anxiety and borderline personality disorder) would be associated with maximizing (or hyper activating) strategies (Ma, 2006). Depression: Insecure IWM, Internal cognitive representations of the self as unlovable and of attachment figures as unloving/untrustworthy (Beck Cognitive Triad). Bowlby (1980) himeself talked about depression. Anxiety: Insecure IWM, chronic vigilance and anxiety leading to anxiety disorders (Haaga et al., 2002) Stress-related disorders: Attachment insecurity would compromise an individual’s ability to cope with traumatic life events and would therefore predispose to the formation of post-traumatic stress symptoms and/or disorder (Muller et al., 2000)
- 25. Borderline Personality Disorder: Borderline pathology is generally associated with the exaggeration of symptomatology and of negative affect. The readiness to report distress is consistent with preoccupation with regard to attachment (Dozier et al., 1999). Eating Disorders: It has been postulated that the symptoms of eating disorders maintain proximity to the attachment figure, albeit in a maladaptive way (Cassidy & Shaver, 2002) Attachment disorders: Attachment disorders are rare to non-existent in low- risk samples, still rare in higher-risk samples, but readily identifiable in maltreated and institutionalized samples
- 27. • Child–Parent Psychotherapy (CPP) This manualized dyadic intervention has been used primarily with impoverished and traumatized families with children younger than 5 (Lieberman et al., 2006). CPP sessions include both parent and child together and take place either in the home or in an office playroom. Sessions are unstructured, with the themes largely determined by the parent and by the unfolding interactions between the parent and child. CPP emphasizes enhancing emotional communication between parent and child, sometimes by exploring links between the parents’ early childhood experiences and their current feelings, perceptions, and behaviors towards their children This emphasis on emotional communication, and defensive processes that threaten to distort it, highlights the link between attachment theory and CPP.
- 28. • Video-based Intervention to Promote Positive Parenting (VIPP) Video-based Intervention to Promote Positive Parenting (VIPP) is a brief, home-based attachment intervention delivered in four home visits to parents of infants less than 1 year old, typically in lower-risk families (Juffer et al., 2008). VIPP was drawn explicitly from attachment research and attempts to promote maternal sensitivity through interveners’ presentation of written materials and review of in-home, videotaped infant–parent interactions. An expanded version, VIPP-R, provides an additional three- hour home visit that focuses on the parent’s childhood attachment experiences.
- 29. • The Circle of Security (COS) Originally created as a time-limited group psychotherapy using video feedback, the intervention is easily adapted for individual therapy (Marvin et al., 2002). More recently, parenting DVDs based on the model have been created; these combine education about attachment with an opportunity for caregivers to reflect on their child’s needs and the challenges each faces in meeting those needs For the video-therapy approach, an observational procedure including the standard SSP and the Circle of Security Interview are completed at baseline for treatment planning. Toward the end of treatment, a second SSP is conducted for additional review. In this treatment, the SSP is used to not to classify attachment patterns, but rather to illustrate the parent’s emotional presence and the child’s exploratory and comfort-seeking behavior
- 31. • Attachment and Biobehavioral Catch-up (ABC) Dozier and her colleagues developed a 10-session intervention aimed at reducing barriers to the development of secure attachment relationships between foster parents and the young children in their care (Dozier et al., 2005). They note four major areas of challenge facing caregivers who foster young children: (a) young children in foster care may reject care that is offered to them, (b) caregivers’ own histories may interfere with their providing nurturing care, (c) young children in foster care may need special help with self-regulation, and (d) young maltreated children may be especially sensitive to frightening behavior in caregivers. These premises were used to develop the ABC program’s four treatment modules: (a) parental nurturance, (b) following the child’s lead, (c) ‘overriding’ one’s own history and/or non-nurturing impulses, particularly as regards off-putting behavior and negative emotional reactions in children, and (d) avoiding frightening behavior with the child.
- 32. Some recommendations for treatment in Adults • Story breaking: rethinking narrative in more coherent fashion • Story making: elaborating on a healing story to enhance consciousness of one’s own mental life • Dismissing patients: need to break open a self-constrained narrative • Pre-occupied patients: capturing confusion and overwhelmed feelings in narrative • Unresolved patients: Find narrative for traumatic pain • Listen to linguistic cues and gaps in memories
- 33. References Ainsworth, M. D. S. (2006). Attachments and other affectional bonds across the life cycle. In Attachment across the life cycle (pp. 41-59). Routledge. Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. N. (2015). Patterns of attachment: A psychological study of the strange situation. Psychology press. Bowlby, J. (1997). Attachment and loss. Vol. 1 Attachment. London, UK: Pimlico. Bowlby, J. (1973). Attachment and loss. Volume II. Separation, anxiety and anger. In Attachment and loss. volume II. Separation, anxiety and anger (pp. 429-p). Bowlby, E. J. M. (2008). Loss-Sadness and Depression: Attachment and Loss Volume 3 (Vol. 3). Random House. Brennan, K. A., & Shaver, P. R. (1998). Attachment styles and personality disorders: Their connections to each other and to parental divorce, parental death, and perceptions of parental caregiving. Journal of personality, 66(5), 835-878. Cassidy, J., & Shaver, P. R. (Eds.). (2002). Handbook of attachment: Theory, research, and clinical applications. Rough Guides. Dozier, M., Stovall, K. C., & Albus, K. E. (1999). Attachment and psychopathology in adulthood. IN: Handbook of Attachment: Theory, research, and clinical applications. Ed. by Cassidy J & Shaver PR. Juffer, F. E., Bakermans-Kranenburg, M. J., & Van Ijzendoorn, M. H. (2008). Promoting positive parenting: An attachment-based intervention. Taylor & Francis Group/Lawrence Erlbaum Associates. Lieberman, A. F., Ippen, C. G., & Van Horn, P. (2006). Child-parent psychotherapy: 6-month follow-up of a randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 45(8), 913-918. Ma, K. (2006). Attachment theory in adult psychiatry. Part 1: Conceptualisations, measurement and clinical research findings. Advances in Psychiatric Treatment, 12(6), 440-449. Marvin, R., Cooper, G., Hoffman, K., & Powell, B. (2002). The Circle of Security project: Attachment-based intervention with caregiver-pre-school child dyads. Attachment & human development, 4(1), 107-124.
Editor's Notes
- #14: Performed by Ainsworth and Bell (1970) Controlled observation of children’s attachment behaviour using the ‘Strange Situation Classification’ (SSC): • Mother leaves child in unfamiliar environment • Child is approached by stranger • Mother returns • Looks at separation protest, stranger anxiety and reunion behaviour Three patterns of attachment: • Secure (60% of sample) • Insecure – avoidant (15%) • Insecure – resistant (10%) • Insecure – disorganized(15%) • Ainsworth suggested that attachment type was determined by primary carer’s (mother’s) behaviour and how sensitive the carer is to the child’s needs