Attachment & Loss
Attachment Theory
✤
Definition of Attachment:
✤
An enduring emotional tie to a special person, characterized by
a tendency to seek and maintain closeness, especially during
times of stress.
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Roots of Attachment Theory
✤
John Bowlby applied ethology to
infants
✤
Influenced by Konrad Lorenz
✤
Infant’s innate behaviours are
evolved responses which
promote survival
✤
These behaviours include:
sucking, crying, smiling,
clinging, and following.
✤
Behaviours are modified
from inception by the
behaviour of the Primary
Care Figure (PCF).
5
PCF reactions...
✤
✤
Bowlby found that temporary separations from PCF evoked distinctive
type of reactions (separation anxiety) from infant, toddler, etc.
More importantly, he showed how infant/toddler’s reactions upon PCF
return may evoke the very behaviour the infant/toddler intended to
prevent.
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Enter: Mary Ainsworth
Made the
distinction
between strength
of attachment and
security of
attachment.
“Is the child who clings to his mother - who is afraid of the world and the people
in it, and who will not move off to explore other things or other people - more
strongly attached or merely more insecure?”
Ainsworth
The natural
question that had
to be asked was:
Secure Attachment
Infant / toddler uses
caregiver as a secure base
May show distress at
separation, but the baby
can be soothed at reunion
Parents of these children
display sensitivity to
infants/ toddlers needs
QuickTime™ and a
decompressor
are needed to see this picture.
Secure
Attachment
(cont.)
Some parents report
having attachment issues of
their own from the past, but
have gotten over them.
Interestingly, their
marriages are also less likely
to be conflicted than those
of the parents of insecurely
attached children.
Development of the Strange Test
✤
✤
A colleague of Bowlby’s (Ainsworth) developed experiment /method to
classify patterns of attachment between infants and mothers: Strange
Situation Test (SST) during separation.
Led to the development of 2 categories of attachment
✤
1 type being Secure and 3 types of Insecure.
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Strange Situation
Insecure - Anxious / ambivalent
✤
✤
Infant/toddler(s) (IFT) found on the SST who have PCF’s who are
over-anxious, insensitive to their child’s needs, and discourage
exploration.
(IFT)
✤
Shows great distress during separation
✤
Clings and cries angrily upon return
✤
Distress continues after reunion for much longer than securely
attached infants
13
Insecure / Avoidant
✤
Are infant/toddler(s) (IFT) found on the SST who have PCFs who do
not show feelings, cannot tolerate closeness, punish child’s
attachment behaviour.
✤
(IFT) then learns to:
✤
Inhibit their tendency to cling and cry
14
Insecure / Avoidant
✤
During the SST when (PCF) re-appears (IFT) appears indifferent and
uncaring will even ignore (PCF). But this is not the true case as
inside they are physiologically aroused.
✤
Research has showed that (PCF’s) can be responsive to (IFT’s)
under low levels of stress, but under high levels become less
responsive.
15
Disorganized / disoriented
✤
✤
In this case the IFT has a PCF who often feel
helpless, and are frightened by their own children.
The PCF often lacks in confidence with respect to their ability to care for and control
their child and they may see their child as more powerful than themselves.
✤
Ultimately, this conditions the (IFT) to develop disorganized and contradictory
behaviour.
16
Disorganized / disoriented (cont.)
✤
(IFT’s) may cry during separation but avoid
the PFC upon return or they may approach
the PFC upon return then freeze/fall, hit
themselves, rock back and forth, etc.
✤
This group shows the greatest distress and in adult life have the
most problems in living.
17
The Disorganized / Disoriented PCF: Why?
Experience of their own childhood trauma
Active addictions
Loss of parent before birth of child
Currently experiencing a trauma / related
problem
Function of Insecure Attachments
WHY WOULD CHILDREN CONTINUE TO ACT APPARENTLY
INSECURELY ?
ANXIOUSNESS / AMBIVALENCE
AVOIDANT
(Cling / Stay close / Protest)
(Stands of own two feet / seek dependence / inhibit feelings)
DISORGANIZED / DISORIENTED (Stands of own two feet / seek dependence / inhibit
feelings / act inconspicuous / withdraw / freeze / )
Thoughts folks?
• Attachments in later
childhood What do we think
we Know?
Attachments patterns that have been
established by two years of age appear to
remain stable and predict quality of
relationships in later childhood
Anxious / ambivalent school children seem to
lack confidence and assertiveness
necessary for interaction with peers.
Avoidant children show more aggression to
other children and teachers rate them as
more hostile, impulsive, and withdrawn.
Attachments in later childhood what do we
think we know?
Meanwhile, disorganized children
appear to be a risk for psychiatric
problems in later childhood (12 and
beyond).
Further research has demonstrated
that attachment patterns are indeed
hard to break and that the
assumptive world that the child
experienced between 0 - 2 is the
lens in which they view world as
older children.
This is important because ...
It’s all about
building trust!
Four Categories of Basic
Trust
Self Trust
Other Trust
High
High
Anxious /
Ambivalent
Low
High
Avoidant
High
Low
Disorganized
Low
Low
Secure
Attachment
Insecure
Determinants of Outcome after
Bereavement:
Risks factors for chronic
bereavement
Research says...
1. Personal vulnerability of the bereaved
2. Attachment to the deceased
3. Events / circumstances lead up to and
including death
4. Social supports and other circumstances
taking place after death
5. Dependent relationships
6. Ambivalent relationships
The Research Project
Test clinical impressions/hypothesis which suggest that:
(1) Love and loss are intertwined
(2) Childhood attachments patterns / separation from parents / relationships in later life influence how
we cope with stress and loss, and;
(3) Understand the problems/dynamics which cause people to seek help after bereavement in adult
life.
And ultimately, to understand the chains of causation and to clarify the
reasons why some people come through the pain of bereavement and
emerge stronger and wiser than before while others suffer lasting
damage to their mental health.
Bereaved participants
181 patients who attended Royal London Hospital
43 men
138 women
74% had been bereaved for over a year before entering into the study
average age 41
Relationship of the dead
n = 34
person to the respondent
n = 31
•
Spouse or partner
•
Mother
•
Father
•
Child
•
Stillbirth
•
Miscarriage
•
Sibling
•
Other
•
Multiple
•
n=9
n = 25
n=1
n=3
n = 12
n = 12
n = 33
Scoring Exceptions
Most Yes/No questions are scored
Yes = 1
No = 0
Except for:
Section 1 question (1) No = 1
Section 1 question (2a) No = 1
Section 1 question (29) No = 1
Section 11 32 = score 1 PT. FOR NEVER OR 1 PT. FOR OFTEN
FINDING YOUR ATTACHMENT TYPE: INSECURE /
SECURE
Do not score section 1I 34 and 35
Section 11: Childhood
Vulnerability
Section 1: Parenting
Corresponding numbers
•
Parental distant control
Corresponding numbers
11, 15, 16, 28
•
Childhood illness
17, 18, 19, 20
•
Childhood timidity
•
Parental over protection
•
7, 8, 9a, 9b, 12
Parental depression / psych
•
Parental separation
•
6, 24
Parental unusual closeness
•
10, 13, 25, 26,
Parental rejection / violence
27
1, 3, 4, 5, 14
•
Childhood aggressive
distrust
•
Childhood Dresden vase
•
Childhood unhappiness
•
Childhood care giving
If “yes” is chosen for any indicated number give 1 point, if “no” zero point
5, 6
7, 10, 12, 15,
16, 24, 25
20, 26, 27, 28,
29, 30, 31
8, 14, 17,18,
19
9, 32, 33
11, 23
FINDING YOUR ATTACHMENT TYPE: INSECURE /
SECURE
If you score 11 or less attachment style = secure
More than 21 attachment style = insecure
Average score from bereaved study participants was 17
Other subcategories scoring to follow
SCORING YOUR ANXIOUS / AMBIVALENT
SCORE
SUM THESE CATEGORIES
PARENTAL UNUSAL CLOSENESS
SI
PARENTAL OVERPROTECTIVENESS
CHILDHOOD TIMIDITY
DRESDEN VASE
•
•
- 6, 4
SI - 17, 18, 19, 20
SII - 7, 10, 12, 15, 16, 24, 25
SII - 8, 14, 17,18, 19
10 MORE = INDICATES ANXIOUS AMBIVALENT ATTACHMENT
SCORE = 7 WAS AVERAGE SCORE FOR BEREAVED PARTICIPANTS
SCORING AVOIDANT
ATTACHMENTS
SUM THESE CATEGORIES
PARENTS INTOLERANT OF CLOSENESS
CHILD INTOLERANT OF CLOSENESS
SI - 28
SII - 26
CHILDHOOD AGGRESSIVENESS / DISTRUST
SII 20, 27, 28, 29,
30, 31
•
•
SCORE OF 6 OR MORE INDICATES AVOIDANT ATTACHMENT
SCORE 3.8 WAS AVERAGE SCORE FOR BEREAVED PARTICIPANTS
SCORING DISORGANIZED
SUMATTACHMENTS
THESE CATEGORIES
FAMILY EXPERIENCE DANGER / PERSECUTION
PARENTAL REJECTION / VIOLENCE
SII - 4
SI - 10, 13, 25, 26,
27
PARENTAL DEPRESSION / PSYCH
SI - 7, 8, 9a, 9b, 12
CHILDHOOD UNHAPPINESS
SII - 9, 32, 33
COMPULSIVE CAREGIVING
SII - 11, 23
SECURE
ATTACHMENTS
• The more reported security of attachment the
less severe distress reported AFTER
BEREAVEMENT
• Why?
Correlations
Low Secure Attachment
secure
parenting
=
harmonious adult
relationships
Low Marital
Disharmony Score
Low
Problematic
Coping Score
Low Overall Distress Score
Securely Attached will still seek and
Sometimes need treatment
• Securely attached are not free from distress, but more likely to
cope better and have lower levels of distress
• Those that sought help and who had low insecure scores
suffered from
•
Obsessional symptoms, sleep disorders, symptoms of post-traumatic stress,
depression and anxiety
•
Causes of the latter symptoms: unexpected, untimely, or violent bereavements
•
Ultimately, it appeared secure attachments sometimes leave us unprepared for
traumatic events that occur over a lifetime.
Summary secure Attachments = Less
distress after bereavement
• Secure attached are:
1. More self-confident
2. Seek out support and help when needed
3. Have a reasonable sense of autonomy
4. Marriage is more harmonious and provide a buffer from distress
Shows great distress during
separation
Anxious / Ambivalent
Clings and cries angrily upon
return
Distress continues after
reunion for much longer than
securely attached infants
Remember these are the folks who scored high on Parental Unusual
closeness and/or Overprotection along with Childhood timidity and/or high
‘Dresden Vase scores.
Results showed that participants who scored high on Anxious/ Ambivalence
bereaved for protracted periods of time and had difficulty with loneliness.
However, anxious/ambivalent attachment in childhood and long lasting
severe grief after bereavement could not be explained by the
anxious/ambivalent dependence on the lost person.
So what explains the persistence of grief for these folks?
Persistence of Grief?
Long lasting grief appeared to be entangled with anger and
resentment - freezing the ability to let go the deceased.
What else do folks think is going on here?
Correlations
Anxious/Ambivalent
insecure
parenting
=
conflicted adult
relationships
Marital Disagreements
Disagreements
with deceased
Chronic Grief
attach to / push away
Cling
Anxious / Ambivalence:
In light of bereavement
Summary
• People who experience anxious / ambivalent relationships in childhood and
people who make dependent attachments in adult life are both likely to suffer
severe and lasting grief and loneliness after bereavement.
• It appears that these persons do not see love as something that is given,
but is demanded - a la from parents.
• In adulthood then so-called love is lost (via death) and their fear and rage
complicates and magnifies grief
• They are caught in a web of needing to cling and holding back from
clinging = high anxiety. So when their loved one dies - who do they cling
to or go for support?
Parents intolerant of closeness / do
not mirror
Avoidant Attachments
IFT inhibit their tendency to cling
and cry
During the SST when (PCF) reappears (IFT) appears indifferent
and uncaring will even ignore / avoid
(PCF).
Avoidant attachments in childhood were highly correlated in adult life with difficulty
in showing affection and with high scores on emotional Inhibition/Distrust and
Aggression /Assertiveness
Avoidant attachments was also highly correlated with Marital Disagreements.
Avoidant attachments were also found to correlate with Disagreements with the
now deceased and that the bereaved person never cries - and the prediction of
delayed grief...
Interestingly, the avoidant attached person did say that they would like to cry
more.
Inability to
express grief
The Avoidant Griever
Five out of 10 participants
who said they never cry
received diagnosis as
having a psychosomatic
disorder.
However, psychosomatic
diagnosis was not a key
ingredient to the avoidant
griever.
Inability to grieve and
delayed grief, although
related to avoidant
attachments, appeared to
also be correlated with need
to control...
Avoidance and Need to Control
The bereaved delayed grief because:
•
They were holding grief in check because need to look after
a parent / child
•
Lifelong neurosis
•
Past bouts with depression
•
Post-traumatic stress reactions
•
Alcoholism
•
Personality disorders
The Avoidant Griever
Ultimately, the findings confirm that children of parents who
discouraged the expression of attachment (hugging/cuddling,
sharing feelings) will find it difficult to acknowledge and
express both grief and affection.
This was found to persist in adult life, to increase the risk of
interpersonal conflicts and to inhibit the expression of grief.
Mapping the Avoider
Continuous lines indicate
significant correlations
Interrupted lines indicate
non-significant trends
Why Do Patterns of Childhood
Remain into Adulthood
A clinical insight:
We return to old conditioning under stress and in times of survival...
Avoidant attachments only make children independent of their parents, they
have not survived because of keeping away, but because they have found a
safe proximity and they are rewarded for it (are continued to be fed and
protected).
Thus, they will find people who perpetuate assumptive world, but upon death
this separateness is “forever” - thus what do I do and who do I turn to.
The PCF lacks in confidence with
respect to their ability to care for and
control their child and they may see their
child as more powerful than themselves.
(IFT’s) may cry during separation but
avoid the PCF upon return or they may
approach the PCF upon return then
freeze/fall, hit themselves, rock back
and forth, etc.
Disorganized
Attachments
These are participants who scored high on Parental
Depression / Psychiatric Problems; Parental Violence;
Childhood Unhappiness; Compulsive Caregiving;
Family Persecution.
During childhood these folk often felt helpless /
hopelessness and may have become caregivers for
their parents / siblings.
Disorganized Findings and Patterns of
Behaviour
Findings revealed that disorganized type after bereavement
suffered from depression, anxiety, and panic and used
alcohol to self medicate.
There is also a tendency for these folk to feel extreme guilt
and report suicidal behaviour
Interestingly, findings did indicate the disorganized type
would seek help from a professional, but not turn to family
members for support.
Findings also revealed that the disorganized type indeed has
characteristics of the avoidant and anxious/ambivalent type.
Disorganized Findings and Patterns of
Behaviour
Clinical Insight
Findings also reveal that the disorganized type
display a serious need to protect oneself and
distrust others. But, interestingly enough, the
disorganized type can trust enough in so much as
their trust leads to a confirmation of their
assumptive world
Mapping the
Disorganized
Continuous lines indicate
significant correlations
Interrupted lines indicate
non-significant trends
Influence of disorganized
attachments on
psychological problems is
not limited to the years of
childhood.
Task and Questions
Task
Watch movie and provide evidence of
attachment / grief details related to
movie and characters.
Take notes
Be as analytical as possible