3. Attachment across the lifespan

Question 1

attachment as a biological imperative

Answer 1

infant must adapt to caregiver, defensively excluding whatever behaviour threatens the attachment bond
quality of nonverbal communication in attachment relationship that determines the infant’s security or insecurity and with that comes the infant’s approach to their own feelings
security of attachment, resilience and ability to raise secure children are all correlated with the individual’s capacity to adopt a reflective stance towards experience

Question 2

attachment in therapy

Answer 2

therapist’s role is to help client deconstruct the attachment patterns of the past and to construct new ones in the present
sense of a secure base arises from therapist’s effectiveness in supporting the client to tolerate, modulate and communicate about difficult emotions
pre-linguistic roots of attachment - therapist needs to be attuned to nonverbal expressions that client won’t have words for (process important)
if they don’t have words to articulate their experience, will enact it with others

Question 3

secure attachment

Answer 3

reflective stance towards experience
based on metacognition, can step back from immediate reality and respond based on the mental state that underlies it

Question 4

external reality

Answer 4

things that happen, situations we co create and people we are involved with

Question 5

representational model of the world

Answer 5

ideas we have about how the world works, and the boxes that we tend to fit our experiences into
highly subjective

Question 6

reflective stance

Answer 6

individual reflects consciously and unconsciously on the meaning of their experience rather than taking what happens at face value or as a reality (good understnading of impact or inlfuence of out representational model of world)

Question 7

mindful self

Answer 7

who or what actually does the reflecting on the experience

Question 8

attachment theory and levels of experience

Answer 8

attachment theory deals with external reality, representational model of the world and reflective stance

Question 9

therapist mindful self

Answer 9

therapist’s mindful stance may have a contagious effect, that sparks the client’s own experience of mindfulness
the therapist’s reflective stance also kindles the client’s ability to mentalise

Question 10

attachment for the infant manifests in 3 ways

Answer 10

1. seeking, monitoring and attempting to maintain proximity to a protective attachment figure who’s usually a relative. Regularly mother regardless of level of involvement.
2. using attachment figure as a secure base. child generally feels free to explore however when attachment figure temporarily absent, exploration stops.
3. clings to an attachment figure as a safe haven in situations of danger or moments of alarm

Question 11

attachment figure availability

Answer 11

matter not just of accessibility but emotional responsiveness as well
child’s appraisal of caregivers accessibility most critical, depends on caregiver availability in past

Question 12

classification of infants- avoidant

Answer 12

babies explored through entire procedure but also avoided mother on return
sacrificed connection for exploration
apparent lack of distress but HR during separation still quite elevated
avoidant behaviour is a defensive accomodation related to detachment

Question 13

classification of infants- ambivalent

Answer 13

continuously preoccupied with mother’s whereabouts, angry or passively inconsolable upon reunion
sacrificed exploration for connection
angry- wanted reconnection and expressions of rejection on mothers return
passive- capable only of faint solace, too overcome by helplessness and misery to approach mother directly

Question 14

classification of infants- secure

Answer 14

equal access to impulses to explore when safe and seek solace in connection when they don’t

Question 15

disorganised/disoriented attachment

Answer 15

responded in bizarre or contradictory ways
attachment figure is simultaneusly experienced as both a safe haven and source of danger, child caught between contradictory impulses to approach and avoid
in parents with anger or abuse reactions, but also when child experiences parent as frightened (PPD, trance-like states)

Question 16

internalised object relations

Answer 16

internal working models of self and other
set of unconscious and conscious rules for organising information relevant to attachment
parents’ internal working models exert a decisive influence on the quality of these formative interactions that then shape our internal working models

Question 17

mary main

Answer 17

hypothesised that the rules we internalise in the course of our first relationships arise in infancy from our experience in relation to particular attachment figures
internal working models of self and others

Question 18

adult attachment interview (AAI)

Answer 18

individuals asked to recollect and reflect on history of relationship with own parents including experiences of loss, rejection and separation
questions and follow up probes draw on memories related to attachment
can prompt person to demonstrate if they have the capacity for coherent disclosure (hallmark feature of a secure state of mind)

Question 19

SST v AAI

Answer 19

SST captures quality of attachment specific to a particular relationship
AAI assesses current overarching state of mind with respect to attachment

Question 20

intergenerational transmission of attachment patterns

Answer 20

attachment patterns have a strong propensity to persist across generations

Question 21

why is secure attachment related to adaptive emotion regulation

Answer 21

secure infants can afford to be attuned to own attachment related feelings and needs, can be aware of and express them
avoidant infants cannot afford to be aware of or express their attachment related feelings and needs, anticipating mum’s rejection and own anger in response to this. Inhibit or minimise internal experiences.
ambivalent infant develops strategy for amplifying and maximising both awareness and the expression of their attachment related feelings and needs to ensure continuing care (hyperactivation in anxious attachment)

Question 22

reflective functioning

Answer 22

mentalising, the process by which we realise that having a mind mediates our experiences of the world, is associated with reflective functioning
enables us to respond to out expeirnece on basis not only of observed behaviour but also of underlying mental states including desires, beliefs, feelings that make behaviour understandable and give it meaning

Question 23

reflective funcitoning scale

Answer 23

evaluates stregnth of an individual’s mentalising capacity

Question 24

strong mentalising capacity

Answer 24

associated with greater receptivity to therapist’s interpretations in treatment
1. Awareness of the nature of mental states (understanding of self and others invariably incomplete, people may elaborately disguise internal states, some psychological responses are predictable given certain circumstances)
2. explicit effort to identify mental states underlying behaviour (accounting for behaviour in terms of beliefs feelings and desires; understanding our interpretation of others may be influenced by our own mental states or realising that feelings about a situation may be inconsistent with observable aspects of the situation)
3. recognition of the developmental aspects of mental states
4. awareness of mental states in relation to the interviewer or therapist

Question 25

co-regulation -> affect regulation

Answer 25

in early stages babies depend on their attachment figures to help them modulate their overwhelming affect
situation selection and modification done for children by caregivers
as children progress developmentally, expected to take more responsibility for regulatory processes and parents oversee and guide this self-regulation

Question 26

parents who succeed in containing their infant’s distress will usually have a

Answer 26

securely attached child with a solid potential for mentalising
parents can contain infant’s distressing affect through communicating effectively and in the language of physical care that:
1. they understand the cause of distress and its emotional impact
2. they can cope with the distress and alleviate it
3. they can recognise the child’s emerging intentional stance, child’s ability to infer intention behind parent’s behaviour (parent able to see child as separate being with own mind, crucial component of the 3)

Question 27

interactive affect regulation

Answer 27

parents who successfully contained their infant’s unmanageable emotions with responses conveying empathy, coping and appreciation of child’s internal stance
reinforcing child’s secure attachment

Question 28

projection of will

Answer 28

client consciously or unconsciously projects the responsibility for change onto you and takes an inactive stance in therapy

Question 29

initiating client into psychotherapy

Answer 29

to foster collaboration, be explicit of what we expect of them and they can expect of us, be open about therapy structure
shared understanding of client’s working model and its relationship to the problem, do not move forward until you have this shared understanding
whatever happens in relationships outside therapy will repeat in therapy especially once working alliance secure
explicit about how our focus on their interactions with the therapist can help them reach their goals in treatment

Question 30

preoccupied (anxious ambivalent) clients

Answer 30

that have a fear of abandonment and engage in overplayed helplessness will need the therapist to structure therapy to end when time appropriate and make room for client protest
they will not see the end of therapy on their own and communicate this to the therapist
therapists can legitimise a staggered termination process in which they may leave prematurely with understanding they can return when necessary and tolerable