L10: Attachment Styles: Effects on Development and Behavior

Question 1

Why are attachment styles important?

Answer 1

• Provides diagnostic data that have clinical relevance and predictive value - Helps navigate complex and difficult relationship both personally and professionally - Can help: minimize emotional needs of pts, minimize pt reactivity and keep office setting a safe place conducive to pt self-disclosure and healing

Question 2

What is Bowlby’s Hypothesis on attachment styles?

Answer 2

• Behavioral patterns of seeking care and expressing emotions form as a function of mother’s response to child - Patterns that become preferred are those that provide felt security: repeated patterns are internalized and become working models / attachment styles

Question 3

What are the 4 basic attachment styles and what fosters their formation?

Answer 3

1.) Secure 2.) Anxious-ambivalent aka Ambivalent-insecure* 3.) Avoidant aka Avoidant-insecure* 4.) Disorganized aka Disorganized-insecure or disoriented* *all known as insecure

Question 4

Describe each of the attachment styles on the spectrum of anxiety, avoidance/attachment axes.

Answer 4

1.) secure: low anxiety, low avoidance, high attachment 2.) anxious-ambivalent: high anxiety, low avoidance, high attachment 3.) avoidant: low anxiety, high avoidance, low attachment 4.) disorganized: high anxiety, high avoidance, low attachment

Question 5

What are the characteristics of each attachment style for a child or adult following a particular attachment style? What are characteristics of caregivers that lead to each of these styles?

Answer 5

Question 6

What do internalized working models of relating reflect for a clinician?

Answer 6

• Child’s internal representations of relationships - Quality of caregiver-child interactions - Child’s expectation of caregiver’s responsiveness to attachment needs - Child’s attempt to regulate affect and keep her/himself safe - Child’s capacity to mentalize

Question 7

What is the function of mentalizing? How do insecure styles alter mentalizing and what occurs when mentalization fails or is problematic?

Answer 7

• Ability to mentalize enables one to consider behavior from multiple perspectives. - Failure to mentalize leaves one stuck in rigid, reaction, repetitive patters of interaction - Problems in mentalizing are prominent in personality disorders.

Question 8

What causes insecure attachment and indiscriminate attachment behavior? What are these predictive of?

Answer 8

• Causes: infants being reared in institutional settings, disrupted affective communication between parent and infant and particularly disorienting/confusing behaviors on part of parent. - These are predictive of later behavioral problems in a child

Question 9

What is the function of reorganization? When does it occur? Who does it occur in? What are ways in which reorganization occurs?

Answer 9

• Reorganization is designed to maintain the attention and involvement of the caregiver. - Occurs between 18 months and 6 years old in many disorganized infants or children - Ways to reorganize include: child seeks to control through punitive hostile or humiliating behaviors OR through solicitous, directing and caregiving behaviors – child starts acting like parent.

Question 10

What ways do disorganized infants change their attachment behaviors?

Answer 10

• Child undergoes reorganization process to change their attachment behaviors into controlling ones that are directed at parent. - Ways: child seeks to control through punitive hostile or humiliating behaviors OR through solicitous, directing and caregiving behaviors – child starts acting like parent.

Question 11

What is psychopathology according to Bowlby?

Answer 11

• a succession of experiences that divert direction of pathways away from resilience and competent functioning.

Question 12

What are the signs indicating that attachment trauma has occurred that can lead to psychiatric problems?

Answer 12

• Severe chronic physical and/or sexual abuse - Disorganized/disoriented attachment patterns - Anxiety and depression

Question 13

What are key findings of Main’s Adult Attachment interview?

Answer 13

• An individual’s working model of attachment is observable in characteristic patterns based on their narrative presentations - Interview asks participants to describe childhood attachment relationships and experiences. 1 year old child of these parents are observed according to Strange Situation Procedure. - The way an adult talked about early attachment experiences correlated with attachment styles identified by Ainsworth, ie. secure, anxious-ambivalent, avoidant, disorganized. - Children of AAI mothers after assessment had same style of attachment as parent. - Adult security is reflected in ability to talk about past attachment experiences in a coherent and collaborative way. - Mother’s who are aware/reflective of their own attachment processes are more likely to be sensitive to child’s attachment needs. - Attachment styles of parents tend to be passed on to their children unless there are significant other influences/variables.

Question 14

According to Main, how does one determine an individual’s working mode of attachment?

Answer 14

• The mode of attachment pertaining to an individual is observable in characteristic patterns of their narrative presentations obtained through the Adult Attachment Interview.

Question 15

What are the characteristics found during Main’s interview that correspond to the basic attachment styles?

Answer 15

Question 16

How do attachment styles affect mate selection?

Answer 16

• We tend to unconsciously seek out those who resonate with our early attachment figures and patterns of relating however unsatisfactory they may have been.

Question 17

What are the characteristics of a couple whose styles are secure/secure?

Answer 17

• Each partner functions as secure base for other - Partners are empathetic of other’s needs - Can move back and forth between dependent child and comforting adult - Can openly express needs for comfort/contact, and also receive this

Question 18

What are the characteristics of a couple whose styles are anxious / avoidant?

Answer 18

• Become trapped in vicious cycles - More anxious partner demands love, more avoidant partner withdraws and / or attacks other for expression of dependency needs - Highly conflicted due to anxious partner’s fear of abandonment and avoidant partner’s fear of intimacy

Question 19

Each time you ask the patient about a different time of his life, he goes into a detailed discourse that makes you wonder how relevant it all is. He describes in detail and with over-flowing emotion how his father would take time off from his busy schedule to take him fishing and how proud his father was of him no matter what size fish he caught and how hard it was to go back home realizing it would be a long time before they would be close like that again. He also says that it is important to him that his doctor be available to take phone calls when he needs to talk or has a question, and asks you if that is something you do. Given the above description, what attachment style does this patient exhibit?

Answer 19

• Anxious-ambivalent

Question 20

When you ask the patient to describe his mother, he looks away, lowers his head, and stares into space. In a few seconds he responds, “What did you say? Oh, yes, my mother. She was OK. She let me get a dog once, but I didn’t know how to take care of it, so we had to get rid of it. I think I was 4 at the time. I liked to hold him tight, but he didn’t behave and would wiggle and jump out of my arms and I would get mad at him and chase him around the house. I think he loved me, but when I chased him he’d bark. My mother would laugh, but then she got angry and told me I had to get rid of him. I think his name was Spot, or maybe it was Boy, I can’t remember things that long ago.” Given the above description, what attachment style does this patient exhibit?

Answer 20

• Disorganized

Question 21

While taking a psychosocial history with a new patient, he responds to your questions in a direct and confident manner and is able to describe the positive and negative influences key figures had on his life. He tears up as he reports the recent death of his mother, indicates he misses her a lot, and that he appreciates you taking the time to ask him about important people in his life. Given the above description, what attachment style does this patient exhibit?

Answer 21

• Secure

Question 22

When asked about what his parents were like, he reports, “They’re great. The best parents anyone could have. We had no problems in our family. Everyone got along great. I never heard a cross word between my parents, and they were always there for me.” When asked how close he was to his mother, he replied unemotionally, “I knew my mom loved me. She died recently. The funeral was really nice and quite a few people came. She didn’t have much time for us kids, though, working as she did. Is this really important?” Given the above description, what attachment style does this patient exhibit?

Answer 22

• Avoidant

Question 23

John comes home from work. He enters the house without saying he’s home. Mary, preparing dinner in the kitchen and hearing him enter, says, “Is that you John?” He answers, “Yup,” and goes to the BR to change clothes. After changing clothes, he sits down, turns on the TV and watches the news. Mary calls him for dinner, and they eat with her asking questions about his day, and him responding with short and non-descriptive replies. She asks if he notices she fixed his favorite dish for dinner. He says, “Now that you mention it, yes. Thanks.” She says she really wanted to please him since she loves him so much and she’d do anything for him. She then says, “Let’s go to a movie tonight and sit in the rear of the theatre so we can cuddle.” He says, “I’d rather stay home and read. You can go with a friend if you like, I don’t mind.” Mary says, “John, seeing the movie is not the point. I want to be with you! Why don’t you ever want to spend time with me? You come home and plop in front of the TV and show no interest in me or my day. I don’t think you love me anymore. Maybe you have someone else in your life that’s more important than me. You do seem a lot happier around that new secretary of yours than you do at home.” John responds, “That’s ridiculous, I spend a lot more time at home with you than I do with her. I love you a lot; I told you that yesterday, or was it last week? I just need some space at times. Go to the movie with your friend; I’ll be fine.” Mary responds, “OK, OK. I’ll stay home with you and we can sit together on the couch and I can run my fingers through your hair while you read.” John responds, “Why do you have to hang on me all the time. You need to get a life of your own! Go to the movie. I’m going to bed!” Given the above description, what combination of attachment styles does this couple exhibit?

Answer 23

• Anxious-ambivalent/avoidant