L9: Attachment and Loss in Human Relationships

Question 1

Define attachment.

Answer 1

• Attachment is defined as a relatively enduring emotional bond with another person (or object) that forms in response to exposure, interaction and familiarity.

Question 2

What are the basic characteristics of attachment bonds? What behaviors are indicative of attachment?

Answer 2

• Bonds are: Person-specific (not interchangeable), Persistent, Emotionally significant - Behaviors seen: proximity-seeking and separation protest (crying, checking etc.)

Question 3

What are determinants of the attachment hierarchy?

Answer 3

• Time spent - Quality of care - Adult’s emotional investment - Emotional responsiveness of adult - Repeated presence across time

Question 4

Name the core functions of attachment. Explain.

Answer 4

• Protection/survival (establishing safe haven and secure base) - Regulation of physiological arousal and emotional distress - Development of a sense of self (through mirroring) - Foundation for mentalizing (process of making sense of one’s own mind and minds of others)

Question 5

What is mirroring? What is its function? How can it be accomplished during child development and in therapy?

Answer 5

• Mirroring refers to “feeling felt” in order to develop a sense of self. - It develops a sense of self in the person performing the mirroring. - Parent must be open to receiving signals from the child and respond in attuned way. Child needs to find him/herself in gaze of caregiver in order to know him/herself. Child perceives image of him/herself in caregiver’s response and internalizes it. - As therapist, give pt a different view of themselves than what they were experiencing before. Provide feedback that is affirming so that pt may internalize it.

Question 6

What is mentalizing? What is its function?

Answer 6

• Mentalizing is the process of making sense of one’s own mind and the minds of others. It serves to promote self-expression and empathy.

Question 7

How is “mind” developed?

Answer 7

• Children develop their minds from the outside in, not from the inside out. We co-create one another. - Experiences shape the brain connections that create the mind and enable an emerging sense of self in the world. - None of us is a person until we are called forth by the responsiveness of others.

Question 8

What does too much attachment lead to?

Answer 8

• Loss of autonomy and freedom - Loss of identity - Inability to move on in face of loss - Dependency based relationships that drag others down

Question 9

What does too much detachment lead to?

Answer 9

• Loss of connection to the human community - Loneliness - Isolation - Loss of meaning and purpose

Question 10

What are effects of attachment loss?

Answer 10

• Anxiety, despair, depression

Question 11

What are losses that are disenfranchised and under-recognized?

Answer 11

• Relationship loss - Perinatal loss - Infertility - Loss of homeland/culture - Loss of physicial abilities

Question 12

Explain concept of cumulative loss?

Answer 12

• Cumulative loss are losses that are not fully integrated and accumulate in reservoirs that can erupt with there are loss(es) of current attachment figures or anniversaries of loss.

Question 13

How do abusive caregivers disrupt the function of attachments?

Answer 13

• Heighten attachment needs, but provide minimal safe have and secure base functions - Hinder development of self-regulatory capacities - Erode self-esteem and self-efficacy

Question 14

What are primary predictors of depression in adults? How should you screen your pts for depression?

Answer 14

• Heredity - Severe situational stress - Early attachment trauma resulting from loss, abuse or neglect