Lecture_9_Attachment & Loss in Human Relationships

Question 1

define attachment:

Attaching/Detaching: Basic Concepts:

• What is meant by the term attaching?
  
  • when does it begin, and to whom/what?
• What is meant by the term detaching?
  
  • ​what is this a strategy for?

Answer 1

• What is meant by the term attaching?
  
  • ​connecting with another in some emotionally significant manner; investing oneself emotionally in another
    
    • when does it begin, and to whom/what?
      
      • ​early symbiosis; parent-child; romantic attraction; pets; land; photographs
• What is meant by the term detaching?
  
  • disconnecting from another
    
    • what is this a strategy for?
      
      • part of a normal, rythmic process, that may involve loss; a strategy of defense

Question 2

define attachment:

Importance of Attaching & Detaching:

• What are attaching and detaching basic to?
• What role do they play?
• How do these styles or patterns of attachment/detachment develop?
• How will they be involved in patient encounters?
• What does our ability to form attachments enable us to do?
• What does our ability to detach enable us to do?
• What does too much attachment lead to? Too much detachment?

Answer 2

• What are attaching and detaching basic to?
  
  • basic to survival and development
• What role do they play?
  
  • play a determining role in how mental and emotional development proceeds
• How do these styles or patterns of attachment/detachment develop?
  
  • styles (patterns) of both develop over time
    
    • endure and affect all subsequent relationships, including patient-doctor
• How will they be involved in patient encounters?
  • ​Many of the patient concerns you will see in practice involve attachment & loss
• What does our ability to form attachments enable us to do?
  
  • feel connected with others
  • experience a sense of being loved and loving
  • feeling part of a larger whole
• What does our ability to detach enable us to do?
  
  • ​distance when we feel threatened or too close
  • reduce emotional intensity
  • experience a sense of ourselves as autonomous and free
  • may involve a sense of loss
• What does too much attachment lead to? Too much detachment?
  • Too much attachment:
    
    • loss of autonomy & freedom
    • loss of identity
    • inability to move on in the face of a loss
    • dependency based relationships that drag others down
    • Examples: enmeshed couples; chronic grief
  • Too much detachment:
    
    • loss of connection to the human community
    • loneliness
    • isolation
    • loss of meaning & purpose
    • Examples: personality style; “rugged individualism”

Question 3

recognize the basic concepts and terminology of attachment theory:

describe the basic characteristics of attachment and behaviors associated with it:

Basic Concepts/Terminology/Behaviors of Attachment Theory:

• What is the definition of attachment?
• What are the characteristics/behaviors (activators of these behaviors) of attachment bonds?
• What are the attachment hierarchies and how are they determined?
• What are some common attachments?

Answer 3

• What is the definition of attachment?
  
  • a relatively enduring emotional bond with another person that forms in response to exposure, interaction, and familiarity.
• What are the characteristics/behaviors (activators of these behaviors) of attachment bonds?
  
  • Characteristics:
    
    • person-specific
    • persistant
    • emotionally significant
  • Behaviors:
    
    • proximity seeking*
    • separationg protest*
    • clinging; crying; checking, etc. (activated by internal distress or external threat)
    • * = often not present in cases of children w/abusive parents
• What are the attachment hierarchies and how are they determined?
  
  • infants typically have 2-3 attachment figures, but one is preferred in times of distress
    
    • determined by:
      
      • time spent
      • quality of care
      • adult’s emotional investment
      • emotional responsiveness of adult
      • repeated presence across time
• What are some common attachments?
  
  • people, places, animals, homes
  • land, profession, books, art work, music
  • others, depending on what is important to the family/culturally

Question 4

name the core functions of attachment:

Core functions of attachment:

• What are the core functions of attachment and what are some details about each core function that are important?

Answer 4

• What are the core functions of attachment and what are some details about each core function that are important?
  
  • Protection/Survival:
    
    • Safe Haven:
      
      • Protection, Comfort, soothing (a place where)
        
        • hurts can be healed
        • that is safe
        • that has our best interests at heart
        • we are not afraid to be known
        • we are loved & treasured
        • that is a santuary from the worries of life
    • Secure base:
      
      • a place from which to explore
      • a place to return for refueling, support
        
        • attachment takes precedence of exploration
          
          • secure attachment fosters exploration and separation
          • insecure attachment inhibits exploration and separation
  • Regulation: of physiological arousal & emotional distress
    
    • the comforting/soothing provided by a caregiver:
      
      • helps keep a child’s emotions within manageable bounds for the child’s developing system
      • fosters development of the child’s own self-regulatory capacities
    • cycle: Match–Mismatch–Reparation
  • Development of a sense of self
    
    • ​​the role of mirroring
      
      • (mirroring –> “feeling felt”–> sense of self)
        
        • parent is open to receive signals of the child and respondes in an attuned way
          
          • child needs to find herself in the gaze of the caregiver in order to know herself
          • child perceives image of himself in caregiver’s response and internalizes this
      • Edward Tronick (Still-Face experiment): What did we learn from it?
        
        • Concept of mirroring
        • –Mirroring –> ‘feeling felt’ –> sense of self
        • –Mirroring promotes self-expression, empathy, capacity to mentalize
        • What’s Mentalize mean?
          
          • The ability to see oneself “from the outside and see others from the inside.”
  • Foundation for mentalizing (learning about the human mind)
    
    • the process of making sense of one’s own mind and the minds of others
    • mirroring promotes self-expression, empathy, and the capacity to mentalize
      
      • the ability to see oneself “from the outside and see others from the inside”
      • “The capacity to perceive, reflect on, and understand oneself and others’ intention and behavior

Question 5

describe the efects of attachment and loss on physical and psychological well-being

Neurobiology of Attachments:

• How does energy & information pass from one neuron to the next?
• What does this pattern of on-off signals cause to form?
• What is the influence of these linkages?

Answer 5

• How does energy & information pass from one neuron to the next?
  
  • energy & information pass from one neuron to another through neuro-transmitters in the brain.
• What does this pattern of on-off signals cause to form?
  
  • on-off firing patterns of neurons form “neural net profiles” of experience
• What is the influence of these linkages?
  
  • these linkages influence the liklihood that these neurons will fire together in the future

Question 6

describe the efects of attachment and loss on physical and psychological well-being:

Working models:

• What are working models?
• What happens to them and how are they used?

Answer 6

• What are working models?
  
  • internalized mental representations of early experienced interaction patterns with attachment figures:
    
    • cognitive-affective sequences based on experience of self in relation to another
• What happens to them and how are they used?
  
  • ​become habitual and are used with little conscious awareness (implicit memory)
  • regulate, interpret, predict behavior

Question 7

describe the efects of attachment and loss on physical and psychological well-being:

Key Research Findings From Attachment Research:

• What are the key findings from attachment research?

Answer 7

• What are the key findings from attachment research?
  
  • ​co-created *relationships of attachment *are the key context for development
  • preverbal experience makes up the core of the developing self
  • the stance of the self toward experience predicts attachment security better than the facts of personal hisotyr themselves

Question 8

describe the efects of attachment and loss on physical and psychological well-being:

Attachment Loss:

• Who is the main researcher re: attachment loss and what did he/she say?
• What makes the mourning process so intense & painful?
• What is the consequence?
• Is this restricted to only humans?

Answer 8

• Who is the main researcher re: attachment loss and what did he/she say?
  
  • Bowlby: we are designed by natural selection to resist prolonged separation & the giving up of primary attachment figures
• What makes the mourning process so intense & painful?
  
  • This resistance plays a role in making the mourning process so intense & painful
• What is the consequence?
  
  • attachment loss will often create anxiety & despair
    
    • Stages of Grief–
      Bowlby:
      
      • Numbness or protest
      • Yearning & Searching
      • Disorganization & Despair
      • Reorganization
• Is this restricted to only humans?
  
  • No, example from 11/15/2001 where an accident in India led witnesses to see about 100 elephants crying loudly, trumpeting, tears rolling down their faces, and circling the corpses of their fellow elephants that died near the railroad tracks.

Question 9

describe the efects of attachment and loss on physical and psychological well-being:

Attachment Loss_Forms of Loss:

• What are the different forms of attachment loss? Examples?
• What can happen if these losses are not dealt with appropriately?

Answer 9

• What are the different forms of attachment loss? Examples?
  
  • Disenfranchised & Under-recognized loss:
    
    • loss of a relationship
      
      • child: abortion, death, cut-off
      • spouse: death, divorce, coming out process
    • perineatal losss: before, during and after birth
    • intertility
    • loss of a homeland or culture
    • loss of physical abilities
• What can happen if these losses are not dealt with appropriately
  • Cumulative loss
    • anniversaries of loss may precipitate symptoms (e.g. anxiety and depression
    • loss of current attachment figures will bring up emotions connected with earlyier losses of attachment figures
      
      • even losses that occur during the pre-verbal period of development
    • If not fully integrated, loss experiences accumulate in reservoirs that can erupt

Question 10

describe the efects of attachment and loss on physical and psychological well-being:

Disruptions in the attachment system:

• What sorts of things can upset/make an attachment system malfunction? What do these do to the child?
• What are the primary predictors of depression in adults?

Answer 10

• What sorts of things can upset/make an attachment system malfunction? What do these do to the child?
  
  • predispositions (temperament) in the child can lead to decreased attachment seeking behavior
  • parental behavior and/or neglect (temperament, cumulative life experience) can be disorganizing for the child
  • Abusive caregivers:
    
    • heighten attachment needs, BUT provide minimal safe haven and secure base functions
      
      • the greater the threat, the more the child’s attachment seekig behavior is activated
    • hinder development of regulatory capacities
    • erode self-esteem and self-efficacy
• What are the primary predictors of depression in adults?
  
  • Heredity
  • Severe situational stress
  • Early attachment trauma resulting from:
    
    • loss
    • abuse
    • neglect
• YOU WILL ALWAYS WANT TO SCREEN FOR THESE IN PTS