The Influence of Individual Attachment Styles on Group Members’ Experience of Therapist Transitions

Abstract

Attachment theory has recently been applied to clinical practice in an effort to improve understanding and treatment of the maladaptive relational patterns clients bring to therapy. While most of this research has focused on individual therapy, interest in the application of attachment theory to group psychotherapy is growing. This paper will explore the impact of clients’ attachment styles on their experiences of co-therapist transition in an ongoing psychodynamic therapy group. This discussion will elucidate how knowledge of attachment theory and an understanding of clients’ individual attachment styles can be useful in predicting responses to therapist-initiated terminations and transitions.     

Authenticity: a mediator in the relationship between attachment style and affective functioning

Attachment has been show to exhibit a strong effect on emotional well-being throughout an individual’s lifetime. This study examined individuals’ authenticity as a potential mediating variable in the relationship between insecure attachment and affective functioning. Authenticity was examined from multiple perspectives to better define its role as a mediating variable. Results showed that avoidant attachment is a predictor of affective functioning, and that authenticity acts as a mediating variable in this relationship. Anxious attachment showed no direct relationship with affective functioning, yet evidence was found for an indirect pathway from anxious attachment through authenticity on affective functioning. The differing results by attachment style support Mikulincer, Shaver, and Pereg’s theory suggesting a two-part model of emotional response style, wherein individuals with avoidant attachment deactivate emotion and individuals with anxious attachment show hyper-activation when coping with emotion. The study examines the construct of authenticity and its importance in affective functioning. Implications for therapists working with clients are made that highlight the importance of authentic relationships in therapy and life.     

Changes of attachment status among women with personality disorders undergoing inpatient treatment

Background: Attachment has increasingly received attention in psychotherapy and has been used as a predictor of process and outcome. Studies investigating changes of attachment styles during psychotherapy are very rare. Method: Forty women with either borderline (BPD) or avoidant personality disorders (AVPD), treated as inpatients, were investigated using an attachment interview (interpersonal relations assessment (IRA)), and questionnaires to determine therapy outcome at the beginning and after seven weeks of therapy. The IRA uses similar questions as the adult attachment interview (AAI) and is used as the basis for the adult attachment prototype rating (AAPR), a procedure to assign individuals to prototypical categories of attachment. Results: The study showed that the therapy in general was effective. In contrast to other studies, we did not find many women classified as secure at the end of their therapy. Comparisons of pre‐post‐ratings revealed instead that clients within both subgroups received higher ratings for the avoidant prototypes at the end of therapy, indicating deactivation of attachment. Changes from ambivalent to avoidant attachment were linked with better outcome among women with borderline personality disorder (BPD). Conclusions: This study adds further evidence to the result that attachment styles do not change dramatically during a time‐limited psychological treatment of personality disorder. Instead, the study showed that features of preoccupied/ambivalent attachment were less significant after seven weeks of therapy. For women with BPD, these changes were linked with a more favourable outcome which might reflect a more structured and deactivated attachment status as a result of inpatient therapy.     

Control of the Mind Edited by Seymour M. Farber and Roger H. L. Wilson

Abstract

This article describes an innovative model of couples therapy designed to mitigate marital instability. The authors suggest that combining ongoing couples therapy with a separate relationship-focused group for each partner favorably impacts each person’s neuropsychophysiological regulation and their ability to participate in a stable intimate marriage.

The neurobiology of attachment theory is seen as providing understanding of the affect regulation issues operational in many couple relationships. The safe and secure attachments worked out in the relationship-focused group therapy are seen as improving neuropsychophysiological integration and regulation.     

Maternal depression and children's attachment representations during the preschool years

This longitudinal study aimed to investigate the impact of chronic and transient maternal depression on children's attachment representations at 4 years of age measured with the Attachment Story Completion Task ( Bretherton, Ridgeway, & Cassidy, 1990 ). The impact of concurrent maternal depressive symptoms was also considered. A secondary aim was to investigate the continuity of attachment classification at 15 months with child attachment representations at 4 years. Children of mothers who were concurrently depressed were more likely to have attachment representations characterized by uncontained physical aggression. In contrast, there were no significant relationships between exposure to prior chronic maternal depression and children's attachment representations at 4 years, nor were there any significant relationships between behavioural assessments of attachment during infancy and later representational assessments. Findings are discussed in the context of caregiving behaviours that may foster secure attachment relationships and influence a child's social‐emotional development, limitations of representational measures, as well as poor attachment stability.     

Multiple attachment relationships within families: mothers and fathers with two young children

Security of attachment between mothers and fathers and their 2 children was examined in 41 maritally intact families. Strange Situation assessments of attachment security for the younger children (mean age = 1 year 10 months), Attachment Q-sort ratings of the older children (mean age = 4 years 8 months), and ratings of parental caregiving behavior of both children were obtained. Younger and older children developed concordant attachments to both parents. Parents were consistent in their caregiving behavior toward their 2 children. However, parents were not congruent in their attachment to their 2 children. Associations were found between maternal caregiving and attachment only in the younger group. The results support the idea that parental caregiving behavior accounts for only modest portions of the variance in attachment security; evolving attachments integrate developmental inputs from the children and the caregivers in the network of early family relationships.     

Is early attachment security carried forward into relationships with preschool peers?

The association between early parent‐child attachment security and peer rejection among preschool children was examined. Children in three preschool classrooms (N = 37) participated. Mothers rated their children's attachment security at age 3 years on the Attachment Q‐Set (Waters, 1987). Sociometric ratings were collected from classmates at age 4 years through individual picture interviews. Teachers rated externalizing and internalizing behaviour exhibited at preschool. Lower attachment security was associated with greater subsequent peer rejection and higher externalizing and internalizing behaviour scores. An exploratory path model suggested that the linkage between early insecure attachment and later peer rejection may be mediated by externalizing behaviour.     

The Nonhuman Environment in Normal Development and in Schizophrenia by Harold F. Searles

Abstract

Somatic psychology, the interplay of the body, the mind, the emotions, and the social context, significantly contributes to the theory and practice of group therapy. The processing of sensory experiences in the here-and-now of the therapy group helps group members to develop self-awareness, the ability to understand their relationships with others, and the capacity for empathy. When group members know what they experience, they can understand how others feel and resonate emotionally with those feelings. Neurobiology, sensory processing, and attachment theories help us to understand how the sense of self develops somatically. Principles of somatic therapies are applied to group therapy practice in working with attachment disorders, transference impasse, and trauma. The importance and implications of the group therapist’s embodied attunement are explored.     

Marriage and Attachment

SUMMARY

Attachment behavior (Bowlby, 1969) is considered an integral part of intimate human relating throughout the life span. This research examined the recollections of ten happy couples in long-term marriages as to their attachment experiences in childhood, and their current attachment experiences in marriage. The findings indicated that none of these happily married subjects were raised in homes where both parents were physically and emotionally available. Yet, in adult life they had clearly succeeded in establishing fulfilling long-term relationships. These findings suggested that attachment behavior is subject to modification throughout the life cycle and is not rigidly fixed in childhood. The data suggested that insight, changes in the parent/subject relationship, and the marital relationship were some of the primary factors which could account for the changes in attachment behavior.     

Breaking up is Hard to do,Especially for Strongly “Preoccupied” Lovers

Abstract

Is a relationship breakup harder on certain people? To address this question, the present study investigated the relationship of individuals’ attachment styles to various reported aspects of a relationship's dissolution: initiation of the breakup, emotional reactions to the breakup, reasons for the breakup, and experiences and perceptions following the breakup. One hundred nineteen undergraduates completed an extensive questionnaire concerning a past romantic relationship that had broken up. Feeney, Noller, and Hanrahan's (1994) Attachment Style Questionnaire (ASQ) provided continous measures for five attachment styles or “attitudes”: confidence, discomfort with closeness, need for approval, preoccupation with relationships, and relationships as secondary. Principal-components analyses served to derive criterion indexes from the breakup questionnarie measures, which were individually regressed on the five ASQ scales. As predicted form attachment theory, respondents scoring high on preoccupation with relationships (reflcting anxious/ambivalent attachment) showed distinctive responses to the relationship breakup, in contrast to those scoring high on other attachment styles. Specifically, those strongly preoccupied with relationships reported (a) that their partner was unhappy in the relationship and had initiated the breakup, (b) having experienced difficulty adjusting to the breakup and felling it had been a mistake, and (c) more negative emotion and less positive emotion following the breakup. Implications of these findings are discussed     

Maltreated Children in Out-of-Home Care: The Relation between Attachment Quality and Internalizing Symptoms

Maltreated children in out-of-home care are at high risk for poor relationships with caregivers (i.e., biological parents and substitute caregivers) and high levels of internalizing symptoms. It is unclear if these poor relationships are related to, and account for a large portion of the variance in maltreated children’s internalizing symptoms, above and beyond maltreatment type and out-of-home care factors. This study examined the relation between attachment quality with both biological parents and substitute caregivers and children’s internalizing symptoms within a sample of 493 maltreated children (aged 9–11; 51.0?% male) recently placed in out-of-home care. A series of hierarchical regression models indicated that greater child-reported attachment quality with both biological parents and substitute caregivers was associated with fewer child-reported anxiety (β?=??.15, p?<?.01; β?=??.29, p?<?.001, respectively) and depression symptoms (β?=??.14, p?<?.01; β?=??.28, p?<?.001, respectively) as well as fewer child internalizing symptoms (β?=??.12, p?<?.05; β?=??.14, p?<?.01, respectively). Attachment quality with the biological parent and substitute caregiver each explained a significant proportion of the variance in children’s internalizing symptoms, above and beyond child demographics, maltreatment type, and out-of-home care variables. The study also examined whether children’s attachment with substitute caregivers moderated the relationship between children’s attachment with biological parents and children’s internalizing symptoms. No statistically significant moderation effects were found. Future clinical work should focus on enhancing attachment quality between children and both biological parents and substitute caregivers, as these relationships appear to individually relate to the children’s internalizing symptomology.     

Attachment relationships and physical activity in adolescents: The mediation role of physical self-concept

ObjectivesBased on the integration of attachment and physical self-perception perspectives, the present study examined links between adolescents' engagement in physical activity and their attachment relationships with mothers, fathers, and friends, respectively, and assessed the potential mediation role of physical self-perception in this link.Design and methodsUsing a cross-sectional design, questionnaire data was obtained from 767 adolescents (49% boys, M_age = 12.92, SD = .86) and structural equation modeling was used to examine relationships among variables.ResultsAttachment security with parents and friend was associated with higher levels of physical activity. There was partial support of the mediation role of physical self-perception, as adolescents who were securely attached to mother and friend perceived themselves as having better physical condition, which in turn predicted greater engagement in physical activity. The mediation role of physical self-perception between mother attachment and PA was stronger for female adolescents. Secure attachment to father had a direct positive effect on physical activity. The direct effect was strongest for male adolescents.ConclusionsOur findings highlight the importance of relationship-based intervention strategies to enhance and maintain healthy regular physical activity among adolescents.     

The Two Faces of Man by Joost A. M. Meerloo

Abstract

The mystery of why some people are compelled to repeatedly engage in relationships with people who are cruel to them is frequently pondered in literature and psychology. The present paper posits that the etiology of this pathological relationship pattern derives from a parental relationship that was both highly exciting and highly frustrating. Spontaneous recapitulations of the passionate masochistic relationship in the therapy group allow the patient, the therapist and the group to appreciate the exact nature of the “bad” partner’s appeal for the patient and its link to parental antecedents. In addition, the author suggests, group therapy can provide attachment experiences that are stimulating and rewarding enough to override the patient’s attraction to the toxic partner(s) and build an enhanced capacity for intimacy. The cases of two patients are presented who spent three and a half years in the same long term psychodynamic group, and who, through the processes described above, successfully resolved their masochistic relationship patterns.     

Fat Women’s Experiences in Therapy: “You Can’t See Beyond…Unless I Share It with You”

Abstract

This article reports the results of a qualitative exploration of fat women’s experiences with weight-related microaggressions in psychotherapy. We conducted semi-structured interviews with 15 women about their weight-related experiences as therapy clients and asked for their advice to therapists who work with fat women. We used a general inductive approach to code the data into themes and found that common microaggressions included therapists who overly focused on weight, therapists who appeared to be less interested in clients because of their weight, and dissatisfaction with waiting room seating options. Participants advised therapists to allow their clients to initiate conversations about weight. Results suggest the need for increased awareness of: (a) how clients’ weight may impact therapists’ attitudes and choice of interventions and (b) how weight might influence fat clients’ in-session presentations.     

Attachment representations and characteristics of friendship relations during adolescence

Attachment theory proposes that experiences with the primary caregivers are an important basis for the development of close social relationships outside the parent-child relationship. This study examined the association between representations of attachment, as assessed with the Adult Attachment Interview (AAI), representations of friendship and peer relations, as assessed with an interview in a sample of 43 adolescents. Secure attachment representations were significantly related to interview-based assessments of close friendships, friendship concept, integration in a peer group, and emotion regulation within close friendships. Attachment experiences reported during the AAI, their integration, and their coherency were related to friendship quality and friendship concept. Results show the close associations between attachment representations and friendship relationships during adolescence. The associations between peer relations and attachment representations differed depending on whether an interview approach or a questionnaire approach was used.     

Adoption,attachment, and relationship concerns: A study of adult adoptees

We examined the impact of adoptive status and family experiences on adult attachment security and how attachment predicts relationship outcomes. Adults adopted as infants (N = 144) and a sample of nonadoptees (N = 131) completed measures of attachment security at recruitment and 6 months later; other measures assessed parental bonding and adoptees’ reunion experiences (Time 1), and relationship variables (e.g., loneliness, relationship quality; Time 2). Insecurity was higher for adoptees and those reporting negative childhood relationships with parents. For adoptees only, recent relationship difficulties also predicted insecurity. Attachment dimensions were more important than adoptive status in predicting relationship variables and mediated the effects of adoptive status. The results support the utility of attachment theory in understanding adoptees’ relationship concerns.     

School-Aged Children’s Attachment Dismissal Prospectively Predicts Divergence of Their Behavioral and Self-Reported Anxiety

Recent studies on attachment in middle childhood suggest that dismissing children tend to underreport their psychological distress relative to physiological indices of distress. However, this has yet to be examined in the context of behavioral indicators of distress. In this longitudinal study, a community sample of children (N?=?34, M _age?=?9.59 years) completed the Child Attachment Interview at Time 1. Three years later, they returned and completed the Trier Social Stress Task for Children (TSST-C), providing ratings of their state anxiety before and after the stressor. Four raters coded children’s behavioral signs of anxiety (e.g., non-signaling gestures, eye movement, posture, facial expression) on a 7-point scale during the storytelling and arithmetic tasks in the TSST-C. Hierarchical linear regressions revealed that greater attachment dismissal was associated with greater behavioral anxiety in both the story and math tasks, but was not associated with greater increases in self-reported anxiety. Dismissal prospectively predicted increased divergence of behavioral and self-reported anxiety, such that higher dismissal was associated with higher divergence scores (i.e., underreporting of anxiety relative to behavioral indicators). We discuss these results in terms of their contribution to understanding attachment and emotion in an understudied developmental phase.     

Reliability and stability of adult attachment patterns

A basic premise of attachment theory is that internal models of attachment remain relatively stable across the life span. We examined stability and change in adult attachment representations over 8 months in a sample of young adults (N = 144; Mean age = 24.5 years). Attachment patterns were assessed by categorical and continuous ratings across three methods—self-report ratings, expert ratings based on semi-structured interviews, and reports of romantic partners—and showed moderate stability. Interview ratings tended to show higher stability than self-report ratings. Changes in attachment ratings (across methods) were not consistently related to life events that had occurred in the intervening 8 months. The relationship between reliability and stability was discussed, and where the “true” stability could be estimated independent of unreliability, it was found to be very high (r's ranging from .72 to .96). The results highlight the importance of using multiple indicators in assessing adult attachment and using continuous rather than categorical ratings in the assessment of stability.