Theories of Attachment: The Long and Winding Road to an Integrative Developmental Science

Although traditional accounts of attachment theory attempted to partition the organism’s attachment and separation responses into those that were instinctive and those that were the result of the developmental environment, recent findings from epigenetics are indicating that no such partitioning is possible, even in principle. Rather than assuming the expression of a given behavioral trait is based on some set of instincts (as Bowlby and many of his colleagues did for attachment and separation responses), behavioral development is now seen as a self-organizing, probabilistic process in which pattern and order emerge and change as a result of ongoing co-actions among developmentally relevant components both internal (e.g., genes, hormones, neural networks) and external (e.g., temperature, diet, social interaction) to the organism. Exploring the specific prenatal and postnatal features of the mother–infant interaction system is providing a new appreciation of the complexity of the origins and maintenance of early attachment and its long-term consequences.

Assessment of Adult Relatedness: A Review of Empirical Findings From Object Relations and Attachment Theories

Assessment techniques designed to measure adult behavior and mental representation that emphasize relatedness constructs are reviewed. These measures grow out of two traditions, object relations and attachment theories. Although these two paradigms are fairly well elucidated theoretically, the relevant assessment literature is only more recently expanding, especially that focusing directly on adult attachment as opposed to childhood attachment, in addition to a presentation of various projective and objective measures, this review highlights the clinical and research implications for integration of these two paradigms around the cognitive, affective, and behavioral vicissitudes of adult relatedness.     

Genetic Library: Grief and Bereavement

As genetic counselors, we frequently encounter families that have experienced a significant loss, be it a pregnancy, a child, or a parent. The purpose of this Genetic Library is to introduce genetic counselors to some of the research that is currently being conducted in the areas of grief and bereavement support, as well as end-of-life care. Of course, it is impossible to capture the richness of these articles in one or two paragraphs. We therefore encourage interested genetic counselors to request and review the full version of these papers.     

The Trauma and Complicated Grief of Ambiguous Loss

Ambiguous loss is a newly identified type of loss that occurs when a loved one is physically present, but psychologically absent. Dementia is just one example. Because the lost person is here, but not here, grief is frozen, life is put on hold, and people are traumatized. With no official verification of death, no possibility of closure, and no rituals for support, there is no resolution of grief (Boss 1999). Clergy, especially pastoral counselors, can witness and provide comfort for such uncanny loss because people rely on them for support, not just from the clear loss of death, but from the ambiguous losses, catastrophic and ordinary, that inevitably will occur across the life course.     

The Interface Between Attachment and Intersubjectivity: Perspective from the Longitudinal Study of Disorganized Attachment

This article considers the interface between the concepts of attachment and intersubjectivity in light of accumulated research on infant development. Both Tomasello (1999) and Hobson (2002) have argued persuasively that the flexible human capability for sharing mental states with others reframes and revolutionizes our older, more highly channeled primate biological heritage. In contrast to this emphasis on discontinuity from primate to human evolution, attachment theorists have stressed the continuities between human attachment and attachment in other primates. The implication of new work on infant intersubjectivity for reframing aspects of attachment theory is first explored. By the same token, however, the extent to which the infant–caregiver attachment relationship functions to maintain positive engagement and regulate the infant's fearful arousal will have escalating consequences over development for the organization of intersubjectivity. Therefore, attachment research has much to offer in understanding the development of joint attention and the sharing of mental states under conditions of increased emotional arousal. The potential contributions of attachment research for understanding the development of intersubjectivity are discussed in light of recent work from the author's lab on forms of young adult symptomatology associated with deviance in the early intersubjective dialogue between mother and infant. The clinical implication emerging from all these diverse areas of research is that fostering more collaborative forms of communication may lie at the heart of evolutionary change, developmental change, and changes resulting from psychodynamic psychotherapy.     

The Adult Attachment Projective Picture System: Integrating Attachment Into Clinical Assessment

This article summarizes the development and validation of the Adult Attachment Projective System (AAP), a measure we developed from the Bowlby–Ainsworth developmental tradition to assess adult attachment status. The AAP has demonstrated excellent concurrent validity with the Adult Attachment Interview (George, Kaplan, &; Main, 1984/1985/1996 Finn, S. E. 2007. In our client's shoes: Theory and techniques of therapeutic assessment., New York, NY: Psychology Press.  [Google Scholar]; Main &; Goldwyn, 1985–1994 Lis, A., Mazzeschi, C., Di Riso, D. and Salcuni, S. 2011/this issue. Attachment, assessment, and psychological intervention: A case study of anorexia. Journal of Personality Assessment, 93: 434–444. [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]; Main, Goldwyn, &; Hesse, 2003 Lyons-Ruth, K. and Jacobvitz, D. 2008. “Attachment disorganization: Unresolved loss, relational violence, and lapses in behavioral and attentional strategies”. In Handbook of attachment: Theory, research, and clinical applications , 2nd ed, Edited by: Cassidy, J. and Shaver, P. R. 666–697. New York, NY: Guilford.  [Google Scholar]), interjudge reliability, and test–retest reliability, with no effects of verbal intelligence or social desirability. The AAP coding and classification system and application in clinical and community samples are summarized. Finally, we introduce the 3 other articles that are part of this Special Section and discuss the use of the AAP in therapeutic assessment and treatment.     

The Loss and Grief in Immigration: Pastoral Care for Immigrants

Immigration is common in this increasingly globalized world. Immigration is a psycho-social-geographical transition that involves a series of losses and changes, most of them obvious and expected, but some of them hidden and unexpected. Immigration also involves changes in one’s identity, as inner change tries to match outer change. The original story of immigration—by Abraham in the Bible—highlights some of the issues immigrants typically confront. A survey of Taiwanese immigrants in San Francisco and Vancouver, Canada illustrates some of the most troubling of these issues. Congregations, particularly bicultural congregations, are especially well-equipped to minister to the needs of the newly immigrated. Pastors need to be sensitive to the issues and needs of immigrants in a world where we are all foreigners in one sense or another.     

Dispositionality: Beyond The Biconditionals

I defend pretence hermeneutic fictionalism against the Autism Objection. The objection is this: since people with autism have no difficulty in engaging with mathematics even if they cannot pretend, it is not the case that engagement with mathematics involves pretence. I show that a previous response to the objection is inadequate as a defence of the kind of pretence hermeneutic fictionalism put forward as a semantic thesis about the discourse in question. I claim that a more general response to the Autism Objection is to deny the premise that people with autism cannot pretend. To motivate this response, I appeal to psychological studies suggesting that people with autism can understand pretence and they can pretend under certain conditions. Finally, I provide explanations for why it is the case that people with autism do not have a problem with engaging in mathematics whereas they have so much difficulty with other kinds of figurative language and pretence.     

The Aging Of Grief: Parents' Grieving Of Israeli Soldiers

Abstract

This chapter examines long-term parental grief of soldiers within the context of the Israeli society. Parental grief is discussed along the life span, commencing at the immediate phase following the loss through the bereavement process in middle to late adulthood and its manifestations in aging. Interviews with a group of elderly bereaved parents whose sons were killed during military service give further support to previous findings regarding the notion that the passage of time has no diminishing effect on their grief nor does it relinquish their attachment to the deceased. With aging, there appears to be an increase in internalized involvement with the long-lost child, fears of fading memories, and the need to eternalize the deceased. In reviewing the past, parents reevaluate their coping with the loss and their relationship with the surviving children. The parents' preoccupation is twofold: On one hand, the strong attachment seems to continue in inner representations of the lost child, and, on the other, this preoccupation is enhanced externally owing to Israeli society's attitude toward dead soldiers. An intersection is therefore established between society and bereaved families. Grief is apparently a central theme in aging parents who are preoccupied with the “aging” of their grief rather than their own aging.     

Suicidal Ideation in Elderly Bereaved: The Role of Complicated Grief

This study examined whether symptoms of complicated grief at baseline predicted suicidal ideation during a depressive episode in elderly bereaved individuals. Over a 17-month period, serial ratings of suicidal ideation, hopelessness, and symptoms of depression, anxiety, and complicated grief were obtained from 130 elderly participants who had lost their spouses within the past 2 years. Groups of active and passive suicidal ideators, as well as nonideator controls, were compared via analysis of variance (ANOVA) with respect to levels of complicated grief, depression, and anxiety. Elderly bereaved with both active and passive suicidal ideation were found to have higher symptomatic levels of depression, hopelessness, complicated grief, and anxiety, as well as lower levels of perceived social support, than nonideators at study entry. Fifty-seven percent of the patients with high complicated grief scores were found to be ideators during the follow-up versus 24% of the patients with low complicated grief scores. Patients with any suicidal ideation had higher symptom levels of depression, anxiety, and complicated grief when they were ideators as compared with periods when they denied ideation. Fifteen out of the 39 ideators had recurrent depressive episodes versus 5 of the 91 nonideators. Patients with a history of suicide attempts were more likely to be ideators after loss than other bereaved. Thus, the condition of having high levels of complicated grief symptoms and depressive symptoms appears to make bereaved individuals vulnerable to suicidal ideation. Detection of high levels of complicated grief could help clinicians identify patients who may be at heightened risk for suicide.     

The Phenomenology of Bereavement, Grief, and Mourning

Loss, understood as a process of bereavement, grief, and mourning, most immediately affects our bodily experience in our world, known in the phenomenological tradition as our lived world. Unlike Cartesian conceptions of the body as a self-contained entity, encapsulated within the skin, our bodying forth, as articulated in the discourse of Merleau-Ponty, and more recently Drew Leder, entails various manifestations of lived experience. These reflections on miscarriage loss, understood through the notions of Merleau-Ponty's chiasmic structure of flesh, and Drew Leder's recessive, ecstatic, and dys-appearing body, provides the possibility for a phenomenology of lived loss.     

Caregiving: The Forgotten Element in Attachment

In attachment theory, an attachment behavioral control system in the child and a complementary caregiving system in the parent act together to protect the young. The attachment account, however, fails to supply a motivation for caregiving. As a result, it cannot give a theoretical explanation for the responsive and attentive behaviors empirically observed in caregivers of secure children. In this article, we present an account of caregiving that places emotion at the center of caregiving (the connection theoretical orientation). In this account, the dyadic emotion of caring serves as an autonomous motivation to see that the needs of a specific dependent are met. Unlike the "on-off" caregiving in attachment theories, connection caring is conceptualized as enduring and variable: Caregivers experience different levels of caring over the course of a relationship. Through the emotional concepts of caring, empathy, and responsibility, the connection theoretical orientation is able to provide the coherent account of caregiving that the attachment theoretical orientation's cybernetic concepts have been unable to supply.