Attachment-Based Psychotherapy: Helping Patients Develop Adaptive Capacities

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Indeed, our hypothesis is that they occur when a child is attempting to control crying, for they tend to vanish if and when crying breaks through. Crittenden, for example, noted that one abused infant in her doctoral sample was classed as secure B by her undergraduate coders because her strange situation behavior was "without either avoidance or ambivalence, she did show stress-related stereotypic headcocking throughout the strange situation. This pervasive behavior, however, was the only clue to the extent of her stress".

Drawing on records of behaviours discrepant with the A, B and C classifications, a fourth classification was added by Ainsworth's colleague Mary Main.

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If the behaviour of the infant does not appear to the observer to be coordinated in a smooth way across episodes to achieve either proximity or some relative proximity with the caregiver, then it is considered 'disorganized' as it indicates a disruption or flooding of the attachment system e. There is rapidly growing interest in disorganized attachment from clinicians and policy-makers as well as researchers. Sroufe et al. Main and Hesse [70] found most of the mothers of these children had suffered major losses or other trauma shortly before or after the birth of the infant and had reacted by becoming severely depressed.

Across different cultures deviations from the Strange Situation Protocol have been observed. A Japanese study in Takahashi studied 60 Japanese mother-infant pairs and compared them with Ainsworth's distributional pattern. Although the ranges for securely attached and insecurely attached had no significant differences in proportions, the Japanese insecure group consisted of only resistant children, with no children categorized as avoidant. This may be because the Japanese child rearing philosophy stressed close mother infant bonds more so than in Western cultures.

In Northern Germany, Grossmann et al. Another study in Israel found there was a high frequency of an ambivalent pattern, which according to Grossman et al. Techniques have been developed to allow verbal ascertainment of the child's state of mind with respect to attachment. An example is the "stem story", in which a child is given the beginning of a story that raises attachment issues and asked to complete it. For older children, adolescents and adults, semi-structured interviews are used in which the manner of relaying content may be as significant as the content itself.

Main and Cassidy observed that disorganized behavior in infancy can develop into a child using caregiving-controlling or punitive behaviour in order to manage a helpless or dangerously unpredictable caregiver. In these cases, the child's behaviour is organized, but the behaviour is treated by researchers as a form of 'disorganization' D since the hierarchy in the family is no longer organized according to parenting authority.

Patricia McKinsey Crittenden has elaborated classifications of further forms of avoidant and ambivalent attachment behaviour. These include the caregiving and punitive behaviours also identified by Main and Cassidy termed A3 and C3 respectively , but also other patterns such as compulsive compliance with the wishes of a threatening parent A4. Crittenden's ideas developed from Bowlby's proposal that "given certain adverse circumstances during childhood, the selective exclusion of information of certain sorts may be adaptive.

Yet, when during adolescence and adulthood the situation changes, the persistent exclusion of the same forms of information may become maladaptive". Crittenden proposed that the basic components of human experience of danger are two kinds of information: [79]. Crittenden terms this "affective information". In childhood this information would include emotions provoked by the unexplained absence of an attachment figure. Where an infant is faced with insensitive or rejecting parenting, one strategy for maintaining the availability of their attachment figure is to try to exclude from consciousness or from expressed behaviour any emotional information that might result in rejection.

Causal or other sequentially ordered knowledge about the potential for safety or danger. In childhood this would include knowledge regarding the behaviours that indicate an attachment figure's availability as a secure haven.

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If knowledge regarding the behaviours that indicate an attachment figure's availability as a secure haven is subject to segregation, then the infant can try to keep the attention of their caregiver through clingy or aggressive behaviour, or alternating combinations of the two. Such behaviour may increase the availability of an attachment figure who otherwise displays inconsistent or misleading responses to the infant's attachment behaviours, suggesting the unreliability of protection and safety.

Type C was hypothesized to be based on heightening perception of threat to increase the disposition to respond. By contrast, type B strategies effectively utilise both kinds of information without much distortion. This may lead their attachment figure to get a clearer grasp on their needs and the appropriate response to their attachment behaviours. Experiencing more reliable and predictable information about the availability of their attachment figure, the toddler then no longer needs to use coercive behaviours with the goal of maintaining their caregiver's availability and can develop a secure attachment to their caregiver since they trust that their needs and communications will be heeded.

Research based on data from longitudinal studies, such as the National Institute of Child Health and Human Development Study of Early Child Care and the Minnesota Study of Risk and Adaption from Birth to Adulthood, and from cross-sectional studies, consistently shows associations between early attachment classifications and peer relationships as to both quantity and quality. There is an extensive body of research demonstrating a significant association between attachment organizations and children's functioning across multiple domains.

Although the link is not fully established by research and there are other influences besides attachment, secure infants are more likely to become socially competent than their insecure peers. Relationships formed with peers influence the acquisition of social skills, intellectual development and the formation of social identity.

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Classification of children's peer status popular, neglected or rejected has been found to predict subsequent adjustment. Their social and behavioural problems increase or decline with deterioration or improvement in parenting. However, an early secure attachment appears to have a lasting protective function. Studies have suggested that infants with a high-risk for autism spectrum disorders ASD may express attachment security differently from infants with a low-risk for ASD.

Some authors have questioned the idea that a taxonomy of categories representing a qualitative difference in attachment relationships can be developed.


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Examination of data from 1, month-olds showed that variation in attachment patterns was continuous rather than grouped. However, it has relatively little relevance for attachment theory itself, which "neither requires nor predicts discrete patterns of attachment. There is some evidence that gender differences in attachment patterns of adaptive significance begin to emerge in middle childhood.

Insecure attachment and early psychosocial stress indicate the presence of environmental risk for example poverty, mental illness, instability, minority status, violence. Environmental risk can cause insecure attachment, while also favouring the development of strategies for earlier reproduction.

Adrenarche is proposed as the endocrine mechanism underlying the reorganization of insecure attachment in middle childhood. Childhood and adolescence allows the development of an internal working model useful for forming attachments. This internal working model is related to the individual's state of mind which develops with respect to attachment generally and explores how attachment functions in relationship dynamics based on childhood and adolescent experience. The organization of an internal working model is generally seen as leading to more stable attachments in those who develop such a model, rather than those who rely more on the individual's state of mind alone in forming new attachments.

Age, cognitive growth, and continued social experience advance the development and complexity of the internal working model.

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Attachment-related behaviours lose some characteristics typical of the infant-toddler period and take on age-related tendencies. The preschool period involves the use of negotiation and bargaining.

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Ideally, these social skills become incorporated into the internal working model to be used with other children and later with adult peers. As children move into the school years at about six years old, most develop a goal-corrected partnership with parents, in which each partner is willing to compromise in order to maintain a gratifying relationship.

Generally, a child is content with longer separations, provided contact—or the possibility of physically reuniting, if needed—is available. Attachment behaviours such as clinging and following decline and self-reliance increases. By middle childhood ages 7—11 , there may be a shift toward mutual coregulation of secure-base contact in which caregiver and child negotiate methods of maintaining communication and supervision as the child moves toward a greater degree of independence.

The attachment system used by adolescents is seen as a "safety regulating system" whose main function is to promote physical and psychological safety. There are 2 different events that can trigger the attachment system.

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The ultimate goal of the attachment system is security, so during a time of danger or inaccessibility the behavioral system accepts felt security in the context of the availability of protection. By adolescence we are able to find security through a variety of things, such as food, exercise, and social media. Higher levels of maturity allows adolescent teens to more capably interact with their environment on their own because the environment is perceived as less threatening.

Adolescents teens will also see an increase in cognitive, emotional and behavioral maturity that dictates whether or not teens are less likely to experience conditions that activate their need for an attachment figure. For example, when teenagers get sick and stay home from school, surely they want their parents to be home so they can take care of them, but they are also able to stay home by themselves without experiencing serious amounts of distress.

Here are the attachment style differences during adolescence: [94]. Attachment theory was extended to adult romantic relationships in the late s by Cindy Hazan and Phillip Shaver. Four styles of attachment have been identified in adults: secure, anxious-preoccupied, dismissive-avoidant and fearful-avoidant.

Securely attached adults tend to have positive views of themselves, their partners and their relationships.