Last updated on 18th April 2013
This post is also available as a Word format download.
This post is also available as a Word format download.
I'm a doctor and psychotherapist who's interested in using attachment ideas to improve how helpful I can be for clients. Awareness of attachment issues informs therapy, it doesn't dictate it. An obvious question is whether it's sometimes worth assessing attachment in a "formal" way. I'm no expert in this area. I'm an "informed amateur" and, after reading and exploring a good deal around the subject, my impression is that it can be pretty useful at times to assess attachment. The Wikipedia article on Attachment measures provides an excellent overview of the field while, for much more in depth information, the two attachment books and the various websites that I've described in previous blog post
Here are half a dozen recent research papers with broad social implications (all details & abstracts to these studies are given further down this blog posting). Kay and colleagues publish on "Inequality, discrimination, and the power of the status quo: Direct evidence for a motivation to see the way things are as the way they should be." They report four studies showing how widely this motivation acts - with political power, public funding, gender demographics, and in attacks on those who are trying to work for change. There's relevance here to the second paper by Wilper et al on "Health Insurance and Mortality in US Adults" estimating that, even after adjusting for income, education, health status, weight, exercise, smoking and alcohol use, lack of insurance was associated with about 45,000 excess deaths annually in the United States among people aged 18 to 64. Still in the area of inequality and discrimination, Wexler et al publish on
Last week I wrote about "A couple of fine books on attachment". Today I want to highlight what a fantastic resource the internet is - below are details of half a dozen websites that offer lots of attachment information, and also details of further websites that are helpful but more limited.
I wrote earlier this month on "Attachment, compassion & relationships". I've been aware of John Bowlby's work on adult-child attachment for many years but, when I've approached it for insights that might help in my work as a psychotherapist, I've been put off by the complexity of assessment methods and variety of reported attachment styles, as well as by the rapidly growing size of the relevant academic literature. As Jude Cassidy and Phillip Shaver write in their preface to the 2008 meister work "Handbook of attachment (2nd ed)" - see more details at the end of this blog post - "Anybody who conducts a literature search on the topic of 'attachment' will turn up more than 10,000 entries since 1975, and the entries will be spread across scores of physiological, clinical, developmental, and social psychology journals, will include numerous
Well I didn't sleep too well last night. Catero, my wife, and I went to the cinema yesterday evening and watched "500 Days of Summer" . I enjoyed it and it got me thinking about relationships. The "Summer" of the title is a woman who doesn't believe in romantic love. She's kind of charming and maddening and, as I biked away from the cinema, I wondered how I would have approached treating her if she had come to me for therapy! Interestingly a newspaper reviewer commented that the film is "weirdly incurious about the inner life of its female lead".
Here are half a dozen studies on the long-term effects of various forms of abuse & deprivation. Paras et al systematically reviewed the association between a history of sexual abuse and a lifetime diagnosis of a somatic disorder. They found significant links with functional gastrointestinal disorders, nonspecific chronic pain, psychogenic seizures, and chronic pelvic pain. When analysis was restricted to studies where sexual abuse was defined as rape, they also found an association with fibromyalgia. Abstracts and links, for this research paper and the further papers described, can be found lower down this page.
Here are six studies relevant to improving psychotherapy outcomes. Brewin et al report on using imagery-based interventions to help people with depressioin. Lydiard et al highlight the importance of sleep-related disturbances as a treatment target in PTSD. McCrady and colleagues show that working with couples rather than just individuals seems more effective when using behavioural therapy to help women with alcohol use disorders. Geerts et al describe rather amazing research investigating "The role of parental bonding and nonverbal communication in the short-term treatment response was investigated in 104 depressed outpatients. At baseline patients completed the Parental Bonding Instrument. We registered the nonverbal involvement behaviour of patients and interviewers from video recordings of baseline clinical interviews and calculated the convergence between patient-interviewer behaviour over the interview ... As hypothesized, low maternal care and high paternal overprotection predicted a poor response to an 8-week treatment. Maternal care was positively correlated with nonverbal convergence. Moreover, convergence moderated the relationship between maternal care and the response to treatment: Lack of convergence between patients and interviewers turned out to annul the positive effects of maternal care on the treatment response.
Here are five papers on childhood, the effects childhood experience can have on adulthood, and the effects adults may then have on their own children. The first paper by Brody et al. is the encouraging one. It demonstrates how caring parenting can combat genetic vulnerability - "involved-supportive" mothering greatly reduced the link between vulnerable genes and subsequent youth substance abuse. The Van Meurs et al study shows the reverse - how problem behaviours in one generation of children increases the likelihood that, when these children become parents themselves, their own children will develop similar problem behaviours.