attachment theory for nj nasw new
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Still Face Experiment
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Graduated Cambridge 1928
School for maladjusted children -> child psychiatrist
Trained at British Psychoanalytic Institute (Klein)
Published 44 Juvenile Thieves in 1944
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Tavistock after the war (1946) Children -> Children and Parents First published family therapy paper 1949
A 2 year old goes to the hospital in 1952 (Robertson)
Mary Ainsworth worked with him from 1950 1954
Attachment published in 1969
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Nanny leaving family
Boarding school when 7 or 8
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Attachment relationship Seek proximity and contact Especially when
Frightened Tired Sick
Concepts from ethology and cybernetics Departure from drive theory
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Five tasks Provide a secure base Help client to explore relationships Examine working models between client and therapist Explore links between current expectations beliefs etc. and early relationships Explore current models of self and other
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Deeply influenced by 2 analytically oriented social workers
Link between parents childhood and childrens problems Including family members in therapeutic process
Owed social workers a great deal of gratitude
Learned everything from social workers
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Security Theory with Blatz in Toronto
Bowlbys research group in 1950
Mothers in Uganda - 1953
Paper on relationship patterns with Bowlby - 1956
Baltimore study - 1963
Strange situation - 1971
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Mother as secure base
Mother child interaction patterns
Parental responsiveness to infant signals
Three categories Secure Avoidant Resistant / Ambivalent
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Dynamic Maturation Model
Strategies not styles
All strategies are adaptive and protective
Affect and Cognition
New strategies available when older
A/C not disorganization
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Fonagy 1997
Reflective function
Mind Mindedness
Ability to interpret actions others and own
Awareness of mental states / willingness to think about them
Difficulty knowing what another is thinking
Link to secure attachment
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Observation
Verbal analysis
Projective
(Self report)
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0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
100%
Disorganized Resistant Avoidant Secure
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Waters 1985 Based on Strange Situation For home observation by observer 12 48 months 90 items (depends on version)
Child readily shares with mother When child returns to mother, sometimes fussy for no reason Child will accept comforting from adults other than mother
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Observed semi-structured play (5 mins) Measures fit / attunement of dyad Coded based on
Facial expression Vocal expression Position and body contact Expression of affection Pacing of turns Control Choice of activity
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0 15 Months 15 30 Months Adults Cooperativeness Cooperativeness Sensitivity Compulsiveness Compulsiveness Control Difficultness Threateningly
coercive Unresponsiveness
Passivity Disarmingly coercive
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Intervention Rationale Parent Education Parent can reflect & integrate
Needs new information
Short-term counseling Parent can integrate and has information Needs dialogue for problem-solving
Parent-child intervention Parent needs help focusing on conflicting information
Adult psychotherapy Parents behavior not consciously generated, triggered, maladaptive
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8 or 20 weeks
Psychoeducation
Attachment focus parent as secure base and safe haven
Parental self-care
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Initial work with parents trust, shame
Usually parents and one child
Speaking on behalf of the child
PACE Playfulness Acceptance Curiosity Empathy
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1.6 million adoptees in US living with adoptive parents
2-4% of families have an adopted child
20,000 children adopted from abroad / yr
50,000 domestically adopted
510,000 children in foster care in 2006
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Separation from parents
Possible multiple placements
Possible maltreatment / neglect / poor conditions
0%
20%
40%
60%
80%
Institutionalized Adopted Norm
% Disorganized
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First listed in DSM III
Failure to thrive removed in DMS III-TR
Requires hx of pathogenic care
2 subtypes
Withdrawn / Inhibited
Indiscriminate / Disinhibited
Questions about diagnosis / prevalence
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Turning away from parents
Role of peers
Attachment to significant other
Capacity for emotion regulation in social interactions
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Feel safe when the other is nearby and responsive
Engage in close, intimate, bodily contact
Feel insecure when the other is inaccessible
Share discoveries with one another
Play with one another's facial features and exhibit a mutual fascination and preoccupation with one another
Engage in "baby talk"
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Strange Situation AAI Synonyms Secure Autonomous B Avoidant Dismissing A Resistant Preoccupied C
Anxious Angry resistant Ambivalent
Disorganized Unresolved Fearful Avoidant Cannot classify
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Avoidant / Dismissing Disorganized
Secure Anxious / Preoccupied
Low anxiety
High anxiety
High avoidance
Low avoidance
Basic attachment theory
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Avoidant / Dismissing Secure
Disorganized Anxious / Preoccupied
- Other + Other
+ Self
- Self
Alternative axes
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If I encounter an obstacle / become distressed
Approach relationship partner for help
Likely to be available and supportive
Relief and comfort
Can return to other activities
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Conflicting research
Strategic (whatever works)
Secure => Secure
Some transposing (A/C/A; C/A/C)
Grandmother may be better predictor
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Main 1985 AAI
Hazan and Shaver 1987 3 paragraphs
Bartholomew and Horowitz 1991 Relationship Questionnaire, 4 styles
Brennan, Clarke, Shaver 1998 ECR
Crittenden 1999 DMM
Fraley, Waller, Brennan 2001 ECR-R
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5 Words for each attachment figure
Give Examples
20 questions, increasing pressure
Narrative coherence more than content
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
NonClin M
NonClin F Ado Euro At Risk Clinical
Disorg / CC Preoccupied Avoidant Secure
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Experience in Close Relationships Revised
Derived from 323 items in 60 self-report measures
Revised using item response analysis
2 scales (anxious, avoidant)
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Expect they can rely on the availability and sensitivity of the people they love Able to become emotionally close and express affection Feel comfortable depending on and being depended on Feel calmed and comforted by contact and support when distressed Generally sensitive to others signals Coherent narratives about life events
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Tend to minimize or dismiss importance of close relationships Uncomfortable with emotional intimacy, physical contact Derive sense of self-worth from independence Disparage sentimentality, tenderness, discussion or expression of feelings Tend to withdraw or attempt to cope alone Sparse narratives, unable or unwilling to describe specific examples
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Seek intense emotional intimacy but feel ambivalent toward others Experience others as not accessible enough Leading to distress, frustration, anger, anxiety, passive helplessness May feel smothered while not quite getting enough Turn to others for support but disappointed Tend to have trouble staying on topic, excessively long descriptions, crying continuously, vague words (dadadadada)
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Have had trouble getting beyond / making meaning of traumatic events Appear inconsistent, contradictory, dissociative in intimate relationships Have difficulty trusting significant others Contradictory responses when distressed Controlling through hostile, critical, punitive responses or over-involved smothering care-giving Talking about traumatic events show disorientation, disorganization, dissociation
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Individuals Accelerated Experiential Dynamic Psychotherapy (AEDP)
Couples Emotionally Focused Therapy for Couples (EFT) Psychobiological Approach to Couples Therapy (PACT)
Families / Children Dyadic Developmental Psychotherapy
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Accelerated Experiential Dynamic Psychotherapy
Non-pathologizing
Dyadic regulation of affect
Creating safety for core / primary affect
Meta-processing
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Attachment behaviors in intimate relationships make sense
Couples recognize their cycles / dance
Couples build new patterns through experiential practice
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Therapists and attachment strategies / styles
Attachment and therapeutic alliances
Attachment in and out of the office
Supervisory relationships
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Factors impacting grief Attachment to person who died Attachment history
Concept of compulsive self-reliance
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Emotional dysregulation
Possible similar roots (temperament)
Possible issues of fit
Prenatal stress?
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Insecure attachment
DMM compulsive caregiving, compulsive compliance
Mothers possibly dealing with unresolved losses
Need more data on fathers
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Attachment neglected in organizational behavior literature
Secure attachment and leadership
Secure leaders more likely to delegate
Secure attachment and trust
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Nature, nurture, or both?
Parent / child fit
Epigenetics
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LGBT
Culture?
Across caregivers?
Age / Lifespan?
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Secure attachment and coming out
LGBT relationships similar
Perceived discrimination and attachment
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Conflicting research Questions about Western bias Asian Americans, Hispanic
Americans more anxious attachment than Caucasian
African Americans, Asian Americans more avoidant attachment than Caucasian
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More research needed Primary or secondary attachment
figure? Different roles and potential
impact? Multiple caregivers?
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Earned secure attachment Some evidence of change over
lifespan Adolescence More avoidance in later years
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What is being measured?
What is most useful to clinicians
Categorical / Dimensional?
Styles / Strategies?
Insecure styles adaptive?
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[email protected] www.jonathansibley.net
ApplyingAttachment Theoryin your Clinical WorkAgendaOne of many lensesA quick exampleInsecure attachmentSecure AttachmentSecure AttachmentBowlby 1Bowlby 2Bowlby additional backgroundBowlby key conceptsBowlby on psychotherapyBowlby and social workInfluences LorenzInfluences - HarlowHistory AinsworthAinsworth conceptsDMMDMM - CrittendenMentalizationInfants and ChildrenAssessmentsStrange situationStrange Situation DistributionAttachment Behavior Q-SetChild Adult Relationship Experimental Index - CARECARE IndexClinical ApplicationsParenting Interventions(Crittenden)Circle of securityParenting - Circle of SecurityParenting Dyadic Developmental PsychotherapyAdoption / Foster CareAdoption / Foster Care IssuesReactive Attachment D/OTeensAdultsSimilarities between adults and childrenAttachment vocabularyAttachment typesAttachment typesSecure base scriptIntergenerational TransmissionAdult assessmentsHistory of adult attachment measuresAAIAAI DistributionECR-RAttachment prototype questionnaire - Pattern AAttachment prototype questionnaire Pattern BAttachment prototype questionnaire Pattern CAttachment prototype questionnaire Pattern DClinical ApplicationsAttachment-based therapiesAEDPEmotionally Focused Therapy (EFT)Attachment and the therapistApplications of attachment theoryAttachment and griefAttachment and ADHDAttachment and eating D/OAttachment and the workplaceAttachment Temperament debateHow universal?LGBTCultureCaregivers / FathersLifespanAdditional issuesThank you!