Attachment Theory

and Therapy
Paige Lichtenberger, MA
What is Attachment Theory?

 focuses on relationships and bonds between people

 Emotional bond with another person
 Central theme
 Primary caregivers who are available and responsive to infant’s needs
allow child to develop sense of security
What Did We Think Before?

 Behavioral theories attachment is learned behavior!

 Attachment= result of feeding relationship between child and caregiver
John Bowlby

 Interested in separation anxiety and distress when children separated

from primary caregivers
 Recorded 3 measures:
 Stranger anxiety response to arrival of stranger
 Separation anxiety distress level when separated from caregiver; degree of
comfort needed on return
 Social referencing degree that child looks at caregiver to check how they
should respond to something new
What Did He Find?

 Attachment= product of evolutionary processes

 Children born with innate drive to form attachments with caregivers
 Feedings didn’t diminish anxiety of children when separated
 Nurturance and responsiveness are primary determinants
 Attachments most likely formed when:
 Sensitive responsiveness
 Respond accurately to baby’s signals, not necessarily who they spent more time
with
Harry Harlow

 Harry Harlow
 Studies on maternal deprivation and social isolation (1950s & 1960s)
 Newborn rhesus monkeys separated from birth mothers and reared by surrogate
mothers
 Placed in cages with 2 wire monkey mothers
 1 held bottle and 1 covered with soft terry cloth
 Obtained food from wire mother, but spent most of time with cloth mother
 When frightened, turned to cloth mother
Mary Ainsworth
 “Strange Situation” (1970s)
 Observed children between 12-18 months
 Responses to situation where children were briefly left alone then reunited with their
mothers
 3 major styles of attachment:
 Secure
 Ambivalent-insecure
 Avoidant-insecure
Main & Solomon (1986)

 Follow-up to Strange Situation

 4th attachment style: disorganized-insecure
 Confusing mix of behavior
 May seem disoriented, dazed, or confused
 May avoid or resist caregiver
 Likely linked to inconsistent caregiver behavior
 Caregiver may serve as source of comfort AND fear
 Child has no organized strategy that allows them to feel safe and get
needs met
Stages of Attachment (Schaffer &
Emerson)
 1. Asocial Stage (birth-3 months)
 No particular attachment to specific caregiver
 2. Indiscriminate Attachment (6 weeks-7 months)
 Preferences for primary and secondary caregivers
 Still accept care from others, but respond more positively to primary
 3. Specific Attachment (7-11 months)
 Strong attachment and preference for 1 specific individual
 4. Multiple Attachments (after 9 months)
 Strong emotional bonds with other caregivers
Factors that Influence Attachment

 Opportunity for attachment

 Children who don’t have primary care figure (i.e. orphanage) may fail to
develop sense of trust needed to form attachment
 Quality caregiving
 Caregivers who don’t respond quickly and consistently prevent children
from learning they can depend on people responsible for their care
2 Theories Important in Forming
Attachments
 Learning theory
 All behavior is learnt rather than innate biological behavior
 Children born blank slates
 2 types of learning:
 Classical conditioning: Pavlov
 Operant conditioning: Skinner
 Evolutionary theory: Bowlby, Harlow, Lorenz
 Children come into world biologically pre-programmed to form attachments with
others because this will help them survive
 Infant produces innate “social releaser” behaviors (crying and smiling) that
stimulate innate caregiving responsiveness from adults
Attachment in Adulthood
 Secure
 Parent behavior capable of regulating their emotions
 Child distress when mother leaves and greets mother on return
 Adult comfortable in relationships, able to seek support from partner
 Avoidant-Dismissive
 Parent behavior unresponsive, uncaring, dismissive
 Child doesn’t seek mother when she returns, focuses on environment
 Adult greater sense of autonomy, tend to cut themselves off emotionally
from partner
 Anxious
 Parent behavior responds to child inconsistently
 Child very upset at departure, explores very little
 Adult fears rejection from partner, strong desire to maintain closeness
Attachment Leads to Behavior
Cognitive: “No one will
truly care for me” “I
can’t trust anyone”
Cognitive “I’m stupid, always
Response mess up, a whore”
“Nobody understands
me and what I need”

Working
model of
Behavioral
attachment
Response
activated in
memory

Emotional: depressed,
Behaviors:
angry, irritable, lonely,
aggression, isolation,
guilt/shame, Emotional risky bx, response-
ambivalent, anxious, Response
seeking bx
numb
Disorganized Attachment Style and
Control Sensitivity
 Difficulty forming coherent narrative
 Haven’t learned healthy ways to self-soothe
 Struggle to use others to co-regulate emotions
 Difficult to open up or seek out help, difficulty trusting others
 Difficulty managing stress
 Hostile/aggressive behaviors
 See the world as an unsafe place (need to protect self from others)
 Adults fear close proximity/intimacy in relationships, fear showing vulnerability,
extreme rage/anger in response to perceived confrontation/threat, lack personal
boundaries, express little/no empathy for others
 Self-beliefs: “I’m not worthy of love” “I’m unable to get the love I need from others”
 Other-beliefs: “Others are unable and/or unwilling to meet my needs” “Others will hurt
me AND I deserve it”
 1. Attachment Style
The Conflict Cycle (view of self and
others)
a.k.a. trauma re-
enactments 2.
Stressf
ul
Event

3.
5.
person'
others’
s
Reactio
Feeling
n
s
4.
person'
s
Behavi
or
 Youth Caregiver Therapist

Cognitive I am bad, unlovable, I am ineffective. I am ineffective.

damaged.
This kid is causing This family/parent is so
People are dangerous. I trouble. He’s making difficult. They need to
can’t trust anyone. things chaotic for just do what I ask them
everyone. to do.
Emotional Shame, Anger, Fear, Frustration Anxiety, Frustration, Anger,
Hopelessness Helplessness Burnout, Loss of
Empathy

Behavior (Coping Avoidance, Aggression, Over-reacting, Reactivity, Control,

Strategy) Pre-emptive Rejection Controlling, Shutting Punitive Responses
and Self-protection down/Disconnecting
Emotionally
The Cycle ”I’m being controlled; I ”He keeps fighting me; I ”I have to up the ante
have to fight harder.” better dig my heels in.” or this family will never
“This provider doesn’t do the right thing.”
get it- I’m not going to
bother.”
Relational Re-Enactment Systems
Approach to Treatment (REStArT)
 Goal= interrupt conflict cycle
 Gives youth chance to experience feelings that have been inaccessible to
them because they were being acted out
 Chance to find new ways of relating and responding
Importance of Routines and Rituals

 Trauma often associated with chaos and loss of control

 Predictability helps build feelings of safety
 Repetition is important way that all people gain skills
 Routines used to:
 Support safety and modulation through establishment of predictability
 Support and reinforce key goals
Attachment Narrative Therapy
 Developed by Joanne C. May
 Working with children and families in foster care, adoptive homes,
residential treatment facilities, community mental health clinics
 Designed to heal long-term effects of early childhood trauma
 Incorporate caregiver narratives as tool to help address and repair
unmet needs of child/adolescent
4 Types of Narratives
 1. Claiming
 Caregivers describe how they would have like to have parented the child
as a baby
 2. Developmental
 Caregivers speak in first person about developmental stages of child and
share hopes and dreams for child’s successful development
 3. Trauma
 Caregivers tell third-person, fairy tale-like stories that feature protagonist
who experiences challenges similar to those faced by child
 4. Successful Child
 Caregivers use third-person to tell story that highlights capable protagonist
who overcomes obstacles and achieves success
The Adult Attachment Interview
(AAI)
 Developed by Mary Main
 Encourages individuals to recollect and reflect upon history of their
relationships with their own parents, experiences of loss, rejection,
and separation
 *full protocol need to contact Mary Main
 Mary Main, Ph.D. (psychadmin@berkeley.edu)
Brief Protocol
 1. “To begin with, could you just help me to get a little bit oriented to your
family- for example, who was in your immediate family, and where and whom
did you live?”
 2. “Now I’d like you to try to describe your relationship with your parents as a
young child, starting as far back as you can remember.”
 3. 4. Could you give me 5 adjectives or phrases to describe your relationship
with your mother/father during childhood? What memories or experiences led
you to choose each one?
 5. To which parent did you feel closer, and why?
 6. When you were upset as a child, what did you do, and what would happen?
Could you give me some specific incidents when you were upset emotionally?
Physically hurt? Ill?
 7. Could you describe your first separation from your parents?
 8. Did you ever feel rejected as a child? What did you do, and do you think your
parents realized they were rejecting you?
 9. Were your parents ever threatening toward you- for discipline, or jokingly?
 10. How do you think your overall early experiences have affected your adult
personality? Are there any aspects you consider a setback to your development?
Cont.

 11. Why do you think your parents behaved as they did during your
childhood?
 12. Were there other adults who were close to you- like parents- as a
child?
 13. Did you experience the loss of a parent or other close loved one
as a child, or in adulthood?
 14. Were there many changes in your relationship with your parents
between childhood and adulthood?
 15. What is your relationship with your parents like for you currently?