2. Graduated Cambridge 1928School for maladjusted children
->child psychiatristTrained at British PsychoanalyticInstitute
(Klein)Published 44 Juvenile Thieves in1944
3. Tavistock after the war (1946)Children -> Children and
ParentsFirst published family therapy paper1949A 2 year old goes to
the hospitalin 1952 (Robertson)Mary Ainsworth worked with himfrom
1950 1954Attachment published in 1969
4. Nanny leaving familyBoarding school when 7 or 8
5. Attachment relationshipSeek proximity and contactEspecially
whenFrightenedTiredSickConcepts from ethology
andcyberneticsDeparture from drive theory
6. Five tasksProvide a secure baseHelp client to explore
relationshipsExamine working models betweenclient and
therapistExplore links between currentexpectations beliefs etc. and
earlyrelationshipsExplore current models of self andother
7. Deeply influenced by 2 analyticallyoriented social
workersLink between parents childhood andchildrens
problemsIncluding family members intherapeutic processOwed social
workers a great dealof gratitudeLearned everything from
socialworkers
8. Security Theory with Blatz in TorontoBowlbys research group
in 1950Mothers in Uganda - 1953Paper on relationship patterns
withBowlby - 1956Baltimore study - 1963Strange situation -
1971
9. Mother as secure baseMother child interaction
patternsParental responsiveness to infantsignalsThree
categoriesSecureAvoidantResistant / Ambivalent
10. Dynamic Maturation ModelStrategies not stylesAll strategies
are adaptive andprotectiveAffect and CognitionNew strategies
available whenolderA/C not disorganization
11. Fonagy 1997Reflective functionMind MindednessAbility to
interpret actions others and ownAwareness of mental states /
willingness tothink about themDifficulty knowing what another is
thinkingLink to secure attachment
14. Waters 1985Based on Strange SituationFor home observation
by observer12 48 months90 items (depends on version)Child readily
shares with motherWhen child returns to mother, sometimes fussyfor
no reasonChild will accept comforting from adults otherthan
mother
15. Observed semi-structured play (5 mins)Measures fit /
attunement of dyadCoded based onFacial expressionVocal
expressionPosition and body contactExpression of affectionPacing of
turnsControlChoice of activity
17. Intervention RationaleParent Education Parent can reflect
& integrateNeeds new informationShort-term counseling Parent
can integrate and has informationNeeds dialogue for
problem-solvingParent-child intervention Parent needs help focusing
on conflictinginformationAdult psychotherapy Parents behavior not
consciouslygenerated, triggered, maladaptive
18. 8 or 20 weeksPsychoeducationAttachment focus parent
assecure base and safe havenParental self-care
19. Initial work with parents trust, shameUsually parents and
one childSpeaking on behalf of the
childPACEPlayfulnessAcceptanceCuriosityEmpathy
20. 1.6 million adoptees in US living withadoptive parents2-4%
of families have an adopted child20,000 children adopted from
abroad / yr50,000 domestically adopted510,000 children in foster
care in 2006
22. First listed in DSM IIIFailure to thrive removed in DMS
III-TRRequires hx of pathogenic care2 subtypesWithdrawn /
InhibitedIndiscriminate / DisinhibitedQuestions about diagnosis /
prevalence
23. Turning away from parentsRole of peersAttachment to
significant otherCapacity for emotion regulation insocial
interactions
24. Feel safe when the other is nearby and responsiveEngage in
close, intimate, bodily contactFeel insecure when the other is
inaccessibleShare discoveries with one anotherPlay with one
anothers facial features and exhibit amutual fascination and
preoccupation with oneanotherEngage in "baby talk"
27. Avoidant /DismissingSecureDisorganizedAnxious /Preoccupied-
Other + Other+ Self- SelfAlternativeaxes
28. If I encounter an obstacle / become distressedApproach
relationship partner for helpLikely to be available and
supportiveRelief and comfortCan return to other activities
29. Conflicting researchStrategic (whatever works)Secure =>
SecureSome transposing (A/C/A; C/A/C)Grandmother may be
betterpredictor
30. Main 1985 AAIHazan and Shaver 1987 3 paragraphsBartholomew
and Horowitz 1991 Relationship Questionnaire, 4 stylesBrennan,
Clarke, Shaver 1998 ECRCrittenden 1999 DMMFraley, Waller, Brennan
2001 ECR-R
31. 5 Words for each attachmentfigureGive Examples20 questions,
increasing pressureNarrative coherence more thancontent
32. 0%10%20%30%40%50%60%70%80%90%100%NonClinMNonClin F Ado Euro
At Risk ClinicalDisorg / CCPreoccupiedAvoidantSecure
33. Experience in Close Relationships RevisedDerived from 323
items in 60 self-report measuresRevised using item
responseanalysis2 scales (anxious, avoidant)
34. Expect they can rely on the availability andsensitivity of
the people they loveAble to become emotionally close and
expressaffectionFeel comfortable depending on and beingdepended
onFeel calmed and comforted by contact andsupport when
distressedGenerally sensitive to others signalsCoherent narratives
about life events
35. Tend to minimize or dismiss importance ofclose
relationshipsUncomfortable with emotional intimacy,physical
contactDerive sense of self-worth from independenceDisparage
sentimentality, tenderness,discussion or expression of feelingsTend
to withdraw or attempt to cope aloneSparse narratives, unable or
unwilling todescribe specific examples
36. Seek intense emotional intimacy but feelambivalent toward
othersExperience others as not accessible enoughLeading to
distress, frustration, anger, anxiety,passive helplessnessMay feel
smothered while not quite gettingenoughTurn to others for support
but disappointedTend to have trouble staying on topic,excessively
long descriptions, cryingcontinuously, vague words
(dadadadada)
37. Have had trouble getting beyond / makingmeaning of
traumatic eventsAppear inconsistent, contradictory,dissociative in
intimate relationshipsHave difficulty trusting significant
othersContradictory responses when distressedControlling through
hostile, critical, punitiveresponses or over-involved smothering
care-givingTalking about traumatic events showdisorientation,
disorganization, dissociation
38. Individuals Accelerated ExperientialDynamic
Psychotherapy(AEDP)Couples Emotionally FocusedTherapy for
Couples(EFT)PsychobiologicalApproach to CouplesTherapy
(PACT)Families / Children Dyadic DevelopmentalPsychotherapy
39. Accelerated Experiential
DynamicPsychotherapyNon-pathologizingDyadic regulation of
affectCreating safety for core / primaryaffectMeta-processing
40. Attachment behaviors in intimaterelationships make
senseCouples recognize their cycles /danceCouples build new
patternsthrough experiential practice
41. Therapists and attachment strategies/ stylesAttachment and
therapeutic alliancesAttachment in and out of the officeSupervisory
relationships
42. Factors impacting griefAttachment to person who
diedAttachment historyConcept of compulsive self-reliance
43. Emotional dysregulationPossible similar
roots(temperament)Possible issues of fitPrenatal stress?
44. Insecure attachmentDMM compulsive caregiving,compulsive
complianceMothers possibly dealing withunresolved lossesNeed more
data on fathers
45. Attachment neglected inorganizational
behaviorliteratureSecure attachment and leadershipSecure leaders
more likely todelegateSecure attachment and trust
46. Nature, nurture, or both?Parent / child fitEpigenetics
47. LGBTCulture?Across caregivers?Age / Lifespan?
48. Secure attachment and coming outLGBT relationships
similarPerceived discrimination andattachment
49. Conflicting researchQuestions about Western biasAsian
Americans, HispanicAmericans more anxiousattachment than
CaucasianAfrican Americans, AsianAmericans more avoidantattachment
than Caucasian
50. More research neededPrimary or secondary
attachmentfigure?Different roles and potentialimpact?Multiple
caregivers?
51. Earned secure attachmentSome evidence of change
overlifespanAdolescenceMore avoidance in later years
52. What is being measured?What is most useful to
cliniciansCategorical / Dimensional?Styles / Strategies?Insecure
styles adaptive?