Sunday, May 5, 2013

Attachment Theory And Therapy

As classes at the Tampa Bay Institute for Psychoanalytic Studies, Inc approach the Spring semester’s end next week, I reflect back on the Second Year’s course in Attachment and Affects. Attachment theory, pioneered by John Bowlby, is a relational theory that conceptualizes an innate human motivation to be connected with others. Crying, clinging and proximity are behaviors infants and toddlers have adapted to remain safe and secure. When parents respond in an attuned fashion, children can use the secure base from which to explore the world. Therapists, too, strive to co-create a safe place which allows better for exploration of interiority. Moreover, human beings require management of their affects, and emotional regulation starts out in the caregiver-infant dyad, where mutual regulation, then infant self regulation can develop. Affect regulation is seen as a necessary component to optimal growth and development. Theorists differ: intersubjectivity may allow for attachment within which there is affect regulation; or, conversely, attachment may allow for intersubjectivity within which emotional regulation is achieved.

Humans throughout life struggle to balance our longings for connection with our striving for autonomy. In traditional psychoanalysis, ‘freedom’ usually meant freedom from dependence, and [masculine] autonomy was privileged over [feminine] connectedness. Dependency, as in human infancy, creates conflict and engenders humiliation. The ubiquitous dilemma is the striving to be connected in dialectical tension with the striving for independence, or as Benjamin might describe it, the tension between recognition (contact and connectedness) and negation (the illusion of omnipotence and control). 

Attachment Theory promotes understanding of how affects foster communication and build relationships, positing ways that early attachment, separation, and loss influence subsequent capacities (and behavioral styles) to form bonds with others, including the therapeutic dyad. It recognizes that development is relationship-based and contextualized, and that affective sharing affects self- and mutual regulation. Patterns of attachment are universal, though they may differ in relation to different caretakers, by culture, or even depend on particular self states. Many contemporary psychoanalysts see attachment, with it concomitant object seeking and need for relationship (to have recognition, to share affectivity), as primary to development. The need for attachments exists throughout life and its presence does not necessarily constitute regression.Though therapists may facilitate the recommencement of patient development, we need not conflate patient-hood with infancy. Relational patterns, developed early in life, are carried forward into the therapeutic relationship and therapy may help a patient reevaluate the expectation that everyone is as unreliable, disinterested, or dangerous as the patient’s parents might have been. 

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