Attachment Theory in Psychodynamic Psychotherapy

Attachment Theory in Psychodynamic Psychotherapy

Psychodynamictheories (Psychodynamic) emphasize the importance of childhood and the relationships we had with our caregivers, based on the belief that these relationships shaped our personalities and problems. This contrasts with theories of the cognitive behavioral approach, which focus on the present.

This does not mean that every problem we face as adults is caused by our parents. Rather, it means that our earliest relationships are among the fundamental elements that helped shape who we are today.

One of the most important aspects of psychodynamic psychotherapy is specifically exploring these early bonds and their significance for our happiness and relationships as adults.

But what exactly is attachment, and how did it become an important part of psychodynamic psychotherapy?

John Bowlby’s Attachment Theory

“Attachment can be described as the emotional bonds that connect one person to another across space and time, such as the bond between a mother and child.”

Its importance in the world of psychotherapy began with a British psychiatrist named John Bowlby, who, after working with emotionally troubled children, focused on the importance of the relationship between mother and child.Bowlby observed a connection between children’s early separation from their mothers and their later difficulty adapting. These observations formed the basic principles of attachment theory..

At the time, many people believed that attachment between a mother and child was primarily due to the fact that the mother provided food for the infant.

“However, Bowlby showed that attachment to a caregiver provides security, protection, and safety, which are essential to a child’s chances of survival.”

Bowlby believed that children form bonds with anyone who provides consistent care and is sensitive and responsive to them. The behavior that most clearly demonstrates this attachment is seeking proximity to the caregiver.

Bowlby also believed that infants need to develop a relationship with at least one caregiver in order to develop socially and emotionally.

Bowlby’s work was later expanded considerably by the American developmental psychologist Mary AinsworthMary Ainsworth during the 1950s and 1960s, adding another dimension to the child’s search for proximity to a caregiver.

More recent studies have continued to explore attachment theory. While some aspects have been intensely debated, others have been retained within psychodynamic approaches and “Relational Psychotherapy.”

The Basic Principles of Attachment Theory

1. A child has an innate need to form (emotional) bonds

Bowlby said that evidence for this can be seen in the child’s search for physical proximity to the primary caregiver and the use of signals such as crying, laughing, and movement to elicit a response from the caregiver.

2. Continuous care should be provided by the primary caregiver throughout the first two years of the child’s life

Bowlby emphasized that the first two years are a critical stage during which attachment is at its most vulnerable. If the bond is broken, the child may experience “maternal deprivation,” which refers to separation resulting from the loss of the mother. Bowlby proposed that the consequences may have a major impact on the child’s social, emotional, and cognitive functioning.

3. The primary caregiver serves as an initial model for future relationships through what is called the “internal working model” (a thought process based on past experiences that helps a person understand responses and actions).

The “internal working model” is one of Bowlby’s best-known concepts. Essentially, Bowlby stated that an infant’s relationship with their primary caregiver leads to the development of an “internal working model.” This model provides a framework for understanding the world, the self, and other people, and therefore guides the child’s interactions with those they encounter. Put simply, the caregiver acts as a model for future relationships through the “internal working model.”

4. The importance of attachment quality

In 1978, Mary Ainsworth and her colleagues designed a study to test the quality of attachment between mother and child, calling the method the “Strange Situation.” The study involved observing how a child reacted when their mother left the room. Through this study, Mary Ainsworth identified four attachment patterns among children:

Secure attachment: The child plays happily and explores their surroundings while the mother is in the room but quickly becomes distressed when separation occurs. When the mother returns to the room, however, the child seeks contact with her and resumes playing.

Avoidant attachment: The child shows no distress when the mother leaves the room and does not appear interested when she returns.

Anxious/ambivalent attachment: The child does not explore while the mother is present and becomes angry and tense when she returns to the room. The child does not resume playing after the mother returns.

Disorganized/disoriented attachment: The child may display contradictory behaviors, such as not looking at the mother while crying or showing no emotion toward her.

Ainsworth also observed that infants who received affectionate and consistent care during their first months cried far less by the end of their first year and were better able to play and explore their surroundings.

In addition, Bowlby stated that when a caregiver remains unavailable to the child, the child’s anger and distress may result in emotional detachment, which may later prevent the child from developing healthy, strong emotional relationships.

Using these attachment patterns, many other studies found that children with a disorganized attachment pattern tend to display maladaptive relationship styles characterized by violence and withdrawal. Furthermore, children with an anxious attachment pattern appear to be at risk of developing internalizing problems such as depression and anxiety in adulthood.

In closing, it is worth noting that although Bowlby initially referred to the mother as the primary caregiver, this idea has since been extended. Most therapists believe that the primary caregiver does not have to be the mother for a child to develop a secure attachment pattern.

The Importance of Attachment in Adulthood and Psychotherapy

Although most attachment studies focus on infants and children, this work was extended to adults during the 1980s, particularly within psychodynamic psychotherapy. Specifically, it was proposed that the internal working models we develop as children remain stable throughout adulthood.

For example, an adult with a secure attachment pattern will speak coherently about their past and the relationships in which they were involved. In contrast, an anxious adult may speak about past experiences in an emotional and confusing way. The focus of psychotherapy will therefore be on recognizing these patterns and creating a safe environment in which a more secure base can be rebuilt.

Specifically, the psychotherapist may use “transference” and “countertransference” first to understand the relationships between the client and the client’s primary caregivers, and second to observe how others respond to the client’s avoidant, resistant, or disorganized internal working model. From this, the therapist can use the power of the therapeutic relationship—providing the client with a secure base—and create a safe environment in which the client can behave differently from their earlier attachment representations and begin healing broken bonds.

The therapeutic alliance—the relationship between therapist and client—provides a safe space in which the client can express feelings of anger, sadness, or distress and also work on reframing their old narratives.

Source:Harley Therapy

Image: by Jenna Christina on Unsplash