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 paper1949“A 2 year old goes to the hospital”in 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 parent’s childhood andchildren’s problemsIncluding family members intherapeutic process“Owed social workers a great dealof gratitude”“Learned everything from socialworkers”
8. Security Theory with Blatz in TorontoBowlby’s 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 Parent’s 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 care”2 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"
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?