Attachment Theory and its Importance to Therapy

The suggestion that early childhood experiences shape adult functioning paved the way for attachment theory, which underpins the modern psychodynamic approach to therapy. John Bowlby (1958, 1969) developed attachment theory, maintaining that experiences with primary caregivers determined personality development, and Mary Ainsworth later furthered this work with her “Strange Situation” experiments (Ainsworth & Bell, 1970; Ainsworth, 1973).
 
In these, a child and its mother entered a room in which there was a person unknown to the child. The mother then left the child there, with the stranger, a situation a child would experience as dangerous. Their reactions were observed. After a few minutes, the mother returned, and observation of the child’s behaviour continued. The observed behaviours eventually led to the classification of four different attachment styles.
 
Secure children would cry when left with a stranger, but then when the mother returned they would reconnect with her and would be soothed until they could self-regulate. Some children, though, seemed unconcerned by the mother’s departure - they acted as if the stranger (a real and present threat) didn’t exist, completely ignoring them, and then when the mother returned, would stay disengaged. These were described as insecure-avoidant. Others would cry when the mother left, but when she returned they could not be soothed by her, and were never able to self-regulate. These were described as insecure-resistant, or sometimes as insecure-ambivalent. The fourth kind would display odd, irrational behaviour when the mother left, like hitting themselves, and these were described as insecure-disorganized.
 
Attachment theory went on to inform individual psychodynamic therapy approaches such as ISTDP (Davanloo, 1990, 2000), as well as both family and couples therapy approaches. Psychodynamic therapies such as ISTDP pay specific attention to the effect of early relationships with primary caregivers - to the child’s (sometimes pre-verbal) understandings and internalizations that resulted from these relationships, and how these manifest in individual attachment styles.

These early patterns of relating to ourselves and to others can persist into adulthood, and go on to affect our lives and relationships. In extremely general terms, secure children often become autonomous adults, avoidant children often become dismissive adults, resistant or ambivalent children often become preoccupied adults, and disorganized children often become fearful adults.
 
Why is any of this relevant to you? Because no matter what problems bring you to therapy, what is behind them, what is driving them, is likely something related to your relationship with others, and ultimately, to your relationship with yourself.
 
Imagine a child who has been abandoned by one or both parents. Their unconscious, infant understanding of the situation may have led them to view themselves as somehow being repulsive - as having repulsed the abandoning parent. This might show up in adulthood as an impulse to please others for fear of ever being rejected again, or it might show up as a pattern of rejecting connection first before you yourself can be rejected once again. Your internal system – the way you make sense of the world and your relationships in it - might be centred upon the unconscious sense of somehow being less-than, of somehow lacking in inherent value. A person might respond to this by turning their feelings in upon themselves and becoming self-punitive, for example, or might turn their feelings outward, onto others, and become abusive. Attachment can thus be seen to have a very real effect on every aspect of your life, and without healing, perhaps through therapy, can also become generationally active - getting passed down in one way or another to your descendants.

Ainsworth, M. D. S. (1973). The development of infant-mother attachment. In B. Cardwell & H. Ricciuti (Eds.), Review of child development research (3, 1-94) University of Chicago Press: Chicago.
 
Ainsworth, M. D. S., & Bell, S. M. (1970). Attachment, exploration, and separation: Illustrated by the behavior of one-year-olds in a strange situation. Child Development, 41, 49-67.
 
Bowlby, J. (1958). The nature of the child’s tie to his mother. International Journal of Psychoanalysis, 39, 350-371.
 
Bowlby, J. (1969). Attachment. Attachment and loss: Vol. 1. Loss. Basic Books: New York, NY.
 
Davanloo, H. (1990). Unlocking the Unconscious: Selected Papers of Habib Davanloo, MD. John Wiley & Sons: Chichester, England.
 
Davanloo, H. (2000). Intensive Short-Term Dynamic Psychotherapy: Selected Papers of Habib Davanloo, MD. John Wiley & Sons: Chichester, England.