Attachment Therapy with Adolescents and Adults

Theory and Practice Post Bowlby

Dorothy Heard, Una McCluskey, Brian Lake

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9781780490427
• eBook ISBN: 9780429911071
• Topic: Psicologia
• Subtopic: Storia e teoria della psicologia

This is a revised edition of an important title originally published in 2009. It is written primarily for psychotherapists and other practitioners and describes a new and effective form of dynamic therapy designed for working with adults and with adolescents. The theory, on which the new form of therapy is based, is centred in a paradigm that extends and crucially alters the paradigm for developmental psychology opened by the Bowlby/Ainsworth attachment theory. It describes a pre-programmed process, the dynamics sustaining attachment and interest sharing, which is activated as soon as people perceive that they are in danger. This process is made up of seven pre-programmed systems which interact with one another as an integrated whole. They include Bowlby's two complementary goal-corrected behavioural systems: attachment (also referred to as careseeking) and caregiving. Whenever the process is able to function effectively, it enables people to adapt more constructively and co-operatively to changing circumstances.

PART I

THE THEORETICAL BACKGROUND
FOR AN AUTONOMOUS SELF THAT
IS IMMERSED IN THE DYNAMICS
OF ATTACHMENT AND INTEREST
SHARING

CHAPTER ONE

Introducing a new attachment paradigm

There is no doubt that Bowlby’s ideas have had an immense and beneficial impact on our understanding not only of children but also on the organization of services for their care. We describe in Appendix 1 the two instinctive goal corrected systems he introduced—the attachment/careseeking system and the caregiving system. Although Bowlby stated that both systems were active throughout life, the emphasis put on the instinctive behaviour of infants and children seeking care and protection from parental caregivers does not describe sufficiently the common concerns of adult clients, the people for whom the authors have written this book. This state of affairs means that many therapists and other practitioners have found little guidance from attachment theory, as it stands, to help with difficulties that are commonly complained of by adult clients.

Although adult clients frequently bring troubles with careseeking and caregiving to therapists, Bowlby’s model does not help in answering the following questions:

1. How does it come about that human beings seem to want to survive with wellbeing and enjoy using and developing their skills and talents in company with others who share the same interests?
2. How are we able to form long-lasting friendships with our peers, from childhood onwards, in which people are creative while relating to each other on an equal footing, without one being (in Bowlby’s language) “older and wiser” than the other?
3. How do some adults manage to have long-term affectional and interest sharing monogamous sexual relationships, while others live with sexual relationships that although passionate are short term or promiscuous?
4. How do we cope with anxiety and fear when there is no caregiver available to help us?
5. Why do we spend time and resources maintaining a particular lifestyle, which we mourn and try to replace when it is lost?

And finally

• 6. How do we understand that elusive concept “the self”?

Working with adult clients, Heard and Lake found that it was essential to conceptualize further than they had done previously about these six questions and especially about the final one on the self which would help us answer questions such as: “Who am I?”; “I’m not doing what I want to do”; “I don’t know why no one likes me, I just know I am not popular”; and “When that examiner was so cold and cutting, I went blank and could not remember anything”.

Need to conceptualize further

Heard and Lake had also found that, in addition to finding answers to the questions mentioned above, they found they had to be clear about:

1. How to recognize creativity in ordinary people and the effects that being creative can have upon their sense of themselves;
2. How people show, in observable forms, the emotions they experience when they actually reach (or fail to reach) the goals of careseeking, caregiving, interest sharing, affectional sexuality, or a strategy for personal defence;
3. The differences between the kind of caregiving that reaches the goal of careseeking for careseeking infants and young children, and the sustained caregiving of mature adults who can respond to the emotions expressed by older children, adolescents, and adults with empathy.

Moreover, in the situation of seeking care, as Ainsworth showed in the Strange Situation Test (see Appendix 3), exploration is noticeably diminished, at least in infancy. There is much anecdotal evidence showing that whenever adults give attention to seeking care, exploration in other directions may be curtailed if not completely inhibited.

All that we have said above raises issues that affect the self, which we see as an autonomous entity, immersed in the dynamics of exploratory interest sharing and attachment. In this last sentence we are giving a foretaste of issues which will be discussed about the self in a logical order as the book unfolds.

The extensions to attachment theory finally selected

The answers to the questions were initiated by Lake and later developed in concert with Heard (1986, 1997). Three more instinctive behavioural systems (a system for interest sharing with peers, a system for affectional sexuality, and a system for personal defence) were added to Bowlby’s two, as well as two more systems whose function is to support the self when no caregiver is available.

One of these last two systems is referred to as “the external supportive system”; in effect it is the particular lifestyle which we live in and maintain, built from memories of situations in which effective caregiving has been experienced. The other is the “internal supportive/unsupportive system”, built on the “internal working models” a self constructs from its experience of relating to its most important caregivers. These two systems can only be supportive when a self has experienced sufficient empathic care on a regular basis from his or her most important caregivers, who need not be the biological parents. Otherwise the so-called supportive systems are unsupportive. In this book the two systems have been given the title of the supportive/unsupportive systems. They are discussed in Chapter Ten together with a description of the internal working models we create and store of the self relating to another person or to groups of people.

The recognition of a restorative dynamic process that maintains wellbeing

Soon after the publication of The Challenge of Attachment for Caregiving, Heard and Lake realized to the full that the three instinctive or unlearnt systems that had been added to Bowlby’s two, and also the two supportive/unsupportive systems, behaved as an unlearnt process whose function is to restore and maintain survival with wellbeing; and that this process (composed of seven systems) swings into action whenever an infant, child, or adult senses an occurrence that acts as a threat to his or her sense of wellbeing. At that point the attachment careseeking system and the system for personal defence are activated; then, after an empathic caregiver has interacted with a careseeker in a supportive manner, the experience of wellbeing is restored (as far as is possible, depending on how empathic the caregiver has been). Wellbeing is maintained until another threat is sensed, and the process of restoration begins all over again. Heard and Lake have named the process “the Restorative Process” or “RP”. The RP is fuelled by the dynamics of attachment and interest sharing; and the theory on which the dynamic process is based is called “the theory of attachment based exploratory interest sharing”.

The recognition that a new paradigm had been opened

Heard and Lake did not recognize until 2007 that they could claim they had opened a new paradigm. They had done so by hypothesizing the existence of: (1) the dynamic RP and (2) a new understanding of the self, which is introduced in Chapter Three. There was good reason for the delay.

Until there was some evidence that the hypothesis on which the RP rested actually existed as a reliable theory, the hypothesis was only an interesting idea, as also were Heard and Lake’s ideas about the self. The only evidence that existed at that time came from: (1) the experience Heard and Lake had had of actually treating clients using the hypothesis that the process existed; and (2) reports of how other therapists treated their clients. However, McCluskey’s study demonstrating the emotive power of body language and her use of Heard and Lake’s theoretical ideas, added harder evidence than only having personal experience of using the ideas. The consequence was that Heard and Lake recognized that they were doing something other than extending the Bowlby/Ainsworth attachment theory.

Heard and Lake were well grounded in Freud’s perceptive clinical observations and knew the theoretical explanations he thought out in order to understand, and explain to other people, the observations he made. They were also aware of how much Bowlby had learnt from Freud. Speaking from their own perspectives, Heard and Lake shared Bowlby’s views about the exceptional value of Freud’s clinical observations, but followed Bowlby’s theoretical formulations rather than those of Freud.

It should be borne in mind that Freud was working on “instincts” almost fifty years before Bowlby entered the field. When he was well established, Freud had made two statements about instincts, which are quoted by Bowlby (1969/1982, p. 37). In the first Freud raised his doubts about the use of trying to classify instincts “by working over psychological material” (1915), and suggested that it would be desirable if assumptions could be taken from some other branch of knowledge and carried over to psychology. As is well known, he chose the theory used by the chemists and physicists of his day. In the second statement, made after wrestling with the problem for a further ten years, Freud stated (1925) that there was no more urgent need in psychology than for a securely founded theory of the instincts on which it might be possible to build further. He added that nothing of the sort then existed.

How does a person become a theoretian, how do theories come about, and what is a theory?

The authors consider that any curious person (be they an experienced creative scientist such as Einstein or a young child) who ponders on why something happens, and finds an explanation about some aspect of human nature (or indeed about anything else in the universe) that satisfies his or her curiosity, and removes uncertainty (at least for the time being) is a theoretician. Thus there is nothing magical about looking for and finding theories.

The authors call people “explorers” who seek out and find an explanation for something that has awakened their interest and curiosity and leads to a sense of satisfaction. They may find an explanation in the literature which they consider matches whatever they had been groping towards, and which they adopt; or after contemplation and reflection on the nature of whatever is of compelling interest, a novel explanation “arrives” which is sensed to be “right”. Once such an explanation strikes an explorer he or she often becomes motivated to share and discuss the new finding with like-minded peers (cf. Archimedes leaping out of his bath crying “Eureka”).

Scientific research we consider describes working at a professional level in order to discover a valid explanation for how and when a particular “something” happens. It is an activity which is absorbing and exacting, but also hugely enlivening and invigorating. However, once a “discovery” is made the first task is to replicate it and establish its validity by deriving hypotheses from the discovery and learning whether it can be replicated. At this point research has its moments of uplift when the findings support the hypothesis; and downturns are suffered when a hypothesis that was hoped to contribute to the explanation of why something happens, is shown to be mistaken; even then, a negative finding properly investigated is always a valuable discovery and often gives hints that end in adapting the theory, deriving another hypothesis from the adapted theory, and testing it.

The definition of a theory used in this book

The authors follow the definition of a theory given in the Concise Oxford English Dictionary (COD), which defines the word theory as: “a supposition or system of ideas explaining something, especially an explanation that is based on general principles independent of the facts, phenomena, etc. to be explained”. A theory is considered in the COD to be opposite to a hypothesis, which is defined as a supposition made as a basis for reasoning without assuming that it is true.

However, it is important to distinguish suppositions that are related to theories from those that relate only to hypotheses. Heard and Lake distinguished the two by referring to suppositions made when working out a theory as presuppositions which they considered were inspired guesses about what may actually be occurring. Presuppositions allow a theory to be constructed from which researchers can derive hypotheses by saying: “If this presupposition is correct then such and such will follow.” Findings from hypotheses so derived will then either support or refute the presuppositions in the theory.

Is everyone an explorer?

Not everyone can be considered to be an explorer. There is much anecdotal evidence to suggest that there are two outstanding reasons why many people are not. The first is that some non-explorers have for personal reasons taken on board the views of would-be mentors, and without questioning, blindly follow him, her, or often them; even after an ongoing relationship with that “mentor” has ended. Alternatively some people believe that something happens because it is fated to occur, or it is an act of the god or gods that members of a community believe in and follow. Therefore there is no point in looking further.

Both these groups of non-explorers tend to hold fixed, and often immutable, views about why and when particular phenomena happen. Anyone holding either of these non-exploratory views resists the introduction of new paradigms that are based on an observation that cannot be explained by an existing theory. We describe our understanding of a paradigm derived from Thomas Kuhn later in this chapter.

The authors are all explorers and have been trained to use scientific methodology in which a theory is seen as a tool to suggest hypotheses that when tested will be shown to support the theory or indicate it is mistaken. In Part II we describe a form of therapy for individuals and for groups, in which hypotheses are tested by a professional caregiver in the course of therapy in a manner that is experienced by careseekers as therapeutic.

We are well aware that by stating that we are taking a scientific approach to therapy, we are likely to be written off by some therapists as being uninterested in emotions and unaware of what many clients find upsetting, painful, and frustrating; and there is good reason for this belief.

There are considerable differences between many of the people who are primarily researchers, and those who are primarily therapists. Researchers can choose the subject they wish to study and can disregard phenomena which do not seem to have a bearing on the objectives of the research. Sometimes a neglected phenomenon has just never been considered to be important, but commonly the methodology to test the presence of particular phenomena has not yet been worked out. The investigation of feeling states has suffered this fate.

The methodology McCluskey uses records aural data and in some instances data from one or more video cameras carefully placed to film nonverbal signals passing between a professional caregiver and an adult careseeker. The records from both sets of data can be studied and re-studied—in slow motion if desired—by many observers.

This methodology was worked out wel...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Acknowledgments
• About the Author
• Foreword
• Preface
• PART I The Theoretical Background for an Autonomous Self That is Immersed in the Dynamics of Attachment and Interest Sharing
• PART II Therapy Guided by the New Attachment Paradigm
• PART III
• GLOSSARY
• REFERENCES
• INDEX