Adult Attachment and Couple Psychotherapy

The 'Secure Base' in Practice and Research

Christopher Clulow

• Publisher: Routledge
• Year: 2012
• Print ISBN:
  9780415224154
• eBook ISBN:
  9781134592371
• Topic: Psychology
• Subtopic: Education in Psychology
• Index: Psychology

Attachment theory has triggered an explosion of research into family relationships, and has provided a conceptual basis for the work of practitioners. Adult Attachment and Couple Psychotherapy brings research and practice perspectives to bear on the adult couple relationship, and provides a framework for assessing and working with secure and insecure partnerships.
Divided into three parts, the book:
* looks at what is meant by secure and insecure attachment in the couple
* describes how theory and research have been applied to practice, and how practice has added to the understanding of the complex problems that couples bring to therapy
* examines the significance of training and the organisation of work for effective practice with couples.
Using vivid illustrations from clinical and community work, Adult Attachment and Couple Psychotherapy offers stimulating reading for all those involved in this field who wish to re-assess their models of practice.

Part I

Conceptualising the couple in attachment terms

Chapter 1

Patterns of relating in the couple

James Fisher and Lisa Crandell

This chapter aims to offer a description of our attempt to conceptualise attachment in couple relationships, and to provide a brief discussion of the implications this may have for the capacity for intimacy. In the past two decades, Mary Main and colleagues have conducted seminal research directed at understanding the expression of attachment in adulthood (George et al., 1985; Main et al., 1985). They have developed the Adult Attachment Interview (AAI) which assesses ‘an individual’s state of mind with respect to attachment’ (Main and Goldwyn, 1994: 1) and have investigated how representational models of attachment are related to dyadic functioning in parent–child relationships. We asked ourselves how one might extend this approach to an examination of attachment in couple relationships. This has led us to the notion of what we are calling ‘complex’ attachment.

Although some researchers have begun to expand and develop the approach which underpins the AAI for the study of adult couple relationships, these studies are at an early stage, especially with clinical populations (Cohn et al., 1992; Crowell and Treboux, 1995; Hazan and Shaver, 1994; Kobak and Hazan, 1991). To our knowledge, no-one has yet attempted to connect the AAI methodology with an object relations psychoanalytic approach to the adult couple relationship. Those familiar with the problems of psychoanalytically oriented research into intersubjective psychological processes will recognise the significant difficulties inherent in this endeavour (Shapiro and Emde, 1995). However, there is a remarkably widespread interest in the AAI among therapists from a psychoanalytic perspective, strengthening the potential links between psychoanalysis and the world of empirical research (Hobson, 1995; Patrick et al., 1994; Fonagy et al., 1991a; Fonagy et al., 1993a; Main, 1993). Therefore it was also our aim to construct a conceptual model which would reflect our psychodynamic understanding of the couple, from what is generally termed an object relations approach (Ruszczynski, 1993).

With these goals in mind, we shall now turn to the ideas and research that have formed the basis of our thinking. There is a growing consensus that the quality of a person’s primary attachments in childhood is intimately linked with patterns of interpersonal relatedness throughout the life-span. In the past decade, empirical evidence has emerged to support the position of Bowlby, who stated: ‘On the way in which an individual’s attachment behaviour becomes organised within his personality turns the pattern of affectional bonds he makes during his life’ (1980: 41).

The evidence for this assertion has come from two strands of investigation. One tradition of research has been based on observations of infants and their primary caregivers. The aim has been to identify patterns of infant social behaviour that are taken to reflect an underlying attachment organisation, and to trace the developmental sequelae of these patterns. The second strand of research has involved a shift away from behavioural observations of infants and caregivers to the study of adults’ mental representations of attachment relationships. Here the focus has been on the manner in which individuals mentally organise and think about their childhood attachment relationships, and how this influences the quality and nature of their relationships in adulthood. In other words, it is not the quality of primary attachments in childhood itself that shapes adult interpersonal relationships, but rather the ‘mental representations’ of those attachments which are critical for adult intimate relationships.

Both traditions are relevant for our focus on attachment in couples, and each has implications for thinking about a person’s capacity for intimacy. Therefore, we shall address each methodological approach in turn.

BEHAVIOURAL OBSERVATIONS OF INFANTS AND CAREGIVERS

The Strange Situation Test or SST (Ainsworth et al., 1978) has become the standard measure for assessing attachment security in the infant–caregiver dyad. In the SST, a caregiver and 12–18-month-old infant are introduced to a laboratory room supplied with toys. For 20 minutes the dyad engages in a series of standardised phases. Seven brief sequences, each lasting a matter of minutes, are recorded on film:

• a caregiver and infant are introduced into an unfamiliar room with toys in it;

• they are joined by a female stranger;

• the caregiver leaves the infant with the stranger;

• the caregiver returns and the stranger leaves;

• the caregiver leaves;

• the stranger returns;

• the caregiver returns.

In response to the two separation and reunion sequences with the caregiver, infants are classified into one of three primary attachment categories.

Infants classified as ‘secure’ may or may not exhibit distress when separated from their caregiver. If they are distressed, they seek contact with the caregiver upon reunion. They are effectively comforted by this contact so that they become settled and return to play. Secure infants who are not distressed during the separation, typically greet their caregiver with delight upon reunion, making a bid for emotional contact with a smile and/or gesture. There is a symmetry with respect to the infant’s expression of the need for either physical or emotional contact with the caregiver and the reception of that contact in such a way that the infant is content.

Infants classified as ‘ambivalent’ exhibit marked distress upon separation and generally seek contact with the caregiver upon reunion. However, unlike the distressed ‘secure’ infants, these infants are not settled by their caregiver’s attempt to comfort them. They continue to fuss and cry, simultaneously seeking physical contact and resisting it. They do not settle emotionally or return to play. In this system there is asymmetry between the infant’s expression of the need for contact and the reception of that contact such that the infant remains in a state of discontent.

Infants classified as ‘avoidant’ generally show no or minimal distress during separation. However, unlike the non-distressed secure infants, these infants typically avoid their caregivers upon reunion. In many cases, the avoidance is pronounced and present even when the caregiver makes repeated attempts to engage the infant. Also, unlike their secure counterparts, these infants generally exhibit restricted affect. This is quite striking in its own right. In addition, there are now several studies showing that avoidant infants have elevated heart rates and galvanic skin responses that indicate physiological arousal, despite their rather bland affective presentation. In this system we might say that there is a discrepancy between the infant’s internal emotional state and his or her external affective presentation.

In more recent years, a fourth category, ‘disorganised’, has been identified (Main and Solomon, 1987; Main and Hesse, 1990). These infants exhibit a disorganised behavioural strategy for responding to the stress of the situation and demonstrate peculiar and/or competing behaviours (for example, beginning to approach the parent upon reunion but then dropping prone onto the floor). Infants who are classified as disorganised are also given an alternative classification in one of the three primary categories.

There are a number of studies tracing the sequelae of infant attachment organisation on personality functioning and the quality of interpersonal relating in later years (for example, Arend et al., 1979; Cassidy, 1988; Londerville and Main, 1981). These studies indicate that insecure attachment is associated with difficulties in social competence and impaired peer relations in childhood. The findings are consistent with the idea that the quality of the parent-infant attachment relationship lays the foundation for social development in later childhood. The question then arises, ‘what about adulthood?’ Is there any evidence to suggest that attachment continues to impart an influence on relationship patterns later in life? Indeed, what is attachment in adulthood, and how might we assess it?

ADULTS’ MENTAL REPRESENTATIONS OF ATTACHMENT AND DYADIC FUNCTIONING

A fundamental assumption of attachment theory is that, from early attachment experiences, an ‘internal working model’ of relationships is constructed (Bowlby, 1969, 1973, 1980) and that it is this model (which is primarily unconscious) that is carried forward and re-enacted in subsequent relationships. Therefore, as the focus moves from identifying behavioural patterns of attachment in infancy to mapping the influences of attachment in adulthood, there is a shift to the level of mental representations of attachment (Main et al., 1985).

The most sophisticated and well-validated measure for assessing representational models of attachment in adulthood is the Adult Attachment Interview (AAI). On the AAI, adults are asked to describe their relationships with their parents in childhood. They are asked to provide adjectives that characterise the parent–child relationship and to provide illustrative examples of memories that support those adjectives. Similarly, they are asked to describe incidents involving being ill, hurt and separated from parents. Finally they are asked how these relationships may have influenced their personality, and for their understanding of why their parents behaved as they did. The interviews are audio-taped and transcribed verbatim. The transcripts are then rated for the coherence of the subject’s discourse using the criteria of quality, quantity, relation and manner (Main and Goldwyn, 1994). Four categories have been identified that parallel the infant classifications delineated by the SST.

Individuals classified as secure (referred to as ‘free to evaluate’) share a common organisation of thought regarding their early parent–child relationships. They demonstrate a flexible and reflective manner of thinking and conversing about these relationships, have access to specific memories, value early attachment experiences, integrate positive and negative aspects of their parents into a coherent presentation and acknowledge the influence of those experiences on their adult personality. Individuals classified as ‘dismissing’ have difficulty accessing specific childhood memories, have restricted affect, devalue the importance of early attachment experiences and present an idealised or contradictory presentation of their early parent–child relationships. Individuals classified as ‘preoccupied’ (also referred to as ‘enmeshed’) have access to specific memories but are flooded by the negative content of these memories and are unable to integrate their experiences into a coherent understanding of the parent–child relationship. Their organisation of thought is typically confused, disjointed, entangled and marked by a preoccupied anger towards their parents. Like the disorganised infants in the SST, some adults on the AAI demonstrate a disorganised, disorientated organisation of thought that is specifically related to issues of death, abuse and/or other instances of trauma. They are classified ‘unresolved/disorganised’ and also given an alternative classification. (Crowell and Treboux provide further details of the AAI, including its psychometric properties, in Chapter 2.)

How is attachment, as assessed by the SST in infancy, related to representational models of attachment in adulthood? There are now a number of studies reporting that parental representational models of attachment are significantly related to infant SST classifications, even when parents are given the AAI before the birth of their child (for example, Fonagy et al, 1991a). In other words, the model of attachment that an individual has at the level of mental representation predicts attachment behaviour of his or her child at one year of age. This connection between parental representations of attachment and parent–child patterns of relating has been an important and intriguing finding.

More recently, researchers and clinicians have begun asking whether these representational models of attachment might also influence and/or reflect the quality of intimate relationships in adulthood. The studies that are emerging suggest this is the case. Couples in which there are two insecure partners show more negativity and conflict, less constructive patterns of communication, poorer marital adjustment and greater difficulty regulating affect than couples where at least one of the partners is secure (Cohn et al., 1992; Kobak and Hazan, 1991; Paley et al., 1995; Pianta et al., 1995). It is a curious finding that couples with one secure partner seem to function in a similar manner to couples with two secure partners (although see Chapters 2 and 4 for data suggesting that gender can act as a differentiating variable). It has led us to question what it is about a secure state of mind in relation to attachment that affords the capacity for more adaptive forms of relating, and what attachment means in the context of adult intimate relationships.

COMPLEX ATTACHMENT

Both the SST and the AAI refer to attachment relationships in childhood. Whether we are talking about an infant responding to separations from and reunions with his or her caregiver, or the manner in which an adult recalls and describes parental relationships from childhood, the focus is on an individual’s attachment experiences vis-à-vis the attachment figure. When distressed, the child turns to the parent for comfort and reassurance. Or again, the adult recalls the memories of the times s/he turned (or didn’t turn) to the parent. In each case, one individual is in the dependent position and the other is in the depended-on position. In this sense, the attachment is unidirectional.

We are proposing, in common with other attachment researchers, that in adult couple relationships each partner functions as an attachment figure for the other. In this way, the attachment system is bidirectional. In the ideal form, each partner can tolerate the anxieties of being dependent on the other and also being depended on by the other. As the exigencies of the relationship require, the partners can move empathically and flexibly between the dependent and depended-upon positions. In this way, each partner experiences both the position of the ‘infant’, who is emotionally dependent upon the attachment figure, and that of the attachment figure who provides comfort and reassurance to the ‘infant’. It is this dual nature of attachment in the couple that has prompted us to use the term ‘complex attachment’ to indicate that this system has an added dimension compared with attachment in parent–child dyads.

We anticipate that the quality of complex attachment in the couple will be strongly influenced by each partner’s representational models of attachment. That is, we expect secure states of mind in relation to childhood attachment relationships to be related to this capacity for reciprocity in the couple relationship, whereas insecure states of mind will be related to fixed positions and rigid patterns of relating. For example, in couples where there is a dismissing partner, it may be that the individual functions well in the depended-on position but is unable to tolerate the dependent position. However, we note the findings reported in Chapter 2 cautioning against assuming that representations of attachment will be the same across different relational domains.

On the basis of pilot data, a research team at the Tavistock Marital Studies Institute (TMSI) has worked at developing an instrument for assessing the idea of complex attachment and exploring how it may be related to couple functioning. The Couple Attachment Joint Interview (CAJI) is a semi-structured clinical interview that is derived from the AAI and has a similar format of probing different aspects of attachment. It differs from the Current Relationship Interview described in Chapter 2, and the Couple Attachment Interview described in Chapter 4, in that it is addressed towards and conducted jointly with both partners as if they were an entity. From this standpoint it asks about attachment-related issues in the partnership. For instance, how does the couple describe their ways of responding to illness, loss and separations? Do they feel they can depend on each other, and do they provide detailed descriptions in support of those beliefs? During the interview, do they demonstrate a capacity to see and consider the partner’s position? Unlike the AAI, which activates an individual’s representational model of attachment with respect to a previous caregiver, the CAJI is in some ways more like the SST, or rather, like two SSTs happening simultaneously, with each partner in potentially reversible roles. The difference is that the coder’s attention is directed towards joint representations of the partnership as well as observed behaviour, thus distinguishing it from the SST and the Secure Base Scoring System described in the next chapter. Another differentiating factor is that it attempts to capture the security of the relationship as a whole rather than the attachment status of each partner in relation to it – it thereby aims to be a measure of couple functioning. The resulting couple ‘template’ of complex attachment is like two overlapping individual attachment templates, if one pictures a ‘template’ as a configuration of behaviour and mental representations. The CAJI will remain a concept until the coding manual is developed into a reliable research tool.

Based on our conceptualisation of complex attachme...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• Contents
• Notes on the contributors
• Foreword by Jeremy Holmes
• Acknowledgements
• List of abbreviations
• Introduction
• Part I Conceptualising the couple in attachment terms
• Part II Applications to couple psychotherapy
• Part III A secure base for practice
• Appendix 1
• Appendix 2 Attachment style descriptive paragraphs: Bartholomew and Horowitz, 1991
• Bibliography
• Index