Responding to Loss

A Resource for Caregivers

Adolf Hansen

• Publisher: Routledge
• Year: 2020
• Print ISBN: 9780415785235
• eBook ISBN: 9781351841955
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Reading this book, caregivers will find ways to increase their effectiveness by understanding more fully what their care receivers are experiencing, by finding creative ways to assist them in processing what is happening, and by working with them to discern responses to loss that are emotionally healthy, intellectually coherent, spiritually genuine, culturally sensitive, relationally authentic, and personally fulfilling.

CHAPTER 1
Possibilities for Meaning: Attachments

In life there are numerous possibilities for meaning. They often grow out of a reflection on life in which individuals: first, identify those attachments that really matter at the present time; second, relate them to previous experiences; and third, decide how to develop them in the future.

Central to these attachments are relationships, many of which are with other persons. However, there are also relationships with things (physical objects), places (locations), events (actual occurrences), and a variety of intangibles (a certain type of music, a perception of beauty, a dream, a sense of humor, etc.).

Every functioning human being has relationships in each of these categories; however, the nature of those relationships varies from one individual to another. Yet the most significant for virtually all persons is relationships with other persons. It consists of both feelings (emotional ties) and thoughts (intellectual formulations), with feelings more influential for some, and thoughts more influential for others.

Infant and childhood experiences are the most crucial in the development of such relationships, particularly in the establishing of attachments. John Bowlby formulated the basic framework for the approach that he and others have called “attachment theory.” He sets forth this perspective in three volumes that he entitles Attachment and Loss (1969, 1973, 1980). The most crucial tenets, taken from a more detailed outline [1, pp. 39–41], are summarized in the paragraphs that follow.

First, attachment behavior is understood as any form of behavior that results in an individual attaining or retaining proximity to another person who is clearly identifiable and who is distinctively preferred. The proximity, or closeness to another person, takes time and energy, not only to develop, but also to maintain. It emerges when the other person is plainly differentiated and decidedly more desirable [2].

Second, attachment behavior leads to the development of attachments that become affectional bonds if that development occurs in a basically healthy manner. This takes place initially between a child and his or her parent(s) or primary caregiver(s) and later between an adult and an adult. Conversely, if the development is basically unhealthy, the affectional bonds may emerge in only a minimal manner, or may not emerge at all.

Third, the formation, maintenance, disruption, and renewal of attachments give rise to many of the most intense emotions that human beings experience. Throughout these four movements inherent in the cycle of life, there exist not only the broad range of feelings, but also the most penetrating depth of feelings, whether they are in the arena of gladness and joy, of anguish and anger, or sadness and pain.

Fourth, attachment behavior in an adult is not necessarily indicative of a fixation at, or a regression to, an earlier, immature stage of development—a point of view set forth by some on the basis of conceptualizations that derive from theories of orality and dependency. Neither is attachment behavior indicative of some form of pathology.

Fifth, the most important determinants of the pathway along which an individual’s attachment behavior develops are the experiences he or she has with attachment figures during the years of infancy and childhood, and, to a lesser extent, adolescence. These experiences also shape the pattern in which the attachment behavior becomes organized.

Sixth, the way in which an individual’s attachment behavior becomes organized within his or her personality determines—to a large extent—the pattern of affectional bonds he or she makes throughout life. To understand such an organization, and the ways it has developed, however, not only informs an individual of the likelihood of patterns that may emerge, but also provides opportunities for the individual to affirm, modify, or acquiesce to such patterns.

Further expression of this paradigm was carried out by Mary Ainsworth, particularly in the volume, Patterns of Attachment: A Psychological Study of the Strange Situation, in which she focuses on the attachment of infants to their mother figures, utilizing empirical data to compare and contrast relationships between behavior in “the strange situation” and at home [3].

In a more recent article, Ainsworth moves beyond infancy in understanding attachment. In doing so she deals with long-lasting interpersonal relationships that, at times, involve affectional bonds [4, pp. 33–51]. She distinguishes these affectional bonds from relationships by indicating: 1) that relationships are necessarily twofold, while bonds can be characteristic of an individual; 2) that relationships may be long-term or brief, while bonds are by definition long-term; and 3) that relationships between individuals grow out of the development of varied interactions, some of which do not pertain to an affectional bond. In order to clarify her distinctions, she defines an affectional bond as “a relatively long-enduring tie in which a partner is important as a unique individual, interchangeable with none other” [4, p. 37].

A number of other researchers have also made important contributions to the development of attachment theory. Conferences in London in 1981 and 1988 were each summarized in separate volumes. The first, The Place of Attachment in Human Behavior, brought a broader recognition to this paradigm [5]. It dealt with infant-mother attachment, problems in parenting, bonding in adult life, and disorders in adult life. The second, Attachment Across the Life Cycle, raised awareness even further [6]. It focused on the nature of attachment, patterns of attachment, and clinical applications.

A subsequent conference in Toronto in 1993 brought together researchers and clinicians to review the developing state of knowledge regarding attachment theory and practice. A book was produced from that conference entitled Attachment Theory: Social, Developmental, and Clinical Perspectives [7].

Interest in producing an even broader, more representative collection eventuated in a volume in 1999 called Handbook of Attachment: Theory, Research, and Clinical Applications [8]. It brings the field up to date in a manner that combines an in-depth analysis and a comprehensive overview.

Many additional writings pertaining to attachment have emerged in the last decade of the 20th century and the early years of this century [9]. Three are particularly noteworthy since they relate attachment theory to other psychological approaches. The first one is the special issue of the Journal of the American Psychoanalytic Association in 2000 entitled “Psychoanalysis, Development and the Life Cycle” [10]. The collection of articles focuses on the dialog that is needed between psychoanalysis and attachment theory. In the words of the editors, “It seems it is time for rapprochement. Our hope is that with this publication more and better dialogue will take place, and that more psychoanalysts will begin to take account of the enormous contributions, as well as the challenges, that attachment theory can provide” [11, p. 1048].

The second is a volume by Peter Fonagy, Attachment Theory and Psychoanalysis [12]. It explores more fully the interactions between attachment theory and a range of psychoanalytical schools of thought, from Freud to the evolving relational or intersubjective approaches [12, pp. 123–134]. In this process, points of contact as well as divergence are noted. Throughout, there is an attempt to build bridges that will enable an integration of these approaches.

The third is a book by Jeremy Holmes, The Search for the Secure Base: Attachment Theory and Psychotherapy [13]. It sets forth a new paradigm in psychotherapy with adults, one that utilizes an attachment-informed therapy. Permeating this approach is the attempt to bring about a rapprochement between psychoanalysis and attachment theory. To assist in that process, a “brief attachment-based therapy” is delineated as a treatment modality [13, pp. 144–167].

Growing out of the development of attachment theory are numerous theoretical and clinical distinctions. Three rather straightforward ones that are utilized in this volume are: 1) that relationships are very significant in understanding human behavior; 2) that attachments involve particular kinds of relationships; and 3) that affectional bonds involve particular kinds of attachments. Whereas Bowlby uses attachments and affectional bonds interchangeably [1, p. 39; 2] and Ainsworth speaks of attachments as a certain type of affectional bond [4, p. 38], either of which can be properly defended, this analysis will deal with attachments in a broader sense and will speak of affectional bonds as a certain type of attachment.

These distinctions may be depicted in an image of three circles: the largest circle indicates relationships; the smaller circle within it signifies attachments; and the smallest circle at the center of the other two represents affectional bonds. The latter is identified by Bowlby in the words: “Intimate attachments to other human beings are the hub around which a person’s life revolves, not only when he is an infant or a toddler or a schoolchild, but throughout his adolescence and his years of maturity as well, and on into old age” [1, p. 442].

In the utilization of attachment theory in this volume, the understanding of attachments is, therefore, broader in scope and more varied in intensity than the approach of Bowlby, Ainsworth, and others. Hopefully, this will place findings that already have been established in a larger co...

Table of contents

• Cover
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Preface
• CHAPTER 1 Possibilities for Meaning: Attachments
• CHAPTER 2 Loss as a Break in an Attachment
• CHAPTER 3 Responding to a Break
• CHAPTER 4 Responding Before the Break Has Taken Place
• CHAPTER 5 Responding After the Break Has Taken Place
• CHAPTER 6 Responding in a Personal Way
• CHAPTER 7 Being Transformed through Responses
• CHAPTER 8 Resources for Transformation: Attachments
• POSTSCRIPT A Personal Story
• Index