The Attachment-Based Focused Genogram Workbook

Expanding the Realms of Attachment Theory

Rita DeMaria, Briana Bogue, Veronica Haggerty

• Editorial: Routledge
• Año: 2019
• ISBN:
  9781351709040
• Edición: 1
• Categoría: Psychology
• Categoría: Clinical Psychology

The Attachment-Based Focused Genogram Workbook is a hands-on guide for clinicians looking to integrate attachment research and family systems theory into their practice, with particular attention to intergenerational transmission processes.

The book introduces a range of relationship mapping and timeline tools, grounded in the use of focused genograms and the Intersystem Approach. Examining the importance of the therapeutic bond within a variety of client-systems, the book outlines a new methodology for identifying childhood attachment patterns, adult attachment styles, family scripts and attachment narratives, and contextual social bonds. Exercises are also included throughout to encourage reflective thinking and to consolidate key concepts.

Utilizing genograms as an essential tool in systemically focused family practice, this workbook will help therapists at all levels to apply and strengthen systemic considerations for clinical practice and research. The text also complements the revised edition of Focused Genograms, which uniquely applies attachment research for individuals, couples, and families in contextual clinical settings.

Part I

Foundations of the Focused Genogram Applications of Attachment Theory

1 Attachment-Based Focused Genograms

The Intersystem Approach and Applications of the Attachment Theory Construct

Overview

Welcome to the Attachment-Based Focused Genogram Workbook (FGW). The purpose of the FGW is to provide a guide for students, therapists, clinical supervisors, and researchers in using the attachment-focused genogram (FG) assessment tools. FGs allow clinicians to explore intergenerational transmission of attachment bonds and narratives that influence beliefs, attitudes, behaviors, emotional functioning, illnesses, trauma, and more – for individuals, couples, and families. The application of the attachment-based FG maps, in particular, fosters and establishes the formation of a therapeutic alliance and a thorough and well-integrated treatment plan.

The overarching goal of this FGW is to provide you with a new way to develop your Case Formulations (CFs). Each chapter begins with objectives and provides guided instructions to help you gain mastery over developing goals, tasks, and a therapeutic bond with your client-system. The Intersystem Approach (IA) influences the therapist’s selection of techniques and strategies that are the best fit for the client-system. The client-system is likely to experience greater confidence in treatment because of the therapist’s immediate attention to the problem, via a thorough assessment and flexibility in beginning treatment and establishing an attachment-focused therapeutic alliance. While the body of literature on the use of genograms in clinical training is extensive, it is based predominantly on Bowenian Family Systems Theory. Unfortunately, most Bowen-oriented articles are older and none of them reference the FG. The extant literature focuses on the clinical application of a broad-based genogram or specific (topical) genograms (McGoldrick, Gerson, & Petry, 2008). The ideas in these articles are often very general and could be applicable to any prototype of a very basic and traditional genogram despite the multicultural focus. In addition, the articles and books do not stress integration, theory, or training. The most recent edition of Focused Genograms: Intergenerational Assessment of Individuals, Couples and Families (2017) along with this new Attachment-Based Focused Genogram Workbook provides an integrated method for exploring individual, couple, family, and community intrapersonal and interpersonal dynamics. Further, the concept of therapeutic posture (TxP) has been defined, described, and detailed as an application to strengthen the therapeutic alliance within this workbook, a new and unique consideration within the context of genograms. The inclusion of attachment theory as a primary relational construct using various genograms, CFs, maps, and timelines for all four domains of the IA, along with a differentiated attachment-focused clinical approach when working with client-systems, provides a comprehensive and systemic approach in clinical practice.

Each chapter starts with objectives and contains background information and exercises to help you learn the concepts and apply the tools. The objectives of this chapter are as follows:

Objectives

1. 1 List the ways you can use the FG Roadmap to describe the IA for the four domains (Exercise 1.1).
2. 2 Describe how using the IA, FGs, and attachment-based mapping and timelines might help you in your ability to conceptualize a case (Exercise 1.2).

The IA and the Attachment-Based FGs

The IA is an integrative dialectical and systemic approach to assessment and treatment. Dialectics provide a logical methodology for developing a meta-theory of change, a meta-theory of human development and relationships, and a dialectical conceptual process that allows for an understanding of the dynamic relationships among systems (DeMaria, Weeks, & Twist, 2017). Dialectical thinking is the process by which clinicians can hold conceptions of both the individual and the intergenerational family system simultaneously. This remarkable method for case conceptualization works for even the most complex multi-person client-system cases.

FGs provide an attachment-based, multidimensional infrastructure that provides a way of thinking integratively among the IA’s four domains: the individual, the couple, the family, and the contextual, which encompasses the sociocultural-geopolitical climate of the client-system. In Focused Genograms, 2nd edition, we developed a new set of FGs that provide useful tools for clinicians. These tools include the mapping and timeline tools that have been expanded and infused with attachment theory. Using the FG tools (FGs, maps, and timelines) helps the practitioner conceptualize the client-system holistically integrating the IA’s four domains. This workbook includes the application and uses of all the FG mapping and timeline tools. We also provide a compendium of FG questions, from both editions of the FG books (DeMaria, Weeks, & Hof, 1999; DeMaria et al., 2017), which will help guide the assessment of your clients as you explore and address the various FGs.

Attachment theory has been integrated into each domain such that the attachment terms for each domain are pictured within it. For example, the individual domain addresses childhood attachment experiences and lists the childhood attachment patterns of secure, anxious-avoidant, anxious-ambivalent, and disorganized. The adult and family/intergenerational domains are similarly listed. The interactional construct of the self in a relationship is part of the original dialectical meta-theory of the IA and includes intrapsychic elements of the self and interpersonal elements of relationships with others. Finally, the outer domain, or the fourth domain, is the contextual domain. It includes cultural, religious, political, and natural elements.

Figure 1.1 incorporates the inner and outer dialectics with all the domains, the FG maps and timelines, and includes four generations (labeled G0–G4) illustrating the intergenerational transmission of attachment bonds within the overall approach. The outer dialectic creates a boundary around the intergenerational family system and incorporates numerous aspects of the contextual domain.

Within each FG, clinicians can develop maps and timelines for each of the four domains. The individual domain maps the childhood attachment patterns with parental figures using the Internal Models Map (IMM). The couple domain uses the Couple Interaction Map (CIM), which provides a guide for identifying adult attachment-style interaction patterns as well as other aspects of couple interactions. The Family Connections Map (FCM) provides a guide for exploring family-of-origin (FOO) attachment-focused family dynamics through the attachment lens. The Social Bonds Ecomap (SBE) provides a guide for exploring social bonds within and among all the domains.

Figure 1.1 The IA and Intergenerational Transmission of Attachment Bonds.

A timeline accompanies each map to track the events that have taken place in each domain that influence the presenting problem.

Parallel to the FG maps, the FG timelines correspond to each IA domain. Adding to the richness of relational mapping, the timelines capture developmental information and life events on a continuum. Their subjects include the following:

• Exploring childhood attachment experiences and developmental struggles, abuse, or trauma.
• Intergenerational patterns of fairness and entitlement that impact secure/insecure attachment for individuals, couples, and families.
• Intimate relationship experiences through adolescence and adulthood.
• Family-life traumas and tragedies, along with patterns of intimate family violence during the client/couple/family life cycle.
• Multigenerational contextual and community impacts for individuals and families.

Timelines provide an important tool to assist the student and practitioner to understand a client – feedback, clarification of life experiences, relationship and contextual information that help formulate diagnoses, and treatment plans.

Table 1.1 visually represents the FG Roadmap, a conceptual framework for using the FG tools as part of the IA case formulation. The attachment-based tools provide specific mapping tools and timeline tools for each domain.

Table 1.1 The FG Roadmap

Exercise 1.1 FG roadmap Worksheet

Directions: After reviewing the IA and the intergenerational transmission of attachment bonds (Figure 1.1) and the FG Roadmap (Table 1.1), in the space below, enter the four domains (Individual, Couple, Intergenerational/Family, and Contextual) under the heading. Then using the other two headings, list the attachment-based FG maps and timeline experiences belonging to each of those domains.

Expanding Your Clinical Perspective and Skills

Integrative thinking is a more commonly applied term than dialectics and incorporates systemic thinking as well. The IA is an important integrative approach that has been developed and enhanced over 35 years. The IA is a dialectical meta-theory with two key integrational constructs: attachment theory and interactional theory. These constructs provide practitioners a systemic approach to assessment and intervention. Consequently, you will learn to think in an integrative way about clients, which will also enhance your ability to engage with each person within the client-system. Kallio (2011) suggests that using the term integrative thinking captures the potential evolution of adult cognitive development. This is supported by Seigel’s (2004) ideas about the human brain’s development of complexity as it ages, with a healthy brain maintaining flexibility. Also, Hill (2015) suggests that an integrated mind and body are goals of therapeutic healing. Therefore, practitioners who focus their attention on the development of systemic assessment will also lead to integrative thinking, which may further yield to wisdom over time in clinical practice. Although further discussion of the adult capacity to think integratively is beyond this brief description; therapists, who continually explore using the combined IA and FG and their related foci, will likely enhance their therapeutic relationships with ind...