Tailoring AEDP Interventions to Attachment Style (Page 6)


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[1] At this point, I want to share a frame that is important and arises from time to time when I present this material in training programs.  Attachment style characterizes the relationship, not solely the person, because attachment status and states of mind change with relationship (Bowlby, 1988; Main, 2005). Yet, throughout this paper, for ease of expression, I may refer to avoidant patients or ambivalent patients, or I will speak of people who exhibit dismissive or preoccupied states of mind.   What I mean by these labels is “a person who habitually, though not always, tends to manifest dismissive or preoccupied behaviors in relationship, and who is doing so now in the context of the patient/therapist dyad.”  To avoid that mouthful, I may speak more simply of dismissive patients or preoccupied patients.

[2] Earned secure attachment is a pattern noted in the Adult Attachment Inventory (Main, 2000) to describe a person who grew up with the background that led to insecure attachment, who has experienced a relationship with another person that enables them to rise above their insecurity to the point that they can express themselves with the coherence and cohesiveness that characterizes secure attachment. (Siegel, 1999, 2007, 2010)

[3] The Strange Situation is a procedure in which the attachment behaviors of children and their caregivers between ages 12-24 months are observed. In abbreviated form, the mother, stranger and child are in a room. The mother leaves, and the child is left with the stranger for a short time. The observer notes how the child responds when the mother leaves and when the mother returns. The child who expresses distress when she leaves, resumes play and engages with her upon her return is classified as secure.  The child who ignores her when she leaves, plays/explores little, and ignores her upon return is classified as avoidant.  The child, who protests when she leaves, is distraught while she is gone, and unsoothable upon her return is classified as resistant or ambivalent.

[4] Diana Fosha added transformation to her original two-factor theory of affect and relatedness. (Personal communication, October 2015)

[5] State One includes defense, distress and anxiety and also incorporates transformance glimmers of health and resilience.  State Two refers to core affective experiences such as categorical emotions, coordinated relational experiences, ego state work, receptive affective capacity, authentic sharing, somatic “drop down” states. State Three refers to transformational affects of mastery pride and joy, the grief of mourning the self, healing affects: gratitude, feeling moved, the tremulous affects, clicks of recognition and the realizations affects associated with new understanding.  State Four is core state, a state where calm and the sense of truth prevail and give rise to a coherent, cohesive narrative to stabilize change.

[6] Diana Fosha first articulated this in a conversation among AEDP faculty in a meeting early 2013 when I presented my grids showing the constellations of insecure attachment styles.

[7] Fonagy (1997) makes an interesting point about how maltreatment affects self-reflective function. More accurate to the picture than underdevelopment is fractionation – that reflective skill development does not happen along a singular progressive pathway – but evolves along varied pathways, influenced and molded by many dynamic interactions.

[8]  Here, I am fascinated by the entry point that arrives through the imaginal channel, and in future works I want to explore the connection to the convergence of pretend as knowing play and the pretend mode of experience, en route to expanding the reflective capacity.

[9] There is a description of such technique called model scenes, from Lichenberg & Lachman (1992).