A Matter of Security by Friedemann Pfafflin
Attachment theory as developed by John Bowlby has since the 1960s stimulated theorizing about the normal and psychopathological development of children, women and men. In an unprecedented way it demonstrated how psychological functioning depends on adequate emphatic interaction from the very beginning of life.
The quality of the interaction between the newborn and his or her caregiver, the attachment patterns experienced, the developing process of mentalization of these experiences and the resulting attachment representations are crucial for how an adult will interact with other persons and his or her environment.
Taking this into account, it is not surprising that forensic psychotherapists and psychiatrists enthusiastically engage in attachment research, using its achivements for a better understanding of their clients and for the improvement of the care they offer, both as individual therapists and as protagonists of the systems of detention in secure psychiatric units and in prisons, which have to offer a milieu of security for the sake of society as well as staff and their clients.
In both settings one finds an accumulation of failed primary attachment processes that need remedy to interrupt the ‘circuit of misery, violence and anxiety’ which Sherlock Holmes (Conan Doyle 1895) identified as one of our greatest problems, and which Murray Cox, the founder of the Forensic Focus series, cited in his seminal work, Mutative Metaphors in Psychotherapy. The Aeolian Mode (Cox and Alice Theilgaard (1987), London: Jessica Kingsley Publishers.
This volume gathers a body of original work on attachment theory applied to forensic psychiatry and psychotherapy, and also some previously published seminal work from this field.
In the first section on theoretical issues, Peter Fonagy gives a survey of research findings on the developmental roots of violence in the failure of mentalization. He focuses on a time of violence which is predominantly encountered in the lives of forensic psychiatry and psychotherapy patients, and which is embodied as an act of overwhelming rage, and he suggests ‘that violent acts are only possible when a decoupling occurs between the representations of subjective states of the self and actions.
Paradoxically, he comes to the conclusion that ‘violence is a gesture of hope, a wish for a new beginning, even if in reality it is usually just a tragic end.
Thomas Ross examines the heterogeneous terminology used in attachment theory and research. According to him, the terms ‘(attachment) representation’, ‘(attachment) style’, and ‘(attachment) prototype’ are usually used adequately and in accordance with the corresponding construct. They denote an intrapsychic mode of handling interpersonal relationship experiences (attachment representation) or relate to manifest behavioural correlates of attachment (attachment style).
When the focus is on testing clinical hypotheses and the differentiation of manifest attachment behaviour (‘attachment style’), the usage of‘attachment type/prototype’ seems appropriate. ‘(Attachment) pattern’ and ‘(attachment) organisation’ are applied in inconsistent ways in the literature. The terms ‘attachment status’, ‘attachment quality’, and ‘ attachment classification’ (as a result of a classification process) are not really helpful, or rather useless, as they do not add information beyond what is denoted by the above-mentioned terms.
Furthermore, they contain social connotations, which might lead to misunderstandings when discussing human attachment. The same applies to the occasionally used terms ‘attachment pathology’ and ‘attachment difficulty’. They imply social judgments that are not empirically justified.