Attachment Issues in Psychopathology and Intervention by Leslie Atkinson
The notion that early, maladaptive parent-child relations play a causal role in psychopathology has long been central to developmental theorizing. However, it was not until John Bowlby provided a broadly alluring paradigm and Mary Ainsworth developed the practical means to verify it that the early relations, later psychopathology hypothesis received concerted empirical attention.
Bowlby and Ainsworth worked in strong partnership. Bowlby carefully integrated Ainsworth’s research findings so as to validate and modify his own theorizing; Ainsworth drew on the ethology and naturalistic observation that formed the basis of Bowlby’s thought.
Nevertheless, the emphases of each of these scholars were not entirely complementary: Bowlby focused on the extreme adversities that brought children to clinical care, whereas Ainsworth was concerned with direct mother-child interaction under normative conditions.
Methodological differences also underlie each of these approaches: Bowlby drew upon clinical experience to weave inferences and speculations into coherent theory; Ainsworth focused on detailed behavioral observations, which she summarized quantitatively and qualitatively and subjected to statistical test.
These contrasts are most evident in efforts to apply attachment theory to clinical populations. The contributors to this volume take up the challenge of integrating these two traditions, that of combining research knowledge and clinical expertise while neither rigidly constraining clinical work norreplacing data and hypothesis testing with clinical intuition.
To accomplish this, they reevaluate attachment theory, incorporate diverse approaches in its study, broaden it, qualify it, refocus it, and change it.
As a physician and psychoanalyst, John Bowlby used case study material to construct and verify a theory of extreme adversity and trauma, of abandonment and loss, of psychopathology.
For example, Bowlby drew on case experience to describe the caregivers of school-refusing children (suffering from general anxiety, depression, and psychosomatic difficulties) as immersed in highly conflictual marriages, engaged in role reversal, expressing extreme resentment and anger, and using guilt induction and threats of suicide, abandonment, or expulsion from the family.
For Bowlby, issues of protection and distress regulation were paramount to attachment theory. Four characteristics of his approach stand out as most relevant: the use of case study material to develop and validate theory, belief in the extremity of conditions surrounding insecure attachment (and, by inference, belief in the extremity of insecure attachment), a focus on frank psychopathology, and belief in the centrality of protection or distress regulation.
Bowlby’s work led to a rich clinical literature, wherein attachment theory, as applied to individual cases, is used to understand psychopathology and therapeutic intervention.