Complicated Grief, Attachment, and Art Therapy. Группа авторов

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СКАЧАТЬ MacWilliam

      The origins of attachment

      Attachment theory rests on two fundamental principles: 1) a well-functioning attachment relationship provides a secure base that optimizes autonomy and provides support and comfort under stress, and 2) attachment relationships inform the development of “internal working models,” which are the basis for how we perceive and organize experience, like a script that is performed over and over again with new and various actors. Attachment figures are individuals to whom we seek proximity, from whom we resist separation, to whom we turn when in distress, and from whom we garner support and encouragement as we explore the world, engage in meaningful activities, and strive to master new challenges (Fraley and Davis, 1997). Loss of such a person creates a great disruption that is easily recognized as acute grief. Resolution of acute grief requires successful adjustment to far-reaching effects of the loss, both practical and psychological. Complicated grief occurs when resolution is impeded (see Chapter 3 for more detail).

      Often, attachment and bonding are discussed interchangeably, but they are not one and the same. Neufeld and Mate describe attachment as “a force of attraction pulling two bodies toward each other.” Attachment is at “the heart of relationships and of social functioning…[it is] the pursuit and preservation of proximity, of closeness and connection: physically, behaviorally, emotionally, and psychologically” (2004, p.17). Harville Hendrix describes attachment as a physical and spiritual yearning for the early symbiotic union of the womb. He uses the term “Eros” to describe it, a Greek word we equate with romantic love, but which originally had the broader meaning of “the life force” (1988, p.17). Sigmund Freud would describe such a force as a “libidinal drive.” Simply put, attachment is motivated by an instinctual need to orient oneself, a turning towards the “other” in an attempt to make sense of the world and one’s place in it.

      In the pursuit of attachment, however, we are paradoxically driven towards a state of independence. Having blissfully enjoyed a sense of intimate “oneness” with our mothers for about the first 12 to 16 months of life, the advent of crawling and walking propel us towards a state of independence, a process Margaret Mahler called “separation individuation.” A child’s state of feeling both distinct from and connected to its mother has a profound impact on all later relationships. If a child is fortunate, he will be able to make clear distinctions between himself and other people, maintaining flexible boundaries that he can open or close at will (Hendrix, 1988). Mahler suggested that a child suffers greatly if this individuation process is not handled with care, leading to profound confusion about who one is: What is self and what is other? What is me and what is not me? Early arrestments in this time of life can make for a complicated and intensely painful experience of grief in adulthood.

      Less widely known, but perhaps more easily understood, Neufeld and Mate identify six “ways of attaching,” ascending from the more simplified to complex:

      1.Senses. The emphasis is placed on physical proximity. A child needs to feel attached through smell, sight, sound, or touch.

      2.Sameness. Usually in evidence by toddlerhood, the child seeks to be like those he or she feels closest to.

      3.Belonging and loyalty. To be close to someone is to feel possessive of him or her, and to be obedient and faithful to that person.

      4.Significance. Needing to matter to the person we are closest to, and seeking to please him or her and win his or her approval.

      5.Feeling. Marked by a seeking to be emotionally open and vulnerable with an attachment figure; a willingness to share one’s feeling states.

      6.Being known. Usually observable by the time a child enters school, this is when a child seeks to share his or her secrets and insecurities in the hopes of being completely seen, heard, and embraced, in spite of them.

      Essentially, Neufeld and Mate describe the dynamics of intimacy: the integration of both good and bad feelings—loving someone, even though they have disappointed you, and continuing to love yourself, when you have disappointed someone else—which allows for the vulnerable experience of more complex emotions, and enhances one’s capacity to think and learn. Integration also happens to be the work of grief, the ability to make sense of what we’ve lost. One’s conscious reflection upon the mysteries of one’s unconscious processes and pressures is essential to this work.

      Bonding

      Bonding characterizes the nature of the emotional connection established between the child and the “other” he or she has attached him or herself to, usually whoever is established as the primary caregiver—often the mother. Feeding is the first collaborative effort in which both mother and child engage, thus it has a significant impact on the quality of the earliest bond formed. But an adequate exchange of nutrients alone does not a healthy emotional connection make.

      While Abraham Maslow’s hierarchy of needs originally suggested food was our first and foremost priority on the road to self-actualization, Harry Harlow (who worked with Maslow) later determined contact-comfort and attachment to be primary when it comes to cognitive and emotional development, after conducting controversial social isolation experiments on infant monkeys. Furthermore, Renee Spitz studied infants in orphanages who were adequately fed and held but failed to bond with their caretakers, which resulted in “a failure to thrive.” Spitz thus determined bonding to be an important aspect of attachment, and a benchmark of development that allows for growth on all spectrums.

      WHAT MAKES FOR A HEALTHY BOND?

      If the feeding experience is a pleasurable one—consisting of snuggles, smiles, caresses, and cooing—the infant is able to establish a sense of security and begin to formulate a mental picture of a loving mother, described by object relations theorists as a “libidinal object” (Winnicott, 1970). As previously discussed, this will help the child develop and later sustain a sense of self in his mother’s absence; he has achieved what Margaret Mahler would describe as object constancy, which is similar to developmentalist Jean Piaget’s concept of object permanence. The child comes to understand that the mother is a separate individual with her own identity, and continues to exist whether or not he can perceive her physical presence. The child has found a “compass point” from which to properly orient himself psychologically and emotionally (Neufeld and Mate, 2004).

      Achieving an optimal, healthy bond is reliant upon a variety of factors, both internal and external. Edith Jacobson felt that biology and experience mutually influenced each other and continue to interact throughout development. She also emphasized affective perception: because experience is subjective, there is no such thing as an objectively good mother, only mothering that feels good to a particular baby (Tyson and Tyson, 1990). This raises the issue of temperament and resulting styles of attachment.

      Temperament

      When the temperament of the babe and the disposition of the mother are in sync, they are considered “attuned.” Temperament is a term used to describe a child’s innate disposition, as evidenced by observable behaviors. Thomas, Chess and Birch began the classic New York longitudinal study in the early 1950s regarding infant temperament, by rating infants on nine temperamental characteristics. Ultimately, they found the infants fell into one of three major categories: the easy child, the difficult child, and the slow-to-warm-up child (1968). They found these attributes to exist across cultures, and determined about 65 percent of children fell into one of these three categories (the rest had temperaments that were not so distinctly determined).

      Mary K. Rothbart (Rothbart and Hwang, 2005) defines temper-ament as individual differences in reactivity and self-regulation that manifest in the domains of emotion, activity, and attention. She identified three underlying dimensions of temperament, using factor analysis on data СКАЧАТЬ