The October 2000 Clinical Research Conference in Niagara-on-the-Lake

ATTACHMENT: A PERSPECTIVE FOR COUPLE & FAMILY THERAPY.

Susan Johnson

John Bowlby was perhaps the very first family therapist. In 1944 he wrote a book called "Forty Four Juvenile Thieves: Their Characters and Home Life". He understood the power of context and the impact that context, especially interactions with others, had on the development of a person's inner life and sense of self. He knew Bertalanffy, the father of systems theory, and thought in terms of control systems and he created his theory while working with delinquent young people and bereaved adults. For his labors he was ostracized and branded as a "Barrabas" for betraying the traditional psychoanalytic doctrine of his time. For almost 20 years after the publication of his famous trilogy, Attachment (1969) Separation (1973) and Loss (1980), only developmental theorists and researchers like Ainsworth and Main tested and applied his theory. They used his theory to understand the interactions between mother and child.

In the 1980's however a few social psychologists like Hazan and Shaver, and a few clinical psychologists like John Byng-Hall and myself, began to take seriously Bowlby's belief that we are social beings who have an absolute requirement for emotional bonds with a few, precious others. It became clear that Attachment Theory offered an understanding not just of the bond between parent and child but of the needs and passions of adult lovers. Bowlby himself believed that emotional bonds with attachment figures were a central part of people's lives "from the cradle to the grave". He spoke, like more recent feminist writers, of the need to depathologize dependency and how strength and resilience is about being able to reach out to others and so create a safe haven in a potentially dangerous world.

In the last decade research on attachment theory has exploded and it has been used more and more as a basis for clinical intervention. The clinical research conference will present many of these interventions, interventions for different kinds of people, the very young and the elderly, and for different kinds of problems, including depression and post traumatic stress. For those who are unfamiliar with this research and its clinical significance, we can just sample a tiny portion of these research results. Researchers found that those who had a sense of being able to depend on key others cope better with missile attacks in the Gulf War and experienced less negative effects. Securely attached adolescents can take a meta-perspective and meta-communicate with their mothers in arguments. Trauma experts believe that the most significant factor in recovery from traumatic stress is not trauma history but whether a survivor can seek comfort in the arms of another. Securely attached partners seem to be more empathic and more able to create satisfying relationships and are less likely to become depressed if the relationship becomes distressed. Secure bonds seem to promote curiosity and cognitive exploration as well as an open communication style. Researchers can accurately predict a child's behavior when separated and reunited with his/her mother from the way the mother talks about attachment before the child is born.

What then are the basic tenants of attachment theory that will be elaborated on at the conference ? ( I hope Bowlby will forgive the over simplification and/or errors here).

• Evolution has wired into human beings basic needs for contact, comfort and connection with key others. Isolation is inherently traumatizing.
• Secure emotional bonds offer us a safe haven and a secure base. They render both inner and outer worlds safer and more manageable. They are especially crucial at times of uncertainty, vulnerability and change.
• The basis of secure bonding is accessibility and responsiveness. When these are missing, separation distress ensues. This distress follows a predictable sequence of angry protest, clinging and seeking, depression and despair and, finally detachment.
• Interactions with attachment figures organize and shape our internal constructions of self and other and dictate how we regulate and integrate our emotions.
• Dependence and independence are two sides of the same coin not the opposite ends of a continuum. The more securely connected we are and the more we can count on others, the more autonomous and curious and free to explore we are.
• There are only so many ways to deal with the frustration of attachment needs. These ways are to hyper-activate attachment behaviors to try to get other to respond, to shut such needs down and avoid closeness especially when one is vulnerable, or to flip between these two in a disorganized manner. If we are not secure enough to reach for comfort, we tend to develop one of these habitual ways of relating to others, especially in times of stress.

At the conference Dr Stephen Suomi will begin the proceedings by reminding us of our primate past and what we can learn from our fellow primates. Then Cindy Hazan will focus on evolution and an overview of attachment theory and Roger Kobak will relate the theory to the practice of couple and family therapy. Howard Liddle will then describe how attachment theory informs his interventions with delinquent adolescents and I will talk on how to create pivotal attachment events that redefine the quality of the bond between adult partners. Nancy Cohen and Marlene Moretti will take us back to considering interventions for infants and young adolescents and Pam Alexander and Valerie Whiffen will talk about taking an attachment perspective on healing from trauma and depression. There will then be a panel discussion on same sex attachments, working with the elderly, custody issues and attachment and change in therapy. The final morning will focus on violent relationships from an attachment perspective with Don Dutton and discussant Virginia Goldner. The conference will end with Vivian Carlson offering a cross cultural perspective on attachment relationships.

To offer a personal perspective for a moment, I agreed to chair this conference because I believe that couple and family therapy must have a cogent, integrated theory of close relationships to guide intervention, if not attachment theory then another. Such a theory should tell us what is pivotal in a relationship dance, help us formulate goals and target our interventions. Such a theory should help us understand and predict our clients responses to each other and to our interventions and enable us to foster lasting change. In my practice of emotionally focused couple and family therapy, I have found this theory immensely helpful. It offers me a map for helping people defuse negative cycles like criticize/defend and for the construction of positive cycles of trust and connection. In the end, it was not reading John Bowlby or even some of the wonderful work published by the presenters at this upcoming conference that convinced me of the relevance of this theory. I was convinced by the couples and families who came to me for help.

I hope you will come and join us to hear about what this perspective has to offer the M&FT field, as well as to share your ideas and thoughts with your colleagues in the beautiful setting of Niagara on the Lake.

Sue Johnson is Professor of Psychology & Psychiatry at the University of Ottawa in Canada and Director of the Marital and Family Therapy Clinic at the Ottawa Hospital. She is one of the originators and the main proponent of emotionally focused therapy for couples and families (EFT). EFT is now one of the most clearly delineated and empirically validated brief interventions for distressed couples. A summary of recent research suggests that with this approach over 70% of couples are non-distressed at the end of therapy (10-12 sessions) and that theses results tend to be stable. Sue is also a well known international presenter and teacher and offers externships in EFT in Ottawa.