Attachment Theory: A Guide for Practice in Couple and Family Therapy

Volker Thomas

After Stephen Suomi's Thursday night introduction to attachment in primates and his fascinating report on uptight, laid back and jumpy monkeys, conference attendees were ready to jump into human attachment and family therapy. The title of the Friday morning plenary, Attachment Theory: A Guide for Practice in Couple and Family Therapy fit our readiness well.

The first speaker was Cindy Hazan who entitled her talk, Sex Differences in Human Mating: Cosmological or Cosmetic? Dr. Hazan is an Associate Professor of Human Development at Cornell University. In recent years she has investigated the processes of attachment formation between adults. At the beginning of her talk Dr. Hazan made her bias very open when she referred to attachment theory as a brilliant theory that provides a far more accurate evolutionary model of human mating than the currently popular men-are-from-Mars-women-are-from-Venus accounts. Moreover she critically discussed sexual strategies theory (Buss & Schmitt, 1993) as a scientific evolutionary model that tries to explain human mating. This theory claims that men "naturally" seek out and take advantage of opportunities to copulate with as many different females as possible, while women prefer one male who has resources and appears willing to share them with her and her offspring (Hazan & Diamond, 2000). According to the research on sexual strategies theories sex differences in mate preferences seem statistically reliable and culturally universal.

As an alternative explanation for mate selection Hazan proposed to explore human mating from an attachment theory perspective. In the course of evolution human offspring were born after shorter and shorter gestation that left them exceptionally immature and dependent on the nurturance of their caregivers. A flexible mechanism developed that fostered an enduring bond between offspring and caregiver. This mechanism was attachment. According to attachment theory, attachments have four defining features, proximity maintenance, safe haven, separation distress, and secure base. Citing many empirical research studies Dr. Hazan argued that in adulthood the same four features would be redirected toward a mate.

In contradiction to sexual strategies theory Dr. Hazan proposed that sex in the human species serves more than a reproductive function. For example, multiple features of human sexual anatomy and physiology support the view that humans evolved to bond with their reproductive partners. Research based on attachment theory has shown that women and men equally seek kindness, understanding, and intelligence in a mate rather than physical attraction (men) and resources (women) as suggested by sexual strategies theory. For sexual strategies theory, mating is about reproduction of genes via sexual activity. Emotional bonds are relevant only insofar as they help or hinder this process. From an attachment perspective, these bonds belong at the center, rather than the periphery, of evolutionary theories of human mating (Hazan & Diamond, 2000).

The next question Dr. Hazan raised was about the mechanisms that lead to forming attractions between potential mates and then to pair bonding? Romantic infatuation serves as such a mechanism. Additionally, twin researchers suggest that human mating may be a largely" adventitious" process. Dr. Hazan added that propinquity may be an integral part of this process. Ppropinquity affords not only opportunities for mating but the kind of prolonged bond that increases familiarity and  in turn, enhances the mutual attractiveness of potential mates. "As every zookeeper knows, a nearly sure-fire way to get two members of any species to mate is simply to house them in the same cage. Why must it be different for Homo Sapiens " (Hazan & Diamond, 2000, p. 197). Finally then, the factor primarily responsible for the shift from attraction to infatuation is reciprocal liking, or the perception that the person one is interested in feels the same way.

In the conclusion section of the article (Hazan & Diamond, 2000) on which she based her talk Dr. Hazan summarizes her argument from propinquity to attachment eloquently,

Propinquity and familiarity further narrow the pool. Potential mates who are encountered daily at the river's edge have an advantage over those residing on the other side. Within this pool, they are vigilant for signs of reciprocal interest, expressed in easily recognized flirtation behaviors. A slightly prolonged gaze, a smile, or a subtle violation of personal space may trigger romantic infatuation. If mutual, the psychological and neurochemical processes that ensue make each person the sole focus of the other's attention and passion and render alternative potential mates less desirable. The same processes stimulate a seemingly insatiable longing for close physical contact. This physical intimacy in turn triggers a release of hormones that boost desire for continued contact. In time, their neurobehavioral systems become mutually conditioned to the stimulus of the mate such that she or he comes to have a uniquely powerful effect on physical and psychological well-being. A pair bond is in place. The two are attached (p. 201).

At the conclusion of Dr. Hazan's presentation a lively discussion ensued. Many in the audience wondered out loud about the concept of propinquity. Many comments expressed appreciation for the switch from sexual stereotyping that is implied in sexual strategies theory to mutual liking and support that is reflected in the attachment perspective of human mating. Questions that remained open included, does this mating theory equally apply to older couples? The term "mating" seems to imply propagation. However, with a divorce rate of almost 50% many people seek partners with whom they do not wish to propagate. Dr. Hazan's presentation was limited to heterosexual couples. Thus, one wonders whether and how her arguments would apply to lesbian, gay, and bisexual relationships.

In the second part of this plenary Dr. Roger Kobak spoke about The Implications of Attachment Theory for the Assessment and Treatment of Family Dysfunction. Dr. Kobak is a clinical psychologist and Director of Training in the Department of Psychology at the University of Delaware. His research focuses on the role of parent-teen relationships in fostering the social and emotional development of adolescents. More recently, this has included helping caregivers, both parents and teachers, manage the stresses involved in working with emotionally disturbed children and adolescents.

According to Dr. Kobak, attachment theory and research provide for a normative model of healthy and adaptive functioning. Parental sensitivity to the child's signals in infancy results in the child's confidence in the availability of the caregiver, an increased capacity for exploration and self-confidence, open communication between caregiver and child, and the development of a reflective function. The parents' ability to establish a cooperative partnership in early childhood results in the child's development of perspective taking (reflective functioning), the capacity to maintain cooperative conversations, to negotiate goal conflicts, and the basis for self-regulation, conscience, and frustration tolerance. The Internal Working Model (IWM) or confidence in the availability of the attachment figure guides and structures interactions and regulations of behavior.

This attachment model has several specific implications for the assessment of family dysfunction. Dr. Kobak gave examples of interactional cycles in distressed relationships. These cycles include reciprocal negative exchanges that are rigid and highly predictable, pursue-withdraw sequences and mutual accusations of who is responsible for experienced problems. These families have specific patterns of communication and expression of emotion. For example, negative feelings are expressed in distorted ways, there is a lack of validation or of the sense of being understood, family members take an adversarial rather than cooperative position, and there is a lack of repair processes in these families. Most family members make the cognitive appraisal that the other person is no longer a source of safety and protection, but rather a threat or danger. This may lead to parental anger and rejection, parental neglect, marital conflict, parental favoritism and jealousy, adolescent violent outbursts and suicide threats, unpredictable dissociative states, and the experience of parental abandonment. Conversely, the parents appraise the child as threatening or a burden. This leads parents to perceived failure as caregivers, social isolation, and lack of secure base. When assessing the parents' level of reflective functioning, clinicians find that the parents' ability to take the child's perspective or to understand problematic behavior is a distorted expression of a legitimate need. These parents have a limited ability to catch themselves and to understand their contribution to the problem. Finally, these parents have a limited capacity to assess their internal states and that of the child and to reappraise a situation.

What are the implications for treatment? Dr. Kobak suggested three main implications. First, the clinician helps to connect the dysfunctional patterns of interaction to the core cognitive appraisals or IWM in the treatment contract. Specifically, problematic emotions (e.g., fear, anger, sadness) can be reframed as distorted expressions of attachment concerns. Second, goal of therapy is to increase the parents' reflective functioning. By providing a secure base the therapist promotes the acceptance of unacceptable thoughts and thus empathizes with the parent's self. Equally important is to empathize with the child, to assert clear expectations and limits, to monitor the relationships (e.g., closeness and distance, reducing reactivity to negative child behavior), and to initiate repair processes. The therapist helps the parents how to apologize for lapses in parenting. Third, the therapist monitors interactions and reflective functioning for signs of movement toward more open and cooperative communication, greater confidence on the part of the child in the parent, and a greater sense of competence and efficacy on the part of the parent.

Dr. Kobak's complex and dense presentation sparked many questions and comments. Many focused on the specific application of attachment concepts to the practice of working with families. Some noted the lack of fathers in the traditional attachment theory literature and the long-term flexibility of attachment styles. Specifically, the question was raised whether family therapy can change children's and parents' attachment styles from less secure to more secure. Dr. Kobak assured the audience that attachment styles are not carved in stone and that they can be changed through the process of therapy.

References

Buss, D.M., & Schmitt, D.P. (1993). Sexual strategies theory: An evolutionary perspective on human mating. Psychological Review, 100, 204-232.

Hazan, C., & Diamond, L.M (2000). The place of attachment in human mating. Review of General Psychology, 4(2), 186-204.

Volker Thomas, Ph.D. is Associate Professor and Director of the Marriage and Family Therapy Program in the Department of Child Development and Family Studies at Purdue University.