Attachment Theory, the Transmission of Affect and the Therapeutic Process

March 30th, 2007 by Paul Renn

Attachment theory describes a behavioural system, the function of which is to regulate human attachment, exploration and fear. Attachment is defined as any form of behaviour that results in a person attaining and retaining proximity to a differentiated other. The primary caregiver is the source of the infant’s stress regulation and, therefore, sense of safety and security. Attachment theory emphasises the role of the parent as mediator, reflector and moderator of the child’s mind, and the child’s reliance on the parent to respond to their affective states in ways that are contingent to their internal experience. Within the close parent-child relationship neural networks dedicated to feelings of safety and danger, attachment, and the core sense of self are sculpted and shaped. These networks are conceptualised as internal working models of attachment.

Characteristic patterns of interaction operating within the family’s caregiving-attachment system give rise to secure, insecure and disorganized patterns of attachment. These are represented in the child’s internal working models of self-other relationships. Secure attachment is promoted by the interactive regulation of affect, which facilitates the recognition, labelling and evaluation of emotional and intentional states in the self and in others, a capacity known as reflective function or mentalization. The recognition of affects as having dynamic, transactional properties is the key to understanding behaviour in oneself and in another. The child comes to recognize his or her mental states as meaningful self-states via a process of parental affect mirroring and marking. Secure children are able to use sophisticated cognitive strategies to integrate and resolve their fear of separation and loss.

When the parent is unavailable or unpredictable, the infant develops one of two organized insecure patterns of attachment, avoidant or ambivalent-resistant. These defensive strategies involve either the deactivation or hyper-activation of the attachment system. Deactivation is characterized by avoidance of the caregiver and by emotional detachment. In effect, the avoidant child “immobilizes” the attachment system by excluding thoughts and feelings that normally activate the system. Hyper-activation is manifested by an enmeshed ambivalent preoccupation with the caregiver and with negative emotions, particularly anger. However, the ambivalent child appears to cognitively disconnect feelings from the situation that elicited the distress.

It should be noted that the strength of the attachment bond is unrelated to the quality of the attachment relationship. Indeed, abused children and battered spouses typically show signs of being strongly, albeit traumatically, attached to their abusive caregivers or partners. Neurobiological data indicate that mother-infant interaction activates specific neuroendocrine systems. For example, the stress response entailed in avoidant behaviour appears to be maintained by the release of catecholamines and cortisol, the main stress hormone, whereas attachment and nurturing behaviour seem to depend on the availability of oxytocin and vasopressin, positive neuropeptides associated with loving physical touch. Significant disruptions in caregiver-infant affective communications are associated with disorganized and ambivalent-resistant forms of child attachment. Unregulated shame-exchanges in particular create a rupture to the attachment bond and are an important source of severe emotional disorders associated with the under-regulation of aggression in children and adults.

The Transmission of Affect

Attachment theory may be considered a theory of emotion regulation. As noted above, the mechanism of transmitting attachment organization and, thereby, a characteristic style of regulating affect, lies in the particular quality of the person’s early caregiving experience. Subtle fine-grain interactive micro-behaviours are related to attachment and to the transmission of emotion from one generation to the next. Such micro-behaviours operate at the level of implicit relational knowing and include the co-ordination of gaze direction, vocal inflections, body posture, and facial expressions. The infant perceives and remembers the mother’s repetitive subtle behaviours in the form of pre-symbolic interactional expectancies. This pre-verbal intersubjective process ‘instructs’ the infant into the logic of being and relating and is experienced as a phenomenological form of knowledge conceptualized as unformulated experience. Thus, the cumulative impact of parent-child interactions that are consistently matched or mismatched creates a structuring effect on the infant for good or ill. In later life the person generalises these interactional expectancies to other interpersonal contexts.

Attachment research, then, demonstrates that discrete patterns of secure, insecure, and disorganized attachment have as their precursor a specific pattern of infant-mother interaction and their own behavioural sequelae. Repeated patterns of interpersonal experience are encoded in implicit-procedural memory and conceptualized as self-other working models of attachment. These mental models consist of generalized beliefs and expectations about relationships between the self and key attachment figures, not the least of which concerns one’s worthiness to receive love and care from others. Research utilizing the Adult Attachment Interview shows that the mother’s state of mind in respect of her attachment history, as expressed in a particular narrative style, may be classified as secure-autonomous and her child as securely attached, despite her having experienced early trauma in the form of separation, loss and /or abuse. Such findings indicate the resolution of trauma and the attainment of ‘earned security’ via subsequent secure attachment experiences which may, of course, include a therapeutic relationship.

Attachment research indicates that parents’ internal working models of attachment are transmitted to the growing child and powerfully influence his or her working models of attachment. These, in turn, mediate all subsequent relationships, particularly those forged with intimate, sexual partners in adulthood. Research also shows that older children and adults continue to monitor the accessibility and emotional responsiveness of those with whom they have formed a meaningful emotional attachment. The person seeks to maintain an optimal degree of proximity to his or her attachment figure throughout the life cycle in order to sustain feelings of security. Choice of adult romantic partner is one of the most significant mechanisms by which attachment patterns and early affectional ties are externalized and maintained, particularly in instances of unmourned loss. This finding is supported by clinical experience and observation, most directly in work with couples. Here, a certain fit or match may be discerned in the respective partners’ early insecure attachment histories, with implicitly encoded maladaptive interpersonal patterns being externalized and destructively played out in their current relationship.

A meta-analysis of research findings show that caregivers who have a secure-autonomous style of attachment are capable of a wide range of emotional experience and expression and thus are skilled emotion regulators. This means that they are able to observe their child’s distress without becoming overly aroused because of experiencing vicarious personal distress associated with their own attachment histories. This leaves the secure caregiver free to respond to the infant’s emotional distress in a flexible and appropriate manner, thereby repairing normal interactive ruptures to the attachment bond in a relatively consistent way. The child, in turn, develops a matching secure pattern of attachment organization and a free and flexible style of emotion regulation. Research has demonstrated that secure attachment established in childhood perseveres and extends into adulthood.

In contrast to secure parents, caregivers with a predominantly dismissing style of attachment are restricted in the emotions that they are able to express to others, and of which they are conscious in themselves. Their infant’s distress activates personal distress characterized by an aversive emotional reaction and an attempt to assuage vicariously induced stress. In consequence, dismissing caregivers ignore, or turn away from regulating, their infant’s stress and, instead, focus on managing their own emotional conflicts. To avoid rejection, the child minimizes expressions of need and vulnerability and becomes disconnected from his or her emotional states. Thus, the child tends to match the caregiver’s dismissing state of mind by developing a predominantly avoidant pattern of attachment, together with a dismissing and restricted style of regulating emotion. Children classified as avoidant have been found to show a marked lack of empathy towards peers in distress and to behave in aggressive and hostile ways.

Parents with preoccupied-enmeshed states of mind in respect of attachment are considered to have an under-controlled emotion regulation system, as manifested by an exaggerated style of emotion regulation and by attempts to heighten or maximize their emotional experience. Because of the attachment need to have their infant emotionally dependent on themselves, preoccupied caregivers focus on the infant’s negative feelings to the exclusion of helping the child regulate his or her emotions. Thus, although preoccupied-enmeshed caregivers may appear to respond in a sensitive way, they do not act quickly or appropriately to end the infant’s distress. As with dismissing parents, they are unable to allow the needs of the distressed child to take precedence over their own needs. The failure to provide appropriate and consistent soothing serves to keep the infant intensely focused on the attachment relationship, thereby reducing the chances of the child becoming emotionally independent of the caregiver. In such infant-mother dyads, the child is likely to develop a matching ambivalent-resistant pattern of attachment organization and a style of regulating emotion that is preoccupied and under-regulated, particularly in respect of anger.

With respect to disorganized/disoriented attachment, findings indicate that infants develop this pattern in reaction to caregivers who display frightened and/or frightening behaviour associated with their own unresolved early trauma. Such fear-inducing parental behaviour may consist either of maltreatment or of alternating forms of caregiving wherein emotional availability is followed by an abrupt entrance into dissociative, trance-like states that may be activated by the child’s distress and need of comfort. In effect, the disorganized caregiver’s mental states take precedence over the infant’s attachment communications and initiatives. Moreover, because of their own unintegrated fear, disorganized caregivers may perceive the child as a source of alarm. The child, in turn, comes to associate his or her own fearful arousal as a danger signal for abuse or abandonment by the caregiver.

A relational context in which the attachment figure is, at one and the same time, the source of alarm and the source of its solution presents the infant with an irresolvable paradox: fear of the parent activates the attachment and fear behavioural systems compelling the infant to seek proximity to the attachment figure, but proximity-seeking has the effect of increasing the child’s fear. This paradox of ‘fright without solution’ results in a collapse of behavioural and attentional strategies which is manifested as odd, disoriented approach-avoidance conflict behaviours. A distinct aspect of this behaviour consists of simultaneous and contradictory tendencies to approach and flee from the attachment figure. In a caregiving-attachment system of this kind, the child’s attachment system remains in a state of high activation and he or she fails to develop a coherent, organized strategy for coping with the stress of separation. Since there is no physical escape from this traumatizing situation the infant shifts from a state of hyperarousal and angry protest to a state of despair, followed by emotional detachment and dissociation, thereby matching the mother’s dissociated state. Findings show that a child may be classified as disorganized with one parent but not with the other. This supports the view that attachment disorganization emerges within a particular relationship and is transmitted at an intergenerational level.

As emphasised above, the role of the parent as mediator, reflector, interpreter and moderator of the child’s mind is crucial. The child’s recognition of mental states as meaningful self-states, is brought about by parental affect mirroring and marking. Thus, the child is reliant on the caregiver to respond at the behavioural level to affective states, particularly to states of distress, in ways that are containing and contingent to his or her internal experience. In parents with unresolved trauma, reflective functioning may become easily dysregulated or disorganized by their infant’s distress leading to a failure to distinguish between their own feelings and those of their child. Developmental studies emphasise the way in which maternal behaviour that is aggressive and intrusive, or fearful and withdrawn, as well as parental miscommunications and misattunements, are critical in the intergenerational transmission of attachment and of trauma. Significant disruptions in mother-infant affective communications are associated with disorganized and resistant forms of infant attachment. These findings emphasise that the parent’s capacity to reflect on and organize their subjective experience is a key factor in mediating the relationship between early trauma and later psychopathology. Deficiencies in parental reflective functioning, in the form of a compromised capacity to mirror and mark the child’s affective states, leaves the child with an inner life that is experienced as barren and unknowable. Consequent feelings of alienation and isolation become fundamental to a fragmented and empty sense of self, and to the failure to develop sustaining and nurturing relationships with others in later life.

The Therapeutic Process

The therapeutic relationship provides the opportunity for the client to find his or her identity, multiplicity, and intentionality in the mind of the therapist as part of a continuous intersubjective process. This collaborative process is used to conceptualize the developmental antecedents and interpersonal features of the client’s difficulties in living, particularly his or her strategies for managing closeness and distance in intimate relationships, and the influence that these factors have on the formation of the therapeutic alliance. An aspect of this process is the identification of distinct patterns in the complex dynamic interplay between the client’s early interpersonal matrix and his or her current relationships, including that with the therapist. This facilitates an exploration of the way in which archaic relational configurations are being perpetuated in the here and now, in everyday life and in the transference-countertransference matrix, particularly at times of intense interpersonal stress.

The client’s symptoms and destructive and self-destructive behaviours are understood as expressing unresolved traumatic experience encoded and stored in implicit-procedural memory in the form of non conscious state-dependent memories, expectancies or fantasies. These organize the client’s subjective experience and emerge in the relational system or intersubjective field, being communicated directly to the therapist via the client’s narrative style and expressive behaviour. This, in turn, activates matching countertransferential roles and responses in the therapist which enables him or her to participate in the vicissitudes of the client’s subjective experience moment-by-moment.

Crucial aspects leading to therapeutic change include the repair of inevitable ruptures to the therapeutic relationship, the interactive regulation of heightened affective moments, the provision of new perspectives, the reorganization of maladaptive patterns of expectancies or fantasies, the transformation of implicitly encoded representations, and the promotion of reflective functioning. An emotionally meaningful therapeutic relationship facilitates a collaborative co-construction of the client’s dissociated traumatic experience and promotes recognition of the mental states that motivate human behaviour in various relational contexts. This, together with the client’s growing realization that he or she can contingently influence the therapist and, by extension, others in everyday life, engenders a secure sense of self and recognition of other people as separate, differentiated subjects who can be related to in non coercive ways.