The Great Attachment Debate

As you and my other loyal readers know, I am constantly looking for effective ways to integrate the best concepts from Attachment Theory, Differentiation Theory and Neuroscience into my couples work.  As far back as 1995, I set up a live debate between Harville Hendrix, David Schnarch and myself on this topic. In my consultation groups we are always working to push the edges of these theories and apply them to challenging couples, learning how to distinguish when to use interventions from each of these theories.

Recently I made the happy discovery that Psychotherapy Networker magazine was organizing a similar discussion called,  “The Great Attachment Debate.”  Rich Simon, the editor, is an excellent interviewer. He collected 6 experts in this area to discuss the pros and cons of Attachment Theory, trying to understand whether or not it is even relevant.

I am hopeful we can continue this dialogue here. For my June and July newsletters, I am going to summarize what the “experts” had to say, summarizing one hour interviews into brief synopses of the main points, with hopes of agitating you to jump into the discussion and report on your experiences with these models, especially your experience using them with your couple clients.

The 6 experts interviewed were Alan Sroufe, Jerome Kagan, Dan Siegel, David Schnarch, Sue Johnson and Alan Schore.

Alan Sroufe, a leading attachment researcher on the Minnesota Longitudinal Study, began the debate stating that 40 years of research has supported Bowlby’s ideas about Attachment theory. Based on John Bowlby’s work, Sroufe followed 180 children born into poverty. He authored The Development of the Person: The Minnesota Study of Risk and Adaptation from Birth to Adulthood. He makes a strong case for Attachment being a Developmental Theory, reminding us that Bowlby strongly emphasized the importance of actual experience.  It is the quality of experience in infancy that allows babies to learn how to elicit positive (or negative) reactions from others. His data shows that troubled children (in latency and adolescence) with positive secure attachment are more likely to recover in adulthood than troubled children who did not have early secure attachment. He also found that children with histories of anxious attachment are more likely to have problems in adolescence than are the securely attached children. He describes the infancy experience as essential, but not more important than later experience. It does however form the foundation for healthy development.

Next, along came Jerome Kagan, a Daniel and Amy Starch Research Professor of Psychology, Emeritus at Harvard University, and co-faculty at the New England Complex Systems Institute. He strongly confronted therapists’ comfort with Attachment theory. He proclaims that the case for Attachment Theory is dead. He explains that it is an idea that is way, way overstated and that most child development researchers abandoned this theory long ago. He says clinicians find it much more compelling than any child development researchers. In fact, he is not even certain that Attachment can be measured in the “Strange Situation” lab experiment. The lab is an unfamiliar environment. In his research, babies who cried in the lab also cried more at home.

He concurs that there is no disagreement across professions that variations of experience do occur in early bonding. However, he states that the empirical data do not support the idea that consequences from the early bond persist into adulthood. He believes that temperament is more significant and has shown that an infant's “temperament” is quite stable over time

For Kagan, “Social class is a far better predictor of adult outcome than anything measured in the Strange Situation.” The three factors that most strongly predict anxiety, depression, addiction and college graduation are 1) social class 2) temperament, and in a very distant 3rd place, what happens in the first year of life.

He believes that Bowlby’s ideas were so popular because he was writing post-World war II.  After the horror of the genocidal killings and bombings, people were craving gentleness, the value of nurturance and thus the cultural context supported Bowlby’s ideas.

If you are mainly a systemic thinker, you will resonate with his position that, “Most importantly, identification with social class never goes away.” And you might enjoy the title of one of his publications, “The temperamental thread. How genes, culture, time, and luck make us who we are.”

Next Dan Siegel, an innovator in interpersonal neurobiology and  a clinical professor of psychiatry at the UCLA School of Medicine presents another way to think about the importance of Attachment.  He states that sub-optimal attachment results in impaired brain integration. And, that of course a lack of brain integration will have long lasting effects.

He states that genes, relational influences and experience all contribute to forming synaptic connections in the brain. Health emerges from increased brain integration and that lack of health derives from impediments to integration in the form of either blockages to linkage or differentiation.

In his interview with Rich, Dan focuses more on the process of therapy. He states that effective therapy helps to integrate the brain in terms of increasing vertical or bilateral integration. To do this, therapy might involve medication, meditation, neuroplasticity training, or SNAGing interventions (Stimulating Neural Activation and Growth) and increasing and developing the fundamental aspects of good relationships.

I love the richness of these different points of view. It makes me realize how much we still don’t know about early development and brain development, in spite of all the recent scientific advances in the field. However, for all of us who work with couples, it is undeniable that the quality of connection/attachment is crucial to how partners feel being together.

Please share your reflections and join me again next month, when I’ll summarize the other three presenters in my next newsletter/blog post.

Our resource called “In Quest of the Mythical Mate Practice Development Kit” is a 10-CD set with workbook and other materials for couples therapists. It integrates some important childhood development ideas into the practice of couples therapy. Click here to find out more or order.

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Dr. Stephanie Buehler
Dr. Stephanie Buehler

I didn’t listen to the debate because I feel that I’ve lived through it in my head over the past few years! Attachment vs. systems, attachment vs. systems? Well, systems have won. When I discuss attachment with my clients, it seems to be only a very tiny part of what is influencing the dynamics in their relationship. I have even gotten funny looks from clients as I try to connect attachment style to their current situation, as they try to figure out how their mother treated them as an infant is making them more or less distant from their partner. And people who say they grew up fairly contented (they do exist!) really don’t like to entertain the idea that their beloved mama was somehow emotionally detached.

Pursuer-distance dynamics, triangles, roles, family of origin experiences, transmission of anxiety, managing reactions, separating fantasy from reality, differentiation are much more useful concepts in working with couples. Though I respect the work of people in the attachment camp, it doesn’t resonate in the here-and-now world in which most of our busy clients like to live. As a sex therapist, I use family systems cognitive behavioral therapy and it works beautifully. No need to debate any longer, systems it is for me.

lidy
lidy

hi ellen – this is such an interesting debate and i look forward to the next installment. i have been a practicing counsellor for many years with a specialty in working with couples. as a transactional analyst i speak with my clients about script but always add the appendage that our script values and beliefs are already being laid down intrauterine and that, together with our genetic coding, becomes the precursor to the character, that is already evident at our birth. additionally i believe that in the interactions with those people most significant in the first years of our life these characteristics become increasingly entrenched in creating who we ultimately become. so i think attachment and systems both play a part but so too do genetics and environment. 🙂

Carol Gibbons, MFT
Carol Gibbons, MFT

Fascinating! One of my favorite topics! From my observations, Attachment is a deficit/no deficit issue, so it will be irrelevant for those who had “good enough” parenting, and pivotal and pervasive for those who did not. I find Attachment theory is a useful way to communicate to clients a complex and sometimes illogical set of enduring attitudes and behaviors while avoiding blame or unrealistic expectations.

Ann Langey
Ann Langey

This is so interesting. I believe that a ‘good enough’ treatment does change the brain and that adults who are deprived and neglected by ‘unavailable’ (drug addicted) mothers can be motivated in therapy and change in incredible ways — especially if their defensive structure has kept them ‘other oriented’ (so-called pre-occupied/co-dependent) and looking for connection. If their defensive structure is more “I’ve been hurt and the world owes me” (entitled/depressive/given up) they will have a more difficult time with relationships. I think about it ALL when sitting with a couple — systemic, attachment, cultural, object relations, gender, differentiation/developmental model, etc. It seems the object relations have to be based on attachment experiences and subsequent defensive structures so if you stay on that level you can’t help but be helpful with the DYNAMICS in their relationship.
Ann Langley, Ph.D.
Redwood City, CA

Ümit Çetin
Ümit Çetin

Every theory points out to some aspect of the disco ball_to borrow from your analogy in one of your lessons. So, every theory is useful to some extent, and not every theory can cover the complexity and variety of all human phenomena. Still, we may find ourselves more biased toward one approach rather than another. I think, this arises out of an interaction between the therapist’s psychological makeup, her clints’ profile, the place where she works, the dominant culture, and the zeitgeist. As you indicated in your post, the critical point is understanding when and where these theories are relevant, and when and where they are not.

Within the context of couples therapy, attachment theory might help the partners to gain an empathical viewpoint, if there are serious issues in their attachment history. One thing I am cautious about attachment theory is that I perceive it as deterministic. Everything happens mostly in early infancy which implies painful and hopeless consequences. In this respect, Siegel’s theory is vitally important for me in its emphasis on neuroplasticity. It fills me with optimism.

Kagan’s emphasis on temperament is another basic dimension. I am reminded of Brazelton whom I read many years ago. He talks about the importance of the match between the infant’s temperament and the caregiver’s approach. That matching will also probably affect the quality of the attachment between them.

Based on my own (limited) experience, I am sceptical about Kagan’s thesis that social class is a better predictor in predicting anxiety, depression and addiction. However, I do not know the relevant literature.

Thank you very much for your summarization of this really great debate.

Ümit

Ellyn
Ellyn

Lorie Teagno, a psychologist who trained with me long ago, sent an eloquent response to my blog post on the Attachment Debate. She has always been a strong supporter of Differentiation-based couples work. She is co-director of The Relationship Institute in La Jolla and co-author of a wonderful book on Intimacy and Infidelity. Please click here to read it. https://www.couplesinstitutetra…bate-.html

lorie teagno
lorie teagno

I really enjoyed and felt enlivened by David Schnarch’s presentation and felt like a professional “prayer” was answered as I have struggled in the past decade with the direction couples therapy was going with the dominance of attachment, neurobiology and EFT focus as THE ANSWER, the ONE TRUE path to helping clients become whole, satisfied and intimate beings and partners.

While the attachment research has been an asset to clinicians, where I find myself confused and perplexed is when the research on attachment is applied to clinical interpretations of what a resilient, loving adult relationship is and should be. Maybe it’s me, but so often I hear at these conferences the call to help our clients create the pristine, secure attachment with their significant other that they “should have had” or “needed” with their primary caregiver.

I am of the belief that human beings and all beings always have the opportunity to evolve or change, and sometimes not at our own initiation. That is the nature of existing or co-existing. We are influenced by factors both within and outside of ourselves. To this end I have always believed that the original attachment bond is certainly important to the social, emotional and psychological aspects of the infant, but like so many systems in the human and other parts of nature, there is overlap in the system designed to ensure survival. Thinking along these lines, I believe that any of us who do not receive optimal bonding have innumerable opportunities in our lifetimes to change, repair or replace that bonding, and that the choice is the most reliable when it begins with ourselves.

Before we can choose a good partner and trust our choice we must have a strong, clear and realistic view of ourselves. We must essentially learn to trust ourselves. Given the difficulties inherent in being human, we will all often be disappointed by others and ourselves. If we put our early unfinished bonding experience in the laps of our partners before we assume its full responsibility, I believe we limit our personal growth and the eventual growth of our relationship with our partners. If I make my partner responsible for my wholeness, my history and my sense of connection, then I believe we are stopping short of what individuals and couples are capable of in terms of deep, resilient and abiding love and commitment.

Loving and being love is ongoing work and joy. Susan Johnson, a highly regarded therapist in the marital field for the last decade plus, asserts that her therapeutic approach, Emotionally Focused Therapy, EFT ensures no relationship relapse because it creates emotional accessibility and responsiveness in partners. I do not doubt that it can create some of both of the latter, but I would add that creating a sense of the individual as a competent, satisfied separate self who is also connected to another especially during conflict is a more adaptive model of relationships and human beings. I also do not believe that no relapse is likely in any human being. As Freud said ,”regression in the service of the ego” or as I say it less eloquently, in the face of stress, some regression is likely, perhaps necessary, and temporary.

Susan Johnson also adds that “A secure bond is the best protection against helplessness and meaninglessness”. There is no doubt that on the face that statement is appealing, but I do not think it is as true as an alternative statement, “A secure bond with oneself (a clearly defined, separate self) and a connection with another or others is the best protection against helplessness and meaninglessness.” Separate and connected and an expansive sense of self give us constant growth opportunities.

I have spoken to my colleagues over the last decade decrying the lack of an open a dialogue between the attachment proponents of marital therapy and those of us who huddle under the umbrella of Differentiation theory- at present a loosely knit group of practitioners. I am so relieved to see this beginning!

The Differentiation therapists assert that the most resilient relationships go through developmental stages that move beyond a more symbiotic relationship to one that allows for, expects and benefits from personal differences. In fact, we assert that the differences are fodder for growth. We also view the tension that develops in relationships much like biologists do as the necessary fuel for growth, evolution and change.

A dialogue with all clinicians who are curious, respectful and committed to the scientific agenda of discovery, sharing and respecting is what I am suggesting. It is unlikely that ONE group is correct; can we make room for mutual respect of our differences that benefits our field, our clients and ourselves?

Maybe I’ve been in the field too long and I am nostalgically recalling (and glamorizing) the days when the videotape series was made with one client interviewed by many of the pre eminent therapists representing the various therapeutic approaches at the time: Carl Rogers, Fritz Perls, Albert Ellis, and the like. I would like to see us return to a more expansive and mutually open and respectful discussion so we as clinicians and leaders in our field can contribute to the evolution of marital therapy; a therapy that has place at the table for both attachment and differentiation theorists and clinicians as well as others.

I am hopeful that the Networker has started this discussion so that the field can also evolve and become it’s best differentiated and differentiating as well as attached “self”.

Anne
Anne

I am really taken with Umit and Lorie’s comments. As I work through the material we are studying i can’t get enough about neurobiology, I use the word differentiation a dozen times a day and attachment theory slides off me like spaghetti on the wall. So I am curious abut what this says about me, my environment, my psychological makeup and my learning style.

Dr. Ellyn Bader

Dr. Ellyn Bader is Co-Founder & Director of The Couples Institute and creator of The Developmental Model of Couples Therapy. Ellyn is widely recognized as an expert in couples therapy, and since 2006 she has led innovative online training programs for therapists. Professionals from around the world connect with her through internet, conference calls and blog discussions to study couples therapy. Ellyn’s first book, "In Quest of the Mythical Mate," won the Clark Vincent Award by the California Association of Marriage & Family Therapists for its outstanding contribution to the field of marital therapy and is now in its 18th printing. She has been featured on over 50 radio and television programs including "The Today Show" and "CBS Early Morning News," and she has been quoted in many publications including "The New York Times," "The Oprah Magazine" and "Cosmopolitan."

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