Hidden Eating Disorders: Attachment and Affect Regulation in the Therapeutic Relationship

From the time I began working at a clinic that specialized in therapy with individuals with eating disorders, I have repeatedly encountered cases of clients hiding these symptoms from their therapists. When they finally do reveal the disorder, their therapists often worry that their clients are more disturbed than they thought and that, they, the therapists, did something wrong in the therapy. Although some therapeutic rupture can be part of the picture, I have found that these disclosures often reflect a client’s growing trust in the therapist’s presence and ability to help with feelings that have been, until now, dealt with through the eating behaviors themselves. In my attempts to understand what happens before and after an individual shares a hidden eating disorder with a therapist, I have found ideas from attachment theory, in particular those that explore links between attachment, affect regulation, and self-reflection, to be very helpful. Many authors have noted that eating disorders are related to problems with attachment, loss and separation, and affect regulation. Difficulties in these areas make it hard for clients to be self-reflective or use insight productively. In this article, I discuss my experience with the integration of these dynamics, which I have found to be key to successful psychotherapy with clients who hide their eating disorders.

Homecoming as Safe Haven or the New Front: Attachment and Detachment in Military Couples

Traumatized military couples represent a new population for the application of attachment theory constructs. An innovative clinical social work practice model, grounded in a synthesis of social and psychological theories, aims to assist these couple and families who are navigating very difficult transitions. Since social support is known to be a central protective factor in mediating the long-term adverse effects of combat trauma, this therapeutic focus addresses two compelling problem areas: the disruption of secure attachments and affect dysregulation. The effects of deployment stressors on soldiers, their intimate partners, and their families are discussed in depth. Clinical illustrations highlight the utility of a phase-oriented culturally responsive couple therapy practice approach that has clear clinical implications for military couples.

Au Revoir: An Attachment and Loss Perspective on Termination

Traditional views of psychotherapy hold that termination allows both for a consolidation of therapeutic work and an opportunity to work through issues of separation and loss. Such a view suggests not only that those issues will resolve in treatment, but also that endings are inevitable, permanent, and that the feelings invoked can and should be mastered and worked through. Recent research on termination, attachment, loss and grieving suggests a different conception. Consideration of that research can better ground therapists in more nuanced techniques for ending treatment in both child and adult psychotherapy.

The language and policy of care and parenting: Understanding the uncertainty about key players’ roles in foster care provision

Recent debates about the care provided to looked-after children have been characterised by uncertainty about the differing roles and responsibilities of foster carers, birth parents, and social workers. To explore the assumptions underlying these uncertainties, we drew upon Foucauldian Discourse Analysis and compared the discourses used by professionals (social workers in a group discussion about foster placement breakdown) with those used by policy-makers (in the Governmental green paper ‘Care Matters’). In both cases, a discourse based upon Attachment Theory was used to explain why placements succeed and fail, and to predict the repercussions of failure. However, there was a key difference in the way that professionals and policy-makers constructed the roles of key players in foster placements. The social workers constructed the birth parents as the parental figures for children in care, constructing themselves in a non-parental role. ‘Care Matters’ largely ignores the role of birth parents, and instead constructs social workers as parental figures. Neither source viewed foster carers as parental and ‘Care Matters’ positions this group as strictly professional. We discuss the incongruence of foster placements being understood through Attachment Theory, while foster carers are understood as non-parental figures, and also the repercussions of labelling a social worker as a parent, and the professionalization of the role of the foster carer.     

虚拟社区与成员心理联结机制的实证研究:基于认同与纽带视角

对于虚拟社区成员与社区之间连接的关系纽带的本质与类型及其对网民参与行为的影响目前仍缺乏研究。本文基于社会认同理论和纽带理论的扩展与深化,揭示了网民参与虚拟社区的两种心理来源和心理依附机制。通过1028份问卷的实证调查,证明网民对虚拟身份的自我认同是社区认同的部分中介变量,社区成员通过纽带人际依恋和身份群组依恋共同构成与社区之间的心理联结系统,并且线下联系只有在社区内产生人际依恋时才会产生。文章也证明了社区类型对模型的调节作用,最后对该模型的理论贡献和管理应用意义进行了讨论。     

Security of Attachment as a Predictor of Symbolic and Mentalising Abilities: A Longitudinal Study

The development of symbolic and mentalising abilities was examined in 33 children whose security of attachment had been assessed in infancy. It was found that securely attached children: (i) were better able to incorporate an experimenter's play suggestions into their sequences of symbolic play at 31 months; and (ii) performed better on a version of Wimmer and Perner's (1983) unexpected transfer task at age 4. There was also evidence of superior mentalising abilities among the secure group at age 5, despite no group differences being found in general cognitive ability. We suggest that these security-related differences might be related to mothers' propensity to treat their securely attached children as individuals with minds. In support of this hypothesis, mothers in the secure group adopted more sensitive tutoring strategies, and were more likely to describe their children in terms of their mental characteristics. Possible developmental pathways linking security of attachment in infancy with subsequent development were investigated using path analyses.     

Child Care Caregiver Sensitivity and Attachment

Changes in child care caregivers' sensitivity and in children's attachment security were examined in three studies. Study one involved 55 children enrolled in community based child care. There was no intervention in these sites. Caregiver responsive involvement and children's attachment security did not change over time or when children changed caregivers. Study two involved 71 toddler age children enrolled in family child care homes. The caregivers of these children were enrolled in a family child care training project. Six months after the training security scores increased and caregivers of children who became secure or remained secure were more sensitive following training. Study three involved 36 children enrolled in center-based child care. Children were observed before and after selective staff replacement and in-service training to increase caregiver sensitivity. Six months following intervention security scores increased and caregivers of children who became secure or remained secure were more sensitive following training.     

Elements of a Theory of Place Attachment and Socio-Territorial Belonging

The aim of this paper is to furnish elements both theoretical and empirical useful for the formulation of a theory of place attachment and socio-territorial belonging, two dimensions that are analytically distinct but empirically co-present and interrelated. After delineating a frame of reference which accounts for the distinction and interrelation between place attachment and socio-territorial belonging, the structure of social belonging, of socio-territorial belonging and its relations with other components of human action, and of dynamics of socio-territorial belonging, consideration is made of results from surveys conducted in diverse geographical and social contexts, comparing them with those of surveys carried out in Italy in recent years (1985–2000).     

Correlates of the Randolph Attachment Disorder Questionnaire (RADQ) in a Sample of Children in Foster Placement

This study examined mental health and attachment problems in children in foster care. This study also obtained data concerning the validity of the Randolph Attachment Disorder Questionnaire (RADQ). Children were selected according to length of time in placement and age and screened for mental health symptoms using the Child Behavior Checklist and the RADQ. The findings showed that children in foster care have reported symptoms within the range typical of children not involved in foster care. The conclusion is that the RADQ has limited usefulness due to its lack of specificity with implications for treatment of children in foster care.