Attachment and Separation: Obstacles for Adoptees

Adoptees face challenges unique to their status as individuals who have been relinquished by birth parents and raised by other persons. They may encounter obstacles when passing through normal stages of development. They may face extra challenges in developing healthy attachments and successfully separating and creating a solid sense of self as an individual. This article will highlight some ofthese potential obstacles and challenges for adopted persons.     

Attachment Style Differences in the Parental Interactions and Adaptation Patterns of Divorcing Parents

The purpose of this study was to determine if the quality of children's relationships with their primary residential par- ents interacts with interparental conflict to predict children's postdi- vorce psychological adjustment problems. It was predicted that a high quality relationship would moderate the relation between inter- parental conflict and children's psychological adjustment problems such that this relation would be significantly attenuated for children with high quality relationships, defined in terms of high levels of acceptance and high quality communication. No support was found for this hypothesis. Implications of these findings for the development of preventive intervention programs and directions for future research are discussed.     

Karen Horney and Psychotherapy in the 21st Century

Many ideas currently circulating in the psychological and psychoanalytic communities have correspondence with the theories put forth by Karen Horney during the first half of the twentieth century. This paper provides an overview of Horney’s theoretical departures from Freud and an introduction to her then controversial views of motivation and relationship. Compatibility between Horney’s ideas and attachment theory, self-psychology, intersubjectivity, and the person in the environment is discussed. Two clinical cases are presented, illustrating Horney’s theory and approach. An earlier version of this paper was presented at the 2004 National Meeting of the Committee on Psychoanalysis of the Federation of Societies for Clinical Social Work in New York.     

A Case Study of a Maltreated Thirteen-Year-Old Boy: Using Attachment Theory to Inform Treatment in a Residential Program

This paper presents therapeutic interventions from an attachment perspective with a thirteen-year-old boy with a history of maltreatment, living in a residential treatment facility. Attachment theory holds that accumulated memories of experiences with caregivers become organized into representational structures called internal working models. The guiding principles of the therapy begin with the critical role played by the individual therapist as an attachment figure. The central purposes of the therapy are conceived as promoting the restructuring of the internal working models of others to reflect expectations of trustworthiness and reliability, and models of the self as worthy to receive care. The approach described is contrasted with common approaches to residential treatment that rely on environmental behavioral contingencies, modeled on social learning theory.     

Shame,the Affective Side of Secrets: Commentary on Barth’s Hidden Eating Disorders

This paper expands on the ideas presented by Barth’s article on hidden eating disorders. The topic of eating disorders continues to be an important focus of clinical work. Applying constructs related to the experience of shame, I explore the way that feelings of shame may impact an exploration of eating disorders by the patient and clinician.

Voice and Cure: The Significance of Voice in Repairing Early Patterns of Disregulation

This paper illustrates the value of the analyst’s awareness of the importance of her voice with its various intonations in the telephone treatment of a patient with early infant/mother attachment patterns of disregulation. The authors describe the significance of a particular kind of pervasive verbal intrusion by the patient’s mother and how through the use of voice pattern, tone, and rhythm in an extended period of telephone therapy, the patient was able to solidify a more secure attachment. Finally, the authors demonstrate how the verbal music in the analyst/patient and the mother/child dyads enhances self and interactive regulation.

Dissociation,Traumatic Attachments,and Self-Harm: Eating Disorders and Self-Mutilation

Self-harm, such as eating disorders and self-mutilation, represents dissociated compensatory attempts to serve self-regulatory functions. Self-harm develops when the child who has become attached to those who have inflicted pain and suffering maintains that attachment by inflicting pain on himself. Brain imaging studies have found that the communication pattern between parent and child shapes the way the child’s attachment system adapts to experiences with the attachment figure, literally hardwiring the child’s brain. The good news is that a safe and secure attachment is very good medicine and can rewire the brain. An attachment-based multi-phase approach to treatment is presented.

Dyadic Developmental Psychotherapy: an evidence-based treatment for children with complex trauma and disorders of attachment

Dyadic Developmental Psychotherapy (DDP) is a family therapy treatment based on Attachment Theory. It is an integration of several approaches, methods and techniques that have a strong evidence base. The approach was originally developed to treat children with disorders of attachment and has been shown to be effective. It has since been more broadly used to help families with a variety of difficulties, including complex trauma. This paper outlines the primary principles and components of DDP and the evidence to support the effectiveness of the components and, therefore, of DDP.     

Family Expressiveness and Attachment

This study examines how family expressiveness relates to individuals' internal working models of attachment relationships. Seventy-two college students completed the Family Expressiveness Questionnaire (FEQ, Halberstadt, 1986) and participated in the Adult Attachment Interview (AAI, George, Kaplan, & Main, 1985). When the young adults' attachment interviews were coded using the attachment Q-sort (Kobak, Cole, Ferenz-Gillies, Fleming, & Gamble, 1993), dismissing attachment and preoccupation with attachment were associated with family expressiveness. When total family expressiveness was categorized by type of affect (positive and negative) and power relation (dominance and submission), low levels of family expressiveness were related to dismissing attachment. Negative dominance was the only type of family expressiveness that was related to both security/anxiety and deactivation/hyperactivation of attachment. Results are discussed in terms of primary and secondary attachment strategies and distinctions between dominant and submissive negative affect.     

A Preliminary Investigation of the Effectiveness of Attachment Therapy for Adopted Children with Reactive Attachment Disorder

The purpose of this preliminary investigation was to examine the effectiveness of attachment therapy for adopted children diagnosed with Reactive Attachment Disorder (RAD). Although attachment therapy is widely utilized in the practice community, outcomes of such therapy have not been well documented. In this study a pretest–posttest one-group design was used with a sample of 24 adopted children who received attachment therapy from trained, licensed therapists. Therapy was funded by the Georgia Office of Adoptions under a contract with a non-profit adoptive parent advocacy group which provided training of therapists and direct services to families. RAD was measured with the Randolph Attachment Disorder Questionnaire (RADQ), Third Edition; functional impairment was measured with the Child and Adolescent Functional Assessment Scale (CAFAS). Statistically significant decreases in scores on the RADQ and CAFAS from pretests to posttests indicate improvement for the children who received therapy. In spite of methodological limitations, the current study adds to the limited knowledge about effective treatment for RAD.