Formation of secure attachment in adulthood as a mental health intervention

Formation or regeneration of a sense of security in adults who experienced insecure attachment in childhood enhances resilience and improves psychological wellbeing.

An instinctive drive for attachment is our fundamental survival mechanism in early childhood.[1] Attachment behaviour is any action intended for getting a response from a preferred person, someone who is usually wiser or stronger. In general terms, attachment can be defined as a specific style of relating to other people, and we can distinguish attachment dynamics into secure and insecure. According to Bowlby’s attachment theory [2], an insecure, unreliable, and inconsistent attachment relationship with a caregiver in infancy diminishes resilience to trauma and stress and makes children liable to mental breakdowns in critical circumstances. On the contrary, a secure, or consistent and sensitive attachment style is a basis for a more constructive and optimistic child development trajectory. Insecure attachment in childhood has been found to confer risks to the development of psychopathology in adulthood and is considered a susceptibility factor to mental illness.[3] Yet, the formation or reinstatement of a feeling of secure attachment in later life may improve resilience and enhance psychological wellbeing. [1,3,4] 

A British psychologist John Bowlby indicated that many psychiatric patients were unconfident and immature people developing mental disorders in stressful situations.[2] The research demonstrated that most of these individuals had experienced neglectful parenting, which was at the core of insecure attachment in infancy. Bowlby claimed that, depending on caregivers’ attachment style, children form the internal working models, which are conceived as the background for directing one’s views, emotions, and actions in the context of later-life interactions.

Yet, insecure attachment relationships do not result in psychopathology linearly. Factors such as social and family life, intelligence, substance use are likely to augment the effects of insecure attachment on the way to a mental disorder.[1] Nevertheless, a substantial body of research, including longitudinal studies of the long-term consequences of insecure attachment relationships in early years on mental illness in later life, has supported Bowlby’s ideas. Replicated findings of Harris, Brown, and Bifulco [5] demonstrated that the loss of a parent or long separation from parents in early life had conferred risk to adult depression due to lack of care.[5] Coffino [6] pointed out that the strongest predictor of depression in adulthood was the history of parental death between 5 and 10 years old.

Carlson, Egeland and Sroufe [7] investigated in a longitudinal study the developmental pathway of a borderline personality disorder (BPD) from childhood to adulthood. They documented that repetitive contradictory cues, characteristic of disorganised attachment in childhood, were strongly linked to a failure in regulatory approaches to manage stressful situations in later life. The study reports that disorganised attachment, one of the insecure attachment forms, is related to dissociative processes in later life, a marker in BPD development.

While exposure to insecure attachment styles in early life is conceived as the risk factor for later-life mental illness, the formation and regeneration of a feeling of security in adulthood may improve mental health and resilience to stress. Mikulincer and Shaver [3] report that the effects of an enhanced sense of security on different psychological indicators have been observed in the “security priming” trials that employed triggering mental associations with caring attachment figures. For example, security providers’ name priming has alleviated symptoms of eating disorders, including distortion of body perception in women diagnosed with eating disorders. Later research by Mcguire, Gillath, Jackson and Ingram [4] has demonstrated encouraging further steps in translating attachment priming into psychological interventions for adolescents and adults suffering from depressive symptoms. Participants exposed to the security primes showed a greater decline in depressive symptoms than the control group. These findings highlight the calming, curing, therapeutic effects of support provided by relationship companions, and the feeling of relief and protection resulted from mental images of caring experiences and affectionate and loving attachment figures. 

Attachment in the context of psychology generally refers to the permanent emotional proximity between children and parents or caregivers, which is necessary to prepare children for the challenges of adulthood. Secure attachment in childhood tends to facilitate mental wellbeing and generate emotional resources for managing stress, whereas insecure attachment styles are likely to result in psychopathology. Yet, the research evidence causes us to be positive about the effectiveness of clinical interventions that enhance individuals’ sense of attachment security—the regeneration or formation of a feeling of secure attachment in adulthood can strengthen resilience and alleviate mental illness symptoms. 

Photo by Thiago Cerqueira

 

 

References

  1. Mikulincer M, Shaver P. Attachment in adulthood. Structure, dynamics, and change [Internet]. New York: The Guilford Press;2007 [cited 2021 March 20]. 370 p. Available from: https://www.academia.edu/34596672/Attachment_in_Adulthood_-_Structure_Dynamics_and_Change-Mario_Mikulincer_PhD_Phillip_R._Sha.pdf
  2. Bowlby J. The making and breaking of affectional bonds. BJPsych Int. 1977 [cited 2021 March 20];130(3):201-210. DOI: 10.1192/bjp.130.3.201
  3. Mikulincer M, Shaver P. An attachment perspective on psychopathology. World Psychiatry. 2012 [cited 2021 March 17];11(1):11–15. Available from: https://onlinelibrary.wiley.com/doi/full/10.1016/j.wpsyc.2012.01.003 DOI: 10.1016/j.wpsyc.2012.01.003
  4. Mcguire A, Gillath O, Jackson Y, Ingram R. Attachment security priming as a potential intervention for depressive symptoms. J Soc Clin Psychol. 2018 [cited 2021 March 20];37(1):44-68. Available from: https://guilfordjournals.com/doi/pdf/10.1521/jscp.2018.37.1.44#:~:text=Secu%2D%20rity%20priming%20is%20thought,Canterberry%20%26%20Gillath%2C%202012).
  5. Bifulco AT, Brown GW, Harris TO. Childhood loss of parent, lack of adequate parental care and adult depression: a replication. J Affect Disord Rep. 1987 [cited 2021 March 18];12:115–128. Available from: https://pubmed.ncbi.nlm.nih.gov/2955002/ DOI: 10.1016/0165-0327(87)90003-6
  6. Coffino B. The role of childhood parent figure loss in the etiology of adult depression: findings from a prospective longitudinal study. Attach Hum Dev. 2009 [cited 2021 March 20]; 11(5):445-470. DOI: 10.1080/14616730903135993
  7. Carlson EA, Egeland B, Sroufe LA. A prospective investigation of the development of borderline personality symptoms. Dev Psychopathol. 2009 Fall; [cited 18 March 2021];21(4):1311-34. DOI: 10.1017/S0954579409990174