Clinical Implications of Attachment

By Jay Belsky; Teresa Nezworski | Go to book overview

12
A Clinical Approach to Attachment

Stanley I. Greenspan, M.D. Dept. of Health & Human Services

Alicia F. Lieberman, Ph.D. University of California, San Francisco

Attachment patterns in infants have been of enormous interest to clinical and research psychologists because of the patterns' importance in understanding human survival, coping strategies, and psychological health and illness. How infants learn to relate to others and organize emotional experiences of these relationships may be viewed from a number of different perspectives. These perspectives include the way in which the infant and caregiver initiate their relationship in terms of individual differences in sensory, motor, cognitive, and affective patterns; the manner in which the relationship is sustained and recovered from disruptive stresses (e.g., separations, illness, etc.); the range of affects incorporated into the relationship pattern (e.g., the degree and balance of pleasure, assertiveness, anger, sadness, etc.); and the emerging unique character or identity of the relationship pattern (e.g., preferred affects and themes). Various clinical and research approaches derived from differing theoretical assumptions have focused on one or another of these perspectives, sometimes with the assumption that one perspective is a window on others. This chapter discusses these various approaches to attachment patterns in the context of: its broader clinical roots (in the context of infant psychopathology), current definition of attachment, and the current empirical literature on one well-studied type of attachment pattern. It also presents an integrated developmental model that can incorporate both clinical and research perspectives. In this model, attachment is viewed as an ongoing process that has specific attributes related to the challenges of each developmental phase in the first 4 years of life.

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Clinical Implications of Attachment
Table of contents

Table of contents

  • Title Page v
  • Contents vii
  • Contributors xiii
  • Preface xv
  • I General Issues 1
  • 1: Clinical Implications of Attachment 3
  • References 15
  • 2: The Role of Infant-Caregiver Attachment in Development 18
  • Acknowledgment 30
  • Appendix: Attachment, Patterns of Adaptation, Continuity and Change 30
  • References 35
  • II Determinants of Attachment Security and Insecurity 39
  • 3: Maternal, Infant, and Social-Contextual Determinants of Attachment Security 41
  • Appendix: Attachment, Patterns of Adaptation, Continuity and Change 88
  • 4: Maternal Antecedents of Attachment Quality 95
  • Introduction 131
  • Appendix: Attachment, Patterns of Adaptation, Continuity and Change 132
  • 5: Relationships at Risk 136
  • Acknowledgments 164
  • References 164
  • References 167
  • III Consequences of Attachment Security and Insecurity 175
  • 6: Attachment and the Ontogeny of Conduct Problems 177
  • References 210
  • Summary and Conclusions 241
  • References 246
  • References 246
  • 8: Attachment and the Development of Behavior Problems 253
  • References 295
  • 9: Avoidance and Its Relation to Other Defensive Processes 300
  • Acknowledgments 318
  • References 318
  • IV Clinical Applications 325
  • 10: Clinical Applications of Attachment Theory 327
  • References 348
  • 11: Intervention in Insecure Infant Attachment 352
  • References 382
  • 12: A Clinical Approach to Attachment 387
  • References 415
  • Author Index 425
  • Subject Index 435
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