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.