Assessing Adult Attachment: A Dynamic-Maturational Approach to Discourse Analysis

10 09 2011

My review of “Assessing Adult Attachment: A Dynamic-Maturational Approach to Discourse Analysis”.

Assessing Adult Attachment front cover

Attachment theory has come a long way since John Bowlby’s paper “Forty-four Juvenile Thieves” was published in 1944. In the paper Bowlby wrote about his work with disturbed youth in London. He theorized for the first time that the nature and security of an individual’s relationships to their primary caregivers during infancy and early childhood equips them with the methods they will use to express their feelings and needs in later life. Those relationships also predict how people will form relationships with significant others during adulthood.

Through further research into Bowlby’s initial ideas – and the invention of the Strange Situation experiment – Mary Ainsworth was able to develop a clear system of classification for this theory, which could be used to identify three unique patterns of attachment: Type A (Avoidant), Type B (Secure), and Type C (Ambivalent).

This rudimentary ABC system has been at the heart of attachment theory since its inception, and has paved the way for a host of psychological texts and theories. Titles such as “Attached” by Dr. Amir Levine and the “Attachment-Focused Family Workbook” by Daniel A. Hughes join countless other attachment-specific books currently on sale, and Dr. Sue Johnson’s research into relationships and subsequent development of her Emotionally Focused Therapy (EFT) program have brought about a revolution in the field of couples therapy. Indeed, a recent issue of the American Association of Marriage and Family Therapy’s ‘Family Therapy Magazine’ was entirely devoted to The Science Of Love, reporting the recent findings of groundbreaking research focused on the understanding of romantic love and adult attachment.

It is clear, therefore, that the ABC classification system of attachment theory has a lot to offer those in the therapeutic field, but it is not without its problems, either. First, it often seems overly simplistic: the classifications can be vague and unreliable, everyone is forced to classify themselves with one of just three basic attachment styles, and there is no option of further classification within each division. Second, it is too limiting: people frequently feel typecast and stuck within one specific attachment style, with no option for change or progress. Third, it is outdated and culturally biased: the system was derived from work in the cognitive sciences in the late 1970s, and based largely on findings from observations of middle-income, low-risk American families. And fourth, it offers very little in terms of a solution: once someone has identified their attachment style, then what?

The main cause of these problems has been the source of the classification data itself: the Adult Attachment Interview (AAI), an interview and coding method developed by Mary Main and Ruth Goldwyn in the 1980s which has been the primary method of collecting and interpreting attachment information ever since. Now, at last, with this book, Crittenden and Landini have provided us with a more up-to-date, efficient and multicultural alternative, which continues to be compatible with the AAI data collection method, but works equally well with other forms of interview, too: their own Dynamic-Maturational Model (DMM) of attachment.

Various theoretical perspectives on attachment can be applied to the interpretation of the AAI. Main and her colleagues developed the AAI based on a version of attachment theory that assumed that (1) by adulthood most adults had a single representation of attachment relationships, (2) this relationship reflected one of the Ainsworth patterns of infant attachment, (3) these patterns were transmitted from mother to child across generations, and (4) frightening circumstances disrupted the organizational process, leading to a state of disorganization in infancy or lack of resolution of the frightening circumstances in adulthood.

In the Dynamic-Maturational Model of attachment and adaptation, none of these four assumptions are made. To the contrary, the DMM approach to attachment theory presumes that adults have multiple dispositional representations, each unique to the information processes underlying it. Second, the array of strategies is developmentally expanded from its roots in infancy, with endangered individuals most often using the later developing and more complex strategies. Third, it is understood that each individual constructs his or her own dispositional representation from his or her own experience. Sometimes this will reflect similarities to the parent’s dispositional representation, but, especially in cases of parental disturbance or inadequacy, children will often organize the opposite strategy from the parent… Finally, exposure to danger is assumed to be the essential condition that elicits attachment behavior, and, across repeated experiences, leads to organized self-protective strategies.

Clearly, the introduction of this model represents a major leap forward in our understanding of attachment and attachment theory, offering a far more detailed and multicultural system of classification than the old ABC model. Over the course of this book, Crittenden and Landini fastidiously lay out a new classification system, with many numeric subdivisions within each individual attachment strategy. In fact, the research is so exhaustive and delivered in such great detail that it seems almost impossible that any clinicians reading this would not recognize each of their clients at least somewhere within the text. The downside to this is that this is not an easy book to read; it is certainly not something you will want to flick through to help you relax at the end of the day. But those who do make their way through the sometimes dense and challenging text will come out feeling incredibly rewarded for their perseverance, armed with a new treatment model for working with their clients and a new understanding of the complexities of adult attachment.

Essentially, what the field of attachment theory has been sorely lacking is its own Diagnostic and Statistical Manual — a modern, flexible, and multicultural tool which will provide practitioners with the common language and standard criteria for the classification of specific attachment styles, and their best-practice solutions. Now, with Crittenden and Landini’s long-awaited book, it finally has it.

Critically, though, this book aims to do much more than serve as just a DSM for attachment theory. As well as a basis for gathering empirical data, the authors provide us with a compassionate new guide for treatment formulation, and there is a chapter – titled ‘But What Shall I Do?’ – dedicated specifically to this cause:

Researchers are happy with a reliable classification, but not so psychotherapists and others who must guide troubled individuals and their families. They need an action plan. In this chapter we describe how one uses an AAI classification, combined with information about the history and current functioning of the speaker and his or her family, to derive a functional formulation. The functional formulation is the professional’s dispositional representation (DR) of the relation between the service structure and the individual and his or her relationships. Like all DRs, a functional formulation is dynamic; it is always changing as new information is integrated into the existing set of information… We describe how to derive functional formulations that can guide treatment both at its onset and, with feedback and updating, across the course of treatment.

Crittenden and Landini then go on to demonstrate exactly how their model can be used as a therapeutic tool, using the initial classification as starting point to guide both the therapist and client toward the resolution of past issues and the reorganization of the thoughts and language that shape both our ideas of self and attachment strategy. Furthermore, this model aims to shift the focus on attachment styles from one of disorder to one of function; from the old deficit-based model to one that is dynamic and optimistic. Rather than an emphasis on diagnosis simply for the sake of identification or labels, the authors stress their hopes that this model might open the doors to new ways of thinking in not just the mental health field, but others as well, concluding that:

When functioning is understood as attempts to protect rather than to damage or harm, alliances between mental health professionals and people in need of care become more likely.

Many say that DMM theory and methods are complex, too complex for working clinicians. After a century of trying to understand and ameliorate mental illness, it seems unlikely that simple theory, simple assessment, and quick manualized treatment will be more successful than our past efforts. It is more likely that theory needs to be sufficiently complex to represent the crucial aspects of the life experiences of people with mental illness. The assessments need to be sensitively attuned to the encrypted communications of very distressed adults, and to be coded by skilled professionals trained to a high level of reliability.

Possibly, the greatest potential of the DMM-AAI is its capacity to focus observation precisely while retaining the openness to expand and change understanding of observations. We hope this book will be used to promote accuracy of observation, clarity of interpretation, and – most important – discovery of new ideas about human adaptation. Psychological tools that yield useful data without restricting thinking are very valuable. The DMM-AAI does more: It opens the door to groundbreaking basic and applied research of as much relevance for the social sciences as for the healing professions.

This is a groundbreaking piece of work, containing a life-span view of adaptation that is both intuitively succinct and simple in structure, yet also completely nuanced in execution. Researchers and clinicians alike will undoubtedly benefit from the wealth of information shared here, and it is a must-have for anyone with an interest in attachment theory, representing a major evolutionary step forward in the field.

5 out of 5 stars.

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Saying No To Naked Women

28 05 2011

I thought I would share some of my book reviews on this blog, as they do contain some interesting themes.

I’ll start with my review of “Saying No To Naked Women” by David R. Yale:

Saying No To Naked Women

In the summer of 1974, Jack Derritt leaves the city and all of his material possessions behind and heads out to the Arkansas countryside, to live in a shack and take stock of his life. Tired of meaningless flings and constant feelings of misery and self-doubt, Jack wants to figure out why he’s never been able to find a stable, loving relationship, and why he never feels good enough for anyone. He asks himself: “Why is there a throbbing hurt inside me that never leaves?”

This is the opening to David R. Yale’s “Saying No To Naked Women; the story of one man’s struggle to free himself from porn values and sexual addiction”. With Jack’s story as an example, Yale’s novel shows us how our childhood fears can continue to haunt us as adults, manifesting themselves as self-doubt or insecurity, and preventing us from living fulfilling lives or maintaining loving relationships.

As Jack attempts to settle in his new home, he comes to realize that there is no escape from his inner monologue, which is often delivered in his father’s voice, constantly reminding him what a failure and a disappointment he is.

“I’ll never produce anything worthwhile. No woman will ever want me – once she sees my terrible faults. I’ve managed to fool people, but they’ll see: I don’t know what I’m doing. My father is right. I’m a parasite.”

We learn that Jack’s parents were Orthodox Jews and Marxists, and that Jack was raised in a climate of fear and secrecy, and taught to hide his identity. His parents never told him they loved him; instead they made him feel inadequate, and different from the rest of the world. The legacy of the Rosenbergs hung over his head, as a reminder of what might happen to his family if their religious and political beliefs were discovered. It’s these feelings of fear which continue to haunt Jack as an adult, as he remains convinced that he’ll never meet anyone who could possibly understand or value him for the man he is, and that he must always conceal his true self if he wants to be accepted.

Jack seems trapped in a spiral of loneliness, depression and paranoia, and at times this can be frustrating to read. Yale’s story takes a while to get going, and his pace is slow to start with. He focuses closely on setting the scene and building up the characters, but it is not always clear where this is leading, or to what end. Readers who find themselves struggling through the first half of this book should be encouraged to persevere, as the second half rewards us with plenty of valuable lessons and the denouement contains a powerful and important message. Yale’s prose is engaging and easy to read, and I found myself deeply involved in the story, once I had decided to stick with it, past the uncertain beginning. After around 200 pages, the story finally takes an interesting twist, as the solution to Jack’s torment begins to unfold.

One day, divine intervention strikes: he gets stung by a bee in the woods, and the resulting adrenaline shot sends him into a feverish dream world. In this dream world, Jack is visited by a mystical mentor, in the form of a Chassid, who begins to lead Jack through a number of conversations and sessions of immersion therapy which transform his way of thinking about himself and others.

This exposition is somewhat reminiscent of “A Christmas Carol” by Charles Dickens; just as Scrooge meets the Ghosts of Christmas Past, Present, and Yet To Come, so too must Jack accompany the Chassid on a journey through his childhood, a summary of his present life, and an enactment of what the future might be like if he continues along his current path. Yale’s novel is a Dickensian fairytale for the modern age, demonstrating the ways in which childhood fears and insecurities can leave many men struggling with the porn values and sexual addictions that are so prevalent in society today.

Jack comes to realize that he views sex as a form of validation. He tells the Chassid, “I feel like there’s something wrong with me if I’m not having sex on a regular basis.” The Chassid then helps him see how this is connected to his childhood, and he how can end this cycle:

“Some of your anger was at your Dad for not teaching you how to be a man?”
“Yes.”
“And you turned that anger against women – the more frustrated you got the angrier your fantasies got?”
“Damn! What do I do now?”
“Learn how to communicate your feelings to women.”

The Chassid requests that Jack repeat a mantra: “I define myself. I do not let others define me. I do not let my parents define me.” Through this mantra, Jack begins to understand that his parents do not control him any more, and that he is able to live his own life. He begins to let go of the fear and secrecy he learned as a little boy, and to set himself free of the doubt and anger that have controlled him for so long.

“You must affirm yourself… Every time you think a negative thought about yourself, you have to confront it, and contradict it… You can’t deal with yourself the way your parents treated you. I forbid you! When you find you’re making harsh, critical judgments about yourself, stop! And then affirm yourself.”

Through these teachings, Jack is finally able to forgive his parents for their shortcomings, and to uncover the happiness and confidence he has always longed for. He begins to feel accepted by others, and understands what it takes to have a healthy and fulfilling relationship; knowing that the sexual fantasies and flings of his past were just a repeat of the anger and confusion he felt as a child. Finally, by the time he awakes from the dream world of the fever, Jack has learned to integrate the Chassid’s teachings into himself, as an alternative to the voice of his father, which once ruled his thoughts:

“I’m sure not used to thinking strategically like this. It’s a new experience.”
“Do you like it?”
“It makes me finally feel like I have power over my own life.”
“Even without the Chassid?”
“Yes. But maybe the Chassid has become part of me.”

Yale’s novel teaches us that we must understand, forgive, and honor both ourselves and other people in order to find happiness, and that, instead of holding on to our anger, living well is often the best revenge of all. Jack’s story is one that many men will be able to relate to, and the teachings of the Chassid will no doubt resonate with them, too.

One criticism I have, though, is that the book seems unsure of its audience. As a fictional novel about a man setting off into the wilderness to reflect on his life, the book might initially seem to fit alongside classics such as Thoreau’s “Walden”, Kerouac’s “Lonesome Traveler”, Pirsig’s “Zen and the Art Of Motorcycle Maintenance”, and Krakauer’s “Into The Wild”. However, what separates this book from those (including its misleading title) is the suggestion that it is some kind of self-help manual. The back cover suggests that this book “unlocks invisible behavior patterns you must understand to solve personal troubles and identify problem people”, and this certainly seems a little far-fetched.

As a systemic marriage and family therapist, I enjoyed reading about the Chassid’s immersion therapy techniques, and recognized the narrative therapy methods employed to help Jack re-write his own story and take control of his life. I’m sure many readers will benefit from Yale’s suggestions of how to find happiness and overcome the demons of the past. But, while these techniques may work well for some, suggesting that this book could serve as a universal guide to love and happiness seems a little extreme. Those who are simply looking for an engaging fairytale about a man in the wild, on a journey to self-fulfillment, will find that this is a story worth reading. It won’t appeal to everyone, but this is a worthy book, and one that should be recommended to anyone struggling to find love as a consequence of painful childhood experiences.

3 out of 5 stars.

In addition to my review, I’d like to add that I agree with Dr Thaddeus Birchard, an expert in sexual compulsivity and addiction, who states that “sexual addiction, like any addictive substance or process, is a response to the pain and distress of narcissistic damage. All addictions have a common underlying psychobiological process. I think of narcissistic damage as the outcome of a disturbance in attachment. The function of an addiction is therefore to anaesthetize the subjective distress created by the narcissistic damage.”

In other words, sexual addiction often forms as a means by which to avoid dealing with the pain that is caused by attachment injuries from the past. And it is only by identifying and resolving these injuries -through successful therapy sessions – that the addiction can be truly cured.

If you currently suffer from sexual addiction – or are in a relationship with someone who you suspect may be a sex addict – I can help you with these issues. Don’t wait for that change – make it happen now!