Attachment Theory and A Glance at Attachment Disorders

Eren Yıldızhan

doi:10.21673/anadoluklin.237462

Review

Bağlanma Teorisi ve Bağlanma Bozukluklarına Genel Bir Bakış

Year 2017, Volume: 22 Issue: 1, 66 - 72, 30.12.2016

Eren Yıldızhan

https://doi.org/10.21673/anadoluklin.237462

Cited By: 7

Abstract

Bağlanma sistemi, bebeğin hayatta kalması ile ilgili
yaşamsal önemi olan, sadece insana özgü olmayıp doğada bütün memeli türlerinde
görülen evrimsel bir sistemdir.

Anne çocuk ilişkisinden başlayarak kişinin hayatı boyunca
kurduğu bütün ilişkilere bir taslak olan bağlanma, kronik hastalık durumlarında
kişinin tedavi ekibi ile kurduğu ilişkide de belirleyici olabilmektedir.
Temelde güvenli ve güvensiz bağlanma olarak ikiye ayrılır, güvensiz bağlanma
ise kendi içinde kaygılı bağlanma, kaçıngan bağlanma ve dezorganize bağlanma
olmak üzere üç tiptir. Güvenli bağlanması olmayan kişiler, bazen sorunlu ilişki
kurma biçimleri nedeni ile “zor hasta” olarak tanımlanarak klinik ilgi odağı
olmaktadırlar. Bağlanma biçimleri ve buradan kaynaklanabilecek olası sorunlar,
literatürdeki bilgiler ışığında incelendiğinde, basit birtakım girişimlerin
doktor-hasta ilişkisindeki bazı zorluklara çözüm olabileceği görülmektedir.
Hastaların farklı bağlanma biçimlerini dikkate almak ve hasta ile işbirliği
içinde tedaviyi planlamak, hastaya sunulan hizmetin kişiye özgü düzenlenmesinde
yol gösterici olabilir. John Bowlby tarafından temelleri atılan bağlanma
teorisi ile ilgili bilgi sahibi olmak ve hastaların farklı bağlanma biçimlerini
tanıyarak terapötik işbirliğinde nasıl konumlandığımızı dışarıdan görmek,
doğabilecek sorunları önceden kestirmeye yarayabilir ve bize birtakım çözüm
önerileri sunabilir.

Keywords

Bağlanma; Tedaviye Uyum; Zor Hasta

References

1. Bowlby J. The making and breaking of affectional bonds. II. Some principles of psychotherapy. The fiftieth Maudsley lecture. Br J Psychiatry. 1977; 130: 421-31.
2. Bowlby J. Attachment and Loss, Vol. 1: Attachment. New York: Basic Books; 1969.
3. Bowlby J. Attachment and Loss, Vol. 2: Separation: Anxiety and Anger. New York: Basic Books; 1973.
4. Bowlby J. Attachment and Loss, Vol. 3: Loss: Sadness and Depression. New York: Basic Books; 1980.
5. Kraemer GW. A psychobiological theory of attachment. Behav Brain Sci. 1992; 15: 451–93.
6. Bretherton I, Munholland KA. Internal working models in attachment relationships: A construct revisited. In: J. Cassidy and P.R. Shaver, Editors, Handbook of Attachment. New York: Guilford; 1999. p. 89–111.
7. Hazan C, Shaver PR. Romantic love conceptualized as an attachment process. J Personality Social Psychol. 1987; 52: 511–24.
8. Mickelson KD, Kessler RC, Shaver PR. Adult attachment in a nationally representative sample. J Pers Soc Psychology. 1997; 73: 1092–106.
9. West ML, Sheldon-Kellor AE. Patterns of Relating: An Adult Attachment Perspective, New York: Guilford Press; 1994.
10. Klohnen EC, John OP. Working models of attachment: A theory-based prototype approach. In: Simpson JA, Rholes WS, editors. Attachment Theory and Close Relationships. New York: Guilford, 1998. p. 115–40.
11. Özer Ü, Yıldırım EA, Erkoç ŞN. Major depresyon olgularında intihar düşünce ve davranışının bağlanma biçimi ile ilişkisi. Arch Neurosciatr. 2015; 52: 283-8.
12. Bartolomew K, Horowitz LM. Attachment styles among young adults: A test for four-category model. J Pers Soc Psychol. 1991; 61: 224-6
13. Wilhelm K, Tietze T. Difficult doctor-patient interactions. Applying principles of attachment-based care. Medicine Today. 2016; 17(1-2): 36-44.
14. Main M. Metacognitive knowledge, metacognitive monitoring, and singular (coherent) vs. multiple (incoherent) model of attachment: Findings, and directions for future research. In: C. Parkes, J. Stevenson-Hinde and P. Marris, Editors, Attachment across the life cycle. London: Routledge; 1991. p. 127–60.
15. Fonagy P, Steele H, Moran GS, Higgett AC. The capacity for understanding mental states: the reflective self in parent and child and its significance for security of attachment. Infant Mental health Journal. 1991; 12: 201–18.
16. Lyons-Ruth K, Block D. The disturbed caregiving system: relations amongst childhood trauma, maternal caregiving, and infant affect, and attachment. Infant Mental Health J. 1996; 17: 257–75.
17. Adshead G. Psychiatric staff as attachment figures. Br J Psychiatry. 1998; 172: 64–9.
18. Blackwell B. Sick-role susceptibility. Psychother Psychosom. 1992; 58: 79–90.
19. Groves JE. Taking care of the hateful patient. N Engl J Med. 1978; 298: 883–7.
20. Lipowski ZJ, Somatization. The concept, and its clinical application. Am J Psychiatry. 1988; 145: 1358–68.
Dozier M. Attachment organization, and treatment use for adults with serious psychopathological disorders. Development and Psychopathology. 1990; 2: 47–60.
22. Ciechanowski P, Katon W, Hirsch I. Attachment style and adherence in the diabetic patient. Psychosom Med. 1999; 61: 110.
23. Yılmaz Özpolat AG, Ayaz T, Konağ Ö, Özkan A. Attachment style and perceived social support as predictors of biopsychosocial adjustment to cancer. Turk J Med Sci. 2014; 44: 24-30.
24. Maunder RG, Hunter JJ. Attachment and psychosomatic medicine: developmental contributions to stress and disease. Psychosomatic Medicine, in press.

Attachment Theory and A Glance at Attachment Disorders

Year 2017, Volume: 22 Issue: 1, 66 - 72, 30.12.2016

Eren Yıldızhan

https://doi.org/10.21673/anadoluklin.237462

Cited By: 7

Abstract

Attachment system which has survival importance for the
baby, is not unique to humans, it is an evolutionary system that is seen in
nature in all mammals.

Attachment, as a template for all reliationships, begining
with the mother-baby interaction, may have a decisive role in states of chronic
disease. Basicly, attachment can be secure or insecure; insecure attachment has
also three types: anxious attachment, avoidant attachment and disorganised
attachment. Patients lacking a secure
attachment pattern may be in the focus of clinical attention as “difficult
patients” due to the maladaptive reliationship patterns. When we invesitegate
the attachment patterns and problems related to these patterns in the
literatüre, we observe that certain basic interventions can be solution for the
problems in doctor-patient reliationship. Considering the patient’s attachment
style and making a plan in collaboration with the patient is heplful in
individualising care. Having knowledge of the attachment theory of John Bowlby
and having an outsider perspective of our place in the therapeutic alliance by
recognizing different attachment patterns of patients may help us to predict
potential problems and find possible solutions.

Keywords

Attachment; Treatment Adherence; Difficult Patient

References

1. Bowlby J. The making and breaking of affectional bonds. II. Some principles of psychotherapy. The fiftieth Maudsley lecture. Br J Psychiatry. 1977; 130: 421-31.
2. Bowlby J. Attachment and Loss, Vol. 1: Attachment. New York: Basic Books; 1969.
3. Bowlby J. Attachment and Loss, Vol. 2: Separation: Anxiety and Anger. New York: Basic Books; 1973.
4. Bowlby J. Attachment and Loss, Vol. 3: Loss: Sadness and Depression. New York: Basic Books; 1980.
5. Kraemer GW. A psychobiological theory of attachment. Behav Brain Sci. 1992; 15: 451–93.
6. Bretherton I, Munholland KA. Internal working models in attachment relationships: A construct revisited. In: J. Cassidy and P.R. Shaver, Editors, Handbook of Attachment. New York: Guilford; 1999. p. 89–111.
7. Hazan C, Shaver PR. Romantic love conceptualized as an attachment process. J Personality Social Psychol. 1987; 52: 511–24.
8. Mickelson KD, Kessler RC, Shaver PR. Adult attachment in a nationally representative sample. J Pers Soc Psychology. 1997; 73: 1092–106.
9. West ML, Sheldon-Kellor AE. Patterns of Relating: An Adult Attachment Perspective, New York: Guilford Press; 1994.
10. Klohnen EC, John OP. Working models of attachment: A theory-based prototype approach. In: Simpson JA, Rholes WS, editors. Attachment Theory and Close Relationships. New York: Guilford, 1998. p. 115–40.
11. Özer Ü, Yıldırım EA, Erkoç ŞN. Major depresyon olgularında intihar düşünce ve davranışının bağlanma biçimi ile ilişkisi. Arch Neurosciatr. 2015; 52: 283-8.
12. Bartolomew K, Horowitz LM. Attachment styles among young adults: A test for four-category model. J Pers Soc Psychol. 1991; 61: 224-6
13. Wilhelm K, Tietze T. Difficult doctor-patient interactions. Applying principles of attachment-based care. Medicine Today. 2016; 17(1-2): 36-44.
14. Main M. Metacognitive knowledge, metacognitive monitoring, and singular (coherent) vs. multiple (incoherent) model of attachment: Findings, and directions for future research. In: C. Parkes, J. Stevenson-Hinde and P. Marris, Editors, Attachment across the life cycle. London: Routledge; 1991. p. 127–60.
15. Fonagy P, Steele H, Moran GS, Higgett AC. The capacity for understanding mental states: the reflective self in parent and child and its significance for security of attachment. Infant Mental health Journal. 1991; 12: 201–18.
16. Lyons-Ruth K, Block D. The disturbed caregiving system: relations amongst childhood trauma, maternal caregiving, and infant affect, and attachment. Infant Mental Health J. 1996; 17: 257–75.
17. Adshead G. Psychiatric staff as attachment figures. Br J Psychiatry. 1998; 172: 64–9.
18. Blackwell B. Sick-role susceptibility. Psychother Psychosom. 1992; 58: 79–90.
19. Groves JE. Taking care of the hateful patient. N Engl J Med. 1978; 298: 883–7.
20. Lipowski ZJ, Somatization. The concept, and its clinical application. Am J Psychiatry. 1988; 145: 1358–68.
Dozier M. Attachment organization, and treatment use for adults with serious psychopathological disorders. Development and Psychopathology. 1990; 2: 47–60.
22. Ciechanowski P, Katon W, Hirsch I. Attachment style and adherence in the diabetic patient. Psychosom Med. 1999; 61: 110.
23. Yılmaz Özpolat AG, Ayaz T, Konağ Ö, Özkan A. Attachment style and perceived social support as predictors of biopsychosocial adjustment to cancer. Turk J Med Sci. 2014; 44: 24-30.
24. Maunder RG, Hunter JJ. Attachment and psychosomatic medicine: developmental contributions to stress and disease. Psychosomatic Medicine, in press.

There are 24 citations in total.

Details

Subjects	Health Care Administration
Journal Section	REVİEW
Authors	Eren Yıldızhan
Publication Date	December 30, 2016
Acceptance Date	November 21, 2016
Published in Issue	Year 2017 Volume: 22 Issue: 1