The Challenge of Attachment for Caregiving

The Challenge of Attachment for Caregiving describes a theoretical model for the development of caregiving that complements and also extends attachment theory. The model highlights the conditions under which adult caregivers can remain in a state of arrested development, impairing their own ability to give care and resulting in attachment problems for those who seek care from them. It shows how insecure attachment in childhood and adolescence impedes the development of caregiving and how, in times of crisis, even securely attached individuals need appropriate support in order to sustain their capacity to give effective care. Constructing a systemic model of the self, the authors place the instinctive systems for caregiving and careseeking (attachment) within a theory that relates them to other systems of the self, such as the systems for sharing interests, sexuality and for self-defence. The model describes the interplay between these goal-corrected behavioural systems. Because it includes the defensive mechanisms and strategies which an individual values most, it is particularly helpful to the therapist in understanding the interpersonal processes between people who are seeking to influence each other's behaviour. It is presented in a form that enables the therapist to formulate hypotheses about a client's predicament and their way of relating to the therapist and then explore and test these hypotheses in the course of therapy. Drawing on many years' experience as clinicians and researchers, Dorothy Heard and Brian Lake explore in depth an aspect of human development which has profound implications for our future survival. Presenting its own challenge to both theory and practice, this book offers students and practitioners a new perspective on attachment.

Dorothy Heard is a pyschoanalytic psychotherapist in private practice and was formerly a Consultant in John Bowlby's Department at the Tavistock Clinic, London. Brian Lake was formerly Consultant in Psychotherapy at St James's University Hospital, Leeds

The conceptual base for a theory of companionable caregiving -- A caregiving focus to an extension of attachment theory -- Caregiving from an evolutionary perspective -- Human non-verbal and symbolic communication and two alternative patterns of relating -- Bowlby's model for instinctive behaviour - based on the concept of goal-corrected behavioural systems -- Extensions to Bowlby's model of instinctive behaviour -- The emergence of high-order systems of the self -- The construction of a theory of companionable caregiving -- Categorising the functions of instinctive systems of the self with comments on their development -- From behavioural systems to adult relationships by way of internal working models -- How values are acquired and assigned to oneself, people and other entities -- Implicit concepts of caregiving in the development of the concept of self/ego ideals -- Values and ideals in promoting maturation and well-being -- Principles of therapy guided by an attachment-based theory of caregiving -- Theories used by therapists that implicitly or explicitly incorporate the caregiving aspects of attachment -- Assessment -- The therapeutic alliance and the creation of a safe base for personal development -- Separation anxiety, impingement and the therapeutic frame -- The Strange Situation Test -- The adult attachment interview -- An outline of the emergence of the study of attachment style in adults -- Questionnaire about a prospective client for assessors to complete after assessment: to be used in association with the assessment procedure described in Chapter 13