| Attachment
It
is therefore no wonder that 85 per cent of abused boys (and girls) are 'insecurely
attached' (Karen 1994) and, as insecurely attached adult men, they come for help
defended against forming intimate attachments which are both threatening and longed
for. Bowlby (1969) saw attachment as a biological, instinctive bond with the caregiver.
Remaining close to the caregiver is important for survival - the parent needs
to be a 'secure base' from which the child goes out into the world.
The child
develops what Bowlby (1973) called 'an internal working model' that forms the
basis of his personality. This model is created by the child, over time, in response
to his repeated experiences in attempting to form attachments. The model is cognitively
formed in the child's mind in response to questions about himself such as 'Am
I worthy of support or not?' and about the caregiver 'Can I rely on this person
to provide the care I want or not?' The model guides the child's future relationships
with others and his attitude to self. The child learns to interact in predictable
ways that are shaped by his expectations of his caregiver (Friedrich 1995).
So
a child is securely or insecurely attached. A securely attached child has been
able to develop an internal working model from his experience of having caregivers
that have been consistent, supportive in times of distress and attuned to his
needs. Insecure attachments generally fall into three categories; resistant/ambivalent,
avoidant and disorganized (Alexander 1992). Insecurely attached children have
usually experienced caregivers as inconsistent, not attuned to their needs and
unable to soothe them in times of distress.
Resistant/avoidant
children behave in ways that indicate they want and seek out contact from
caregivers, while at the same time behaving with angry resistance. Such children
can seem to be clingy and needy while at the same time creating distance by their
behaviour from the very person they seek to be closer to. Caregivers often respond
to such children by seeking care from the child rather than vice versa.
Avoidant
children often appear to snub or avoid their caregivers. They become guarded in
their interactions with others as a result of having caregivers who were emotionally
unavailable, who disliked any sign of the child's need for them and who encouraged
them to become independent before they were developmentally ready.
Disorganized
attachment is seen in children who do not consistently demonstrate any pattern
of attachment but may flip from one to the other. This seems to be related to
the fact that the caregiver is both the source of the child's distress and the
child's comforter. This pattern can be seen in children who have been abused by
someone such as Stephen and Mike's grandfather who, while severely abusing them,
also gave them a sense of importance, pleasure and being cared about.
As described
in their story Gramps was a frequent carer of the boys - taking them on holiday,
spending time with them and generally paying a great deal of attention to them.
Their own father, Gramps's son, was unapproachable, angry and domineering during
their childhood, no doubt as a consequence of his own parenting by a father who
used children to satisfy his own needs. Gramps had abused several of his own children,
as well as his grandchildren.
Specific attachment-related
features originating from insecure attachments and frequently found in families
where sexual abuse occurs include rejection, role reversal/parentification and
fear/unresolved trauma (Friedrich 1995). In forming my relationships with Stephen
and Mike I was very conscious of all three aspects. My belief is that the problems
experienced by both men stemmed from their early experiences within a sexually
abusive family and the 'internal working model' they had developed throughout
their childhood and adolescence, which was still in operation for them as adults.
By providing them with a relationship of warm acceptance, empathic understanding
and respect they have an opportunity for growth and healing. In providing a different
kind of relationship, which may not fit their perceptions or expectations of what
relationships are, I can make a difference to their experience of self in relationship
with another.
So an alliance is formed between us when we agree
to work together. A successful alliance depends upon how well I can create a therapeutic
space characterized by safety. Stephen's first contact with me emphasized his
lack of safety and his need to be able to trust himself to another human being
in order to repair the damage caused by his early life. He wrote of the need for
confidentiality as part of that safety and the need for somebody who could empathize
with him in his distress - his fear of judgment, rejection and exposure all came
through his words: 'I.. .feel your empathy coming through, and that I could talk
to you. . . talking to just anyone (is) very frightening. . .I feel as if I could
trust you.'
Mike described his need for safety and the lengths
he went to in order to maintain his anonymity; 'I still remember how risky it
felt to be standing at those bookshelves, and how I travelled to other towns to
be anonymous enough...'
- Etherington, Kim, Narrative Approaches to Working
with Adult Male Survivors of Sexual Abuse, Jessica Kingsley Publishers London,
2000.
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Personal
Reflection Exercise #4
The preceding section contained information
about attachment in the therapeutic relationship. Write three case study examples
regarding how you might use the content of this section in your practice.
Peer-Reviewed Journal Article References:
Hébert, M., Daspe, M.-È., & Cyr, M. (2018). An analysis of avoidant and approach coping as mediators of the relationship between paternal and maternal attachment security and outcomes in child victims of sexual abuse. Psychological Trauma: Theory, Research, Practice, and Policy, 10(4), 402–410.
Sætren, S. S., Augusti, E.-M., & Hafstad, G. S. (2021). Affective inhibitory control and risk for internalizing problems in adolescents exposed to child maltreatment: A population-based study. Journal of Abnormal Psychology, 130(2), 113–125.
Shevlin, M., Murphy, S., Elklit, A., Murphy, J., & Hyland, P. (2018). Typologies of child sexual abuse: An analysis of multiple abuse acts among a large sample of Danish treatment-seeking survivors of childhood sexual abuse. Psychological Trauma: Theory, Research, Practice, and Policy, 10(3), 263–269.
Sousa, C., Mason, W. A., Herrenkohl, T. I., Prince, D., Herrenkohl, R. C., & Russo, M. J. (2018). Direct and indirect effects of child abuse and environmental stress: A lifecourse perspective on adversity and depressive symptoms. American Journal of Orthopsychiatry, 88(2), 180–188.
QUESTION
18
What are the three categories of insecure attachments with abused adolescents?
Record the letter of the correct answer the .
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