Attachment and Trauma in Object Relations Family & Couple Therapy Family Therapy Institute of Firenze April, 2005 David E. Scharff, M. D. Jill Savege Scharff, M. D. International Psychotherapy Institute
Dec 27, 2015
Attachment and Trauma in Object Relations
Family & Couple Therapy
Family Therapy Institute of FirenzeApril, 2005
David E. Scharff, M. D.Jill Savege Scharff, M. D.
International Psychotherapy Institute
Affect Development and Therapy (Schore)
• Early right brain development• Entrainment• Importance of affect match and mis-
match in family & couple relationship
Attachment Theory (Bowlby, Ainsworth)
• Types:
Secure
Insecure - Resistant
Insecure - Ambivalent
Disorganized/Disoriented (Traumatic)
Attachment Theory (Bowlby, Ainsworth)
• Adult attachment (Main)
• Attachment in couplesMatching different attachment styles
Separations and reunions
Therapist and separation
Fonagy, Jurist, Gergely & Target2003
• Transformation of Attachment Theory to Theory of Growth of Mind– Mentalizing– Reflective Function– Interpersonal Interpretive Mechanisms– Regulation of Affect– Development of the Self
Evolutionary Function of Attachment
• Bowlby: Survival in the wild
• Fonagy et al: Building a mind that knows itself and others
Social Origin of Affect Regulation
• From Co-Regulation to Self-Regulation• Developmental Schema of Affect
Regulation– Co-Regulation: Marking, contingency, coupling
Marking as contingent and the same 0-3 months– Shift in infant’s preference at 3 months: Now wants Non-Contingent “Nearly the same,
but clearly not the same” response from mother– Mother down regulates negative affect
1st & 2nd Order Affects
• Tompkins, Ekman• Universal Primary Emotions: Happiness,
sadness, anger, fear, disgust, surprise– Recognizable from facial expressions, vocal
signs
• Secondary Affects– More complex, subtle – Shame, Pleasure, Envy, etc.
Genetics vs. Social Environment
• Previous Studies: Most variance due to genetic endowment
• Fonagy’s argument: Studies have use wrong environment. – The right environment is the early mental
interaction that grows a mind to filter and give meaning to experience
– Risk or protection for expression of genes– Example: Suomi’s ADD monkeys
Reflective Function in Childhood
• A control system• Psychic Equivalence• Pretend Mode• Playfulness and Alternate Views to
Child’s Own Mind• Trauma constricts playfulness and
increases prevalence of psychic equivalence
Playing with Pretend Mode
• Sensitization• Building Representations• State Regulation• Communication• Mentalizing
– Cognitive advances at Oedipal phase
Agency of the Self
• Physical – Somatization of Affect• Social• Teleological – about 1 year• Intentional – 18-24 months• Represenational/Autobiographical – 3-4
years
Playing with Reality
• Marking and Affect Mirroring• Marking of Non-Consequentiality• Decoupling from Reality• Empathy and Pretend Play• Importance of “False Belief”• Pretend Mode in Psychotherapy
Complex Attachments in Couples(Fisher & Crandell 2001)
• Secure & Secure
• Secure & Insecure:
Preoccupied Man & Secure Woman
Preoccupied Woman & Secure Man
• Dismissive & Dismissive
• Preoccupied & Preoccupied
• Good
Relationship
• At Risk
• Low Risk
• Low Risk
• At Risk
Attachment & Psychoanalytic Therapy
• Verbal Exchange is also Exchange of Affect
• Marking
• “Not for real” in pretend mode
• Attunement . . .
Attachment & Psychoanalytic Therapy (continued)
• Emotional regulation
• Sensitive pointing to internal states
• Establishment of 2nd order representations
• Adaptation & transformation of affect through externalization
Attachment & Couple Therapy
• Reading of one’s own and partner’s mind
• Regulation of affective states
• Transforming 1st Order into 2nd Order Affects
• Changing the dynamics of mirroring:– From escalations of augmenting the “same”
into down-regulation of “nearly the same, but clearly not the same.” . . .
Attachment & Couple Therapy (continued)
• Moving through Holding to Containment
• Using playfulness to move from psychic equivalence to pretend mode
• Increase Non-Consequentiality, De-Coupling
• Move from expressions in the body to increase couple’s reflective function . . .
Attachment & Couple Therapy(continued)
• Improve the Couple’s holding and containment to improve shared mentalizing
Attachment & AbuseBartholomew, Henderson & Dutton 2001
Risk of Being Abused
• Secure • Dismissing • Preoccupied • Fearful
• No Abuse• Leaves Abusive
Partner• At Risk• Lower Risk (unless
also Preoccupied)
Attachment & AbuseBartholomew, Henderson & Dutton 2001
Risk of Perpetrating Abuse
• Secure
• Dismissive
• Preoccupied
• Fearful
• Low Risk
• Likely to Leave
• Potential Violence/Abuse
• Not Demanding? Low Risk
Attachment & AbuseBartholomew, Henderson & Dutton 2001
Research Findings on Abusive Couples
• Preoccupied Men & Preoccupied Women (most common pattern)
• Preoccupied Men & Fearful Women (a stereotype of abuse)
• Fearful Men & Preoccupied Women (mutual abuse; more female perpetrators)
References
Clulow, C. (2001). Adult Attachment and Couple Psychotherapy. New York and London: Brunner/Routledge.
Fonagy, P., Gergely, G., Jurist, E., Target, M. (2003) Affect Regulation, Metalization, and the Development of the Self. New York: Other Press.
Scharff, D. E. and Scharff, J. S. (1991). Object Relations Couple Therapy. Northvale, NJ: Jason Aronson.
Scharff, J. S. and Scharff, D. E. (1998). Object Relations Individual Therapy. Northvale, NJ: Jason Aronson.
Scharff, D. E. and Scharff, J. S. (eds.) (In Preparation) Treating Relationships: Advances in Object Relations Couple and Family Therapy.