Treating Attachment Disorders From Theory to Therapy

by Brisch, Karl Heinz; Kronenberg, Kenneth

• ISBN13: 9781593850449
• ISBN10: 1593850441
• Edition: 1st
• Format: Paperback
• Copyright: 2004-05-04
• Publisher: The Guilford Press

Summary

Attachment theory and research have greatly enhanced our understanding of the role of parent-child relationships in the development of psychopathology. Yet until now, little has been written on how an attachment perspective can be used to actively inform psychotherapeutic practice. In this invaluable work, Karl Heinz Brisch presents an attachment-oriented framework for assessing and treating patients of all ages. Rich, extended case examples form the core of the book. Demonstrated are the ways attachment-oriented interventions can effectively be used to treat a wide range of patients: couples trying unsuccessfully to conceive, women with severe postpartum depression, children and adolescents with behavioral and emotional disturbances, adults with relationship difficulties and work problems, and others. Applications in short- and long-term psychotherapy are discussed, as well as use of the model in such other contexts as prevention in infant mental health, family therapy, and group work. A vital resource for practitioners, this book is also a compelling text for graduate-level psychotherapy courses.

Author Biography

Karl Heinz Brisch, MD, is a child and adolescent psychiatrist and psychotherapist, as well as an adult psychiatrist and neurologist; a training psychoanalyst at the Psychoanalytic Institute; and head of the Department of Pediatric Psychosomatic Medicine and Psychotherapy at the Children's Hospital at the Ludwig-Maximilians-University of Munich, Germany. Dr. Brisch's primary research is on the development of infants and children with high-risk conditions and the development of attachment and its disorders. He has led longitudinal research projects on attachment disturbances and early psychotherapeutic interventions. He is a member of the World Association of Infant Mental Health and of the Society for Research in Child Development.

Table of Contents

Acknowledgments to the English Edition	xiii
Acknowledgments to the German Edition	xv
Foreword	xvii
Lotte Köhler
Preface	xxiii
Introduction	1	(6)
Section I. Attachment Theory and Its Basic Concepts	7	(48)
Historical Overview	7	(7)
The Development of the Concepts of Attachment Theory	14	(41)
Basic Assumptions of Attachment Theory	14	(6)
The Concept of Sensitivity	20	(4)
The Concept of Attachment Quality in Children	24	(2)
The Classification of Infant Attachment Quality	26	(3)
Correlations of Strange Situation Behavior with Other Variables	29	(1)
The Concept of Attachment Representation	30	(5)
Attachment across Generations and throughout the Life Cycle	35	(4)
The Significance of Protective and Risk Factors	39	(2)
Attachment and Separation in Other Psychotherapeutic Schools	41	(14)
Section II. Attachment Disorders	55	(18)
Attachment and Psychopathology	55	(3)
The Theory of Attachment Disorder	58	(4)
Attachment Classification in Diagnostic Manuals	62	(2)
The Diagnosis and Typology of Attachment Disorders	64	(9)
No Signs of Attachment Behavior	65	(1)
Undifferentiated Attachment Behavior	66	(1)
Exaggerated Attachment Behavior	67	(1)
Inhibited Attachment Behavior	68	(1)
Aggressive Attachment Behavior	68	(1)
Attachment Behavior with Role Reversal	69	(1)
Psychosomatic Symptoms	70	(3)
Section III. Attachment Therapy	73	(14)
Therapeutic Theory	73	(3)
Treatment Technique	76	(11)
General Considerations for Adult Psychotherapy	76	(4)
General Considerations for Child and Adolescent Psychotherapy	80	(3)
Special Considerations	83	(4)
Section IV. Treatment Cases from Clinical Practice	87	(152)
Manifestations of Attachment Disorders Prior to Conception	87	(9)
The Unfulfilled Desire for Pregnancy-Fear of Attachment to the Fantasized Child	87	(9)
Prenatal Attachment Disorders	96	(19)
The Pregnant Mother's Fear That Imminent Birth May Dissolve Her Attachment to the Child	96	(7)
Complications in Pregnancy and High-Risk Pregnancies	103	(6)
The Diagnosis of Prenatal Abnormalities	109	(6)
Postnatal Attachment Disorder	115	(15)
The Mother with Postpartum Depression	115	(6)
The Mother with Postnatal Psychosis	121	(6)
The Trauma of Prematurity	127	(3)
Attachment Disorders in Childhood	130	(33)
No Signs of Attachment Behavior	131	(6)
Undifferentiated Attachment Behavior	137	(5)
Exaggerated Attachment Behavior	142	(5)
Inhibited Attachment Behavior	147	(2)
Aggressive Attachment Behavior	149	(4)
Attachment Behavior with Role Reversal	153	(2)
Psychosomatic Symptoms	155	(8)
Attachment Disorders in School-Age Children	163	(14)
School Phobias	163	(7)
Underachievement	170	(3)
Aggressiveness	173	(4)
Attachment Disorders in Adolescence	177	(21)
Addictive Symptoms	177	(6)
Antisocial Behavior and Delinquency	183	(6)
Neurodermatitis	189	(9)
Attachment Disorders in Adults	198	(37)
Panic and Agoraphobia Symptoms	198	(10)
Depressive Symptoms	208	(6)
Narcissistic Symptoms	214	(6)
Borderline Symptoms	220	(6)
Psychotic Symptoms	226	(5)
Depression in Old Age	231	(4)
Summary	235	(4)
Section V. Prospects for Further Application	239	(12)
Family Therapy	244	(1)
Group Psychotherapy	245
Education	146	(101)
Critical Issues	247	(4)
Afterword	251	(6)
Inge Bretherton
Appendix: Brief Précis of the Adult Attachment Interview Protocol Excerpted from George, Kaplan, and Main (1996)	257	(2)
Notes	259	(6)
References	265	(20)
Index	285