What About Me? Sibling Play Therapy When a Family Has a Child With Chronic Illness
Lawrence C. Rubin in Handbook of Medical Play Therapy and Child Life, 2017
Chronic illness can isolate family members from each other as well as from supportive relationships beyond the family. Debilitating pain, extended healing time, intensive treatments, and concerns about infection and compliance with treatment regimens can all contribute to this isolation. There may be fears of infection, or culturally reinforced beliefs about illness and disability that limit contact. The regular routines of family life that reinforce strong attachment can be disrupted and ambivalent attachment bonds can be challenged. Siblings may be separated due to hospitalizations, specialized treatments away from home, or the reluctance to interact due to not knowing how to be helpful and supportive. Children with the chronic illness can be protective of their siblings, not wanting to burden or worry them, while healthy siblings may not be as quick to share their successes, not wanting to make the sibling who is ill feel left out of those positive events. Competition for limited parent/caretaker time and energy can lead to jealousy for any of the siblings who see the other as having more attention and support. Fredrickson (2001, 2004) described how negative emotions from these events can lead to fight, flight, or freeze responses that can reduce siblings’ abilities to take alternate views of a situation, initiate positive actions, or mobilize personal strengths.
Tangled Minds
Alexandra E. Schmidt Hulst, D. Scott Sibley in Contextual Therapy for Family Health, 2018
There are various systemic theories that describe ways in which anxiety is influenced by and influences family systems. Attachment theory, foundational in emotionally focused therapy, proposes that insecure attachments fuel relationship distress and conflict (Johnson, 2004), where partners or family members are deeply worried about whether their loved ones will meet their emotional needs and respond in a way that seeks to build intimacy and connection. These emotional fears and the chronic conflict or distance that accompany them often present as individual anxiety symptoms. In another example, Priest (2015) used Bowen family systems theory to frame research findings that individuals who had been exposed to family abuse and violence were more likely to report symptoms of generalized anxiety disorders (GAD) and romantic relationship conflict. In that study, individual differentiation—an ability to remain emotionally present with others while also reacting autonomously—helped to mediate the effects of family abuse and violence on GAD symptoms.
Attachment-Based Psychotherapies for People with Acquired Brain Injury
Giles N. Yeates, Fiona Ashworth in Psychological Therapies in Acquired Brain Injury, 2019
Within this new direction for brain injury services as a whole, psychotherapy has acquired a key role: to facilitate individual and family adjustment from a relational point of view. This new emphasis has led clinicians to reconsider old theoretical formulations that had as a main tenet the relevance of attachment history, as well as to explore newly developed psychotherapy intervention that explicitly draw on attachment theory in both formulation of survivor difficulties and specific therapy techniques. These attachment-informed therapies prioritise both emotion and relationships, including the intrapersonal ‘old me-new me’ relationship and the relationship between survivor therapists and rehabilitation team, and bring these dimensions to bear on all material that a survivor shares about their lives and difficulties post-injury. Intervention techniques employed in these models are characterised by an intense focus on explicit and implicit relating and emotional patterns within the therapy room and closely following the timing of the therapeutic dialogue. In this section we will present two examples of individual and couples therapy interventions informed by attachment theory.
Attachment Style and Risk of Suicide Attempt Among New Soldiers in the U.S. Army
Published in Psychiatry, 2022
Jing Wang, James A. Naifeh, Holly B. Herberman Mash, Joshua C. Morganstein, Carol S. Fullerton, Stephen J. Cozza, Murray B. Stein, Robert J. Ursano
Attachment theory was first proposed by Bowlby (Bowlby, 1969) to describe the emotional attachment between infants and their primary caregivers. Distinct attachment styles were later conceptualized and extended to measure and examine emotional ties in adult relationships (Ainsworth et al., 2015; Hazan & Shaver, 1987). For example, the attachment self-report (ASR) scale was developed to assess three attachment styles: secure, anxious-ambivalent, and avoidant attachment, with the latter two styles representing insecure attachment (Hazan & Shaver, 1987). Applying two internal working models concerning the view of self and others (Bowlby, 1973), these were expanded to four distinct styles of attachment: secure, preoccupied, fearful, and dismissing (Bartholomew & Horowitz, 1991). Whereas preoccupied attachment is analogous to the anxious-ambivalent attachment, dismissing and fearful attachment reflect two different forms of avoidance attachment. Specifically, dismissing attachment reflects a form of avoidance that is rooted in a positive view of self and a desire for independence, while fearful attachment reflects a form of avoidance that is rooted in a negative view of self and a feeling of vulnerability.
Emerging Adult Women’s Views-of-Self in Intimate Partner Relationships That Are Troubled
Published in Issues in Mental Health Nursing, 2019
Allison McCord Stafford, Claire Burke Draucker
A common way that romantic views-of-self have been conceptualized is through attachment orientations (Furman & Simon, 2006). Adult attachment theory suggests that persons who have early caregivers who provide nurturing and consistent care develop secure attachment orientations; as adults, these individuals are able to comfortably balance personal independence and dependence on partners for intimacy and support (Bonache, Gonzalez-Mendez, & Krahé, 2017; Burk & Seiffge-Krenke, 2015). Persons who have early caregivers who provide detached or inconsistent care develop insecure attachment orientations; as adults, these individuals have difficulty balancing needs for independence and intimacy (Burk & Seiffge-Krenke, 2015). In EAs, conflict, aggression, and violence in romantic relationships have been associated with insecure attachment (Bonache et al., 2017; Burk & Seiffge-Krenke, 2015; Furman & Simon, 2006). No studies, to our knowledge, have explored how EA women in troubled relationships describe how they view themselves in the context of their relationships and what these descriptions might reveal about how insecure attachment orientations could contribute to the relationship troubles they experience.
Perceived Social Support Mediates the Negative Impact of Insecure Attachment Orientations on Internalized Homophobia in Gay Men
Published in Journal of Homosexuality, 2021
Vincenzo Calvo, Maria Cusinato, Natasha Meneghet, Marina Miscioscia
Attachment representations may also affect internalized homophobia indirectly, with the mediating role of perceived social support. Previous literature indicates that individuals’ attachment orientations influence and shape their perception of the quality and quantity of the support they receive from significant others (Collins & Feeney, 2004). Studies in the field of attachment theory have shown that secure attachment is associated with a stronger perception of the availability of support, whereas insecure attachment orientations tend to reduce the perceived quantity and quality of the support received from social and relational sources (Calvo & Bianco, 2015; Mikulincer & Shaver, 2007). Recipients of support contribute significantly to their support experiences in various ways, which include how they mobilize (or fail to mobilize) support, and how they cultivate mutually-supportive relationships with others (Collins & Feeney, 2004).
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