Treating Attachment Pathology


Book Description

This book rectifies a much neglected area in the conceptualization and treatment of attachment disorders. The interface between attachment, psychic structure, and character pathology has been largely ignored in the clinical literature until recent years, and when discussed, it has been generally relegated to the domain of child psychopathology. Because human attachment is such a basic aspect to motivation and adjustment, attachment disruptions in childhood color psychic development and often leave deep and enduring deficits in personality and adaptive functioning. The author shows that patients with attachment deficiencies and associated characterological vulnerabilities have fundamental structural deficits in personality organization that lie at the heart of our current understanding of disorders of the self. Offering the first comprehensive paradigm on the psychoanalytic treatment of adult and adolescent attachment disorders, Jon Mills argues that attachment pathology is a disorder of the self based on developmental trauma that predisposes patients toward a future trajectory marked by structural deficits, character pathology, and interpersonal discord that fuel and sustain myriad forms of clinical symptomatology. This pivotal work constitutes a treatise on the governing psychic processes of attachment on self-organization, adaptation, and conflicted intersubjective dynamics in non-childhood populations, and on the intervening relational parameters in treating their emergent clinical pathologies. Through conceptually astute technical strategies grounded in sold clinical practice, the author offers one of the most extensive and original frameworks in the psychoanalytic treatment of attachment disorders.




Attachment Issues in Psychopathology and Intervention


Book Description

To be a human being (or indeed to be a primate) is to be attached to other fellow beings in relationships, from infancy on. This book examines what happens when the mechanisms of early attachment go awry, when caregiver and child do not form a relationship in which the child finds security in times of uncertainty and stress. Although John Bowlby, a psychiatrist and psychoanalyst, originally formulated attachment theory for the express purpose of understanding psychopathology across the life span, the concept of attachment was first adopted by psychologists studying typical development. In recent years, clinicians have rediscovered the potential of attachment theory to help them understand psychological/psychiatric disturbance, a potential that has now been amplified by decades of research on typical development. Attachment Issues in Psychopathology and Intervention is the first book to offer a comprehensive overview of the implications of current attachment research and theory for conceptualizing psychopathology and planning effective intervention efforts. It usefully integrates attachment considerations into other frameworks within which psychopathology has been described and points new directions for investigation. The contributors, who include some of the major architects of attachment theory, link what we have learned about attachment to difficulties across the life span, such as failure to thrive, social withdrawal, aggression, anxiety, depression, bipolar disorder, dissociation, trauma, schizo-affective disorder, narcissistic personality disorder, eating disorders, and comorbid disorders. While all chapters are illuminated by rich case examples and discuss intervention at length, half focus solely on interventions informed by attachment theory, such as toddler-parent psychotherapy and emotionally focused couples therapy. Mental health professionals and researchers alike will find much in this book to stimulate and facilitate effective new approaches to their work.




Treating Pathological Narcissism with Transference-Focused Psychotherapy


Book Description

Filling a crucial gap in the clinical literature, this book provides a contemporary view of pathological narcissism and presents an innovative treatment approach. The preeminent authors explore the special challenges of treating patients--with narcissistic traits or narcissistic personality disorder--who retreat from reality into narcissistic grandiosity, thereby compromising their lives and relationships. Assessment procedures and therapeutic strategies have been adapted from transference-focused psychotherapy (TFP), a manualized, evidence-based treatment for borderline personality disorder. Rich case material illustrates how TFP-N enables the clinician to engage patients more deeply in therapy and help them overcome relationship and behavioral problems at different levels of severity. The volume integrates psychodynamic theory and research with findings from social cognition, attachment, and neurobiology.




Treatment of Personality Disorders


Book Description

It has been almost twenty years since DSM-III created a major shift in psychi atric classification procedures and in diagnostic and treatment practice by introducing the multi-axial system and, for our patients specifically, the Axis II: Personality Disorders. Researchers and clinicians were forced to focus on many issues related to the field of personality and its disorders. This meant an immense impetus for research, both empirical and theoretical. Many recent developments are described in this book, as reviews or as original articles. This book also covers developments in Europe as well as in North America. Important questions still remain unanswered, such as: What is the relationship between the different clusters: A, B, & C? Are we talking about dimensions, categories, or typologies? What can be done for patients who have more than one personality disorder? Is a pro typical approach required? Consequently, is a multiconceptual approach in treatment and research required? The authors contribute to this discus sion and provide guidelines for further thinking in research and treatment planning. For clinicians, it is of major importance to know whether the disorder can be influ enced by treatment, and whether permanent change is really possible. A very impor tant question is whether a person indeed has a personality disorder, and how this diagnosis affects clinical practice.




Psychodynamic Diagnostic Manual


Book Description

Now completely revised (over 90% new), this is the authoritative diagnostic manual grounded in psychodynamic clinical models and theories. Explicitly oriented toward case formulation and treatment planning, PDM-2 offers practitioners an empirically based, clinically useful alternative or supplement to DSM and ICD categorical diagnoses. Leading international authorities systematically address personality functioning and psychological problems of infancy, childhood, adolescence, adulthood, and old age, including clear conceptualizations and illustrative case examples. Purchasers get access to a companion website where they can find additional case illustrations and download and print five reproducible PDM-derived rating scales in a convenient 8 1/2" x 11" size. New to This Edition *Significant revisions to all chapters, reflecting a decade of clinical, empirical, and methodological advances. *Chapter with extended case illustrations, including complete PDM profiles. *Separate section on older adults (the first classification system with a geriatric section). *Extensive treatment of psychotic conditions and the psychotic level of personality organization. *Greater attention to issues of culture and diversity, and to both the clinician's and patient's subjectivity. *Chapter on recommended assessment instruments, plus reproducible/downloadable diagnostic tools. *In-depth comparisons to DSM-5 and ICD-10-CM throughout. Sponsoring associations include the International Psychoanalytical Association, Division 39 of the American Psychological Association, the American Psychoanalytic Association, the International Association for Relational Psychoanalysis & Psychotherapy, the American Association for Psychoanalysis in Clinical Social Work, and five other organizations. Winner--American Board and Academy of Psychoanalysis Book Prize (Clinical Category)




Attachment and Psychopathology


Book Description

This volume applies attachment theory and methods to extend our understanding and prediction of psychopathology. Studies of such populations as divorced mothers, chronically ill infants, Romanian adoptees, children of mothers with anxiety disorders, and boys with gender identity disorder reveal a variety of clinical implications and highlight issues for attachment theory. Chapters utilize research into a recently discovered form of attachment, the disorganized pattern, as well as new technologies for classifying attachment security beyond infancy. This book should be of interest to practioners, researchers, and students of clinical and developmental psychology, psychiatry, pediatrics, and social work, as well as other professionals concerned with human development.




Attachment Theory and Research in Clinical Work with Adults


Book Description

Written with the practicing psychotherapist in mind, this invaluable book presents cutting-edge knowledge on adult attachment and explores the implications for day-to-day clinical practice. Leading experts illustrate how theory and research in this dynamic area can inform assessment, case formulation, and clinical decision making. The book puts such concepts as the secure base, mentalization, and attachment styles in a new light by focusing on their utility for understanding the therapeutic relationship and processes of change. It offers recommendations for incorporating attachment ideas and tools into specific treatment approaches, with separate chapters on psychoanalytic, interpersonal, cognitive-behavioral, and emotionally focused therapies.




Psychodynamic Psychotherapy for Personality Disorders


Book Description

This book includes the work of 22 contributing writers in addition to the three primary authors, John F. Clarkin, Ph.D., Peter Fonagy, Ph.D., and Glen O. Gabbard, M.D. Each contributor has extensive clinical experience, and some also have research experience, with the assessment and treatment of specific personality disorders.




Attachment Theory and the Psychoanalytic Process


Book Description

Attachment theory, the brainchild of child psychiatrist and psychoanalyst John Bowlby, has begun to have a worldwide impact among clinicians within the last ten years. This interest marks a departure from the early fate of attachment theory. At first shunned by the psychoanalytic community, Bowlby's brilliant and groundbreaking effort to recast basic psychoanalytic concepts within system theories and a new, ethologically based model of the importance of affectional ties across the life span was taken up by a group of gifted developmental researchers. Empirical research not only tested and confirmed many basic propositions of attachment theory, but also extended Attachment theory in unexpected and creative ways. Bowlby was surprised and gratified by this turn of events, but also disappointed that his intended clinical audience has not taken the theory and run with it. This edited book is in part a testament to the fact that clinicians are beginning to do just that; they are taking Attachment theory and research creatively to examine clinical issues. In doing so, new vistas and hypothesis are being put forward showing that Attachment theory is alive and well. In this volume the editors gathered a distinguished group of clinician-scholars from around the world (Argentina, Italy, Mexico, UK, USA and Spain) to examine and extend Bowlby's legacy.The book should be of interest to clinicians regardless of their orientation. Attachment theory cuts across boundaries of clinical modalities-individual, group or family therapy-and orientations-psychoanalytic, cognitive or behavioural. The book should also be of interest to researchers who may find the heuristic value of clinical insights a valuable addition to the legacy of Attachment theory.




Attachment and Sexuality


Book Description

The papers featured in Attachment and Sexuality create a dense tapestry, each forming a separate narrative strand that elucidates different configurations of the relationship between attachment and sexuality. As a whole, the volume explores the areas of convergence and divergence, opposition, and integration between these two systems. It suggests that there is a bi-directional web of influences that weaves the attachment and sexual systems together in increasingly complex ways from infancy to adulthood. The volume’s unifying thread is the idea that the attachment system, and particularly the degree of felt security, or lack thereof in relation to early attachment figures, provides a paradigm of relatedness that forms a scaffold for the developmental unfolding of sexuality in all its manifestations. Such manifestations include infantile and adult, masturbatory and mutual, and normative and perverse. Also central to the papers is the idea that the development of secure attachment is predicated, in part, on the development of the capacity for mentalization, or the ability to envision and interpret the behavior of oneself and others in terms of intentional mental states, including desires, feelings, beliefs, and motivations. Topics discussed in the book will help to shape the direction and tenor of further dialogues in the arena of attachment and sexuality.