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  • 0 P004 New Perspectives on Practice: The Great Attachment DebateP004, Attachment, Session 3, Dan Siegel 04.28.2011 11:02
    I have followed with a great deal of interest the Great Attachment Debate to date. Thank you for putting it on. I was very pleased to hear Dan Siegel’s remarks, and I was pleased that he so effectively rebutted the comments of Dr. Kagan. I had thought of writing my own rebuttal, but I found that Dr. Siegel’s remarks rendered them moot, for the most part.
    Though I was trained and practiced for 18 years in the U.S., I find that I have perhaps more of a European perspective today, since I live and work in London. I agree that Dr. Van IJzendoorn’s research is certainly excellent, important, and considerable. His meta-analysis I think puts paid to any questions regarding the validity and reliability of the AAI as an assessment instrument.
    On the other hand, there the trail seems to run cold. There has been much valuable research and reporting with regard to memory systems, brain function, and so on. For example, see Joseph leDoux’s wonderful books, The Emotional Brain and The Synaptic Self, which provide, so far as I can tell – and I am not a researcher, but a mere clinician – excellent support for the entire attachment approach. This includes reports of very important research which shows that even though memory may not be accessible via explicit memory systems, it is accessible via implicit memory, which does give us access to the hidden and forbidden content of the avoidant attachment style and indeed of any attachment style from those preverbal days of infancy and early childhood. Thus we can have access to the workings of the unconscious mind.
    The problem it seems to me is the validity of the assumptions on which the Mary Main model of attachment is founded. Here I found the research going off in all directions, so I think that Dr. Kagan made a valid point about the difficulties with attachment research, in the U.S.A. I have added the emphasis because there is another model of understanding attachment that has unfortunately been marginalized in the U.S. through methods which one may perhaps gain an insight into in Candace Pert’s most excellent and entertaining autobiographical book, Molecules of Emotion. But I digress.
    In my desire to learn more about attachment and the discrepancies that I was finding, I located Dr. Patricia Crittenden, and since then I am happy to say that I have learned more than I ever thought that I needed to know about her Dynamic Maturational Model (DMM) of Attachment. I have also learned a great deal more about the ABCD model.
    One of the things that did not make sense for the Mary Main, or ABCD model, is that a particular attachment style should remain constant for three generations. That is could, e.g. an anxious or preoccupied attachment style from grandmother to mother to child, is certainly possible. That it must is contradicted by both common sense and practical, i.e. within my practice, experience. The second anomaly, assuming for the sake of this argument the existence of a “D” (or “U”) category, is that any clients with unresolved loss or trauma must be assigned to this category, which I think was a part of what Dr. Siegel was saying. In my experienced unresolved loss and trauma can occur in any of the categories. But that may not be precisely what he was contending.
    In Dr. Crittenden’s DMM attachment approach, which uses a modified form of the AAI, there is a much more elaborated schema for classification. In the first place, she returns to the original designations used by Mary Ainsworth of A, B, and C, and gives them a nominal designation of Avoidant, Balanced and Coercive, which is certainly a lot simpler to understand than the use of designations such as D, E, F, and U, especially when those letter designations are neither consistently indicative of the nominal classification nor are they in the same relative order as that used in the original Ainsworth schema.
    In addition, Dr. Crittenden divides her category of B, or Balanced (meaning secure, but also denoting the balanced use of cognition and affect in information processing) further into 5 sub-categories ranging from that closest to Avoidant to that closest to Coercive. She also divides both the Avoidant and Coercive categories into 8 sub-categories which range, in a circular configuration from the 1 designation meaning closest to Balanced to the 8 which is closest to the final category of Psychopathy, though numbers 7 and 8 of both Avoidant and Coercive contain elements of serious psychopathology.
    In addition, the designations of unresolved loss, unresolved trauma, disorganization, disorientation and depression are used as modifiers of the main strategy.
    Even further in differentiation, attachment strategies may vary according to attachment figure, and of course it can vary over time, and ought to for our clients in therapy. I may further add in my own observation that attachment can vary according to circumstance. As one of my clients put it, as we were doing her Attachment Centred Therapy based on her AAI, “I use the same strategy with my mother [Avoidant, and her mother seems to be Coercive] that my husband uses with me, and it drives me crazy when he does it to me, but I do the same thing to her.” And of course she uses a Coercive strategy with her husband.
    Finally, I disagree with Dr. Siegel’s statement regarding the informal use of the AAI, as I understand it. Although I did start out using it that way, since I have taken Dr. Crittenden’s training in the administration and analysis of the AAI in her modified format, I find that the formal administration of the AAI, with transcription and then coding of the discourse markers, puts me light years ahead of where I was in working with my clients in the informal way.
    We still have a long way to go. For example, I believe there is a third dimension to categorization that has not yet been addressed, in addition to avoidance and anxiety. Regardless, for those who wish to take a more wide-ranging and inclusive view of the world and the possibilities within, I can recommend that they go beyond the parochialism of the currently limited model available to those of you in the U.S., and investigate Dr. Crittenden and colleagues’ exposition, on a world scale, of the DMM, Dynamic Maturation Model approach to Attachment.

    Charley Shults
    London

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