Laura Wood, MA, LPC, RDT
& Mike Rechtien, MA, PLPC
On Fridays at Castlewood Treatment Center clients participate in a three hour group led by Laura Wood and Mike Rechtien called Attachment-Expressive. The goal of this group is to combine cognitive and expressive therapies to facilitate client’s movement from dismissive and preoccupied forms of attachment to secure attachment as measured by the Adult Attachment Interview (AAI). Attachment styles are, essentially, strategies we learn as children as a means to getting our needs met. Often clients with eating disorders have learned attachment strategies that worked well as a child as a means of survival, but now negatively affect their lives and relationships and directly correlate with their eating disorder.
Because attachment work is complex, expressive therapies are used as a way of helping clients explore the many facets of their strategies. There is an increasing amount of literature being published on the efficacy of creative/expressive arts therapies; specifically on the use of creative arts therapy interventions in combination with traditional talk therapy methods (Ziff & Beamish, 2004).
In our work we use a variety of the creative arts therapies, with a main focus on the use of drama therapy-expressive based work. Drama processes inherently allow the depth and breadth of one’s inner experience to be actively explored. It promotes changing behavior, skill-building, integration of feelings and personal growth. Expressive work allows the client to examine the very attachment issues that they experience, rather than just learning about it didactically. Additionally, expressive work also fosters clients to be connected to the body and enter into the here- and- now and activates the attachment system in the brain so the change process can begin.
The group begins each week by looking at a different attachment style or concept and first helps clients broadly understand the idea. From there, clients then use expressive work to explore the concept in relationship to their own life and experiences and move the work from the cognitive realm to that of the affective.
The idea is to take the following concepts (which are indicative of attachment difficulties for specific clients) and show them, in front of the group, the ways in which their information processing has been injured.
Loving Behavior: The dedication of the parent to the development of the child as an individual which allows the child to have a process of unfolding to become who they are, rather them molding them into whom they ‘should’ be.
Rejection: When the child comes to the parent with tender or vulnerable feelings and is made to feel bad about her expression of them.
Neglect: The parent is available physically but unavailable emotionally.
Involving Behavior: Involving behavior is when the parent uses the child’s attachment system to become the object of child’s attention.
Role Reversal: The child takes on roles or responsibilities that are the parents
Loving behavior, rejection, neglect, involving behavior and role reversal are concepts that result in the child developing the following strategies (or lack thereof) as a way of relating and coping in the world:
Idealization: Discrepancy between overall picture or presentation of parent at an abstract or semantic level, and the “actual” behavior of the parent when recounting specific passages from memory.
False Self: Externally constructed representation of what is perceived by the child that gains approval and positive response from attachment figures.
Mentalizing and meta-communication: The ability to hold “mind in mind.” One’s process of honoring and holding and understanding their own point of view, opinion or feelings about something in their life; while being able to think and feel or be curious about how another person feels about the same situation or experience.
Coherence of Narrative: The strongest indicator that an adult will produce a securely attached infant. This scale scores the ability of the speaker, while telling their story, to adhere to society’s implicit rules of conversation – truthfulness, quantity, relevance and manner. This indicates ease with the topic as well as freshness of speech – an ability to think in the moment and gain new insights even while speaking about past history.
In a recent group clients explored the concept of role reversal. Here is a section from the Attachment/Expressive Modules as written and led by Laura Wood and Mike Rechtien.
Concept: Involving Behavior
Involving behavior is when the parent uses the child’s attachment system to become the object of the child’s attention. This is usually not intentional, but sometimes it is, and at the highest level it becomes a form of role reversal. When the parent engages in involving behavior the child learns that his/her emotional display has a negative effect on the parent as well as consequences for the child. This reaction is internalized and serves to make the child feel responsible for the parent’s experience.
From this one learns is to dismiss their own feelings and to feel the feelings of the other. This imposed behavior by the attachment figure misuses the god/evolution given empathic abilities or qualities of the child for the benefit of the parent. In healthy attachment, the parent would model empathy and compassion for and towards the child so it learns self love and compassion before and while it learns the same for others. Without this initial period of self love and self care, the ability to love others from a healthy ego is stunted. Involving/Role Reversal is a way of shaming/ridding the child of its survival-necessary narcissistic tendencies too quickly in its developmental process. It involves the child in the business and affairs of the adult’s emotions when exactly the opposite should be happening. This is a learned attachment strategy – the child learns to ignore its own natural instincts to focus on the emotional (or physical or sexual) needs of the adult in order to get its own needs for comfort and safety met. These behaviors, on the part of the attachment figure, lead the child into lifelong dysfunctional relationships marked by enmeshment, caretaking and codependency.
Involving anger is the reason that when something happens in relationship, all the past hurt comes in and it feels as if it is a continuation of what always happens. Involving anger often sounds like “you always do…” or “you never understand…” Often this anger gets displaced/re-enacted on relationships in the present and is a marker of unresolved early attachment dysfunction.
Once the clients have a sense of the concept the expressive work looks something like this:
Remember and Resolve to stop the Re-enactment
1. Revisit – a scene from more recent adult life with an attachment figure (someone you care about, have emotions that could become vulnerable around) where a disproportionate amount of anger arose within you, seen in what you said or what you thought in the moment.
2. Reinterpret (the anger) – break the scene down, view it in slow motion and identify the origin of the involving anger. Attend to the angry feelings as well as the injured feelings that are present.
3. Reevaluate the actions and intentions of the parties in the present scene from this new metacognitive perspective.
4. Release –Allow a scene to be created in where the anger can be directed toward the person responsible for the original injury.
5. Rewrite the script in coherent and collaborative form and read it aloud.
6. Revise – imagine a scene in the near future where involving anger could invade the scene and role play it.
7. Reintegrate – act out the scene with a safe and appropriate reaction while still validating the feelings activated from the past.
Mark Schwartz, Sc.D, Lori Galperin, LCSW, Laura Wood, LPC and Mike Rechtien, PLPC will be lecturing at various places this fall on this very topic. Visit the Castlewood website for more information.