Castlewood Eating Disorder Treatment Center Blog

Attachment: Otherwise Known as Love

Guest Post by Tamara Blum, MSW, LCSW

In her book on case examples from her psychotherapy practice, Deborah Luepnitz (2002) paraphrases Arthur Schopenhauer’s fable on the dilemma of intimacy: A troop of porcupines is milling about on a cold winter’s day. In order to keep from freezing, the animals move closer together. Just as they are close enough to huddle, however, they start to poke each other with their quills. In order to stop the pain, they spread out, lose the advantage of co-mingling, and again begin to shiver. This sends them back in search of each other, and the cycle repeats as they struggle to find a comfortable distance between entanglement and freezing. (p.2) Attachment and Eating DisordersThis push-pull of seeking warmth and connection and the inevitable frictions that come with closeness is found to one degree or another in all human relationships. The desire is to manage the human condition of mortality by creating a life of shared meaning with a loved one. And so in all of us there are drives for emotional and physical intimacy. All too easily a relationship can become derailed by fear. Some of the ways this fear has shown up in my practice is “Will you leave me?” “Am I more important than your work?”  “Do you love me enough to  fill in the blank with:  control your anger? Care about the things that are important to me? Get well?” In order to understand adult love relationships, we need to start with understanding love from a child’s perspective. In a nutshell, Bowlby (1969) was the first to advocate for the emotional lives of children, that children have needs beyond the physical, needs for emotional attunement, empathy, warmth, and predictable loving responses from mothers (appropriate now to expand this to fathers as well). Bowlby termed this secure attachment- that the infant experienced the mother as a secure base and safe haven. It took psychological researchers until the mid-1980’s to begin to apply Bowlby’s work to adult love relationships. In treating adult couples, Susan Johnson (2008) refers to what Schopenhauer’s porcupines were doing as a couple’s dance. The aim is to look to a couple’s attachment histories and patterns of interactions within the relationship in order to help each person lean into the relationship, or preserve the safety of the relationship from an attachment perspective. So that when the question of, “Will you be there for me when I need you?” arises in the relationship, there is security in the answer. In addition to countering negative, destructive, reactive cycles within the relationship, Johnson (2002) highlights other goals of couples therapy, specific to trauma survivors:
  • a sense of safe emotional connectedness through easier communication.
  • an ability to respond to each other in a way that is cohesive, not divided, especially during intrusive symptoms such as flashbacks.
  • share the impact of the trauma with each other.
  • use the relationship as a source of comfort.
  • be a comfort to each other when attachment needs arise.
  • offer acceptance and reassurance to each other, directly countering the trauma experience. (p. 161)
One avenue towards greater self-understanding of your specific role in the “dance” you do with your partner is to take a closer look at the core beliefs, or schemas, underlying your thoughts and behaviors. Young (2003) defines schemas as core beliefs based on unmet emotional needs, usually leftover from our childhoods. Young, Klosko, and Weishaar (2003) lay out these needs: 1. Secure attachments to others (includes safety, stability, nurturance, and acceptance) 2. Autonomy, competence, and sense of identity 3. Freedom to express valid needs and emotions 4. Spontaneity and play 5. Realistic limits and self-control (p. 10) So schemas, which arise from the unmet needs listed above, often lead to maladaptive coping responses- what may have been adaptive at the time of the injury or unmet need usually does not serve us well in our adult love relationships. For example, someone living with core beliefs based on a Mistrust/Abuse Schema learned (adaptively) as a child that it was safer to be self-reliant than to trust the Adult Attachment Figure, the perpetrator (in this schema) of abuse. That child, now grown, may avoid becoming vulnerable and trusting their life partner; they may become a keeper of secrets; they may choose any one of a number of barriers to intimacy- self-protective behavior that no longer serves either self-interest or the interest of the relationship. So what is a well-intentioned but struggling person to do about all of this? There are many pathways to healing ourselves and our relationships. It can be helpful to identify your core beliefs and to trace each core belief back to its origins in order to heal it, using imagery or Internal Family Systems. Traditional therapies like Cognitive Behavioral Therapy (CBT) can be helpful too, but evidence suggests more effective therapies are ones that tap into our affective experience, as in the case of CBT-Enhanced (Dancyger & Fornari, 2009). We hold our memories emotionally, not cognitively, so if we are to find healing on a deep level, it is the emotional/affective part of the brain we need to be engaging. With practice, the hope is to work towards the skill of mentalization- that is to step out of the heated interaction or hot emotion, and just notice what is happening within yourself, remembering the core belief that is being activated, and choosing a new, healthier, more empowered, more compassionate (to Self and others) response. This is taking a healthy risk towards greater intimacy within your relationships and a happier, more peaceful experience of living.  References:  Bowlby, J. (1969). Attachment and loss: Vol 1. Attachment. New York: Basic Books. Dancyger, I.F. & Fornari, V.M. (2009) Evidence-Based Treatments for Eating Disorders:         Children, Adolescents, and Adults. New York: Nova Science Publishers, Inc. Johnson, S. (2002). Emotionally Focused Couple Therapy with Trauma Survivors:         Strengthening Attachment Bonds. New York: Guilford Press. Johnson, S. (2008). Hold Me Tight: Seven Conversations for a Lifetime of Love. New York: Little Brown & Co. Luepnitz, D. (2002). Schopenhauer’s Porcupines. Basic Books: New York. Young, J., Klosko, J., & Weishaar, M. (2003). Schema Therapy: A Practitioner’s Guide. New York: Guilford Press. Tamara Blum, MSW, LCSW Tamara BlumMs. Blum is passionate about approaching therapy from a social work background. Her Master of Social Work comes from the Brown School at Washington University, where she specialized in Mental Health and Family Therapy. She has received post-graduate training in Emotionally-Focused Therapies and Internal Family Systems. In addition to specializing in the treatment of eating disorders, Ms. Blum also focuses on resolving trauma, improving relationships, and healing grief. Ms. Blum is an Adjunct Professor at Saint Louis University and Southern Illinois University Edwardsville, supervising graduate level social work students. She guest lectures frequently to graduate students on grief and loss and works in the Family Therapy Lab at Washington University. Recently, she also served as an advisor and presenter to the Cochlear Implant Research Advisory Committee. Ms. Blum maintains professional affiliations with the National Association of Social Workers (NASW) and the Missouri Society for Clinical Social Work.