Attachment, autonomy, intimacy: some clinical implications of attachment theory.
This paper reviews the origins and current state of attachment theory, especially as relevant to the practice of psychotherapy. It is suggested that attachment experience becomes internalized as self-narrative around the age 3-5, and that these self-narratives form the basis of reflexive self-function and autobiographical competence in later life, as revealed by the Adult Attachment Interview. It proposes that the fundamental aims of psychotherapy can be characterized as the search for intimacy and autonomy, arising on the basis of parental attunement and containment of healthy protest, of which analogues are to be found in adult psychotherapy. A 'triangle of attachment' is introduced at whose apices are attachment, detachment and 'non-attachment' respectively. Attachment, which arises out of a secure base, provides the starting point for intimacy; the capacity for healthy protest and therefore detachment is the basis of autonomy; from non-attachment comes the capacity to reflect on oneself and so to disidentify with painful or traumatic experience.
Holmes
J
J
Department of Psychiatry, North Devon District Hospital, Barnstaple, Devon, UK.
D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005610:Freedom; D049673:History, 20th Century; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009769:Object Attachment; D011572:Psychoanalysis / Q000266:history; D013811:Psychotherapeutic Processes; D011613:Psychotherapy / Q000379:methods*