Establishing An Adult Patient’s Attachment
Mary Main, a developmental psychologist, searched for representational artifacts in her adult patients that harked back in part to the style of linguistics used by the parents of her patients. Main reasoned that an individual’s working model of attachment would be revealed in characteristic patterns of narrative, discourse, and imagination, as well as behavior.
The AAI asks individuals to recollect and reflect upon the history of their relationships with their own parents, including experiences of loss, rejection, and separation. This semi clinical interview has proven to be a powerful tool for assessing attachment in infancy with adult patients.
The AAI cannot be conducted on the basis of this brief, modified précis of the protocol, which omits several questions as well as the critical follow-up probes. The full protocol, together with extensive directions for administration, can be obtained by writing to Professor Mary Main, Department of Psychology, University of California at Berkeley, Berkeley, CA 94720. Rather this brief interview will help the therapist establish state of mind of the patient.
THE ADULT ATTACHMENT INTERVIEW
1. To begin with, could you just help me to get a little bit oriented to your family – for example, who was in your immediate family, and where and whom did you live?
2. Now I’d like you to try to describe your relationship with your parents as a young child, starting as far back as you can remember.
3 – 4. Could you give me five adjectives or phrases to describe your relationship with your mother/father during childhood? I’ll write them down, and when we have all five I’ll ask you to tell me what memories or experiences led you to choose each one.
5. To which parent did you feel closer, and why?
6. When you were upset as a child, what did you do, and what would happen? Could you give me some specific incidents when you were upset emotionally? Physically hurt? Ill?
7. Could you describe your first separation from your parents?
8. Did you ever feel rejected as a child? What did you do, and do you think your parents realized they were rejecting you?
9. Were your parents ever threatening toward you – for discipline, or jokingly?
10. How do you think your overall early experiences have affected your adult personality? Are there any aspects you consider a setback to your development?
11. Why do you think your parents behaved as they did during your childhood?
12. Were there other adults who were close to you – like parents -as a child?
13. Did you experience the loss of a parent or other close loved one as a child, or in adulthood?
14. Were there many changes in your relationship with your parents between childhood and adulthood?
15. What is your relationship with your parents like for you currently?
The Concept of Metacognitive Knowledge And How It Relates To State of Mind
Metacognitive knowledge centrally involves the ability to grasp what cognitive scientists call the appearance-reality distinction, without which it is impossible to realize that our ideas and perceptions may be without validity, or that others may believe things that are not true. For example, a person’s belief that another person is “stupid.” The concept and capacity of metacognitive knowledge allows a person the capacity to reason that this sort of belief can sometimes simply be untrue. To the extent that our patients are unaware of the “fallible nature of knowledge” their desire as well as their ability to reflect on their experience tends to be limited. For example, a patient recently made an unequivocal assertion that seemed quite implausible. When the therapist expressed curiosity about his conviction, the patient said it simply felt true. Then added decisively, as if this should be the last word on the subject, “Aren’t feelings the ultimate facts?”
With a functioning capacity for metacognition, we may for the moment find ourselves in a particular state of mind; lacking such a capacity, it’s as if we simply are that state of mind.
As therapists, our own capacity for metacognitive understanding of both partners in the therapeutic couple is crucial in enabling our patients to change. For it is this kind of understanding that allows us to respond reflectively, rather than reflexively – that is, to be able to consider the complex meanings of feelings, beliefs, and wishes rather than take them, immediately and unquestioningly, at face value.
It is therefore crucial to establish the connection between language communication toward the child and that child’s attachment. “Knowing that language can conceal as much as it reveals – and that internal representations are largely unconscious, hence unverbalizable – Mary Main concentrated her attention on the particular ways the parents in her study used words, rather than the particular words they used: That is, she focused more on process and form than on content. It is specifically this approach to understanding the representational world – through attention primarily to how, rather than what, people communicate – that has made her work with the AAI invaluable to clinicians.”
So when we use language as a tactical force to control our children we may be creating unconscious fantasies in the minds of these little children. When we make children feel “stupid” “unlovable” “unworthy” or we don’t give them the sense of validation they deserve, we are in effect creating a young adult who will grow-up harboring these same kinds of feelings, feelings of being inadequate and/or accepting less than what they truly deserve (For example: tolerating abuse, neglect, and disrespectful behavior from others as well as themselves). They may repeat negative self-affirmations that are not true like “I am ugly.” These feelings are not part of a functional productive psyche and may hinder the adult child‘s successes. As children acquire anxieties about themselves in childhood and create representational ideas about themselves that remain in large part fixed in their unconscious minds, they may fall victim to a dark malignant force. The AAI is a tool clinicians use to help unravel the mysteries of their patient’s unconscious life.
Source:
Wallin, David J. Attachment In Psychotherapy. New York. Guilford Press. (2007)
Additional Contact Information:
Mary Main, Ph.D.
Department of Psychology
Room 3210, Tolman Hall #1650
University of California, Berkeley
Berkeley, CA 94720-1650
Phone: 510-642-5292
Fax: 510-642-5293
Email: psychadmin@berkeley.edu
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