June 2017 ByDr Dayal Mirchandani Inadequate nurturing in infancy can lead to insecure attachment patterns causing emotional and psychological problems in adulthood. However, a new therapy offers the hope of quick healing, says Dr Dayal Mirchandani Reena (35), a high-powered executive, perpetually got into difficult relationships. Her ex-boyfriends had variously cheated on her: they had physically abused her, borrowed money that was never returned, and even cut off all association with no explanation. It was only after one of her friends listed out all her short-term “loser” relationships, that she admitted she had a problem and agreed to therapy. In therapy Reena became much clearer about her own patterns. She realised that she would make excuses for the other person, ignoring the warning signs anyoneelse would easily have recognised. For instance, one of her ex-boyfriends would drink, claiming that this was only on weekends. It was only after he started borrowing money that she noticed how much he was spending on alcohol. Another had road rage, and would often mutter or make threatening gestures at other drivers. When she moved in with him she found that he was verbally abusive and could barely restrain himself from violence. Her most recent partner had been a 42-year-old who lived with his widowed mother. She heard he had broken off with a number of long-term partners after promising to marry them. Eventually, when she broached the subject of marriage he started to avoid her. Within a few sessions her therapist informed her that her relationship issues were caused by aninsecure attachment pattern. This probably dated back to infancy when she had been separated from her mother who developed tuberculosis, and had to be isolated for a few months. He explained that in the late 1940s the British psychiatrist Bowlby noticed that infants in orphanages failed to thrive. He noticed that these children had multiple caretakers, someone to clean, someone else to feed each shift. He suggested that each child be placed in the care of one nurse with whom they bonded and suddenly these children started gaining weight, smiling more, and appeared less miserable. The realisation of the importance of this bond led to changes in childrearing practice. Unlike earlier, even hospitals started admitting the mother along with a hospitalised baby especially in the first two years of life. Like all mammals, human infants are born with an instinct to bond with their mother, to ensure survival. Based on the quality of the maternal-infant bond during the first 30 months of life, the child develops a pre-verbal map of security in relationships. If the mother is nurturing and attuned to the needs of a child an inner map is built within the child that sees relationships as a source of nourishment and growth. This is known as secure attachment. A nurturing mother recognises a child’s distress and responds appropriately; soothes the child in ways that makes the child feel safe; is available and plays with the baby whenever it wants. On the other hand if the primary caregiver is unavailable due to depression; or is addicted to digital media or work; or is abusive or inconsistent, then the child develops insecure attachment. Three main patterns of attachment have been identified: Avoidant, Anxious and Disorganised. These children are more likely to be stressed, have psychological and academic problems, and are even at a higher risk of heart attacks, immune disorders, and even cancer in Insecure attachment types • Dismissing-avoidant: These individuals avoid close relationships, focus on themselves, are self-reliant, need a lot of space, find dealing with animals or things easier than dealing with people. They often report that their primary caretakers were not available due to depression, work or mental disturbances. • Anxiously preoccupied: Find it difficult to set boundaries or say no, focus on approval from others, find it difficult to say “No. They yearn to be in a relationship, overly concerned with others’ opinions, get upset and stressed if alone, often angry or upset if feeling ignored and will pick fights if partner is busy with work or others. • Disorganised: Make very poor partner choices, on the lookout for danger, with hair trigger responses, react especially with anger, controlling or inappropriately blaming. Often report very difficult childhood experiences such a violence or abuse. They have a high risk of addictive behaviour and personality disorders. adulthood. You can read about the harmful effects on health at https://acestoohigh.com In the 1980s two researchers, Cindy Hazan and Phillip Shaver of the University of Denver found that the patterns of adult romantic relationships were dependant on their attachment experiences as a child. The majority of adults (60 per cent) in America were securely attached, able to make good partner choices, and handled closeness and intimacy in a healthy manner. Disturbed emotional patterns in infancy create insecure adults with troubled relationships About 40 per cent of adults were insecurely attached due to unsatisfactory experiences with parental figures. (Box1). These individuals often have difficulty with relationships and make poor partner choices like Reena. Breakups are much more upsetting for them and in addition Fortunately, there has been a recentbreakthrough in the treatment of adultattachment disorders which integrates thebest of current practices with hypnosis they have a much higher risk of developing psychological disorders such as anxiety, depression or addictions and stress-related health issues. Worse still, children of such parents are at a much higher risk of developing similar patterns. We don’t have figures in India but we can expect similar percentages as in the US with the breakdown of the family and spread of consumer and digital culture. Sometimes it appears that the person has matured and outgrown these insecureattachment patterns, especially if they are in a committed long-term relationship with a secure partner. Even so, individuals with these insecure attachment would benefit from any practice that builds up their self-esteem and self-acceptance and enables them to feel safer in relationships. Till recently these insecure attachment patterns were difficult to treat. For one thing, these patterns were difficult to identify. Secondly, the issues arise from a pre-verbal stage of development which talking therapies do not address. Plus many of these individuals find it difficult to trust a therapist as they’ve been traumatised in relationships. In recent years a number of therapeutic methods have emerged, but in practice they are difficult to implement. Fortunately, there has been a recent breakthrough in the treatment of adult attachment disorders which integrates the best of current practices with hypnosis. Dr Daniel Brown, Ph.D., an associate Professor of psychology at Harvard Medical School, is a long-time Buddhist meditator who has even written two books in collaboration with HH the Dalai Lama. He has recently published a book, Attachment Disturbances in Adults: Treatment for Comprehensive Repair (Norton 2016), that details attachment disorders,their effects on the mind-body and his revolutionary approach to repairing this. The cornerstone of his approach is teaching the individual to use the Ideal Parent Figure (IPF) Imagery, where under hypnosis the patient repetitively evokes positive parental images that help them to feel seen, secure, loved and wanted. This helps the person repair their internal maps to that of being secure. In addition to this, Brown’s model develops meta-cognitive skills and collaborative behaviour with therapist and others. Once Reena was convinced about the nature of her relationship issues she set about “sorting herself out” with the same ferocity that had served her well at work. Talking to her mother and aunts, she discovered that her mother had not been functional for a year due to her tuberculosis and her aunts had each taken turns to come spend time and help with taking care of Reena. The early stage of therapy was focussed on helping Reena repair her attachment maps and build a secure base. With her therapists she developed an image of a new “mom” fully attuned, protective, never rejecting “available in just the right way” though her early childhood. Using this imagery under hypnosis and self-hypnosis, she experienced numerous interactions right from birth through her childhood with this Ideal mother. Asshe progressed with ideal parent imagery her therapy shifted to developing “metacognitive skills”, a greater awareness of negative beliefs, self-criticism, sense of self and developing greater insight into her own and others* states of mind. Within three months after beginning therapy she started dating a number of men and after a few months, progressed to a committed relationship with one of them. She reports that the relationship is comfortable and satisfying, very unlike her earlier relationships. While Dr Daniel Brown's method is not a self-help approach, it offers people with these difficulties a relatively rapid way of healing and a healthier life, as Reena discovered. Dr Mirchandani is a Mumbai based psychiatristMumbai, who focuses on behavioral methodsand rational psycho-pharmacological techniquesto heal his patients.
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