CAN ATTACHMENT THEORY HELP DEFINE WHAT IS MUTATIVE IN COUPLE PSYCHOANALYTIC PSYCHOTHERAPY?  

DR CHRIS CLULOW Lecture at IAN


By Linda Quigley

Chris has a very relaxed and comfortable way of presenting which makes it all sound easy, until later when the complexity of the topic and his work methodology hits home.  As past Clinical Director at the Tavistock Centre for Marital Studies, the writer of many books and articles,  he has years of working experience and academic knowledge to share.

This talk focussed on a paper where he explores the concept of Bowlby’s Attachment Theory who stated that attachment had a precise meaning that relates to an innate behavioural system. Bowlby formulated the theory of four types of behaviour in relation to a significant other (the mother or main care-giver) in our formative years. They are (i) a need to seek proximity (ii) displays of distress at separation (iii) retreating to safety when perceiving a threat to the self (iv) exploration from a ‘secure base’. If the attachment figure is accessible and responsive, a child develops the confidence to feel secure when the attachment figure is not in physical proximity. If there is not a secure attachment, various other attachment styles evolve.  Examples of how things may play out in crisis situations were given when individuals with disorganised/ pre-occupied/ enmeshed/avoidant/anxious attachment styles become couples. These example scenarios were recognisable, sometimes amusing and sometimes painful as we began to see how our early experiences and defence mechanisms come to the fore when our needs are not met in close relationships. These may not be observable to ourselves or others in non-threatening situations, but are likely to reveal themselves in the therapeutic engagement.

Although Bowlby’s work focussed on mother and infant , there is debate, Chris suggests that these same structures can be applied to adult attachments  and in particular couple therapy and has extrapolated to couple psychotherapy some of the therapeutic applications of attachment theory that Bowlby had written about later in his publishing lifetime. He asks, how does the rhythm of separations and reunions, endemic to the psychotherapeutic process, mirror the anxiety provoking situation? Add to this the client almost certainly being in a period of heightened anxiety, or emotional conflict, which can disturb coherent thought and reflectiveness, what is helpful in effecting change’?

Transference and counter-transference and interpretation have always been tools and may serve as a way to re-enact and evaluate behaviours within the safety of the therapeutic relationship, together with contingent mirroring (Winnicott). More currently, he talked of Susan Johnson (EFT * 'The Practice of Emotionally Focused Couple Therapy Creating Connection - 2004) which drew his attention to a part of his own practice criteria, ‘accessing and reprocessing feelings’. He shared a vignette of a couple with whom he had worked. He demonstrated how he tuned into the feelings rather than the story. The husband has been working abroad, and his wife had withdrawn from him since her mother had died.  The wife states that since his return home, he has been a heavy presence, but she had been avoiding getting into arguments with him, although the previous day she was not able to suppress the anger and there had been a very big argument.  The husband stays silent, although he does not appear passive. There is a long, difficult silence. Rather than address the silence, or ask about the argument, or what started it – Chris gets an image of the husband as a child who wants to be rescued, but fights against this by withdrawing (thus protecting himself or being passive aggressive) possible interpretations, but he does not say this. He comments only on the possibility that the husband ‘is longing for someone to make it all better by being available to him and offering him support, but in the absence of this he seems to have become isolated?’. The husband was able to get in touch with his feelings and express something. Obviously Chris was able to tell us more about what the couple were able to discover together, but I was struck by Chris's openness, curiosity and ability not to  be 'the expert' to resist interpreting the feeling in the room, or the silence, or acting as the adjudicator.

For me, this was a tour of discovery about keeping ourselves open to new thinking and he mentioned current ideas around Mindfulness, Mentalisation, Neuroscience. The message was   to stay curious in the room, to be open to metaphor and your own instinct, to create a secure base for exploration to manage the ‘not knowing’ and to get back to Bowlby  who said he did not advocate ‘I know, and I will tell you’ but rather,  ‘You know, you tell me’.
Dr Chris Clulow’s presentation style and great knowledge, did not disappoint, I hope I have given it justice.

Linda Quigley

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