Clinical Application of Explanatory Theory

Contemporary Attachment Theory and Self Psychology
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Contemporary Attachment Theory and Self Psychology
Introduction
Mellissa is a 28-year-old Hispanic woman. She is currently separated from her husband of two years with Mellissa given full custody of their 6-years-old daughter. Mellissa is currently employed as a waitress at a local bar where she mostly works at night. She grew up in the foster system. She was born to a drug-addicted mother who was not able to provide proper care for her and her younger brother. Mellissa and her brother were placed in foster care when she was four years old. She was separated from her brother as they went to different foster homes. During her time in foster care, Mellissa was mostly neglected and moved around much until adulthood. She spent little time associating with other kinds and mostly stayed alone. Mellissa insecurity and insensitivity to her husband led to the separation. Furthermore, Mellissa is unable to control her emotions since she is angry and aggressive at most times and struggles in self-esteem and assertiveness. Melissa believes that she has failed to be a good mother to her daughter.
Contemporary attachment theory
The theory of attachment developed by a British psychoanalyst John Bowlby seeks to understand the intense distress that is experienced by children who are separated from their parents and its relationship to the bond that develops between emotionally intimate adults relationships. Bowlby (1969, 1973, 1980) explains that infant attachment remains crucial over a person’s lifetime.

A typical statement states from “the cradle to the grave” (Bowlby, 1973). The childhood experiences regarding attachment to parents or caregivers allow people to generate feeling and behaviors that aid them in creating and maintaining proximity to attachment figures.
Mellissa childhood experience was characterized by a mother who could not be available to comfort her in times of distress, inconsistency in caregiving since she moved from foster to foster home and separation from her biological brother. According to the theory, an infant requires to develop a positive relationship with at least one primary caregiver to ensure that the child is successful in social and emotional development and more crucially in learning how to regulate their feelings. Mellissa’s mother was a drug addict, therefore, was unavailable as a primary attachment figure. The mother was unable to provide the protection, support, and care that Mellissa and her brother required. Moreover, her movement between foster homes led her to lack other caregivers. According to the theory, when a caregiver is unresponsive and inattentive to an infant needs, the child experiences separation, distress, and anxiety as is the case with Mellissa. Furthermore, such infants grow up being insecure in relationships. Mellissa’s was insecure in her relationship with her husband leading to the separation.
According to Bowlby (1973), infants who are three years and younger lack the emotional capacity to handle stress. Accordingly, it is the duty of the caregiver to alleviate stress in the infant where doing otherwise would lead to the child’s lasting psychological damage. Scientists and neuropsychologists affirm Bowlby’s attachment theory by stating the fact that infants lack the necessary brain development to deal correctly with stress, particularly distress. It is, therefore, the duty of the primary caregiver to ensure that a child develops in a stress-free environment. Stressful environments negatively impact an infant’s brain development especially where the primary caregiver does not help in alleviating stress. The right brain, in particular, the hypothalamic-pituitary-adrenal axis is the stress-regulating part of the brain. When a child is stressed, a stress hormone called cortisol is released. When the hormone is released in large quantities and more frequency, the infant can suffer stunt brain development and neural connections. Mellissa lived in a very stressful environment when she was an infant. Having a drug addict as a mother meant that the mother was not available to alleviate stress for Mellissa, in fact, she even contributed to the stress. Since Melissa was young, she could not handle stress. As a result, she suffered catastrophic emotional distress that undoubtedly interrupted the development of her brain. Mellissa lacked a good foundation for emotional development.
Modern neuroscience has enabled us to understand the brain development relating to the attachment theory. The earliest infant relationships, especially with caregivers, bind the brain structures that a person uses to relating lifelong. Those early childhood relationship experiences are encoded in the neural circuitry, entirely in implicit memory outside of awareness. The form of attachment the infant is exposed to become the schemas, templates, “rules”, for relating that operate in a lifetime. These attachment patterns are unconscious and can continue to shape the responses and perceptions of the brain regarding new relational experiences. In the case of Mellissa, her insecure attachment in infancy has become a roadmap for future attachments. Unconsciously, she feels insecure about relationships since she never has one with a primary caregiver when she was young. Her experiences are engraved in her brain since those experiences helped shape her life to the way it is. Mellissa’s separation from her mother and brother at a young age resulted in depression and lack of attachment security. A further contribution to Mellissa’s attachment situation was the fact that she never has a proper foster home where she could develop a secure attachment with other caregivers. Her brain developed believing that she cannot develop secure attachments in her life.
Neuroscientists have confirmed that the human brain has the innate biological capacity to grow new neurons and moreover to create new synaptic connections between neurons lifelong. Any experiences cause neurons to fire, and when the experiences are repeated, it causes the neurons to fire repeatedly. Repeated experiences result in stronger neural connections. Mellissa’s childhood experience has become strongly connected with the brain. At a young age, Mellissa was separated from her mother and brother. When in a foster home, she never stayed at one place for a long time. Considering these factors, Mellissa’s brain failed to perceive any strong connection to a home or a caregiver. Due to her constantly shifting homes and changing caregivers, no deep connection ever developed for any particular home. Emotionally, Mellissa was all alone since she lacked a secure attachment to any caregiver. Consequently, her brain interpreted relationships as short and insecure.
A crucial factor in brain development is attuning to other people’s behaviors and expressions of intention such as body gestures and facial expressions. The brain carries information from these factors and helps a child to process and know his/her experience. The development of the infant comes from stabilization of these factors in the brain leading to a permanent psychological significance. If a parenting style is dismissive, indifferent, neglectful, distant, absent, shaming, rejecting, judgmental and physically-emotionally unavailable, it leads to the child developing an insecure-avoidant attachment. The child withdraws from interactions with the caregivers and other people, is indifferent to the caregiver, focuses on self and not other, does not seek comfort or soothing and the child has a defensive exclusion of affects. The brain develops depending on the environment it is exposed in. Similarly, Mellissa grew up in an environment with neglectful, distant and physically-emotionally unavailable caregivers. Consequently, any activity in the present is triggered by a similar activity in the past. The memories of her childhood trigger responses in whatever she experiences currently. Mellissa’s brain developed to respond to situations as it is familiar to her. She would show anger and agitation over activities since she learns to do so in foster care.
Self Psychology
Kohut developed a theory where he states that the quality of relationships that a child has with his or her caregivers has a substantial role in developing a healthy narcissistic and cohesive personality structure (Kohut, 1971). A child develops two mental constructs through the interaction with the empathic environment: the idealized parental imago and the grandiose self. The caregivers attribute the development of a child’s sense of self. Mirroring of the infants’ needs for admiration and approval. Failures to empathize with the child and their responses were the roots of almost all psychopathology (Kohut, 1977). According to this theory, failure to of parents to empathize with their children leads to the child experiencing depression. The individual feels the emptiness of life, is lethargic and apathetic. Furthermore, a deep understanding of Kohut’s psychology of self enables one to understand the factors leading to narcissism. Mellissa possesses most of the symptoms attributed to self-psychology. She suffers from depression since she is separated and also work as a waitress in a bar in order to provide for her daughter. She believes that she does not provide the best care for her daughter. Mellissa also usually elicits anger and frustration showing characters of being a narcissistic person.
Kohut divided the self into three key poles: empathy, self-object and tripolar self. Empathy, which is the first element is the most crucial in a child’s development, Kohut believes that lack of empathy of parents to their children is the root cause of most mental problems. When a parent is in sync with the children’s needs, they can help move the child from grandiose self to the cohesive self. However, in Mellissa’s case, empathy was not part in her development. Her mother was a drug addict and could not be available in Mellissa’s and her brother’s childhood development. Mellissa’s mother failed to empathize with her children’s needs, and she was also unable to provide proper care for them. The lack of empathy for Mellissa’s needs when she was young has led to her improper psychological development. Also, in the foster care, Mellissa’s needs lacked any empathy from the caregivers. Her needs were neglected by the caregivers who showed little interest in caring for Mellissa. Mellissa was left all alone in her own world where she received no interest from the parent or other caregivers.
Self-object if the second pole in Kohut’s self. This is the process where individuals extend their images of self onto activities and objects. The individual feels incomplete without their preferred activity or objects ranging from sports to jewelry. The self-object aid an individual in idealizing with other people they admire, activities they love or people they love. The connection received from idealization is crucial to the development of a child. For example, a child who connects with a person they admire will draw upon of that person’s wisdom, power, and goodness. The desire to be like others, which Kohut calls the alter ego helps an individual to adapt their image to fit that of others. Mellissa lacked these self-objects. It is evident that she was neglected and consequently sidelined for any activities such as sports. Since she would spend most of her life moving between foster homes, Mellissa became unable to extend her image onto objects and activities. Mellissa suffered optimal frustration that Kohut explains as the frustration when the self-object is unavailable (Kohut, 1977). Mellissa might have idealized and object or activity but due to her constant shifting of foster homes and the neglect she faced, she was unable to participate in activities or have the desired object. These self-psychology projects went on to affect Mellissa’s adult life such as choices in work and life partners. Mellissa work at night in a bar and she is separated from her husband. Mellissa also lacked to idealize any person through self-objects. It may have resulted in her life not being the way she wanted it to be. It is evident that Mellissa fails to meet the self-object needs.
The final pole in self-psychology is the tripolar self. Tripolar self revolves around three internal poles: exhibitionistic and grandiose needs, alter ego needs and the necessity of an omnipotent figure. Based on Mellissa’s interaction with other people in her life, she lacks grandiose and alter ego needs. Her life is full of being neglected and abandoned and, therefore, failing to have those needs. Mellissa’s childhoods experience causes her to lack any ambition in life. She has a failed marriage and furthermore a lost brother. Mellissa also lacks the need for an omnipotent figure in her life. She is used to living alone and being separated from other people.
Mellissa’s case should be a clinical setting. She should receive medical treatment that will aid her to cope with distress, stress, anger, and frustration. Mellissa should be given psychoanalytic help in order to determine the best way forward for her. If she goes unchecked, her life would remain miserable and can even lead to serious health problems attributed to depression and stress.
Diversity issues
Bowlby’s theory of attachment stipulates that mothers provide the best form of attachment for an infant. The theory assumes that the most formative relationship for an individual usually occurs between an infant and his/her mother. However, this may be only the norm for the Western middle-class families. In most other socioeconomic groups and cultures, the role of attachment falls to a wider range of caregivers. Due to limited resources and the daily survival need for a majority of the world’s population, the role of caregiving responsibilities is distributed across a network of relatives and even friends. A child receives multiple caregivers, and the infant can attach to the mother, father, siblings, aunts, uncles or grandparents. This issue shows that attachment should not be narrowly defined and studied rather it should be broadened. There are different attachment styles, and they vary among different cultures and socioeconomic groups. An infant can have more one attachment, and it is the role of the caregiver to ensure that the attachment is secure.

References
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