Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-23T08:59:53.271Z Has data issue: false hasContentIssue false

The Making and Breaking of Affectional Bonds

II. Some Principles of Psychotherapy: The Fiftieth Maudsley Lecture (expanded version)

Published online by Cambridge University Press:  29 January 2018

John Bowlby*
Affiliation:
Tavistock Clinic, Belsize Lane, London NW3 5BA

Summary

An account is given of how a clinician guided by attachment theory approaches the clinical conditions to which the theory is held to apply, which include states of anxiety, depression and emotional detachment. Assessment of a patient is in terms of the patterns of attachment and caregiving behaviour which he commonly shows and of the events and situations, both recent and past, which may have precipitated or exacerbated his symptoms. The problems posed by relevant information being suppressed or falsified are noted.

Viewed in this perspective a psychotherapist is seen to have a number of interrelated tasks: (a) to provide the patient with a secure base from which he, the patient, can explore himself and his relationships; (b) and (c) to examine with the patient the ways in which he tends to construe current interpersonal relationships, including that with the therapist, and the resulting predictions he makes and actions he takes, and the extent to which some may be inappropriate; (d) to help him consider whether his tendencies to misconstrue, and as a result to act misguidedly, can be understood by reference to the experiences he had with attachment figures during his childhood and adolescence, and perhaps may still be having.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1977 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Argles, P. & Mackenzie, M. (1970) Crisis intervention with a multi-problem family: a case study. Journal of Child Psychology and Psychiatry, 11, 187–95.Google Scholar
Balint, M. (1965) Primary Lave and Psychoanalytic Technique. London: Tavistock.Google Scholar
Balint, M. (1968) The Basic Fault. London: Tavistock.Google Scholar
Caplan, G. (1964) Principles of Preventive Psychiatry. New York: Basic Books; London: Tavistock.Google Scholar
Cohen, M. B., Baker, G., Cohen, R. A., Fromm-Reichmann, F. & Weigert, E. (1954) An intensive study of twelve cases of manic-depressive psychosis. Psychiatry, 17, 103–37.Google Scholar
Deutsch, H. (1937) Absence of grief. Psychoanalytic Quarterly, 6, 1222.CrossRefGoogle Scholar
Fleming, J. & Altschul, S. (1963) Activation of mourning and growth by psychoanalysis. International Journal of Psychoanalysis, 44, 419–31.Google Scholar
Guntrip, H. (1975) My experience of analysis with Fairbairn and Winnicott. International Review of Psychoanalysis, 2, 145–56.Google Scholar
Hamburg, D. A. & Adams, J. E. (1967) A perspective on coping behaviour. Archives of General Psychiatry, 17, 277–84.Google Scholar
Hamburg, D. A., Hamburg, B. A. & Barchas, J. D. (1974) Anger and depression in perspective of behavioural biology. In Parameters of Emotion (ed. Levi, L.). New York: Raven Press.Google Scholar
Heard, D. H. (1974) Crisis intervention guided by attachment concepts: a case study. Journal of Child Psychology and Psychiatry, 15, 111–22.CrossRefGoogle ScholarPubMed
Heard, D. H. (in press) From object relations to attachment: a framework for family therapy. British Journal of Medical Psychology. Google Scholar
Lind, E. (1973) From false-self to true-self functioning: a case in brief psychotherapy. British Journal of Medical Psychology, 46, 381–9.Google Scholar
Main, T. F. (1957) The ailment. British Journal of Medical Psychology, 30, 129–45.CrossRefGoogle ScholarPubMed
Malan, D. M. (1963) A Study of Brief Psychotherapy. London: Tavistock Publications.Google Scholar
Malan, D. M. (1973) Therapeutic factors in analytically-oriented brief psychotherapy. In Support, Innovation and Autonomy (ed. Gosling, R. H.). London: Tavistock Publications.Google Scholar
Malan, D. M., Heath, E. S., Bacal, H. A. & Balfour, F. H. G. (1975) Psychodynamic changes in untreated neurotic patients: II. Apparently genuine improvements. Archives of General Psychiatry, 32, 110–26.Google Scholar
Neki, J. S. (1976) An examination of the cultural relativism of dependence as a dynamic of social and therapeutic relationships. Parts 1 and 2. British Journal of Medical Psychology, 49, 122.CrossRefGoogle Scholar
Paul, N. L. (1967) The role of mourning and empathy in conjoint marital therapy. In Family Therapy and Disturbed Families (eds Zuk, G. H. and Boszormenyi-Nagy, I.), pp 186205. Palo Alto, California: Science and Behavior Books.Google Scholar
Pedder, J. (1976) Attachment and new beginning. International Review of Psychoanalysis, 3, 491–7.Google Scholar
Raphael, B. (1975) Management of pathological grief. Australian and New Zealand Journal of Psychiatry, 9, 173–80.Google Scholar
Raphael, B. & Maddison, D. C. (1976) The care of bereaved adults. In Modern Trends in Psychosomatic Medicine (ed. Hill, O.). London: Butterworth.Google Scholar
Rosen, V. H. (1955) The reconstruction of a traumatic childhood event in a case of derealization. Journal of the American Psychoanalytical Association, 3, 211–21. Reprinted in Survivors of Suicide (ed. Cain, A. C.). Springfield, Illinois: C. C. Thomas, 1972.Google Scholar
Seligman, M. E. P. (1975) Helplessness: on Depression, Development and Death. San Francisco: W. H. Freeman.Google Scholar
Truax, C. B. & Mitchell, K. M. (1971) Research on certain therapist interpersonal skills in relation to process and outcome. In Handbook of Psychotherapy and Behavior Change (eds Bergin, A. E. and Garfield, S. L.). New York: Wiley.Google Scholar
Winnicott, D. W. (1965) The Maturational Processes and the Facilitating Environment. London: Hogarth Press.Google Scholar
Winnicott, D. W. (1971) Playing and Reality. London: Tavistock Publications.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.