And All for the Love of Attachment

December 3, 2009

(Bolstered by Soren Kirkegaard’s lament that “ours is a paltry age because it lacks passion,” Dr. Alan Karbelnig writes this regular column to provoke thoughtful reaction from his SGVPA colleagues. He has been a member of SGVPA since 1988, served as its president in the early 1990s, and chaired its Ethics Committee for from 1995 to 2010. Alan is a Training and Supervising psychoanalyst at the New Center for Psychoanalysis. He practices psychoanalytic psychotherapy and forensic psychology in South Pasadena.)

Problems of love should be deferred to the poets, or so the French Psychoanalyst Jacques Lacan believed. If you happen to be in the throes of feeling in-love, then you will agree that Lacan was oh-so-correct. Yet the psychoanalytic field of attachment theory – immensely popular during the past 50 years – delves precisely into that realm, and all from the perspective of the white-coated garb of the 20th century Man of Science. Attachment theory started with the work of John Bowlby during 1958. Later, led by Psychologist Mary Ainsworth and others during the 1960s and 1970s, it flourished. She proposed four basic patterns of “attachment:” secure, anxious, avoidant, or disorganized.

When approached from an observational perspective, attachment theory offers useful ideas. Simply by observing the body language, verbalization patterns, and similar phenomena at an airport bar, for example, the trained observer may well be able to discern whether a particular individual enjoys one or another attachment style. If you observe the pilfering of a wallet from an attractive woman’s purse, perhaps you may well be witnessing a manifestation of a disorganized attachment.

These are extremely useful ideas, but only in certain limited contexts. When making a referral to another therapist – let’s say because the psychotherapist’s attachment capacity has so collapsed that she becomes obsessed about retirement or suicide – some information about the patient’s attachment style may well be helpful. Subsequent psychotherapists would then have a response set to guide them in understanding how that person connects to others. Certainly this could be helpful in understanding patients’ interpersonal experiences, and of course even in the way they might form a connection to the psychotherapist.

But from the point of view of the patient, what matters is “love,” not attachment. This is one of the many problems resulting from the famous APA Scientist-Practitioner Model. Scientist-psychotherapists must beware of the immense gap between the external observation of human experience and internal, subjective experience. This massive fissure – between observed psychology and experienced psychology, between the “It” and the “I” – has been haunting professional psychologists since their profession limped away from philosophy during the last century. Descriptions of attachment are all well and good; but from the perspective of the patient with the rejecting mother, for example, or the distant boyfriend, what is missing is ….. LOVE! Real people feel fear, yearning, loneliness, and emptiness; real people do not experience “anxious attachment.”

Further, the training of professional psychotherapists immersed in this and similar 20th century logical positivistic models risks missing the real experiences of real persons. And these can only be ascertained by listening – and listening extremely carefully – to those consulting you. Again, ideas from attachment theory certainly help us to characterize and categorize; they help us to communicate with one another. But they also may interfere with our ability to really hear those seeking our help.

I have long believed that, if you want to work as a psychotherapist, for God’s sake don’t study science or psychology! Study the fields that best capture the human subjective experience – poetry and prose, philosophy and political science, history and anthropology. This is the literature of human subjective experience.

Staring into this immense chasm between objective observation of human experience, and subjective experience itself, poet W. B. Yeats wrote of his despair in ever finding comfort from the categorizations of the natural sciences. His words offer a fitting example of where the rational lexicon of scientific psychology ends and the artistic language of poetry begins. In The Circus’ Animal’s Desertion (1939), Yeats writes in a fashion that speaks to the real human experience:

Now that my ladder’s gone

I must lie down where all ladders start,

In the foul rag-and-bone shop of the heart


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