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  • Aspasia Venieri

Attachment Style & Psychopathology

Updated: Jun 13, 2023

By Aspasia Venieri


parent holding kid'shand road pavement

How the attachment style and the early maladaptive schemas can develop psychopathology


According to Bowlby (1982, 1988), infants have an innate repertoire of behaviors that helps them maintain the proximity of others for their survival and coping with distress and threats. He suggested that this attachment system is active throughout life and adults also seek proximity and support when stressed. It develops from early relational experiences with the attachment figures (Bowlby, 1969, 1973). The memories of these experiences, create internal working models (IWM) for the self and others, which are stable attachment styles that guide one’s relational expectations, emotions, and behaviors (Fraley & Schaver, 2000). Ainsworth et. al. (1978), as well as several longitudinal studies reviewed by Milkulincer & Shaver (2003, 2007), and Brennan et al. (1998) measure the attachment along 2 dimensions: Attachment Anxiety & Attachment Avoidance. The attachment styles that derive are the following:


Ι. Anxious Attachment

People with an anxious attachment style in their relationships worry that the other people will not be available and supportive in times of need. Accordingly, they make efforts to maintain closeness to others through hyperactivating strategies (Feenlay & Noller, 1990; Milkulincer et.al.,1998). They appraise threats as extreme and their own coping resources as deficient. They are vigilant regarding potential threats and dangers (Cassidy & Kodak, 1998).


In cognitive therapy, the restrictive Internal Working Models of people with anxious attachment are not deleted but changed through the activation of new or more adaptive ones (Bouton, 2004). Bosmans et al. (2010) suggest the development of new attachment related cognitive schemas which can arise from the relationship with an accepting therapist, increased mentalization experiences, and new more compassionate understanding of previous negative interaction with attachment figures.


ΙΙ. Avoidant Attachment

People with avoidant attachment distrust the people’s goodwill & capacity to help. They make efforts to maintain independence & self-reliance through deactivating strategies. They are reluctant to seek help, based on their previous experiences with their caregivers who were unavailable when they needed them as young children. They deal with stress on their own relying on cognitive and behavioral distancing strategies that suppress threat related thoughts (Birnbaum et. al., 1997; Fraley & Schaver, 1997; Lussier et. al., 1997)


Both, the anxious and the avoidant attachment type possess internal working models of unavailable, unreliable, frustrating, rejecting attachment figures which lead to relevant emotions and behaviors (Milkulincer & Schaver, 2003, 2007).


ΙΙΙ. Fearful Avoidant Attachment

People who combine the internal working models and the behaviors of the above two dimensions develop a Fearful Avoidant Attachment Style feeling more vulnerable under stress (Milkulincer & Schaver, 2003, 2007).


ΙV. Secure Attachment

People with a secure attachment style possess well developed Internal working models of comfort, security, positive self-regard, and have confidence in proximity seeking for support as a means of coping with threats. They hold optimistic attitudes about coping with life’s challenges, possess self-efficacy and remain emotionally stable (Milkulincer & Florian, 1995; Milkulincer et al., 2003; Shorey et al., 2003).


The Internal Working Models that derive from the parental attachment style and affect the way people attach to other people can be conceptualized and have been approached as cognitive schemas (Schorpita & Barlow, 1996; Holmes, 1993; Mason et. al., 2005; Bosmans et. al., 2010; Baldwin et. al., 1993; Bretherton, 1990; Collins & Read, 1994; Waters & Waters, 2006). Schemas are cognitive structures for screening, coding, recalling & evaluating impinging stimuli. They are stable cognitive patterns, specific rules that govern the information processing behavior (Clark, Beck & Alford, 1999).


The anxious attachment style is associated with the ‘sentinel’ schema, which provides faster detection of threat, vigilance, alerting others about danger, efforts to get others provide support. The avoidant attachment style is associated with the rapid fight, flight schema in narratives of threatening events, where the importance of the threatening stimuli is minimized and quick self-protective action is taken, either by escaping or by fighting against the danger (Ein-Dor et al., 2011).


Childhood Emotional Abuse (CEA) predicts insecure attachment in adulthood more than sexual or physical abuse (Riggs & Kaminski, 2010). Furthermore, there is a link between anxious attachment style with physical and psychological forms of intimate partner violence/ perpetrator (Henderson et al., 2005), as well as the use of drugs and decreased emotional maturity (Mortazavi et al., 2012).


The Early Maladaptive Schemas (EMS) are like the internal working models but are not limited only to interpersonal relationships with other people; they may be components of IWMs (Simard et al., 2011). A specific maladaptive schema may remain deactivated until a schema contingent in context or increased in distress activates it. This could explain the attachment’s cross temporal instability. (Fraley,2007; Sroufe, Egeland & Kreutzer, 1990). Every attachment style is associated with a different frequency of Early Maladaptive Schemas. The Fearful Avoidant, which is also called Disorganized by other theorists, has the highest frequency of EMSs, and then the Anxious or else Preoccupied attachment style (Mason et al., 2005).


The unmet childhood needs for secure attachment and adverse experiences may lead to the development of EMSs in adulthood (Young et al., 2003).


Unmet needs:

· Secure attachment to others

· Autonomy, competence & sense of identity

· Freedom to express needs & emotions

· Spontaneity to play

· Realistic limits & self-control


Young et. al. (2003) developed a taxonomy of EMS and assigned them to 5 domains, which differ in cognitive content.


1. Disconnection / Rejection: It is related to traumatic or abusive experiences during childhood.

· There can be no safety, security, contact and response from other people – Emotional Deprivation.

· A relationship with a significant other will not last - Abandonment, Instability

· Others will do anything to satisfy their own needs - Mistrust, Abuse

· One does not belong to any group - Social isolation, Alienation


2. Impaired Autonomy and Performance:

· One cannot function successfully autonomously – Failure

· One is incapable of handling problems – Dependency, Incompetence

· A catastrophe will happen - Vulnerability to harm or illness


3. Overvigilance & Inhibition:

· Not able to control his feelings & impulses - Inhibition

· Must succeed in professional and private life - Unrelenting standards, Hypercriticism


4. Impaired Limits:

· Has difficulty respecting and giving rights and competence to others - Entitlement, Grandiosity

· Is intolerant to frustration towards achieving goals - Insufficient self-control, Self- discipline


5. Other Directedness:

· Is submissive and gives control if his/her life in order to avoid others’ anger - Subjugation

· Satisfies the needs of others, often to self-detriment - Self- sacrifice


Hoffart et al, (2005) separated Young et. al. (2003) schemas in 4 categories:Disconnection, Impaired autonomy , Impaired Limits and Exaggerated Standards


Research shows that these Schemas are associated with psychopathology. Depression, anxiety, eating disorders, emotional exhaustion as well as bad interpersonal relationships and worse adaptation are some of the problems they seem to predict (Freeman et al., 2002; Rittenmeyer, 1997; Stiles, 2004). Schemas of social isolation/alienation, dependency/incompetence, caught obedience, self- control /inadequate self-discipline were the most important predictors of addictive tendencies (Bakhsi & Nikmanesh, 2013).


Cognitive Behavioral Therapy – CBT focuses on identifying the attachment style and the Early maladaptive Schemas that lead to psychopathology and through a wide range of techniques it substitutes it with new or more adaptive positive schemas.



References:


Bakhshi, B.F, & Nikmanesh, Z. (2013). Role of early maladaptive schemas on addiction potential in youth. Int J High Risk Behavioral Addictions, 2(2): 72-6.


Baldwin, M.W., Fehr, B., Keedian, E., Seidel, M., & Thomson, D.W. (1993). An exploration of the relational schemata underlying attachment styles: Self-report and lexical decision approaches. Personality and Social Psychology Bulletin, 19, 746–754.


Bosmans, G., Braet, C., & Van Vlierberghe, L. (2010). Attachment and symptoms of psychopathology: Early maladaptive schemas as a cognitive link? Clinical Psychology and Psychotherapy, 17: 374-385.


Bouton, M.E. (2004) Context and behavioural processes in extinction. Learning and Memory, 11, 485–494.


Bowlby, J. (1969). Attachment and loss: Attachment. New York: BasicBooks.


Bowlby, J. (1982). Attachment and loss: Vol. 1. Attachment(2nd ed.).New York: Basic Books. (Original work published 1969)


Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. London: Routledge.


Brennan, K.A., Clark, C.L., & Shaver, P.R. (1998). Self-report measurement of adult attachment: An integrative overview. In J.A. Simpson & W.S. Rholes (Eds.), Attachment theory and close relationships (pp. 46–76). New York: Guilford Press.


Bretherton, I., Ridgeway, D., & Cassidy, J. (1990). Assessing internal working models of the attachment relationship: An attachment story completion task for 3-year-olds. In M. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the pre-school years: Theory, research, and intervention (pp. 273–308). Chicago, IL: University of Chicago Press.


Chorpita, B.E., & Barlow, D.H. (1998). The development of anxiety: The role of control in the early environment, Psychological Bulletin, 124, 3–21.

Clark, D.A., Beck, A.T, & Alford, B.A. (1999). Scientific foundations of cognitive theory and therapy of depression. Chichester: John Wiley & Sons, Inc.


Collins, N.L., & Read, S.J. (1994). Cognitive representations of attachment: The structure and function of working models. In K. Bartholomew & D. Perlman (Eds.), Attachment processes in adulthood (pp. 53–92). London: Jessica Kingsley.


Ein-Dor, T., Milkulincer, M., & Shaver, P. R. (2011). Attachment Insecurities and the Processing of Threat Related Information: Studying the Schemas Involved in Insecure People’s Coping Strategies. Journal of Personality and Social Psychology, 101(1): 78-93.


Feeney, J. A., & Noller, P. (1990). Attachment style as a predictor of adult romantic relationships. Journal of Personality and Social Psychology, 58, 281–291. doi:10.1037/0022-3514.58.2.281


Fraley, R.C. (2007). A connectionist approach to the organization and continuity of working models of attachment. Journal of Personality, 75, 1157–1180.


Fraley, R. C., & Shaver, P. R. (2000). Adult romantic attachment: Theoretical developments, emerging controversies, and unanswered questions. Review of General Psychology, 4(2), 132–154. https://doi.org/10.1037/1089-2680.4.2.132


Fraley, R. C., & Shaver, P. R. (1997). Adult attachment and the suppression of unwanted thoughts. Journal of Personality and Social Psychology, 73(5), 1080–1091. https://doi.org/10.1037/0022-3514.73.5.1080


Freeman, D., Garety, P., Kuipers, E., Fowler, D. & Bebbington, P. (2002). A cognitive model of persecutory delusions. British Journal of Clinical Psychology, 41, 331–347.


Henderson, A. J. Z., Bartholomew, K., Trinke, S. J., & Kwong, M. J. (2005). When Loving Means Hurting: An Exploration of Attachment and Intimate Abuse In a Community Sample. Journal of Family Violence, 20(4), 219–230. https://doi.org/10.1007/s10896-005-5985-y


Hoffart, A., Sexton, H., Hedley, L. M., Wang, C. E., Holthe, H.,Haugum, J. A., Nordahl, H. M., Hovland, O. J., Holte, A. (2005). The structure of early maladaptive schemas: A confirmatory factor analysis and a psychometric evaluation of factor-derived scales. Cognitive Therapy and Research, 29, 627–644.


Holmes J. (1993). John Bowlby and attachment theory. London: Routledge.


Lussier, Y., Sabourin, S., & Turgeon, C. (1997). Coping strategies as moderators of the relationship between attachment and marital adjustment. Journal of Social and Personal Relationships, 14, 777–791. doi:10.1177/0265407597146004Ma


Mason, O., Platts, H., &Tyson, M. (2005). Early maladaptive schemas and adult attachment in a UK clinical population. Psychol Psychother, 78(Pt 4): 549-64.7.


Mikulincer, M., & Shaver, P.R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford Press. Morgan, C.D., Wieder


Mikulincer, M., & Florian, V. (1995). Appraisal of and coping with a real-life stressful situation: The contribution of attachment styles. Personality and Social Psychology Bulletin, 21, 406-414.


Mikulincer, M., & Shaver, P.R. (2003). The attachment behavioral systemin adulthood: Activation, psychodynamics, and interpersonal processes. In M.P. Zanna (Ed.), Advances in experimental social psychology (Vol. 35, pp. 53–152). San Diego, CA: Academic Press


Mikulincer, M., Orbach, I., & Iavnieli, D. (1998). Adult attachment style and affect regulation: Strategic variations in subjective self–other similarity. Journal of Personality and Social Psychology, 75(2), 436–448. https://doi.org/10.1037/0022-3514.75.2.436


Mortazavi, Z., Sohrabi, F., & Hatami, H.R. (2012). Comparison of attachment styles and emotional maturity between opiate addicts and non-addicts. Annals of Biological Research, 3(1): 409-14.


Riggs, S. A., & Kaminski, P. (2010). Childhood emotional abuse, adult attachment, and depression as predictors of relational adjustment and psychological aggression. Journal of Aggression, Maltreatment & Trauma, 19(1), 75–104. https://doi.org/10.1080/10926770903475976


Rice, K. G., Cunningham, T. J., & Young, M. B. (1997). Attachment to parents, social competence, and emotional well-being: A comparison of Black and White adolescents. Journal of Counseling Psychology, 44, 89–101. doi:10.1037/0022-0167.44.1.89R


Rittenmeyer, G. J. (1997). The relationship between early maladaptive schemas and job burnout among public school teachers. Dissertation Abstracts International, 58 (5-A), 1529.


Shorey, H. S., Snyder, C. R., Yang, X., & Lewin, M. R. (2003). The role of hope as a mediator in recollected parenting, adult attachment, and mental health. Journal of Social and Clinical Psychology, 22,685–715.doi:10.1521/jscp.22.6.685.22938.


Simard, V., Moss, E., & Pascuzzo, E. (2011). Early Maladaptive Schemas and Adult Attachment: A 15-year Longitudinal Study. Psychology and Psychotherapy: Theory, Research and Practice, 84: 349-366.


Sroufe, L.A., Egeland, B., & Kreutzer, T. (1990). The fate of early experience following developmental change: Longitudinal approaches to individual adaptation in childhood. Child Development, 61, 1363–1373.


Stiles, O.E. (2004). Early maladaptive schema and intimacy in young adults' romantic relationships. Ph.D. Dissertation. Alliant International University,


Waters, H. S., & Waters, E. (2006). The attachment working models concept: Among other things, we build script-like representations of secure base experiences. Attachment & Human Development, 8, 185–197. http://dx.doi.org/10.1080/14616730600856016


Young, J. E., Klosko, J., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. New York: Guilford




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