SYSTEMIC THERAPY

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SYSTEMIC THERAPY ATTACHMENT NARRATIVES

• Rudi Dallos, Ph.D
• Arlene Vetere, Ph.D

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Dynamic Systems
Many of the most intense emotions arise during
the formation, the maintenance, the disruption
and the renewal of attachment relationships. The
formation of a bond is described as falling in
love, maintaining a bond as loving someone, and
losing a partner as grieving over someone.
Similarly, threat of loss arouses anxiety, and
actual loss gives rise to sorrow whilst each of
these situations is likely to arouse anger. The
unchallenged maintenance of a bond is experienced
as a source of security and the renewal of a bond
as source of joy. (Bowlby, 1980)
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ATTACHMENT NARRATIVE THERAPY

• Creating a secure base
• Exploring Narratives and Attachments within a
  Systemic Framework
• Considering Alternatives
• Future and Maintaining the therapeutic base

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THEORETICAL PERSPECTIVES

• ATTACHMENT NARRRATIVE THERAPY
• Why the 3 perspectives need each other?
• Social Constructionist - Narrative practice
• Attachment Theory
• Systemic Theory and practice
• Persons and families in social/cultural contexts

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THE NARRATIVE TURN IN ATTACHMENT THEORY

• Internal working models attachment as a set of
  belief, expectations, stories we have about
  ourselves and others
• Narrative approaches - move to assessing
  attachment through the content and structure of
  the stories people tell about their lives
• Narrative ability to tell coherent stories
  about our lives is shaped by our attachment
  experiences in families

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Internal Working Models

• Beliefs and expectations about
• Ones own and other peoples behaviour
• Views of the SELF How loveable, worthy and
  acceptable am I?
• How available and interested are others in me,
  and in caring for and looking after me?
• These guide our actions, thoughts and feelings
  how we try to keep ourselves safe, close to and
  loved by others

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Internal Working Models

• SECURE able to use feelings and cognitions to
  make sense of events
• INSECURE
• AVOIDANT Shut down and deny feelings, display
  of distress is expected to annoy the caregiver so
  engage in pretending - put on false front
  distrust of feelings
• AMBIVALENT Expect carer to be inconsistent, not
  able to predict their availability or verbal
  promises. Develop clingy and coercive strategies
  to secure attention and caring - distrust of
  words
• DISORGANISED Carer may be confusing,
  frightening, abusive, child finds it difficult to
  develop and predict a consistent pattern
  distrust of words and feelings

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ATTACHMENT STYLES AS COMMUNICATIONAL PATTERNS

• ATTACHMENT AS OPEN or CLOSED COMMUNICATION IN
  FAMILIES
• INSECURE ATTACHMENT INVOLVE DISTORTIONS OF
  COMMUNICATION - such that we cannot say openly
  or clearly how we feel and what we need
• ATTACHMENT STYLES AS A SET OF FAMILY
  COMMUNICATIONAL RULES
• SECURE Expression of feelings met by
  acknowledgement, reflection and negotiation
  semantic and emotional responses
• DISMISSIVE Communication of feelings met by
  injunction to suppress feelings, avoidance,
  rejection semantic responses
• PRE-OCCUPIED Symmetrical escalating expressions
  of feelings, mutual accusation, blaming
  emotional response

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Family Patterns

• INSECURITY can develop from FAMILY patterns
• Parents may differ in their styles , e.g. mother
  avoidant/dismissive , father ambivalent/pre-occupi
  ed
• Parents may switch positions
• MOTHER FATHER
• Pre-occupied Dismissive
• CHILD ?

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CLAIRE

• Int ..can you describe your family in terms of
  relationships ?
• Claire Its very false, its very strange. I mean
  its changed a lot. When I was younger it was
  just awful all the time, I dont like anger now,
  its like, arguing non stop. It was horrible I
  would do anything to stop them arguing and anger
  is like fear. I dont like anger now, its like
  an emotion that cant be controlled and that
  scares me....But recently everyones been really
  trying but it still seems, it seems really false
  to me..
• The only thing I ever hear them talking about is
  me and if I didnt have this anorexia its kind
  of like, would everything fall apart, at least
  its keeping them talking. And they wont argue
  while Ive got this because it might make me
  worse. So um...thats kind of bought, sort of
  like, Im not in control as such but Ive got
  more control over the situation that way.
• Int So if you were upset or distressed or
  frightened when you were young, who would you go
  to?
• Claire Nobody. I wouldnt go to anybody. The
  only time I ever did was once when Mum was at
  work and I had to sleep in my brothers room. I
  cant remember why, and there was a picture of me
  and her when we were little, cuddling, and I was
  only young and I was looking at this picture and
  I was crying so much because I thought because
  theyre older than most parents that she was
  going to die really soon and I went down to Dad
  and he was like Dont be stupid and go back to
  bed, and I had to go back to bed. And after that
  I didnt bother going to him. I would just bottle
  it all up and just not bother

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Implications for Therapy

• Naming and regulating emotions
• Standing in the emotional shoes of the other
• Comforting and self soothing
• Information processing
• Transformations in memory systems

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Felt security in a relationship

• Affect regulation (less reactivity, hyper-arousal
  under-arousal)
• Support seeking
• Information processing (curiosity, open, more
  toleration of uncertainty)
• Communication (meta-communication, disclosing,
  collaborative, assertive, empathic)
• Sense of self (elaborated, articulated,
  positive)

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THERAPY AS SCAFFOLDING Emotional and cognitive

• Therapy and scaffolding
• Encourage a secure emotional base stance of
  acceptance and non- judgement
• Encourage noticing peoples feelings
• Offer words, phrases to help identify feelings
• Offer words and phrases to talk about how others
  feel
• Offer words and phrases to help discuss how
  people comfort each other
• Offer words, phrases , stories to assist
  integration of feelings and events

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Systemic Techniques and Attachment Styles

AMBIVALENT/PRE-OCCUPIED
AVOIDANT/DISMISSIVE
Encouraging expression of feelings
Encouraging expression of cognitions
Enactment Role play Empathic Questions Internalise
d Other Interviewing beliefs/ punctuation Areas
of conflict How conflict is managed Caring and
comforting
Genograms Life line Tracking Circularities Mapping
Relationships Scaling questions Circular
questions Shared/family beliefs
REFLECTING TEAMS
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Attachment Narrative Therapy with Families/Couples

• Creating a secure base
• Mapping the context talk about talk
• Engaging warmly with each member of the family
• Reflecting on our relationships in the room
  modeling open communication
• Use of self therapist reflecting on his/her own
  experiences
• Adopting a non-blaming approach - working
  together vs fixing families, purpose is not to
  find fault in the past or present
• Externalizing Framework
• Exploring the problem - beliefs, feelings,
  explanations
• A conservative (paradoxical) framework - not
  pushing for change
• Access, expand, reprocess emotional experience
• De-escalating unhelpful patterns

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Attachment Narrative Therapy with Families/Couples

• Exploring Narratives and Attachments within a
  systemic framework
• Current attachments
• Gossiping - circular questioning
• Trans-generational attachment traditions
• Encouraging sociality/empathy
• Impact of the problem on the family relationships
  and vice versa
• Encouraging awareness of self and others in
  interaction

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Attachment Narrative Therapy with Families/Couples

• Considering Alternatives
• Contemplating alternative narratives and
  responses
• Family experiments in and outside the therapy
  room
• Unique outcomes exceptions
• Working within and between moving between
  intra and interpersonal narratives
• Promoting secure bonding interactions

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Attachment Narrative Therapy with Families/Couples

• The future and maintaining the therapeutic base
• Contemplating futures
• Consolidating change
• Plans to deal with relapse
• Considering ways of continuing contact
• Feelings about separation, ending therapy

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Exploring Patterns of Comforting

• When you were upset or frightened as a child
  what happened?
• How did you get to feel better? Who helped you to
  feel better? How did they do this?
• What have you learnt from this for your own
  family?
• What do you want to do the same?
• What do you want to do differently?
• How do people comfort each other in your own
  family/ relationship?
• How do you comfort your children?
• How do they comfort you?
• Can be done as a family or couple interview or as
  a one-to-one conversation.

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Corrective and Replicative Scripts

• This utilises ideas from John Byng-Hall that
  families make comparisons across the generations
  in terms of similarities and differences between
  how our own parents were with each other and us (
  the children) and how this is repeated or
  altered in the next generation.
• Importantly it allows us to work in a positive
  frame with the family in that we can construe the
  intentions of the parents positively, i.e. they
  have tried to repeat what was good or correct
  what they felt was bad about their own
  experiences. This can then lead to a discussion
  of whether these attempts have been successful or
  not, and possibly how they might be altered,
  strengthened, elaborated etc.
• What are your thoughts about how similar or
  different your relationship with each other and
  your children is to your parents (
  grandparents) relationships ?
• What have you tried to make similar or different
  to either of these relationships?
• What do you value vs feel critical about in
  either of your parents relationships
• Does what you have tried to repeat/change work?
  Is there anything that you want to alter,
  strengthen, abandon about what you have been
  trying to repeat or change?

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How to Contact Us

• r.dallos_at_plymouth.ac.uk
• a.vetere_at_surrey.ac.uk