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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by seldomseen on November 23, 2008, at 7:27:31
So much of psychiatric theory is based on the premise that the ability to form stable attachments is necessary for stable relationships, and these relationships form the basis of a mentally healthy human.
I beginning to wonder if this is true.
My years as a clinical scientist have taught me that there is considerable (that is a gross understatement) variability among individuals. We are all sooooo very different in our physiology.
I mean some people must, simply due to their nature, attach very freely and without reserve. Others may be much more resistant to attachment. Still others are in the middle.
I think this continuum surely exists regardless of pathology but is rather dictated by genetic, physiological factors within the individual.
Surely this physiological basis can be directly influenced by environment, but in this baseline ability there must be marked difference between individuals.
I wonder if I am on the outer end of the continuum of attachment and it is just my nature to be solitary. That, in fact, there is nothing wrong with me at all. My resistance is just *me*.
There is a complicating factor, however, (at least for me) - the history of abuse that would be predicted to influence my ability to attach. Therefore, it may not be *me* but a true morbidity.
So the question is, how to tell the difference between pathology and physiology.
The answer to this question does have some ramifications - namely, whether or not to continue therapy and treatment.
And I just don't know the answer to it.
Any ideas?
Seldom.
Posted by Dinah on November 23, 2008, at 8:33:41
In reply to Humans must exist along a continuum of attachment, posted by seldomseen on November 23, 2008, at 7:27:31
Actually I totally agree with you. I think that the angle of psychology may sometimes overestimate the power of environment just as the psychopharmacologists underestimate it.
I always figured it was most likely as you said. A basic temperament influenced by the environment.
Perhaps it's because of my life with dogs. I would see parent/child or siblings who were uncannily alike in things you'd never even think might be genetic. And that was true even with sire/puppy, who likely had never met one another. But I also saw how the expression of that temperament could be greatly affected by the environment. So, as the example that struck me most heavily, a mother dog who had a reserved, anxious, not terribly attached temperament and who had grown up in a home with so many dogs that individual attention was unlikely turned out so that she wasn't really able to attach and was quite distrustful, making life in a real home a bit difficult. While her daughter, with the exact same native temperament I'm sure, grew up in a household with just a few other dogs, kids popping in and out, etc. She never grew to be warm and fuzzy precisely. But she grew up to be a relatively well adjusted dog with an attachment to at least one person, and not nearly as anxious or defensive.
I'm not saying the first dog grew up in an abusive environment. She didn't. Any number of dogs could and did grow up just fine. It wasn't a puppymill. It just was a home where the attention was spread a bit further. A more resilient dog, or one with a more outgoing temperament, would have been just fine. Nor was she a horrible dog. On the surface she was more or less the same as any other dog. She just preferred her own company and was a bit suspicious of the motives of others. She never snapped at anyone. It wouldn't have even occurred to her that she could.
It wasn't a bad home. It wasn't a bad temperament. It was merely a bad combination.
She never did get all better and behave like other members of her breed. Yet she, and we, were happy enough together, and perhaps her home with us helped her to be happy.
I'm a bit perplexed as to why this would make you wish to give up therapy though? You clearly have attached to your therapist. Has that attachment been beneficial?
Absolutely there is no requirement or even desirability of going to therapy longer than is beneficial to you. If it doesn't help your functioning, if you think you have gotten all you can from it, etc., then it is time to quit. I think it's a good thing to evaluate this from time to time. Maybe you and your therapist could discuss it?
If I may be a bit bold? I notice that the tone of this post is very detached and clinical, and sounds different from what I am accustomed to hearing from you. Not that you don't regularly impress me greatly with your common sense. But the tone is usually different.
I have noticed in myself (and with great amusement) that I have two ways of getting absolutely furious. The first is by best illustrated by my losing my words altogether. But when I'm angry in the second way, my words get longer and longer, and my writing style more... brilliant (not in the sense of wonderful, but in the sense of a diamond - sharp edged and glittering).
Is it at all possible that your absolute calm and logical sequence of thoughts in this posts is as indicative of anger as it would have been if you had screamed?
I'm not saying it is. I know not everyone is like me. Heck, I always figure I'm the only one so weird as I am. But I thought I'd offer it anyway.
Posted by Wittgensteinz on November 23, 2008, at 10:21:50
In reply to Humans must exist along a continuum of attachment, posted by seldomseen on November 23, 2008, at 7:27:31
Is it a question of: whether your difficulty/resistance to attachment/your solitary nature is indeed pathological OR if it is simply something that fits within the (normal) spectrum of human physiology?
I think the problem here is the 'normal'. The question of ones attachment style being normal or not surely depends on how you personally perceive yourself and your relationships. Diagnoses tend to rest on negative characteristics (the aspects of your personality/behaviour that lead to disfunction) rather than on neutral observations - the one exception that comes to mind is that of the overt schizoid personality disordered person - the person who does not attach to others but also has no desire, ever, to do so. A person with true overt SPD, which is a very narrow diagnosis, will have no reason to seek help for their mental health - one even has to wonder whether such people exist - this is in stark contrast with the person with covert SPD.
What I mean is - if you are a solitary person yet you are able to keep a job, look after yourself, live without the burden of intolerable sadness and anxiety, then there is nothing pathological about your attachment style. Another person might have the same attachment style but spend their days avoiding social situations, longing for the relationships they were unable to form etc. I don't think it is the attachment in itself and alone that constitutes mental health, it is the effects of that attachment style on the way that person functions (or fails to function) in society.
As for the question of why/how someone came to have a certain attachment style and not another - genetics and environment will both have a contribution. A person with a certain genetic make-up will be predisposed to X attachment style - if they then experience A, B and C in their early life, this might seal the disposition. This explains co-morbidity in many (if not all) mental illnesses between early childhood environment and onset of a given psychiatric pathology - each person might carry a certain disposition toward X but when extra factors are present that disposition is increased significantly. That's not to say that all those raised in abusive environments will go on to develop psychiatric pathologies or that all those with these pathologies had deficits in their early environment. There will also be those who didn't need those extra factors to be present in order to develop the same problems.
I think the question of whether or not your early environment is the 'cause' of your adult attachment style cannot be answered - it will likely be a combination of genetics and your experiences that will have contributed to who you are and how you attach. What is important is to ask yourself whether your psychotherapy is serving a purpose to you in your functioning in society. Do you long to be able to attach in a way you cannot? Does your attachment style cause you suffering/limitations? If this is the case, then it surely is pathological in nature? Even supposing your way of attaching is 100% genetics determined, fixed and unchangeable (which would give a rather bleak outlook and is at odds with the adaptable nature of human beings), there is still the question of addressing the way you feel about your attachments or lack of - even if you weren't able to change the way you attach.
I know I haven't posted on your earlier threads. Reading what you have written about the way your currently feel toward your therapist, it seems you have a lot of anger toward him. It is interesting that you are questioning psychology/psychiatric theory per se, when there is already all this going on in terms of you and your therapist. Are these two separate lines of thought or are they connected? On the one hand you write of the natural feeling of abandonment and hurt one would experience at being locked out and being forgotten triggered by your therapist's actions of late - and on the other you write of your skepticism of psychology in general - did one lead to the other?
From reading what you have written in the past, I always had the feeling that you have a good, strong attachment with your T. My feeling is that the answer you arrive at in regards to your questions about physiology and pathology should be explored once you have worked through the way your T's actions have made you feel lately, rather than as a grounds as to whether or not to terminate. There was something you said in an earlier thread about how your relationship with your T was pretty much emulating that you had with your parents - and it made me wonder whether your therapist's being open about his desires toward you was still something in need of further discussion/exploration.
I hope I haven't missed the point completely here and that this makes some sort of sense! I also hope I haven't stepped over the mark and if so, I'm sorry.
I really feel for you and what you're going through. Have you put these questions to your T?
Witti
Posted by seldomseen on November 23, 2008, at 12:30:24
In reply to Re: Humans must exist along a continuum of attachment » seldomseen, posted by Dinah on November 23, 2008, at 8:33:41
"I'm a bit perplexed as to why this would make you wish to give up therapy though? You clearly have attached to your therapist. Has that attachment been beneficial?"
I don't know, Dinah if it has been beneficial or not. Forming that attachment (or the perceived one) has certainly been difficult, and the source of much consternation on my part. What I don't know is if it has been difficult because of my past, or the difficulty arises out of who I am. If it is a function of my past, then I adamantly think I should stay in therapy and continue working. However, if it is just who I am, and I am comfortable that, then why continue to force the issue and work toward making a square peg fit into a round hole?
"Absolutely there is no requirement or even desirability of going to therapy longer than is beneficial to you. If it doesn't help your functioning, if you think you have gotten all you can from it, etc., then it is time to quit. I think it's a good thing to evaluate this from time to time. Maybe you and your therapist could discuss it?"
I do plan to discuss this with him. The last time we met, I did bring up the notion that my issues might be physiology based. He was rather dismissive of that theory.
"If I may be a bit bold? I notice that the tone of this post is very detached and clinical, and sounds different from what I am accustomed to hearing from you. Not that you don't regularly impress me greatly with your common sense. But the tone is usually different.
I have noticed in myself (and with great amusement) that I have two ways of getting absolutely furious. The first is by best illustrated by my losing my words altogether. But when I'm angry in the second way, my words get longer and longer, and my writing style more... brilliant (not in the sense of wonderful, but in the sense of a diamond - sharp edged and glittering).
Is it at all possible that your absolute calm and logical sequence of thoughts in this posts is as indicative of anger as it would have been if you had screamed?"
Perhaps. I am clearly not happy with my current course in therapy. Sometimes it is hard to escape being a scientist. To be honest, I am as comfortable in the world of reason and logic as I am in the supernatural and emotive. I've also been working on a manuscript today, so there is some inevitable spill over in verbiage.
"I'm not saying it is. I know not everyone is like me. Heck, I always figure I'm the only one so weird as I am. But I thought I'd offer it anyway."I don't think you are weird at all. None of us are.
Seldom.
Posted by Phillipa on November 23, 2008, at 12:55:21
In reply to Re: Humans must exist along a continuum of attachment » Dinah, posted by seldomseen on November 23, 2008, at 12:30:24
I'm wierd I know that. Raised myself alone and then tried to raise three kids help them be independent, go to nursing school and try to figure out if I really killed my Mother as a baby as she said I did and that her illness was my fault. Thought over it but now aging and my independance disappeared and left as a clingy scared person. Why did therapists say you're over it and it's time to move on. Am I? Feel frozen in actions. So don't know if the science personality leaves out some of the emotional as numb. Sorry I'm not psychology saavy as you guys. I'm trying. Love Phillipa
Posted by seldomseen on November 23, 2008, at 12:59:15
In reply to Re: Humans must exist along a continuum of attachm » seldomseen, posted by Wittgensteinz on November 23, 2008, at 10:21:50
"Is it a question of: whether your difficulty/resistance to attachment/your solitary nature is indeed pathological OR if it is simply something that fits within the (normal) spectrum of human physiology?
...
What I mean is - if you are a solitary person yet you are able to keep a job, look after yourself, live without the burden of intolerable sadness and anxiety, then there is nothing pathological about your attachment style. Another person might have the same attachment style but spend their days avoiding social situations, longing for the relationships they were unable to form etc. I don't think it is the attachment in itself and alone that constitutes mental health, it is the effects of that attachment style on the way that person functions (or fails to function) in society."I think I'm a functioning member of society. I also know that being alone is not a big deal for me at all. In fact, sometimes it is a huge relief to NOT be burdened with others. Is that a pathology? That relief? I get lonely sometimes, but have I ever really felt alone? I don't know. I've fallen madly, utterly in love (and it was wonderful), seen that relationship end, suffered the heartbreak, then experienced the relief of being free from it.
I don't know what my attachment style is, only that what is going on right now between my therapist and me is hurtful.
"...I think the question of whether or not your early environment is the 'cause' of your adult attachment style cannot be answered - it will likely be a combination of genetics and your experiences that will have contributed to who you are and how you attach.
What is important is to ask yourself whether your psychotherapy is serving a purpose to you in your functioning in society."It isn't helping my function in society. It may have helped me to actually fall in love, but I function just fine either way.
"Do you long to be able to attach in a way you cannot?"
This is a great question. One, of course, I don't have the answer to. I'm having a lot of trouble separating out what *I* want, versus what theory, my therapist, the rest of the world, *tells* me I should want."Does your attachment style cause you suffering/limitations?"
The primary source of my suffering is the relationship with my therapist I think. Why are his missteps so painful? Why do I not, simply understand that these things happen and it doesn't change anything and just move with it? I do that in other relationships. Why not him? Of course one could argue that those other relationships are quite superficial and that I simply don't really care enough to be bothered by it.
"I know I haven't posted on your earlier threads. Reading what you have written about the way your currently feel toward your therapist, it seems you have a lot of anger toward him. It is interesting that you are questioning psychology/psychiatric theory per se, when there is already all this going on in terms of you and your therapist. Are these two separate lines of thought or are they connected?"
I think they *are* connected.
"On the one hand you write of the natural feeling of abandonment and hurt one would experience at being locked out and being forgotten triggered by your therapist's actions of late - and on the other you write of your skepticism of psychology in general - did one lead to the other?"As I indicated, they are connected, but I don't know if they are causal. I'm not skeptical of psychology, in fact, a picture of Freud hangs in my bedroom (wow, wouldn't he have a field day with THAT?). I'm just wondering if my therapist and I may have missed something fundamental about me.
"From reading what you have written in the past, I always had the feeling that you have a good, strong attachment with your T. My feeling is that the answer you arrive at in regards to your questions about physiology and pathology should be explored once you have worked through the way your T's actions have made you feel lately, rather than as a grounds as to whether or not to terminate."
That is just good, sound advice. Though temporally related, I think you are dead on that these should be treated as two separate issies.
"There was something you said in an earlier thread about how your relationship with your T was pretty much emulating that you had with your parents - and it made me wonder whether your therapist's being open about his desires toward you was still something in need of further discussion/exploration."
Oh lord I hope not.
"I hope I haven't missed the point completely here and that this makes some sort of sense! I also hope I haven't stepped over the mark and if so, I'm sorry.
I really feel for you and what you're going through. Have you put these questions to your T?"
You haven't missed anything, thank you for your response.
Witti
Posted by rskontos on November 25, 2008, at 14:26:42
In reply to Humans must exist along a continuum of attachment, posted by seldomseen on November 23, 2008, at 7:27:31
Seldom,
Lately I too have been fascinated with attachments and attachment theories. I have proposed several of these questions to my p-doc/t who has found my questions "very good observations or very good questions" yet I find the responses of his does not yet find the mark within my own self. His answers or opinions are not yet what i am looking for. Yet the answer I seek I am not sure is his to answer, although at the present I have no response even to my own questions.
I am wondering if once an attachment is wronged in some way, however it is interrupted, is it ever able to be repaired. And I too, wonder if stable attachments are necessary for stable relationships. I have always moved from one relationship to another and forgot one to move to the next without any hesitation. I have only now been told this is not correct.
I am not bothered by being alone. I get lonely but I am fine most of time. I usually am alone even when I am with people. I like to remain at the outer limits of people anyway and observe them.
I like your statement "humans must exist along a continuum of attachment." And why wouldn't there be variability in attachment and what is healthy and what isn't.
Everyone had good points about their observations regarding how this might be affecting you in your situation but from a purely scientific point of view I think you are absolutely correct.
Regarding continuation of therapy, I must admit I struggle with that too, and I have been in therapy for a much shorter time than you.
rsk
This is the end of the thread.
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