460 - Complicated Grief and Attachment

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Complicated Grief and Attachment

Dr. Dawn-Elise Snipes PhD, LPC-MHSP

Podcast Host: Counselor Toolbox and Happiness Isn't Brain Surgery

Objectives

~ Define Complicated Grief

~ Identify how loss of or lack of an attachment relationship may represent a loss that needs to be grieved.

~ Explore the overlap between complicated grief and trauma

~ Identify risk factors for CG

~ Explore tasks for successful grief resolution

Definitions:

~ Loss: Change that includes being without someone or something in this case the primary attachment relationship

~ Secondary loss: Other losses as a result of a primary loss. Example, loss of security when rejected by primary caregiver

~ Grief: Reaction or response to loss; includes physical, social, emotional, cognitive and spiritual dimensions.

~ Trauma: Any situation that causes the individual to experience extreme distress

Attachment

~ Attachment

~ Attachment is the quality of the relationship with the caregiver characterized by trust, safety and security.

~ The quality of the infant-parent attachment is a powerful predictor of a child's later social and emotional outcome

~ Determined by the caregiver's response to the infant and toddler when the child's attachment system is 'activated'

Internal Working Model

~ Children's attachment with their primary caregiver leads to the development of an internal working model which guides future interactions with others.

~ 3 main features of the internal working model

~ a model of others as being trustworthy (what is the loss here?)

~ a model of the self as valuable (what is the loss here?)

~ a model of the self as effective when interacting with others. (what is the loss here?)

~ Secure attachments also help children

~ Feel loved and accepted

~ Learn to manage their emotions

~ Address dichotomous thinking and cognitive distortions

Bowlby on Attachment and Grief

~ Attachment Relationships Help Regulate Psychological And Biological Functions Including:

~ Mastery and performance success

~ Learning and performing

~ Relationships with others (and future attachment)

~ Cognitive functioning

~ Coping and problem solving skills

~ Self-esteem

~ Emotion regulation

~ Sleep quality

~ Pain intensity (physical and emotional)

Bowlby

~ Attachment and safety stimulate a desire to learn, grow and explore

~ Caregivers provide support and reassurance (Safe haven)

~ Encouragement and pleasure (secure base)

Feeney J Pers Soc Psych 631 -648 2004

Bowlby

~ Loss of an attachment relationship

~ Disrupts attachment, caregiving and exploratory systems

~ Attachment: Activates separation response and impacts restorative emotional, social and biological processes

~ Exploratory system: Inhibits exploration with a loss of a sense of confidence and agency.

~ Caregiving: Produces a sense of failure and can include self blame and survivor guilt

Trauma

~ Trauma is any event that is distressing or disturbing

~ How do we know what is distressing or disturbing

~ Erodes a sense of safety (Triggers fight or flight)

~ Emotional (including dysregulation)

~ Mental (interpretations and schemas)

~ Physical (object permanence, darkness, pain, prior experiences)

~ Adverse Childhood Experiences that may disrupt primary attachment

~ Immediate family member with a mental health or addiction issue

~ Immediate family member who is incarcerated

~ Divorce

~ Abuse (child or DV)

~ Neglect

How Can Disrupted Attachment ïƒ Trauma

~ The primary attachment figure remains crucial for approximately the first 5 years of life

~ Trust/mistrust (Ages 0-2)

~ Object Permanence

~ Autonomy/shame (Ages 2-7)

~ Egocentrism: children assume that other people see, hear, and feel exactly the same