[Attachment and attachment-based intervention: the Circle of Security intervention project in Hamburg].

Klinik für kinder-und Jugend -psychiatrie,-psychotherapie und-psychosomatik, Zentrum für Psychosoziale Medizin, Univversitätsklinik Hamburg-Eppendorf, Hamburg.
Praxis der Kinderpsychologie und Kinderpsychiatrie (Impact Factor: 0.58). 01/2011; 60(6):417-29.
Source: PubMed


Since the early sixties empirical research into early childhood and the parent-infant relationship has increased, commonly informed by attachment theory. The mutually regulated interaction within the attachment and care giving relationship of mother and infant gives this relationship its exceptional emotional quality. Early attachment experiences organize socio-emotional and cognitive development beyond childhood. Attachment theory and research define observable behaviors and the level of internal representations as an intervening variable of the transmission of attachment patterns between mother and child. Basic attachment derived concepts are the starting points of the Circle of Security approach. The Circle of Security Intervention Project in Hamburg for mothers with postpartum mental illness and their infants is described in more detail. Specific aspects are discussed with reference to a diagnostic case study.

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    ABSTRACT: Clinically significant separation anxiety disorder in childhood leads to adult panic disorder and other anxiety disorders. The prevailing pathophysiological model of anxiety disorders, which emphasizes extinction deficits of fear-conditioned responses, does not fully consider the role of separation anxiety. Pathological early childhood attachments have far-reaching consequences for the later adult ability to experience and internalize positive relationships in order to develop mental capacities for self-soothing, anxiety tolerance, affect modulation, and individuation. Initially identified in attachment research, the phenomenon of separation anxiety is supported by animal model, neuroimaging, and genetic studies. A role of oxytocin is postulated. Adults, inured to their anxiety, often do not identify separation anxiety as problematic, but those who develop anxiety and mood disorders respond more poorly to both pharmacological and psychotherapeutic interventions. This poorer response may reflect patients' difficulty in forming and maintaining attachments, including therapeutic relationships. Psychotherapies that focus on relationships and separation anxiety may benefit patients with separation anxiety by using the dyadic therapist-patient relationship to recapture and better understand important elements of earlier pathological parent-child relationships.
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