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welcome to my scientifically informed
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insider look at mental health topics if
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you find this video to be interesting or
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helpful please like it and subscribe to
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my channel hello this is dr. grande
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today I have a couple questions the
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first is what is attachment theory and
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the second is how does attachment theory
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relate to personality disorders so
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attachment theory is mostly based on a
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child's relationship with their mother
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now this can also include a caregiver
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other than the mother but almost all the
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time when we see in the research
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literature it's specifically talking
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about the relationship with a mother now
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some researchers believe that attachment
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theory may be able to partially explain
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the development of anxiety depression
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personality disorders as well as other
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factors like marital problems poor
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academic performance and other negative
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outcomes
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so essentially attachment may be a major
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determining factor in the organization
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of personality and it may be ideological
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to psychopathology meaning it may
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contribute to the cause of mental
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disorders now considering what we know
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about personality and psychopathology
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this is a fairly bold claim those that
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really kind of support attachment theory
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in this role this is giving attachment
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theory a lot of influence and in essence
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minimizing the effects of other
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environmental factors and genetic
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influences even still it is hard to deny
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that attachment is critical it seems to
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have effects across a few different
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domains although the research literature
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is really mixed in terms of specifics we
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don't get a lot of specific connections
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from attachment theory over to
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psychopathology I'll talk about some of
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the findings that we see in the research
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literature in a moment
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now attachment theory really isn't
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talking about one theory there are
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actually many attachment theories and
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each have different attachment styles
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one of the main challenges with
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attachment theory in terms of
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understanding it really has to do with
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the separate theories and all the
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attachment styles that they have we see
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the same words or similar words used in
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different ways to mean different things
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with all these attachment styles
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it can become confusing quite quickly
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for example if we look at the work of a
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researcher named Bowlby who developed
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really the first popular theory of
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attachment we see in this theory there
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is both secure and insecure attachment
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so that's something that really
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continued on into other theories and
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with this theory specifically insecure
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attachment itself is actually divided in
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two types so essentially we can look at
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all attachment as either secure or
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insecure and then we can further divide
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the insecure type into anxious and
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avoidant attachment styles now here's
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where things get a little more confusing
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anxious is also referred to as
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preoccupied resistant anxious ambivalent
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and anxious preoccupied avoidant is also
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referred to as dismissive so really way
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too many terms that mean the same thing
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looking at the attachment Styles
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delineated by researchers named Main and
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Goldwyn we see it doesn't get a whole
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lot less confusing here we see four
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Styles secure autonomous insecure
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dismissing insecure preoccupied and
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unresolved with respect to loss of
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trauma also referred to as disorganized
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so this is a bit more straightforward
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but still a little confusing and it is a
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fairly popular attachment theory another
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fairly popular model comes from
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researchers named Bartholomew and
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Horowitz this model is somewhat similar
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to the prior model and both of these
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models are widely used in the research
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literature this model has four Styles
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now I'm going to explain these in a
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little more detail secure attachment
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this is considered healthy attachment we
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see a capacity to maintain close
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relationships without losing a sense of
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autonomy we see that somebody places
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value on intimate relationships and they
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are thoughtful when discussing
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relationships the second style is
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dismissing attachment with this style we
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see someone who has restricted emotions
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flat effect they downplay the importance
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of close relationships they place a
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strong emphasis on being self-reliant
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and independent and they're not clear
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and trustworthy when they discuss
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relationships
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moving to the third attachment style
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this is preoccupied attachment here we
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see someone who needs other people to
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accept them they tend to idealize others
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they are over involved in close
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relationships and we see exaggerated
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emotionality and incoherence when
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discussing relationships and that brings
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us to the fourth style fearful
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attachment here we see someone who
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avoids close relationships because they
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are afraid of rejection they tend to
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distrust other people and they feel
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insecure so most of the confusion occurs
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between the last two models I talked
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about probably because they're so
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similar and they are each the basis for
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separate popular psychometric
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instruments so both theories have tests
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that were based on their respective
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attachment styles so this can make it a
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little tricky when comparing research
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because one article might use one of the
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tests based on one theory and another
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article could use the test based on
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another theory and of course this means
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it could be challenging to try to
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compare them now moving toward this
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relationship between attachment Styles
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and personality disorders I'll first
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start with research that looks at
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attachment styles and all of
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psychopathology and a few other factors
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now as I mentioned before we see mixed
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results in the research literature some
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studies have found that there's really
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no association between attachment style
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and psychopathology right just nothing
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there other studies have found some
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relationships many of the associations
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are related to the insecure attachment
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style in general and not necessarily the
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individual insecure attachment types we
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see a positive association between
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insecure attachment and criminality as
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well as violence we also see the
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insecure attachment has a positive
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association with cluster B personality
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disorders so cluster B has four
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personality sorters antisocial
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borderline narcissistic and histrionic
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Personality Disorder now the dismissing
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attachment style is related to conduct
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disorder substance use disorder as well
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as narcissistic and antisocial
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personality disorders and preoccupied
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attachment increases the risk of being
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diagnosed with schizophrenia
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borderline histrionic and
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obsessive-compulsive personality
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disorders now there's something
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interesting about the attachment styles
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and the relationship to psychopathy one
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of the outcomes from some of these
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measures of attachment Styles is cannot
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classify meaning somebody takes the test
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and the test cannot determine what type
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of attachment style they have it would
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appear perhaps they don't have any
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attachment style at all not secure and
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not insecure this particular finding
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cannot classify is actually associated
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with psychopathy I find this interesting
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because one of the observations I've
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made when working with people who score
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high in psychopathy is they don't tend
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to have an appreciation for the
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importance of attachment as a general
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construct so they might look at a mother
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who is being very distant from a child
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like she's being extremely rejecting
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kind of cruel and they don't really
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think anything about that they don't
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feel a certain way about it whereas
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individuals who are not psychopathic
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would react strongly to that it's almost
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like those high and psychopathy are just
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indifferent to the whole issue of
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attachment in general as I indicated now
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another way to view this model is to
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think about the distinction between self
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and others so the way somebody thinks
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about themselves and the way somebody
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thinks about others but I think this is
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a really interesting way to
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conceptualize the attachment styles so
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with secure attachment we see a positive
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view of self and a positive view of
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others so everything's positive with the
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preoccupied attachment style we would
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see a negative view self and a positive
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view of others so a person doesn't feel
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too good about themselves but they like
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other people right that makes sense when
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you think about the preoccupied
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attachment style now the dismissing
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attachment style that person would have
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a positive view of themself but a
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negative view of others right so they
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feel good about themselves but they
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don't like others and then the fearful
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attachment style we would see a negative
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view of self and a negative view of
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others so everything's negative without
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attachment style now somebody could
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clearly fit into one of those categories
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or they could be kind of in more
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at the same time for example somebody
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could have both positive and negative
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views of themselves but a negative view
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of others so they would be dismissing
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and fearful they would kind of be in
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both categories another thing that can
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happen is that somebody can have a
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positive and negative view of themselves
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and a positive and negative view of
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others we refer to this as disorganized
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attachment now when looking at the model
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this way we see that attachment theory
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can be connected to personality
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disorders conceptually now that means is
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that the research literature may not
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have findings that show that a
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particular attachment style is
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associated with a specific personality
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disorder but there can still be a way to
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think about that relationship between
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attachment styles and personality
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sorters essentially a way to bring the
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two constructs into alignment a better
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way that we can understand them now the
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way this is done is to look at each
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personality disorder and see what fits
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in terms of the attachment dimension so
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the attachment style that would relate
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to that person a sorter then look at the
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model of self how somebody views
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themselves look at the model of others
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how they look at other people as well as
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a central belief that they have that
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maintains the personality disorder I
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find that this is actually a really
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useful way to think about personality
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sewers from another angle right to use
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attachment theory to understand
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personality disorders a little bit
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better so I'm going to go through each
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of the ten personality disorders and
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look at the various factors that I just
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talked about so I'm gonna line up the
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attachment style the model of self the
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model of others and the belief to each
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personality sweater so starting with
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cluster a personality pathology we see
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paranoid person is wetter here we see a
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fearful attachment style the model of
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self would be special unique and
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different so almost seems like it lines
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up a little bit with narcissism in terms
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of others others can't be trusted in
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terms of the belief I am safer being
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alone because others can't be trusted
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right so all those kind of make sense in
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terms of paranoid thinking moving to
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schizoid person
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sorter the attachment style is
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dismissing the attitude towards self is
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passive and unaffected others are
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emotionally unresponsive and the belief
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is the world is unresponsive therefore
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I'm not going to bother creating
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relationships moving this gets a tipple
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person idea sorter we see two attachment
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styles are really represented fearful
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and dismissing in terms of the self this
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is really non-existent there's no sense
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of self and this is the only personality
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disorder like this in terms of others
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others do not have good intentions and
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in terms of the belief I am unusual now
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moving to cluster B personality
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pathology starting with antisocial
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personality disorder here we see a
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combination of fearful and dismissing
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the model of self at the core this is
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really unlovable but the appearance is
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entitled and we think that is defensive
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so if somebody has the sense of
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entitlement to protect themselves but
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again they don't feel like they can
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really be loved in terms of the model of
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others others will never love or care
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for me and in terms of the belief I need
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to be tough and powerful so no one will
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hurt me moving to borderline personality
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disorder the attachment style here is
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disorganized and this is the only
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personality disorder that has this type
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of attachment so with the model self of
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course we have both positive and
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negative and when looking at others we
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have both positive and negative in terms
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of the belief we see I can't tolerate
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things not going my way
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others are great and no they're not so
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again we see that back and forth that
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typifies borderline personality
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now moving to narcissistic personality
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here we see fearful and dismissing the
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model of self is extremely fragile but
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there's an appearance of koffice right
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so this is interesting because if we
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look at antisocial which I just talked
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about we see the model self is one way
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but then there's an appearance of
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something else we have the same thing
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with narcissistic personality
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in terms of the model of others others
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expect greatness from me and the belief
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I'm entitled to special treatment
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looking at histrionic Personality
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Disorder we see preoccupied attachment
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the model self insignificant and
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unimportant looking at others others are
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a valuable source of attention so notice
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how the model of self and the model of
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others really work together here
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insignificant and unimportant that's
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what they think of themselves and others
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are a valuable source of attention so
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that attention kind of satisfies those
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concerns of feeling insignificant and
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unimportant right so that relationship
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seems pretty clear and it makes sense
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how it progresses here when we look at
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history onic in terms of the belief I
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need the attention of others to feel
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valuable again quite consistent with
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what we already see here now moving to
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clusters see personality pathology and
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the first disorder here is avoidant
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personality we see preoccupied and
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fearful so the model self frightened of
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rejection and inferior in terms of
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others others are to be avoided and the
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belief even though people will reject me
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I want someone to like me now looking at
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dependent person is order we see a
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preoccupied attachment style the model
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of self fragile and inferior in terms of
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others others need to take care of me
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and the belief I am a weak person and I
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cannot survive without others and that
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brings us to the last person I disorder
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obsessive-compulsive personality sorter
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we see a preoccupied attachment style
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here the model of self unfailingly
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reliable looking at others others expect
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me to be perfect and the belief I must
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always be prepared to prove my
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competency so again I find this a really
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useful way to look at attachment theory
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and personality pathology at the same
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time it kind of brings them together
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it's kind of a quick yet still profound
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way to explore the personality disorders
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and how they function what people are
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kind of thinking if they have one those
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personality sorters it's sometimes
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difficult to relate attachment theory to
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personality pathology
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and a personality traits in general and
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this offers kind of a conceptual model
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that I think can be useful in clinical
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practice so if you're working with
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somebody with a particular personality
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disorder it gives you again kind of a
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fast way to say how could this relate to
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attachment theory is there anything
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going on with attachment theory and I
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need to pay attention to based on the
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personality pathology that I'm working
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with attachment theory is deeply rooted
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in psychoanalytic theory and
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psychoanalytic theory isn't necessarily
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really popular right now it always has a
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research base that's there but it's not
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again kind of exceedingly popular like
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we see with cognitive behavioral therapy
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for example so I think when
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psychoanalytic theory kind of became
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more minimized attachment theory went
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along with it
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and I think this is a little bit
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unfortunate because I think attachment
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theory actually does explain a lot but
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without a lot of research into it we're
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not going to find out what those
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connections really are I know whenever I
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talk about topics like attachment theory
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there will be a variety of opinions
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please put any opinions and thoughts in
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the comment section they always generate
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early interesting dialogue as always I
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hope you found my analysis of this topic
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to be interesting thanks for watching
