12. Anxiety & Attachment - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Out of the Developmental Chrysalis in Intimacy and Relationship Therapy
Chapter 12: ANXIETY & ATTACHMENT
by Ronald Mah





Anxiety is a part of normal life and processing.  The body and the brain respond to it chemically.  When there is intense stress, the brain is flooded with cortisol, which is a stress hormone.  This changes the brains metabolism and eventually its morphology.  As the amygdala is more active, the hippocampus is likely to become less efficient.  The hippocampus is like a librarian, taking in the welter of sensory information about the outside world from many different parts of the brain and organizing it in forms that can be explicitly remembered.  Rich in receptors for cortisol, the hippocampus acts like a thermostat during periods of normal stress and turns down the hypothalamic-pituitary-adrenal (HPA) axis, in effect, shutting off the alarm caused by the amygdala's reactions.  "But chronic cortisol elevations- an inevitable consequence of severe, long-term stress- can erode the hippocampal functioning.  Chronic stress can actually cause the hippocampus to shrink, impairing a person's ability to attend to and remember what's happening in the outside world.  When this happens, the healthy push-pull equilibrium between the amygdala and the hippocampus (in which the amygdala promotes sympathetic arousal, including the eventual release of cortisol, and the hippocampus down-regulates it breaks down (Arden and Linford, 2010, page 31).

In response to external circumstances affecting internal processes, ones ability to self-soothe is critical for healthy development.  No matter how emotionally, spiritually, intellectually, and physically present and available for soothing a parent or intimate partner may be, no one can fully soothe an individual's anxiety.  At the last moment, there will always be some residue anxiety that the individual must manage him/herself.  The individual will always have some actual or existential experiences of being alone.  In such times and experiences, the individual must be able to self-soothe.  Wright (2009) discussed self-soothing relative to a fundamental goal of Bowen Theory (from Murray Bowen, also known as family-of-origin theory and therapy) called differentiation.  Differentiation from the family-of-origin to achieve improved emotional equilibrium and capacity for self-soothing is anxiety provoking.  Differentiation "requires an ability to hold on and stay 'on course' while feeling emotionally distressed… self-soothing …refers to an individual's efforts or capacity to calm oneself while in a state of emotional distress, and during subsequent autonomic nervous system arousal.  From this perspective, the capacity for self-soothing is believed to develop through the internalization of soothing or comforting experiences during early development.  Many of the contemporary psychoanalytic theories and approaches (in particular, self-psychology and the inter-subjective/relational theories) would argue to varying degrees that deficits in this capacity can be corrected through the appropriately managed transference relationship (Kernberg, 2007)" (Wright, 2009, page 30).

Secure attachment is related to the development of an autonomous self.  No matter how well the caregiver or the partner in the couple's relationship tries to be available and appropriately responsive, there cannot be perfect reaction that will preclude or prevent distress or anxiety.  For the baby, the child, and then the adult, there will always be periods of distress before the intimate person can respond, and there will also always be disrupted feelings that persist despite soothing, problem-solving, and protective response.  Secure attachment is not only seeking support from invested and available others, but also a child or individual developing him/herself as a competent respondent to stresses.  When facing emotional, psychological, social, and relationship (and other) threats, securely attached people can rely on either attachment figures (parents, teachers, partners, etc.) or on themselves- that is, their own resources and skills.  The shift or development of the ability to handle threats on his or her own- that is, without relying on others' interventions fosters an independent sense of mastery.  Rather than feeling helpless or vulnerable because of continued dependence on attachment figures, securely attached individuals have a personal sense of power and control.  Critical to a sense of mastery is the ability to self-soothe.  "…security-enhancing interactions with attachment figures facilitate the construction of specific soothing processes within the self.  The… perspectives on self-soothing imply that the development of this capacity may involve, or even depend upon, the validation or soothing from another person or external source" (page 30-31).

Neuroscience and attachment research has found that interpersonal relationships have strong impact on the brain's physical structures and processes.  Neuroscience research has found that the human brain is intricately social in nature.  "...as a species, we're constantly getting into each other's heads, affect each other's moods and emotions, rewiring each other's neural networks.  Therapy works primarily as a nervous system-to-nervous system regulator (like mother to child, mate to mate, friend to friend) that helps clients ramp down their own brains' arousal levels and reactivity, as well as activate their neural capacity for regulating their own emotions" (Arden and Linford, 2010, page 29).  Arden and Linford's comments about how therapy works reflects how therapy is a particular human relationship that gains its efficacy from general nervous system-to-nervous system regulation, while referencing earlier systems.  The original other system person or external source is normally the parent or parents.  Once soothing is internalized, the individual develops the ability to self-soothe, which will be tested in later, particularly in intimate relationships.  In the couple or other close relationship, self-soothing includes not losing the self to pressures and demands, including or especially from the partner.  In a couple and or as a member of other intimate dyads or groupings.  An individual needs to be able to center him/herself as emotions and fears may be destabilizing.  The individual will need to activate inner skills, resources, and resiliency to stabilize him/herself when feeling deprived or challenged, and to do so without indulging him/herself in unhealthy processes.   This process or requirement is expressed in varied terminology in different theories.  For example, "References to self-soothing have also been found in the work of Marcia Linehan (1993) in developing the dialectical behavioural therapy approach.  Linehan's reference to self-soothing is brief, but part of the larger and more comprehensive construct of 'Distress Tolerance' for which the skills include distraction, self-soothing, improving the moment and thinking of the pros and cons. She describes self-soothing as comforting, nurturing and being kind to oneself through pleasant activities, using the five senses.  The aim is to move one's mind away from troubling thoughts, feelings and impulses in order to gain immediate relief from distressing emotional reactions.  Related to the broader construct of self-soothing as discussed above, Linehan also describes the use of emotion regulation and mindfulness skills as separate and distinct categories" (Wright, 2009, page 31).

The individual needs to strive to become more aware of and develop more control over how they react emotionally-- known as emotional reactivity per Bowen theory to the stresses of the intimate relationship.  With this growth, he or she is more likely to make productive choices that incorporate both feelings and rational thinking despite intense anxiety or disruption between the partners or members of the dyad or group. The individual can interact with the other important person as more of a solid self.  Instead of being triggered by the highly charged emotions of the other person, which may be also highly reactive or impulsive, the individual is more likely to choose responses and behaviors based on clearly thought out values and beliefs.  The individual is more likely to successfully balance among self-expression, seeking harmony, and the emotional comfort of the other person.  Overall, the anxiety level lowers and potential damage to the intimate relationship is decreased.  This was what Vlad for example, was not doing well.  As he addressed this in therapy, eventually he was able to manage his anxiety much better to the benefit of his emotional health and his relationship with Collyn.

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
phone: (510) 614-5641
fax: (510) 889-6553
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