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14 Attachment and Caregiving Functions, Interactions, and Implications Melanie Canterberry and Omri Gillath Caregiving involves helping others who are in need. Help may consist of various behaviors such as giving money, holding the door open for another, lending an ear in times of trouble, or providing encouragement in the face of life’s challenges. Help may be required for different lengths of time (one instance or an extended period), and can be provided to a range of people (from close friends and family members to strangers). Different theories have been used to explain: why some people help those in need and others do not; the quality of help rendered; and the consequences of care provided (for a review see Penner, Dovidio, Piliavin, & Schroeder, 2005). Recently, attachment theory and methodologies stemming from this theoretical approach have been employed to study and explain people’s tendency to help, motivations for helping, outcomes of help provision, and ways to change people’s helping or caregiving tendencies (e.g., Collins & Feeney, 2010; Mikulincer, Shaver, Gillath, & Nitzberg, 2005). In this chapter, we begin by describing the two behavioral systems of attachment and caregiving, followed by a review of research investigating the association between the two systems. We then propose a model of caregiving system dynamics and describe how enhancing a person’s attachment security influences their caregiving behavior in the context of couple and family relationships. We conclude with the possible therapeutic implications of invoking attachment security in helping and supporting people to become more sensitive and responsive caregivers. The Wiley-Blackwell Handbook of Couples and Family Relationships, First Edition. Edited by Patricia Noller and Gery C. Karantzas. Ó 2012 Blackwell Publishing Ltd. Published 2012 by Blackwell Publishing Ltd.

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Page 1: 14 Attachment and Caregiving - Gillath Lab · Feeney and Collins (2001, 2003) emphasized the importance of different motives for helping people, while also examining the association

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Attachment and Caregiving

Functions, Interactions, and Implications

Melanie Canterberry and Omri Gillath

Caregiving involves helping others who are in need. Help may consist of various behaviorssuch as giving money, holding the door open for another, lending an ear in times oftrouble, or providing encouragement in the face of life’s challenges. Help may be requiredfor different lengths of time (one instance or an extended period), and can be provided to arange of people (from close friends and family members to strangers). Different theorieshave been used to explain: why some people help those in need and others do not; thequality of help rendered; and the consequences of care provided (for a review see Penner,Dovidio, Piliavin, & Schroeder, 2005). Recently, attachment theory and methodologiesstemming from this theoretical approach have been employed to study and explainpeople’s tendency to help, motivations for helping, outcomes of help provision, and waysto change people’s helping or caregiving tendencies (e.g., Collins & Feeney, 2010;Mikulincer, Shaver, Gillath, & Nitzberg, 2005).

In this chapter, we begin by describing the two behavioral systems of attachment andcaregiving, followed by a review of research investigating the association between the twosystems. We then propose a model of caregiving system dynamics and describe howenhancing a person’s attachment security influences their caregiving behavior in thecontext of couple and family relationships. We conclude with the possible therapeuticimplications of invoking attachment security in helping and supporting people to becomemore sensitive and responsive caregivers.

The Wiley-Blackwell Handbook of Couples and Family Relationships, First Edition.Edited by Patricia Noller and Gery C. Karantzas.� 2012 Blackwell Publishing Ltd. Published 2012 by Blackwell Publishing Ltd.

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Attachment Theory and Research

Attachment theory, as advanced by Bowlby (1982) and Ainsworth (e.g., Ainsworth,Blehar, Waters, & Wall, 1978), stipulates that humans have evolved a behavioral systemthat encompasses a repertoire of behaviors that assure proximity to a “stronger and wiser”other (an attachment figure) in order to increase chances of survival. Thus, in situationswhere a person’s safety is threatened, or the person is unable to care for him or herself, theattachment system is activated, motivating the person to seek proximity to an attachmentfigure. This attachment figure, who is usually one’s primary caregiver in infancy andchildhood, can provide protection, guidance, and support thereby assisting in theregulation of the person’s distress and helping to re-establish a sense of security. Thus,the attachment system is most important early in life when humans are most vulnerableand dependent on others for survival. Bowlby (1988), however, claimed that the systemremains important throughout life. As such, the attachment system will mobilize adults toseek proximity in times of need during adulthood (e.g., Cassidy & Shaver, 2008;Mikulincer & Shaver, 2007a; chapters 6, 13 in this volume).

Over time, repeated interactions with an attachment figure lead to the development ofmental representations of others and of the self (Bartholomew & Horowitz, 1991).Positive views of others as loving, caring, and trusting, and of the self as a capable andconfident individual also worthy of love and support, result in the development attach-ment security. This sense of security (or feeling protected) in one’s relationships is knownto be associated with emotional stability, development of a positive self-image, andformation of positive attitudes toward relationship partners and close relationships ingeneral (e.g., Hazan & Shaver, 1987; Feeney & Noller, 1990; Mikulincer & Florian,1998). Moreover, attachment security is thought to broaden people’s relationship skillsand views of relationships, providing them with a larger pool of cognitive, affective, andbehavioral resources from which to draw in dealing with the ups and downs of relation-ships. Furthermore, having a sense of security is also known to facilitate the operationof other complementary behavioral systems articulated by Bowlby (1982) such as thecaregiving system (e.g., Gillath et al., 2005a, 2005b).

Individual differences in attachment

Not all children experience the same types of interactions with their caregivers. In theprevious section we described how a supportive and sensitive relationship between a childand his or her caregiver is associated with a sense of security, which Ainsworth et al. (1978)argued is a central feature of a secure attachment style. However, if a person’s attachmentfigures are not reliably available and supportive then people are more likely to develop aninsecure attachment style (i.e., high levels of attachment anxiety and/or avoidance).

Experiences with a caregiver who engages in inconsistent and/or intrusive caregiving isthought to result in higher levels of attachment anxiety (for a review, see Mikulincer &Shaver, 2007a). Attachment anxiety reflects the degree to which a person worries aboutrejection or the unavailability of their attachment figure in times of need. It is also thought

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to reflect the tendency to be hypervigilant to threat and clingy when threat is present.People high on anxiety tend to adopt a hyperactivating strategy, which involves a chronicactivation of the attachment system and a tendency to present oneself as vulnerable and inconstant need of help.

Conversely, attachment avoidance is thought to result from childhood experiences withcold and rejecting caregivers resulting in the child needing to cope with distressing eventson his or her own. Attachment avoidance is thought to reflect a person’s distrust inrelationship partners and the tendency to maintain behavioral independence and emo-tional distance from relationship partners. People high on avoidance tend to adopt adeactivating strategy in dealing with attachment-related distress involving an increasedthreshold for threat and constant attempts at downplaying the importance of potentialthreats and the need for emotional closeness or help (compulsive self-reliance).

People low on both anxiety and avoidance are said to be secure or to have a secureattachment style. While throughout this chapter we refer to people as secure, anxious, oravoidant, we use these terms not to denote discrete categories or types of people, but ratherto connote people’s relative positioning along the primary attachment dimensions ofanxiety and avoidance.

To this point, we have briefly described the attachment behavioral system, its structure,functioning, and dynamics. We now turn to describing a related behavioral system—thecaregiving system.

The Caregiving System

The term caregiving refers to a broad array of behaviors designed to reduce suffering orfoster growth and development in a significant other such as a child or relationship partner.Thus, unlike the goal of the attachment system which is the attainment of felt security, thegoal of the caregiving system is to attend another person’s need for felt security byproviding sensitive and responsive care. Consequently, the caregiving system is activatedwhenever a significant other is perceived to be in need, and deactivated when the need ismet, or the care recipient appears to be protected and in a secure state. Bowlby (1982)regarded the attachment and caregiving systems as evolutionary and complementarybehavioral systems. Despite the importance of the caregiving system and its proposedassociation with the attachment behavioral system, relatively little is known about thecomponents, dynamics, and functioning of this system. In the remainder of this section wepropose a behavioral systems model of caregiving, similar to Mikulincer and colleagues’(Mikulincer et al., 2003; Mikulincer & Shaver, 2007a) behavioral systems model ofattachment (see also chapter 11 in this volume) that depicts one possible way in which thecaregiving system functions.

Specifically, we suggest that when a person is alerted to the signs of another in need(such as witnessing someone in distress), the caregiving system of that person is activated(see Figure 14.1). Similar to attachment system functioning (see chapter 11 in thisvolume), there are likely to exist individual differences in people’s tendencies to: (i)perceive such distress cues; (ii) understand or interpret them; and (iii) act upon them (we

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discuss individual differences in caregiving tendencies later in this chapter). After sensingdistress, the helper is required to make a decision as to whether they can provide immediatehelp. If the person can help and alleviate another’s suffering, aid is likely to be provided(e.g., parent soothes a crying baby). Once the needy person’s suffering is alleviated, thecaregiving system is deactivated in the helper. If one cannot render immediate assistance, orthe help provided does not alleviate the suffering of the person in need (e.g., the baby is stillcrying), the helper is required to make a further decision regarding whether the provision ofhelp is a viable option at all (e.g., Can I get someone else to assist, orwill a repeated attempt(s)to render assistance likely result in alleviation of the person’s suffering?). If the answer to thisquestion is yes, the helper is likely to continue to try to provide help (either by re-engaging inhelping behavior or by seeking additional help). These persistent attempts to render help arethought to hyperactivate the caregiving system resulting in more effortful caregivingbehaviors. If subsequent attempts at helping are deemed not feasible, people are likely toengage in deactivating strategies geared towards distancing themselves from the situation inan attempt to reduce the activation of the caregiving system.

This model shares similarities with the attachment behavioral systems model suggestedby Mikulincer and Shaver (2007a; chapter 11 in this volume) and models of helpingbehavior articulated within the literature on prosocial behavior (e.g., Collins &

Figure 14.1 A model of the caregiving behavioral system activation and dynamics

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Feeney, 2010; Latan�e & Darley, 1970). The new model has some advantages over existingmodels of helping behavior. Firstly, the model focuses on the caregiving behavioral systemand its functioning. Secondly, it provides a simple depiction of the decision-makingprocess involved in helping/caregiving. Thirdly, it outlines the corresponding dynamics ofthe attachment and caregiving systems and the associations between the two systems. Theoperation of the caregiving system as depicted in the model presented in Figure 14.1 ismost evident in the emotional and behavioral reactions of parents in response to theirchildren’s signals of need or distress; however, the model can also be used to describehelping situations among adult romantic partners, friends, and even strangers drawn tothe pain, need, or distress of another (Mikulincer & Shaver, 2007a).

In support of the proposed model, Feeney and Collins (2001) found that anxiouslyattached people, who are known to adopt a hyperactivating strategy in their attachmentsystem, also seem to adopt such a strategy with their caregiving system. Thus, anxiouslyattached people were likely to provide help to their partners when the partner was involvedin both low and high stress situations. In other words, regardless of whether their partnerneeded help or not—help was provided. We suggest this behavior reflects the hyper-activation of helping strategies in the caregiving model discussed above. Conversely,avoidant individuals were less likely to provide emotional support to their partner,especially when the partner was highly stressed, or in great need for assistance. We arguethat avoidant individuals’ lack of caregiving was driven by deactivating behavioral andcognitive-affective responses across both the attachment and caregiving systems.

Individual differences in caregiving

Several different approaches have been used to explain why some people help and others donot, as well as the kind of help people provide. Among these approaches many have focusedon the process level rather than the individual differences level, such as the decision-makingmodels (e.g., Latan�e & Darley, 1970) or the cost–reward models (e.g., Piliavin, Dovidio,Gaertner, & Clark, 1981). Nevertheless, some approaches have used personality models,based on traits such as agreeableness (e.g., Graziano, Habashi, Sheese, & Tobin, 2007),prosocial predisposition (Penner, Fritzsche, Craiger, & Freifeld, 1995), or dispositionalcompassion (e.g., Unger & Thumuluri, 1997), and more recently attachment security (e.g.,Gillath et al., 2005b) to explain differences in the tendency to provide care.

Kunce and Shaver (1994) were the first to suggest a way to measure such differences.Their measure includes four subscales of caregiving: proximity versus distance; sensitivityversus insensitivity; cooperation versus control; and compulsive caregiving. The scaleclassifies people into three patterns of caregiving: responsive, controlling, and compulsive,which are linked with individual differences in attachment style. Thus, secure individualstend to be high on proximity and sensitivity, reflective of responsive caregiving, and low oncompulsive caregiving. Anxious individuals tend to be high on both proximity andcompulsive caregiving (potentially related to their hyperactivated system) and low onsensitivity as compared with secure individuals. Avoidant individuals tend to be low onproximity and compulsive caregiving. These findings reflect patterns of caregivingbehavior that are in line with what is known about attachment styles and relationship

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experiences. Following Kunce and Shaver’s work, in recent years more attention has beengiven to the links between caregiving and individual differences in attachment (seeMikulincer & Goodman, 2006; Mikulincer & Shaver, 2007a; chapter 11 in this volumefor reviews).

For example, Feeney and Collins (2003) investigated how partner perceptions ofcaregiving affect the relationship, highlighting the importance of caregiving style forrelationship functioning. Perceiving the partner to have a responsive style was associatedwith higher relationship satisfaction; whereas, perceiving the partner as having a com-pulsive caregiving style was associated with a decline in relationship satisfaction. Thisfinding was also true for people’s self-ratings of compulsive caregiving, such that peoplereporting a compulsive style reported less relationship satisfaction over time.

In addition to individual differences in styles and tactics of caregiving, research byFeeney and Collins (2001, 2003) emphasized the importance of different motives forhelping people, while also examining the association with attachment style. For instance,providing care to benefit from it or because you feel obligated, which are more egotisticreasons for helping, were more common among insecurely attached people. However,anxious people also helped because they enjoyed helping, felt that providing care benefitsthe relationship or that their partner needs them. Although people high in avoidance hadfew reasons for providing care, they had numerous motivations for not providing care,such as avoiding stressful situations and feeling a lack of concern for their partner’sproblems. Low levels of trust and interdependence, and low levels of knowledge about howto effectively provide care were also associated with lower motivation to help amongavoidant people.

Feeney’s and Collins’s work mainly focuses on the interaction between attachment andcaregiving within romantic relationships. Below we further discuss this interaction, whilegeneralizing it to other contexts. This discussion will later allow us to draw implicationsfrom this body of research on attachment and caregiving more broadly.

The Interplay between Attachment and Caregiving

While the caregiving system is functionally different from the attachment system,attachment researchers argue that the operation of one system influences the functioningof the alternate system (e.g., George & Solomon, 1999; Mikulincer & Shaver, 2009).Furthermore, the interaction of these behavioral systems has been found to shape people’sbehavior in close relationships (e.g., Collins, Guichard, Ford, & Feeney, 2006). Morespecifically, we (e.g., Gillath et al., 2005a, 2005b) and others (e.g., Feeney & Collins,2001) have argued that while people have a natural tendency to provide care to dependentor needy others, the normative operation of the caregiving system can be suppressed oroverridden by non-normative functioning of the attachment system—specifically attach-ment insecurity.

For example, in a situation where siblings David and Peter experience distress, bothsiblings may focus on their own distress and call on the other for support and comfort.Alternatively, each sibling may focus on the other sibling’s signs of distress, and attempt to

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provide their brother with care and support. These two possible reactions by the siblingsmay result from differences in attachment security, which are thought to influence theavailable mental resources of each sibling to attend compassionately to the other’s need forhelp. Mikulincer and Shaver (2004) argue that secure individuals have the mentalresources and the flexibility to direct attention away from their own concerns, therebytemporarily suppressing their attachment needs, and activating their caregiving system toattend to the needs of others. In rendering assistance, secure individuals are thought toregulate their own emotions ensuring that their own personal distress does not impedetheir effective helping of others (e.g., Batson, Fultz, & Schoenrade, 1987; Fredrick-son, 2001). Furthermore, it is argued that secure individuals’ past experiences withsensitive and responsive caregivers influence the development of models of how to be aneffective caregiver (Kunce & Shaver, 1994).

In contrast, Mikulincer and Shaver (2004) contend that insecure individuals lack themental resources and/or the attentive capacity to detect and respond to the signals of othersin need. As a result, insecure individuals are unlikely to have the mental flexibility to divertattention away from their own personal distress to that of others. Alternatively, insecureindividuals’ past experiences with rejecting or inept caregivers may have mitigated thedevelopment of coherent mental representations of how to respond to others in need.Thus, insecure individuals may notice the distress of others but do not know how to renderassistance (Collins & Feeney, 2000; Kunce & Shaver, 1994; Mikulincer & Shaver, 2004).Therefore, individuals’ interactions with caregivers may not only shape their attachmentstyle but also influence the development of their caregiving style.

The links between attachment and caregiving have been demonstrated in different typesof relationships and contexts. For example, in the realm of volunteering, secure individualswere found to spend more time volunteering, to engage in more volunteering activities,and to report more altruistic reasons for volunteering as compared with people scoringhigh on attachment avoidance or anxiety (e.g., Gillath et al., 2005b). Similarly, Priel,Mitrany, and Shahar (1998) found that high school students high on anxiety or avoidancewere perceived by peers as less supportive than their secure classmates and were less likely toengage in reciprocally supportive relationships than secure peers. Finally, S€orensen andcolleagues (2002) found that low scores on the dimensions of anxiety and avoidance (i.e.,secure attachment) predicted adult children’s planning to care for their older parents,suggesting that secure adult children are care-oriented even before care is explicitly calledfor (see also chapter 6 in this volume; Karantzas, Evans, & Foddy, 2010). Becauseattachment security has been linked with numerous positive caregiving-related outcomes,orienting people toward a secure attachment style or more secure behaviors is likely toresult in increased caregiving by individuals, and less caregiving-related strain. We nextreview the literature on the enhancement of attachment security.

Enhancing the sense of attachment security

It has been argued that attachment security can be enhanced through therapy, a long-termcommitted relationship, or via experimental manipulations (e.g., Mikulincer &Shaver, 2007b; Gillath, Selcuk, & Shaver, 2008). In our studies, we used varioussubliminal (implicit) and supraliminal (explicit) methods to invoke/prime attachment

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security. These methods have included: the presentation of pictures implying attachment-figure availability (e.g., a Picasso drawing of a mother cradling an infant in her arms, or acouple holding hands and gazing into each other’s eyes); the presentation of the names ofsecurity-providing attachment figures or words associated with the sense of securityprovided by an attachment figure (e.g., love, hug, comfort); and guided imageryconcerning either the availability and supportiveness of attachment figures or security-enhancing interactions (e.g., describing a time when one received comfort and supportfrom a loved one; Mikulincer & Shaver, 2007b).

These security primes seem to temporarily activate mental representations of attachmentfigures and the support and comfort they provide, increasing an individual’s sense ofattachment security and positively affecting behaviors and cognitions. Various studies havecompared the effects of security priming with other types of priming to further ascertainbeneficial qualities of security priming relative to other forms of affect-enhancing primes.Thus, security priming has been compared to emotionally positive but attachment-unrelatedstimuli (e.g., pictures of a large amount of money, the names of close others who are viewedpositively but do not serve attachment needs) or self-esteem-related stimuli (e.g., words thatdescribe positive events related to one’s sense of self; e.g., Gillath, Hart, Noftle, &Stockdale, 2009). Such studies have consistently found that attachment-related stimuliyield positive mental health outcomes such as greater sense of well-being, lower aggression,and lowermental health symptoms above and beyond other nonattachment-related positivestimuli. The positive outcomes of security priming have been demonstrated even in studieswhen the security primes were presented in conjunction with threatening situations(Mikulincer, Gillath, Halevy, Avihou, Avidan, & Eshkoli, 2001). Furthermore, thesepositive effects of security priming have also been found to be long lasting (Gillathet al., 2008), suggesting that priming may yield shifts in people’s insecure attachment styles.

When it comes to caregiving-related behaviors, experimentally increasing people’s senseof attachment security was found to increase compassionate responses to others’ sufferingeven among insecure individuals (Mikulincer et al., 2005). People high on attachmentavoidance typically have less empathic reactions to others’ suffering, and are unwilling tohelp a distressed person. However, when exposed to a security prime, avoidantly attachedpeople tend to be more prosocial, compassionate, and helpful in their behavior. Similarly,although people high on attachment anxiety tend to react emotionally to a person in need,their reaction tends to be more inwardly focused, marked by higher levels of personaldistress, and is not associated with actual helping behavior. However, when exposed to asecurity prime, anxiously attached people show increased levels of caregiving (for similarfindings see Mikulincer et al., 2001; Mikulincer et al., 2003). These findings provideevidence for a causal link between attachment security and the tendency to care, such thatenhancing one’s sense of attachment security increases a person’s tendency to be morecompassionate and behave in a more prosocial and caring manner.

Implications

What does all this tell us about care provision in the real world? As reviewed in previoussections of this chapter, survey and experimental data have helped to elucidate attachment-

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related factors associated with the likelihood of providing care and the effects of doing (ornot doing) so. The use of attachment theory as a framework, and methodologies used intesting the predictions derived from this framework, have improved our understanding ofhow caregiving may be enhanced through various priming techniques. This understand-ing, in turn, has the potential to improve caregiving in the real world and aid in thecounseling of those in caregiving situations. In this last section we suggest some ways inwhich academic knowledge can be applied to therapy and caregiving in real life.

The first step in this application process involves examining whether findings obtainedin the laboratory are replicated in caregiving contexts outside the laboratory. The fewstudies that have investigated the links between attachment and real-world caregivingsuggest that indeed the associations between attachment and caregiving hold. For example,one study examining couples where one partner was diagnosed with metastatic cancerfound that attachment security was associated with decreased difficulty in providing care,whereas attachment avoidance was associated with increased difficulty in providingemotional support to one’s spouse (Kim&Carver, 2007). Similarly, Braun and colleagues(Braun, Mikulincer, Rydall, Walsh, & Rodin, 2007) found that attachment anxiety wasrelated to greater difficulty in providing care to a spouse with cancer and to perceptions ofmore time spent engaging in caregiving tasks.

Attachment style also seems to predict the emotional well-being of an individual whencaring for another. For instance, spousal caregivers reporting high levels of attachmentanxiety and avoidance were also found to report high levels of depression (Braunet al., 2007; Rodin et al., 2007). Recently, Gillath and colleagues (in press) reportedsimilar findings, such that attachment insecurity, especially attachment avoidance, wasassociated with greater depression and loneliness among older adults who provide care fortheir romantic partner. Together these findings suggest that the associations foundbetween attachment and caregiving in laboratory studies are consistent with the findingsof studies investigating the associations between these behavioral systems in real-worldcaregiving contexts.

The second step in linking academic knowledge to practice involves applying thepriming methods used to increase security in the laboratory to enhance caregiving in thereal world. For instance, engaging in cognitive or affective therapies that repeatedly drawon examples of positive relationship experiences may induce a sense of security and positivemood that may lead to greater openness in therapy dealing with attachment insecuritiesand difficulties in being a sensitive and responsive caregiver for others. Moreover, frequentreminders of positive past relationship experiences can be used to help clients generatemore positive representations of attachment figures and relationships in general, and may,over time, improve their attachment orientations and their caregiving tendencies andabilities. It may be that getting clients to think about the positive aspects of past attachmentrelationships, or recalling examples of positive encounters with attachment figures, nomatter how fleeting or infrequent, can be particularly important in therapeutic approachessuch as narrative therapy. In this form of therapy, the therapist acts as a collaborator inhelping the client re-author past disparate and unresolved relationship experiences. In thisrole, the therapist may prime security in clients through having them recall positiverelationship experiences—helping insecurely attached people rewrite their narratives of pastrelationships in such a way that they arrive at a more healthy view of these relationships.

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These revised narratives, facilitated in part through security priming, can then influence theway the client acts as a caregiver in current and subsequent relationships.

Other scholars have highlighted the importance of heightening feelings of attachmentsecurity in therapy in dealing with relationship issues such as spousal support, forgive-ness, and couple conflict (e.g., Johnson & Whiffen, 2003; Obegi & Berant, 2009;chapters 20, 23 in this volume). For example, emotionally focused therapy for couples(see chapter 23 in this volume) is geared toward having partners develop a secure basewith the therapist and with one another, thereby improving the couple’s sense ofattachment security, which is expected to improve the quality of their relationship,including caregiving and care receiving. The therapeutic session is thought to provide asafe haven and a secure base for the couples to explore and tend to relationship hurts andtraumas. By invoking a sense of safety and security in clients during the therapy session,couples are able to attend to challenging and hurtful relationship issues that theyotherwise would not. Furthermore, the therapist is thought to act as a model of how toengage sensitive and responsive caregiving thereby demonstrating to couples how to bean effective and loving caregiver.

Specific interventions based on attachment theory have been developed aimed atimproving parent–child relationships by reducing parental insensitivity and increasingchildren’s attachment security and improving the quality of adult familial attachmentrelationships (see Bakermans-Kranenburg, Van Hzendoorn, & Juffer, 2003; Egeland,Weinfield, Bosquet, & Cheng, 2000; van Ijzendoorn, Juffer, & Duyvesteyn, 1995). Theseinterventions often involve psycho-education regarding the qualities and benefits ofdeveloping attachment security and strategies on how individuals can recognize theirown insecure cognitions and behaviors and correct such thoughts and actions. Some ofthese interventions also assist insecurely attached individuals to become more sensitive tothe attachment needs of others. Such interventions have been successfully tried withfamilies of cancer patients and incarcerated parents (e.g., Makariev & Shaver, 2010; Zaider& Kissane, 2010). Using such interventions that educate people about attachment securityand insecurity while providing them with strategies to enhance their sense of attachmentsecurity are likely to increase insecurely attached people’s capacity to help others, improvethe quality of help they provide, improve their mental well-being, and possibly reducecarer burnout.

In the spirit of the interventions outlined above, less formal psycho-education can beprovided to insecurely attached clients in therapy, teaching clients about the associationsderived from research between attachment and caregiving styles. As noted in theliterature, avoidant individuals report poor knowledge about how to provide care, whileanxious individuals tend to be overbearing in their attempts to render assistance. As aresult, therapists can provide practical information to insecure clients, such as teachingthem ways to correctly notice signs of need in others and strategies on how to offer helpthat meets a person’s needs without providing too much help. Findings by Gillathet al. (2005b) suggest that helping behavior has a facilitative component, wherebynonaltruistic helping can promote a sense of attachment security, which in turn is likely topromote further caregiving driven by altruistic motives. Thus, encouraging insecurelyattached people to help others may foster attachment security and subsequentprosocial behavior.

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In conclusion, our chapter describes the associations between the attachment andcaregiving systems. Moreover, experimental research suggests that caregiving-related pro-cesses can be affected by changes made to one’s sense of attachment security. Specifically,enhancing one’s sense of security can result in prosocial outcomes including the increase insensitive and responsive caregiving behaviors. We have argued that security priming has aplace beyond the laboratory and has the potential to influence attachment-based approachesto therapy targeted at increasing people’s attachment security and improving their capacitiesto be loving and supportive caregivers. The research and implications for therapy wediscussed in this chapter should be useful to psychologists, therapists, educators, and policymakers who are invested in improving the quality of caregiving dyads—whether these beparent and child, a pair of siblings, two best friends, or a romantic couple.

References

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Bakermans-Kranenburg, M. J., Van Hzendoorn, M. H., & Juffer, F. (2003). Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin,129, 195–215.

Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of afour-category model. Journal of Personality and Social Psychology, 61, 226–244.

Batson, C. D., Fultz, J., & Schoenrade, P. A. (1987). Distress and empathy: Two qualitativelydistinct vicarious emotions with different motivational consequences. Journal of Personality, 55,19–39.

Bowlby, J. (1982). Attachment and loss: Vol. 1 Attachment (2nd edn.). New York: Basic Books.(Original work published 1969)

Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. London: Routledge.Braun, M., Mikulincer, M., Rydall, A., Walsh, A., & Rodin, G. (2007). Hidden morbidity incancer: Spouse caregivers. Journal of Clinical Oncology, 25, 4829–4834.

Cassidy, J., & Shaver, P. R. (Eds.) (2008). Handbook of attachment: Theory, research, and clinicalapplications (2nd edn.). New York: Guilford Press.

Collins, N. L., & Feeney, B. C. (2000). A safe haven: An attachment theory perspective on supportseeking and caregiving in intimate relationships. Journal of Personality and Social Psychology, 78,1053–1073.

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