“Addictions from an Attachment Perspective”—A Review (part V)

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Welcome back. This is part V of my multi-part blog series wherein I review the 2014 edited volume entitled Addictions from an Attachment Perspective—Do Broken Bonds and Early Trauma Lead to Addictive Behaviours? In this post we’ll look at two chapters:

1) Chapter Five—Taking the Toys Away: Removing the Need for Self-Harming Behavior by Lynn Greenwood

2) Chapter Six—Using “Intent” to Remedy Mal-Attachment by Bob Johnson

Let’s get started.

Greenwood’s chapter pulls heavily from case material, so I’ll only mention a few bullet points. If my bullet points pique your interest then you may wish to visit Greenwood’s supporting case material.

After describing a detailed case, Greenwood states:

  • People with anorexia often feel that it is only by restricting food to a sometimes dangerous level that they can communicate their fragility and vulnerability.

When I read this statement by Greenwood, I added the following marginalia: “It sounds like a person caught up in an addictive process is using the body to literally represent the psychological.” I was also reminded of the Frontline piece that originally aired on 05.02.95 entitled When the Bough Breaks. [1] Bough Breaks is about research into why it is some toddlers have a tough time sleeping through the night. The video profiled three mother – toddler pairs (although the fathers were also involved to some degree). One pair in particular fought constantly over food. The young girl (probably around age two) would hold food in her mouth for hours on end. The young girl was otherwise non-responsive. This “food holding” behavior frustrated her mother no end. Ultimately the researchers—the husband and wife team of Roy and Elisabeth Muir at the Hincks-Dellcrest Centre, University of Toronto—worked with the mother so that she could read and understand what her daughter was trying to say through her “food holding” behavior: she did not feel “seen” and, as a result, she felt insecure. The Muirs used a play technique they called Watch, Wait and Wonder (which is profiled in Bough Breaks). The Muirs were able to help this mother – toddler pair. Had they not, I wonder if this girl would have gone on to develop some type of eating disorder. I highly recommend When the Bough Breaks.

Greenwood gives us this “take home” message:

  • Anorexia has similarities to drink or drug addiction in that it takes the edge off difficult feelings and becomes the route through which all emotion is expressed.

Again, we get this sense that addiction is centrally about affect regulation. A bit further along Greenwood continues thus:

  • Indeed, there is something powerful about the denial of appetite and the literal and symbolic refusal to ingest.

Returning to the Bough Breaks example above, when you view the young girl in the video, it does appear that she feels calm as she engages in food holding behavior. It also appears that she enjoys the feeling of being in control, especially of her mother’s behavior. Sadly, some schools would frame the young girl’s behavior as “defiant” or even “oppositional.” These frames discount the possibility that the young girl is trying to convey something very important through her behavior: she feels unseen and, as a result, she feels unsafe.

Greenwood covers a number of examples of how she works with people suffering from eating disorders using attachment theory as a background. I’ll leave you to access this information if it is of interest to you. Let’s move to Bob Johnson’s chapter—Using “Intent” to Remedy Mal-Attachment.

Johnson starts out by echoing a point that I have made in earlier parts of this series: People can form “addictions to any human activity you care to name; sex, hobbies, money, work, violence [especially domestic violence], and stalking, together with more conventional ones of gambling, alcohol, nicotine, legal, and illegal drugs.” Johnson then hits on the one overarching fear that confronts all addicts of all stripes:

If the addict once desists, they are terrified that the emotional pain that they fear so much will overwhelm them so they continue their addiction, whatever it might be, as if their life depended on it, which, as they see it, it does.

Johnson then offers up a way to frame addiction using Bowlby’s theory of attachment as a background. Johnson frames addiction as “long term suicide.” As Johnson puts it, “The roots of this ‘long term suicide’ are to be found in their earliest mal-attachments, just as Bowlby saw with such clarity in his concept of how insecure attachment patterns develop from relational misattunement and trauma.” As mentioned in part I, the following statement by Johnson may rile some working in the field of mental health, especially the field of addiction:

All mental health problems, especially and including addiction, are “software problems”, not “hardware problems” and require copious software support and insight to correct.

Translation: Johnson essentially rejects the notion that genetics underlies addiction, that is to say, there is a gambling gene or an alcoholism gene (more on this below). As mentioned in part I, if you believe that genetics underlies addiction, then very little of the information presented in Addictions from an Attachment Perspective will be of help to you. The “genetics versus environment” debate is hotly contested and will not be taken up here. Suffice it to say that the authors writing (speaking) in Addictions from an Attachment Perspective come out decidedly on the side of environment. As an example, Johnson, pulling from his many years of clinical experience, flat out announces that “where secure infant attachment prevailed” early on, “addiction … is inconceivable.” To drive home this point, Johnson mentions that many of the addicts he has worked with comment along the lines of, “I’m stuck at [age] two.” Over decades of clinical work, Johnson has come to a simple and yet robust conclusion. Johnson reveals,

[These conclusions] are “simple, but not easy.” In fact underlying every psychiatric symptom, whether that be anorexia, hallucinations, paranoia, depression, bi-polar, psychosis, anxiety, murder, or war, is a fear, an infantile fear—the loss of an infant parental attachment bond.

Johnson now comes up with a novel but compelling way to frame insecure attachment early in life. His frame tends to build on Bowlby’s focus on “parentification” and “role reversal”—in essence asking the child to take on the role of parent. These are topics I have blogged about at length. Bowlby viewed parentification and role reversal as royal roads to a life plagued by insecure attachment. Adultification’s evil twin is infantilization—treating a child or adult as if they were an infant. Helicopter parenting—where the parent(s) does everything for the child and, later, young adult—is a form of infantilization. Here’s how Johnson puts it:

Infantism is a novel term for an elementary process—where attachment in infancy is unsound, and insecure, then that person once they do arrive in adulthood is deprived of the chance to update his survival strategies [i.e., his Inner Working Models].

Johnson is saying the same thing I have said many times before (pulling from Bowlby’s work): secure attachment early in life (if all goes well) is the foundation upon which robust executive function skills rest. Again, one of the central EF skills is the ability to modify or otherwise update Inner Working Models. Either way, adultification and infantilization rob the individual of that fundamental foundation. I like Johnson’s insight here because he seems to be saying that when people report (typically in therapy) that they don’t feel as if they are adults (when they chronologically are), what they are reporting is they have a tough time updating survival strategies of which updating Inner Working Models is one. It then makes sense that addictive processes would be attractive substitutes. They are simple but yet potentially destructive prepackaged survival strategies if you will. Sadly, advertisers are all too eager to sell addictive substances and processes as roads toward being an adult. One has to look no further than the once popular ad campaign for Virginia Slims cigarettes that trumpeted the tagline “You’ve Come a Along Way Baby.” For more on this theme, see Jean Kilbourne’s 1999 book entitled Deadly Persuasion—Why Women and Girls Must Fight the Addictive Power of Advertising.

I’ll end by giving Johnson the last word, one that seems to condemn the nihilism that often accompanies postmodern thought: [2]

The notion that “addiction was found to be an inherited disease” is anathema to me, especially as it feeds the nihilism that currently prevails and blocks the ineffable blossoming which occurs when a more humane attachment informed model, is implemented.

In part VI we’ll look at chapter seven—Struggling With Abstinence by Richard Gill. See you then.


[1] Click on the following link to view summaries and comments concerning When the Bough Breaks. We used to give copies of When the Bough Breaks to organizations free of charge. We only asked that they provide us with feedback concerning the video. Many of the comments are from organizations that received a copy of Bough Breaks.

[2] Bowlby fought against the tide of postmodern thought that began to surround him in the 1970s when he took issue with the self-esteem movement. Writing in his trilogy on attachment, Bowlby states:

Not infrequently the state of mind of someone severely depressed is described, or explained, in terms of loss of self-esteem. This is a concept I believe inadequate to the burden placed upon it. For it fails to make manifest that the low self-evaluation referred to is the result of one or more positively adverse self-judgments, such as, that the self is incapable of changing the situation for the better, and/or is responsible for the situation in question, and/or is intrinsically unlovable and thus permanently incapable of making or maintaining any affectional bonds.

Effectively Bowlby is saying that the self-esteem frame, like the oppositional or defiant frames, covers over what the behavior in question might be saying about the early attachment history. These frames are nihilistic in that they tend to send the message that “very little can be done about one’s current plight.” And what can be done often takes the form of simple prescriptions: read an affirmation from a postmodern perspective, or just say no to behavior from a behavioral perspective. Here’s the bug-a-boo: the pattern of early insecure attachment leading to an addictive process in adulthood is characterized by simple explanations and behaviors according to Arlene Vetere (see part IV). Ergo, the nihilistic tendencies of both postmodernism and behaviorism tend to lock a person within the prison of simple explanations and behaviors (which I think is Bowlby’s, as well as Bob Johnson’s, point). In essence, nihilistic tendencies tend to lock people within their respective addictive process(es). Nihilistic tendencies keep us from the understanding and insight (i.e., Johnson’s software support) that have the potential to set us free from addictive bonds. Again, frames say a lot about what can be done, and, just as important, what cannot be done.