This post reviews what John Bowlby, the father of attachment theory, had to say about grief and loss. The implications of these ideas for clinical practice will be covered in the next post in this series on attachment, grief and loss.
Bereavement and grief were the primary focus of Bowlby’s book, “Loss: Sadness and Depression”, the third volume of his trilogy. In this work, he proposed a framework for understanding normal as well as abnormal grief reactions.
Bowlby was an ethologist. He considered grief to be a natural part of an attachment behavioral system (also present in other mammals) which was designed by natural selection to discourage the prolonged separation of an infant from his/her primary attachment figure(s) to increase the chances of survival and thus of reproduction.
Bowlby believed that because infants of many species require the protection of older individuals in order to survive, they evolved both physical and behavioral adaptations to capture and hold the attention of and maintain proximity to potential caregivers. When an attachment figure is judged to be unavailable by an infant, the infant experiences anxiety and attempts to reestablish contact through behaviors such as calling, searching, crying, approaching and clinging. Bowlby believed that these “protests” against separation on the part of infants serve the evolutionarily adaptive function of keeping protective attachment figures nearby.
Bowlby thought that the same psycho-behavioral tendencies to protest the loss of and to seek reunion with an attachment figure expresses itself when an adult loses a loved one. In other words, he believed that the same psycho-behavioral phenomena underlie both temporary and permanent separations from attachment figures and regardless of the age of the person experiencing the loss.
Bolwby believed that as with an infant’s reactions to separation from a caregiver, adult grief follows predictable phases generally first involving intense protest, then despair and then hopelessness when the protests do not bring about reunion with the loved one. After this there is typically a reorganization phase involving a gradual renewal of interest in other activities and relationships. Though these phases are often experienced sequentially, they are not always or necessarily and may sometimes be experienced in a different order or in a cyclical manner depending on the person and the circumstances.
Bowlby believed that grief involves moving through this sequence of emotional reactions and that while perhaps difficult to experience, it is ultimately necessary for the well-being of the bereaved. Bowlby further believed that not experiencing these emotions following significant loss can lead to psychological and physical ill health. Both suppressed (unexperienced) and unresolved (unending) grief are thus considered pathogenic by Bowlby.
Bowlby also proposed a framework for disordered forms of mourning. According to his framework, disordered mourning runs along a continuum with chronic mourning on one end and the prolonged absence of conscious mourning on the other. Chronic mourning involves an unusually extended grief reaction combined with a prolonged difficulty engaging in normal activities. People suffering from chronic mourning may find themselves overly preoccupied with thoughts of their missing partners and not able to function normally for a protracted period. The absence of grief involves a notable lack of distress whether in the form of anger or despair. People at this end of the continuum seek little support from others and continue in their regular work and social activities seemingly unimpeded by the loss. Bowlby believed that both ends of this continuum are problematic and that most people who are reasonably secure with respect to attachment (explained below) will naturally move through the process of experiencing and expressing negative emotions following a significant loss.
Bowlby thought that the way a person responds to loss stems partly from the way that person’s attachment system became organized in childhood. More specifically, he thought that those whose attachment systems are organized such that they are preoccupied by attachment anxiety (i.e., who anticipate rejection and loss chronically) and those whose are organized to defensively suppress attachment related feelings (i.e., who are avoidant of attachment related distress) are more likely to suffer from physical and/or psychological distress during bereavement. He believed that those who are secure with respect to attachment are most likely to move through the phases of a normal grief reaction.
In attachment theory a person’s attachment “style” is thought to result from the internalization of their particular history of attachment experiences. The style in turn results in an identifiable pattern of relational expectations, emotions and behaviors. Four styles have been identified by attachment researchers: avoidant, anxious, secure and fearfully avoidant. Those with an avoidant style distrust relationship partners and strive to maintain independence and emotional distance from others. Those with an anxious style are dependent and frequently worry that a partner will not be available in times of need. Those who do neither are considered secure with respect to attachment. Those who exhibit both tendencies are considered to be fearfully avoidant.
Each of these styles involve distinct strategies aimed at alleviating distress and maintaining supportive relations when a person’s attachment system is activated due to a perceived threat. When proximity seeking is expected to be successful, a person will likely make persistent attempts to achieve proximity, support and protection. These efforts are referred to as “hyper-activating” strategies because they involve strong activation of the attachment system until the attachment figure is perceived as being available and responsive. Hyper-activating strategies involve behaviors such as approaching, begging, crying, clinging, being hypervigilant regarding the attachment figure’s intentions, motives and behavior and intense distress and protest if he or she seems insensitive or unresponsive.
If a person believes that seeking an attachment figure will not achieve safety or comfort and may even elicit anger or punishment and thus increase distress, this will cause the person to deactivate the attachment system and seek to handle the problem alone. The primary function of “deactivating” strategies is to keep the attachment system shut down. This may involve denying or de-emphasizing attachment needs, avoiding emotional involvement in and dependence on close relationship partners, suppressing attachment related thoughts and attempting to remain autonomous.
Bowlby suggested that attachment reorganization after a significant loss depends on the way a person’s attachment system has become organized over time which results in the patterns referred to here as attachment styles. Those with an anxious style, find it more difficult to deactivate painful feelings, thoughts, and memories related to the deceased attachment figure. Those with an avoidant style are more likely to suppress distressing feelings, thoughts and memories of the deceased. Those with a secure style are more likely to be able to process feelings, memories, and thoughts without either becoming lost in them or having to disengage from them. These styles have implications not only for how a person grieves, but also for how a clinician works with grieving clients. The clinical implications of the foregoing will be covered in the next post in this series.