Title:Stuck Between Under and Overattunement: An Adolescent's Struggle with Attachment, Autonomy and Sexual Identity
Volume: 5
Issue: 3
Author(s): Linda Jacobs
Affiliation:
Keywords:
Adolescent, attachment, attunement, case report, development, parent therapy, psychotherapy.
Abstract: Background: Psychoanalytic treatment has undergone vast shifts in the last few decades, significantly
influenced by the proliferation of infant research and attachment theory; since Ainsworth's seminal
work much research has focused on the components of or impediments to the development of secure attachment.
Stern (1985) suggests that both underattunement and overattunement can lead to insecure attachment.
Beebe and colleagues' research (2012) points to the correlation between mid-range contingent maternal responsiveness
and secure attachment and lowered or heightened responsiveness as factors in the development
of disorganized attachment. However, little has been written on the influence of the combination of underattunement
(from early deprivation) and later overattunement and its impact on attachment and emotional development.
Method: This paper will explore the attachment predicament of an adolescent girl whose developmental
experience was informed by both underattunement and overattunement. It will further explore the
therapeutic work with the adolescent and her parents, which focused on attachment issues and the maternal
overattunement, which led to a particular attachment dilemma. The patient was adopted from an orphanage at
the age of 6, after been removed from a situation of extreme maternal neglect. When she was 13 she developed
symptoms that were repeatedly misdiagnosed as psychosomatic. However, the mother's intense vigilance
over her daughter's life led her to pursue medical information, which ultimately uncovered a very serious
illness. Thus, the over-responsivity of her mother, while recreating the girl's ambivalent attachment experience,
simultaneously served to rescue her from early neglect as well as a potential debilitating illness. The
girl's attachment was profoundly affected by this event and led ultimately, not only to a reemergence of the
original ambivalent attachment, but to the girl's homosexual object choice. The mother's deep disappointment
with this choice further exacerbated the girl's attachment anxiety. Discussion: Security of attachment allows a
teen to engage in discussion of disagreements, and lessens dysfunctional anger. Thus, secure teens are able to
assert themselves with their mothers in ways that support rather than rupture attachment. Research has further
suggested a link between secure attachment and affect regulation in adolescence. In this case, the girl's attachment
was both powerful and fragile and she was unable to assert herself sufficiently because of her terror
of attachment; she continually raged against the constraints imposed by her mother but acted out in problematic
ways when those constraints were loosened. Psychoanalytic practice has traditionally avoided involving
parents in therapeutic work with adolescents, largely with the intention of promoting the adolescent's separation
and autonomy. However, I will present, in this paper, an approach to analytic work that engaged these
parents in reflective experience and helped them to fully appreciate their daughter's profound struggle with the
early experience of rejection, her longing for and anxiety around autonomy, and her desperate search for connectedness
and maternal acceptance.
