​In the works: Companion on Attachment

Interview with Majella van Maaren

 

A new Bolk’s Companion on attachment is in the works: it explores the development of the emotional bond between a baby or growing child with one or more adults, and how disruptions in this attachment process can affect later life. For this is something we all will encounter in medical practice! Educator Loïs Eijgenraam and editor Majella van Maaren are working vigorously on bringing it out. We asked Majella about the theme of this book.

 

Majella: We want to make this topic more accessible and understandable for doctors. Patients are all very different—no two are alike—with a wide variety of patterns in behavior, personality, and mental health issues. Doctors are taught to apply DSM labels to symptoms and patterns. But you’d like to understand more about why this particular patient is behaving this way right now. Or how they developed these specific personality traits and behavioral patterns. It turns out that childhood attachment processes are almost always a key factor here.

 

Editor: Why would you, as a doctor, want to know more about this?

Majella: About 40% of adults experience insecure attachment as children. You might ask: What impact does that have on the child’s or adult’s behavior later in life? What is attachment, anyway, and why is secure attachment important? In the book, we explain the attachment pyramid, a model of the emotional developmental stages of a young child that is widely used in the Netherlands.

In the book, we relate this pyramid to the development of the so-called “lower senses” which children develop in the early years of life: the sense of touch, the sense of life, the sense of movement, the sense of balance, and the sense of warmth/creativity (see also the Companion Consciousness, the Brain, and Free Will, GVO 20 and 21, chapter 4, by Arie Bos). This provides a foundation from which you can also view children or adults phenomenologically, thereby gaining greater insight into behavior, psychological problems, and possible therapeutic approaches. The phenomenology of the lower senses thus helps in arriving at an effective therapy plan.

This approach—linking the attachment pyramid to the lower senses—is quite unique and is primarily based on practical experience and insights. You could call this way of looking at things “practice-based.”

 

Editor: Could you say a little more about the importance of attachment?

Majella: Healthy, secure attachment appears to be of fundamental importance for the development of many different brain functions, which are called “executive functions” (see also Arie Bos’s Companion: Consciousness, the Brain, and Free Will). These are the many and varied skills you need in everyday life to function effectively. You must be able to coordinate these individual skills—such as momentarily holding back your emotions, using your short-term memory, seeing the big picture, and planning—with one another. We need to be able to harmonize these aspects with one another in order to function well in life. This can be applied to something simple, like how to plan doing the dishes, but it can also involve asking: What does it take to set and achieve certain goals?

Only when you can develop executive functions—and secure attachment is a key factor in this—can you navigate life skillfully. And that, in turn, is a key factor for our health in the broadest possible sense. Attachment is often uncharted territory for doctors; there is much to be gained in this area during patient consultations. With this Companion, Loïs and Majella hope to contribute to a better understanding of the patient in the consultation room, of their behaviors and characteristics, and possible forms of support and treatment.

​