亲附理论AttachmentTheory.doc

亲附理论 Attachment Theory武汉精神卫生中心 熊 卫一、亲附理论的简介 亲附理论是由社会学家John Bowlby (1907-1990）根据儿童与母亲之间的互动观察结果而提出来的一种理论。从心理学的角度来讲，亲附理论的核心意义主要是指儿童早年与母亲之间的关系不仅影响会儿童当时的行为，而且对其成年后的行为模式及人际交往模式都有影响。精神分析理论，尤其是客体关系学家发现John bowlby 的研究结果与客体关系理论的某些发现非常相似。随后，亲附的概念逐渐被精神分析治疗师们所采用。 在上个世纪七十年代，研究人员推测安全的亲附行为是由婴儿与其亲附对象之间的一种内在的工作模式（internal working model）所支撑的。这个内在的工作模式是婴儿重复体验母婴之间恰当的照顾模式所形成的。 通过这种母婴之间的照顾互动模式，婴儿理解了在不同的情况下，亲附对象是如何对他的要求进行反应的，他自己又是如何回应的。这种在生命早期所建立起来的模式会对婴儿的未来一生都有影响。所以，我们说没有哪一种因素会比孩子在家庭中的体验对其人格发展的影响更大。二、什么是亲附 亲附是一种能力，即个体与他人建立牢固情感联系的能力； 亲附是一种生存的需要，即不愿意的与亲附对象的分离或者完全丧失亲附对象会导致情感 伤痛和人格紊乱； 从物种进化学的角度来讲，幼小的动物与父母呆在一起具有物种保存的价值。 亲附有二个方向：婴儿指向父母；父母指向婴儿 亲附行为是一种谱性行为，它可以在二个极端之间逐渐变化或移动。 两极表现：牢固的捆绑-丧失或分离； 稳固的联结-不稳固的联结。 亲附的焦点：婴儿-母亲之间的互动。 人类或动物，为保持亲近所采取的行动：哭泣、微笑、身体的的趋向性移动。 人类或动物对分离的反应：抗拒、失望、冷漠。 人类婴儿倾向于参与社会性互动，对形成亲附关系具有一种生物学倾向性。在童年早期的剥夺亲附关系会导致严重的心理损害。 三、John bowlby理论的优势 可观察的资料； 将个体外在的互动与内在精神世界相联系； 个体的精神健康与提供情感支持与保护的亲附对象密切相关； 早年的亲附模式可以预测将来的行为方式； 内在的工作模式对亲附行为有调节作用； 不同学科领域的赞同与支持； * 精神分析； * 家庭治疗的理论与实践； * 发展心理学； * 婴儿的行为观察； * 来自幼儿园/孤儿院的资料； * 来自人种学与动物行为学的资料。Bowlby提出的四种不正常亲附行为模式焦虑型亲附（Anxious attachment）强迫性自我结盟型亲附（Compulsive self-reliance ）强迫性照顾提供型亲附（Compulsive care-giving）情感冷漠型亲附（ Emotional detachment）焦虑型亲附的特征 持续的害怕失去亲附对象； 过分的依赖或不成熟行为； 容易发展出神经症性症状、抑郁、恐怖、自责与受虐、过分尽责； 处于病理性的抚养环境下的儿童，可能出现： * 爱的需要长期被拒绝或没有回应； * 养育不连续； * 被威胁失去父母的爱； * 抛弃这个家庭或杀害配偶或自杀； *母亲以孩子作为她自己的亲附对象。 强迫性自我结盟型亲附的特征 渴望爱与支持； 小心地自我保护以免被拒绝或被疏远； 自我照顾； 将怨恨转移到弱者身上； 处于应激状态时，倾向于产生心身症状或抑郁。 作为儿童，具有某些与焦虑型亲附相似的体验或经历。强迫性照顾提供型亲附的特征 与他人的关系紧密，但情感联系却很片面； 不求助于任何人，而只是照顾与关心别人； 如果是孩子，他们会照顾无能的母亲或其它兄妹 可能是在公共福利机构长大； 对表达情感感到自责； 与Winnicott所说的假性人格特征相似； 是无助的助人者。情感冷漠型亲附的特征 没有能力与任何人发展稳定的情感关系； 童年早期的经历中，常有母亲关系的剥夺； 在童年后期，有被父母拒绝的经历； 常具有精神病理性或癔症性人格特征。 成人亲附访谈（Adult Attachment Interview，AAI）。AAI是一个半定式的检查工具，共有十八个问题，要求被试描述童年时的情况。检查结果被录音，然后录音整理成文字资料，并根据录音资料对被试的亲附关系进行评定、分类。根据AAI的评定结果将亲附模式分为四类： 安全自主型: 对童年描述是连贯而有序的； 先入为主或纠缠不清型: 对童年的描述混乱不清； 解离型：对亲附关系的描述理想化或明显贬损； 丧失未解决型：与丧失或虐待有关问题的描述明显混乱。亲附行为模式的临床意义 已经有大量的研究说明，父母的不安全亲附模式，尤其是混乱/丧失未解决型，与孩子的情绪行为问题高度相关 混乱型亲附模式孩子常有人际交往困难、情绪调节困难、攻击行为；他们的父母常童年时有受虐待的经历，成年后有虐待行为、酒精依赖等等问题。 丧失未解决型亲附模式者常有严重创伤以历，成年后有可能存在精神病的问题。 解离型亲附模式者通常会拒绝治疗，而纠缠不清型则容易过度卷入治疗或依赖治疗者。成人亲附访谈Adult Attachment Interview，AAI1、 Could you start by orienting me to your early family situation, where you lived, and so on? If you could start with where you were born, whether you moved around much, what your family did for a living at various times.2、 Id like you to try to describe your relationships with your parents as a young child. If you could start from as far back as you can remember.3、 Id like you to choose five adjectives that reflect your childhood relationship with your mother. This might take some time, and then Im going to ask you why you chose them. 4. Question 3 repeated for father.5. To which parent did you feel closest and why? Why isnt there this feeling with the other parent?6. When you were upset as a child, what would you do?7. What is the first time you remember being separated from your parents? How did you and they respond? Are there any other separations that stand out in your mind?8. Did you ever feel rejected as a young child? Of course, looking back on it now, you may realise that is wasnt really rejection, but what Im trying to ask about here is whether you remember ever having felt rejected in childhood.9. Were your parents ever threatening with you in any way - maybe for discipline, or maybe just jokingly?10. How do you think these experiences with your parents have affected your adult personality? Are there any aspects of your early experiences that you feel were a set-back in your development?11. Why do you think your parents behaved as they did during your childhood?12. Were there any other adults with whom you were close as a child, or any other adults who were especially important to you?13. Did you experience the loss of a parent or other close loved one while you were a young child?14. Have there been many changes in your relationship with your parents since childhood? I mean from childhood through until the present?15. What is your relationship with your parents like for you now as an adult?16. How do you respond now, in terms of feelings, when you separate from your child?17. If you had three wishes for your child twenty years from now, what would they be? Im thinking partly of the kind of future you would like to see for your child.18. Is there any particular thing which you feel you learned above all from your own childhood experiences? What would you hope your child might learn from his/her experiences of being parented?对陌生情景的试验1、 Parent and infant are introduced to the experimental room. Parent and infant are alone. Parent does not participate while infant explores. 2、 Stranger enters, converses with parent, then approaches infant. Parent leaves inconspicuously. 3、 First separation episode: Strangers behavior is geared to that of infant.4、 First reunion episode: Parent greets and comforts infant, then leaves again. 5、 Stranger enters, converses with parent, then approaches infant. Parent leaves inconspicuously. 6、Continuation of second separation episode: stranger enters and gears behavior to that of infant. 7、Second reunion episode: Parent enters, greets infant, and picks up infant; stranger leaves inconspicuously. 8、The infants behavior upon the parents return is the basis for classifying the infant into one of three attachment categories. 根据陌生情景试验结果的分类 Securely attached 安全亲附 Anxiously attached: Avoidant 焦虑亲附:回避型 Anxiously attached:Ambivalent/Resistant 焦虑亲附:矛盾/拒绝型 Disorganise