This research study identifies important information about the prevalence and type of self-protective attachment strategies people use in mental health, child-protection, and violent criminal cases. The findings are easily extended to other criminal cases and divorce and custody cases. The study also points to important, and often not-considered, approaches to working with clients and developing case strategies.
The researchers looked at four groups of people and found fascinating insights into the prevalence and type of attachment strategies: there are few to no people using DMM-defined “secure” attachment patterns who are involved in mental health treatment, dependency (State child protection cases), or violent criminal offending.
The study found that using the DMM-method to code an adult attachment interview (AAI) is an effective forensic method for identifying and understanding the significance of an adult’s attachment pattern. The Berkeley method for coding an AAI transcript may or may not be forensically valid (Forslund et al.), but this 2021 study concluded the DMM-method is valid. Even if the Berkeley method is useful, it returns a very high rate of unclassifiable transcripts and uses an attachment model with insufficiently detailed patterns. The Berkeley method also returns many false-secure patterns, thus failing to identify people and children who are at higher risk and needing more tailored assistance.
Spieker, S.J., Crittenden, P.M., Landini, A. and Grey, B., 2021. Using parental attachment in family court proceedings: an empirical study of the DMM‐AAI. Child Abuse Review, 30(6), pp.550-564. https://onlinelibrary.wiley.com/doi/full/10.1002/car.2731
The researchers used 332 British adult attachment interviews from an archive of AAI’s which fit into one of the four groups. The first group was for “normative” samples, meaning people who had no known involvement in any of the higher risk groups. The risk groups were for people who were in psychotherapy for a wide range of reasons, parents in child care proceedings (dependency in the U.S.), and incarcerated adult violent offenders.
The DMM Model: overview
The Dynamic Maturational Model of Attachment and Adaptation (DMM) is an advanced attachment (developmental) model which incorporates a wide range of biopsychosocial model components. It describes how humans respond to danger across their lifespan. These responses are sometimes called defense mechanisms, and in the DMM are referred to as self-protective strategies, which are grouped into patterns identified by attachment science findings.
DMM attachment patterns are an extension of Mary Ainsworth’s original A, B, and C patterns. The basic DMM patterns are identified in the chart below. The B patterns are in the center of the chart, and the A and C patterns increase in complexity and risk towards the top and bottom of the chart. The Ainsworth patterns of A1-2, B1-5, and C1-2 are considered “secure” or normative. The higher A3-8 and C3-8, and AC and A/C patterns (all bolded) are considered “insecure” or “at risk.”
|Strategy||DMM strategy label||Strategy||DMM strategy label|
|A7||Delusional idealizing||A8||Externally assembled self (no self)|
|A5||Compulsive promiscuity (social or sexual)||A6||Compulsive self-reliance (social or isolated)|
|A3||Compulsive caregiving||A4||Compulsive compliance or performance|
|A1||Inhibited / idealizing||A2||Socially facile / distancing (distal)|
|B1||Distanced from the past||B2||Accepting|
|C1||Threateningly angry||C2||Disarmingly desirous of comfort|
|C3||Aggressively angry||C4||Feigned helplessness|
|C5||Punitively angry and obsessed with revenge||C6||seductive and obsessed with rescue|
|AC||Dysfunctional balanced A and C strategies||A/C||Dysfunctional alternating A and C strategies|
The findings – Prevalence rates
As with other DMM-based studies, in the normative group, two thirds (65.9%) of participants fell into the Ainsworth “secure” (normative) patterns, and 34.1% fell into the higher DMM (higher risk) patterns (A3 or C3 and higher, and the AC combination patterns).
However, the general prevalence pattern in all three of the other groups was quite different. In the mental health group, only 13.3% were in the normative patterns and 86.7% were in the higher DMM patterns.
In the family forensic group (dependency cases), only 1.2% (one case) was in the B patterns. 86.7% were in the higher DMM patterns.
In the criminal group, 90% were in the higher DMM patterns.
Across all three risk groups, only 1.9% of the AAI transcripts were assessed as using Ainsworth’s normative strategies. None of the transcripts showed use of A1-2 or C1-2 strategies. Rates of the very complex AC strategies using A5-8/C5-8 were highest in the dependency and criminal groups, 28.4% and 40% respectively.
Significance of the findings
If the study’s findings are reliable, what this means is that professionals working with people in these groups will virtually always be working with people who are using challenging self-protective strategies to survive life’s dangers. Professionals can offer much more help if they understand what, for each attachment pattern, is dangerous and safe and how information processing is biased.
The researchers suggested their findings imply several things for professionals. Service plans should always be attuned to the adult’s childhood-developed self-protective strategies and traumas. Chronic depression and/or elevated or depressed arousal should always be addressed first. Likewise, establishing a feeling of safety is important to address before asking parents to prioritize their children’s safety. For parents in dependency cases who are using high A strategies, such as A5-8 (about 33%), where a key issue in these strategies is a desperate need to avoid negative feelings and shame, it may be best to focus on helping them reveal and regulate those negative feelings, rather than learning how to inhibit them even further. For most parents in dependency cases, case plans should include components to address the parent’s need for self-protection (in addition to the obvious need to protect their children).
This is a well done study and offers useful information. However, it did not look at difficult divorce cases (sometimes called high conflict cases) or other types of criminal cases. In CSI’s experience, the attachment patterns in difficult divorce cases and many criminal cases virtually always involve at least one party surviving life’s dangers with thinking and behavior patterns described in the higher DMM patterns. Unlike the violent criminal and dependency groups above, CSI finds much less A7-8 and C7-8 in typical divorce cases. The AC patterns are less common, but still in the 10-20% range.
The prevalence numbers and DMM theory are critical to understand. It is extremely difficult to find attachment coders who are sufficiently trained and qualified to conduct a forensic assessment or offer advice on case plans. Since the people and problems most professionals will always be working with will involve more intense self-protective strategies, it’s less important to know the exact strategy. It is helpful to know the general A or C pattern being used, and to apply advanced relational techniques informed by the DMM, Trauma Informed Care, biopsychosocial models, and CSI’s Conflict Model.
It’s usually difficult for people using the higher strategies to feel safe, so Job number one is to help them feel safe.
Since attachment is intimately connected to information processing, providing a sense of safety also helps clients recall their histories with more detail and accuracy, thus allowing them to provide the professional with better information about the context of their presenting problems. Safety also helps them have the hope of opening up to consider alternative approaches to managing their problems. Avoiding the problem and avoiding responsibility can be better managed when the clients trust the professionals in their case.
Forslund, T., Granqvist, P., van IJzendoorn, M.H., Sagi-Schwartz, A., Glaser, D., Steele, M., Hammarlund, M., Schuengel, C., Bakermans-Kranenburg, M.J., Steele, H. and Shaver, P.R., 2022. Attachment goes to court: Child protection and custody issues. Attachment & Human Development, 24(1), pp.1-52. https://www.tandfonline.com/doi/pdf/10.1080/14616734.2020.1840762