Skip to main content
Top
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Research article

Attachment and coping in psychosis in relation to spiritual figures

Authors: Philippe Huguelet, Sylvia Mohr, Isabelle Rieben, Roland Hasler, Nader Perroud, Pierre-Yves Brandt

Published in: BMC Psychiatry | Issue 1/2015

Login to get access

Abstract

Background

Studies have found higher levels of insecure attachment in individuals with schizophrenia. Attachment theory provides a framework necessary for conceptualizing the development of interpersonal functioning. Some aspects of the attachment of the believer to his/her spiritual figure are similar to those between the child and his/her parents. The correspondence hypothesis suggests that early child-parent interactions correspond to a person’s relation to a spiritual figure. The compensation hypothesis suggests that an insecure attachment history would lead to a strong religiousness/spirituality as a compensation for the lack of felt security. The aim of this study is to explore attachment models in psychosis vs. healthy controls, the relationships between attachment and psychopathology and the attachment processes related to spiritual figures.

Methods

Attachment models were measured in 30 patients with psychosis and 18 controls with the AAI (Adult Attachment interview) in relationship with psychopathology. Beliefs and practices related to a spiritual figure were investigated by qualitative and quantitative analyses.

Results

Patients with psychosis showed a high prevalence of insecure avoidant attachment. Spiritual entities functioned like attachment figures in two thirds of cases. Interviews revealed the transformation of internal working models within relation to a spiritual figure: a compensation process was found in 7 of the 32 subjects who showed a significant attachment to a spiritual figure.

Conclusions

Attachment theory allows us to highlight one of the underlying dimensions of spiritual coping in patients with psychosis.
Literature
1.
go back to reference Bowlby J. Attachment and loss, vol. 3. New-York: Basic Books; 1980. Bowlby J. Attachment and loss, vol. 3. New-York: Basic Books; 1980.
2.
go back to reference Bowlby J. By ethology out of psycho-analysis: an experiment in interbreeding. Anim Behav. 1980;28(Pt 3):649–56.CrossRefPubMed Bowlby J. By ethology out of psycho-analysis: an experiment in interbreeding. Anim Behav. 1980;28(Pt 3):649–56.CrossRefPubMed
3.
go back to reference Zeifman D, Hazan C. Pair bonds as attachments: Reevaluating the evidence. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical Applications. 2nd ed. New-York: The Guilford Press; 2008. p. 436–55. Zeifman D, Hazan C. Pair bonds as attachments: Reevaluating the evidence. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical Applications. 2nd ed. New-York: The Guilford Press; 2008. p. 436–55.
4.
go back to reference Main M, Goldwyn R. Adult attachment rating and classification system. In A topology of human attachment organization assessed in discourse, drawings and interviews. Edited by Main M. New-York: Cambridge University Press; 1990. Main M, Goldwyn R. Adult attachment rating and classification system. In A topology of human attachment organization assessed in discourse, drawings and interviews. Edited by Main M. New-York: Cambridge University Press; 1990.
6.
go back to reference Georges C, Kaplan N, Main M. Adult Attachment Interview Protocol 3rd edition. Berkeley: University of California; 1996. Georges C, Kaplan N, Main M. Adult Attachment Interview Protocol 3rd edition. Berkeley: University of California; 1996.
7.
go back to reference Dozier M. Attachment organization and treatment use for adults with serious psychopathology disorders. Dev Psychopathol. 1990;2:47–60.CrossRef Dozier M. Attachment organization and treatment use for adults with serious psychopathology disorders. Dev Psychopathol. 1990;2:47–60.CrossRef
8.
go back to reference Gumley AI, Schwannauer M, Macbeth A, Fisher R, Clark S, Rattrie L, et al. Insight, duration of untreated psychosis and attachment in first-episode psychosis: prospective study of psychiatric recovery over 12-month follow-up. Br J Psychiatry. 2014;205(1):60–7.CrossRefPubMed Gumley AI, Schwannauer M, Macbeth A, Fisher R, Clark S, Rattrie L, et al. Insight, duration of untreated psychosis and attachment in first-episode psychosis: prospective study of psychiatric recovery over 12-month follow-up. Br J Psychiatry. 2014;205(1):60–7.CrossRefPubMed
9.
go back to reference MaBeth A, Gumley A, Schwannauer M, Fisher R. Attachment states of mind, mentalization, and their correlates in a first-episode psychosis sample. Psychol Psychother. 2011;84(1):42–57. discussion 98–110.PubMed MaBeth A, Gumley A, Schwannauer M, Fisher R. Attachment states of mind, mentalization, and their correlates in a first-episode psychosis sample. Psychol Psychother. 2011;84(1):42–57. discussion 98–110.PubMed
10.
go back to reference Shevlin M, Houston JE, Dorahy MJ, Adamson G. Cumulative traumas and psychosis: an analysis of the national comorbidity survey and the British Psychiatric Morbidity Survey. Schizophr Bull. 2008;34(1):193–9.CrossRefPubMed Shevlin M, Houston JE, Dorahy MJ, Adamson G. Cumulative traumas and psychosis: an analysis of the national comorbidity survey and the British Psychiatric Morbidity Survey. Schizophr Bull. 2008;34(1):193–9.CrossRefPubMed
12.
go back to reference Dozier M, Stovall-McClough KC, Albus KE. Attachment and psychopathology in adulthood. In: Shaver JCPR, editor. Handbook of attachment: Theory, research, and clinical Applications. New-York: The Guilford Press; 2008. p. 718–44. Dozier M, Stovall-McClough KC, Albus KE. Attachment and psychopathology in adulthood. In: Shaver JCPR, editor. Handbook of attachment: Theory, research, and clinical Applications. New-York: The Guilford Press; 2008. p. 718–44.
13.
go back to reference Granqvist P, Kirkpatrick LA. Attachment and religious representations and behaviour. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical Applications. New-York: The Guilford Press; 2008. p. 906–33. Granqvist P, Kirkpatrick LA. Attachment and religious representations and behaviour. In: Cassidy J, Shaver PR, editors. Handbook of attachment: Theory, research, and clinical Applications. New-York: The Guilford Press; 2008. p. 906–33.
14.
go back to reference Sroufe LA, Waters E. Attachment as an organizational construct. Child Dev. 1997;48:1184–99.CrossRef Sroufe LA, Waters E. Attachment as an organizational construct. Child Dev. 1997;48:1184–99.CrossRef
15.
go back to reference Granqvist P, Hagekull B. Religiousness and perceived childhood attachment: Profiling socialized correspondence and emotional compensation. J Sci Study Relig. 1990;38:254–73.CrossRef Granqvist P, Hagekull B. Religiousness and perceived childhood attachment: Profiling socialized correspondence and emotional compensation. J Sci Study Relig. 1990;38:254–73.CrossRef
16.
go back to reference Gumley AI, Taylor HE, Schwannauer M, MacBeth A. A systematic review of attachment and psychosis: measurement, construct validity and outcomes. Acta Psychiatr Scand. 2014;129(4):257–74.CrossRefPubMed Gumley AI, Taylor HE, Schwannauer M, MacBeth A. A systematic review of attachment and psychosis: measurement, construct validity and outcomes. Acta Psychiatr Scand. 2014;129(4):257–74.CrossRefPubMed
17.
go back to reference Mohr S, Brandt PY, Borras L, Gillieron C, Huguelet P. Toward an integration of spirituality and religiousness into the psychosocial dimension of schizophrenia. Am J Psychiatry. 2006;163(11):1952–9.CrossRefPubMed Mohr S, Brandt PY, Borras L, Gillieron C, Huguelet P. Toward an integration of spirituality and religiousness into the psychosocial dimension of schizophrenia. Am J Psychiatry. 2006;163(11):1952–9.CrossRefPubMed
18.
go back to reference WHO. Classification statistique internationale des maladies et des problèmes de santé connexes. Genève: Organisation Mondiale de la Santé; 1993. WHO. Classification statistique internationale des maladies et des problèmes de santé connexes. Genève: Organisation Mondiale de la Santé; 1993.
19.
go back to reference Hesse E. The adult Attachment Interview. In: Cassidy J, Shaver PR, editors. Handbook of attachment : Theory, research, and clinical Applications. New-York: The Guilford Press edition; 2008. p. 552–98. Hesse E. The adult Attachment Interview. In: Cassidy J, Shaver PR, editors. Handbook of attachment : Theory, research, and clinical Applications. New-York: The Guilford Press edition; 2008. p. 552–98.
20.
go back to reference Mohr S, Gillieron C, Borras L, Brandt PY, Huguelet P. The assessment of spirituality and religiousness in schizophrenia. J Nerv Ment Dis. 2007;195(3):247–53.CrossRefPubMed Mohr S, Gillieron C, Borras L, Brandt PY, Huguelet P. The assessment of spirituality and religiousness in schizophrenia. J Nerv Ment Dis. 2007;195(3):247–53.CrossRefPubMed
21.
go back to reference Bowlby J. Attachment, vol. 1. New-York: Basic Books; 1969. Bowlby J. Attachment, vol. 1. New-York: Basic Books; 1969.
22.
go back to reference Bowlby J. Attachment and loss Volume 2. New-York: Basic Books; 1973. Bowlby J. Attachment and loss Volume 2. New-York: Basic Books; 1973.
23.
go back to reference Bowlby J. The making and breaking of affectional bonds. London: Tavistock; 1979. Bowlby J. The making and breaking of affectional bonds. London: Tavistock; 1979.
24.
go back to reference Mikulincer M, Shaver PR, Cassidy J, Berant E. Attachment related defensive processes. In: Obegi JH, Berant E, editors. Attachment theory and research in clinical work with adults. New-York: The Guilford Press edition; 2009. Mikulincer M, Shaver PR, Cassidy J, Berant E. Attachment related defensive processes. In: Obegi JH, Berant E, editors. Attachment theory and research in clinical work with adults. New-York: The Guilford Press edition; 2009.
25.
go back to reference Rieben I. Qualité de l’attachement dans la psychose et figures spirituelles. Swizerland: Lausanne; 2012. Rieben I. Qualité de l’attachement dans la psychose et figures spirituelles. Swizerland: Lausanne; 2012.
26.
go back to reference Lukoff D, Nuechterlein KH, Ventura J. Manual for the Expanded Brief Psychiatric Rating Scale. Schizophrenia Buletin. 1986;12:594–602. Lukoff D, Nuechterlein KH, Ventura J. Manual for the Expanded Brief Psychiatric Rating Scale. Schizophrenia Buletin. 1986;12:594–602.
27.
go back to reference First MB, Spitzer RL. Gibbon M. Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Edited by Edition P. Washington D.C: Williams JBW; 1997. First MB, Spitzer RL. Gibbon M. Structured Clinical Interview for DSM-IV-TR Axis I Disorders. Edited by Edition P. Washington D.C: Williams JBW; 1997.
28.
go back to reference Spitzer RL, Williams JBW, Gibbson M, First M. The Structured Clinical Interview for DSM IIIR. Washington D.C: American Psychiatric Association; 1990. Spitzer RL, Williams JBW, Gibbson M, First M. The Structured Clinical Interview for DSM IIIR. Washington D.C: American Psychiatric Association; 1990.
29.
go back to reference Van Ijzendorn MH, Bakermans-Kranenburg MJ. Attachment representations in mothers, fathers, adolescents and clinical groups: A meta-analytic search for normative data. J Consult Clin Psychol. 1996;64:8–21.CrossRef Van Ijzendorn MH, Bakermans-Kranenburg MJ. Attachment representations in mothers, fathers, adolescents and clinical groups: A meta-analytic search for normative data. J Consult Clin Psychol. 1996;64:8–21.CrossRef
30.
go back to reference Couture S, Lecomte T, Leclerc C. Personality characteristics and attachment in first episode psychosis: impact on social functioning. J Nerv Ment Dis. 2007;195(8):631–9.CrossRefPubMed Couture S, Lecomte T, Leclerc C. Personality characteristics and attachment in first episode psychosis: impact on social functioning. J Nerv Ment Dis. 2007;195(8):631–9.CrossRefPubMed
31.
go back to reference Dozier M, Lee S. Discrepancies between self-and other report of psychiatric symptomatology. Effects of dismissing attachment strategies. Dev Psychopathol. 1995;7:217–26.CrossRef Dozier M, Lee S. Discrepancies between self-and other report of psychiatric symptomatology. Effects of dismissing attachment strategies. Dev Psychopathol. 1995;7:217–26.CrossRef
32.
go back to reference Dozier M, Lomax L, Tyrrell CL, Lee SW. The challenge of treatment for clients with dismissing states of mind. Attach Hum Dev. 2001;3(1):62–76.CrossRefPubMed Dozier M, Lomax L, Tyrrell CL, Lee SW. The challenge of treatment for clients with dismissing states of mind. Attach Hum Dev. 2001;3(1):62–76.CrossRefPubMed
33.
go back to reference Mulligan A, Lavender T. An investigation into the relationship between attachment, gender and recovery from psychosis in a stable community-based sample. Clin Psychol Psychother. 2010;17(4):269–84.PubMed Mulligan A, Lavender T. An investigation into the relationship between attachment, gender and recovery from psychosis in a stable community-based sample. Clin Psychol Psychother. 2010;17(4):269–84.PubMed
34.
go back to reference Ponizovsky AM, Nechamkin Y, Rosca P. Attachment patterns are associated with symptomatology and course of schizophrenia in male inpatients. Am J Orthopsychiatry. 2007;77(2):324–31.CrossRefPubMed Ponizovsky AM, Nechamkin Y, Rosca P. Attachment patterns are associated with symptomatology and course of schizophrenia in male inpatients. Am J Orthopsychiatry. 2007;77(2):324–31.CrossRefPubMed
35.
go back to reference Ponizovsky AM, Vitenberg E, Baumgarten-Katz I, Grinshpoon A. Attachment styles and affect regulation among outpatients with schizophrenia: relationships to symptomatology and emotional distress. Psychol Psychother. 2013;86(2):164–82.CrossRefPubMed Ponizovsky AM, Vitenberg E, Baumgarten-Katz I, Grinshpoon A. Attachment styles and affect regulation among outpatients with schizophrenia: relationships to symptomatology and emotional distress. Psychol Psychother. 2013;86(2):164–82.CrossRefPubMed
36.
go back to reference Quijada Y, Tizon JL, Artigue J, Kwapil TR, Barrantes-Vidal N. Attachment style predicts 6-month improvement in psychoticism in persons with at-risk mental states for psychosis. Early Interv Psychiatry. 2012;6(4):442–9.CrossRefPubMed Quijada Y, Tizon JL, Artigue J, Kwapil TR, Barrantes-Vidal N. Attachment style predicts 6-month improvement in psychoticism in persons with at-risk mental states for psychosis. Early Interv Psychiatry. 2012;6(4):442–9.CrossRefPubMed
37.
go back to reference Tyrrell CL, Dozier M, Teague GB, Fallot RD. Effective treatment relationships for persons with serious psychiatric disorders: the importance of attachment states of mind. J Consult Clin Psychol. 1999;67(5):725–33.CrossRefPubMed Tyrrell CL, Dozier M, Teague GB, Fallot RD. Effective treatment relationships for persons with serious psychiatric disorders: the importance of attachment states of mind. J Consult Clin Psychol. 1999;67(5):725–33.CrossRefPubMed
38.
go back to reference Benedetti G. Le sujet emprunté. Le vécu psychotique du patient et du thérapeute. Paris: erès; 1998. Benedetti G. Le sujet emprunté. Le vécu psychotique du patient et du thérapeute. Paris: erès; 1998.
39.
go back to reference Read J, Perry BD, Moskowitz A, Connolly J. The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry. 2001;64(4):319–45.CrossRefPubMed Read J, Perry BD, Moskowitz A, Connolly J. The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry. 2001;64(4):319–45.CrossRefPubMed
40.
go back to reference Fonagy P, Gergerly G, Jurist EL, Target M. Affect regulation, mentalization and the development of the self. London: Karnak; 2002. Fonagy P, Gergerly G, Jurist EL, Target M. Affect regulation, mentalization and the development of the self. London: Karnak; 2002.
41.
go back to reference Allen JP, Fonagy P, Bateman AW. Mentalizing in clinical practice. Washington D.C: American Psychiatric Publishing Inc; 2008. Allen JP, Fonagy P, Bateman AW. Mentalizing in clinical practice. Washington D.C: American Psychiatric Publishing Inc; 2008.
42.
go back to reference Korver-Nieberg N, Berry K, Meijer CJ, de Haan L. Adult attachment and psychotic phenomenology in clinical and non-clinical samples: a systematic review. Psychol Psychother. 2014;87(2):127–54.CrossRefPubMed Korver-Nieberg N, Berry K, Meijer CJ, de Haan L. Adult attachment and psychotic phenomenology in clinical and non-clinical samples: a systematic review. Psychol Psychother. 2014;87(2):127–54.CrossRefPubMed
43.
go back to reference Bakermans-Kranenburg MJ, Van IJzendoorn MH. The first 10,000 Adult Attachment Interviews: distributions of adult attachment representations in clinical and non-clinical groups. Attach Hum Dev. 2009;11:223–63.CrossRefPubMed Bakermans-Kranenburg MJ, Van IJzendoorn MH. The first 10,000 Adult Attachment Interviews: distributions of adult attachment representations in clinical and non-clinical groups. Attach Hum Dev. 2009;11:223–63.CrossRefPubMed
44.
go back to reference Dozier M, Stevenson AL, Lee SW, Velligan DI. Attachment organization and familial overinvolvement for adults with serious psychopathological disorders. Dev Psychopathol. 1991;3:475–4849.CrossRef Dozier M, Stevenson AL, Lee SW, Velligan DI. Attachment organization and familial overinvolvement for adults with serious psychopathological disorders. Dev Psychopathol. 1991;3:475–4849.CrossRef
45.
go back to reference Ciechanowski PS, Katon WJ, Russo JE, Walker EA. The patient-provider relationship: attachment theory and adherence to treatment in diabetes. Am J Psychiatr. 2001;158:29–35.CrossRefPubMed Ciechanowski PS, Katon WJ, Russo JE, Walker EA. The patient-provider relationship: attachment theory and adherence to treatment in diabetes. Am J Psychiatr. 2001;158:29–35.CrossRefPubMed
46.
go back to reference Blackburn C, Berry K, Cohen K. Factors correlated with client attachment to mental health services. J Nerv Ment Dis. 2010;198:572–5.CrossRefPubMed Blackburn C, Berry K, Cohen K. Factors correlated with client attachment to mental health services. J Nerv Ment Dis. 2010;198:572–5.CrossRefPubMed
47.
go back to reference Picken AL, Berry K, Tarrier N, Barrowclough C. Traumatic events, posttraumatic stress disorder, attachment style, and working alliance in a sample of people with psychosis. J Nerv Ment Dis. 2010;198:775–8.CrossRefPubMed Picken AL, Berry K, Tarrier N, Barrowclough C. Traumatic events, posttraumatic stress disorder, attachment style, and working alliance in a sample of people with psychosis. J Nerv Ment Dis. 2010;198:775–8.CrossRefPubMed
48.
go back to reference Berry K, Barrowclough C, Wearden A. Adult attachment, perceived earlier experiences of care giving and trauma in people with psychosis. J Ment Health. 2009;18:280–7.CrossRef Berry K, Barrowclough C, Wearden A. Adult attachment, perceived earlier experiences of care giving and trauma in people with psychosis. J Ment Health. 2009;18:280–7.CrossRef
49.
go back to reference Laing RD. The Divided Self. London: Tavistock publications Ltd; 1960. Laing RD. The Divided Self. London: Tavistock publications Ltd; 1960.
50.
go back to reference Andreasen NC, Black DW. Introductory textbook of psychiatry. 3rd ed. Washington D.C: American Psychiatric Publishing Inc; 2001. Andreasen NC, Black DW. Introductory textbook of psychiatry. 3rd ed. Washington D.C: American Psychiatric Publishing Inc; 2001.
51.
go back to reference Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M. Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet. 2009;373(9661):408–15.CrossRefPubMed Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M. Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet. 2009;373(9661):408–15.CrossRefPubMed
52.
go back to reference Bellack AS, Mueser KT, Gingerich S, Agresta J. Social skills training for schizophrenia. A step by step guide. 2nd edition. New-York: The Guilford Press; 2004. Bellack AS, Mueser KT, Gingerich S, Agresta J. Social skills training for schizophrenia. A step by step guide. 2nd edition. New-York: The Guilford Press; 2004.
53.
go back to reference Talia A, Daniel SI, Miller-Bottome M, Brambilla D, Miccoli D, Safran JD, et al. AAI predicts patients' in-session interpersonal behavior and discourse: a "move to the level of the relation" for attachment-informed psychotherapy research. Attach Hum Dev. 2014;16(2):192–209.CrossRefPubMed Talia A, Daniel SI, Miller-Bottome M, Brambilla D, Miccoli D, Safran JD, et al. AAI predicts patients' in-session interpersonal behavior and discourse: a "move to the level of the relation" for attachment-informed psychotherapy research. Attach Hum Dev. 2014;16(2):192–209.CrossRefPubMed
54.
go back to reference Penn DL, Corrigan PW, Bentall RP, Racenstein JM, Newman L. Social cognition in schizophrenia. Psychol Bull. 1997;121(1):114–32.CrossRefPubMed Penn DL, Corrigan PW, Bentall RP, Racenstein JM, Newman L. Social cognition in schizophrenia. Psychol Bull. 1997;121(1):114–32.CrossRefPubMed
55.
go back to reference Mohr S, Borras L, Betrisey C, Pierre-Yves B, Gillieron C, Huguelet P. Delusions with religious content in patients with psychosis: how they interact with spiritual coping. Psychiatry. 2010;73(2):158–72.CrossRefPubMed Mohr S, Borras L, Betrisey C, Pierre-Yves B, Gillieron C, Huguelet P. Delusions with religious content in patients with psychosis: how they interact with spiritual coping. Psychiatry. 2010;73(2):158–72.CrossRefPubMed
56.
go back to reference Allen JP. The attachment system in adolescence. In: Shaver JCPR, editor. Handbook of attachment : Theory, research, and clinical Applications. 2nd ed. New-York: The Guilford Press; 2008. p. 419–36. Allen JP. The attachment system in adolescence. In: Shaver JCPR, editor. Handbook of attachment : Theory, research, and clinical Applications. 2nd ed. New-York: The Guilford Press; 2008. p. 419–36.
Metadata
Title
Attachment and coping in psychosis in relation to spiritual figures
Authors
Philippe Huguelet
Sylvia Mohr
Isabelle Rieben
Roland Hasler
Nader Perroud
Pierre-Yves Brandt
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0617-4

Other articles of this Issue 1/2015

BMC Psychiatry 1/2015 Go to the issue