Attachment-individuation: I. Clinical notes toward a reconsideration of "adolescent turmoil"

Adolescent Psychiatry, 2000 by Doctors, Shelley R

Anna Freud's (1958) claim that turmoil is normative in adolescence has blurred the distinction between healthy and pathological development for too long. Offer's research (Offer, 1969; Offer and Offer, 1975), which refuted the concept of normative adolescent turmoil, has never been integrated into psychoanalytic theory. Further, the ferment characterizing contemporary psychoanalysis, the explosion of relational theories, and the exciting findings of attachment studies and other developmental research have barely found their way into psychoanalytic theorizing about adolescence, at least in part due to the privileged place of "adolescent turmoil" in developmental theory. Thus, there is the paradox that psychotherapy with adolescents, widely viewed as the most freewheeling area of psychotherapeutic work, is also the last bastion of psychoanalytic drive-structural theory.

Separation-Individuation

The concept of adolescent turmoil has deep roots in psychoanalytic theory because it is intertwined with ideas about the adolescent's need to separate from the parents of childhood. When one believes the internalized tie to the parents becomes sexualized in puberty (S. Freud, 1905), the universal incest taboo provides the rationale for the so-called need to disengage from that tie (A. Freud, 1958). The difficulties attendant on such an endeavor are thought to produce adolescent turmoil. Anna Freud's (1958) term adolescent turmoil describes the psychological upset she believed was normally attendant on "the mental pain caused by the difficult task to withdraw cathexis and give up a position which holds out no further hope for the return of love, that is, for satisfaction" (p. 262). Blos (1967) linked this process of psychological reorganization to Mahler's (1968) work on separation-individuation and described adolescence as the second individuation, by which he meant a higher order individuation process in which the adolescent sheds family dependencies and loosens infantile object ties to become a member of the adult world.

Although the writings of Anna Freud and Blos provide countless examples of the complications attendant on the reorganization of the inner experience of the parent in adolescence, too often their theories are simplified, misconstrued, and conflated with observations at different levels of abstraction. For example, the adolescent's social involvement with the peer group is taken as evidence of renunciation of inner ties to the parents. Professionals and laypeople alike have come to believe that maturity depends on the adolescent's giving up parental connections. My late colleague, Dick Marohn (1998), assailed this confusion and claimed that adolescents do not normally separate from the parents of childhood, if that is taken to mean a renunciation of internal attachment. Marohn said that adolescents need secure emotional bonds to loved ones to sustain them throughout life. I believe that it is the absence of sufficiently secure emotional bonds to parents that produces adolescent turmoil, not the struggle to renounce secure ties.

Attachment-Individuation

I suggest that a focus on the security of the adolescent's attachment to the parents of childhood can illuminate and clarify the question of adolescent turmoil. Secure adolescents build on earlier ties and complexify them but never renounce them. Secure ties allow for the evolution of the bond, the relationship, and the sense of self and other within the relationship. Individuation is advanced by secure attachment; at every stage of life, individuation is supported by well-functioning intersubjective environments providing requisite selfobject experiences. When attachment bonds are insecure, however, turmoil results from the adolescent's attempt to rework and improve emotional bonds (Doctors, 1998a, b). From this vantage point, turmoil is not normative but is a function of insecure attachment (Ainsworth et al., 1978).

The phrase attachment-individuation comes from the work of infant researcher Lyons-Ruth (1991), who reviewed Mahler's data and writings (Mahler, 1968; Mahler, Pine, and Bergmann, 1975) and coined the phrase that contrasts with Mahler's term, separation-individuation. Lyons-Ruth took issue with Mahler's claim that ambivalence toward the caretaker is normal on the part of a toddler in need of comfort. Lyons-Ruth drew on attachment research (Ainsworth et al., 1978) to reinterpret Mahler and said that heightened ambivalence was more likely to be related to difficulties in parent-infant interaction than, as Mahler had claimed, to normative ambivalence related to a "fear of reengulfment." Whereas Mahler believed that individuality was attained by differentiation from a fused mother-infant state, we now recognize that, early on, self and other can be more easily distinguished than previously thought. Moreover, it is the nature of the connection established between self and other that is crucial for development. In wellfunctioning intersubjective systems (providing requisite selfobject experiences), the sense of connection and sense of distinctiveness develop in tandem. Attachment-individuation (Lyons-Ruth, 1991) emphasizes the child's "propensity to establish and preserve emotional ties to preferred caregivers at all costs [italics added], while simultaneously attempting to find a place within [italics added] these relationships for his or her own goals and initiatives" (p. 10). In this model, no conflict is presumed normally attendant on this phase, unless the child cannot find a place within the "preserved" relationship for his own goals and initiatives.I When the child's own goals and initiatives are experienced as threatening the emotional attachment to the caretaker, inner conflict develops (see Stolorow, Brandchaft, and Atwood, 1987, pp. 88-99). The ambivalence that then can be observed emanates from the child's difficulties in maintaining a sense of inner connection with the parent while asserting individuality.