Treating Attachment Pathology

This book rectifies a much neglected area in the conceptualization and treatment of attachment disorders. The interface between attachment, psychic structure, and character pathology has been largely ignored in the clinical literature until recent years, and when discussed, it has been generally relegated to the domain of child psychopathology. Because human attachment is such a basic aspect to motivation and adjustment, attachment disruptions in childhood color psychic development and often leave deep and enduring deficits in personality and adaptive functioning. The author shows that patients with attachment deficiencies and associated characterological vulnerabilities have fundamental structural deficits in personality organization that lie at the heart of our current understanding of disorders of the self. Offering the first comprehensive paradigm on the psychoanalytic treatment of adult and adolescent attachment disorders, Jon Mills argues that attachment pathology is a disorder of the self based on developmental trauma that predisposes patients toward a future trajectory marked by structural deficits, character pathology, and interpersonal discord that fuel and sustain myriad forms of clinical symptomatology. This pivotal work constitutes a treatise on the governing psychic processes of attachment on self-organization, adaptation, and conflicted intersubjective dynamics in non-childhood populations, and on the intervening relational parameters in treating their emergent clinical pathologies.Through conceptually astute technical strategies grounded in sold clinical practice, the author offers one of the most extensive and original frameworks in the psychoanalytic treatment of attachment disorders.

By Jon Mills

Part 1 Part I: Theoretical and Diagnostic Considerations
Chapter 2 1 Conceptualizing Attachment Pathology
Chapter 3 2 The Attachment Disordered Self
Chapter 4 3 Borderline Organization, Trauma, and Attachment
Part 5 Part II: Treatment Perspectives
Chapter 6 4 Beginning the Treatment
Chapter 7 5 The Fragile Nature of Therapeutic Alliance
Chapter 8 6 Managing Primitive Defenses
Chapter 9 7 Embracing Countertransference
Chapter 10 8 Reaching the Affect
Part 11 Part III: Extended Case Studies
Chapter 12 Engaging Alexithymia in a Depressed, Eating Disordered, Body Dysmorphic Adolescent Female
Chapter 13 Feeling Closeted: Der Todestrieb, Guilt, and Self-Punishment in a Bipolar Gay Man
Chapter 14 Homo Homini Lupus: Treating a Case of Systemic Ritualistic Abuse
Chapter 15 Postscript from the Unconscious