In this paper, Dr. Gwen Adshead looks at the importance of attachment relationships between patients, their care-givers and even the institution. These are of particular importance in forensic settings, where patients can be detained for many years. In the paper, she describes how some difficult responses – such as self-harm or violence – can be understood as attachment behaviours, and how this has implications for treatment.
Attachment theory argues that psychological development and functioning are affected by our earliest attachments to care-givers. Failed or pathological attachments in childhood may give rise to a repetition of maladaptive attachment patterns in adulthood. Relationships between patients and both psychiatric care- givers and institutions may resemble attachment relationships.