Attachment Theory as a Model of Doctor–Patient Interaction

Abstract

Individuals' attachment styles have been traced throughout the life span, informing our understanding of long-standing interpersonal patterns and self-care habits. Recent scholarship has identified direct and indirect mechanisms through which attachment theory may impact individuals' health outcomes, with specific emphasis on endocrine and behavioral responses to stress. This article reviews extant literature on medical patients' attachment styles and also proposes a new line of research: an investigation of the interaction between patients' and providers' attachment styles. As medical establishments place more emphasis on effective patient-provider communication, attachment theory serves as an apt framework for clarifying, measuring, and training medical personnel in the advancement of patient-centered care.From birth, we are genetically wired to attach to our caregivers for survival. These first relationships not only shape expectations for the self and for future relationships, but they also shape the organization of the brain, nervous system, and endocrine system. In other words, how we attach to others in early childhood can affect how we develop interpersonally and biologically throughout the life

Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships

“…This is a circumstance that is likely to lead to frustration because, unlike romantic relationships, HCP–patient relationships are asymmetric—the bond is not reciprocal, even when the health provider is well attuned and responsive within professional boundaries. 22 Our survey did not probe the characteristic of the non-substitutability of the HCP who serves attachment functions, which remains to be explored in future research.…”

“…At times of health-related threat or distress, individuals direct attachment attitudes and behaviours (proximity seeking or avoidance, trust or distrust, expression or suppression of distress) towards HCPs in a manner similar to the way they would react towards a romantic partner if distress occurred in that context. 17 22 This would explain why variations in healthcare utilisation 17 and perceived difficulty in HCP–patient relationships, 20 in particular, might be correlated with patterns of romantic attachment.…”

Two is a perfect number: Patient–doctor relationship and patient attachment style in palliative care

“…The continuity of attachment pattern from childhood to adulthood was subjected to debate (Bartholomew and Horowitz, 1991; Collins, 1996; Fraley, 2002; Fraley and Roberts, 2005; Fraley and Shaver, 2000; Lewis et al, 2000; Mikulincer and Shaver, 2007; Pierce et al, 1992; Rothbard and Shaver, 1994; Troy and Sroufe, 1987; Zimmermann et al, 1997). That notwithstanding, Bowlby’s idea of attachment was investigated in adults in reference to variables such as different sociodemographic parameters (Adamczyk and Bookwala, 2013; Bartholomew and Horowitz, 1991; Fraley and Davis, 1997; Fraley and Shaver, 1998; Harms, 2011; Hazan and Shaver, 1987; Zeifman and Hazan, 2008), health condition (McWilliams and Bailey, 2010), health practices (Davis et al, 2015), eating habits (Faber and Dubé, 2015), and disorders (Pace et al, 2016), in pregnant women (Sabuncuoglu and Basgul, 2014), medical patients in general (Cassedy et al, 2015; Ciechanowski et al, 2002; Maunder and Hunter, 2009), or with medically unexplained symptoms (Ciechanowski et al, 2002; Schroeter et al, 2015), in anxious (Alberts and Hadijstavropoulos, 2014) or difficult patients (Taylor et al, 2000), diabetics (Ciechanowski and Katon, 2006), post-surgery (Gur-Yaish et al, 2014), and cancer patients (Clark et al, 2011; Hinnen et al, 2014; Holwerda et al, 2013; Klest and Philippon, 2016; Lo et al, 2009; Mack et al, 2009). Sirois and Gick (2014) pointed out that attachment style might be crucial in patients who have chronic arthritis and by the same token are subjected to physical and emotional suffering which triggers their social, attachment behavior.…”

Assessing emotional aspects of midwives’ intrapartum care: Development of the emotional availability and responsiveness in intrapartum care scale

“…Attachment Theory (Ainsworth, 1978;Bowlby, 1971) focuses on emotional aspects of interpersonal relationships and is increasingly applied to understand and improve interactions between patients and providers in health care (Bay-Smadja and Rahioui, 2015;Cassedy et al, 2015;Hooper et al, 2012). Originally conceptualised to describe emotional bonds between a child with its caregiver (Bowlby, 1971), the concept of attachment has also been applied to interpersonal interactions across the life course (George and West, 2001).…”