I had an invite from Seva Counselling Centre, to attend a lecture on Attachment Based Family Therapy (ABFT) by Dr. Pravin Israel, clinical psychologist and senior researcher at the Akershus University Hospital in Norway, with roots from Hyderabad. As a teacher and Counsellor, I had practiced Solution Focused Brief Therapy (SFBT) but ABFT – I had no idea!
According to Dr. Pravin, in India, relatively little importance seems to be given to the mental health problems of young people. Young people seldom seek help or come to mental health clinics.
Though parenting is fundamental to the survival and success of the human race, yet little scientific information is available about parenting. There exists a strong attachment between parent and child and when that bond is strained or ruptured, it leads to various mental health problems, among others, depression, self-injury and suicide in adolescents.
The quality of interpersonal relationships in family can precipitate or aggravate the above mentioned problems in adolescents, he says. ABFT explores the relationship between parent and the adolescent. It aims to repair interpersonal ruptures and rebuilds emotionally protective, secure-based, parent-child relationships.
The primary assumption of ABFT is that high family conflict, harsh criticism, physical or emotional neglect or abuse, can rupture attachment bonds. Ruptured attachments and a negative home environment may inhibit young people from developing the internal and interpersonal coping skills needed to safeguard against stress leading to depression.
According to Dr. Pravin, the adolescent phase is a complex one with needs, interests and desires that are strong and complicated. The adolescent tends to experience opposing desires and to waver between needs for support and independence, selfishness and selflessness, traditional values and a desire for individuality. Because of ambivalence in his views and judgments, it is often difficult for him to take a standpoint in close relationships. Such experiences create feelings of inadequacy and in turn, feelings of insecurity that overwhelms the adolescent.
Many adolescents strive towards goals and achievement levels that are un-realistic in view of their actual endowments and acquired abilities; they repeatedly fail and experience deep disappointment and even despair. Sometimes, parents pressure the adolescents and young adults into striving towards goals they lack the ability to achieve. This is often accompanied by feelings of inadequacy tinted with depression.
During adolescence conflicts arise from a variety of causes – quarrelling parents, nagging and teasing by a family member, being misunderstood by a friend or rejected by the peer group cause internal stress. When conflict and stress increase, it may lead to mental disturbances.
Adjusting aspirations to abilities and skills is essential in avoiding situations of severe conflict and in promoting personality integration. ABFT steps in to help adolescents and their parents address relationship issues and thereafter turn to solve other conflicts that may be bothering the adolescent.
According to attachment theory, individuals who have a safe and sound sense of security, have higher self esteem, are able to adapt to situations, have problem solving skills and ability for direct communication – the essential skills needed for autonomy and individuation. In contrast individuals with insecure attachments most likely engage in maladaptive strategies and social isolation.
Dr. Pravin talked about a case where Tina, a fifteen year old was clinically depressed. She harboured tremendous resentment against her mother. The mother, a single working parent, would send her to the grandparents during summer holidays. Unfortunately, there the poor child was sexually harassed by a friend of the family. The mother had no clue and was perplexed about Tina’s hostility towards her.
An ABFT therapist was able to help both mother and the daughter. An individually oriented therapist may not have uncovered and helped them resolve this painful experience that was causing distress and damage.
There is scarcity of family therapy treatments that are specific to adolescents. ABFT is a new model designed for treating depressed and suicidal adolescents. It was developed by Professor Guy Diamond and his team in Philadelphia, USA.
The model is approved by relevant authorities in USA as an empirically validated model. It focuses on family relationships rather than addressing symptoms separately. Here, the adolescent talks about what caused the rupture while the parent listens with respect and helps them to tell their story.
The ABFT therapist focuses on resolving past or current impasses in the attachment relationship. Both the parent and the adolescent take mutual responsibility for change thus rebuilding trust and reshaping relationships.
Listening to Dr. Pravin’s brilliantly presented lecture, I could see that almost everyone present in the auditorium became introspective. May be thinking of their adolescent days and ruptured attachments!!
The premise of this article is that repairing attachments problems can promote better self-regulatory capacities in adolescents which in turn can lead to a decrease in depression and suicidal behaviour.