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.

Table of Contents:
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

About the Author :
Jon Mills, Psy.D., Ph.D., ABPP, is a psychologist, philosopher, and psychoanalyst in private practice in Ajax, Ontario, Canada. He is a diplomate in psychoanalysis and clinical psychology with the American Board of Professional Psychology and is currently president of the Section on Psychoanalysis of the Canadian Psychological Association.

Review :
It is a rare treat indeed and one that is increasingly uncommon to have the richest, most detailed clinical material presented alongside tightly organized and coherent clinical theory. This book is of immense practical value. In teaching simple but effective therapeutic techniques, the book succeeds in identifying a previously frequently overlooked set of clinical problems and in meeting these in the most powerful way that modern analytic technique is able to muster. This book is an absolute gem! Mills' work is a welcome addition to the literature. It goes beyond simply linking adult psychopathology to early attachment difficulties. Mills' work provides a theoretical framework for understanding attachment from a psychodynamic/psychoanalytic perspective and then uses this theoretical framework to discuss the aetiology and treatment of adult disorders. Although Mills is working from a psychoanalytic/psychodynamic perspective, this book offers much to clinicians from all perspectives. Mills is clearly passionate about his work, and it is hard not to feel the same excitement when reading his work... The theoretical discussions and treatment considerations are rich, nuanced, and informative. Under the author's highly knowledgeable and skillful guidance, attachment theory once the pariah of psychoanalysis, is demonstrated by him to be central to understanding human development, and errors in attachment to be central to the development of psychopathology. Thus, attachment has now become a major player in psychoanalytic theory and clinical application. Dr. Mills ably demonstrates the role of attachment disorder in adult dysfunctional ways of being. It is the immediacy of the importance of attachment in the clinical situation which clearly distinguishes this worthy book. Attachment is no longer simply a feature of infancy in childhood. It is a matter for a lifetime and is a major player in adult psychopathology. I urge all mental health workers to read it. Mills' work is a welcome addition to the literature. It goes beyond simply linking adult psychopathology to early attachment difficulties. Mills' work provides a theoretical framework for understanding attachment from a psychodynamic/psychoanalytic perspective and then uses this theoretical framework to discuss the aetiology and treatment of adult disorders. Although Mills is working from a psychoanalytic/psychodynamic perspective, this book offers much to clinicians from all perspectives. Mills is clearly passionate about his work, and it is hard not to feel the same excitement when reading his work.