Roderick D. MacLeod, PhD, FAChPM Goodfellow Unit, School of Population Health, University of Auckland
Objectives:
-
Participants will understand how individuals develop and display empathy.
- Participants will understand how individuals learn to care and develop caring human relationships.
| Attachment | Size |
|---|---|
| RMacLeod Learning to Care in Medicine 5-7-09.pdf | 6.57 MB |
Attachment Theory Expansion Please
Questions from our group:
We appreciated this presentation and the insight about attachment theory.
Of course the best scenario is when both the caregiver and patient have "secure" dispositions due to good parenting or other role models at key developmental times.
What are ways that the caregiver can approach the patient/family member when the caregiver is aware of other combinations of relationships between himself/herself and the patient.
That is: (Caregiver; Pt/Family) = 1) Secure; Insecure-Avoidant 2) Secure; Insecure-Anxious 3) Insecure-Avoidant; Insecure Avoidant 4) Insecure-Avoidant; Insecure-Anxious 5) Insecure-Anxious; Insecure Avoidant 6) Insecure Anxious; Insecure Anxious
Are some of these combinations more difficult than others to work through? If so, how does one decide when to transition to another caregiver who can be the primay provider who can connect with and work with the patient more effectively?
Attachment theory response
Thank you for the interest in this aspect of care. I can't be sure but I feel that the appropriate thing to do is to assess which sort of style one is dealing with and if possible adjust one's response accordingly. During times of unpredictability and threat we tend to need more feelings of safety and consistency. If we recognise our own style then perhaps we can go some way to adapting those (although I suspect that insecure-avoidant and insecure-anxious may never be in a position to adjust). Those who are not 'secure' carers may find it difficult to care in as effective a manner as those who are not. That is, in Osler's terms for example - secure types will be more likely to have that "aequinamitas" that he felt was essential.
Insecure-avoidants will not expect others to be available to them in times of difficulty (and so will not be aware perhaps of others needs so much) and patients may perceive them as cold, aloof or unemotional and so not as approachable (I think our participants met some of this type in receiving their medical care!)
Insecure-anxious types lack faith in their own ability so perhaps are unlikely to be in a caring situation at the end of life?
I'm not sure if that answers the question adequately but if we are secure in our caring abilitites then we are the ones who could or should adapt accordingly.
Hope that helps
With best wishes
Rod MacLeod