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Attachment and coping in psychosis in relation to spiritual figures

Abstract
Background

Studies have found higher levels of insecure attachment in individuals with schizophrenia. Attachment theory provides a framework necessary for conceptualizing the development of interpersonal functioning. Some aspects of the attachment of the believer to his/her spiritual figure are similar to those between the child and his/her parents. The correspondence hypothesis suggests that early child-parent interactions correspond to a person’s relation to a spiritual figure. The compensation hypothesis suggests that an insecure attachment history would lead to a strong religiousness/spirituality as a compensation for the lack of felt security. The aim of this study is to explore attachment models in psychosis vs. healthy controls, the relationships between attachment and psychopathology and the attachment processes related to spiritual figures.
Methods

Attachment models were measured in 30 patients with psychosis and 18 controls with the AAI (Adult Attachment interview) in relationship with psychopathology. Beliefs and practices related to a spiritual figure were investigated by qualitative and quantitative analyses.
Results

Patients with psychosis showed a high prevalence of insecure avoidant attachment. Spiritual entities functioned like attachment figures in two thirds of cases. Interviews revealed the transformation of internal working models within relation to a spiritual figure: a compensation process was found in 7 of the 32 subjects who showed a significant attachment to a spiritual figure.

Conclusions

Attachment theory allows us to highlight one of the underlying dimensions of spiritual coping in patients with psychosis.

Keywords: Attachment; Psychosis; Adult Attachment Interview (AAI); Symptoms; Spiritual coping; Schizophrenia

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If one’s sense of self was relentlessly undermined in childhood – or believed to have been so – by those in whom one was forced to depend upon for food and shelter, might one elect trust something other than another human? Especially if one never developed a functioning and effective sense of trust, autonomy, initiative or competence… and is still dependent on something outside oneself for direction?

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