Background and Purpose: The situation leading to the death of a close relative is a unique and irrevocable experience of separation which evokes a state of emotional strain for the patient and the family. This situation therefore is an especially effective trigger of the so-called ‘attachment system’. Attachment research in recent decades has shown that already in early infancy every person develops special attachment strategies activated in cases whenever a person cannot cope on its own with dangers. Only four such patterns of attachment have been specified, namely ‘secure’, ‘insecure-avoidant’, ‘insecure-ambivalent/enmeshed’ and ‘disoriented/disorganized’. Since the dying are usually brought to the hospital by members of the family, the doctor responsible for treatment can perceive with unusual clarity the patterns of attachment within the family system, and can integrate such observation into her treatment strategy. This article suggests an attachment-informed therapy in the field of palliative medicine. It seems apparent that such approaches provided by the attachment theory for relief during the terminal phase are not only relevant in a palliative context but also applicable within the overall field of medicine and care-giving relating to terminal patients and their families. Methods: To the doctor familiar with the attachment patterns and the conditions of their formation, clinical observation easily reveals which pattern is active among the dying and the accompanying members of the family. Here, cases are used to show how these insights can be realized in the psychotherapeutic care of patients and their families on a palliative ward. For example, in a case of ‘avoidant’ attachment, denied emotions can be addressed carefully and still existent hopes for protection and support can be reinforced; in a case of so-called ‘ambivalent-enmeshed’ attachment, overly intense relationships can be disentangled, and in a case of ‘disorganized’ attachment, emotion regulation can be supported and clarity in the relationships can be promoted. Results: The clinical results show that psychotherapeutic intervention based on insights imparted by the attachment theory are of special benefit in relieving the psychological strain for the dying and their families.

This content is only available via PDF.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.