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Unresolved states of mind regarding experiences of loss/abuse (U/d) are identified through lapses in the monitoring of reasoning, discourse, and behavior surrounding loss/abuse in response to the Adult Attachment Interview. Although the coding system for U/d has been widely used for decades, the individual indicators of unresolved loss/abuse have not been validated independently of the development sample. This study examined the psychometric validity of U/d, using individual participant data from 1,009 parent–child dyads across 13 studies. A latent class analysis showed that subsets of commonly occurring U/d indicators could differentiate interviewees with or without unresolved loss/abuse. Predictive models suggested a psychometric model of U/d consisting of a combination of these common indicators, with disbelief and psychologically confused statements regarding loss being especially important indicators of U/d. This model weakly predicted infant disorganized attachment. Multilevel regression analysis showed no significant association between ratings of unresolved other trauma and infant disorganized attachment, over and above ratings of unresolved loss/abuse. Altogether, these findings suggest that the coding system of U/d may have been overfitted to the initial development sample. Directions for further articulation and optimization of U/d are provided. [ABSTRACT FROM AUTHOR]

Objective: While the relationship between attachment anxiety and avoidance and the severity of prolonged grief disorder (PGD) has been well‐studied, less is known about the relationship between disorganized attachment and PGD. We test the associations between disorganized attachment and the interaction between it and attachment avoidance and anxiety on PGD. Method: Participants (N = 258) who had lost a family member from 0.5 to 8.0 years before the survey completed the experiences in close relationships‐revised, the adult disorganized attachment scale, and the PGD‐13 scale. Results: The model explaining PGD symptoms through attachment, taking into account the level of disorganized attachment, explained variance in PGD significantly better than the model taking into account only the level of attachment anxiety and avoidance as predictors. Additionally, the relationships between attachment avoidance and PGD were positive, negative, or neither, depending on the configuration of the levels of disorganized attachment and attachment anxiety. Conclusion: Future research into the relationships between attachment and PGD should take into account disorganized attachment. Attachment‐informed grief therapy focused on insecure styles of attachment – including the disorganized style – to the deceased person and other loved ones may prove a promising approach for bereaved persons who experience PGD. [ABSTRACT FROM AUTHOR]

Unresolved loss and unresolved trauma in adult mothers, and the commonly disorganized attachment pattern developed by their infants, have been repeatedly reported in longitudinal research literature as a crucial correlate or precedent of severe pathology. We describe and illustrate how unresolved loss and unresolved trauma are manifested in verbatim-transcribed language and how they are to be detected, so that psychoanalysts and clinicians in general are able to distinguish them and understand how such "states of mind" evidence the process of fragmentation they involve. We follow each example with a resolved transcript so it can be contrasted with a nonresolved case. We then describe excerpts of a taped "disorganized infant" – an example of infants who are usually babies of unresolved mothers, as shown during the Adult Attachment Interview. The analyst's ability to identify and understand these "states of mind" and the subsequent sensitive reflection on the transcendental role of primary traumatic relations, which are involved in fear and the destructive dynamics of mental fragmentation – as seen in empirical research on attachment – can facilitate a resourceful integrative analytic scrutiny of the processes gone through by patients, and encourage the discovery of alternatives for working through the disturbing experience. [ABSTRACT FROM AUTHOR]

Attachment theory predicts that family bereavement leads even securely attached individuals to experience temporary attachment insecurity. This article explores how incoherence, a narrative marker of attachment insecurity, is displayed in the talk of families undergoing bereavement family therapy. This study uses the lens of attachment theory, and specifically the Adult Attachment Interview (AAI), to explore how members of five families talked about the loss of a close family member and how interactions between therapist and family members could hinder a coherent dialogue about the death. The families were recruited through Winston's Wish, a UK-based family bereavement charity. The analysis centers on the "Telling the story" intervention, used at the start of therapy, in which family members together tell the story of the death. Families also retold the story in an extra family session toward the end of the therapy for the purposes of this research. Transcripts of the therapy sessions were analyzed using thematic analysis, with some codes developed directly from the unresolved loss codes of the AAI and other codes generated from analyzing the transcripts through the lens of attachment theory. Through a micro focus on therapy process, the study provides tentative support for suppositions in attachment theory about the psychological importance of (fostering) coherent speech as well as information about potentially helpful versus unhelpful therapist actions in family bereavement therapy. The findings have relevance for bereavement therapy interventions, therapy training, and research practice. [ABSTRACT FROM AUTHOR]

This study investigates whether individual differences in attachment status can be detected by electro-physiological responses to loss-themed pictures. The Adult Attachment Interview (AAI) was used to identify discourse/reasoning lapses during the discussion of loss experiences via death that place speakers in the Unresolved/disorganized AAI category. In parents, Unresolved AAI status has been associated with Disorganized infant Strange Situation response, a known risk factor for psychopathology (e.g., intemalizing/externalizing/dissociation). This association has been related to anomalous frightening (FR) parental behavior in the infant's presence, behavior presumed to be instigated by vulnerability to trauma-related fright. Here, psychophysiological methods were utilized to examine whether Unresolved AAI status could be detected in brain responses to subtle/symbolic reminders of loss. One year after AAI administration, 31 undergraduate women who had experienced loss (16 Unresolved) underwent continuous electroencephalogram (EEG) recording during a picture-viewing, valence-rating task. Picture onset-locked event-related potentials (ERPs) revealed millisecond responses to 4 picture categories: pleasant people, pleasant nature, cemetery (symbolic death), and gruesome death (dead or dying people). Participants' valence ratings did not differ between groups across picture categories. However, the N2 ERP, implicated in detecting stimulus salience, was selectively greater in Unresolved participants viewing cemetery scenes; it was in fact as high as the N2 for gruesome death images observed throughout the sample. Additionally, Unresolved participants exhibited a right-hemispheric P3 asymmetry across picture categories, suggestive of continuously heightened vigilance/arousal. Together, these results suggest that Unresolved AAI status is associated with greater neurophysiological sensitivity to subtle reminders of loss that may disrupt ongoing mental function. [ABSTRACT FROM AUTHOR]

Liotti proposed that interactions during infancy with a parent suffering unresolved loss could lead to vulnerabilities to altered states of consciousness. Hesse and van IJzendoorn provided initial support for Liotti's hypothesis, finding elevated scores on Tellegen's Absorption Scale - a normative form of dissociation - for undergraduates reporting that their parents had experienced the loss of family members within two years of their birth. Here, we replicated the above findings in a large undergraduate sample (N = 927). Additionally, we investigated mother's and father's losses separately. Perinatal losses, including miscarriage, were also considered. Participants reporting that the mother or both parents had experienced loss within two years of their birth scored significantly higher on absorption than those reporting only perinatal, only father, or no losses. While not applicable to the assessment of individuals, the brief loss questionnaire utilized here could provide a useful addition to selected large-scale studies. [ABSTRACT FROM AUTHOR]

This study’s goal was to gain a better understanding of why some women become unresolved with regard to loss and others do not. Sixty women were administered (a) the adult attachment interview to assess their childhood relationship with their parents and experience of and response to loss and (b) a grief interview that was coded for circumstances surrounding bereavement experiences: relationship to the deceased, cause of death, suddenness, developmental timing, and emotional support. Women were less likely to be unresolved if they had a secure/autonomous attachment classification. The cause of death, regardless of its inherent suddenness, did not increase the risk of being unresolved. Women were more likely to be unresolved only if they perceived their losses as sudden. No other risk factors were significantly related to being unresolved. Findings from this study have important implications for developing effective intervention programs to help adults cope with losses of important people. [ABSTRACT FROM AUTHOR]

Therapies for grief and loss have traditionally focused on the work of grieving. The goal was to reach an endpoint, now popularly called closure. There are, however, many people who, through no fault of their own, find a loss so unclear that there can be no end to grief. They have not failed in the work of grieving, but rather have suffered ambiguous loss, a type of loss that is inherently open ended. Instead of closure, the therapeutic goal is to help people find meaning despite the lack of definitive information and finality. Hope lies in increasing a family's tolerance for ambiguity, but first, professionals must increase their own comfort with unanswered questions. In this article, the authors, one a poet, the other a family therapist and theorist, offer a unique blending of theory, reflection, and poetry to experientially deepen the process of self-reflection about a kind of loss that defies closure. [ABSTRACT FROM AUTHOR]

"Protocol for Excessive Grief" is excerpted from Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols: Basics and Special Situations illustrating a scripted protocol from one of Francine Shapiro's 6 basic protocols. "Scripting" informs and reminds EMDR practitioners of the component parts, sequence, and language used to create effective outcomes, and also generates a template for practitioners and researchers to use for reliability and/or a common denominator so that the form of working with EMDR is consistent. This protocol includes 5 steps: process actual events, including the loved one's suffering or death; process any intrusive images that are occurring; process the nightmare images; process any stimuli/triggers associated with the grief experience; and address issues of personal responsibility, mortality, or previous unresolved losses. The future template is included This protocol addresses the many aspects of grief and mourning to assure the full processing of clients' concerns. [ABSTRACT FROM AUTHOR]

Attachment organization in a combat-related PTSD sample was investigated and compared with previously published clinical and non-clinical samples. The association between insecure attachment and unresolved mourning classification (U-loss) and between U-loss and PTSD symptoms was investigated. Vietnam combat veterans diagnosed with PTSD and in treatment (N = 48) were administered the Adult Attachment Interview, the SCID-IV, and CAPS. The PTSD sample was like non-clinical samples in the incidence of secure attachment (50%), but were more commonly unresolved. Veterans with insecure attachment organizations were more likely than those with secure attachment to be classified U-loss. U-loss classification was associated with greater likelihood of comorbid anxiety disorders and PTSD avoidance/numbing symptoms. The results suggest that while insecure attachment organization is associated with unresolved mourning in response to loss, it is not differentially associated with combat-related PTSD. The relationship between U-loss and PTSD is discussed in light of current literature. [ABSTRACT FROM AUTHOR]

This paper explores the experience of infant observation for mothers, emphasizing the developing relationship between mother and observer and how this relationship shapes the mothers' experience of the year long observation. Their experience of the observation and relationship with the observer from the beginning of the observation through to its termination is explored, as is the impact of the observation on them and their relationship to their infants. Unresolved feelings of loss, hurt, confusion, abandonment and anger at the conclusion of the observation unexpectedly emerged. Practice implications are briefly considered. [ABSTRACT FROM AUTHOR]

Previous studies have related attachment disorganization in children to either dopamine D4 receptor polymorphisms or maternal unresolved loss or trauma and frightening or anomalous parenting. In this study it was examined whether the interaction between genetic (DRD4 7-repeat and -521 C/T) and environmental risk factors (maternal unresolved loss/trauma and maternal frightening behavior) was associated with infant disorganization. A moderating role of the DRD4 gene was found. Maternal unresolved loss or trauma was associated with infant disorganization, but only in the presence of the DRD4 7-repeat polymorphism. The increase in risk for disorganization in children with the 7-repeat allele exposed to maternal unresolved loss/trauma compared to children without these combined risks was 18.8 fold. Similar moderating effects were not found for maternal frightening behavior. Our findings indicate that children are differentially susceptible to unresolved loss or trauma dependent on the presence of the 7-repeat DRD4 allele. [ABSTRACT FROM AUTHOR]

Parental unresolved loss as assessed in the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1985) is significantly associated with infant disorganized attachment. Lapses in the monitoring of both reasoning and discourse and reports of extreme behavioural reactions are evidence of the continuing presence of unresolved responses to loss. (Main, DeMoss, & Hesse, 1994). The original format of the AAI does not include a separate question concerning the experience of miscarriage. We added questions on this subject because, for many parents, miscarriage represents a significant loss. The questions and follow-up probes closely followed the format of the questions in the AAI about loss and were asked immediately after these questions. Answers to the questions about miscarriage were rated with the current classification system for unresolved loss. In a sample of 85 middle-class, non-clinical mothers of 1-year-old infants, thirty mothers (35%) reported that they had experienced a miscarriage. Scores on the 9-point rating scale for unresolved loss due to miscarriage were related to infant disorganized attachment behaviour, r(30) = .30, p = .05. Mothers' unresolved loss was not related to the amount of time that had passed since they had a miscarriage. Unresolved loss due to miscarriage was, however, related to the duration of the pregnancy before miscarriage, r(30) = .56, p = .004. Thus, including a question on miscarriage in the AAI may yield theoretically and clinically important information. [ABSTRACT FROM PUBLISHER]