ATTACHMENT & HUMAN DEVELOPMENT, 2017

VOL. 19, NO. 4, 364–381

https://doi.org/10.1080/14616734.2017.1306087

REVIEW ARTICLE

Roots and routes to resilience and its role in psychotherapy:

a selective, attachment-informed review
Jeremy Holmes
School of Psychology, University of Exeter, Exeter, UK

ABSTRACT ARTICLE HISTORY

Developmental research on resilience is summarised and illustrated Received 31 October 2016
with a case example. Self-reflection, positive relationships, and agency Accepted 9 March 2017
foster resilience in the face of adversity. Attachment and resilience are KEYWORDS
related categories. The different patterns of attachment – secure, Resilience; attachment;
insecure-organised and insecure-disorganised – are manifest in differ- psychotherapy;
ent patterns of resilience, depending on prevailing environmental psychoanalysis; trauma
conditions. However, the greater the environmental adversity, the
less will the resilience factors emerge. Clients tend to present for
psychotherapy when resilience strategies have failed. The therapeutic
relationship has neurochemical and relational characteristic mirroring
the secure mother–infant bond. These foster mentalising, stress inno-
culation, affect co-regulation, self-esteem, and agency, forming the
basis for enduring and more flexible resilience strategies.

Introduction
For more than 30 years, resilience has been a major topic in psychology, exercising some of
the best research minds in our field (Cicchetti, 2010; Fonagy et al., 1995; Garmezy, 1985;
Rutter, 2012; Southwick, Bonnano, Masten, Panter-Brick, & Yehuda, 2014). The aim of this
paper is present an attachment perspective on resilience, and to explore its clinical rele-
vance for psychodynamic psychotherapy.
The term comes from the Latin resiliens, to rebound. Implicit is the idea of a traumatic or
adverse force impacting on a system which, rather than shattering, has sufficient flexibility
and elasticity to “bounce back.” Resilience in the physical sciences implies both strength and
“ductility” – that is, the ability to stretch without snapping or falling apart.
For its use in psychology, Rutter (2012) defines resilience as “patterns of positive adapta-
tion in the context of significant risk or adversity.” Note his characteristically careful quali-
fiers: “patterns” (i.e. a process rather than a fixed property), “context” (seeing resilience in a
specific situation rather than an inherent feature of the individual), “significant” (prolonged
and multiple adversity leads to worse outcomes than single traumatic episodes).
In their recent survey, Wright, Masten, and Narayan (2013) identify four “waves” in the
history of resilience research. Early studies focused on the individual, looking at the personal
characteristics of those most likely to survive or even thrive in the face of adversity. Phase two
moved to Rutter’s contexts and patterns, homing in on developmental processes in families

CONTACT Jeremy Holmes j.a.holmes@exeter.ac.uk

© 2017 Informa UK Limited, trading as Taylor & Francis Group
 ATTACHMENT & HUMAN DEVELOPMENT 365

and wider society that foster or weaken resilience. It recruited a more sociological perspective,
showing how resilience relates to specific social situations. Thus, compared with surviving the
middle-class emotional deprivation found in typical psychotherapy patients, survival in poor
black Chicago gangland calls for different qualities, including and – perhaps counter-
intuitively – validating extreme emotional avoidance (Ungar, 2008). Phase three is that of
“translational research,” converting the insights from fundamental science into real-life pro-
grammes, psychotherapeutic and political, fostering personal and social resilience. Phase four
is the current cutting edge, bringing modern genetics, evolutionary theory, and neuroscience
to bear on the topic.
Here I shall draw on all four phases, aiming to anatomise how psychodynamic psychother-
apy might encourage resilience in its clients.

“What is this life?”: W.H. Davies’ autobiography of a super-tramp

I start with a “case history,” taken not from the clinic, but from the autobiography of a
now largely forgotten author, but which illustrates many aspects of our subject.
W.H. Davies (1908/2011) is best known for his poem Leisure, with its lines: “what is this life
if full of care/We have no time to stand and stare?.” I shall return to later to the resilience–
relevance of this. Through his poetry and autobiography, Davies enjoyed literary success in
the early part of the twentieth century. His pathway from humble origins and adversity
illustrates many aspects of resilience that are relevant to psychotherapists.
The middle of 3 children, Davies was born in the coastal fishing port of Newport, Wales.
His father, a craftsman, died when he was 3. His mother immediately remarried and
handed the children over to their paternal grandparents and broke off all contact with
them. Davies was close to his grandmother. Although an avid reader and a good sports-
man from an early age, he was a difficult child; aged 10 he was arrested for theft and given
12 lashes in punishment. His delinquency continued, and he left school at 14. Soon
afterwards, both grandparents died. For the next 7 years, he became a “super-tramp”
(his phrase) first in the United Kingdom and then the US East coast, finding companions
with whom to travel, begging, taking occasional work on the harsh transatlantic cattle
boats, and engaging in petty crime which enabled him to spend the harsh winters of NE
USA in the comparative comfort and warmth of jail.
Year 1899 was the year of the Klondike “gold rush.” Davies set off for Canada to make
his fortune; but attempting to “jump” a freight train bound West he slipped, severely
injuring his leg, which had to be amputated. He spent 3 months in hospital in Ontario.
His tramping days over, he decided to become a writer. He returned to the United
Kingdom and lived in a Salvation Army Hostel in the East End of London for the next
2 years, regularly sending poems and articles to publishers and newspapers – all without
success. Eventually he was “discovered” when the literary giant George Bernard Shaw
received the ms of his “autobiography” and agreed to write a preface. With its success,
he was embraced as a “working class hero” by the metropolitan literati such as Pound
and Sitwell, who praised (perhaps a touch patronisingly) his John Clare-like1 freshness of
vision and naïve profundity.
His autobiography provides a vivid account of the life at the margins at the end of the
19th and start of the 20th century. There is a freshness in Davies’ descriptions of himself
and his family. He tells the story of his possibly autistic older brother, instructed by their
366 J. HOLMES

grandmother who was going out to “watch the fish” cooking on the stove for their
supper, at risk from a hungry cat. The cat duly ate the fish, much to his grandmother’s
fury on her return. “But Granny” said the brother, “I did watch the fish – all the way down
into the cat’s stomach”! Davies similarly laughs at himself and his early literary efforts.
Davies’ account illustrates many of the features identified in the early research on
resilience. Using a 10-year qualitative “follow-back” methodology, Hauser, Allen, and
Golden (2006) looked, 10 years on, at delinquent boys who had been admitted to a
children’s home. Those showing traits of self-reflection, agency, self-complexity, persis-
tence, ambition, good self-esteem, and the ability to create a coherent narrative were,
despite adverse origins, least likely to reoffend and generally did best.
Davies was similarly determined to survive and succeed, persistent despite setbacks.
He had significant assets – intelligence, an interest in reading, sporting prowess; he was
companionable; he was “pluripotential” in the sense that he managed to switch from
one path, tramping, to another, writing; his autobiography demonstrates “reflexive
capacity,” able to stand back from and laugh at himself and others, and to develop a
coherent story of his life. He clearly demonstrates three key resilience features relevant
to psychotherapy: agency, relationship-competence, and mentalising.
But achieving a degree of resilience takes its toll. Despite being an account of a young
man’s life, there is virtually no mention of women or sex throughout Davies’ autobiogra-
phy. For survival’s sake, Davies suppressed his need for emotional closeness, breached
only on one occasion. About to leave the hospital equipped now with his wooden leg, the
hospital matron came to bid him goodbye and kissed him on the cheek. He writes: “I felt
my voice gone and my throat in the clutches of something new to my experience.”
This breakthrough of unmet craving for love and closeness is also revealed in the
poignant poem, A Fleeting Passion, in which he describes the aftermath of a night spent
with a prostitute:
Let’s grimly kiss with bated breath;
As quietly and solemnly
As Life when it is kissing Death
Now in the silence of the grave
My hand is squeezing that soft breast…

Davies here juxtaposes his devastating experience of the proximity of love and separation
(death as irreversible separation, Bowlby, 1975), and the attempt through his verse to
resolve the paradox that integral to love and attachment is the possibility of loss. His
resilience was founded on emotional self-sufficiency. The tenderness of the mother-
matron – evoking unmourned grief for the mother who had abandoned him – penetrated
this hitherto adamantine defence. As we shall see, supporting survival versus undoing
rigid resilience strategies is a balance which has to be struck in most therapies.

Attachment perspectives on resilience

Resilience and negative entropy
Attachment and resilience are highly related concepts. Davies’ survival was founded on
emotional suppression – in attachment terms, on avoidance, with the defences and
vulnerabilities implicit in that developmental pathway.
 ATTACHMENT & HUMAN DEVELOPMENT 367

From an attachment perspective, resilience is built into our biology. The physics Nobel
laureate Schrodinger (1944) famously defined life in terms of “negative entropy.” Living
matter defies the general tendency of the Universe towards entropy, that is, randomness
and disorder.2 This is the “ordinary magic” (Masten, 2001) of resilience. Achieving and
maintaining negative entropy entails defences, both external and internal. External
defences are directed towards the predators and parasites which feed on other organisms’
negative entropy. Internal defences are needed to preserve the organisms’ internal
contra-entropic order, for example, to identify and destroy de-differentiated precancerous
cells. Excretion represents the “export” of accumulated entropy.
The psychological manifestations of entropy are unregulated affect and cognitive
chaos. Attachment maximises emotional and physical integrity in hostile environments
in three main ways. First, just as the immune system is primed to recognise and neutralise
disease-vectors, the attachment dynamic protects against predators by recruiting help
from stronger, wiser, carers. Second, through affect co-regulation, the attachment bond
reduces “free energy” (Friston, 2010), thus mitigating the adverse consequences of unre-
gulated emotion. Third, the “epistemic trust” (Fonagy & Allison, 2014) which flows from
secure attachment ensures structured and manageable cognition and the capacity to
navigate the social and physical environment.
Contemporary societies see it as their role to foster resilience in their members.
Inoculation programmes strengthen the immune system; similarly, positive parenting
programmes such as “Minding the Baby” (Slade, Sadler, & Mayes, 2005; Slade et al.,
2016) attempt to alter the attachment environment in order to counteract the negative
impact of poverty, stress, and social disruption on psychological development.

Patterns of resilience
A cornerstone of attachment research is the finding that different developmental environ-
ments call forth different relational strategies in infants. Each represents an “adaptation,”
which attempts to maximise security – and therefore resilience – in specific circumstances.
Schematically, these can be characterised as “horizontal,” “vertical,” and “circular.”
Secure attachment is “horizontal” (and “democratic”) in the sense that infants with
mentalising, mind-minded, mothers are seen as sentient beings with projects, desires,
and minds of their own (Allen, Fonagy, & Bateman, 2008; Meins, Fernyhough, Fradley,
& Tuckey, 2001). Biobehavioural synchrony (Feldman, 2015), marked mirroring
(Gergely & Watson, 1996), affect co-regulation (Schore & Schore, 2008), entrained
physiology, and brain-to-brain communication (Feldman, 2015; see below) enhance
infants’ survival chances, both by protecting from external predation and building
the capacity to recognise and regulate emotions and so negotiate the world of social
relationships.
Although occupying different roles, the secure parent–infant relationship is a partner-
ship. Let us now look in more detail at how this reciprocity operates by considering four
resilience-enhancing factors found in secure attachment: mentalising, activeness (as
opposed to passivity) stress inoculation, and the extended self.
368 J. HOLMES

Mentalising
As we have seen in Davies’ story, the ability to mentalise – to stand back from ones own
and others’ thoughts and actions and to see them objectively – can be crucial to coping
with adversity. Fonagy, Steele, and Steele (1991) now classic prospective study showed
that mothers who had themselves experienced childhood adversity were more likely to
have insecure children than those whose childhood was more serene. The exception was
the subgroup of adversity-stricken mothers who were also blessed with high reflexive
function (RF, aka mentalising ability; see Fonagy et al., 1995), of whom 90% had secure
children as classified in the Strange Situation aged 1 year, while none of the parallel low-
RF mothers’ offspring were rated secure. Being able to reflect on adversity is a first step
towards overcoming it.

Activeness
Mentalising mothers foster their children’s autonomy, in contrast to the less resilient
strategies of compliance or helplessness (see below). The autonomous child is thus an
active child, able to tackle and overcome minor stresses and setbacks. This capacity
actively to tackle threat rather than passively to succumb is has also been identified as a
significant aspect of resilience. Davies’ tramping may be an extreme example of “activity,”
but his ability to turn his life around, rather than to collapse following the amputation is
testament to the importance of the activity principle.

Stress inoculation
Secure attachment does not equate to continuous uninterrupted mother–baby harmony
and proximity. Tronick (2007) has shown how, alongside periods of intense physical and
emotional intimacy, normal secure parent–child interactions include “ruptures” in which
parents are regularly out of tune with their infants. In secure attachments, these ruptures are
readily and regularly “repaired,” triggered by the attachment dynamic in which the parent
soothes the distressed infant until peace is restored. The infant goes through many rupture/
repair cycles throughout the day. This observation is consistent with early animal experi-
ments (Levine, 1957) suggesting that “stress inoculation” has a strengthening or “steeling”3
(Rutter, 2012) impact. Rat pups separated from their dams for short periods, when adult
show less fear response and wider exploration compared with those not so subjected. After
these brief separations, rat mothers show enhanced “high-arched licking and grooming”
and this may contribute at physiological and possibly epigenetic levels to the pup’s
resilience (Meaney, 2001). By contrast, prolonged separation of pups from their mothers
has the opposite effect, enhancing anxiety and weakening resistance to stress and disease.
Similar findings have been found in primates (Suomi, 2016) and are likely to apply in
humans. It could be argued that Davies’ harsh childhood primed him to cope with the
physical and social adversity he experienced in the pre-welfare United Kingdom and USA.
Goransson (2009) suggests that today’s middle-class “helicopter” or “curling”4 parents, ever
ready to over-protect their children from stress, may be doing them a disservice, depriving
them of the “Captains Courageous”-type (Kipling, 1897/2014) maturation which mild adversity
overcome engenders.
 ATTACHMENT & HUMAN DEVELOPMENT 369

The extended self

A fourth aspect of secure attachment relevant to resilience is the notion of “the
extended self” (Wilson, Hayes, Biglan, & Embry, 2014). Adversity inevitably arouses
negative affect, so the capacity to regulate affect is a vital aspect of resilience. Stress
and threat activate the limbic system, setting in train the attachment dynamic (Bowlby,
1971). In adults, the left prefrontal cortex (lpfc) regulates and modulates these affective
responses, ensuring appraisal and “slow” behavioural responses in which alternative
adaptive strategies can be considered (Kahneman, 2011). In the first 2 years, the infant’s
lpfc is still undeveloped, and the child draws on (“borrows”) the maternal brain to help
co-regulate his or her emotions, just as newborns are gifted mothers” antibodies in the
colostrum.
This affect co-regulation continues throughout the life cycle, applicable equally in
adult romantic relationships as in infants (Mikulincer & Shaver, 2016). In Coan’s fMRI
hand-holding studies (Coan, 2016), HPA axis activation in response to mild threat was
almost absent when subjects were holding their happily married spouses’ hand as
compared with facing threat alone. The relational aspect of resilience is here graphically
illustrated: united we stand. This capacity to “extend” the self to include significant
others, along with mentalising, active engagement and stress inoculation, are resilience
supports co-extensive with secure attachment.

Insecure attachments
By contrast, the insecure have to rely on different strategies, appropriate to their
developmental environments, but each carrying significant disadvantages. The two
main “organised” forms of insecure attachment, avoidant and anxious attachment, also
provide degrees of resilience. These “vertical” routes to resilience are either typified by
avoidant individuals like Davies, using a “top-down” strategy based on affect suppres-
sion, or, in anxious attachment, “bottom-up” patterns of clinging and affect augmenta-
tion which serve to draw in the carer as a protective shield against trauma.
However, these approaches tend to be more fragile and less flexible than secure
patterns (Bonanno & Burton, 2013). Avoidant children have high levels of stress hormones
(Dozier, Peloso, Lewis, Laurenceau, & Levine, 2008); staying detached consumes psychic
energy then unavailable for other cognitive tasks. Secure individuals can call upon help
when needed but otherwise remain independent and autonomous. The anxiously attached
need the constant accessibility of a Secure Base via texting, telephoning, physical presence,
etc., and without it feel lost. When stressed, the anxiously insecure cannot transcend or
metabolise their negative emotions and are thus more likely to respond in non-resilient
ways – collapse, dependency, chronic depression, or anxiety.
Both secure and “organised insecure” attachment strategies achieve resilience
through the recruitment of an attendant other to provide maximum (secure) or a
modicum (insecure) of resilience in the face of adversity. The disorganised have no
option but to summon what security they can muster from within themselves. Lyons-
Ruth (Gunderson & Lyons-Ruth, 2008) classifies carers of disorganised children as either
“frightened” (withdrawing in the face of the child’s demands) or “frightening” (meeting
the child’s attachment dynamic with attack or dismissal). In disorganised attachment,
370 J. HOLMES

the child is faced with the problem of how to master anxiety in the absence of an
accessible carer, or with one who is a radically insensitive. Adopting a “circular” strategy,
the child turns in on him- or herself, using self-soothing strategies such as mirror-gazing,
stroking or pulling at body parts, eye aversion, rhythmic rocking, etc. as sources of
comfort. Adolescent and adult analogues include self-cutting, self-medication, alcohol or
drug intoxication, and risky sexual behaviour – all providing a degree of temporary
comfort or escape in the absence of self-mentalising, or a reliable and secure base
(Holmes, 2010). While there may be adaptive aspects of this, disorganised attachment is
fundamentally dysfunctional; arousal is on a hair-trigger; mentalising inhibited; and
states of “epistemic hypervigilance” (Fonagy & Allison, 2014) underpin rapid swings
between misplaced trust and radical mistrust.
The disorganised pattern illustrates one of the central paradoxes of resilience: chil-
dren raised in adversity and, therefore in most need of resilience, are those least likely to
encompass resilience-enhancing resources. Disorganised children’s mothers tend to be
poor mentalisers, and therefore unlikely to transmit those skills to their children; their
lpfcs are less accessible for modulating their children’s affect than their secure counter-
parts. Conversely, children raised in conditions which engender secure attachment and
foster resilience will be buffered against adversity. To whom that have, it shall be given.
This paradox flows from the fact that in the developed world at least, the adversities
which contemporary humans face derive not so much from the physical environment –
predators, food scarcity, fire, flooding, and earthquakes – although of course all of these
play their part, but primarily from con-specifics. Neglect, separation, emotional abuse,
environmental degradation, economic deprivation, physical and sexual predation, theft,
gun-crime, inequality and injustice: these are the adversities to which today’s children
are prey. The very “others” to whom the traumatised child turns for comfort and help are
often the source of the threat which stimulates the attachment dynamic and are
themselves are afflicted by the same adversity and threadbare resilience. This irony is
central to the Main–Hesse (Main & Hesse, 1990) theory of disorganised attachment in
which the child is in a “double bind,” or approach–avoidance dilemma, and where “fear
without solution” leads to the circular patterns of self-soothing, a theory later validated
by Lyons-Ruth, Bronfman, and Parsons (1999).

Grounds for hope

For a number of reasons however, it is important not to succumb to pessimism. First, the
four attachment categories are necessarily broad-brush. Clinically, there is often a mixed
picture (Holmes, 2010). Davies undoubtedly used “vertical,” avoidant, emotionally sup-
pressive strategies to cope with the loss of his mother and grandmother, and to
maintain his independence. But he was also a good mentaliser, formed male friendships
easily, had intellectual and sporting skills, was determined, and endowed with buoyant
self-esteem. He fulfilled many of the features of resilience identified in the research
literature (Southwick et al., 2014). He was resilient in the original sense of being able to
bounce back after setbacks rather than shattering. Despite his traumatic accident, he did
not become emotionally as well as physically disabled.
Second, attachment categories, while tending to be stable over time, are not immu-
table and are responsive to context. Depressed mothers tend to have children classified
 ATTACHMENT & HUMAN DEVELOPMENT 371

as insecure, but if their depression remits, either spontaneously or though therapy, their
children revert to secure attachment (Cooper, De Pascalis, Woolgar, Romaniuk, & Murray,
2015). As measured by salivary cortisol responses, secure attachment mitigates the
effects of stress on children growing up in poverty (Fearon et al., in press). A small
number of studies have used attachment status as a psychotherapy outcome measure
and have found significant movement from insecure to secure patterns on the Adult
Attachment Interview (AAI) (Levy et al., 2006).
A third relevant theme is the role of “positive life events” in changing a life course and
contributing to resilience. Brown and his co-workers (Bifulco, 2009) have charted how
depression in working class mothers is triggered or exacerbated by negative life events
such as separation, bereavement, housing difficulties, and unemployment. But they have
also shown that the converse applies: starting a new relationship, getting a job or stable
accommodation, or children’s success at school, help alleviate depression, especially in
the context of a supportive relationship with a key worker or counsellor.
Based on his studies of Romanian orphans, Rutter (2012) conceptualises adoption as a
positive life event. In adversity, adoption can be a massively beneficial; in its absence,
irrelevant. The contextual aspect of the adversity/resilience concept emerged in an early
study of the impact of parental death in childhood. The outcome depended on the
impact of the loss on the family and how it was handled. Bereavement is a risk factor for
psychological difficulties in adolescence, but it is not loss per se that is problematic, but
the associated disruption and chaos (Quinton & Rutter, 1988). Rutter’s work also revealed
the effects of positive life on outcomes for looked-after adolescents. Girls reared in
children’s homes who make good relationships in their late teens are protected from
later psychological illness compared with those who failed to find suitable partners;
comparably, boys who joined the armed services were similarly less likely to be prey
later to alcoholism or petty crime (Rutter, Quinton, & Hill, 1990).
Although both adverse and positive life events are to an extent random and unpre-
dictable, their cognitive appraisal – the meanings that are attributed to adverse events –
is not. Davies’ story illustrates how resilience entails seeing adversity as a challenge
rather than a life-diminishing trauma. Similarly, the capacity to respond and benefit from
positive life events is part of the resilience armamentarium. Although chance and
accident are relevant to resilience, the capacity to respond positively to adversity is
not “random” but contingent on pre-existing positive developmental attachment
experiences.
This leads to a central attachment theme, best approached through recent research
on the timing of menarche in secure and insecure girls. In an ongoing longitudinal
study, Beslky, Houts, and Fearon (2010) have established a relationship between attach-
ment status at 12 months and the onset of menarche. The consistent finding is that
insecurely attached girls reach sexual maturity earlier than the secure group. This led
Belsky to develop an ecological model of attachment in which different environmental
conditions call forth different psychobiological patterns. Adverse environments elicit
“insecure” (“vertical”) strategies, including early sexual maturation, in order to ensure
survival into the next generation.5 It is probable that, via epigenetic processes (Meaney,
2001), these environmental effects persist in the genome and shape future generations’
attachment dispositions. Grandchildren of holocaust survivors have been shown to be
more resilient than controls without a trauma history (Barel, van Ijzendoorn, Sagi-Swartz,
372 J. HOLMES

& Kranken 2010). Using economic adversity as a measure, recent studies show that even
in the presence of adversity, daughters of mothers with mentalising capacity have
delayed menarche compared with the non-mentalising group (Sung et al., 2016).
These studies suggest a number of differing routes to resilience, each of which is
“designed” (in the evolutionary sense) to maximise physical and psychological survival
chances, depending on environmental circumstances. This formulation challenges the
implicit normative assumptions of the terms “secure” and “insecure.” “Vertical,” insecure
attachments are not in themselves “pathological” compared with secure ones, although
they may confer less flexibility.
Summarising the argument so far:

(1) Children of mentalising mothers are more likely to show resilience in the face of
adversity.
(2) Secure attachment provides a developmental context in which these features are
more likely to arise.
(3) Resilience needs to be seen contextually and relationally, rather than as a fixed
property of individuals.
(4) Crucial components of resilience include a sense of agency and activeness,
mentalising-capacity, negative affect processing, and building relationships.
(5) Insecure attachments reflect “least worst” adaptive responses to adverse
circumstances.

Psychoanalysis and resilience

On the whole, resilience does not feature prominently in the adult psychoanalytic literature.
There are perhaps a number of reasons for this. Resilience is a ‘positive psychology’ concept
(Seligman, 2000), emphasising strengths and bolstering defences, while psychoanalysis is
more concerned with challenging and dismantling dysfunctional defences. Second, given
that analysis requires time, money, and consistency, a degree of resilience is a precondition
of being an analysand, at least under prevailing conditions in most Western countries. Third,
while resilience is increasingly seen in terms of ecology and context (Ungar, 2008), psycho-
analysis, traditionally at least, is concerned predominantly with the therapist–patient rela-
tionship, tending to play down the pathogenic role of the prevailing environment, seeing its
impact primarily as a manifestation of the patients’ inner world.6
Nevertheless, the ultimate goal of psychoanalysis and psychoanalytic psychotherapy
must surely be to strengthen its subjects’ capacity to cope with the vicissitudes of life
(Freud’s (1895) “common unhappiness”). Recently, a number of authors (e.g. Akhtar,
2009; Parens, 2009) have argued for the importance of resilience and other positive
features as hitherto neglected psychoanalytic topics. Historically, two important auto-
biographical accounts by psychoanalysts are relevant here, both arising out of Nazi
concentration camp experiences. Bettelheim (1943) noted that inmates with no fixed
beliefs succumbed to the camp regime much more readily than both orthodox Jews and
Marxists. Both, despite the extreme divergence of their ideologies, had “higher” belief
systems which enabled them to resist and temporarily survive even extreme adversity.
Beliefs can be seen here in attachment terms as “security primes” (Mikulincer & Shaver,
2016) deepening acceptance of the inescapable as a resilience strategy in extremis.
 ATTACHMENT & HUMAN DEVELOPMENT 373

Another example comes from Victor Frankl (1946/2006), the founder of “existential
psychoanalysis.” Despite having been at one stage a Nazi sympathiser (Cocks, 1997), as a
Jew Frankl was interned following the “anschluss” of Austria in 1938. He could have
escaped to the USA where he had been offered an academic post, but this would have
meant leaving his parents to their fate. He chose to stay behind and, together with his
wife and parents, was interned, first in Terensienstadt, then Auschwitz and Dachau. All
save Frankl and his sister perished. Like Bettelheim’s survivors, Frankl too had a firm
belief system, in his case in the overwhelming power of love. He attributed his eventual
survival to the fact that during his slave labour in Auschwitz, he befriended a guard who
was having marital difficulties and who confided in Frankl; he was rewarded lighter
duties and more food than his fellow inmates.
Frankl’s story illustrates the ecological or contextual aspects of resilience and the role of
secure attachment. Initially, his strong attachment to his parents was to his disadvantage
and could be seen as resilience lowering. A more avoidant individual might well have fled,
just as in a fire in a crowded building, avoidant individuals are the ones who will not only
break windows and save their own skin but also benefit the whole group by paving an
escape route. Conversely, in the camp itself, by reaching out to others, including the guard,
Frankl’s secure attachment enhanced his resilience and may have saved his life.

Implications for psychoanalytic psychotherapy

This final section reviews some implications for psychoanalytic psychotherapy practice of
this overview. The resilience triad of relatedness, agency, and reflection (Parens, 2009) also
form central themes in most psychotherapies. But fostering these capacities in clients is
often far from straightforward. As we have seen, insecure attachment is an adaptive
response to suboptimal environments. Relinquishing pre-existing resilience strategies in
the hope of establishing more flexible and salutary ones requires trust, time, and courage,
all of which are problematic for the insecurely attached. Davies’ response to the matron’s
spontaneous offer of a loving kiss threatened his previously impervious emotional avoid-
ance – and sent him hopping from Ontario to the East End of London.

Earned security
This brings us to the somewhat controversial – yet from a clinical perspective vital –
question of “earned security.” This construct was developed by AAI coders attempting to
reconcile subjects demonstrating a high degree of coherence and collaboration in their
AAI scripts, yet describing unloving relationships with parents typically associated with
insecure overall ratings (Hesse, 2016; Main & Godwyn, 1989).
Two explanations for the discrepancy have been put forward. The first, unsurprisingly
favoured by clinicians, is that, despite childhood adversity, adult security can be
achieved – “earned” – through positive relationships with other significant individuals
such as grandparents, older siblings, teachers, etc. (Egeland, Jacobvitz, & Sroufe, 1988).
An opposing view, championed by Roisman, Haltigan, Haydon, and Booth-LaForce
(2014), is that “earned security” is an artefact of retrospective studies, and that objec-
tively adequate parental care seen “backwards” through the dark glass of depression is
often wrongly described by those currently unhappy as unloving.
374 J. HOLMES

In an attempt to resolve this impasse, Saunders et al. (2011) first analysed the metho-
dological difficulties which this topic engenders: the paucity of earned security individuals
in high-risk samples, and discrepant ways of measuring adversity – whether un-lovingness
is required from one parent or both (c.f. Pearson, Cohn, Cowan, & Cowan, 1994). In their
low-risk sample, Saunders et al. (2011) then identified 16/121 mothers-to-be on the AAI
who fulfilled the criteria for “earned-secure” with coherent narratives, yet for whom both
parents were deemed, albeit retrospectively, to be neglectful, rejecting, role-reversing or
success-pressurising.
From a psychotherapeutic perspective, their significant findings were (a) the
earned secure group had had higher levels of emotional (but not instrumental)
support from non-parental figures in childhood, whether familial (e.g. grandparents)
or non-familial (e.g. teachers); (b) this extra-parental support was beneficial through-
out childhood and adolescence and not just in the early years; (c) the “earned
security” group’s children, when compared with insecure mothers, were, as per
Fonagy et al. (1995), more likely to be rated secure in the Strange Situation; (d) the
“earned secure” group were more likely to have been in therapy, and if in therapy for
longer, than their insecure counterparts.
Therapy in its essence provides non-familial, non-instrumental, emotionally support;
the benefits of time spent in therapy are incremental and cumulative (c.f. Wampold,
2015). The Saunders et al. (2011) study, especially if replicated prospectively, therefore
strongly suggests that psychotherapy can help transform childhood adversity into
secure attachment, and thereby enhance resilience, possibly even cross-generationally
(c.f. Holmes & Slade, 2017, in press).
For those who are insecurely attached, adversity calls forth “vertical” resilience
strategies: either emotional self-sufficiency or helpless dependency. Daring to give up
these patterns spells danger and therefore evokes the attachment dynamic which
established them in the first place. These tend to be self-perpetuating epigenetic
pathways. Helping clients to move from these established patterns of insecurity to
“earned security,” and to share feelings, trusting another to help modulate and
regulate them is a central challenge for psychotherapy. How might psychotherapy
help bring this about?

Biobehavioural synchrony
Psychotherapy can be seen as a “school for mentalising” (Holmes, 2015). As they develop
mentalising skills, clients begin to step back from themselves and their feelings, and
those of others, to slow them down, and see them more objectively. Humour is also
integral to this process, as Davies’ story illustrates. The capacity for a “light touch” and
for the emergence of shared humour is a mark of progress in therapy.
This clinical account is illuminated by recent attachment-relevant findings from
relational neuroscience. Humour is by definition pleasurable. The oxytocin release
associated with secure attachment bonds – including putatively the therapeutic relation-
ship – has significant hormonal implications in that oxytocin potentiates reward neuro-
transmitters endorphins and dopamine (Feldman, 2015). The dynamics and mutual
entrainment of oxytocin plays a crucial role in secure mother–infant attachment, paving
the way for robust relationships and self-confidence at school age (Feldman, 2015). It
 ATTACHMENT & HUMAN DEVELOPMENT 375

seems likely that biobehavioural synchrony – the attachment “dance” at behavioural as

well as verbal levels (Shai & Belsky, 2011) – between therapists and their clients
analogously plays a significant part in strengthening resilience. The notion of a “good
session” – which is not necessarily cheerful or “happy” and indeed may be suffused with
healing tears – may be one in which mutual oxytocin release associated with being
heard and understood is a key distinguishing feature.

Neuroplasticity
This refers to the ways in which the psychological and social environment impact at a
structural level of the architecture of the brain, including grey matter density, especially
in the prefrontal cortex and amygdala (e.g. Carvalho, Rea, Parimon, & Cusack, 2014).
Adverse childhood experiences (ACE) such as neglect and sexual or physical abuse are
associated in a linear way – the more the ACE events, the greater the likelihood of
depression – with enhanced risk of mental illness in adulthood (Felitti et al., 1998).
However, not all children are similarly affected by ACEs, and that those with “long”
serotonin transporter genes (5-HTTLPR) are more resistant to adversity than those with
the short variant (Caspi, Sugden, & Moffitt, 2003).
There is evidence, both from primate (Suomi, 2016) and human (Caspi, Hariri, Holmes,
Uher, & Moffitt, 2010) studies showing that those with “short” alleles, when in favourable
environments flourish more than those with the “long” allele. This environmental respon-
siveness, or ecological susceptibility model (Belsky & Pluess, 2009), gives hope to
psychotherapists in that clients seeking psychotherapeutic help are often those
damaged by early adversity, and therefore most susceptible to positive influences as
well. Therapists can feel confident that given the right circumstances – which will
include not just the therapy itself but the client’s environmental context – change is
possible. Therapists might also have to remind themselves that those clients who seem
to relatively impervious to therapeutic help – and they do exist! – may be genetically
predisposed to minor rather than damascene improvements.

Agency
Mentalising, even if in the guise of “insight” or “cognitive restructuring,” is central to
most psychotherapeutic work. Mentalising mothers validate their secure offspring’s
agency. They see their children as active choosing beings, with minds, likes and dislikes,
aims and objectives, and projects of their own.
While a sense of “self-agency” (Knox, 2010) is integral to resilience, clients typically
present for psychotherapy in states in which their agency is undermined or under-
developed. They feel “collapsed,” helpless, victimised, unable to “find a way forward.”
Fostering a sense of agency is a key psychotherapy task, difficult though that may be.
Clients may “hear” as criticism interpretations which emphasise the ways in which they
“actively” assume a position of helplessness – which may be for them an entrenched
resilience strategy. Moving from this “vertical” resilience pattern to a more “horizontal”,
and putatively flexible one is far from easy.
In these circumstances, it is essential to avoid “blaming the victim.” To do so would
be to repeat – via transference and projective identification – the childhood experiences
376 J. HOLMES

of criticism and rejection which the AAI studies of earned security reveal. Initially, the
therapist may home in on the agency-diminishing aspects of the client’s story.
Therapists will validate how victims felt compelled to cling to a life-raft of perverse
security in an otherwise terrifying sea of despair, and so to comply with sexual abuse, or
accommodate to a depressed parent’s moods. Step by cautious step, the client will
begin to acknowledge and “own” their contribution to their current – as opposed to
historical – difficulties, and to see how the expectations of invalidation or abuse which
they bring to relationships jeopardise the very longed-for closeness and security for
which they yearn, including that with the therapist.
Hard though it is, liberating agency is a vital part of the psychotherapy process, presa-
ging future resilience. Therapists will be encouraged by – and unabashedly validate – signs
of extra-therapy agency, such as making new friends, finding employment, joining clubs, or
even tidying belongings or embarking on DIY home or gardening projects. Occasionally,
abrupt disruptions or even termination of therapy, since “chosen,” can be construed as
manifestations of agency and, with appropriate caveats, be positively connoted.

Self-esteem and the ‘internal secure base’

The notion of encouragement is problematic for psychodynamic psychotherapists, who are
rightly trained to maintain neutrality. Over-use of praise may betoken seduction or encou-
rage compliance. But self-esteem is intrinsic to resilience, and therapists want their clients to
begin to believe in and feel good about themselves. Again, in severe mental illness, this is no
easy task. Allen et al. (2008) delineate an in-dwelling “alien self” in severe personality
disorders which orchestrates self-destructive actions and relationships. But even in this
seemingly dysfunctional belief-system is the search for a smidgeon of security: safer to
think of oneself as “bad” in a good world rather than acknowledge an environment that has
comprehensively failed to meet one’s developmental needs (c.f. Fairbairn, 1952).
Thus, identifying and challenging persistent low self-esteem is an important therapeutic
and resilience-fostering task. This may be done “cognitively” by challenging dysfunctional
negative beliefs about the self, or more psychodynamically through the instillation of a
“good object” or “Internal Secure Base” (Holmes, 2010) able to mitigate and transcend
temporary failures and setbacks. The impact of non-familial emotional support in “earned
security,” whether contingent or professional, can be seen in these terms.

Affect co-regulation
Affect co-regulation is integral to secure attachment, and differentiates instrumental from
emotional care-giving. Secure-making parents operate here as part of the infants’ extended
self, resonating with their emotions, modulating and naming feelings, and paving the way for
self-regulation as development proceeds. As a result of this dyadic reciprocity, the child’s
affective experience is made up both of his own affects and the attachment figure’s response
to them. Thus, the child’s experience of his inner world is profoundly coloured by the way it is
understood, responded to, and regulated by key figures in his life.
Affect regulation is correspondingly integral to psychotherapeutic work. Attuned thera-
pists mirror, resonate with, and help verbalise their client’s feelings; they also “regulate”, in
the sense of modulating, feelings so that they became available for mentalising – soothing,
 ATTACHMENT & HUMAN DEVELOPMENT 377

stimulating, dampening as needed. Examining the discrepancy between these efforts and
the ways in which pre-existing attachment representations reproduce themselves in the
transference can be a powerful lever for psychic change. Faced with patients’ entrenched
and rigid defences, seemingly seeking to repeat or maintain destructive relationships, alerts
therapists to the unregulated affects that lie at the heart of these resilience-shaped adapta-
tions, and points to the affective environment which brought them about. The aim is always
to create a contrasting environment within the consulting room, where emotions and
expectations that trigger the patient’s defences can be experienced, examined, modulated,
and modified.

Stress-inoculation
Finally, resilience research findings validate a previously unsuspected aspect of psy-
chotherapy – its absence. This is typically construed psychotherapeutically as providing
an in vitro analogue of loss, or even modelling the reality of death and the finitude of
life. But, at a more mundane level, the rhythms of therapy – the weekly or daily “hour”
with its protected time and space, but non-negotiable periodicity, together with regular
holiday “breaks” – is a living embodiment of “stress inoculation.” The quotidian finding/
losing, to-and-fro of therapy, is a school for coping with loss, and in the instillation of
hope that the good object, not absent for ever, will be there again when needed.

Conclusion
Let’s return to Davies’ famous couplet. The ability to “stand and stare” is an aspect of resilience
emphasising the importance of the “present moment” as an antidote to resilience-sapping
past pain or future anxiety. Psychological health entails the ability to let go of the past,
however painful, to resist future worries, and to inhabit and embrace the here-and-now.
Mindfulness meditation is increasingly incorporated into “third wave” cognitive therapy (Kahl,
Winter, & Schweiger, 2012), explicitly training subjects to “stand and stare.” Comparably,
Mentalisation-based therapy (Allen et al., 2008) involves therapist and client together “press-
ing the pause button” – and through “action replay,” putting problematic experience under
the microscope, and so focus, outside time, on the inexorable flux of feelings.
But Davies’ seemingly naïve and simplistic poem takes us a step further in the search
for resilience. The poem goes on:
No time to see, in broad daylight,
Streams full of stars, like skies at night:
No time to turn at Beauty’s glance,
And watch her feet, how they can dance:
No time to wait till her mouth can
Enrich that smile her eyes began?
A poor life this if, full of care,
We have no time to stand and stare.

As well as the injunction to absorb the present moment Davies also points to two other
crucial aspects of resilience. First is connectedness, not just to others and their dancing feet,
but to the natural world – streams and stars – and the ways in which they reflect one
another. The second is the role of the face. A mirroring, smiling, mother’s face is the starting
378 J. HOLMES

point for secure attachment. Unperturbed by adversity, the face becomes the Internal
Secure Base that carries the subject through the horrors, losses, guilt, vicissitudes, setbacks,
and cruelties that, at times life – entropy ever threatening – inevitably brings. It is the role of
psychotherapists to be the guardians of that process. Helping clients to find their unique
internal security simultaneously strengthens the invaluable resources of resilience.

Notes
1. Another “primitive” autodidact nature poet.
2. c.f. Shelley’s elegy for Keats, Adonias: “Life, like a dome of many-coloured glass, /Stains the
white radiance of Eternity” – that is, life is a specific set of “wavelengths,” in contrast to the
chaotic amalgam of white light from which it arose, and to which it must return.
3. “Steeling” is a metaphor taken from material science: subjecting metals to minor stress or
heat strengthens it.
4. A metaphor drawn from the sport of “bowls on ice” in which players “curl” the “chuck” by
smoothing its passage over the ice, thereby ensuring greatest possible distance of travel.
5. A phenomenon, incidentally, also seen in plant species – “stony ground” leads to early seed-
formation compared with those sewn on more fertile soil.
6. An issue over which psychoanalytic candidate John Bowlby and his supervisor Melanie Klein
notoriously disagreed (Holmes, 2013).

Acknowledgements
The author thanks Saman Tavakoli and his colleagues in the Iran Psychotherapy Association for
inviting him to give a lecture at their conference on which this paper is based, also to two anonymous
reviewers and the editor for very helpful and improving comments. Some of the material in this paper
also appears in Holmes and Slade (2017). Its limitations of course rest entirely with the author.

Disclosure statement
No potential conflict of interest was reported by the author.

References
Akhtar, S. (2009). Good feelings. London: Karnac.
Allen, J., Fonagy, P., & Bateman, A. (2008). Mentalising in cinical practice. Washington DC: American
Psychiatric Publishing.
Barel, E., Van Ijzendoorn, M.H., Sagi-Schwartz, A., & Bakermans-Kranenburg, M.J. (2010). Surviving
the holocaust: A meta-analysis of the long-term sequelae of a genocide. Psychological Bulletin,
136, 677–698. doi:10.1037/a0020339
Belsky, J., & Pluess, M. (2009). Beyond diathesis stress: Differential susceptibility to environmental
influences. Psychological Bulletin, 135(6), 885–908. doi:10.1037/a0017376
Beslky, J., Houts, R., & Fearon, P. (2010). Infant attachment security and the timing of puberty.
Psychological Science August, 16. doi:10.1177/0956797610379867
Bettelheim, B. (1943). Individual and mass behavior in extreme situations. Journal of Abnormal and
Social Psychology, 38, 417–452. doi:10.1037/h0061208
Bifulco, A. (2009). Risk and resilience in young Londoners. In D. Brom, R. Pat-Horenczyk, & J. Ford
(Eds), Treating traumatised children: Risk, resilience and recovery. Hove: Routledge.
 ATTACHMENT & HUMAN DEVELOPMENT 379

Bonanno, G.A., & Burton, C.L. (2013). Regulatory flexibility: An individual differences perspective on
coping and emotion regulation. Perspectives on Psychological Science, 8(6), 591–612.
doi:10.1177/1745691613504116
Bowlby, J. (1971). Attachment. London: Penguin.
Bowlby, J. (1975). Loss. London: Penguin.
Carvalho, A., Rea, I., Parimon, T., & Cusack, B. (2014). Physical activity and cognitive function in
individuals over 60 years of age: A systematic review. Clinical Interventions in Aging, 9,
661–682.
Caspi, A., Hariri, A.R., Holmes, A., Uher, R., & Moffitt, T.E. (2010). Genetic sensitivity to the environ-
ment: The case of the serotonin transporter gene and its implications for studying complex
diseases and traits. American Journal of Psychiatry, 167, 509–527. doi:10.1176/appi.
ajp.2010.09101452
Caspi, A., Sugden, K., & Moffitt, T. (2003). Influence of life stress on depression: Moderation by
polymorphism in the 5-HTT Gene. Science, 18, 386–389. doi:10.1126/science.1083968
Cicchetti, D. (2010). Resilience under conditions of extreme stress: A multilevel perspective. World
Psychiatry, 9, 145–154. doi:10.1002/wps.2010.9.issue-3
Coan, J. (2016). Attachment and neuroscience. In J. Cassidy & P. Shaver (Eds.), Handbook of
Attachment (3rd ed.). New York: Guilford Press.
Cocks, J. (1997). Psychotherapy n the third reich: The goering institute. New Brunswick, NJ:
Transaction.
Cooper, P.J., De Pascalis, L., Woolgar, M., Romaniuk, H., & Murray, L. (2015). Attempting to prevent
postnatal depression by targeting the mother–infant relationship: A randomised controlled trial.
Primary Health Care Research & Development, 16(4), 383–397. doi:10.1017/S1463423614000401
Davies, W. (1908/2011). Autobiography of a Supertramp. London: Melville.
Dozier, M., Peloso, E., Lewis, E., Laurenceau, J., & Levine, S. (2008). Effects of an attachment based
intervention on the cortisol production of infants and toddlers in foster care. Development and
Psychopathology, 20, 845–859. doi:10.1017/S0954579408000400
Egeland, B., Jacobvitz, D., & Sroufe, L. (1988). Breaking the cycle of abuse. Child Development, 59,
1080–1088. doi:10.2307/1130274
Fairbairn, R. (1952). Psychoanalytic studies of personality. London: Hogarth.
Fearon, P., Tomlinson, M., Kumsta, R., Skeen, S., Murray, L., Cooper, P., & Morgan, B. (in press).
Poverty, early care and stress reactivity in adolescence: Findings from a prospective, long-
itudinal study in a low-middle income country. In Development and psychopathology (pp.
1469–2198). ISSN 1469-2198.
Feldman, R. (2015). The neurobiology of mammalian parenting and the biosocial context of
human care-giving. Hormones and Behaviour. doi:10.1016/j.yhbeh.2015.10.001
Felitti, V., Anda, R., Nordenberg, D., Williamson, D., Spitz, A., Edwards, B., … Marks, J. (1998).
Relationships of childhood abuse and household dysfunction to many of the leading causes of
death in adults: The adverse childhood experiences study. American Journal of Preventive
Medicine, 14, 245–258. doi:10.1016/S0749-3797(98)00017-8
Fonagy, P., & Allison, E. (2014). The role of mentalising and epistemic trust in the therapeutic
relationship. Psychotherapy, 51, 372–380. doi:10.1037/a0036505
Fonagy, P., Steele, H., & Steele, M. (1991). Maternal representations of attachment during preg-
nancy predict organization of infant-mother attachment at one year of age. Child Development,
62, 891–905. doi:10.2307/1131141
Fonagy, P., Steele, M., Steele, H., Leigh, T., Kennedy, R., Mattoon, G., & Target, M. (1995).
Attachment, the reflective self, and borderline states: The predictive specificity of the adult
attachment interview and pathological emotional development. In S. Goldberg, R. Muir, & J. Kerr
(Eds.), Attachment theory: Social, developmental and clinical perspectives (pp. 233–278). New York:
Analytic Press.
Frankl, V. (1946/2006). Man’s search for meaning. An introduction to logotherapy. Boston, MA:
Beacon Press.
Freud, S. (1895). Studies in Hysteria. S.E. 2. London: Hogarth.
380 J. HOLMES

Friston, K. (2010, January). The free energy principle: A unified brain theory? Nature Reviews
Neuroscience, 13, 2010. doi:10.1038/nrn2787
Garmezy, N. (1985). Stress-resistant children: The search for protective factors. In A.D. Elmsford
(Ed.), Recent research in developmental psychopathology (pp. Pp 213–233). NY: Pergamon Press.
Gergely, G., & Watson, J. (1996). The social biofeedback model of parent-infant mirroring. The
International Journal of Psycho-Analysis, 77, 1181–1197.
Goransson, K. (2009). The binding tie: Chinese intergenerational relations in modern Singapore.
Honolulou: University of Hawaii Press.
Gunderson, J., & Lyons-Ruth, K. (2008, 2008 Feb). BPD’s interpersonal hypersensitivity phonotype:
A gene-environment development model. Journal of Personality Disorders, 22(1), 22–41.
doi:10.1521/pedi.2008.22.1.22
Hauser, S., Allen, J., & Golden, E. (2006). Out of the woods: Tales of resilient teens. Cambridge MA:
Harvard University Press.
Hesse, E. (2016). The Adult attachment interview: Protocol, method of analysis and selected
empirical studies 1985-2015. In J. Cassidy & P. Shaver (Eds.), Handbook of attachment (3rd ed.,
pp. 553–597). New York: Guilford.
Holmes, J. (2010). Exploring in security. London: Routledge.
Holmes, J. (2013). John bowlby and attachment theory (2nd ed.). London: Routledge.
Holmes, J. (2015). Attachment theory in clinical practice: Personal account. British Journal of
Psychotherapy, 31, 208–238. doi:10.1111/bjp.12151
Holmes, J., & Slade, A. (in press). Attachment for therapists: From science to practice. London: SAGE.
Kahl, K., Winter, L., & Schweiger, U. (2012). The third wave of cognitive behavioural therapies what
is new and what is effective? Curr Opi Psychiatry, 25(6), 522–528. doi:10.1097/
YCO.0b013e328358e531
Kahneman, D. (2011). Fast and Slow Thinking. London: Allen Lane.
Kipling, R. (1897/2014). Captains Courageous. London: Signet Classics.
Knox, J. (2010). Self-agency in Psychotherapy. New York: Norton.
Levine, S. (1957). Infantile experience and resistance to physiological stress. Science, 126, 405–411.
doi:10.1126/science.126.3270.405
Levy, K., Clarkin, J., Yeoman, F., Scott, L., Wasserman, R., & Kernberg, O. (2006). Mechanisms of
change in transference focused psychotherapy. Journal of Clinical Psychology, 62, 481–501.
doi:10.1002/jclp.20239
Lyons-Ruth, K., Bronfman, L., & Parsons, L. (1999). Maternal frightened, frightening and atypical
behavior and disorganized infant attachment strategies. In J. Vondra & D. Barnett (Eds.). Atypical
attachment in infancy and early childhood among children at developmental risk. Monographs of
the Society for Research in Child Development, 64, 67–96.
Main, M., & Godwyn, R. (1989). Adult attachment rating and scoring system. unpublished ms. Berkley
CA: University of California, Berkley.
Main, M., & Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorga-
nized attachment status: Is frightened and/or frightening parental behavior the linking mechan-
ism? In M.T. Greenberg, D. Cicchetti, & E.M. Cummings (Eds.), Attachment in the preschool years:
Theory, research and intervention (pp. 161–182). Chicago: The University of Chicago Press.
Masten, A. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56,
227–238. doi:10.1037/0003-066X.56.3.227
Meaney, M.J. (2001). Maternal care, gene expression, and the transmission of individual differences
in stress reactivity across generations. Annual Review of Neuroscience, 24, 1161–1192.
doi:10.1146/annurev.neuro.24.1.1161
Meins, E., Fernyhough, C., Fradley, E., & Tuckey, M. (2001). Rethinking maternal sensitivity: Mothers’
comments in infants’ mental processes predict security of attachment at 12 months. Journal of
Child Psychology and Psychiatry, 42(5), 637–648. doi:10.1111/1469-7610.00759
Mikulincer, M., & Shaver, P. (2016). Attachment in Adulthood (2nd ed.). New York: Guilford.
Parens, H. (2009). Resilience. In S. Ahktar (Ed.), Good feelings (pp. 329–362). London: Karnac.
 ATTACHMENT & HUMAN DEVELOPMENT 381

Pearson, J.L., Cohn, D.A., Cowan, P.A., & Cowan, C.P. (1994). Earned- and continuous security in
adult attachment: Relation to depressive symptomatology and parenting style. Development
and Psychopathology, 6, 359–373. doi:10.1017/S0954579400004636
Quinton, D., & Rutter, M. (1988). Parenting breakdown: The making and breaking of intergenerational
links. Aldershot: Avebury.
Roisman, G., Haltigan, J., Haydon, K., & Booth-LaForce, C. (2014). Earned-security in retrospect:
Depressive symptoms, family stress and maternal and paternal sensitivity from early childhood
to mid-adolescence. In C. Booth La-Force & G. Roisman (Eds.). The Adult attachment interview:
Psychometrics, stability and chance from infancy and developmental origins. Monographs of the
Society for Research in Child Development, 79, 85-107.
Rutter, M. (2012). Resilience as a dynamic concept. Development and Psychopathology, 24(2012),
335–344. doi:10.1017/S0954579412000028
Rutter, M., Quinton, D., & Hill, J. (1990) Adult outcome of institution-reared children males and
females compared. In L. Robbins & M. Rutter (Eds.). Straight and devious pathways from child-
hood to adulthood (pp. 135–157). Cambridge: Cambridge University Press.
Saunders, R., Jacobvitz, D., Zaccagnino, M., Lauren, M., Beverung, L., & Hazen, N. (2011). Pathways
to earned-security: The role of alternative support figures. Attachment & Human Development,
13:4, 403–420. doi:10.1080/14616734.2011.584405
Schore, J.R., & Schore, A.N. (2008). Modern attachment theory: The central role of affect regula-
tion in development and treatment. Clinical Social Work Journal, 36, 9–20. doi:10.1007/s10615-
007-0111-7
Schrodinger, E. (1944). What is Life. Cambridge: Cambridge University Press.
Seligman, M.E.P. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5–14.
doi:10.1037/0003-066X.55.1.5
Shai, D., & Belsky, J. (2011). When words just won’t do: Introducing parental embodied mentalising.
Research in Child Development. doi:10.1111/j.1750-8606.2011.00181.x
Slade, A., Sadler, L., & Mayes, L.C. (2005). Minding the Baby®: Enhancing parental reflective
functioning in a nursing/mental health home visiting program. In L. Berlin, Y. Ziv, L. Amaya-
Jackson, & M. Greenberg (Eds.), Enhancing early attachments: Theory, research, intervention, and
policy (pp. 152–177). New York: Guilford.
Slade, A., Simpson, T., Webb, D., Gorkin, J., Close, N., & Sadler, L. (2016). Minding the Baby®:
Developmental trauma and home visiting. In H. Steele & M. Steele (Eds.), Handbook of attach-
ment-based interventions. New York: Guilford.
Southwick, S., Bonnano, G., Masten, S., Panter-Brick, C., & Yehuda, R. (2014). Resilience definitions,
theory and challenges: Interdisciplinary perspectives. European Journal of Traumatology, 5.
doi:10.3402/ejpt.v5.25338
Sung, S., Simpson, J., Griskeviscius, V., Kuo, S., Schlomer, G., & Beslky, J. (2016). Secure
mother-infant attachment buffers the effects of early life stress on the age on menarche.
Psychological Science, 27, 667–674. doi:10.1177/0956797616631958
Suomi, S. (2016). Attachment in Rhesus monkeys. In J. Cassidy & P. Shaver (Eds), Handbook of
Attachment (3rd ed., pp. 133–154). New York: Guilford.
Tronick, E. (2007). The neurobehavioural and social-emotional development of Infants. New York:
Norton.
Ungar, M. (2008). Resilience across cultures. British Journal of Social Work, 38(2008), 218–235.
doi:10.1093/bjsw/bcl343
Wampold, B. (2015). The great psychotherapy debate: Models, methods and findings (2nd ed.).
Hillsdale NJ: Jason Aronson.
Wilson, D., Hayes, S., Biglan, A., & Embry, D. (2014). Evolving the future: Towards a science of
intentional change. Behavioural and Brain Sciences, 37, 395–460. doi:10.1017/
S0140525X13001593
Wright, O.W., Masten, A., & Narayan, A. (2013). Resilience processes in development: Four waves of
research on positive adaptation in the context of adversity. In S. Goldstein & R. Brooks (Eds),
Handbook of resilience in children. New York: Springer.
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