Feeling disconnected from your partner during quarantine? Attachment theory can provide insight.

In the months since my family and I started social distancing, I have noticed a shift in my marriage. Usually my husband and I love spending time together. We look forward to seeing one another at the end of the day. We have shared dreams for our future. I often feel that what we have is magic.

Almost overnight we needed to work harder to apply our effective listening and communication skills. Although we were able to overcome our differences, many couples continue to struggle. In both the U.S. and China, the divorce rate is expected to significantly increase once COVID-19-related restrictions are lifted. Why are couples having trouble finding common ground?

This global pandemic is triggering the frightened child in all of us. We feel out of control, disconnected, devastated, and many other things that put an emotional, psychological, and social strain on our relationships. Some of us cope by shutting down; others become indifferent, clingy, or lash out. A lucky few of us might be completely calm. One way to understand how this pandemic-induced anxiety impacts relationships is attachment theory.

John Bowlby, the father of modern attachment theory, pioneered the idea that our attachment histories predict how we relate and connect to others. The science of attachment theory is that our caregivers help us organize our emotions as infants until we develop the ability to do this for ourselves. This can be an asset or a detriment, depending on the mental health and emotional availability of the parent. Our attachment histories follow us. Even as adults, especially in times of loss or high stress, our attachment styles are activated. A recent study of the psychological impact of COVID-19 on the Italian general population supports this idea. 

There are four kinds of attachment styles.

Secure attachment. The caregiver responds to the infant in a timely and consistent manner, letting the infant know that he or she is there to meet the infant’s needs, sooth the infant, and keep the infant safe. This secure attachment enables the growing child to perceive and react to others in a healthy manner. As an adult this individual is able to regulate his or her emotions and behave in healthy ways.

Avoidance attachment. The caregiver rejects the infant’s need for closeness and soothing. The infant learns that the he or she can only rely on him or herself to feel safe. As an adult, this individual has difficulty understanding what he or she needs and disconnects from others.

Ambivalent attachment. The caregiver is inconsistent in responding to the infant, showing warmth and love sometimes, while being dismissive and cold at other times. The infant develops an anxious attachment style and becomes clingy to loved ones as an adult.

Disorganized attachment. The caregiver is angry and abusive. The infant learns that his or her environment is unpredictable, and will not be able to develop healthy coping and/or adapting strategies. 

This background on attachment theory should help you understand that how you and your partner are responding to one another during the pandemic is not necessarily indicative of how you feel about each other, but rather a childhood defense mechanism that is being activated under stress, anxiety, and fear. When you feel a threat coming, however small, your brain gets hijacked, and in an attempt to find comfort and safety you unconsciously react with an emotion that may then trigger your significant other’s attachment history. People with avoidant, ambivalent, or disorganized attachment styles might withdraw, become clingy, or fight. Those who have secure attachment styles will cope better. 

Achieving strong attachment with your partner is key to survival.

In therapy, you and your partner can identify your attachment styles and work to understand how your defense mechanisms activate to protect you. But not everyone is ready to or can afford to enter treatment. Here are some tips to improve your communication that you can try at home.

1. Read (and have your partner read) Hold Me Tight by Dr. Sue Johnson. Dr. Johnson believes that adult attachment is reciprocal—we all hold cognitive representations of our early caregivers in our minds. One thing she advises is to create a bonding moment to help couples become emotionally accessible and connected to one another. Achieving strong attachment with your partner is key to survival. 

2. Exchange attachment histories with your partner. Being open about your background will help each of you understand the defense mechanisms at play for one another during this anxiety-provoking time. Discuss how you can support the other’s need for connection. And next time your partner upsets you, before reacting ask yourself what else could be triggering your feelings.

3. Carve out personal time and together time—and be clear about it. Make sure to communicate your needs to your partner. Our attachment histories often dictate our needs in times of stress, and without communication there is too much room for hurt and misunderstanding.

4. Don’t forget to laugh. Humor and playfulness are essential coping mechanisms. Find ways to have fun and joke around with your partner.

5. Seek out positive interactions repeatedly. Thanks to neuroplasticity, our brains are adaptable. The more positive interactions we have, the further we will solidify the positive pathways in our brains. At the same time, the negative pathways will be weakened, and we will feel happier and understand each other better as a result.

6. Practice compassion. How your partner is responding to you during this stressful time is not reflective of what they are really feeling or how much they love you. Everyone craves connection even if they don’t show it. 

Suzanne Gavin is a Licensed Clinical Social Worker and Parent Coordinator http://suzannegavin.com/

What have you always wanted to change about your life? Now is the time to reset.

Part of my job as a mental health practitioner is to help my clients tolerate and even embrace uncertainty. This is the idea of negative capability, a concept originated by the 19th century English poet John Keats. We must train ourselves to be okay in times of volatility, uncertainty, complexity, and ambiguity like we are living in now with COVID-19.

Focus on what you can control right now

Mindfulness is the process of bringing our attention to experiences in the present without judgment, reactivity, or a rush to fix things or run away. It creates a state of clarity, awareness, calm, and receptiveness. One way to practice mindfulness is to meditate, but that is not the only way. You need to learn to focus your awareness away from the stress you are feeling.

Dan Siegel, clinical professor of psychiatry at UCLA School of Medicine, has developed an innovative way of conceptualizing and practicing mindfulness called “The Wheel of Awareness.” It is a chart made up of eight senses, laid out like a bicycle wheel. Along the rim of the wheel are all the different senses you can choose to focus on—touch, taste, smell, sight, hearing, interior of the body, mental activities, and interconnectedness. Interior of the body might mean focusing on your breath, the blood flowing through you, the weight of your bones, or gut sensations you may be feeling. Mental activities include memories, emotions, feelings, thoughts, images, or upcoming plans. Interconnectedness is the ability to connect and bring compassion to yourself, other people, and nature. 

Interconnectedness is a key component of our response to COVID-19, whether we realize it or not. For the past few months, we have been looking beyond ourselves. By sheltering in place, we are protecting our neighbors. We are also protecting other species and the environment. And while much of life will resume as normal when this pandemic is over, we do not have to live in the exact same way we did before. 

Instead of spending time thinking about the things you cannot wait to return to, try reflecting on the things you do not want to reintroduce into your life. What have you always wanted to change? What can you do to be healthier and less hurried? Perhaps being forced to live with ambiguity and vulnerability will help us all calm down. Maybe now is the perfect time to push the reset button.

Adopt one small change each day

In order to cope with change, you must be able to change the way you cope. This idea of “response flexibility,” a term coined by Siegel, allows us to pause between taking in an outside stimulus and responding to it. While the COVID-19 crisis is especially triggering to people with addiction histories, it is also difficult for those of us who feel off-balance when control is stripped away. Mindfully focus on what you can control—your daily schedule, who you speak to, food, exercise, sleep. Start by adopting one small change each day. This will cultivate a more relaxed state of mind, which will not only help you to cope in the present, but to be resilient when the pandemic ends. 

Here are some changes to consider. 

1. Stop judging your feelings. Allow yourself to feel scared and worry about the future. Name those feelings. Doing this helps you release worry and achieve mental calmness, especially during difficult situations.

2. Practice gratitude. For the last few years, gratitude has been a trending topic, and with good reason. It helps us see a world greater than ourselves. Start and end your day by taking inventory of what you have and being grateful for it. 

3. Help others. Helping other people lights up parts of the brain that make you feel pleasure and connection, thereby lowering stress.

4. Maintain a schedule. The brain thrives on predictability. It can be difficult to follow a routine right now, especially if you are unemployed or have kids at home, but I challenge you to try. The benefits to your physical and mental health are undeniable. 

5. Adopt healthy habits for eating, sleeping, and exercising. It is hard to adopt new and healthy ways of eating, sleeping, and exercising (but especially eating because it requires prep time). Take this opportunity to practice mindful eating. The change can be as small as choosing to eat away from your computer. Meanwhile, exercise increases your heart rate which pumps oxygen to the brain, reducing stress and depression.

Mindfulness apps

1. Headspace. Guided exercises and videos train your mind and body for a healthier, happier life

2. Calm. Short, guided meditations cover the basics of mindfulness, along with a library of soothing nature sounds and scenes. Good for beginners

3. Aura. Helps control stress and thoughts through mediation, stories, life coaching, and more. Compatible with Apple Watch

4. Stop, Breathe & Think. Customization tools deliver meditations based on current emotions and feelings

5. Insight Timer. Offers meditations and allows users to share and discuss mindfulness practices with like-minded people around the world

6. Buddhify. Meditation and mindfulness strategies for people with busy lifestyles 

Guided meditation and mindfulness created as a response to COVID-19

1. Wisdom 2.0. Jon Kabat-Zinn, creator of mindfulness-based stress reduction (MBSR), offers a free daily meditation, talk, and Q&A session.

2. Garrison Institute, whose mission is to create a movement for a healthier, safer, and compassionate world, is offering free meditations and webinars focused on managing stress over COVID-19.

Suzanne Gavin is a Licensed Clinical Social Worker and Parent Coordinator http://suzannegavin.com/ 

The benefits of a Coronavirus-mandated telemental health practice

Over the last week, many mental health practitioners have been forced to transition to telemental health as all of us implement social distancing. This is abrupt and perhaps anxiety-producing for those who have never treated clients through videoconferencing—and perhaps never wanted to. But there is no shying away from it. During such an uncertain time, clients need continuity of care. They need your support to keep working toward their goals.

When I decided to move part of my psychotherapy practice to a virtual platform a few months ago, I feared I might not be able to offer my clients my best self. Would my services be less effective through a screen? Would I be less present? And would my clients be less focused or forthcoming? I knew I wasn’t going to overcome these fears by ruminating over them. I had to take the same advice I would give to a client in my situation: exposure therapy. And this is what clinicians are doing now. 

After a brief adjustment period with the videoconferencing format, I have found that I am more present than ever. I feel more attuned to my clients as I engage with them face-to-face—and only face-to-face. I can pick up on the smallest nuances of my clients’ verbal and nonverbal responses. The screen is unflinching.  

Research on videoconferencing has been relatively consistent with my experience. A study by Barbara J. Kocsis and Peter Yellowlees (2018) out of the University of California, Davis examined the advantages to the psychotherapeutic relationship when psychotherapy is carried out over videoconferencing. They concluded that “Telepspychotherapy offers a novel way to reach and form strong psychotherapeutic relationships with many different types of patients, and it may foster therapeutic intimacy in ways that in-person psychotherapy cannot.”

Here are some tips to make your transition to telemental health smoother. 

1.    Education. It is necessary to familiarize yourself with the legal, ethical, and clinical aspects of telemental health before practicing. I use the Telehealth Certification Institute platform, which offers free webinars as well as a certification.

2.    Boundaries. You must create the same private and confidential environment at home that you have in your office. Both you and your clients should set boundaries with the other occupants of your homes. Think ahead and let your family members or roommates know that you will be closing your door between specific times of the day. You can also buy a sound machine.

3.    Screen size. While clinicians can conduct these videoconferences via phone, tablet, laptop, or desktop computer, I prefer a desktop computer screen. If you have the means, you might find that a desktop enhances your focus since you can’t walk around as you can with a phone or tablet. Thus, this option allows for the most transparency between clinician and client.

4.    Video platform. I use Zoom and Doxy.me. Since my clients tend to prefer Zoom and its free sessions only last 40 minutes, I pay for a subscription. Both Doxy and Zoom are HIPPA compliant. 

5.    Payment. Payment must be HIPPA compliant, and many of the apps out there are not. I use Square, for which I have to pay a small interest fee, but it allows me to easily enter a credit card number and is HIPPA compliant.