「依附理論」:以藝術調整幼兒期的不足 The attachment theory: The use of arts to regulate the deficit in early childhood


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「依附理論」是從幼兒對母親的親密渴望發展出來的。這闡明幼兒與依附人物之間的關係,而這人物通常是指幼兒的主要照顧者。 於幼兒期,兒童學習透過對依附者的倚靠,而獲得生理、心理及情緒上的支援。所以,依附關係的質量影響兒童的社交、情緒及認知發展 (Stubbs, 2018)。這個交互關係影響著人們的終生思想及行為。兒童根據對照顧者反應的期望,發展出「內在思路模型」(Bowlby, 1998)。 人們對照顧者尋求安全感、連繫感及親密的感覺 (Fonagy, 2001)。照顧者與兒童的安全關係,可以培養兒童在壓力環境下的自我調節能力。

根據學者的研究 (Perry, 2009) ,創傷、疏忽照顧及虐待經歷,會影響幼兒的腦部發展。如果依附人物在幼兒的日常生活較少出現,對「內在思路模型」會有深遠的影響。 例如父母離異、父母去世、照顧者長期住院、父母或兒童有危疾,都會引致依附不足。由於早期照顧及關注不足,人們會較缺乏自我調適能力、同理心, 及人際界線模糊 (Boronska, 2000)。

於藝術治療,治療師與參與者的互動便好像照顧者與兒童般 (Banister, 2003)。在一個多趣及互信的環境下,接納錯誤可以讓參與者,調整一些兒時欠缺的「調節經驗」。透過藝術過程的正面經驗,他們可以調整不安的感覺,及提升解決問題的能力。

在藝術創作過程中,內在的情感,會轉化為主觀的感受,容許人們最終能以言詞表達壓抑的感覺。「共同專注」, 也許是解釋這轉變的原因 (Isserow, 2011)。治療師與參與者自然而然地,作出思想交流及對話。這可以幫助啟動大腦的獎勵機制,有如嬰兒會留意到,別人正在跟他同時注意到某些物件。參與者能學習到,如何在從別人的觀點看待事情。創作過程使他們在面對一些觀點及感覺時,提升賦予意義的能力,讓藝術作品連繫生活體驗。 當自我反省能力提升、同理心及解決問題的能力加強,最終, 便能建立安全的依附 (Fonagy, Steele, Steele, Morin & Higgitt, 1991, Boronska, 2000) 。

The attachment theory developed from an infant’s intimate desire with its mother. It defined the relationship between a child and an attachment figure, usually their primary caregiver. During early development, children learn to depend upon the attachment figure for physical, psychological, and emotional support. Therefore, the quality of this attachment relationship affects children’s social, emotional, and cognitive development (Stubbs, 2018). This interaction affects thoughts and behaviour throughout the lifetime. Children develop an ‘inner working model’ according to their expectation of the caregiver’s responsiveness (Bowlby, 1998). Individuals search for security, connection, and a feeling of closeness to the caregiver (Fonagy, 2001). A secure relationship between the caregiver-child fosters the child’s capacity for self-regulation in stressful situation.

According to Perry (2009), trauma, neglect, and experiences of maltreatment during early childhood affects brain development. If the attachment figure is less present in a child’s daily life, it will have a profound effect on the ‘inner working model’. For example, individuals with poor attachment may be caused by the divorce of their parents, death of a parent, prolonged hospitalizations of the caregiver, or life-threatening illnesses of parents or child. With early failure of care and attention, individuals may lack self-regulation, boundaries, and empathy (Boronska, 2000).

In arts therapy, the interaction between therapist and participant is like caregivers and children (Banister, 2003). Under a playful and trust environment, the acceptance of making mistake help participants to regulate some of the missed early regulatory experience. They can regulate difficult feeling; and enhance coping mechanism by the positive experience during art creation.

The emotional activities during art creation make implicitly stored affects become felt subjective states; allowing individuals to eventually verbally articulate their suppressed emotions. Joint attention may be a mechanism for change during the art making process (Isserow, 2011). The mind-to-mind contact, and dialogue happen naturally among participants and therapists. This helps to activate the reward system of the brain, like an infant aware of another’s attention on an object. Participants learn to see things in others’ perspectives. The creation process increases the participants’ capacity to identify meanings to thoughts and feelings; finally make connection with artworks and life experience. The increase in ability for self-reflection enhances empathy, coping mechanism and eventually secures attachment (Fonagy, Steele, Steele, Morin & Higgitt, 1991, Boronska, 2000).

Bannister, A. (2003). Creative Therapies with Traumatised Children. Philadelphia: Jes- sica Kingsley Publishers. Boronska, T. (2000). Art Therapy with Two Sibling Groups Using and Attachment Framework. Inscape, 5(1), 2–10. Bowlby, J. (1998). Attachment and loss, Volume 2: Separation: Anger and Anxiety. London: Pimlico. Fonagy, P. (2001). Attachment Theory and Psychoanalysis. NY: Guilford Press. Fonagy, P., Steele,M., Steele,H., Moran,G. S., & Higgitt, A.C. (1991). The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal, 12(3), 201–218. Perry, B. D. (2009). Examining child maltreatment through a neurodevelopmental lens: Clinical application of neurosequential models of therapeutics. Journal of Loss and Trauma, 14, 240–255. Stubbs, R. M. (2018). A review of attachment theory and internal working models as relevant to music therapy with children hospitalized for life threatening illness. The Arts in Psychotherapy, 57, 72–79.

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