Attachment, detachment and borderline personality disorder.

In an attempt to expand understanding of more severe pathology, attachment theory, developed by John Bowlby, is applied to borderline personality disorder in adults. Conceptualized as a condition of profound insecure attachment, with extreme vacillations between a desire for proximity and attachment and a dread and avoidance of engagement, borderline pathology reflects traumatic attachment experiences, beginning early in life. Besides the importance of trauma, disturbances in affect regulation and cognitive distortions are emphasized. The secure base of a therapeutic bond provides consistency, reliability, and affirmation while encouraging exploration of separation and loss experiences, both current and past, in order to modify inner working models of oneself and relationships with others. Implications for prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)