Skip to main content
SpringerLink
Log in

Attachment and the End of Life Experience

  • Chapter
Improving Patient Treatment with Attachment Theory

Abstract

In this chapter, attachment theory will be employed to understand variations in experience and behaviours of dying patients and their loved ones as they negotiate treatment within the health care system. Concepts central to palliative care including the good death, dignity, physician-assisted suicide and grief can all be better understood with the aid of attachment theory. Even more importantly, treatment interventions aimed at supporting an individual’s sense of security may be beneficial in reducing distress and facilitating growth in those facing end of life

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Bowlby J (1980) Attachment and loss: vol. III. Loss: sadness and depression. Basic Books, New York

    Google Scholar 

  • Bowlby J (1982) Attachment and loss: vol. I. Attachment. Basic Books, New York

    Google Scholar 

  • Braun M, Mikulincer M, Rydall A, Walsh A, Rodin G (2007) Hidden morbidity in cancer: spouse caregivers. J Clin Oncol 25:4829–4834

    Article  PubMed  Google Scholar 

  • Braun M, Hales S, Gilad L, Mikulincer M, Rydall A, Rodin G (2012) Caregiving styles and attachment orientations in couples facing advanced cancer. Psychooncology 21:935–943

    Article  PubMed  Google Scholar 

  • Chochinov HM, Hack T, McClement S, Kristjanson L, Harlos M (2002) Dignity in the terminally ill: a developing empirical model. Soc Sci Med 54:433–443

    Article  PubMed  Google Scholar 

  • Curtis JR, Ciechanowski PS, Downey L, Gold J, Nielsen EL, Shannon SE, Treece PD, Young JP, Engelberg RA (2012) Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU. Contemp Clin Trials 33:1245–1254

    Article  PubMed  Google Scholar 

  • Delespaux E, Ryckebosch-Dayez AS, Heeren A, Zech E (2013) Attachment and severity of grief: the mediating role of negative appraisal and inflexible coping. Omega (Westport) 67:269–289

    Google Scholar 

  • de Haes H, Koedoot N (2003) Patient centered decision making in palliative cancer treatment: a world of paradoxes. Patient Educ Couns 50:43–49

    Article  PubMed  Google Scholar 

  • Ellis J, Lin J, Walsh A, Lo C, Shepherd FA, Moore M, Li M, Gagliese L, Zimmermann C, Rodin G (2009) Predictors of referral for specialized psychosocial oncology care in patients with metastatic cancer: the contributions of age, distress and marital status. J Clin Oncol 27:699–705

    Article  PubMed  Google Scholar 

  • Evans AJ (1994) Anticipatory grief: a theoretical challenge. Palliat Med 8:159–165

    Article  CAS  PubMed  Google Scholar 

  • Fonagy P, Gergely G, Jurist E, Target M (2002) Affect regulation, mentalization, and the development of the self. Other Press, New York

    Google Scholar 

  • Ganzini L, Goy ER, Dobscha SK (2009) Oregonians’ reasons for requesting physician aid in dying. Arch Intern Med 169:489–492

    Article  PubMed  Google Scholar 

  • Gladjchen M (2004) The emerging role and needs of family caregivers in cancer care. J Support Oncol 2:145–155

    Google Scholar 

  • Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, Willan A, Viola R, Coristine M, Janz T, Glossop R (2004) Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ 170:1795–1801

    Google Scholar 

  • Hales S, Zimmermann C, Rodin G (2008) The quality of dying and death. Arch Intern Med 168:1–7

    Article  Google Scholar 

  • Hales S, Zimmermann C, Rodin G (2010) The quality of dying and death: a systematic review of measures. Palliat Med 24:127–44

    Google Scholar 

  • Hales S, Lo C, Rodin G (2015) Managing cancer and living meaningfully (calm) therapy. In: Holland JC, Breitbart WS, Jacobsen PB, Lederberg MS, Loscalzo MJ, McCorkle R (eds) Psycho-oncology, 3rd edn. Oxford University Press, New York

    Google Scholar 

  • Hunter MJ, David PJ, Tunstall JR (2006) The influence of attachment and emotional support in end-stage cancer. Psychooncology 15:431–444

    Google Scholar 

  • Johansson AK, Grimby A (2012) Anticipatory grief among close relatives of patients in hospice and palliative wards. Am J Hosp Palliat Med 29:134–138

    Google Scholar 

  • Kearney JA, Byrne MW (2011) Planning with parents for seriously ill children: preliminary results on the development of the parental engagement scale. Palliat Support Care 9:367–376

    Google Scholar 

  • Kunce LJ, Shaver PR (1994) An attachment-theoretical approach to caregiving in romantic relationships. In: Bartholomew K, Perlman D (eds) Attachment processes in adulthood. Advances in personal relationships, vol 5. Jessica Kingsley Publishers, London

    Google Scholar 

  • Lewis MJ (2007) Medicine and care of the dying: a modern history. Oxford University Press, New York

    Google Scholar 

  • Lo C, Lin J, Gagliese L, Zimmermann C, Mikulincer M, Rodin G (2010) Age and depression in patients with metastatic cancer: the protective effects of attachment security and spiritual wellbeing. Aging Soc 30:325–336

    Article  Google Scholar 

  • Lo C, Hales S, Zimmermann C, Gagliese L, Rydall A, Rodin G (2011) Measuring death-related anxiety in advanced cancer: preliminary psychometrics of the death and dying distress scale. J Pediatr Hematol 33(Suppl 2):S140–S145

    Article  Google Scholar 

  • Lo C, Hales S, Jung J, Chiu A, Panday T, Rydall A, Nissim R, Malfitano C, Petricone-Westwood D, Zimmermann C, Rodin G (2014) Managing Cancer And Living Meaningfully (CALM): a phase 2 pilot study of a brief individual psychotherapy for patients with advanced cancer. Palliat Med 29:238–242

    Google Scholar 

  • Marvin RS, Pianta RC (1996) Mothers’ reactions to their child’s diagnosis: relations with security of attachment. J Clin Child Psychol 25:436–445

    Google Scholar 

  • McLean LM, Jones JM, Rydall AC, Walsh A, Esplen MJ, Zimmermann C, Rodin GM (2008) A couples intervention for patients facing advanced cancer and their spouse caregivers: outcomes of a pilot study. Psychooncology 178:1152–1156

    Article  Google Scholar 

  • McLean LM, Walton T, Rodin G, Esplen MJ, Jones JM (2013) A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial. Psychooncology 22:28–38

    Article  PubMed  Google Scholar 

  • Nissim R, Freeman E, Lo C, Zimmermann C, Gagliese L, Rydall A, Hales S, Rodin G (2012) Managing Cancer And Living Meaningfully (CALM): a qualitative study of a brief individual psychotherapy for individuals with advanced cancer. Palliat Med 26:713–721

    Article  PubMed  Google Scholar 

  • Parkes CM (1996) Bereavement. Studies in grief in adult life. Routladge, London

    Google Scholar 

  • Pattison EM (1977) The experience of dying. Simon and Schuster, New York

    Google Scholar 

  • Petersen Y, Koehler L (2006) Application of attachment theory for psychological support in palliative medicine during the terminal phase. Gerontology 52:111–123

    Article  PubMed  Google Scholar 

  • Rodin G, Zimmermann C (2008) Psychoanalytic reflections on mortality: a reconsideration. J Am Acad Psychoanal Dyn Psychiatry 36:181–196

    Google Scholar 

  • Rodin G, Walsh A, Zimmermann C, Gagliese L, Jones J, Shepherd FA, Moore M, Braun M, Donner A, Mikulincer M (2007) The contribution of attachment security and social support to depressive symptoms in patients with metastatic cancer. Psychooncology 16:1080–1091

    Article  PubMed  Google Scholar 

  • Saunders C (1987) I was sick and you visited me. Christ Nurse Int 3:4

    Google Scholar 

  • Shear K, Shair H (2005) Attachment, loss, and complicated grief. Dev Psychobiol 47:253–267

    Article  PubMed  Google Scholar 

  • Stewart AL, Teno J, Patrick DL, Lynn J (1999) The concept of quality of life of dying persons in the context of health care. J Pain Symptom Manage 17:93–108

    Google Scholar 

  • Stroebe MS, Schut H, Stroebe W (2005) Attachment in coping with bereavement: a theoretical integration. Rev Gen Psychol 9:48–60

    Google Scholar 

  • Sumalla EC, Ochoa C, Blanco I (2009) Posttraumatic growth in cancer: reality or illusion? Clin Psychol Rev 29:24–33

    Article  PubMed  Google Scholar 

  • Tan A, Zimmermann C, Rodin G (2005) Interpersonal processes in palliative care: an attachment perspective on the patient-clinician relationship. Palliat Med 19:143–150

    Article  PubMed  Google Scholar 

  • Vogel L (2011) Dying a “good death”. CMAJ 183:2089–2090

    Article  PubMed Central  PubMed  Google Scholar 

  • Weisman A (1972) On dying and denying: a psychiatric study of terminality. Behavioral Publications, New York

    Google Scholar 

  • Yalom ID (1980) Existential psychotherapy. Basic Books, New York

    Google Scholar 

  • Yalom ID (2009) Staring at the sun: overcoming the terror of death. Jossey-Bass, San Francisco

    Google Scholar 

  • Zech E, Arnold C (2011) Attachment and coping with bereavement: implications for therapeutic interventions with the insecurely attached. In: Neimeyer RA, Harris DL, Winokuer HR, Thornton GF (eds) Grief and bereavement in contemporary society: bridging research and practice. Routledge, New York

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychosocial Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada

    Sarah Hales MD, PhD, FRCP(C)

Authors
  1. Sarah Hales MD, PhD, FRCP(C)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sarah Hales MD, PhD, FRCP(C) .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, University of Toronto, Mount Sinai Hosp. , Toronto, Ontario, Canada

    Jonathan Hunter

  2. Department of Psychiatry, University of Toronto, Mount Sinai Hosp. , Toronto, Ontario, Canada

    Robert Maunder

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Hales, S. (2016). Attachment and the End of Life Experience. In: Hunter, J., Maunder, R. (eds) Improving Patient Treatment with Attachment Theory. Springer, Cham. https://doi.org/10.1007/978-3-319-23300-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-23300-0_7

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23299-7

  • Online ISBN: 978-3-319-23300-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation