1st Edition

Working with Attachment Trauma Clinical Application of the Adult Attachment Projective Picture System

Edited By Carol George, Julie Wargo Aikins, Melissa Lehmann Copyright 2023
    246 Pages 5 B/W Illustrations
    by Routledge

    246 Pages 5 B/W Illustrations
    by Routledge

    The Adult Attachment Projective Picture System (AAP) has served as a prominent assessment tool for adults and adolescents internationally for over 20 years. This book introduces the AAP and illustrates the powerful potential for implementing the AAP in clinical practice for assessment, client conceptualization, treatment planning, analysis, and as a therapeutic guide.

    Chapters discuss the full scope of incomplete pathological mourning for attachment trauma, including for the first time in the field Failure to Mourn and Preoccupation with Personal Suffering. Seasoned clinical researchers and psychotherapists provide a snapshot of their clients' unique attachment characteristics and defensive exclusion strategies as assessed by the AAP, and discuss how to use this information in treatment, as well as how to present the AAP results to their clients.

    This book introduces readers to how the AAP can be used with adolescents, adults, and couples, and in custody evaluation and foster care.

    Part I Foundations

    1. The Adult Attachment Projective Picture System

    Carol George

    2. Implications for Psychotherapy Processes and Outcomes

    Steffani Kizziar, Katie Kivisto, Michael Poulakis

    3. Clinical and Neurobiological Applications of the AAP in Adults and Children: Therapeutic Implications

    Anna Buchheim, Manuela Gander

    Part 2 Incomplete Pathological Mourning

    4. Attachment Trauma and Incomplete Pathological Mourning

    Carol George

    5. Failed Mourning: The Sounds of Silence

    Melissa Lehmann

    6. Opening the Attachment Trauma Floodgates: Preoccupation with Personal Suffering

    Caroline Lee, Carol George

    7. Pain, Misery, and Suffering: Unresolved Attachment as a Predictor of Treatment in Male Combat-Related Posttraumatic Stress Disorder

    Deane E. Aikins, Julie Aikins

    Part 3 Adult Psychotherapy and Assessment

    8. From Unresolved to Earned Secure: The AAP as a Powerful Clinical Tool in Psychotherapy

    Stephen E. Finn

    9. Embodying Attachment: Language and Somatic Revelations

    Talia B. Shafir

    10. Using the Adult Attachment Projective Picture System in a Transdiagnostic Approach During Psychoanalytic Treatment: Therapy and Neurophysiological Outcomes

    Anna Buchheim

    11. Confusion, Fear, and Loss: Clinical Application of the AAP with People with Intellectual Disabilities

    Deanna Gallichan, Nancy Poulter, Alex Clark, Kate Stoneman

    Part 4 Adolescents and Parents

    12. Does Therapy Matter for Adolescents in the Foster Care System?

    Linda Webster, David Joubert, Ashley Peterson

    13. Using the Adult Attachment Projective Picture System in Pediatric Health Psychology: Parental Gatekeeping and Attachment Trauma in an Adolescent and his Donor Father

    Marie Leblond, Marie-Julie Béliveau, Marie Achille

    14. Dismissive and Blind to Attachment Distress: The AAP Unravels a Diagnostic Puzzle

    Rex Collins

    15. The Role of the Adult Attachment Projective Picture System in Treating Obesity

    Claudia Mazzeschi, Elisa Delvecchio, Livia Buratta, Daniela Di Riso, Silvia Salcuni, Adriana Lis

    16. Attachment-informed Assessment of Adolescent Conduct Disorder: A Case Study

    David Joubert


    Carol George, Ph.D., is an internationally renowned attachment expert and provides extensive teaching and consultation in the clinical application of attachment. Her books include the Adult Attachment Projective Picture System, Attachment Disorganization, and Disorganized Attachment and Caregiving.

    Julie Wargo Aikins, Ph.D., is an expert in developmental psychopathology and parent-child relationships and consults on the clinical application of attachment theory. She conducts research that includes various measures of attachment, writes and presents on attachment theory, and trains on the use of the Adult Attachment Projective Picture System.

    Melissa Lehmann, Ph.D., is a clinical psychologist at the Center for Therapeutic Assessment. Her practice involves assessment and therapy with clients who have experienced attachment trauma, as well as providing consultation to other clinicians in this area.

    "The editors have brought together an impressive group of international researchers and practitioners to highlight the clinical use of the Adult Attachment Projective Picture System (AAP). The chapters offer compelling examples of the AAP’s value for clinical practice, assessment, or intervention, especially in the context of attachment trauma and intergenerational transmission risk. It is a must for any student or practitioner working with vulnerable adults and parents and seeking to understand the fundamental underlying attachment mechanisms involved in the development of trauma and resilience."

    Chantal Cyr, Ph.D., Full professor, Department of Psychology, Université du Québec à Montréal, and Canada Research Chair in Child Attachment and Development

    "This book is a milestone in demonstrating the broad applicability and critical value of the AAP. The creativity and clinical acumen of the authors will benefit a host of future clients. Moreover, this book builds a bridge from assessors to therapists who will be well-served to have attachment patterns assessed in troubled clients. Kudos to the authors for such a valuable contribution!"

    Hale Martin, Ph.D., Clinical Professor, University of Denver, Therapeutic Assessment Institute

    "This book is a must-have resource for anyone using or considering using the AAP, and anyone interested in assessing attachment. Initial chapters provide an orientation to the foundation for the task stimuli and how responses to them are classified, its uses in practice, and a review of the neurophysiological correlates of its scores. In the remaining chapters, talented experts illustrate the illuminating and unique information emerging from the AAP across a range of ages, settings, and presenting issues."

    Gregory J. Meyer, Ph.D., Professor, University of Toledo; former Editor of Journal of Personality Assessment

    "The Adult Attachment Projective Picture System (AAP) to be an invaluable tool for assessment in medical settings to help clients consider the role of developmentally-based psychodynamic processes in their presenting problems. This book expands the scope of the AAP deep into practice with sophisticated and moving case studies that describe the diversity of contexts in which the AAP can enhance clinical insight and facilitate therapeutic dialogue."

    David J. York, Ph.D., Psychological Assessment and Testing Service, Christiana Care Health System, Newark, Delaware