Research demonstrates that rejection sensitivity develops through early, continuing, or acute experiences of rejection from caregivers and significant others. Rejection sensitivity refers to individuals who anxiously or angrily expect, readily perceive, and intensely react to rejection. The question regarding why rejection is feared by rejection sensitive individuals remains unanswered by existing rejection sensitivity literature. Therefore, the current study answers this question using interpretative phenomenological analysis (IPA) to analyse 8 participants' experiences of rejection sensitivity. Four superordinate themes emerged: `experiences of parenting'; `impact of rejection'; `coping with the concept of rejection'; and `identity'. The primary fundamental finding indicates that rejection sensitivity is the same concept as abandonment anxiety. Participants in the current study demonstrate both rejection sensitivity and abandonment anxiety. Furthermore, the origins and characteristics of both concepts are identified as the same. Therefore, these findings indicate that rejection is feared for the same reason that abandonment is feared. In childhood, abandonment is experienced as terrifying and therefore defences are adopted to avoid further abandonment. The concept of `past in present' means that childhood feelings can be timelessly re-experienced in adulthood as actual and unchanged. Therefore, later rejection situations are perceived as abandonment and accordingly alert an individual to impending danger. As a result, rejection is feared because it is perceived as abandonment and as a threat to survival. This finding is fundamental to the fields of rejection sensitivity and abandonment anxiety, in terms of research and therapeutic work with clients. Integrating existing literature provides much greater depth of knowledge and support for these concepts. Recommended therapeutic approaches for abandonment anxiety can also inform interventions for rejection sensitive clients. Findings also suggest that participants experience annihilation anxiety in relation to perceived rejection, which further increases fear. Clinical applications and implications with respect to the findings arc discussed.

Interpretative phenomenological analysis

Changes in attachment organization and reflective function (RF) were assessed as putative mechanisms of change in 1 of 3 year-long psychotherapy treatments for patients with borderline personality disorder (BPD). Ninety patients reliably diagnosed with BPD were randomized to transference-focused psychotherapy (TFP), dialectical behavior therapy, or a modified psychodynamic supportive psychotherapy. Attachment organization was assessed with the Adult Attachment Interview and the RF coding scale. After 12 months of treatment, participants showed a significant increase in the number classified secure with respect to attachment state of mind for TFP but not for the other 2 treatments. Significant changes in narrative coherence and RF were found as a function of treatment, with TFP showing increases in both constructs during treatment. No changes in resolution of loss or trauma were observed across treatments. Findings suggest that 1 year of intensive TFP can increase patients’ narrative coherence and RF. Future research should establish the relationship between these 2 constructs and relevant psychopathology, identify treatment components responsible for effecting these changes, and examine the long-term outcome of these changes.

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Change in attachment patterns and reflective function in a randomized control trial of transference-focused psychotherapy for borderline personality disorder.

The literature on empathy, primarily from counseling and psychotherapy and secondarily from social and developmental psychology, is reviewed. Obstacles that may account for theoretical confusions and empirical difficulties in studying empathy are highlighted. The decrease in empathy research in recent years appears attributable to the lack of clear focus and effective research tools as well as the shift in interest from empathy to other concepts such as the working alliance. It is argued that there is a need to return to studying empathy. Researchers should distinguish between dispositional and experiential empathy and between intellectual empathy and empathic emotions and indicate whether they are examining therapist or client experience of empathy. Suggestions for future research are offered.

The current state of empathy research

Adult attachment measures: a 25-year review.

The therapeutic relationship.

A panel of 9 therapists generated items for an instrument designed to measure the psychotherapy relationship from the perspective of attachment theory. The initial version of the Client Attachment to Therapist Scale (CATS) contained 100 items that were administered at 4 counseling agencies in survey packets to 138 clients who had completed at least 5 sessions with their therapists. Factor analysis suggested that 36 items loaded on 3 subscales, which we labeled Secure, kvoidant-Fearful, and Preoccupied-Merger. CATS factors correlated in expected directions with survey measures of object relations, client-rated working alliance, social self-efficacy, and adult attachment. Cluster analysis identified 4 types of client attachment. Significant differences in social competencies (object relations, etc.) were evident across types of attachment. Implications of attachment patterns for the understanding of client transference are discussed. Attachment theory was originally developed to explain the behavioral and emotional responses that keep young children and their caregivers in close physical proximity (Bowlby, 1969). From this foundation, attachment theory offers an explanation for responses to separation and loss (Bowlby, 1973) and the development of emotional attachments after infancy (Ainsworth, 1989; Bowlby, 1977). In an optimal attachment bond, the caregiver provides a comforting presence for the child that reduces anxiety and promotes feelings of security. From this secure base, the child is able to explore the physical and social environment (Bowlby, 1969, 1988). In Ainsworth's pioneering studies of attachment (Ainsworth, Blehar, Waters, & Wall, 1978), in sequential phases of a laboratory observation, children explored a novel play environment in the presence of their mother and were then observed during a brief separation from their mother, exposure to a stranger, and reunion with their mother. Three patterns of attachment were identified. Infants who displayed the secure pattern freely explored in their mother's

Attachment Patterns in the Psychotherapy Relationship: Development of the Client Attachment to Therapist Scale.

Current social competencies and memories of attachment bonds with each parent were examined as they related to influences on formation of the working alliance. Female clients (N = 76) at 4 university and community agencies completed surveys containing the Parental Bonding Instrument, the Self-Efficacy Scale, the Adult Attachment Scale, and the Working Alliance Inventory. Results indicated that parental bonds, especially with fathers, were significantly associated with social competencies. Multiple regression analyses indicated that social competencies (self-efficacy and adult attachment) accounted for 14% of the variance in client working alliance ratings, whereas recalled parental bonds accounted for 23% of the variance. Working alliance was negatively associated with father bonds, positively associated with mother bonds, and-among social competencies-significantly associated with capacity for adult attachment

Working alliance, attachment memories, and social competencies of women in brief therapy.

Much of the pioneering research on the stress-buffering effects of social support tended to view support primarily in terms of its perceived availability in the environment. Individual differences were often included in these models, not as independent variables, but only as dependent variables representing psychological or physical health symptoms of distress. In many of these studies, the capacity to benefit from available social support was accepted as a given. After a decade of research in which this paradigm predominated, however, researchers in the mid-1980s increasingly began to view social support as an interaction between individual difference variables and the environment (e. g., B. R. Sarason, Pierce, & I. G. Sarason, 1990; I. G. Sarason, B. R. Sarason, & Shearin, 1986). On the basis of this growing body of research, it appears that at least three conditions are necessary for an individual to derive benefit from social support for coping with a given stressful life event: (1) the environment must offer support of the functional types and from relationship sources that match the coping requirements of the event; (2) the individual must possess social skills necessary to engage in supportive relationships, establish intimacy, and recruit the specific types of social support needed for coping with the Stressor; and (3) the individual must have the personality disposition and willingness to exercise these skills.

Attachment, Social Competency, and the Capacity to Use Social Support

S. B. Robbins (1995) provided a thought-provoking response to the article (B. Mallinckrodt, D. L. Gantt, & H. M. Coble, 1995) that described the development of the Client Attachment to Therapist Scale (CATS). In this reply, recent elaborations of attachment theory are reviewed as applied to adult close personal relationships, and points of similarity and difference between the attachment-based constructs measured by the CATS and measures of client working alliance and transference are clarified.

http://psycnet.apa.org/journals/cou/42/3/320.pdf

Diana L. Gantt

Papers

Attachment Patterns in the Psychotherapy Relationship: Development of the Client Attachment to Therapist Scale.

Working alliance, attachment memories, and social competencies of women in brief therapy.

Attachment, Social Competency, and the Capacity to Use Social Support

Toward differentiating client attachment from working alliance and transference: Reply to Robbins (1995).