Exploring Attachment and Defense Styles Effects on the Self-Reflective Ability Among Individuals with Addictive Disorders

Cara Church, Fielding's School of Psychology

This study included 219 participants, consisting of 104 participants from a methadone maintenance program and 115 participants from an outpatient drug-free program (46% females and 54% males). The Experiences in Close Relationships-Revised was used as a measure for attachment security and assessed the two dimensions of avoidance and anxiety. The Defense Style Questionnaire-88 was used as a measure to evaluate defense mechanisms through conscious derivatives of defenses. The Observing Ego Function Scale was used as a measure of the self-reflective function. Multivariate analyses of variance, analyses of variance, and discriminant function analyses revealed that attachment style and defenses used impacted self-reflective capacity. The drug-free group demonstrated greater use of non-factor and adaptive defenses and the methadone group showed greater use of inhibition, regression, and the immature/maladaptive style. Significant interactive effects were found among the drug-free, dismissing, and avoidant defenses (suppression, withdrawal, and isolation). Those in the dismissing methadone group showed greater use of an immature/maladaptive defense style and regression. An interaction was found between methadone, fearful attachment style, and an immature/maladaptive defense style. Supplemental analyses revealed that not clean participants in both groups had more immature/maladaptive defenses, regression, and inhibition. A significant relationship was found between defenses and self-reflection. The immature/maladaptive defense style significantly related to all aspects of self-reflection. Regression related to impaired self-reflection. The ability to experience affect related to immature/maladaptive and adaptive defenses, regression, splitting, and suppression. Internal awareness related to the immature/maladaptive defense style, and use of inhibition, withdrawal, and splitting. Significant relationships were found between attachment style and self-reflection. The drug-free dismissing group had less ability to experience affect, but overall greater self-reflective ability and impulse control. The methadone dismissing group had greater ability to experience affect, more impulsivity, but less overall self-reflective ability. The drug-free fearful group had greater ability to distance the self without becoming overwhelmed by affect and resulted in overall greater self-reflective ability. The fearful methadone group demonstrated less ability to distance the self without becoming overwhelmed by affect, but resulted in less self-reflective ability.

Keywords: attachment style, defense mechanism, self-reflection, observing ego, mentalization, addiction, methadone