Mindfulness-Based Cognitive Therapy in Reducing Anxiety Symptoms Associated with Attachment Orientation in Same-Sex Couples

Mindfulness-Based Cognitive Therapy in Reducing Anxiety Symptoms Associated with Attachment Orientation in Same-Sex Couples

Shivangi Saha

Western Sydney University, School of Social Sciences

Master of Counselling and Psychotherapy

WELF7020: Practicing Research and Researching Practice

Ireni Farag

September 26th, 2024

Mindfulness-Based Cognitive Therapy in Reducing Anxiety Symptoms Associated with Attachment Orientation in Same-Sex Couples

Anxiety symptoms, characterised by excessive worry, avoidance and a heightened fear response, are the most prevalent global mental health concern (Bandelow & Michaelis, 2015). Research has consistently linked insecure attachment orientation in adults with anxiety symptoms (Mikulincer & Shaver, 2016). In a study, Stevenson et al. (2017) indicate that trait mindfulness has a high probability of playing a pivotal role in explaining the link between insecure attachment styles and anxiety symptoms. Furthermore, existing literature suggests that higher insecure attachment is directly linked to reduced ability mindfulness ability (Stevenson et al., 2021). Finally, a study suggests that higher mindfulness in either partner of a heterosexual romantic relationship mitigates the anxiety symptoms associated with attachment orientation, both within the individual and their relationship (Jaurequi et al.,2023). Thus, the current literature review attempts to explore the influence of mindfulness-based practices and interventions on the intrapersonal and interpersonal attachment orientation of same-sex couples in romantic relationships and proposes how Mindfulness-Based Cognitive Therapy (MBCT) can be adopted by couple and family counsellors as a suitable treatment for anxiety symptoms.

Attachment orientation refers to the typical ways people manage their emotions in their interpersonal relationships, shaped by the care they receive from their attachment figures, such as parents and close partners (Bowlby, 1969). When individuals experience sensitive, loving and supportive care, they develop secure attachment (Bowlby, 1973). Attachment insecurity, however, is understood through two dimensions: anxiety about being abandoned (attachment anxiety) and avoidance of emotional closeness (attachment avoidance) (Bowlby, 1998). This theory is noteworthy in the context of anxiety because in order to fully understand anxiety, it is imperative to consider it in the broader context of an individuals life, especially their romantic relationships. In a milestone study, researchers found that romantic partners significantly influence each others emotional responses, wherein one partners insecure attachment can affect the others tendency to focus on negative information (Ackerman et al. 2011). While malleability in attachment styles is possible (Bowlby, 1988), it is often slow and subtle, and individuals tend to maintain their childhood attachment styles. Therefore, this reveals the need to identify malleable factors that are associated with insecure attachment and anxiety in romantic relationships.

Trait mindfulness, defined as paying attention to the present with attuned, non-judgemental awareness (Kabat-Zinn, 1982), points to a possible modifiable pathway linking insecure attachment and anxiety symptoms (Stevenson et al., 2017). This finding, however, is in direct contradiction with a study that states that while mindfulness may heal insecure attachment wounds, attachment security might also enhance ones ability to be mindful (Goodall et al., 2020). Findings might have been more applicable if the linear assumption that mindfulness directly reduces anxiety linked to attachment orientation was better considered.

However, Creswell (2017) found that trait mindfulness can be strengthened with practice or developed through mindfulness interventions, even brief ones, to manage attachment orientation-based anxiety. Since partners turn to each other for support and validation (Tougas et al., 2016), the authors correctly argue that each partners ability to maintain present-focused, non-judgemental awareness may play a crucial role in managing distress (Bgels & Emerson, 2019). To that end, mindfulness-based interventions seemed to positively affect psychological outcomes between and within partners (Winter et al., 2021). The theoretical premise of MBCT is that building mindfulness skills helps people accept their experiences without reacting or judging, leading to better mental health (Kabat-Zinn, 1982). Additionally, a study by Ghahari et al. (2020) found that MBCT effectively reduced of general anxiety symptoms and sensitivity.

Furthermore, MBCT was found to be effective in reducing depression, anxiety and stress among infertile couples (Masrour et al., 2017). This finding is significant as it demonstrates the efficacy of MBCT within and between couples with anxiety symptoms. Finally, given the effectiveness in the treatment of general anxiety symptoms in individuals and couples, this points to the potential efficacy of MBCT in the alleviation of anxiety symptoms associated explicitly with attachment orientation too. However, this approach does not consider that individuals with high attachment anxiety and avoidance often have negative experiences with mindfulness-based activities such as meditation because of their predisposition to avoid engaging with their thoughts and emotions (Quickert & MacDonald, 2020)

While Jaurequi et al.s (2023) study determines the role that attachment orientation and mindfulness-based strategies play in treating anxiety symptoms in the context of a romantic relationship in a heterosexual relationship, it points to a considerable limitation, i.e., it fails to consider the implications on same-sex couples. Research suggests that discrimination-based distress faced by homosexual couples considerably impacts the way their relationship affects health (Newcomb, 2020). For example, a longitudinal study of gay couples found that minority-based stress had a direct, causal relationship between higher levels of anxiety and negative interactions between partners (Feinstein et al., 2019). This study highlights the gap in existing literature on heterosexual couples and draws attention to the problematic perpetuation that heteronormativity is the cultural standard for romantic relationships, even within the field of research.

A limitation of the studies (Jaurequi et al., 2023; Stevenson et al., 2021) is that they are cross-sectional, suggesting that they are based on empirical findings and have a more theoretical, non-clinical implication. Self-report measures used in the studies (Stevenson et al., 2021; Jaurequi et al., 2023) can introduce bias due to social desirability and inaccurate self-perceptions. Since existing studies (Jaurequi et al., 2023; Ghahari et al., 2020; Masrour et al., 2017) are quantitative in methodology, they only assess whether trait-mindfulness is efficient and not the level of effectiveness.

Therefore, the current mixed-methods study aims to understand the effectiveness and level of effectiveness of MBCT as an intervention to reduce anxiety associated with attachment orientation in the context of same-sex romantic relationships. Not only will the study foster an equitable understanding of the alleviation of anxiety symptomology rooted in attachment styles, in homosexual couples, but it will also bring to attention ways to broaden the understanding of how mindfulness-based interventions can serve as a bridge between personal mental health and relationship dynamics.

References

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Creswell, J. D. (2017). Mindfulness interventions. Annual Review of Psychology, 68, 491516. https:// doi.org/10.1146/annurev-psych-042716-051139

Feinstein, B. A., McConnell, E., Dyar, C., Mustanski, B., & Newcomb, M. E. (2019). The influence of stress on depression and substance use problems among young male same-sex couples: Relationship functioning as an underlying mechanism. Clinical Psychological Science, 7(5), 928940. https:// doi.org/10.1177/2167702619842561

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