Cognitive perspectives on unresolved loss: insights from the study of PTSD.

The authors begin by reviewing recent work on attachment disorganization and its association with parental unresolved loss. They draw connections between this literature and recent theoretical and empirical work on trauma and posttraumatic stress disorder (PTSD). They propose that unresolved loss involves intrusion and avoidance phenomena similar to those of PTSD. Specifically, they develop a model based on the notion that unresolved loss involves the failure to integrate representations of self and the world following a loss. The features of unresolved loss can be understood as emerging as a result of the activation of unintegrated representations of the loss experience and cognitive and behavioral avoidance processes. In this model, the sudden intrusion of memories, cognitions, and emotions associated with the loss automatically captures attention and initiates behavioral dispositions that are incompatible, and hence interfere, with caregiving behavior. Lack of attentional resources and incompatible response-tendencies can also result from safety behaviors directed at avoiding the perceived negative consequences of activating trauma memory. The authors propose that these processes offer a novel way of understanding the disturbances in behavior and speech that are evident in parents who are classified as unresolved with respect to loss in the Adult Attachment Interview.