Using attachment theory to understand patients' responses to a therapist's medical break

The impact of a therapist's planned medical break is described and discussed, using attachment theory. The break is compared to Ainsworth's strange situation test and the responses of patients with avoidant, ambivalent and disorganised patterns of attachment are explored. The paper examines patients' responses at the point where news of the break is given and on reunion and looks at communication through breaks in the frame. An overview is given of the understanding of separation and loss in broader analytic theory and the ways in which these complement Bowlby's theory. The clinical cases are reviewed in the light of several authors.