anadolu klin

Anatolian Clinic the Journal of Medical Sciences

2149-5254 2458-8849

Hayat Sağlık ve Sosyal Hizmetler Vakfı

10.21673/anadoluklin.237462

Health Care Administration

Sağlık Kurumları Yönetimi

Bağlanma Teorisi ve Bağlanma Bozukluklarına Genel Bir Bakış

Attachment Theory and A Glance at Attachment Disorders

Yıldızhan

Eren

Istanbul Bakırköy Ruh Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi

12 30 2016

22 1 66 72 06 09 2016 11 21 2016

1933

Anadolu Kliniği Tıp Bilimleri Dergisi

Bağlanma sistemi, bebeğin hayatta kalması ile ilgiliyaşamsal önemi olan, sadece insana özgü olmayıp doğada bütün memeli türlerindegörülen evrimsel bir sistemdir. Anne çocuk ilişkisinden başlayarak kişinin hayatı boyuncakurduğu bütün ilişkilere bir taslak olan bağlanma, kronik hastalık durumlarındakişinin tedavi ekibi ile kurduğu ilişkide de belirleyici olabilmektedir.Temelde güvenli ve güvensiz bağlanma olarak ikiye ayrılır, güvensiz bağlanmaise kendi içinde kaygılı bağlanma, kaçıngan bağlanma ve dezorganize bağlanmaolmak üzere üç tiptir. Güvenli bağlanması olmayan kişiler, bazen sorunlu ilişkikurma biçimleri nedeni ile “zor hasta” olarak tanımlanarak klinik ilgi odağıolmaktadırlar. Bağlanma biçimleri ve buradan kaynaklanabilecek olası sorunlar,literatürdeki bilgiler ışığında incelendiğinde, basit birtakım girişimlerindoktor-hasta ilişkisindeki bazı zorluklara çözüm olabileceği görülmektedir.Hastaların farklı bağlanma biçimlerini dikkate almak ve hasta ile işbirliğiiçinde tedaviyi planlamak, hastaya sunulan hizmetin kişiye özgü düzenlenmesindeyol gösterici olabilir. John Bowlby tarafından temelleri atılan bağlanmateorisi ile ilgili bilgi sahibi olmak ve hastaların farklı bağlanma biçimlerinitanıyarak terapötik işbirliğinde nasıl konumlandığımızı dışarıdan görmek,doğabilecek sorunları önceden kestirmeye yarayabilir ve bize birtakım çözümönerileri sunabilir.

Attachment system which has survival importance for thebaby, is not unique to humans, it is an evolutionary system that is seen innature in all mammals.Attachment, as a template for all reliationships, beginingwith the mother-baby interaction, may have a decisive role in states of chronicdisease. Basicly, attachment can be secure or insecure; insecure attachment hasalso three types: anxious attachment, avoidant attachment and disorganisedattachment. Patients lacking a secureattachment pattern may be in the focus of clinical attention as “difficultpatients” due to the maladaptive reliationship patterns. When we invesitegatethe attachment patterns and problems related to these patterns in theliteratüre, we observe that certain basic interventions can be solution for theproblems in doctor-patient reliationship. Considering the patient’s attachmentstyle and making a plan in collaboration with the patient is heplful inindividualising care. Having knowledge of the attachment theory of John Bowlbyand having an outsider perspective of our place in the therapeutic alliance byrecognizing different attachment patterns of patients may help us to predictpotential problems and find possible solutions.

Attachment; Treatment Adherence; Difficult Patient

Bağlanma; Tedaviye Uyum; Zor Hasta

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