The tie that binds: Affect regulation, attachment, and psychoanalysis.

Psychoanalytic theory has both expanded and altered its constructs in response to clinical work. The attachment system is a construct in need of integration, and it requires its own motivational status in psychoanalytic theory. The author regards affect regulation (mutual and self-regulation) as a key aspect of the attachment system and as an addendum to Bowlby's ideas, one that is consistent with contemporary findings in infant research. A published case and 2 clinical cases are used to demonstrate the usefulness of the concepts of mutual and self-regulation in clinical work. Illustrated as well are the benefits of an integration of affect regulation and traditional motives for optimizing clinical work. The inclusion of these motivational constructs provides for a more comprehensive psychoanalytic theory that offers enriched explanations of complex psychic and behavioral phenomena.