Exploring Attachment Incoherence in Bereaved Families’ Therapy Narratives: An Attachment Theory-Informed Thematic Analysis

Attachment theory predicts that family bereavement leads even securely attached individuals to experience temporary attachment insecurity. This article explores how incoherence, a narrative marker of attachment insecurity, is displayed in the talk of families undergoing bereavement family therapy. This study uses the lens of attachment theory, and specifically the Adult Attachment Interview (AAI), to explore how members of five families talked about the loss of a close family member and how interactions between therapist and family members could hinder a coherent dialogue about the death. The families were recruited through Winston's Wish, a UK-based family bereavement charity. The analysis centers on the "Telling the story" intervention, used at the start of therapy, in which family members together tell the story of the death. Families also retold the story in an extra family session toward the end of the therapy for the purposes of this research. Transcripts of the therapy sessions were analyzed using thematic analysis, with some codes developed directly from the unresolved loss codes of the AAI and other codes generated from analyzing the transcripts through the lens of attachment theory. Through a micro focus on therapy process, the study provides tentative support for suppositions in attachment theory about the psychological importance of (fostering) coherent speech as well as information about potentially helpful versus unhelpful therapist actions in family bereavement therapy. The findings have relevance for bereavement therapy interventions, therapy training, and research practice.