Abstract
There is an abundance of research demonstrating significant relationships between romantic attachment and sexual intimacy, which in this study refers to sexual communication and sexual satisfaction. However, not many interventions specifically and simultaneously target these two important aspects of romantic relationships. Furthermore, there are a lack of affordable and accessible psychoeducational interventions that provide opportunities for couples to gain basic knowledge about romantic attachment and sexual intimacy. To fill this gap, the authors of the current study took a 10-week, eight-session attachment-focused intervention (The Hold Me Tight Program: Seven Conversations for Connection), adapted it into a 1-day workshop, and focused on the role that attachment plays in sexual intimacy. Pilot data was collected to examine treatment feasibility, acceptability, and knowledge acquisition. In addition, exploratory efficacy data was analyzed with respect to changes in couple attachment patterns, sexual communication and satisfaction, and overall relationship satisfaction. Quantitative results revealed that participating couples showed increases in perceived knowledge acquisition and actual knowledge acquisition about concepts related to attachment and sexual intimacy. Qualitative and quantitative pilot data suggested movement in the expected direction for improvements in couples’ romantic attachment patterns, sexual satisfaction, sexual communication, and relationship satisfaction with a trend towards a statistically significant increase in sexual satisfaction.
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References
Ainsworth, M. D. S., Blehar, M. C., Waters, S., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale: Erlbaum. https://doi.org/10.1037/0012-1649.39.3.387.
Banmen, J., & Vogel, N. A. (1985). The relationship between marital quality and interpersonal sexual communication. Family Therapy, 12(1), 45. Retrieved March 10, 2018 from http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=psyh&AN=1985-30615-001&site=ehost-live&custid=s9004892.
Borkovec, T. D., & Nau, S. D. (1972). Credibility of analogue therapy rationales. Journal of Behavior Therapy and Experimental Psychiatry, 3(4), 257–260. https://doi.org/10.1016/0005-7916(72)90045-6.
Bowlby, J. (1973). Attachment and loss, vol. II: Separation. Basic Books.
Bowlby, J. (1988). A secure base. New York: Basic Books.
Bradford, A. B., Hawkins, A. J., & Acker, J. (2015). If we build it, they will come: Exploring policy and practice implications of public support for couple and relationship education for lower income and relationally distressed couples. Family Process, 54(4), 639–654. https://doi.org/10.1111/famp.12151.
Bradley, B., & Furrow, J. L. (2004). Towards a mini-theory of the blamer softening event: Tracking the moment-by-moment process. Journal of Marital and Family therapy, 30(2), 233–246. https://doi.org/10.1111/j.1752-0606.2004.tb01236.
Burgess Moser, M., Johnson, S. M., Dalgleish, T. L., Lafontaine, M. F., Wiebe, S. A., & Tasca, G. A. (2015). Changes in relationship-specific attachment in emotionally focused couple therapy. Journal of Marital and Family Therapy. https://doi.org/10.1111/jmft.12139.
Busby, D. M., Christensen, C., Crane, D. R., & Larson, J. H. (1995). A revision of the Dyadic Adjustment Scale for use with distressed and nondistressed couples: Construct hierarchy and multidimensional scales. Journal of Marital and Family Therapy, 21(3), 289–308. https://doi.org/10.1111/j.1752-0606.1995.tb00163.
Butzer, B., & Campbell, L. (2008). Adult attachment, sexual satisfaction, and relationship satisfaction: A study of married couples. Personal Relationships, 15(1), 141–154. https://doi.org/10.1111/j.1475-6811.2007.00189.x.
Byers, E. S. (2011). Beyond the birds and the bees and was it good for you?: Thirty years of research on sexual communication. Canadian Psychology/Psychologie Canadienne, 52(1), 20. https://doi.org/10.1037/a0022048.
Carr, A. (2014). The evidence base for couple therapy, family therapy and systemic interventions for adult-focused problems. Journal of Family Therapy, 36(2), 158–194. https://doi.org/10.1111/1467-6427.12033.
Catania, J. A. (1998). Dyadic sexual communication scale. In Handbook of sexuality-related measures (pp. 129–131).
Ciocca, G., Limoncin, E., Di Tommaso, S., Mollaioli, D., Gravina, G., Marcozzi, A.,… Gianfrilli, D. (2014). Attachment styles and sexual dysfunctions: a case–control study of female and male sexuality. International journal of impotence research, 27(3), 81-85. https://doi.org/10.1038/ijir.2014.33
Cohen, S., O’Leary, K. D., Foran, H. M., & Kliem, S. (2014). Mechanisms of change in brief couple therapy for depression. Behavior Therapy, 45(3), 402–417. https://doi.org/10.1016/j.beth.2014.01.003.
Creswell, J. W., & Clark, V. L. P. (2018). Designing and conducting mixed methods research. Sage publications.
Cummings, E. M., Faircloth, W. B., Mitchell, P. M., Cummings, J. S., & Schermerhorn, A. C. (2008). Evaluating a brief prevention program for improving marital conflict in community families. Journal of Family Psychology, 22(2), 193. https://doi.org/10.1037/0893-3200.22.2.193.
Dalgleish, T. L., Johnson, S. M., Burgess Moser, M., Lafontaine, M. F., Wiebe, S. A., & Tasca, G. A. (2015). Predicting change in marital satisfaction throughout emotionally focused couple therapy. Journal of Marital and Family Therapy, 41(3), 276–291. https://doi.org/10.1111/jmft.12077.
Davis, D., Shaver, P. R., Widaman, K. F., Vernon, M. L., Follette, W. C., & Beitz, K. (2006). “I can’t get no satisfaction”: Insecure attachment, inhibited sexual communication, and sexual dissatisfaction. Personal Relationships, 13(4), 465–483. https://doi.org/10.1111/j.1475-6811.2006.00130.
Denton, W. H., Johnson, S. M., & Burleson, B. R. (2009). Emotion-focused therapy-therapist fidelity scale (EFT-TFS): Conceptual development and content validity. Journal of Couple & Relationship Therapy, 8(3), 226–246. https://doi.org/10.1080/15332690903048820.
Devilly, G. J., & Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31(2), 73–86. https://doi.org/10.1016/S0005-7916(00)00012-4.
Fisher, J., Rowe, H., Wynter, K., Tran, T., Lorgelly, P., Amir, L. H., et al. (2016). Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial. British Medical Journal Open, 6(3), e009396. https://doi.org/10.1136/bmjopen-2015-009396.
Fisher, A. R., Stokey, M. F., Sasaki, H. M., & Sexton, T. L. (2014). When it helps, when it hurts: Preliminary results of relationship enhancement education and the hold me tight program. Psychology, 5(10), 1254. https://doi.org/10.4236/psych.2014.510137.
Fitzgerald, J., & Thomas, J. (2012). A report: Couples with medical conditions, attachment theoretical perspectives and evidence for emotionally-focused couples therapy. Contemporary Family Therapy, 34(2), 277–281. https://doi.org/10.1007/s10591-012-9184-8.
Fournier, D. G., Olson, D. H. & Druckman, J. M. (1983). Assessing marital and premaritalrelationships: The PREPARE-ENRICH Inventories. In E. E. Filsinger (Ed.), Marriage and family assessment (pp. 229–250). Beverly Hills, CA: Sage Publishing.
Fraley, R. C., & Shaver, P. R. (2000). Adult romantic attachment: Theoretical developments, emerging controversies, and unanswered questions. Review of General Psychology, 4(2), 132. https://doi.org/10.1037/1089-2680.4.2.132.
Greenman, P. S., & Johnson, S. M. (2013). Process research on emotionally focused therapy (EFT) for couples: Linking theory to practice. Family Process, 52(1), 46–61. https://doi.org/10.1111/famp.12015.
Halchuk, R. E., Makinen, J. A., & Johnson, S. M. (2010). Resolving attachment injuries in couples using emotionally focused therapy: A three-year follow-up. Journal of Couple & Relationship Therapy, 9(1), 31–47. https://doi.org/10.1080/15332690903473069.
Hawkins, A. J., Allen, S. E., & Yang, C. (2017). How does couple and relationship education affect relationship hope? An intervention-process study with lower income couples. Family Relations, 66(3), 441–452. https://doi.org/10.1111/fare.12268.
Hawkins, A. J., Blanchard, V. L., Baldwin, S. A., & Fawcett, E. B. (2008). Does marriage and relationship education work? A meta-analytic study. Journal of Consulting and Clinical Psychology, 76(5), 723. Retrieved March 10, 2018 from http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=eric&AN=EJ823790&site=ehost-live&custid=s9004892.
Hazan, C., & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52(3), 511. https://doi.org/10.1037/0022-3514.52.3.511.
Hendrick, S. S., Dicke, A., & Hendrick, C. (1998). The relationship assessment scale. Journal of Social and Personal Relationships, 15(1), 137–142. https://doi.org/10.1016/j.mefs.2018.04.001.
Hudson, W. W., Harrison, D. F., & Crosscup, P. C. (1981). A short-form scale to measure sexual discord in dyadic relationships. Journal of Sex Research, 17, 157–174.
Johnson, S. M. (2004). The practice of emotionally focused couple therapy: Creating connection. Abingdon: Routledge.
Johnson, S. (2010). The hold me tight program: Conversations for connection. Ottawa: International Centre for Excellence in Emotionally Focused Therapy.
Johnson, S. M., & Greenberg, L. S. (1985a). The differential effects of experiential and problem solving interventions in resolving marital conflicts. Journal of Consulting and Clinical Psychology, 53, 175–184. https://doi.org/10.1037/0022-006X.53.2.175.
Johnson, S. M., & Greenberg, L. S. (1985b). Emotionally focused couples therapy: An outcome study. Journal of Marital and Family Therapy, 11(3), 313–317. https://doi.org/10.1037/0022-006X.53.2.175.
Johnson, S., & Zuccarini, D. (2010). Integrating sex and attachment in emotionally focused couple therapy. Journal of Marital and Family Therapy, 36(4), 431–445. https://doi.org/10.1111/j.1752-0606.2009.00155.x.
Khoury, C. B., & Findlay, B. M. (2014). What makes for good sex? The associations among attachment style, inhibited communication and sexual satisfaction. Journal of Relationships Research, 5, e7. https://doi.org/10.1017/jrr.2014.7.
Kornbluh, M., Ozer, E. J., Allen, C. D., & Kirshner, B. (2015). Youth participatory action research as an approach to sociopolitical development and the new academic standards: Considerations for educators. The Urban Review, 47(5), 868-892. Retrieved March 10, 2018 from http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=eric&AN=EJ1082403&site=ehost-live&custid=s9004892.
Lebow, J. L., Chambers, A. L., Christensen, A., & Johnson, S. M. (2012). Research on the treatment of couple distress. Journal of Marital and Family Therapy, 38(1), 145–168. https://doi.org/10.1111/j.1752-0606.2011.00249.x.
Lynch, L.E. (2015). Couples coping with cancer: A hold me tight pilot intervention study (Doctoral dissertation, Drexel University).
MacNeil, S., & Byers, E. S. (2009). Role of sexual self-disclosure in the sexual satisfaction of long-term heterosexual couples. Journal of Sex Research, 46(1), 3–14. https://doi.org/10.1080/00224490802398399.
Main, M., & Solomon, J. (1986). Discovery of a new, insecure-disorganized/disoriented attachment pattern. In M. Yogman & B. Brazelton (Eds.), Affective development in infancy. Norwood: Albex.
McCarthy, B. (2003). Marital sex as it ought to be. Journal of Family Psychotherapy, 14(2), 1–12.
McLanahan, S., & Sawhill, I. (2015). Marriage and child wellbeing revisited: Introducing the issue. The Future of Children, 25(2), 3–9.
Mikulincer, M., & Shaver, P. R. (2010). Attachment in adulthood: Structure, dynamics, and change. Guilford Press.
Péloquin, K., Bigras, N., Brassard, A., & Godbout, N. (2014). Perceiving that one’s partner is supportive moderates the associations among attachment insecurity and psychosexual variables. The Canadian Journal of Human Sexuality, 23(3), 178–188. https://doi.org/10.3138/cjhs.2443.
Rhoades, G. K. (2015). The effectiveness of the within our reach relationship education program for couples: Findings from a federal randomized trial. Family Process, 54(4), 672–685. https://doi.org/10.1111/famp.12148.
Sandberg, J. G., Busby, D. M., Johnson, S. M., & Yoshida, K. (2012). The brief accessibility, responsiveness, and engagement (BARE) scale: A tool for measuring attachment behavior in couple relationships. Family Process, 51(4), 512–526. https://doi.org/10.1111/j.1545-5300.2012.01422.x.
Shadish, W. R., & Baldwin, S. A. (2003). Meta-analysis of MFT interventions. Journal of Marital and Family therapy, 29(4), 547–570. https://doi.org/10.1111/j.1752-0606.2003.tb01694.x.
Soleimani, A. A., Najafi, M., Ahmadi, K., Javidi, N., Kamkar, E. H., & Mahboubi, M. (2015). The effectiveness of emotionally focused couples therapy on sexual satisfaction and marital adjustment of infertile couples with marital conflicts. International Journal of Fertility & Sterility, 9(3), 393. Retrieved March 10, 2018 from http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=a9h&AN=110709420&site=ehost-live&custid=s9004892.
Štulhofer, A., Buško, V., & Brouillard, P. (2010). Development and bicultural validation of the new sexual satisfaction scale. Journal of Sex Research, 47(4), 257–268. https://doi.org/10.1080/00224490903100561.
Theiss, J. A. (2011). Modeling dyadic effects in the associations between relational uncertainty, sexual communication, and sexual satisfaction for husbands and wives. Communication Research, 38(4), 565–584. https://doi.org/10.1177/0093650211402186.
Tilden, T., & Dattilio, F. M. (2005). Vulnerability schemas of individuals in couples relationships: A cognitive perspective. Contemporary Family Therapy, 27(2), 139–162. https://doi.org/10.1007/s10591-005-4036-4.
Timm, T. M., & Keiley, M. K. (2011). The effects of differentiation of self, adult attachment, and sexual communication on sexual and marital satisfaction: A path analysis. Journal of Sex and Marital Therapy, 37(3), 206–223. https://doi.org/10.1080/0092623X.2011.564513.
Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398–405. https://doi.org/10.1111/nhs.12048.
Vaus, D., Gray, M., Qu, L., & Stanton, D. (2017). The economic consequences of divorce in six OECD countries. Australian Journal of Social Issues, 52(2), 180–199. https://doi.org/10.1002/ajs4.13.
Verschueren, K., Marcoen, A., & Schoefs, V. (1996). The internal working model of the self, attachment, and competence in five-year-olds. Child Development, 67, 2493–2511. https://doi.org/10.2307/1131636.
Weinfurt, K. P., Lin, L., Bruner, D. W., Cyranowski, J. M., Dombeck, C. B., Hahn, E. A., et al. (2015). Development and initial validation of the PROMIS® sexual function and satisfaction measures version 2.0. The Journal of Sexual Medicine, 12(9), 1961–1974. https://doi.org/10.1111/jsm.12966.
Wiebe, S. A., & Johnson, S. M. (2016). A review of the research in emotionally focused therapy for couples. Family Process, 55(3), 390–407.
Wood, N. D., Werner-Wilson, R. J., Parker, T. S., & Perry, M. S. (2012). Exploring the impact of attachment anxiety and avoidance on the perception of couple conflict. Contemporary Family Therapy, 34(3), 416–428. https://doi.org/10.1007/s10591-012-9202-x.
Zayas, V., Mischel, W., Shoda, Y., & Aber, J. L. (2011). Roots of adult attachment maternal caregiving at 18 months predicts adult peer and partner attachment. Social Psychological and Personality Science, 2(3), 289–297. https://doi.org/10.1177/1948550610389822.
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Morgis, B.L., Ewing, E.S.K., Liu, T. et al. A Hold Me Tight Workshop for Couple Attachment and Sexual Intimacy. Contemp Fam Ther 41, 368–383 (2019). https://doi.org/10.1007/s10591-019-09504-x
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DOI: https://doi.org/10.1007/s10591-019-09504-x