Trust and the Role of Attachment: Implications for Oncology

The ability to form an attachment is integral to trust. Attachment is a well-studied phenomenon of human relationships and the nature of development. Originally described in children, attachment styles are psychologically active in adults as well, especially during times of stress. Anxious and avoidant attachments styles well described in adults remain particularly relevant throughout the life span and particularly during times of acute stress. A diagnosis of cancer calls upon a person’s innate attachment tendencies and style. These attachment phenomena work in tandem with trust, yet not exactly parallel. Secure attachment is commonly associated with trust, but anxious and avoidant attachment styles may also be associated with trust and reflect other interpersonal limitations of a patient or clinician. Clinicians working in oncology witness and find themselves interfacing with patients’ unique attachment tendencies. This chapter begins with a description of the key attachment styles and their association with trust. Clinical examples of these key attachment styles and how they may become manifest in oncology settings are provided. Lastly, the chapter offers clinical suggestions in the consideration of attachment in facilitating and cultivating trustful relationships with patients.