Struggle and Blessing. Spirituality and Attachment in Palliative Care

According to John Bowlby, the attachment system is activated in extreme situations of physical or psychological threats such as separation, bereavement, and absence of an important attachment person. Attachment theory differentiates four attachment styles: secure-autonomous, insecure-avoidant, disorganised (unresolved trauma), insecure-enmeshed. Attachment-to-God theory offers an understanding of transcendent attachment figures such as God, Jesus, Buddha, Mohammed, Mary, etc. and focuses on the individual patient’s image of God. Spiritual care in the palliative situation may benefit from an attachment-to-God approach, respecting diverse denominational and religious orientations, and the patient’s representations and need of security. This helps nurses, doctors, chaplains, and other accompanying persons provide a secure base for the patient’s last departure.