Separation Anxiety: The Core of Attachment and Separation-Individuation

This paper, written in honor of Anni Bergman, focuses on the concept of separation anxiety as it was conceptualized and developed in attachment theory by Bowlby and in separation-individuation theory by Mahler and colleagues. The focus is on how separation anxiety manifests differentially in individuals with secure versus insecure attachment and in different subphases of the separation-individuation process, with emphasis on the areas of overlap and divergence in the two traditions. The paper then reviews recent research that has focused on how separation anxiety has provided a transdiagnostic risk factor for psychopathology, including anxiety, depression, and PTSD, complicating the treatment course of individuals with these disorders. These findings have contributed to the delineation of the DSM-5 diagnosis of Separation Anxiety Disorder (SAD) and to the development of new assessment instruments to measure it. We consider how separation anxiety has been assessed in several treatment studies of these disorders and how it is related to other factors such as insecure attachment and reflective function (RF, mentalization in attachment relationships). The ways in which recent research on separation anxiety in individuals with psychopathology, including depression and PTSD, has affirmed and expanded the original formulations of Bowlby and Bergman and her colleagues is also discussed.