Attachment, caregiving, and terminal illness in marital relationships: A qualitative study using attachment theory as a frame for the experience of the well-spouse

This research examined the complex dynamic in marital relationships when a spouse is dying. Published memoirs of seven well-spouses provided the data which were analyzed from an attachment-theoretical perspective. Rigorous adherence to narrative analysis was employed to generate findings. Narratives were analyzed for the experience of attachment on behavioral, cognitive, and emotional levels in the marital relationship as well as descriptions of the experience of caregiving for a spouse who is terminally ill. In addition to narrative analysis of individual memoirs, cross-case comparisons were made and are discussed in terms of similarities and differences in experience. The analysis revealed several noteworthy findings related directly to attachment security of the well-spouse. It was found that dyadic interaction and caregiving quality in the seven marital relationships were impacted by attachment security. Results from this study also provided an in-depth profile of attachment and caregiving dynamics in a secure marital relationship in an intense-need situation. Additional related findings are discussed, including how a spouse's terminal illness threatened the well-spouse's security and how this relates to focus of loss. Throughout all of the findings, it was revealed that affect regulation impacted every aspect of the well-spouse's experience, including the grief process. The findings were related to current adult attachment literature and are shown to contribute to suggestions for future research made by leading attachment researchers. This dissertation concludes with practice implications for individual and couples therapy and recommendations for future research.