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Evidence-Based Complementary and Alternative Medicine
Volume 2013, Article ID 740291, 14 pages
Research Article

Attachment Theory and Spirituality: Two Threads Converging in Palliative Care?

1Ludwig Maximilians University of Munich, Clinic and Policlinic for Palliative Medicine, Germany
2Munich School of Philosophy, Germany
3Ludwig Maximilians University of Munich, Clinic and Policlinic for Palliative Medicine, Munich School of Philosophy, Germany
4Hospital of the “Barmherzige Brüder,” Palliative Unit, Germany
5Research Unit of Health, Man and Society, Institute of Public Health, SDU, Denmark
6Freiburg Institute for Advanced Studies, Germany

Received 10 July 2013; Revised 10 September 2013; Accepted 16 September 2013

Academic Editor: Harold G. Koenig

Copyright © 2013 Cécile Loetz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The aim of this paper is to discuss and explore the interrelation between two concepts, attachment theory and the concept of spirituality, which are important to palliative care and to founding a multivariate understanding of the patient’s needs and challenges. Both concepts have been treated by research in diverse and multiform ways, but little effort has yet been made to integrate them into one theoretical framework in reference to the palliative context. In this paper, we begin an attempt to close this scientific gap theoretically. Following the lines of thought in this paper, we assume that spirituality can be conceptualized as an adequate response of a person’s attachment pattern to the peculiarity of the palliative situation. Spirituality can be seen both as a recourse to securely based relationships and as an attempt to explore the ultimate unknown, the mystery of one’s own death. Thus, spirituality in the palliative context corresponds to the task of attachment behavior: to transcend symbiosis while continuing bonds and thus to explore the unknown environment independently and without fear. Spiritual activity is interpreted as a human attachment behavior option that receives special quality and importance in the terminal stage of life. Implications for clinical practice and research are discussed in the final section of the paper.