Attachment in Psychotherapy

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His work has sparked tremendous interest and exploration into attachment styles and how they may inform individuals’ relationships in adulthood. Studies of ruptures and discourse analysis distinguish in-session behaviors associated with different patterns of insecure attachments, and identify distinct ways of working with them. Attachment theory has tended to make two basic assumptions about the ways these internal working models work: first, they are believed to arise in early development in response to variations in the quality of care and in that sense they are initially highly plastic and environmentally-driven. The optimal distance to create a corrective emotional experience differed for each of the two types of clients, and differed through the three therapeutic phases of engagement, working through, and termination.

These were loss and abandonment, negative interpersonal feelings, and a need to be close and to feel cared for. In contrast, some clients use a deactivating attachment strategy in therapy, just as they do in other close relationships.

Once you have established that a therapist has the credentials and experience you are looking for, it is important to make sure you are comfortable working with that person.

John Bowlby and Colin Murray Parkes realised that identifying the differing patterns of attachment manifested by different people who had suffered loss, and adapting psychotherapy accordingly, better helped them to deal with the bereavement. Based on his work, Bowlby described four different attachment styles: secure attachment, anxious attachment, avoidant attachment, and disorganized attachment. Therefore, clinicians not only need to focus on changing maladaptive coping strategies, but also need to understand the underlying unmet needs that are satisfied by the use of these strategies as well as help individuals learn alternative ways to satisfy their psychological or emotional needs.

A 'must read' for psychotherapists who wish to remain on top of their field, and a rich resource for clinicians in training.