What is Attachment therapy?
Attachment therapy is based on the idea that humans, and more widely mammals, seek to form attachments with each other. The most basic example of this is the parenting and nurturing attachment with offspring. Beyond that we see friendships, family units, tribes, and coupling (or other romantic groups).
The term comes out of the work of Piaget, but other therapy modalities such as psychodynamic and eastern psychology have similar ways of looking at how mammals attach to each other.
Attachment is a vital factor in healthy relationships, if the attachment is not healthy (known as “secure”), then the relationship will not be healthy.
Attachment is a developmental process which occurs over the life span of the human or mammal, although there are thought to be three key stages:
- First 18 months of human life: where the totally dependent newborn baby is bonding with the care giver (usually but not always the mother).
- Around 4 to 5 years old, when the young person is really starting to realise that they are a separate entity and not an appendage to the care giver.
- Adolescence, where the young adult is developing more complex senses of self identity and self awareness, often through challenge and negotiation.
Potentially from the work of Jung and others we might also consider the 20’s as a period of searching for career and life direction, middle age as a period of consolidation, late middle age as a period of reevaluation (“mid life crisis”), and the later years as a period of winding down and taking new roles.
Each stage requires healthy development, otherwise the result will be differences or issues (known as “adaptations”) being carried into the next. As you might imagine this means that the resulting development goes down alternative paths.
Developmental issues with attachment
So what happens when the young human “adapts” and goes down a different path, and why would this happen?
There are two types of trigger in development that cause adaptation, and both are considered reasons for attachment issues, also often considered forms of complex PTSD.
Firstly the more obvious is trauma in the form of “harm”. Physical, sexual, emotional or environmental trauma causes adaptation to cope with danger. This is perhaps easier to imagine, since it is dramatic and clear cut (although obviously awful).
The second form of trauma is “lack”. Humans, and indeed other mammals have certain needs. These include:
- Safety – being keep safe from harm by a care giver, and feeling protected.
- Nurture – being encouraged to grow and develop, and being provided with the practical and emotional support required.
- Acceptance – being acceptated and acceptable to the care giver and group as identity develops
- Encouragement – being encouraged and empowered to grow and develop, and not held back or disempowered or directed.
- The assumption of repair – conflict and error cause “ruptures” (cross words or upset) with the care giver or others. Assuming this will be repaired and resolved is a form of what is sometimes called Unconditional Positive Regard (nothing you do will cause me to reject you – even if I am briefly cross).
If these factors are not catered for in a healthy way most of the time (does not have to be perfect all the time), the effects are adaptation:
- Lack of safety – living in fear, in survival mode, waiting for and expecting the next challenge or disaster (“waiting for the other shoe to drop”).
- Lack of nurture – not having what is needed to develop and grow, feeling stuck and held back, or feeling helpless.
- Lack of acceptance – not being validated, instead feeling fear of rejection, perhaps because of a belief, sexuality or behaviour. Fear of rejection at an early age causes a terror response (care giver is needed to survive so rejection could mean abandonment and death).
- Lack of encouragement – being directed, held back, discouraged or told negative things can cause internalised doubt and poor self image.
- Lack of assuming repair – leads to a fear that any conflict will be catastrophic and never be resolved. This leads to great fear of conflict and occasionally preemptive angry behaviour or disproportionate behaviours.
- With and alongside the above can be a general fear because of not being met, made to feel safe, being wanted or welcome, that means that the person does not feel safe in their own body, does not feel safe having feelings, does not recognise their value or right to be, and does not “see” themselves.
Developmental issues needing resolution
Since Piaget there have been a wide number of psychologists and other researchers contributing to the field and an unfortunate side effect of this is that different groups use different labels or descriptors. Sometimes groups will use the same descriptor for different things, making life confusing. Therefore here the descriptions are non technical instead!
- The person is scared of rejection and abandonment and resorts to trying too hard in an anxious manner to please people and keep them present.
- The person is so used to rejection that they avoid other people and distance themselves. Relationships might be functional, getting work, sex or other outcomes without any depth of relationship.
- The person craves a healthy relationship but is scared of rejection, and therefore sometimes pulls people towards them, but then tends to panic and push them away.
- The person has convinced themselves that they do not really care about relationships and is ambivalent about them.
- The person take on the behaviours and methods of those who have hurt them, either consciously or unconsciously, and becomes hurtful or manipulative of others themselves.
- Alongside the above is the problem of people “internalising” negative beliefs and behaviours and self blaming, or treating themselves harshly because that is what they are used to from others.
- The person is essentially reacting to the type of dysfunctional attachment shown to them, and repeating it in a adaptive way, but under the surface they really need secure attachment.
Resolving attachment development issues
What everyone benefits from is healthy “secure” attachment. By letting go of the fear from trauma and gradually exploring what healthy attachment looks and feels like, and learning to feel safe with it, the person can heal.
There are stages in recovery and it really can not be rushed. Generally although some initial results can be dramatic and positive, long term recovery takes time because it is complex development that needs addressing. At each stage the client is asked to try new ways of behaving, all of which are counter intuitive and feel risky. Therefore this needs to be gradual and at a pace that enables growth, not so fast that it causes more fear and pain. At each completed stage the client then needs time to breathe and reflect and enjoy, before engaging in more growth. Along the way the client needs to build resilience, because although they may be away from the causes of pain and trauma, and therefore there is no “other shoe to drop”, that does not mean that life will be entirely smooth. This means that any hiccups along the way need to be understood as separate from the past, not a repeat. Of course once this occurs, the client feels stronger and more confident as they overcome these things, while maintaining more healthy relationships.
It is important to remember that this is a highly studied area of psychology, and the processes used to enable more positive attachment are effective and predictable in their outcomes if used gently, patiently and according to the individuals needs. Key parts of the process, which is by nature integrative, include parts work (healing the parts and stages of the person), trying new relationship strategies (psycho-education), reconnecting to intuition and physiological responses (somatic processing), understanding beliefs and internalised beliefs (analysis, awareness and change), and massively importantly: self compassion. Additional methods might include hypnosis based regression or somatic processing, mindfulness, CBT self monitoring, analysing interpersonal relationship models, analysing significant personalities in past or present, and body work (often Chi Gung, Yoga or other exercise or massage).
Attachment based therapy works with both individual clients and relationships. It is also highly relevant to people coming out of particular lifestyles such as military service, or those who have faced discrimination due to sexual orientation or faith.
I (Stuart) am an integrative and multi modal therapist and analyst, currently (2020) in my 27th year of professional practice. A speciality throughout my career has been trauma, in particular complex PTSD, and related attachment issues. As well as studying a range of appropriate therapies to graduate and post graduate level, I have completed extensive Continuous Professional Development in the specific field of integrative work (recommended for complex PTSD and attachment), attachment therapy and complex PTSD. My competencies, accreditations and CPD training are all listed HERE