Therapy Through an Attachment Lens
Attachment Theory
Attachment theory lies at the heart of my trauma practice and approach to treatment. In a nutshell, attachment theory looks to our early interactions with caregivers that have significant impact on adult coping skills and form the blueprint of our identity and how we relate to others. Fundamental to this approach is how we interact with others which is one of the reasons we work with group therapy alongside individual sessions. Our identity, emotional regulation, self-perception and our perception of others are keenly influenced in the context of supportive others. If we develop without that underlying need to feel seen and heard, part of belonging, this can have a significant impact on our ability to manage stress, hold a positive regard for our Self and others. Many find themselves in negative feedback loops and experiences as a result.
Attachment and Trauma
Many individuals who are new to therapy frame their concerns around specific issues that they have difficulty solving. This makes total sense. However, they often seek intellectualized solutions that may provide temporary relief, but don’t address underlying issues. Attachment concerns may not necessarily be perceived as classic trauma, but both relate to nervous system reactivity to perceived threat. We may not think of a partner and our communication issues as signaling “threat,” but the body does not operate and respond to cues from our environment the same way as our thinking brain. Hence, this is why a trauma therapist skilled in supporting PTSD also works with attachment concerns primarily from a mindfulness and body-based somatic approach. How we regulate and relate are intertwined. See the graphic below on the overlap and also some of the common distinctions between attachment related issues, (that can present as the DSM condition Borderline Personality Disorder) and C-PTSD (Complex Post Traumatic Stress Disorder).
ADHD, Autism and Attachment
Of course, all of this can be complicated when neurodivergence, especially ADHD and/or Autism is in the picture. (There are other recognized forms of neurodivergence, but these are the two that are the focus of this practice). The reality of the ADHD and also Autistic experiences is that individuals are more vulnerable to lack of bonding and attachment as well as trauma. Some of this is from the circumstances in which ADHDers and Autistics find themselves, the taxing nature of dysregulation, misdiagnoses and misunderstanding as well as certain vulnerabilities that research shows exist from birth. (E.g. Autistic babies having some difficulty latching on to breast feeding and experiencing discomfort).
Affect and Attachment
Attachment is the lens through which we understand ourselves and relationships with others (something vital to couples work). It is also connected to affect regulation, i.e. how we regulate. In other words, attachment has everything to do with Self, regulating and relating. Independence is all well and good, but how we connect to others has a major impact on our overall resilience.
Indeed, secure attachment is a significant way in which we can help heal trauma. (For more information on PTSD, complex trauma, please click here). Trauma splits us from our natural abilities where we lose our inner compass. Secure attachment helps facilitate the transformational process that is inherent in all of us to better tolerate all of our experiences.
Limerance
Limerance is an emotional state that has some overlap with other recognizable mental health conditions such as OCD and addiction. It also shares the intense euphoria and heightened senses that exist in certain other conditions such as those with borderline traits. The effects and complexity can be complicated with added neurodivergence such as Autism and/or ADHD, not to mention relational trauma. All of this underscores the necessity of working with a professional to help “unpack” what is happening and more importantly, select interventions that are helpful. Much of limerence has its origins in anxious attachment and can be understood when we explore some of the stress responses associated with lack of secure attachment in early childhood. (See attachment “cry for help“). This can play out in relationships in all sorts of ways. Building secure attachment with a professional experienced with the emotional fallout and distress associated with poor childhood attachment can help ease this distress and break the reactive patterns that promote this cycle of behavior.
Feeling Safe is The Pathway to Connection
Much of our distress results from the paradoxical conflict we perceive between safety and connection: connection makes us feel vulnerable and safety creates distance between ourselves and others. How do we accomplish both? We do this by learning how to develop secure attachment. We are designed to have the capability to do both no matter where we fall on the attachment spectrum.
“Many symptoms revealed in therapy stem from inner “protest” resulting from separation or disconnection from secure others. Disconnect can be one of the most devastating events affecting humans. We build resilience when we can turn to another in times of distress to make sense of the traumatic.”
Attunement Trust & Connection
Attachment Styles
The following descriptions are helpful in understanding some of our behaviors and coping, but they are by no means comprehensive descriptions. In real life, much of our behavior is nuanced and lies on a continuum or is situation specific. Attachment “styles” are better understood as attachment strategies that are ways in which we respond to the distress associated with disconnection from the attachment figures in our life.
Secure Attachment. When we have consistent caregiving, we are able to approach life with greater flexibility from a place of compassion, calm and capability. Our relationship to our inner self exudes confidence and self-trust which also manifests in our relationship with others.
Avoidant Attachment. When that early caregiving experience lacks attentive presence or is neglectful, some people never gain traction regarding the skills they need to navigate relationships and deal with the inevitable conflicts that can occur among others because we are not identical and have differences. That core of trust that feeds relationships and creates confidence is often lacking. The normal process of repair holds potential for the real or imaginary threat of shame, humiliation, rejection, criticism. Lacking the capacity or knowledge of such repair, individuals tend to avoid intimacy or fail to appreciate the significance of relationships through their own acts of blame or anticipatory rejection. They expect to be rejected all the time, push people away, set impossibly high expectations and can mistake social cues. They might find everyday interactions overwhelming on account of their hypervigilance and reactivity to perceived rejection.
Ambivalent or Anxious Attachment. Inconsistent caregiving resulting from volatile or distracted caregivers can impact individuals who develop anxiety, doubt and insecurity in their relationships and manifest low self-esteem and self-worth. This can result in dependency and approval seeking. They are often described as “overly needy.” Sometimes individuals with this attachment style can be preoccupied by others and find it difficult to set boundaries. Others’ boundaries can provoke panic, fear of rejection and abandonment. Guilt, excessive caretaking and various forms of controlling or manipulative behavior might be used to try to keep others close. Because these individuals often seek reassurance in their relationships, they can be trying on other individuals thereby making rejection a self-fulfilling prophecy.
Fearful/Avoidant Attachment. This attachment style (known as “disorganized” in attachment theory when it applies to children) is marked by inconsistency in behavior and deep distrust of others. It often reflects caregiving that became a source of fear for the developing child. In some instances, the child’s needs were not met at all. Adults who experienced this type of caregiving, may have lacked the capacity to adapt to the interaction with caregiver in a way to get their needs met and determine a consistent pattern of behavior.
This might manifest as “push/pull” behavior in which there is a strong need for intimacy that is followed by pushing those closest away. Signs of disorganized attachment include frequent dysregulation, fear of hurt and abandonment, hypervigilance, difficulty trusting others, splitting behavior (“love you/hate you”), instability in relationships, alternating between being distant and clingy.
Attachment Issues Addressed in Therapy by Attachment Specialist
Distinguishing between attachment styles can be tricky. For instance, Fearful avoidant attachment is heavily rooted in the fight response because the primary survival mechanism requires fighting off or resisting a dangerous attachment figure to maintain safety. A child is not inclined to attack outright an adult caregiver. Rather, it is not uncommon that they develop an internal battle to fight for connection or distance themselves from others. The body asks, “Can I overpower or resist this threat?”
It’s important to note, you cannot think your way out of a physiological high-alert state; you must use the body to calm the brain.
Two massive psychological roadblocks individuals often encounter in attachment work are: Intellectualization and the solitary tracking blindspot.
Intellectualization as a Defense: Individuals with a disorganized attachment style are often highly intelligent and psychologically literate. They make up the fast majority of our practice clients. They often read and re-read material, use clinical language, and might even be able to identify their triggers. However, understanding the nuances of a trauma response intellectually, especially after the fact, is not the same as healing it emotionally. Indeed, “figuring it out” is a very common strategy used by clients that can sway many inexperienced clinicians into believing that a client is “getting it.” In many agency settings, clients are discharged only to relapse not too long after their course of treatment. One of the reasons is that “figuring it out” is a common and briliant defense mechanism to avoid actually feeling vulnerability and panic in the body. You cannot think your way out of a nervous system bypass.
The Solitary Blindspot: The very nature of fearful avoidance is relational. Attachment is about connection. You cannot heal a relational wound in isolation. This is one of the most compelling reasons why we utilize group therapy for our clients who experience deep and embedded attachment wounds that affect their relationships.
Written material or a checklist cannot talk back to you. It cannot mirror your expressions. It cannot co-regulate with you when you freak out. Reading (and taking notes) about attachment alone in a room actually reinforces the avoidant strategy: “I don’t need anyone; I am smart enough to fix myself.” And yes, how ironic, that even being a therapist with attachment wounds and credentials can limit self-healing.
A skilled therapist notices the exact millisecond your eyes dart away, your breathing changes, or your voice tenses up. They interrupt the automatic script while it is happening in the session to help you track the somatic shift, breaking long-entrenched subconscious loops.
In good therapy, it’s quite common that the client experiences hurt or annoyance. This is the opportunity to be guided through a safe, successful rupture-and-repair cycle. This is how you rewrite childhood script.
Group Therapy
Group therapy is one of the best ways to develop the relational skills needed to restore or build secure attachment. Click here to learn more about some of our current groups focused on helping you develop relational health.
What attachment style best describes Your Comfort Zone and relationships?
Adult Attachment
In adulthood, romantic partners are our most important attachment figures for support, comfort and reassurance. However, not every romantic partner is a suitable attachment figure.
The process of evolving to an attachment figure depends on the availability and commitment regarding comfort, support and relief in times of need and development of a felt sense of safety. This takes active nurturing and the ability to make repair in times of disconnect. It is demonstrated by the ability to resume other non-attachment activities as a result of reliance on comforting mental images and thoughts of our romantic partners and also ability to manage threats in their absence.
(Adapted from Mikulincer & Shaver, 2004).
How do We Heal Relational Trauma?
Developing Secure Attachment
It’s wonderful to start out in life in a family that provides the nurturing and attentive environment conducive to secure attachment. That’s a head start upon which we create a relational template for our other relationships. The process of attunement presumed in that caregiving relationship helps us develop an internal sense of what to anticipate from our peer and adult relationships. That “sense” lives in our nervous system and is projected onto our later experiences.
What if we don’t get that “great” start in life?
Fortunately, perfect parenting isn’t the only path to secure attachment. In fact, “good enough” parenting in which we make mistakes, initiate ways to honor those mistakes and repair is, well, good enough. Beyond this, even if parenting is less than “good enough,” parenting isn’t the only path to secure attachment and there’s room for “catch-up.”
Most parents do the best they can and we can shift from early disruptions to learn how to build what is missing. It’s never too late.
In therapy we learn:
- How to transition (e.g. separation stress).
- To repair disconnections.
- To relax while in connection.
- Rituals around safety
- How to really set boundaries.
Post Traumatic Growth
The concept of Posttraumatic growth embraces the new meaning and positive psychological change that comes from healing. This change goes beyond dissipation of symptoms to reach new ways of integrating spiritual principles and core values in ways that promote resilience as well as personal, community and societal healing.
It is not unusual that such healing shines new light on our relationships and sense of purpose. What does this look like? It’s dramatic for some as they change their focus in life, seek new jobs or relationships. It can also bring greater meaning to current relationships.
EFIT-Emotionally Focused Individual Therapy
EFIT is a wonderful approach to healing trauma that might seem counterintuitive in that it centers on the core vulnerabilities that underly many of the coping strategies that may work in the moment, but end up over the long haul confining us to repeated negative cycles which undermine our sense of Self and our relationships with others. Many clients enter treatment having read up on attachment styles, but can’t seem to put this knowledge into new and adaptive ways of being or interacting. EFIT developed by the founder of Emotionally Focused Couples Therapy , uses attachment science to help develop secure attachment by deepening your tolerance for emotions and helping you work through them rather than around.
EFIT is Different from Conventional Talk Therapy
Many clients believe that providing information and data is essential for processing. However, many “solutions” and insights developed that way are soon forgotten after the session and not always helpful in reshaping habitual responses in the moment. EFIT may feel different from such approaches as the therapist takes into consideration non-verbal as well as verbal cues that are shared by the client, even subconsciously, and helps facilitate the client’s expression of core emotional experiences on the path to emotional balance. It is our emotional shifts that help shape our identity and new behaviors.
Click here to learn more about attachment, trauma, community healing and posttraumatic growth.
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Here’s some additional information to help you explore ways of promoting self-awareness to develop self-compassion and manage relational wounds:
- Centering video
- Mindfulness-Based Somatic Psychotherapy
- Cultivating self-compassion
- Autogenic training for managing high stress
You can find other soundbites related to preparation for therapy here . Stay in tune with issues related to your well-being and mental health right here in the Urim Recovery Journal .