Attachment Theory and Psychotherapy

Copyright © 2016, Liz Currin, Ph.D.

You may have heard the term “attachment”, whether in a parenting magazine or an article on relationships.  It is a major construct or concept in the field of developmental psychology.  In brief, it refers to the type of relationship that exists between a child and his or her early primary caregiver, usually a parent.

Psychologists John Bowlby and Mary Ainsworth did much of the groundbreaking work in the field of attachment in the mid-twentieth century.  Attachment theory posits that, due to the nature of interactions with the primary caregiver, children develop one of four attachment styles:

(1) secure—child is distressed when the parent leaves, but positive and content when s/he returns.

(2) insecure-avoidant—child does not appear distressed when parent leaves and is not interested when s/he returns.

(3) insecure—ambivalent/resistant--child is extremely distressed upon parent's departure and displays resistance to contact with parent when s/he returns.

(4) disorganized—child displays behavioral disorganization upon both separation from and reunion with parent; child may wander about, appear confused or “frozen” in his behavioral patterns; child may actually dissociate or become extremely detached from a situation.

Attachment theory looks at the nature of the relationship between a child and its caregiver.  Because children are extremely dependent upon a parent for survival needs, the caregiver's degree of attention and responsiveness to the child's needs is critical in the development of a particular attachment style.  If a child's physical and emotional needs are met reliably and in timely fashion, the child is likely to develop a secure attachment style.

If, however, a parent is unaware of or unresponsive to a child's needs, the child experiences that caregiving relationship--and, by extension, the world-- as unpredictable and frustrating.  The developmental consequence of this is not only an unsatisfying and frustrating relationship with a caregiver, but subsequent difficulties and fears about exploring the world, developing trust, and confidence to engage in new activities.  The parent may be experienced as unavailable, unreliable, perhaps even frightening.

While attachment theory arose out of work with young children, it has since that time been applied to the study of adult relationships, as well.  Researchers believe that, while a child-caregiver relationship and relationships between adults are different in important ways, there are some core principles that underlie both.  One of these is that differences in adult attachment behavior reflect an individual's early experiences with a caregiver.  In other words, we develop expectations about ourselves and about close, intimate relationships based upon our attachment history.  These expectations then form “working models” that guide much of our interpersonal behavior.

Adult attachment styles are similar to those seen in children in the following ways: 

(1) Secure in adults corresponds to secure in children.

(2) Anxious-preoccupied in adults corresponds to anxious-ambivalent in children.

(3) There are two adult attachment styles—dismissive-avoidant and fearful-avoidant—which correspond to avoidant attachment in children.  Dismissive-avoidant may appear as self-sufficiency and independence and a lack of need for close relationships.  Those with a fearful-avoidant style desire close relationships, but are afraid to trust in them.

With regard to attachment styles and psychotherapy, both researchers and practitioners have discovered  that these styles tend to be fairly stable throughout our lives, but that there is the possibility for modifying someone's style both in therapy and general everyday experience. 

Both positive and negative life experiences may alter our working models for relationships.  A devastating betrayal, for example, may seriously undermine an individual's sense of trust and security.  A spouse's affair would be a clear example.  Someone who has never doubted the spouse's devotion and loyalty, upon discovering that he or she has had an affair, may find it almost impossible to trust and to feel emotionally safe in the marriage.  Even if the betrayed spouse decides to end the marriage, he or she will likely have significant trust issues in future intimate relationships.

Adult friendships are another arena in which attachment styles are both revealed and can be altered.  Betrayal of a confidence, a friend unexpectedly distancing himself or herself from the relationship, a friend's growing preference for other relationships, can all damage the sense of trust and predictability that one has had in the past.

Therapy can provide the patient with the opportunity to learn about his or her attachment style and how it developed earlier in life.  It is an opportunity to understand how early experiences have shaped who one is as an adult and how the “working models” and expectations about self and others play out on a day-to-day basis.  Through an ongoing therapeutic relationship, the patient can also begin to learn that there are “benign” people in the environment, that significant others can be capable of sensitivity and emotional and behavioral consistency.  Thus the stage is set for more secure and satisfying relationships.