Is therapy for “attachment disorders” in adults bogus?

This thread has gotten kind of off-topic and it's started hinting at something which is difficult to discuss, which I think is narcissism in therapy. Not the client's narcissism, although that may certainly be there. But the therapist's. Which doesn't mean that the therapist is necessarily all bad or has NPD. Just that it can be a factor (I think).

I may try to start another thread on that topic but probably not today.

Here Today, thanks for explaining more. I understand better now, and I'm really sorry for what you're going through. I can imagine how terrible it would be to do all the work that you did with your therapist, and then, right as things have gotten better and you're working on figuring out how to be in the world, to have her get caught up in her own stuff and be unable to fail or validate who you really are.

I'm sad that she wasn't able to get it. That seems like a pretty basic thing to ask of a therapist. (I'm glad you've found a community where it's safe to be yourself though!)

(Incidentally, do you know if your T does regular supervision/consultation? This seems like exactly one of those times that a T should be talking to someone, other than the client, to help identify and work through their own stuff, so that it doesn't end up hurting the client!)

Thanks...

That's the thing… we are all led to believe it is not just the right thing to do, but the only thing to do for many of life's difficulties. I find all the campaigning for the necessity of therapy to be truly oppressive.

But who is campaigning for therapy to be necessary for others??? I feel it was necessary for ME. And I do find it hard to imagine healing from trauma like mine without professional help. But people do all kinds of things all kinds of ways. In another culture you might heal the same trauma by going on a vision quest or dancing for the gods for days on end. People. In western culture choose self help programs like AA, meds, therapy, simplified living, religious devotion, and many other things to deal with their issues. People close to me suggested therapy because they knew I already had a positive experience with therapy in veterinary school. But no one ever suggested I HAD to do.it, nor do most posters on here say others HAVE to.do.it.

You said: "The idea that you could use an intimate non professional adult relationship to work through attachment issues to me communicates a fundamental confusion as to what attachment issues ARE."

That implies that therapy is required for attachment "issues". This sort of message is all over this site. Every mainstream healthcare and mental health website exhorts everyone to get to therapy at once for any and all life's difficulties. Therapist websites same. Physicians automatically push it for all manner of things. The whole of western culture seems to have been indoctrinated into this model.

Anxiety or depression? You need therapy. Trauma? You need therapy. Grieving? You need therapy. Relationship trouble? You need therapy. Lonely, bored, confused, unhappy? You need therapy.

Maybe there are regional or cultural differences or something at play here?

My doctors have been much more about pushing drugs, which I have never been tempted to take. The subculture in which I was raised isn't big on therapy either - Seeking solace in religion, or friends and family, would be more typical.. Most of my friends wouldn't be in therapy either. I have found therapy very helpful, but I haven't felt pressured into it at all.

That's always been my experience too. Lots of support from family, church, friends, etc. I can't remember therapy ever being suggested except in one instance when it was clear I needed more than all of the above was able to provide. Honestly wish therapy had been suggested sooner. I just don't hear therapy being suggested anywhere in my real life as a first line of defense and certainly not as something for day-to-day issues that can be managed in other ways.

Must admit that therapy is a bit taboo still in my small circle of society. Ex forces here so 'needing' therapy is still seen as a bit of a weakness and in my family stuff is rarely discussed at all, let alone with a total stranger. I have seen a varied range of posters from those who say they would never have therapy at all; those who would never do it again; those who say it has been lifesaving and those who say it has been helpful but not once have I ever got the gist that someone was saying people 'must' go to therapy to be helped. For the most part people just say how it was for them and that is what is right, in my opinion. I must admit that I have never spoken up about my state of mind before and maybe this is why I have never felt the push from society that you describe, but the time I did, I was encouraged into it by a 'friend'.

I think sometimes people are scared of mental health issues, largely because they do not understand them, and do when someone opens up about it they recommend seeing a therapist. A way to relieve themselves of obligation perhaps?

Budfox, I can see how, if this is the message that you feel from society, it could be very frustrating because you may feel that there is no-one to support or help you, and others, in your journey (of self discovery or healing or whatever) using methods other than therapy. I don't know, just probing, trying to figure it out.

In the sentences you quoted from me I am not talking about anxiety, depression, relationship issues, grief, assault, phobias, ocd. Etc etc as you seem to think.
Which proves the point that you don't understand what attachment issues ARE.

Attachment problems are a specific constellation of mood, relational and psych social problems associated with the failure to form attachment with a primary caregiver between the ages of 6 months and 3 years old due to abuse, neglect, trauma, or caregiver absence physically or mentally.

That does not include the majority of PC posters,the majority of therapy clients or the majority of people with relational issues.

Attachment disorders are very difficult to resolve. No matter how you do it. I stand by the statement that I don't understand how people could do it without help. Its hellish to live in that way but the treatment is at times equally so.

But don't quote me and act as if I am generalizing to.everyone needing therapy. Attachment disorders describe a very small and specific subset of therapy clients

My T, who is the head of the state board on child abuse and domestic violence and has worked as a court advocate for abuse survivors for 20,years, has repeatedly told me that there is no sort of abuse or trauma that leaves the sort of permanent wound on a person's soul that attachment trauma does. Its not "issues" in quotation marks, which I personally find offensive.
Its a specific and well recognized kind of severe trauma.

Thanks for your post and thanks for asking about my situation. Given how I wrote about things a year ago or so, I really understand why you wondered.

My last T DOES do regular consultation as well as occasional supervision for special problem areas. But I have reason to believe that her consultation group functions kind of like "clique", the way I see things anyway. I'm NOT cliquish, so that may be one reason why what seemed normal to her seemed kind of "off" to me. I brought up our different temperaments a number of times -- maybe in that sense she was never a good "fit" for me -- but I couldn't understand that when I went to her for the trauma/dissociation issues because I had no "feel" for it at that point.

Same here. I've never had anyone other than my psychiatrist suggest therapy to me, ever. That seems appropriate however, given I am already seeking some kind of treatment and he prescribes psych meds.

I think more people suggest therapy here because it's a psychology site and psychotherapy forum - it's a common interest. In any other context, however, I get the impression that people feel uncomfortable with the subject.

I actually agree that people who suffer from true, diagnosable attachment issues could benefit from the right therapy. If it's the therapy written about in these forums, I don't know. In some cases definitely not. Regardless, there are a lot of people in treatment who don't go on psychotherapy forums, so I don't think that what we see here represents the general therapy client population.

Lauliza, you mentioned earlier that attachment disorders are not diagnosed in adults. Not that i really believe in psychology theories and diagnoses anymore, but what would they be called in adults? Are they personality disorders? That's what I've always understood. I can't really find much information about this (scared to call it an issue) whatever it is in adults.

I quoted you as one example of someone asserting that therapy is a requirement for some condition or subset of people. In that case it was attachment problems. I also see the same kind of thinking for depression, grief, etc so I mentioned that too.

As for attachment problems being a small subset, I'd wager that a majority of long term therapy clients can trace their problems back to early primary caregiver failure. Why does anyone get attached, dependent, addicted in therapy if not because they lacked a secure base in childhood and are seeking it from a therapist? I've been there myself. Difference is I am not there now and hence am not invested in the idea.

I find it discouraging that professionals who may be reading these forums sometimes seem to be more concerned with defending their professional ego or, alternatively, "helping" the person who may have been hurt in therapy, instead of trying to hear what we are saying and learning from it, both personally and professionally. We may not be representative of the general therapy client population, but if that population is not being sampled with well-designed, anonymous studies, the profession will never know.

That probably sounds a little snarky, I know, but my many attempts to suggest things that might improve things have fallen on deaf ears, too. Yes, it's the professionals' job, their professional organization isn't going to do it, here in the U.S. we do not have a government organization who is going to sponsor that kind of study. Who will?

Very common sense question.

Yes, a pd could be the result of an attachment disorder that goes untreated in a child. All people who have attachment styles other than a secure don't have personality disorders, obviously. There's almost always trauma and abuse involved as well when someone has pd.

I don't think it's uncommon for adults with undiagnosed autism spectrum disorders or ADHD (especially females) look like they had childhood attachment "issues" and end up misdiagnosed with pd's as adults. They probably don't always have secure attachment styles because of their difficulty in reading emotions and social cues. So I guess my point is that attachment issues can come on for different reasons and are not always best treated with therapy.

I was once misdiagnosed with BPd but recently been told that I have GAD with fearful /avoidant attachment. Can still be a problem in adulthood.

I am the product of some sort of attachment injury. Has caused me untold suffering. I believe this was exposed in therapy and is part of the reason it was so destructive. You can continue to teach me about this if it makes you feel better, but it's not necessary. I've done my homework on this.

I put "issues" in quotes because I object to the way this stuff is framed. Everything is a "disorder" that requires "treatment". Everything must be delegated to an "expert". If you have attachment trauma, you will suffer forever unless you have a contrived relationship with some role playing stranger in a little office. It's all so confining and reductive. Not judging this practice, rather any suggestion that it's compulsory.

I don't see it as a straight line from attachment trauma to messed up adult to therapy office. Too many variables, too many ways to heal. Maybe one person had terrible trauma in childhood but they are high functioning. Maybe another person had a similar trauma but also got a huge download of the mother's toxic burden in utero and is severely impaired because of the combined effects of these and other stressors. Mercury, lead, fluoride, aluminum, e.g., are potent neurotoxins known to cause psychiatric disorders.

Plus the therapy model is not even evidence based and carries untold risks. Not trying to be offensive, just looking for balance.

Yes. Thank you! I totally agree.

Budfox,
Your point is well taken about balance. There is an inherent risk in therapy, as in any form of treatment. We don't take a drug unless we think the benefits will outweigh the side effects. Therapy doesn't help everyone. I think for those of us where therapy was a successful treatment, the improvement in our life tends to make us a bit enthusiastic about recommending it, but not I think from the need for everyone to do it our way, but out of a desire for other people to find relief from their pain.

Again, I am sorry for your experience. I really do count myself lucky that I found a therapist who deeply understood the process. Being abandoned in the middle of it or being mishandled would have done damage and caused pain beyond belief. I think you're cautioning against a reflex of going to therapy comes from the same place that my urging of therapy comes from, a desire to see people not be hurt and to end up in more pain.

I really replied because of your comment about everything being a "disorder." That really got in the way of my healing for a long time because I saw myself as somehow fundamentally damaged and broken. The reason that attachment theory (I do want to stress not attachment therapy but the theory itself) was so important to my healing was that it gave me a very powerful tool to understand what were, up until then, some very confusing behaviors on my part because I had no context for what was driving me. But even more, it gave me hope of healing, because it allowed me to see that there was nothing wrong with me, my development had just gone awry because I had not gotten what I needed when I needed it. In a broad sense, any normal being that experienced what I did, would react in a similar manner. Normal reactions to abnormal circumstances. And because of the plasticity of the brain, while it is MUCH harder to do as an adult, it is possible to complete your development and heal enough to go forward in a much healthier way to live a fuller life. Knowing I could heal proved to be a big part of the battle for me. I do try to be careful to add the caveat that I get that while this was very effective for me, it's not going to be for everyone, but I do realize I am a strong advocate.

So I just want to say that while I more clearly relate to what BryBrony is saying as it close to my own experience, I do respect what you're saying. Therapy isn't going to solve things for everyone and there are many paths to healing. And people considering therapy should be able to hear both sides, that it can truly be healing but it can also be harmful. Risks should always be taken with open eyes.

One more thing if you'll indulge me. It sounds like with your T, s/he was role playing and the relationship therefore felt very contrived. I can totally understand your anger and even bitterness, about that. That is very different from my experience. The boundaries of my therapeutic relationship were set in different places than my other relationships, there is an asymmetry of information and the care flows in one direction (I actually see payment to a T as a way to balance the relationship so that as a client I am not stranded in a place of constant gratitude which freed me up to express displeasure or anger with my therapist. I got his expertise, he got my money.) However, I do not see the relationship as contrived. We were real people having a real relationship (if not, I do not believe it would have changed me), it's just that I saw a more limited part of my therapist than most other people would see. He was never a strategic therapist, artificially creating situations. He always told me 1) he wasn't smart enough to do that and 2) it wasn't necessary, as in his experience the stuff you needed to deal with eventually arose in the relationship. It is a very deep, very real and important relationship with me. But I also think my T is fairly rare.

Last but not least, I am well aware that I tend to be REALLY verbose, so no need to reply to all I say, or even at all.

AG

I had one t who was forthcoming that therapy isn't the only way to heal an attachment injury. Being in s healthy relationship or having s child is another opportunity to hit the reset button.

Interesting contrast to the thinking that one who has such injuries cannot figure out how to be in a healthy relationship without the help of therapy.
Rather refreshing to hear of a therapist who considered it possible without therapy.

I personally find the interactions with the therapist to be contrived. I believe they are acting a role. That does not make the role not useful, just that it is not real. I don't consider myself as having a relationship (other than in the most general use of term) nor have I figured out what it is the woman is supposed to be an expert in. I use therapy differently than most here do, but when I tried to use it in the way most report - it was a decidedly awful disastrous experience for me.

In my experience the risks are rarely discussed. I also think the risks are significantly more serious than most people anticipate -- especially for people with attachment or relational trauma -- and that harmful outcomes tend to be swept under the carpet and purged from collective therapy consciousness. I don't see therapy as a form of treatment, and I think there is little about it that is reproducible or predictable. If therapy does help I think the therapist would be hard pressed to explain why. Clients are not usually presented with any sort of evidence, and the whole thing unfolds more like some sort of religious indoctrination.

Every therapist I've been to was role playing. It was all contrived. If you pay me I'll pretend you really matter to me. I was playing a role too. The subordinate, the inferior, the wounded child. Sickening really. If nothing else, getting dropped on my head by the last one woke up me to this.

That's really interesting what you said about the payment--I hadn't thought of it that way before. I once was saying to my marriage counselor (for whom I've had a couple forms of transference--and your blog helped with that) when I was upset with him that I was basically paying him to care. And he said that I could pay him to do his job, but I couldn't pay him to care. Like he cares because he chooses to. It's taken some time, but I have come to accept that he does genuinely care about me (as does my individual T). I definitely have some insecure attachment issues going on--once I said to T that I thought I might have an insecure attachment style, and she was like, "Um, you think?"

I like what you say about it being a real relationship between real people, too. My marriage counselor does quite a bit of self-disclosure (generally related to stuff going on with H and I, and showing both good and bad sides to himself), so it feels like I "know him" much more than T. Though I learned, partly from stuff he said, partly from him having to cancel a bunch at one point, and partly from something I accidentally overheard, that his wife has a serious health condition. And because I'm fairly attached to him, and he cares about me, I care about him. My concern for him and what's going on with his wife led to a rather rough session recently where he said he felt bad and like he'd done something wrong that I was worried about him, because the caring and support should only go one way in therapy. Like, it wasn't something I was doing wrong, but something he was doing wrong. But my individual T said it was completely natural for me to care about him because I'm a caring person.

The therapist-client relationship is definitely a unique one, though. Though I understand why certain boundaries have to be there, it can be difficult when they're right there in your face. When you can feel close to someone, but then get reminded that it's essentially a business/professional relationship, that your T may genuinely care, but that you're just one of many clients/patients...and not necessarily as "special" as you want to be--it's just hard. Especially for people with attachment disorders...