Dependency paradox and attachment styles

For those worried about dependency on your therapist this video explains the dependency paradox. Also a good explanation on attachment styles

Sometimes I wonder if most T don't understand this? The ones I've worked with have discussed this directly with me, but my sense here is that a lot don't. This is the whole basis of shifting attachment style to earned secure, and it's the whole basis of why secure attachment can't form.

At patients, I think we get buffeted by societal sentiments and temperaments, chief among these is that mental health care simply represents a catering to weakness. In the US, we have such a strong puritanical tradition that extends into the 'grin and bear' ideal, and that's partly why even in mental health communities there is a disparagement of deeper, lasting relationships between T and patient as 'dependent'. The research is far from resolved on this, and there is clearly room for each T/patient to assess progress and need, the idea that coping with severe attachment disorders can be accomplished without become attached to the T is pretty well refuted.

I wish they would have a transcript. I hate watching videos to get information. (not blaming OP - just voicing my anti-video stance)

Videos can be annoying especially if the graphics overload and fast talking give you a headache.

Here is an article with similar info
The Dependency Paradox - | - Science of Relationships

So..hmm.. Ok, I can count on at least 4 years of therapy ??

this was a neat video, i emailed it to my T

Interesting video--thanks for sharing. Seems like a good potential marriage counseling topic...in my case, I think I'm mostly anxious attachment (with maybe a touch of avoidant thrown in), while H is secure. I've definitely dated some avoidant types in the past--makes sense that those didn't work out...

Three therapists have dubbed me anxiously attached.

One time last year, I said to my T that I thought maybe I have an anxious attachment style. And she was like, "Um, you think?" As in, it was glaringly obvious to her...

i think im a mixture of both

Meaning anxious and avoidant? I always thought of this as 'disorganized' attachment, but I think more and more that this is a form of anxious attachment. The avoidant part seems like a way to draw the other person in the relationship closer, i.e., push them away to make them anxious so they work to get closer to you.

My father and brother are true-blue avoidant buttholes with a touch of NPD thrown in. But I digress...Interacting with them (which I don't do anymore) always felt completely different than being pushed away by someone who has anxious attachment. The coldness that comes with really profound avoidant dismissive attachment is jarring. At least that's my experience...Bleck. I'll take a beer and peach ice cream instead.

Dependency in the context of mutual relationships… good thing. Dependency on someone who has no real stake in your life and who is being paid to care about you… different kettle of fish.

I think it is unethical for therapists to conflate the two. They sometimes drop dependent clients with shocking callousness or irrationality that does not bring to mind true intimate relationships, but rather a business relationship gone bad, or something I cannot quite define.

Agreed that many therapists misuse or don't know how to deal with dependency.

On the other hand, real life relationships have as much selfishness involved or at least self interest involved as any t relationship. Unconditional love of any kind does not exist outside infancy. Even that can be argued as a moms self interest in an evolutionary sense. My point being that most t's aren't any more callous than any other person. They strive to do better but yes they can fail at it.

The difference to me is that in therapy the client might be up to their neck in dependency, while the therapist views them as merely a customer in a business relationship (one of many) and could end the relationship and not be bothered at all. I also find therapy relationships horrifyingly ambiguous, and the meaning of dependency or attachment totally confusing and disturbing. I do not want to be in that position ever again. My therapist seemed totally confused by it, even though she orchestrated it.

Also therapy relationships are marketed as more secure, and the therapist is paid to NOT act out of self-interest, so if they fail in this way, then doesn't that expose a fundamental lie?

A t's paycheck is supposed to be thier only self interest, that and setting boundaries so they don't go crazy or burn out. They sometimes fail at this. I've had really bad therapists. Mediocre ones and fantastic ones too. If I had only seen the bad ones I'd probably be on here warning everyone off therapy too. But the ethical and skilled therapists were worth the time and effort. Wishing that good experience for everyone here.

Sorry, not good enough for me. There should be protections in place so that clients are not rolling the dice with their mental health. It's insane to expect emotional dependency to co-exist with the idea that therapists are just like everyone else and might or might not act out selfishly. Either they represent something different, something safer, something more honest… or they do not. Which is it?

I don't know what protections could possibly keep a t from being human and flawed. I'm not saying it is right for them to abuse clients. I'm talking about the well meaning ones with any sense of ethics. There is risk in everything. Your surgeon can leave scissors and sponges inside you and you have the right to complain to boards sue etc.

But the risks of surgery are generally known. The procedure will be explained to the patient. Therapy clients, far as I can tell, receive little or no info on risks or process.

And if harm is done, usually the client is blamed and the therapist uses manipulative tactics to escape accountability and to pressure the victim into compliance (i.e. there is no problem, just go do more therapy). Medical malpractice is well defined. Psychological malpractice is more subtle, harder to prove.

If they cannot avoid drawing people into dangerous dependency, because therapists are flawed and because the process is experimental and unpredictable and poorly regulated, but they keep doing it anyway, then you have a fundamentally unethical practice.

I'm wondering what are your suggestions, BudFox. I personally have only experiences with highly ethical T-s that have helped me tremendously. Are you suggesting that because there are still risks in the process and because they cannot guarantee me the results, then people should rather stay stuck in where they are? No thanks, that's not good enough for me.

I think that therapy is not so well comparable to surgery or any other medical procedure but rather to the process of parenting. Especially because many times therapy is needed to overcome the consequences stemming from poor parenting. There are good parents, there are worse parents and there are awful parents. In many countries there are regulations with the goal of taking children away from awful parents. But it's not so easy to define when exactly should be done what.

Some parents look ok on the surface but they are actually horrible. My own parents fall into that category - they fed me, they did not beat me but I suffered constant emotional neglect. Some parents might look slightly abusive but the good they provide to the children actually overweighs the abuse.

Why isn't is possible to clearly regulate, which people are allowed to become parents and which not. Because the process is so complicated and you can state in retrospect whether it was good or bad. Because parents are people and people are flawed.

I think generally the same dynamics operate in therapy. Therapy isn't a clear process such as surgery. Well, you could state clear steps such as "First we will establish connection and then we will work on your deep issues until you feel that you no longer need therapy" but that's all terribly vague and thus not very useful. How would you describe a clear procedure for "establishing connection"? It's not a rational process, it relies a lot on feelings that appear between the subjects and you cannot prescribe what feelings each participant will feel.

Similarly, how do you manualize "working on deep issues"? For one person, it needs to become dependent to overcome the deep wounds that were inflicted while she was dependent. For someone else, in means something else. I think it would be impossible again to describe those procedures exactly beforehand because what will really happen depends on the particular therapist and client dyad and thus, there is no way for a therapist to know beforehand what will happen and how the therapy will go.

I do agree, though, that there are many poorly educated therapists out there and perhaps more effort should be put to filter them out. On the other hand, the demand for such services is so high and thus according to simple economic law this will also generate supply. However, the quality of this supply is probably not that great. Just recently I met someone who told me she would want to become a councillor because she has experienced a lot of s... herself and she would want to help other people. I gently tried to tell her that in order to help others it would be extremely useful for her to first work through her own sh... but I don't think she understood. I think she thought that she will just train as a councillor that would be enough.

I personally have taken it to be my responsibility to only see therapists with whom I am certain that I am in good hands. I only see psychoanalysts who have IPA membership because that guarantees that they have had very rigorous admission interviews to assess their personal suitability and they have worked on their own issues during a long intensive therapy. I've seen two such people and they both are just great. But, I pay fully out of pocket and thus I don't have to rely on insurance lists or anything else like that. So, does it mean that only people who can afford to pay out of pocket, should get therapy, because others are more likely to land on bad T-s?

Staying stuck and doing therapy are the only choices? False dilemma. Humans got by for millennia without these overpaid life coaches. I realize some are decent people trying to help. Some of mine were. Doesn't make it ethical. Just by law of averages, you are going to get some good matches that are fruitful. Still not ethical broadly speaking.

It's one thing if there is an appropriate level of risk. But with emotional dependency in therapy, the risks are not even quantifiable. How can you predict what will happen when a paid consultant draws an adult into a dependency relationship? Impossible. Thus, it is a huge and dubious social experiment. It's unethical because they camouflage this basic truth with scientific and marketing jargon. And because they don't really care about the potential for harm nor the true impact of that harm. They're too busy congratulating each other on their teachings and techniques and feeding their wounded or outsize egos.

Would like to see a longitudinal study that tracked people long term who developed emotional dependency in therapy. How many got trapped in an endless cycle of therapy, how many got terminated in damaging fashion and were left that way, and how many truly walked away in one piece or better off.

You still only reiterate how therapy is too risky and bad but don't suggest any concrete working and proven alternatives. I find it non-constructive.

Also, I assume you realise how difficult it is to do such a longitudinal study that you want. In case you don't then as a scientist I can assure you that it would be very difficult and also costly. It is not obvious at all who would be willing to invest into such a study.

OMG! How terrible that a T would behave like that.

I actually kind of agree with this. My T have always told me some variation of "I'm still a person, with feelings, etc...". I always answer them - "you have people's lives in your hands. You don't get have the luxury of 'mea culpa'." There seems to be an attitude in the field that follows the basic design of 'If this therapy works, I'm a genius. If the outcome is negative, then I'm just a person / the patient failed'.

It's a paradox - an imperfect science who's outcomes demand perfection....I think mental health is about 25 yr behind medicine. It really wasn't that long ago that we were bleeding people with leeches....Unfortunately, ours the generation of dramatic change in mental health.

Understanding the brain is at least 25yrs behind the rest of medicine.

I'm actually quite surprised there aren't the kind of longitudinal studies that Budfox suggests!?