More Ranting About Attachment Therapy

I have not done attachment therapy and would not because I personally do not believe in it and think that the structure of therapy is far too limited for that sort of thing. I find it much easier to work on such issues in everyday relationships. It's good that some people have had success with that kind of therapy though.

One interesting thing about digging into past traumas that way though: there are some interesting research studies showing that it can actually be more damaging than helpful because it revives those memories over and over, consolidates them rather than helping to let go. This is some neuroscience work looking at the biological processes associated with it, not just based on anecdotes and self reports. One problem with what therapy does is that it only/mostly raises awareness without changing reactions and the way we deal with things in everyday life and this is probably part of the reason behind all those difficulties between sessions. Why I prefer to use help that is not so structured and can be accessible as needed. Not traumas, but I experienced this in relation to my struggles with addiction - no way I could have resolved that using therapy alone, these things are far too unpredictable for such organized, scheduled work.

I personally also don't believe that serious traumas can truly be healed (vanish as they never existed) - it is more that they become part of who we are and will influence our feelings, choices, behaviors in a persistent way. Same thing when it is said that a good T should have resolved all or most of their issues - what does that even mean? What I believe more is that we can eventually put a lid on them and leave them alone such that they won't have overwhelming power over everything, but that development hardly ever comes from talking alone, it comes from engaging and experience. I think that is better than constantly picking on the scabs (which mere repeated talking and analysis can achieve). In terms of relationships, I think it's better to learn to choose and maintain compatible ones at least for close personal relationships... e.g. for someone who is very independent, don't go with partners that always expect attention and care, or for someone who likes a lot of interaction and attention, probably better to chose ones that are interested and more generous and available. Also maybe better not to repeatedly engage with emotional opposites. I just can't see how a therapist could provide these things as feelings and normal human interaction don't come packed in a box that we only open once and week for an hour and then put in the corner until scheduled again.

But that's the thing. I'm in psychoanalysis and I have preverbal trauma and I have demanded more from my therapists/analysts than many people in this forum and this therapy has been immensely helpful for me in dealing with my trauma.

I see my T 4 days a week and on top of that I sometimes call or email and that's all ok. Also, both of my analyst where from completely different parts of the world and randomly picked. So it's not that psychoanalytic therapy per se is somehow bad or unsuitable for preverbal trauma. Quite the opposite, based on my experience it is one of the best you could get.

The point is that some people have good experience and some have bad. What's the difference? I would say that the person of the therapist is different. It's not the system that treats a patient but a particular therapist who does that. Also, talking about psychoanalytic (just because this is something I have experience with), I bet that the training can vary and some people can consider them to be psychoanalytic therapists without actually being properly trained (gone through their own extensive treatment etc).

Btw, schema therapy is an amalgam from CBT, psychodynamic and other stuff. I think you could quite straightforwardly map schemas with unconscious stuff and transferences. Again, I don't think that schema therapy per se is something that heals but it is very heavily dependent on the therapist - if the therapist has not resolved her own major traumas then no matter how much training she has, she most probably will screw up with trauma patient.

In some sense I also agree with the "inadequate system" view though. I'm taking some psychology classes at the university right now and one of them is clinical psychology. After the seminars of this class I felt completely sick for a week or so because of the overly simplistic-positivistic view expressed by the lecturers (who are practicing clinical psychologists). They expressed no awareness about the complexities of the therapy situation, they seemed to be from a completely different universe than I. I imagine that if someone enters to therapy relationship with these people it can be quite horrible experience - I wouldn't recommend it to anyone. I'm glad that I somehow was able to avoid this mainstream therapy community.

Felican, definitely agree with you about therapists who haven't worked through their traumas. Though I agree with Xynesthesia-they don't ever get resolved. My Ts had worked through their own therapies. All three had issues but the last one could be quite defensive and still had issues bleeding into the therapy and they harmed me.

What harmed me was the psychoanalytic practice of withholding basic therapeutic needs (ie need for safety).Maybe the analytic distance worked good for you, I don't know, but I tried 3, and though all 3 practiced differently, the basic premise was drawing out intense feelings to work through (the transference). I have severe preverbal trauma and had brief psychotic experiences as a result. I've emailed my Ts. Maybe if I could afford to go 3 or 4 times a week like you, I wouldn't feel traumatized. Maybe not. I'll never know. I've been through a lot in my life, overcame much adversity requiring strength and courage. I'm not exaggerating the harm this type of therapy can cause. I do think other types of therapy are less likely to cause harm as many are not relational. Another tenent of analytic therapy is to break down defenses. Mine were dissociative and my whole system shattered. Nothing left to hold me together.

I like what you said about the overly simplistic views. I've experienced that in many job fields. It runs rampant.

I like what Xynesthesia said too about realizing IRL relationships. Funny, I told my therapist that since I feel safe with protective men, perhaps I should find a partner who is naturally protective/has a need to be protective instead of reexperiencing the need in therapy repeatedly and talking about that need to death.

I think 1 or 2 hrs per week with a virtual stranger as a supposed remedy for developmental trauma, or any significant despair or deprivation, is an absurdity.

If some people find it helpful because several completely unpredictable variables lined up magically, that doesn't change the reality that the basic model is ridiculous.

You may see your new mommy/daddy for an hour, no more, no other contact, and abide by the weird boundaries or be shamed, etc etc.

Also might sound cynical, but why assume the therapist cares about your attachment needs or whether you are losing it after sessions? Therapy is a practice designed by and for therapists. They set it up to their liking, then recruit a customer base to make it go.

There is a hierarchy of needs with therapist needs at the top -- income, reputation, self-image, avoiding legal trouble, ego defense, emotional power, protecting the belief system/religion. Clients whose needs infringe on this are punted to another therapist, or unceremoniously deserted, or brought in line via coercive or punitive measures (usually sold as a client benefit).

Ethical concerns center around avoiding liability. Better to traumatize a client with cruel draconian fake boundaries, or by abandoning them when things get messy, than risk legal trouble.

Yikes, i would be worried about making a deal with the devil.

Sure, devil deal.... But everyone is going to have issues-right? Unless you go with a therapist or someone who has also done therapy, maybe they may be unaware of their issues.

So why not go with someone who is compatible, now that I understand myself and my needs? To go with what I know (my parents), I would be with someone neglectful.

It is perhaps not surprising that this would be the hierarchy of needs from the therapist's perspective. One might even call it "healthy self-interest". The problem as I see it is with the concept of "therapeutic alliance". Many people with developmental trauma lack the ability to have this kind of healthy self-interest -- that's one of the reasons for symptoms that lead us to therapy! It would be great if we could develop it and learn in therapy, but too often we don't. Hence, for instance when there was the rupture without repair with my last therapist, there was no more "alliance" (if there ever really was) and my therapist's self-interest took entirely over.

Which is the same kind of developmental trauma that I had experienced in my family of origin -- nobody trustworthy that I could count on to care about me. And without that -- just all kinds of anxiety, uncertainty, doubts about my own value, etc., that I can still (or maybe finally) feel. And for which I was therefore willing to pay somebody to "be there" and help with, exactly how I didn't know -- an illusion they certainly promoted and colluded with.

Hi Unaluna,

I don't have the money to see my t more than 1 time per week. Only on rare situations have I seen her twice in a week. It might be helpful for me if it were possible to see her more often.

On the other hand, seeing her more often might increase my feelings of attachment even more. At this point, my goal is to decrease my feelings of attachment, longing, etc, toward my t. I know that my t would disagree with me, but I feel strongly that, for my own good, I need to switch my focus to task-oriented therapy work, rather than relational work.

It's the last thing the wounded parts of me want, but the adult part of my mind is telling me it's what I need, and is the only way I can continue working with my t.

Hi Feilecan,

Thanks for your input. I agree with you that a small number of therapists exist who are trained and equipped to help those of us with deep attachment needs. Unfortunately, I've searched the Internet for attachment therapists who practice in my area, and there are very few who work with adults. (I live in a large metropolitan area too). Among the few I've found in my area who do work with adults, they don't accept insurance. They are all private pay, and the cost is too high. It just wouldn't work for me.

I'm really glad that you were able find one who has the capability to provide what you need.

It has puzzled me that my t doesn't seem to "get it." Within the last year or so, she took training on attachment issues and working with clients who have them. She told me at the time that she had "changed her viewpoint" on attachment in therapy and understood better why it was necessary.

She offered more connection in sessions after that, and she insisted that she wanted to increase support outside the session if I needed it. But in practice, she didn't follow through when it came to providing the outside support. I still found it very bare bones and almost nonexistent.

The weird thing is...in session, she doesn't act like she wants to hold me at arm's distance. She invites emotional connection. For whatever reason, though, she just does not want to extend it beyond the therapy hour. she has told me that she dislikes email, as it can easily be misunderstood, and that she is not so good at expressing things that way. So maybe it is not just me...still, it seems like if she realizes how much I need that extra support at times, she should adjust her preferences to fit my needs. Instead, I feel like I have to give up what I truly need to fit her preferences.

Hi ElectricManatee,

I'm glad your t offers you the option of outside contact. It makes sense that it might help by letting you observe your needs. I believe that when my t has allowed me to have outside contact, I have actually felt less needy and often didn't need it. Just knowing I could have it if I needed it gave me relief! And for awhile, it worked. But then my t would drop the ball. Each time that happened, my feeling of trust and security in the relationship would break down. Perhaps I should be able to look at the times my t has been responsive versus nonresponsive, and realize that she has been there for me more often than she has failed to be. But even occasional failures in availability in a time I need her is enough to disrupt everything.

The intolerable part is how I feel when I've bitten the bullet to ask for what I need (hate to ask!)...only to be overlooked or offered a 1 or 2 line catch phrase that doesn't actually provide what I need. Instead, it makes me feel that either that my suffering/needs are not important to my t, or that she didn't deem them valid enough to give more than a 30-second glance and response.

It's the exact same way I experienced my relationship with my parents, especially my mom. Extremely limited emotional support. In fact, I can remember as a 4th grader being sternly scolded for calling my mom too much at work. My parents would threaten to spank me if I called her more than once per day. My t knows this. Yet that is how I feel in my relationship with my t as well.

I do think that I need a higher level of care; unfortunately, my husband is disabled and I work full-time as the breadwinner in the family. We don't really have the money to pay for much extra therapy.

It gives me pause that your therapist just got training in attachment issues within the last year or so. I think you are wise to be very cautious if she doesn't have a LOT of training and experience in this area. It's tricky work, and even small moments of misattunement can kick off a total shitstorm, which she would then need to be level-headed enough to help you through. Your T would need to be very clear to herself about what she can and can't offer to you, and to hold to that consistently, and to be very committed to this kind of work. You can't just stroll in and start doing it one day without being pretty solid and stable within yourself and also without getting adequate supervision.

I think my T doesn't like email for therapeutic issues either, which is why most of my outside contact is via phone calls. There have been a few times when I have emailed her to ask for a specific type of reassurance and she has gladly provided it, but for the most part, I want/need to hear her voice and have that back-and-forth interaction.

I do want to say that my T doesn't advertise herself as doing attachment-based therapy. In fact, I don't know if she would identify with that label at all. But her approach focuses a lot on the therapeutic relationship and taking a development-based view of psychology, and that was the environment that drew out these needs and feelings for me. The outside contact piece also developed organically as we got to know each other. So it might be more possible than you think to find a therapist who can help you with this, but it might take asking for some referrals from people who know the providers in your area. I think toomanycats took that approach.

Regardless of how things look going forward, I really hope you can get what you need, whether that's by going into the deeper, younger feelings or by figuring out how to pack them away again so that they don't interfere with your enjoyment of your day-to-day life.

ElectricManatee,

Although my t took attachment-based training recently, she has always approached therapy by focusing on relational and developmental needs aspects. We've also talked about attachment at different times, and she admits it is important in the therapy relationship. So I don't think the training was a completely new idea/approach for her...I'm guessing it just went into more depth or perhaps emphasized the importance more than she may have realized. Maybe the biggest issue is that she just despises email. She has told me I can call in the event of a crises, but I find that hard to do. To me, it seems intrusive. I'm afraid of trying it also, for fear of finding out that she is not any better at providing phone support either. We've had a rupture around the issue of need-support for so long, I've become pretty resistant to the idea of asking for outside support at all from now on.

But what's implied is that client needs come first, within reasonable limits, to such an extent that it's appropriate to bring out nothing less than attachment needs.

The therapist is likened to a selfless parental figure whose love and caring approaches unconditional. That is insane, and sets people up for devastating betrayal.

Therapists are running a business. Plus they might well be emotionally broken themselves, and needing relationships with their clients to be just so, according to their needs.

This made my infinitely sad about the state of things. It is so clear you deserve what you need, don't need so very much, put to good & thoughtful use what you are given. Therapy is tragic for C trauma survivors and people with very tenuous attachment bc therapist seem to be actually trained to be less giving than in other helping professions of their time. I think they see themselves as natural resources their patients threaten to deplete, rather than that doing excellent work with their patients might renew and fulfill them, as well as help us. When I was young and taught in a boarding prep school, "boundary" was a BAD word meaning lazy to my boss. It was all adults on deck, 7 days a week from 7am to 11 pm , and our time to ourselves was the long breaks/vacations . That is extreme and all consuming as a lifestyle, but to treat people suffering such anguish 50 minutes once a week seems stingy and prone to fail with some very worthwhile and worthy people who were hurt through not fault of their own. My T has young children, and I while he is so good in session, astute, attuned, bright, everything you could want, he really doesn't care to connected outside of session and nor would I dare complain about that. Nonetheless, I remember how total immersion environments like NoLS, Outward Bound, and boarding school expect from their staffs in terms of emotional availability, and I just wonder- do these people care enough , do they regard their work as a calling or a job or a career? I find the worldview/perspective of my T eludes me, and the reason it does is bc he goes to great pains to hide it! I would love to see a comparison of how much time people of the same education level put into their helping professions in terms of hours against how much they are paid. For example, if I have a PH'd and work Teach For America in an inner city school and deeply care about the kids in my classes- plan lessons, do the extras, coach a sport, grade papers with individual notes for each kid ,plus mentor younger teachers - how many more hours do I put into my job than a private practice T? In prep schools it is literally 100 plus hour weeks week after week. My neighbor is head of a nonprofit hospice and puts in crazy hours per week- 80, 90. My T definitely works harder for less money than the psychiatrist , but definitely works less hard/less hours for more money than people teaching kids , often with the same kind of credentials. I might have a bias from the good people I know in my personal life who are nurses, social workers, teachers etc and go the extra mile as a philosophy, to see Peaches ' T as being cruel to let her down.

But what part of their training actually translates in this way?

If a doctor receives training in managing high blood pressure with drugs, they can reliably apply that training to real patients.

If a therapist learns about attachment, I dont see how they can apply that in any meaningful way, since human relationships are not at all mechanistic.

The premise seems to be that a therapist can be taught to orchestrate for-hire relationships according to some formula, then apply that formula when a person with attachment problems shows up.

If a therapist believes they are capable of this on a routine basis, they might have a psych disorder.

Also if a client undertakes such a process, are they to ignore the fact that the whole thing has been contrived? And that interactions, ruptures, repair, trust building, etc are at least partly fabrications and not spontaneous in the normal sense, and that much of the resulting drama and turmoil is process-driven?

TLDR: What exactly is meant by attachment therapy?

Btw, I don't know what is attachment therapy either and I have no idea how someone could be trained in it. I believe it requires a particular emotional capacity and a non-judgemental personality on a trainee part but I have no idea even how these qualities could be measured with some standardized test for instance. The only method (highly subjective again) is that a committee of people who themselves possess these characteristics and who themselves are able to function as effective therapists interview the candidates and just recognise people with like mind. Not a manualisable and falsifiable procedure but the only one I could think of that could realistically work.

As I said, I take some psych courses from uni right now and the realisation how everything is so defined and clear to these people made me physically sick. It is good to want to understand something but just because something cannot be defined in simple terms doesn't mean it doesn't exist. I would be far more cautious about things that have been oversimplified.

If someone has attachment trauma they need a therapist who is not trained in attachment therapy (which has been around for ages and has had dubious success) but one who is trained in the neurobiology of attachment trauma. That is an entirely different thing altogether and is a more recent area of study.
My ex T was trained in this. She was detached but supportive and very aware of even my most subtle body language etc that signaled the attachment trauma was activated. Most sessions I left her office fully grounded in the present and clear headed. The goal of attachment trauma therapy is to keep the client within the window of tolerance both in and out of session so that the attachment trauma is able to be self regulated. this is very different to attachment therapy, which activates the attachment and then abandons you to your own mental wolves.

I didn't talk about any particular "attachment therapy" but a therapy in general that attempts to deal with attachment traumas and wounds, regardless of how it is called. I still believe that someone just going through a training of some kind of therapy (evidence based or not) guarantees absolutely nothing because it's the therapist's person who conducts the therapy and not a particular method.

Sorry, that wasn't directed "at you" in any way, but I can see why you think it was. I just posted it as general information. the neurobiology of trauma is a specialty area and very few practitioners have training in it. It is "post degree" fodder and quite different to any other kind of talk therapy or relational therapy. It's more science based and more about fixing the dissociative elements of the attachment trauma.
I think more Ts don't know about it just because it is new and they don't know what they don't know.
I totally agree with you about the person of the therapist being important. If there is no connection or trust it won't help no matter what.

My ex-T had 2 year post doc training in trauma and dissociation and kept up with the neurobiology, I think. But she had a judgmental edge to her personality or personality defense system. I noticed it early when she talked about an experience with her mother but did not have the social smarts fully to understand that it would be an impediment to my therapy. I had tried so many T's and this one at least had good training and seemed to understand (intellectually) what was going on with me.

So I agree with feileacan. The non-judgmental temperament is important. In addition to training too, probably. 4 sessions per week probably would also help, but I would not have been able to afford that.

Hi Satsuma,

I'm glad your t allows the contact you need between sessions. If my t was OK with me having that same level of contact, it would work really well for me. But I'm finally at that point where I'm just not going to ask anymore, or let her lead me into thinking it's OK to contact her midweek if I need to, because there are just too many times it creates problems. She says I misread or misinterpret her meaning at times (which is true), and I say that she provides far too little to meet my needs (also true).

There are only so many times that people can cycle through the same situation and pain of unmet needs before the one with the pain/needs has to take a stand and say "Hey, this is NOT working. Reaching out for help like this, and not getting it, hurts far more than going without."

My t and I have talked quite often over the years about recognizing one's needs and getting needs met. My stand from the beginning of therapy was that the pain of reaching out and not getting needs met was worse than asking and not receiving. My t 's stand was that it is beneficial to recognize one's needs as legitimate and ask for those needs to be met, even if sometimes the answer was No.

Granted, we can't always have what we want, or even what we need at times. Asking for something from someone else in life doesn't guarantee we'll get a Yes. BUT...and here's what sticks in my craw...to reach out and ask for support at a CRITICAL moment from someone who has convinced you they will support you, and to get a NO at THAT time...there's where the damage occurs. I don't expect my t to be there 24/7 (although she has asked me that more than once!). I DO expect her to be there WHEN I TRULY NEED HER.

To me, the frequently of support my t offers, or the amount of support she offers, is NOT the sticking point. It's the TIMING of that support and WHO gets to determine if that need for support is VALID or not.

I know when I need support. If I reach out for it, it's because I've already weighed the situation, tried to talk myself out of needing the help, used coping skills, but realize it is still necessary to have some contact with my t to help ground me. Therefore, if my t decides she doesn't think my need is immediate or that I should be able to use my coping skills to soothe myself at that moment, and she decides either not to respond or to barely respond, I'm going to really resent it...especially if she has encouraged me to reach out when I need it.

Who gets to decide if my need for her support is valid? Me or her? My t spent a long time, early in my therapy, trying to convince me that my needs were valid and not wrong. At the time, I didn't feel worthy of having my needs met. I was too afraid to ask. I didn't think I deserved it. It took a long time to get me to the point where I could identify my needs and reach out to get them met without feeling intense shame. I can do that now, and perhaps that, in itself, is forward movement. It is. I can recognize that.

But what good does it do if my t worked so hard for so long to convince me that my needs are valid, and helped me build up the courage to risk asking for what I need when I need it, if she is then not going to follow through and provide it?

What good does it do if I, having already determined that my need is valid and necessary, ask for my t's support, only to have HER determine (based on her own clinical judgement) that it is not a true need (but perhaps a want), so she decides it would be best for me if she not respond, or do so very sparingly?

Doesn't that invalidate my needs? Doesn't it teach me that I can't trust my own perceptions? That I need somebody else to evaluate my thoughts, perceptions, and needs and then tell me if they are valid, acceptable, worthy of a response?

I find that very confusing, because again, that's what I experienced in my relationship with my parents. (I can't trust myself to know if what I feel is OK, if what I think is right, etc.)

I don't want anybody to misunderstand my t. She truly is VERY caring. I know for an absolute fact that she DOES NOT want to reinforce the invalidation and damaging messages my parents gave me as a child. But doesn't this situation my t and I are in right now do that very thing? Why doesn't she see it?

I get the feeling that maybe you feel like you aren't being heard here, and I just want to say that I absolutely think your viewpoint is valid and reasonable. One thing that has been helpful for me in recognizing that some of my needs weren't met in childhood is coming to a fairly nuanced understanding that my parents are/were not bad people either. They have/had flaws and their own emotional damage, and my personality and temperament was just a particularly bad fit to theirs. It's okay to blame them (because they should have done more to heal themselves and to take better care of me), but it's also okay to recognize that they just couldn't be who I needed them to be. It sounds like you're in a similarly heartbreaking situation with your T, and that's really unfortunate. It doesn't mean you're bad for needing her or that she's bad for not being able to give you what you need.

The thing about you knowing when you need something seems so key. Sometimes I think about babies and how easily they do that. Nobody tells a baby when to cry and when to be happily hanging out. They know when they need something, and they set out to get it in a pretty clear (and loud!) way. Sometimes I wish we could all be so in tune with our feelings and physiological needs but with adult ways of meeting them. And I wish your T was there to pick you up and soothe you without making you feel like you had to convince her that your need for soothing was real and pressing.

For whatever it is worth, and I know this is true, my husband says that I switch back and forth from trying to be an independent superwoman who can do anything and doesn't need anybody's help...to someone who seems like a very young, scared, needy child. I don't like this about me. I want to be the superwoman who feels confident and doesn't need support from others. The part of me that is like that scared, needy child is the dissociative part of me. It just kind of appears when I am under way too much stress.

Even though I am an adult who feels confident most of the time, when I dissociate, I DO feel very young and scared. It's like I've flashed back to my childhood. It's at those times I find I need the extra support from my t. I guess that is why I get so upset and angry if she responds to the adult part of me, with the assumption that I have all of the capabilities of an adult and so, should be able to manage myself. Even though she knows I dissociate like that, she responds in the moment sometimes as though she forgets.

Once I'm able to get out of that "scared child" frame of mind and evaluate what just happened, I have the feeling: "How dare my t hurt that tender, scared part of me that I've kept hidden for decades, after convincing me that it's safe to let her show up and ask for what she needs."

The result is always with me wanting to re-bury her because each failed attempt to get needs met reinforces my belief that those needs are wrong, childish, and a burden to others. And of course that's why I buried her decades ago!

My husband says maybe my t is trying to teach me a balance between being either a superwoman or a scared needy child by sometimes meeting my emotional needs and sometimes not. He could be right, and I can see how this approach might seem productive. My husband points out how much progress I've made over time, and how much I've changed since I began therapy. He says I'd never have been able to weather my mother-in-law's illness and death, taking care of her to the very end, a few years ago. I'm sure some of this inner strength is the result of my work in therapy.

But is the way my t is working with me the best way to help me develop balance? Isn't there a different way that doesn't hurt like h*ll?

If T's are doing this, which I think could be the case, I don't see why they can't clue our adult side in? Or maybe they think we need to let our child selves get it and clue our adult selves in? But it seems very disrespectful and not at all what I wanted and didn't really work for me in the therapy. Though I've been doing OK processing it on my own.

I just thought of something. You know how when parents have a toddler, and they decide to go somewhere without them, so they get a babysitter? But when the parents leave the house, the toddler get distressed and bursts into tears, feeling like they can't live without their mom and dad? But then later (hopefully), they calm down and get busy doing other things?

Do you think that by not responding sometimes, my t could be trying to train that dissociated child part of me that even though it feels horrible when I need her and she is not able to respond, I can survive it and won't die? So that, over time, it strengthens me?

Again, I can see the validity of that approach. But still, it seems so...I don't know...mean I guess.

Is that really the best way? Would responding more frequently be coddling? Would it keep me from getting stronger? I dunno...it still feels, in my heart, like I do need more support. It feels...somewhat too withholding.

Maybe my t and I just can't figure out how to find the balance and "get it right."