How important is attachment for effective therapy?

Indeed.
Is Psychotherapy a Placebo? | Psychology Today
Does placebo effect inflate the effectiveness of psychotherapy?
http://www.sageofasheville.com/pub_d...CHOTHERAPY.pdf
The placebo is psychotherapy | Behavioral and Brain Sciences | Cambridge Core

A placebo effect is still an effect. See: acupuncture.

Believing in fairies keeps tinkerbell alive, dumbo and his feather keeps him flying, and there is always santa clause too

My thoughts too.

If it helps, it helps. It didn’t help me but I don’t doubt that others are helped.

I’ve had some success with acupuncture and self-help books. Since neither of these are “medical treatments”, could also be considered placebos.

Whatever works.

I have no problem if someone believes therapy helped them. I have a problem with the profession pretending like it is something it is not.

Well said.

And don't forget the cost. Rates are $180-over $200/50 minutes in my city and nearly all therapists are out of network. Even if they cut the rate by half, it's not worth it imo. Most people could probably get the same placebo effect by just reading self-help books or joining support groups.

I'm sorry, but my experience is different. I have a relationship with my therapist. It's real, even if I have to pay for it. Even for him, it's a real relationship, even though it's professional. I most definitely could not get the same thing from reading a self-help book. That relationship is the only reason I'm alive. My situation may not be the norm for people who seek out therapy, but I get something out of it regardless.

I don't think reading self-help books (or any psych literature, or engaging in a forum like this) is the same but I personally get much much more out of actively engaging in my everyday life and "ordinary" relationships. Plus a decent lifestyle, i.e. a balanced and non-restricted diet, some form of regular exercise, good relaxation and sleep habits, not allowing extreme stress and toxic people much, etc etc. I do believe that if someone lives a very isolated life, has basic survival and self-preservation problems, constant relationship troubles, no or little rewarding and fulfilling occupation etc etc - then therapy and the relationship with a decent T can make a big difference, perhaps even be life-saving, when it helps to snap someone out of a deep hole. But that's when the so-called attachment issues (the original topic of this thread) can also become potentially destructive, when a client does not have satisfying, enriching normal life attachments, and wants to substitute with a T. I think what a client gets out of therapy (or does not) is also a spectrum, just like most mental illnesses. Including that the same client may find therapy very useful at a particular stage of life, totally useless in another period, and everything in-between.

I do very much agree with stopdog though that therapists and the profession at large often exaggerates and claims many things it is not, and that can be not only misleading and overselling but also damaging for some. The "healing power" of the relationship with the T can be one of those things IMO. Not suggesting at all it is some generic BS but I am quite confident in my opinion that it is more often oversold by the profession than not. And many Ts do not encourage clients to focus more on developing good relationships in their everyday life. There are some exceptions of course - I had a T like that myself and heard of others as well (including on this forum). I think it takes good character, self-control, discipline and generosity from a T to habitually make it clear therapy has many limitations, is not meant to be forever and is not a healthy substitute of normal life, when they can quite easily manipulate and keep many clients for years and even decades due to attachment and other things that could really be found elsewhere as well.

I think attachment is not necessary for effective therapy but it is quite necessary to live a balanced, fulfilling life - we are simply a social species. The form and extent of it varies widely between individuals of course. And if someone (who originally struggled with the interpersonal world) can truly and effectively learn how to have better everyday relationships via therapy and initial attachment to a T, then it is great. I guess then we can say, in retrospect, that it was important. But as an anticipation and without extending it, I think it can be dangerous for some people.

As for the placebo effect - I believe that taking something that was mostly placebo (an OTC "supplement") at one point of my life when I was in a severe depressive episode had made a gigantic difference. Just enough to finally start being more proactive in resolving my issues and living a better life. I thought that stuff worked wonders for me back then, but whenever I tried it again later (when I was much healthier in general and would just have wanted some boost), it never gave me anything at all. I never tried therapy during my darkest, deepest periods of my life - perhaps I would have experienced similar. There is also the thing that if someone is very fragile and vulnerable to start with, anything can potentially have an influence, whether placebo, a listening and validating pair of ears, or some true biochemical effect. Obviously this is also what underlies the potential adverse effects of therapy (and exaggerates premises) on people in a very vulnerable state.

Do you happen to know any newer references? I have my reservations about an analysis made in year 1983 or 1985. I would also have similar reservations about any meta-analysis from the same year that would claim that therapy is super helpful.

My understanding is that the clinical fields of psychotherapy and the academic field of psychotherapy research do not have much overlap. Which effectively means that most psychotherapy research results do not make much sense in clinical context. And thus, claiming anything about it, be it that it's super helpful or that it is no better than placebo, similarly does not make much sense. One's conclusions are only as good as one's data permits and if the data is crap, then so are the conclusions.