Clients’ experiences of attachment in the psychotherapy relationship.

Abstract

J ohn Bowlby (1988), in one of his last scholarly writings, asserted that the adult client-therapist relationship could be understood as a form of attachment. In the decades following his seminal work, a large body of research has accumulated to support this position (for reviews, see Levy et al., 2019;Mikulincer & Shaver, 2016). It is perhaps understandable that much of this attention has focused on the therapist's role in facilitating client change through providing and regulating a secure therapeutic attachment (e.g., Teyber & Teyber, 2017). However, the goal of this chapter is to reexamine this literature from the client's perspective of experiencing attachment in the psychotherapy relationship. We begin this exploration from outside the therapeutic setting by considering the elements of all healthy child-caregiver attachments. HEALTHY CHILD-CAREGIVER ATTACHMENTSSummarizing a large body of theory and research, Mikulincer and Shaver (2016, pp. 15-16) identified five key functions that secure attachment to caregivers serve for a developing child. Attachment figures provide (a) a target for proximity seeking, (b) a safe haven when children feel threatened, and (c) a secure base that permits children to explore the environment and develop growing mastery. Together, these first three elements promote a sense of "felt security."

Adult attachment, emotional intelligence, affect regulation, and self-reported distress in first-year college students at a predominantly White university.

“…We selected affect regulation and emotional intelligence because theory and research provide a strong basis to expect these variables to serve as mediators between attachment and college student adjustment (Mallinckrodt, 2022; Mattanah et al, 2011; Wei et al, 2021), and because research suggests affect regulation skills may be amenable to improvement through psychoeducational interventions (Kotsou et al, 2011). Mikulincer and Shaver (2018) process model of attachment activation suggests that when a primary secure strategy is not successful, each of the two secondary strategies (i.e., hyperactivation associated with anxiety, and deactivation associated with avoidance), should involve a somewhat different profile of deficits in emotional intelligence and problems with affect regulation.…”

On the need to reconcile cultural and professional power in psychotherapy: Humanistic principles that are foundational for feminist multicultural practice.

“…Instead of viewing it as a process in which therapists intervene upon clients, therapeutic change is understood as a process in which clients, quite selectively, take what they choose to learn from their therapists and then adapt it, often covertly, to make sense in their lives. This theory is supported by a volume of research demonstrating that clients shape their therapy success (Angus et al, 2015; Fuertes, 2022; Gordon, 2012; Levitt et al, 2016; Rennie, 1994). Clients are recognized as the arbiters of which interventions are used and how they are applied, often altering therapists’ ideas dramatically.…”