How to Address Attachment Challenges in Trauma Treatment

Published by ninakeeler on

First things first, let’s first talk about attachment.  What is attachment?  In the 1970’s, founders of the term, “attachment theory,” Dr. John Bowlby and Dr. Mary Annisworht referred to it as the way we learn to have relationships between the ages of 0-3 years old. There are two categories of attachment: secure and insecure. Within secure you have the Secure attachment style and within insecure you have anxious-ambivalent, avoidant, and disorganized attachment styles.  Attachment refers to the relationship the child has towards the caregiver and bond refers to the relationship the caregiver has towards the child. 

I believe that attachment styles transfer into how we have different types of relationships.  A person’s attachment style is usually most evident when they are under stress.  I also believe that a person’s attachment style can be affected by trauma. Therefore, as trauma treatment professionals, we need to be aware of attachment theory and how it might play out in our therapy sessions. 

Usually, our clients come to see us under stress.  Therefore, it is important to understand that you are more than likely getting a good look at a client’s attachment style when they are with you in therapy. 

For example, a client who has a secure attachment style will have good boundaries within the therapeutic relationship.  They will also typically be willing to try new thing in between sessions and look forward to reporting back in with you on progress and barriers.  The client with anxious ambivalent-attachment might be overly concerned with your approval of them in the therapy session.  They constantly predict what you are thinking about them and what they think you want to hear from them.  The client with avoidant attachment often struggles to let you support them when they are stressed.  In sessions, they may come off as closed off or angry.  Lastly, the disorganized attachment style will likely struggle to stay in session.  They will struggle with feeling safe, constantly check your motives, and seem to be looking for the negative in everything.  

As I give these descriptions you can see how a client’s attachment style can consume a lot of the therapy session.  Being able to address the client’s attachment style is important in keeping treatment from derailing. 

In this week’s vlog I share, in detail, some things to consider when addressing attachment challenges in trauma treatment.

1. Provide the client with psychoeducation about attachment theory

2. Assist client in identifying when their attachment style is showing up in sessions. 

3. Speak directly to the client’s attachment challenges in session. 

Attachment challenges can easily show up in trauma treatment and if they are not correctly identified, it can become a sore spot between you and your client.  If you feel the therapeutic relationship is struggling, it is worth considering whether or not working from an attachment-based perspective might be helpful.

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