Attachment-based psychoanalytic psychotherapy
As the name suggests, attachment-based psychoanalytic psychotherapy combines the principles of psychoanalytic psychotherapy with attachment:
Psychoanalytic psychotherapy involves working with a client to understand how their past impacts on their present, including how patterns of difficulties in relating to others get repeated over and over again. The therapy aims to understand the reasons why we end up repeating such patterns, even when we truly do not want to. Sometimes we are aware of aspects of why we keep falling into these ways of being, but more often than not they are out of our awareness. Therapy becomes the place to begin to piece together aspects of the jigsaw puzzle that lead us to behave in the ways we do. Part of this process can involve giving time and space for the working through of painful and difficult feelings or episodes in our earlier life that are attempting to be heard and understood via these repeated patterns. Once these have been worked through, we are more able to move on to embrace a life that more closely matches our hopes and dreams for ourselves.
Attachment is the way we describe how we learn to be around people when we are utterly dependent as small babies or infants. Ideally, our carers were able to respond to our physical and emotional needs, leading us to become securely attached. Being securely attached is known to link to a healthy mind and body, and the ability to form happier, healthier relationships.
However, if as babies we pick up that our carers can not manage emotional distress we innately learn to suppress it, leading to an avoidant attachment style. As we grow up, we can feel disconnected from emotion and tend to keep people at arms length, seeing the world through a very rational lens.
Sometimes the only way to get the attention we needed in infancy was to be more 'needy', leading to a more preoccupied or ambivalent attachment style. This can lead us to try to form very close, almost suffocating relationships with people. We can find ourselves feeling overwhelmed by emotion, making it hard to see the wood for the trees.
If our carers in our early life we frightening (e.g. with violence or abuse), or were frightened themselves (perhaps trying to manage their own emotional distress) this often has a profound impact on the way we develop. Here the carers were both the source of distress, and also the source of comfort, which is confusing and disorientating for a young child to manage. As a result, on top of a secure, avoidant or ambivalent attachment style, we may also develop a disorganised attachment style. This attachment style tends to surface at times when we feel under threat of some sort (e.g. when ill, scared or when our world is thrown into disarray).
In attachment-based psychoanalytic psychotherapy, I aim to understand how attachment has shaped the way a person relates to the world and to themselves. This happens both via the material the client discusses, and how it feels to be working together. I pay attention to how therapist and client relate to each other - essentially, what it feels like to be in the room together. The therapeutic relationship is therefore key to the work, and is what sets it apart from some other forms of therapy (e.g. cognitive behavioural therapy, or CBT).