A Reader Asked:
“You write a lot about people that are conscious of their attachment to their therapist …what about those that avoid…” [photo by Alexander Dummer, Pexels.com, supplied by Michelle]
For context, here is the full version of what she wrote
When you’re a child alone in the dark you will take a hand that is given out to you…(I have tried in vein to find the exact comment you wrote it in) and I wanted to say that this may be true for a child (who is always hopeful to survive ) but not for an adult . I think many people (myself included) are “earned avoidant” and would rather sit in the dark with eyes closed then bear the risk of taking an unknown hand. I find myself in this place now whereas before I would have taken the devils hand not to be alone.
You write a lot about people that are conscious of their attachment to their therapist …what about those that avoid…I think I told my first therapist …and probably my second that they were like blocks of wood to me..they could have been switched to someone else and I wouldn’t have minded…I stopped therapy the first time as it felt like a Pavlov’s dog..getting to therapy sitting on chair and starting to cry every Wednesday for three years…it’s obviously where I was at….so I wondered if you would write about that end of the spectrum.
This blog has become a special place for those who experience intense attachments to their therapist, but those “on the other end of the spectrum” are just as important. Let’s go back to Bowlby, who first got us interested in attachment styles. Working with Mary Ainsworth, the two noticed different patterns of attachment in children from age one to two years old. In their experiments, when the mother briefly left the room, the “securely attached” children fussed a bit, but soon accepted their mother’s soothing. Another group, the “anxious-resistant” children were clearly upset, took more time to be soothed and seemed to show anger at the parent for leaving. Those are presumably the ones highlighted in many posts and comments on this blog, who, as adults, show attachment anxiety and cling tightly. The third group, showing “avoidant attachment,” seemed to express the attitude that the mother meant nothing to them. I think those are the ones our reader is talking about, who, as adults, have trouble trusting and forming bonds with a therapist. She says “earned avoidant,” more on that later. Just to be complete, a fourth group termed “disorganized-disoriented” turned up in Bowlby’s research, who seemed not to know what to do, as if they never had found a successful formula for dealing with separation.
For each group of children, separation was stressful. Bowlby’s big discovery was that the differences were not caused by fantasies or genetics, but by their actual experience with mothering. Separation was least stressful for the securely attached children mostly because of consistent, accurate attunement by the mother. The insecurely attached children experienced heightened levels of stress related to less effective maternal attunement and reacted using the various strategies to minimize the stress they experienced.
Acting to minimize hurt, even at the beginning of life, is right in line with the Affect Avoidance Model, which is what I use to make sense of therapy and the problems we deal with. According to that model, maladaptive responses are triggered by actual (or anticipated) negative “core” emotions such as fear and pain, which are not always conscious. These reactions represent our instinctive mind’s efforts, using the tools available, to mitigate some deep down triggering emotion.
So the anxious-resistant kids learned that fussing was the way to communicate their distress and to get at least some of the attention they needed, even if it wasn’t perfect. The avoidantly attached group learned a different strategy, to suppress the sense that the mother mattered in any emotional way. They learn very early in life that needing or actively seeking attention from their mother is a formula for pain, and they avoid it. When such a pattern gets established early in life, long before words, avoidant reactions tend to be completely automatic and not under any kind of conscious control. The avoidant child will be self-sufficient and comfortable with a more solitary existence. These children grow up to be independent and can do quite well without depending much on others.
However, the situation is actually more complicated than that. Avoidant people still have, on some deep level, a need for relationship. In fact, that ongoing need is what necessitates an ongoing denial. Sometimes the need is so intense that it can override the denial. Perhaps that’s what our reader meant when she described herself in childhood as ready to take any hand that was extended. The mind is trying to deal with two conflicting needs, one is to experience human connection and the other is to avoid pain. The need that is most critical at a given moment might take over. However, with more sophistication, humans seek ways to have both. Perhaps her adult solution was to engage in therapy, but experience the therapist as a piece of wood.
The range of possibilities for solving conflicting needs is extensive. Going beyond the case of our reader, another way to solve this dilemma is to seek non-human substitutes for connection. One can gravitate towards intense physical sensations without relationship, for example, addictions, eating disorders and other compulsive patterns. Giving oneself gifts, such as by shoplifting or compulsive buying is another. Interacting with others through psychological manipulation is another way to deny the other’s humanness and dangerousness. (I define manipulation as “bypassing the other person’s free will,” as if they were only a tool to gain something.) Controlling behavior is a related strategy, minimizing the risk of interpersonal hurt by removing the human variability from the interaction. All these non-conscious, automatic strategies serve to minimize the possibility of experiencing “attachment hurt.” I’m sure there are other strategies, generally bearing signs of the stage of development when they were first “invented.”
So what are we to do?
For any repair, the aim is to go deep down and “face the feelings.” The problem is getting past layers of affect avoidance to get there. Let me unpack that statement.
The Affect Avoidance Model says that maladaptive coping is constructed in layers. The first trigger might be a natural fear of being hurt when seeking connection. This fear is taken care of by a first layer of avoidance, consisting of cutting off any conscious feeling of need for the other. However, when the mind detects that a layer of defense may fail, then a new layer is produced. A second layer of defense might be finding some less threatening substitute for connection to take some of the “steam” out of the natural neediness. But this still leaves a powerful human need unfulfilled. A third layer might emerge to protect from the second one failing. This could be to develop a personal value, saying that “neediness is bad and that one should be fully self-sufficient.” When we fail to follow our values, we experience punishing shame. The threat of shame is a common reinforcer of barriers protecting against the need for love. This layer works both for avoidant people and those how are more “clingy.” Almost every commenter in this blog mentions feelings of shame at experiencing needy feelings in relation to the therapist. Thus the adult experience typically would involve multiple layers of defense against unmet but natural human needs. Of course, the more thoroughly the need is blocked, the stronger it gets, so the layers of defense, like walls and moats in a medieval castle, keep having to be reinforced.
What therapists and therapy need to do is work with each layer starting from the most accessible. There are several approaches. We point out a defense and invite the patient to let it go. We can also explain how compulsive behaviors may be covering up a feeling and invite the patient to change those behaviors and brave the emotion. And we naturally offer genuine connection in a way that tends to awaken the need, and bring it to the surface. When neediness appears, acknowledging it, as well as the fear or shame that come with it are part of the process of catharsis (the original term for processing painful feelings so as to take out their sting.) Sharing an intense feeling with an empathic other is the formula for making catharsis happen.
Another way to describe this emotional healing is this: When the context of therapy brings affects into the room, the result is an example of what Alexander and French called a “corrective emotional experience.” The essence of it is a combination of activation of emotional experience and provision of “corrective” information (such as the safe and warm therapeutic relationship), leading to change. More recently, the discovery of the neurophysiological mechanism of reconsolidation showed just how this works, down to the biochemistry and synapses (see my post on the Affect Avoidance Model). The combination of felt affect (feeling plus the visceral reaction that tells us it is more than intellectual) and being exposed to and surprised by a context that contradicts our negative expectations, leads to change in patterns encoded in memory.
The problem for avoidant people is that they are already highly practiced at not feeling the affects that are required for change. Like our reader, they can go for years without their inner self allowing a feeling of neediness or attachment to get through. Probably the best answer is for patient and therapist to be conscious that avoidance of attachment is not healthy and to work at connecting with the intense need that lurks underneath the defenses. This is where a well attuned therapist will help by catching those moments when attachment shows itself. Those, too, are the moments when an aware patient might be able to admit and heal some of the affect. Another is when a relationship is so powerful, for example falling in love with someone outside the therapy, that the attachment breaks through defenses. Then a context of acceptance and safety may help coax affect past the lions that have been guarding the gate.
Now let’s get more specific about the details revealed by Our reader. Remember that I am making some guesses that may not be correct and may not actually apply to her or to you, the reader. She expresses something very interesting. She recounts that in therapy she “felt like a Pavlov’s dog..getting to therapy sitting on chair and starting to cry every Wednesday for three years…” My first guess is that the tears were about missing a human connection. Without conscious awareness, the tears might have been a communication from her inner child. She might have been doing what children do to solve problems: They try to motivate the grown-up to solve the problem. Could her tears have been a nonverbal signal to the therapist that she needed help in solving her dilemma between the need for connection and the anticipation of pain and disappointment being the outcome? That’s my guess (disclaimer: I am not in a position to test out or verify this thought.). I would want the therapist to focus on the tears and what they are saying, and at the same time, to focus on why their meaning is being kept such a secret.
What we hope is that the two needs, to find human connection and to avoid pain will step-by-step come to full consciousness. The anxious anticipation of pain will become active where it can heal in a context of the corrective experience of no real danger. Eventually, underneath the bottom layer, pain left over from early experiences of deprivation will become conscious and heal. At the same time, the availability of human connection (just being understood empathically is enough) will both energize the process and provide corrective information that disappointment and pain are not inevitable.
In the course of this dance, there are usually many twists and turns with different layers of defense appearing to block pain or to block connection. Each one will need to be set aside voluntarily or pushed aside by the sheer desire for connection.
Unfortunately, that is not easy when the blockage against attachment is automatic and powerful. That is why I am emphasizing working together as a partnership to identify blockages (defenses), to process inevitable breaks in attunement that can fuel distancing, and to be open to the fact that the therapy relationship is, or should be, one of genuine and satisfying empathic connection.
I am saying that about the therapeutic relationship for an important reason. Bowlby still has a lot to teach the therapy community. Remember that his first concern was maltreatment in post WWII orphanages where an ongoing vestige from the Victorian era had staff avoiding attachment with kids to prevent “dependence.” Bowlby showed how harmful this was.
Psychotherapy grew up under the same Victorian influence, urging therapists to remain objective and “neutral.” The field of psychotherapy has not entirely gotten over its Victorian fear of “gratifying” patients emotional needs and has not fully accepted that empathic understanding is powerfully healing and pure without violating boundaries or causing harm. (John Norcross’s work on common factors puts empathy at the top of things shown to correlate with successful therapy.) And when it happens, empathic understanding does lead to real, two-way attachment of the therapeutic kind.
To be balanced, let me state the other side of this potentially prickly issue. Sometimes patients focus on the illusory safety of substitutes that are less truly intimate than genuine empathic understanding. These may seem safer than pure empathy. They are the tangible wishes that focus on concrete extras rather than the gold standard of full, empathic understanding of another human being.
However, lest I seem to be promoting excessive rigidity about boundaries, these pages give many examples of how stiffness about boundaries sends the wrong message to the inner child. The message can feel like “your wishes are bad and You shouldn’t dare have them.” In fact, some wishes for concrete exchange with the therapist can be quite benign and may simply be an attempt to see if the therapist actually cares and is human, as demonstrated by willingness to be flexible. Such “token flexibility” is quite different from the lesser gifts or promises that can represent a distraction from the difficult experience of sharing deep feelings with an understanding other.
I hope these thoughts will help. Maybe they will lead to more discussion of the avoidant style that has been relatively underrepresented in these pages.