TIFT #6 Building Secure Attachment

A consumer wrote this. I’ll call her Joan:

"How can adults who have never had safe secure attachment, meet these needs and become healthy well adjusted adults? If we are not able to see a good therapist because of being too debilitated by complex trauma to be able to work and therefore have benefits to pay for good therapy. There must be some way for us to help ourselves heal, but how??

Most government funded programs end up doing more harm than good because of how you get kicked around and never able to build it with a worker, or if you get lucky enough to be assigned to someone good, corrupt management purposely destroys your trust and attachment as soon you start to build it with a front line worker.

Eventually after enough years we are going to give up on the system because it will never help us truly heal. But what then?"

Far too many times, I have heardsimilar experiences from comments tothe Howtherapyworks blog and from patients. That is one big reason for launching a training program, but this consumer deserves an answer.

Mistrust and Self Protection

According to theAffect Avoidance Model, entrenched maladaptive patterns are the result of our mind’s automatic, instinctive (and sometimes conscious) avoidance of actual or predicted pain. The pain ofnot having needs metby primary caregivers in early life is oftencoped withthroughan enduring resolve not to need or trust anyone.

Trust vs. Need

Here is where it gets complicated. Children have a fundamental drive togrow and develop, which causes emotional needs to be treated as life and death necessities. When there is a shortfall, the absolute need for support comes into conflict with the prohibition against neediness or trust.

Such an impasse does not stop the mind from seeking to fulfill emotional needs, but ways of going about it become distorted and compromised. Unfortunately, patterns seekingneed fulfillmentwhile avoiding vulnerability lead to unsuccessful interpersonal patterns. Here are some:

• Seeking people who are familiar in that they resemble family members with whom there is unfinished business. Of course these tend to be people who are dysfunctional and not trustworthy themselves.
• Seeking people who areas dysfunctional as oneself, and therefore who will be understanding and not rejecting.
• Seekingrelationship while avoiding full trust. This is the avoidant attachment style. Those others who are actually trustworthyfeel good when trusted, but experience pain when they are not. Sadly withholding of trust causes them to reciprocate with caution, which leads to feelings of disappointment and further self protection. This kind of interaction has negative effects, not only in the social realm, but at work also, and leads to some of thefinancial stressesmentioned by Joan.
• Another form of insecure attachment is the anxious, clingy type. Fortunately this gives many therapists positive feelings, at least at first. The problem is that, over time, the therapist’s simply being reliablefails todecrease the mistrust. The patient may test even more drastically or escalate demands in the hope of finding proof that trust is safe. The result is the opposite. The therapist withdraws, either emotionally or, more damaging, drops the patient.
• The patient seeks safety by looking, not for real connection and appreciation, but through “tokens” of love. Extra time, money, willingness to cross boundaries, other extraordinary gifts. Therapists may, out of their own weakness or lack of knowledge, forget that the understanding and empathy they naturallyhave to offerare actually the most valuable things anyone can give. They may mislead themselves into thinking that “proof” of love will alter mistrust. It doesn’t.

Perhaps you know of more variations. I’m sure there are many.

Problems with the "system"

Political systems seem inherently to neglect the needs of those with less power and. in particular, those with therelationshipconsequences of complex trauma. Besides political action, another answer, the one embodied here, is to try tohelp therapists learn to understand and handle intense feelings. Inadequate training tends to lead therapists to revert to just being “nice people,” and that is not good enough when it comes to complex trauma. Making the principles clear and accessible can be of benefit to therapists who have not gone deep enough in training or have found traditional theories too complex to absorb.

The Therapeutic Answer: Risk Taking

Joan ends her letter with those words, “What then?” The answer is taking emotional risks, thoughtfully and with informed consent. This is hard to do, and much harder when the inner child or instinctive mind is doing everything possible to avoid risk. The answer is, with some guidance, to identify people who are healthy, to overcome internal barriers to taking graduated risks, and to be careful in evaluating the results. Help from a therapist or reliable other enhances safety. Inevitably, some, hopefully a minority, of risks will not turn out well, requiring work to avoid an unnecessarily pessimistic evaluation. That is why the risk level should be increased by small steps. Even then, it is critical to be ready for failure and to avoid giving up entirely. Whatmakes for change in maladaptive patterns isproviding unexpected positive antidotes to predictions of hurt.

Why “Proof” Doesn’t Work:

Proof involves seeking to eliminate risk by testing, which, in the end, reaffirms not trusting. Testingcarries a readiness for and expectation of failure. A positive resultleaves intact the perception that failure was likely, whilea negative result reconfirms what was expected. There is no surprise, and thereforeno opportunity to fulfill the conditions for Memory Reconsolidation, namely, the juxtaposition oftheold, irrational fear with an unexpected positive antidote.

Getting Help:

Of course, as hopeful as thoughtful risk taking is, it is hard to do. It takes a lot of mental clarity and self-honesty to overcome automatic protections and reluctance. Having some kind of partner is helpful, if not necessary. Even better, if both parties are familiar with what is happening, they may be able to discuss this operation intellectually, before putting it into action. Talk, here, is a way of lowering the level of danger by imagining the possibilities before trying them out. Intellect won’t bring about change, but can increase safety and make it possible to move ahead one more step.

Jeffery Smith MD