Healing A Damaged Self


*** Now Available: Attachment to Your Therapist: A Conversation. This series of posts in expanded E-Book form, on Amazon.***

Cynthia writes: (slightly edited for clarity], I am in therapy. The philosophy seems to be that therapist is to bring out needs and wishes and then not fulfill any of them in order for client to feel frustration, anger, pain, sadness. Then somehow from understanding and being aware of these feelings healing takes place. This is cruel and unusual punishment for some clients and certainly for me. I am an adult but I equate my needs to that of an institutionalized orphan whose physical needs were met but social, emotional,attachment needs were neglected. I am at a child’s level of these needs. Should one recommend catharsis by provoking pain, sadness and anger for a child?  That  would be absurd. I can tell you that by being more revealing and open with me and willing to do what i wish for (like being read to) has triggered hope, love, along with fear, confusion, jealousy, unworthiness, pain and sadness.  I believe closeness will trigger emotions in a much healthier way.  My model is based on the necessary love/bond between mom and baby.  My relationship with my therapist is the closest thing to healthy I’ve ever had. And I get to work through all the necessary emotions. I get frustrated that sessions are so short and only once a week but that is golden compared to no therapy at all!  When I read the comment above by “Me”, I just had to reply.  Some people have deficits that need filling.  To do so is healthy.  We follow the boundaries.  Emotions come to the surface in close intimate therapeutic relationships.  Self esteem can be developed.  I can socially emotionally cognitively mature into my chronological age.  I research psychotherapy and I only find philosophies like yours.  I can’t believe it is 2014 and therapy is still so undeveloped!  So many forums and blogs are filled with people not getting what they need in  therapy!  I’d like to find more information on what my therapist and I are doing!

Later:  My analogy is of the institutionalized Russian orphan babies. Physical needs met but no emotional attachment to anyone. Some die, some become mentally disabled, and some are ok.  I think it is a getting stuck and being in need of certain things to happen before one can move on.  For me it is a stubbornness.  I refused to move unless I felt some love.  I had too much self hate.  Unless I felt love from a significant person (therapist) I was gonna stay stuck. Not all people need the same thing but people need to experience being in a nurturing relationship as close to healthy mother/baby as possible in order to be able to have their own healthy relationships. Attachment. Thank you.   Cindy

Dear Cindy, I really like your description of the therapeutic process. You just weren’t going to get anywhere without feeling genuine love. While your therapist respected boundaries, things like being read to gave you a real sense of being nurtured. That didn’t stop you from feeling many mixed and painful feelings, in fact it triggered them, but the relationship gave you a basis for working with those feelings, together.

What makes this topic difficult to write about is the fact that any action a therapist may take, especially those that go beyond traditional limits, can have very different results depending on the particular therapist and patient. What may be just right for you and your therapist could lead to trouble for a different therapist and patient. Given the real risks, almost any recommendation or suggestion can be mis-applied in a way that could do harm. That is the reason for so much caution and the reason why I can’t make suggestions for specific people in this blog. However, let me do my best to talk about the issues.

An easy but oversimplified way to look at the interaction you describe is a “deficit” model in which people with deprivation in their background, are seen as simply needing a “corrective emotional experience.” Not only is this idea appealingly simple, but it responds to our inner child’s wish to get right to creating a situation that will take away our pain. The problem is that the healing comes not from feeling good, but from working through defenses and painful feelings.

The part of this model that is correct is the re-creation (or creation) of a feeling of safety. As I recently wrote in my post on Mindfulness, one of the conditions for healing is a deep, internal sense of safety and connection that is re-awakened and reinforced by a positive relationship with a therapist. This feeling of relationship is something most of us have internalized around age three. Unfortunately, even if adequately internalized, it can still be vulnerable in stressful situations. For many, this feeling of safety may be even more compromised. When the feeling of safety is not available, healing cannot take place. This is why it is important in therapy to have a feeling that your therapist really does care about you.

A social worker friend once told me, almost in a whisper, “It’s the love that does the healing.” I think there is truth to what she said. But the purest form of love is empathic connection. That is the core of true intimacy. When that happens, unless there is a serious blockage, people can’t help but care for one another. This natural bond is a major part of what creates the safety needed for healing. What all patients need is genuine, accurate empathic connection.

You rightly suggest that your situation may be different from that of other people. When the inner battery pack of connection is less well formed or more vulnerable, and trust has been broken, there is probably more need for literal indications of caring. Those who have more reliable access to their own internalized feeling of security can handle more austere styles of therapy. It is often recognized that a depriving style of therapy does not work well for trauma. It does appear that sometimes tangible indications of the therapist’s personal caring can make all the difference. Still, even with tight limits, it is natural for therapists to care and feel real connection with their patients, and it is natural for this reality to be conveyed in some way.

As you say, what different people need can vary greatly. I remember a patient who had been in psychoanalysis in Europe. When she came to the US, she began to fall apart. What had been holding her together was the quiet, reliable, sphinx-like demeanor of her analyst. For her it was opposite to the loud, dangerous chaos she had grown up with.

Pitfalls and Reasons for Concern:

As you point out, the field of psychotherapy has long been wary about overt expressions of caring and nurturing. It may be because a therapist is afraid of closeness or is guided by Victorian precepts, but let me describe some of the real problems and risks.

First, if boundaries are blurred, which you have indicated is not the case in your therapy, it is all too easy for the therapist’s needs to compromise the patient’s. Therapy is for the patient. What is special about the therapeutic relationship is that a therapist is there for one reason, to help you heal and grow. Boundary violations often start with a rationalization that they are for the patient when they are really not. The end result can be disastrous and very sad, with loss of a good therapy, damage to the patient and damage to a career.

The second problem is that true closeness, that which comes from revealing your deepest feelings and vulnerabilities, the bedrock of any good therapeutic relationship, is often scary. Real intimacy, in the sense of accurate empathic connection, is well known to be one of the greatest challenges to humans. So it is that, in many instances, patients and therapists may prefer more obvious and concrete indicators of love over pure empathy. In this way, gifts, extra time, and other unusual exchanges can be a way of avoiding real closeness even when they seem quite genuine.

Going back to what I said earlier, in cases of severe deprivation like yours, something more overt may be needed to allow you to feel safe and connected, the problem is that telling the difference between a simple genuine gesture and a subtle avoidance of real empathic connection is very hard to distinguish. The same act can mean so many different things.

The third problem is the one that, I think, lies behind many of what seem like prescriptions for hurtful and even sadistic withholding on the part of therapists. We all seek to escape pain. When deprivation in the past has been a source of pain, there is naturally a strong motivation to undo that pain by finding a new relationship where deprivation and abuse will no longer happen. The inner child’s idea is to escape from the pain by undoing it, rather than going through and healing the anger, hurt and other feelings that are the legacy of abuse, neglect, and deprivation. A “Yes” from a therapist will awaken young wishes in full force. Since they are usually pent up wishes from early life, it is often not long before those desires go beyond what even a flexible, caring therapist can do. Wherever a therapist sets limits, those limits will become the here-and-now embodiment of hurt from the past. As you describe, with a trustworthy and empathic partner, one will be able to process painful feelings and heal. Your therapist’s giving to you “triggered hope, love, along with fear, confusion, jealousy, unworthiness, pain and sadness.” Working with these feelings is what therapy is really about, while awakening a feeling of being cared for is what allowed you to dig into the work with confidence that you were not alone.

A fourth common pitfall is that therapists may have trouble saying “No” and, by not setting limits, may imply promises they can’t and won’t keep. The more they give, the more their patient expects. Sooner or later, this pseudo-generosity will create a problem that is much harder to disentangle because the therapist has been an active participant. The other side of the coin is that a therapist’s patient and firm insistence on limits may be what shows true caring and creates a safe framework for growing.

Therapists and good mothers are not that different. They have to deal with the impossible job of always knowing when to say yes, when to say no, and how to keep empathy when the relationship is difficult. Even if the interaction is more governed by rules or a formula, there are subtleties where humanness shows through, hopefully for the better.

You have a fine way of exposing the problem and not leaving room to wriggle out of a straight answer. I hope I have clarified why the issue you bring up is so difficult for all of us.

Next post in the Attachment Series: Shame and Attachment.


PS:  I’m closing this post to comments, to keep the discussion active, so please put your comments on the most recent post where they are approximately relevant. Thank you.  Jeffery


  • Reading Cynthia’s description of her needs and therapy, I can really understand why she would yearn for closeness in therapy and to be read to and so on. Not long ago, I read Annie Roger’s book, A Shining Affliction, and it seemed to me that she was looking for (and eventually found) that same kind of nurturing and care from a therapist.

    I am almost the opposite in my needs. I don’t have difficulty making friends and I have many close relationships. I find myself in the caregiver role a lot. When I began therapy (for issues related to bereavement and adoption), I discovered how powerful therapy can be, and that power lies entirely in the relationship (for which no handbook is provided). My therapist is wonderful and very kind. Certainly empathic. What I learned is that any sign of concern on his part causes me to worry about him. So, when I felt suicidal, I quit therapy so that I wouldn’t cause him any worry.

    Eventually, I worked through that and pulled myself together and went back to therapy, where I am more relaxed now. I have no idea why I used to worry about him so much, to the point where I would quit therapy rather than cause him stress. But I know that if he tried to read to me or act parental, I would feel very alarmed. We’re the same age, for one thing.

    So for me, the safe distance works very well. I feel his empathy quite easily without his having to say anything. He does a good job of preserving an emotional space between us so that I can drag my stuff out (my emotional stuff). But nevertheless, I feel very close to him. But he lets me feel close in a safe way. I don’t know how he does that, given how much I worry about everyone, but he does.

    When I read your blog, I think about how therapists see a different person each hour, with different needs. Maybe one person likes to be complimented or to be read to, and the next one will feel overwhelmed by anything more than a slight smile. How do you figure this out? How do you adjust hour after hour after hour?

  • […] Dr. Jeffrey Smith has hit another one out of the park on his blog Moments of Change. He recently put up an excellent post that discusses what a therapist does and does not provide for a client in therapy and how you deal with the pain of the deprivations and why deprivation is sometimes necessary. This has been a big theme in my healing and I think he does an excellent job explaining what is a very complex issue. If you have ever struggled with what you cannot have from your therapist (Lord knows, I have!) go read this article: Healing a Damaged Self. […]

  • Hi Jeff,
    The issue of what I cannot have from my therapist has been a major theme in my healing and I thought you did an excellent job of addressing what is a very complex issue, the solutions to which vary widely from dyad to dyad. I found this very helpful to read (as I have recently had an old hurt resurface) and shared it with my readers on my blog. I really appreciate the time and care with which you address these topics.

    All my best, AG

  • Dear Jeffery,

    Boundary turns more important after I read this article, and here is a conflict for me as a new learner, how can I tell if I break boundaries without knowing what is boundary? I am afraid it is some blind point in my skills. What I can do with this?Thanks a lot!

  • Amazing that you can put into words how this boundary stuff works. I’ve had issues with my therapist not hugging, but I have also grown more in two years not hugging, than any therapist that was always placating to my needs with hugs. It truly is amazing how the relationship works. Thank you for writing the article and thaks to Attachment Girl for posting on her site.

  • hi! me again! I’d like to say that 45 minutes a week is not enough for me. This is not a bad thing. It’s a true thing. It seems that if I could be adopted by my therapist and his wife for a month or so, then I could internalize the all so important feeling of relationship that healthy people do at around age three and also gain reliable access to my own internalized feeling of security through loving relationships. I cry tears of mourning for what i didn’t get and for what i need.
    Maybe the girl scarred by a chaotic family hasn’t worked through these issues if her therapist’s sphinx-like demeanor held her together. It seems to be the case if she “fell apart” when she came to the USA. She hasn’t internalized a feeling of security.
    I’d like to say that longing for corrective emotional experience does not seem to be a wish to eliminate pain and to just feel good. Deprived people are faced with the same pain as loved people. The difference is that the deprived lack inner resources and there is the added pain of neglect. I expect to and have started to work through fears and defenses that cause me to push my therapist away. I have to because it kills me to have something inside me that puts a wall between me and love. I cannot rest and become inconsolable till I do work through my feelings. I will work for love. Even well-loved children need to learn to come to terms with things such as not getting what they want all the time, sharing parental love with siblings, having to help around the house, having scholastic pressures ect…I expect the pains of life. Imagine that a loving parent would’ve helped me with my homework. That would feel good and supportive and show me value for academics, for finishing things ect. In turn, my report cards would probably not have said,”does not live up to potential”. Yes, a loving relationship feels good! Healing does come from both feeling good from loving a significant person while working through defenses, fears, pain.
    I do not wish for my cry for more than 45 minutes a week to be responded to in ways like these: my desires/needs go beyond what a therapist can do, or the more a therapist gives,the more I expect. I just need to experience healthy loving nurturing living for a certain amount of time. How does it feel to live a whole 24 hours in a healthy way? A week? Year? Am I missing something or doing therapy wrong? Do I need to cry and mourn more? What will that accomplish?
    I appreciate your response to my initial comment above. For the most part I felt understood. You acknowledge that when I process my painful feelings that are amplified within a loving relationship, that I am doing the work of therapy. Yet you make references to fantasies of escaping pain and to just wanting to feel good. It is an illusion to escape pain. If you don’t process it, it will still be there and still affect your life. Perhaps it is where the line is drawn: how much one must mourn what one can never get, and just what one CAN get. Who knows. Some day there will be a virtual reality program that re-creates a loving family experience. I am a wide range thinker and I can’t give up on myself. Not to mention that there is a lot of room for growth in the field of psychotherapeutic therapy! thank you!

    • Dear Cindy, Your persistence is a really great asset.
      1. I agree that the person who was held together by the Sphynx-like therapist wasn’t really growing during that time, though perhaps she needed the time and quiet to be ready to let go of some layers of fear of a more emotional connection.
      2. My point is that healing and growth happen mostly as a result of working [to quote you] “through fears and defenses that cause me  to push my therapist away.” as well as grieving for what you didn’t and possibly can’t have.
      3. On the other hand, if it is possible to have more from your therapist, while I don’t see that as healing in itself, the extra time, etc. can be something that makes it easier or even possible to let go of defenses and feel feelings.
      4. All this splitting hairs is to say that if you and your therapist can work out a compromise you can both live with, you should be able to accomplish the emotional work you need to do.

  • I’m in psychoanalytical psychotherapy also, for many years and still now only really getting to the difficult emotions. I am also confused about the nature of the relationship with the analyst. I sometimes feel I am being offered a relationship that will repair and replace but also encouraged to grieve something I can never have. I am aware of my fantasies of oneness and and a perfect parent and aware I have frustration and anger waiting in the sidelines in reaction to this deprivation. Simply being frustrated that the analyst is not mine and not there with me, inbetween sessions. I stop short of being able to verbalise this and feel annihilation anxiety, without a connection to anyone. This is a very difficult and painful time for me. I would very much like an internalised relationship I can hold on to, something I lacked in childhood and something I’ve been led to believe we cannot find out who we are, without. I suppose I cannot keep a loved one in mind if I cannot consciously hate them. I will read above link to Healing a Damaged Self but in the meantime…if anyone can relate…

    • As a therapist, it is often not possible to distinguish between new internalization that slowly grows and the removal of barriers to accessing an old sense of connection from pre-verbal times. What I believe is that the difficult process of letting go of barriers to exposing our very young needs and wishes and sharing those, even when it feels perilous, is the key to repair. In the end, it doesn’t matter if this leads to new internalization or re-awakening of old ones. JS

      • What if you have a young way of yourself and you never show it because you feel it is very bad. If you eventually show it a little to your therapist and you learn that the only way to fix things is for the “Going on with Normal Life” part of you to help the young part. What if the Going on with Normal Life part doesn’t know how to do it? Can the therapist help at all or is this one of those situations that isn’t really fixable unless you can figure out how to get one way of you to help the other way? Is the therapist trying to tell you that you need to stop thinking or wishing the therapist can help and figure out how you can help yourself? How do you know if therapy can help you or if you should stop because the only real solution is to figure out how to help yourself?

        • I would sure hope that the therapist can help you. The therapist could partner with the “normal life” way to help the younger one. Not sure that is a good enough answer. JS

  • Thanks Jeffery for your quick response! I’m not really sure I understand though. The safety feelings that we internalize by about 3, is this similar in a sense to the ‘mirroring’ that an analyst may describe and that without this we will not be able to freely think or feel about/towards them – in a sense internalising may mean ‘be able to think about, regardless of whether it is positive/negative”? I mentioned deprivation in my post but I’m not sure I used it in the correct sense. I had a very ‘doting’ anxious mother who didn’t ‘do’ separation. So I have a tendency to fantasise similar things as Cynthia mentioned – being adopted by your analyst, we can’t be the first to think it, won’t be the last I’m sure. As laughable as it sounds. It does sometimes feel like you’re led down a path only to be told its a dead end – and ‘now face it’.
    I guess it wouldn’t be worth discovering if it was easy.

    • Dear Pop–
      When a parent or primary caregiver has difficulty acknowledging the reality of the child being a separate human being, I think it can lead to the child also being afraid to acknowledge separation. When this happens (I have seen it in a number of different scenarios), defenses are set up, in effect, to deny or combat separateness as if it were dangerous. In this case, learning that separation is not really threatening, and accepting the experience, is the key to learning to feel comfortable as a “free standing human.” It may take many of those emotionally scary, but actually safe experiences to make a dent on the pattern. Defenses can range from being unable to say “thank you” because it is an acknowledgment of separateness to rage at the other person for having a separate will, to clinginess, to needing a substitute closeness such as drugs, etc.

      So, in the light of the original post, It seems like internalizing a sense of secure connection and coming to feel safe about being separate beings are two different but intertwined developmental acquisitions.

  • Thanks once again for your insight Jeffery. That is essentially my situation you have described. This blog is fantastic, its not easy to find discussions with analysts and other analysands online.

  • I’d like to second what Pop writes about your blog. It is fantastic. I came here today because I was on the verge of acting out by cancelling a session (this, after 10 yrs). But before I did, I figured I’d come here. In short, I will be attending today’s session. Thanks to all participants in this great discussion.

    My indefatigable therapist seems very much in line with your approach to treatment. There is a super strong bond between us, but many aspects of my problems still exist. There is one area of healing that I have achieved, and it has to do with the longing for affection. Cindy covered this nicely in her post. I also felt that without affection I could not have stayed in therapy. So we “did” affection. And it worked. I now feel pretty secure about the need for affection. I guess I have internalized the idea that I can get it, when and if, I really want it. However, I admit I was scared it would escalate into an addiction. This aspect of therapy did not begin (other than a goodbye hug) until a few years into therapy. I think by that time my therapist felt confident that the working parts of my character made it safe enough for her to try it. It was nothing big. Lots of holding hands. Though I am happy about the outcome, I realize how risky it was.

    The more I read, especially things written by clients about therapy, the more I find that affection is being used in therapy. You are the most candid professional I have come across relating to this issue. There is so much to be gained or lost using this form of therapy. It’s disappointing that it isn’t seriously studied. It leaves some of us taking leaps of faith together, which is pure love if it works and immeasurable disaster if it doesn’t.

    Thanks for the help.

  • Thank you so much Jeffrey for your thorough explanation of the pitfalls of physical affection and bending of the boundaries in therapy. I long for touch, but I’m trying to accept my therapist’s rule setting. At first she was encouraging me to e-mail her between sessions, and I gradually allowed myself to write more and more often. She also accepted hugs at the end of the session and I looked forward to the contact and enjoyed it. Today, I asked for a hug when I arrived for my session and she backed off and said “No more hugs. We need to talk about this.” She also said no more e-mails. You’re doing therapy in your e-mails. I want you to do that in here.” Very confusing, since she had encouraged my to write, and painful I might add. It helps to know why she might be pulling in the reigns.

    I like Cynthia’s description of the therapeutic process. Her description is similar to what it feels like for me: first the therapist lures you in so that you allow yourself to feel all this intense longing, and then when you start to trust her a little, she tortures you by cutting off some of the things that lured you in – so that you have frustration, anger, shame and rage to work with. Fun stuff. It is really hard to take sometimes. I get that if she satisfies my desires we have less fuel for discussion, but wow, it’s really tough, and sometimes I really dislike her a lot.

    • Dear Mary, I’m glad you see the positive intentions and merit in your therapist’s pull-back. In the Scarsdale Psychotherapy Self-Evaluation (SPSE, see link on right), item 17 states “Therapist avoids setting bad precedents.” As a therapist, I would rather not allow something first, then take it back. The process involves enough pain without adding any that could be avoided. On the other hand therapists are human and patient’s needs and strengths do evolve. In any case do be sure to talk about your reactions.



  • Just found this site and love it. I have done years (30) of work on my issues. In the past few years, having moved back in the vicinity of my family, I find it extremely hard to tolerate them. After years (lifelong)of discounting, minimizing, and scapegoating by them, it seems I’ve become so healthy I can barely be in their presence because they are such wounded, fearful, unloving people. I used to respond to this with compassion and deep down I think a sacrifice of my true self (per usual) but I’m no longer able to do this. Instead I often feel rage, violation, and find myself speaking up and setting boundaries that totally baffles them (given their lack of healthy boundaries) and I can barely stand to be around them. If it weren’t for my grown children who see them as extended family and would not understand, I might cut off all contact. Thoughts?

    • Dear Kelly, Thanks for your comment. I think this is an important and difficult subject. I want to write a post on it soon, but can’t right away. Please be patient.


  • Hello. I found your blog in searching for answers to some questions I have about therapy. This particular post answers some, thank you for responding to Cynthia’s post. You have helped me understand some of my experiences. Could you shed some light on why when safety, love, caring, vulnerability … is created does my therapist suddenly take longer to respond, become elusive and detached? I find at the moments when I am needing to lean on my therapist the most, he backs away. This phenomena makes me feel my therapist doesn’t trust me. Every time this occurs, I end up shutting down, regretting the experience, and ultimately feel distrustful of my therapist. Why is this happening? Why when in my darkest moments, which is when healing occurs, does my therapist disappear? Why must this be when he steps out and not at other times? What is so terribly sad is that I withhold myself from experiencing safety, vulnerability… just so that my therapist doesn’t leave me. This cannot be helping me?

    • Dear Mary, I can’t tell just what is happening in your therapy, but can mention two patterns that are not uncommon. The first one is that when patients allow themselves to be vulnerable this is a very positive step, but it is often accompanied by increased vigilence and “skittishness” right after. I have noticed this at the end of a very positive session, a time when an offhand comment from a therapist can be taken as negating all the good that has just happened. The lesson for therapists is that good work on the part of patients nonetheless leaves them raw and open, and especially vulnerable at the end of a session.

      The other pattern that is unfortunate, but not uncommon is that therapists are not immune to “schemas”–that is, learned patterns, usually from very early pre-verbal times–that can be triggered by things like emotional closeness. These are involuntary and very automatic.

      Whether a schema is triggered in a patient or a therapist, the way to deal with it is something like a bad habit in golf or tennis. First, identify and name the pattern, then try to practice doing it differently. If it belongs to the therapist then he or she may have some critically important work to do.

      Of course my usual advice pertains: Talk about it in the open. A confident and effective therapist will own his or her part in what happened and help you to process the events.


  • Hello. You have described some of my “end of session” experiences well. I now recognize them more and actively work on not letting my “skittishness” control my thoughts and emotions the following days. In reading your blog and asking my questions, I recognized my pattern of withholding. Thank you for blogging. This helps me process my therapy. I feel like you allow for therapy for people’s therapy. Thank you.

  • Hello Dr. Smith.

    Thank you for deciding to elaborate and expand on this topic. I found this article when I was searching for answers to my attachment issues with my therapist, and found it very interesting. Many comments from others here also helped me to understand the issue better, but I think I’m struggling with the issue in a different way.

    I started my therapy almost 14 years ago, and from the get go, I wasn’t going to attach myself to my therapist because I knew that the therapeutic relationship would end sooner or later. I was never under the illusion that he would fill my needs for my unmet needs from childhood (not that I could talk about that even if I wanted to since I had very little memories of my childhood). I was too scared, intimidated and shy about opening myself up anyway. He made me feel comfortable, and I trusted him. Even when I couldn’t talk at all, somehow he knew what I needed, and he could help me with my issues. After about three years of this, he told me at the begging of our session that he knew what had happened to me. I had no idea how could he have possibly known what had happened to me in the past, but with that, a part told a story non-stop for the next hour. At the end of the hour, there was no time for my therapist to respond to what she shared. He embraced her for a good minute or so before letting go. Soon after this, I stopped going to therapy. For 10 years, I didn’t go back. He kept his door open for me, and I updated him occasionally via emails and I always received prompt responses.

    I’m back in his office, picking up where we left off 10 years ago. He has been a stable force – reliable and true for all these years. There is absolutely no reason not to attach myself, but I still am having a difficult time. I’ve heard from a few others that it is important for us to be able to get connected to therapist in order to go deeper with therapy. It’s too scary when he offers me so much. He encourages me to write to him via email between sessions, which I occasionally do, and he sends me thoughtful responses back without fail. I even have his cell phone # although I doubt I’d ever text him anything. I have so much conflict, fear, shame, and confusion about all this attachment and attachment loss thing in therapeutic relationship. I found many articles relating to early childhood /parental relationship, but I couldn’t find much of anything when it comes to the issue in therapy. Do you have any thoughts on the phobia of attachment? Do you believe a patient needs to experience a strong emotional attachment to her therapist in order for her therapy to become successful?

  • dr Jeffrey & others ~
    it’s good to find blogs & posts out there talking about attachment in therapy..
    I’m someone who came into the whole concept of insecure attachment due to my agoraphobia, & I have spent so many years in & out of therapy without really addressing the core importance of basic trust vs. mistrust between therapist & client. at this point I’m feeling about as isolated & hopeless as ever.. I recently posted at my old blog on the subject ~


    I would really appreciate any advice, wisdom, thoughts from any others who might take the time to read it..
    thanks ~

  • Dr Jeffery, I wonder what would you think about Schema Therapy’s concept of “limited reparenting”?

    • Dear Hobbit, I want to make a post out of this. The short answer is that I think this is a helpful strategy, but probably not for the reason its proponents think. It is easy to picture a set of childhood needs that just need to be fulfilled or bad experiences overridden by good ones, but I think a more accurate version is that good experiences calm enough of the rage and pain to allow processing of the remaining disappointment that is due to the partialness of the love that is given, and that allows lowering of defenses in general.

  • Hi,
    I don’t know if this is possible, but I was wondering if you would be able to write a description of what a good/ perfect relationship with a therapist for someone with attachment issues might look like, (and I don’t mean things like timing of appointments or age of therapist etc but rather the deep emotional stuff). I realise that there would be limitations given that we are all different and our issues are all different but it would help me to maybe see what is right and good about my realtionship with my therapist and work out what needs work. It would also be good to know, within this ‘perfect’ model, where the common pitfalls are in terms of attachment/ transference. (I use the term ‘perfect’ knowing absolutely that no relationship could ever be ideal).
    Hope that makes sense.

  • I have been with my (female)therapist for five years. I am a male, 55 years of age.

    We have been working through major issues during this time and there is a strong client-therapist relationship. I feel safe in it and it is totally confidential.

    A month ago, another male client of hers, who is an acquaintance of mine, disclosed to me that he has become more like friends with her. Yet, he still sees her as a client.

    I brought it up with her and it caused quite a tense atmosphere, with a lot of explanations and defensiveness from her.

    This has caused me a lot of hurt and also jealousy. I have never withheld from her any issues I have because of complete trust.

    I am in great emotional turmoil about it and feel that it has now diverted the “energy” and trust given in this relationship. I

    I am at a critical stage in therapy now and to have anything like this happening now was unimaginable, unasked for and just devastating to me.

    The emotions brought up are the very same ones I had experienced as a child and in young adulthood, of not belonging, not worthy, not good enough, betrayed ect.

    I still trust but the feelings of loss, jealousy and betrayal are not totally resolved because I now fear to bring it up again.

    Perhaps it is now an opportunity to face the underlying causes for emotions like this?

    It could also be an unrealistic fear because she is the first person I have ever trusted to share such deep issues with and with whom so much has been and is being dealt with in such a trusting, safe space. Could it be just a healthy boundary crossing I don’t understand?

    I also need to understand boundary crossings and boundary violations more and how to discern between the two then I guess.

    I feel that knowledge of this other client’s “friendship” with her is damaging to my therapy, which I can I’ll afford to lose.

    I really like this forum and thought to write this and ask advice. I also feel horrible because it feels like I am betraying her by still having these feelings.

    Thank you

    • Dear Anonymous, Would you mind copying this comment to the latest post, Q&A: Burn out Your Therapist? It is totally relevant there, and will be helpful to others. I’m going to close comments on “Healing a Damaged Self.” I’ll respond there.