Professional Documents
Culture Documents
DOI 10.1007/s10615-009-0217-1
ORIGINAL PAPER
Abstract This paper describes a prototype for the treatment of intimate relationships that takes into account how
to evaluate attachment styles in the couple relationship and
in psychotherapy, and how to integrate this understanding
into clinical practice. It is important for the couples therapist to understand attachment, its neurobiological underpinnings, and its origins in early development. Secure
attachment in an adult relationship may be challenged
if one or both partners have experienced disruption of
a primary attachment relationship. The goal of successful treatment is to restore the normative growth of intimacy, empathy, understanding, healthy dependency, and
connection.
Keywords Couples therapy Attachment theory
Psychotherapy
Introduction
All couples encounter problems that are not fully understood. Many of the complaints presented to couples therapists as communication failures or conflicts over specific
issues are actually complaints about thwarted attachment
needs. When presenting problems remain the focus of
communication, unaddressed attachment failures can lead
to protest, fear, and sometimes hopeless withdrawal. It is
important to understand attachment, its neurobiological
underpinnings, and its origins in infant development.
Attachment theory provides the couples therapist with a
M. F. Solomon (&)
Lifespan Learning Institute, 1023 Westholme Ave, Los Angeles,
CA 90024, USA
e-mail: drsolomon@lifespanlearning.org
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Secure Attachment
Attachment theory outlines the basic human responses,
especially the needs and fears that structure long-term
bonds. The basis of attachment is that seeking and maintaining emotional contact with significant others are innate,
primary motivating principles across the life span. The
presence of an attachment figure provides a sense of
comfort and security, a safe haven that offers a buffer
against the effects of stress and uncertainty (Mikulincer
et al. 1993). Secure attachment complements self-confidence and autonomy (Feeney 2007). Secure dependence
and autonomy are two sides of the same coin, rather than
dichotomies, as often presented in the couple and family
literature. The more securely connected we are, the more
separate and individuated we can be. Health in this model
means maintaining a felt sense of interdependency, rather
than attempting to become self-sufficient and maintaining
impenetrable boundaries with others. Dependency, then, is
viewed as an innate part of being human, rather than as a
childhood trait we outgrow.
A sense of connection with an attachment figure is an
innate survival mechanism. It is the natural antidote to
anxiety and vulnerability that can arise in relationships.
Positive attachments create an optimal context for the
continuing development of a mature, flexible, and
resourceful personality. An attachment that has been tested
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importance of the interpersonal process, noting that successful treatment of trauma victims changes the survivors
relationships with others. To achieve these results in individual or couples therapy requires (a) the provision of a
safe milieu to contain emotional outbursts, (b) an opportunity to preserve cognitive awareness in the face of intense
feelings, (c) enhancement of the capacity to connect to
ones core, and (d) the challenge to face the fear of true
closeness with others. Foshas (2003) treatment model is
based on the ability to resonate empathically with anothers
body states and to empathically attune on an intuitive,
nonverbal level. When a person is feeling safe with
another, a safety zone is created in which core emotions
can emerge. If longing for connection, sadness around
disconnection, and fear of showing vulnerability are
received and accepted, an opening in the defensive armor
occurs. The help of a therapist may be needed to facilitate
repeated safe openings.
In applying these models to the couples forum, the
therapists goal is one of interactive repair through a
conjoint therapeutic experience that facilitates enhancement of emotional, physical, and sexual intimacy. The
therapist can, through empathic modeling and promotion of
direct emotional communication, encourage creation of a
growth-facilitating environment that can complete the
interrupted developmental process of each. Under such
conditions it is possible to help partners affect a transformative experience in which each reconnects with dissociated or repressed emotions, and develops the capacity to
empathically attune to each other. Helping to facilitate
mutually satisfying sexual contact (i.e., with its opportunities for warmth and holding, eye contact, smell, and
taste) can play a significant role in re-attuning partners to a
novel sense of personal well-being. This can occur if the
partners have a history of secure attachments or if they are
helped in therapy to overcome the residue effects of trauma
in their early attachment experiences (Solomon 2003).
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repertoire, which is replayed in all subsequent relationships. Depending on the ability to retain the information
without resorting to defenses, treatment can focus on what
one partner believed he or she had found in the other to
induce relational commitment. The therapist clarifies that
people often choose their most intimate relationships with
an unconscious wish to heal the past. If the couple has
difficulty with these ideas, it is important to see this not as a
sign of their resistance alone, but also perhaps the therapists failure to convey the message in a way that can be
receptively incorporated. If the message elicits shame and
this is not repaired, it leads to humiliation, self blame, and/
or strategies to defend a vulnerable core.
If the couple responds by utilizing and giving examples
of the ways their past has played out in their current relationship, it becomes possible to accelerate the healing
process. We shall see in the case that follows how the
therapist is able to help partners communicate primary
needs and yearnings, and encourage discussion of internal
beliefs and attitudes about self and other. In this process,
shameful feelings and negative emotional responses are
attended to and reframed as a positive path to the emergence of core affect (Fosha 2003). This allows expressions
of vulnerability and hurt feelings to be discussed in the
sessions. The therapists role is to redefine intense emotionality as important expressions of attachment failure, so
they can be carefully observed and hopefully healed in the
current relationship.
Case Example
The following case, an expanded version of which
appeared in Healing Trauma: Attachment, Mind, Body, and
Brain (Solomon 2003), illustrates an avoidant, disengaged
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Over a relatively short period of time of conjoint treatment, feelings that were previously experienced as intolerable, overwhelming, or dangerous are held and contained
in the therapeutic milieu. Partners increase the ability to
tolerate the intolerable, and develop the courage to face
what was once believed to be too unbearable to experience.
As they learn to respond behaviorally to one another in
ways that are different from those in past encounters, they
experience a new empowerment and increased selfawareness. Self-esteem is bolstered by the journey into the
abyss and the courageous encounter with inner sadness,
fear, rage, shame, and guilt.
The result of the therapy can be what Main (2002) called
earned secure attachment. When partners stances
toward attachment and defensive system are reorganized
and they have the opportunity to expand their intimate
relating, the ability to feel anger, grief, fear, and pain
unleashes the ability to feel love, joy, courage, and
pleasure.
Conclusion
References
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Siegel, D. J. (2003). An interpersonal neurobiology of psychotherapy:
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Author Biography
Marion F. Solomon is the Director of Clinical Training, Lifespan
Learning Institute; Senior Extension Faculty, Department of Humanities, Sciences and Social Sciences at UCLA. Author of Narcissism
and Intimacy and Lean on Me; Co-editor of Healing Trauma,
Countertransference in Couples Therapy, and The Healing Power of
Emotion.
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