When treating a client with a dismissing/avoidant attachment style the first thing a therapist should do is to establish themselves as a secure base for their client. Creating a secure relationship with one’s client ensures that the client will be able to trust you and see you as someone who can help. Trust is the foundation of everything, without it a client would be unwilling to share. Let us say for example you are treating a client named Pam. She is a 30-year-old lawyer who works for a private company. She is very successful at what she does but does not have any close relationships (peer or romantic) and does not believe that she should have to depend on anyone else. As her therapist the first thing I need to do is establish myself as a secure base so she feels as though she can trust me and believes that I am someone who is worthy enough to know about her personal struggles and life in general.
Assess Past Relationships
The next thing a therapist should do is help the client assess their past relationships and allow the client to reflect upon their expectations, behaviors, and feelings that arise from these relationships (Levy, 2013, p. 1). This can help the therapist to understand why the client chooses to have certain relationships and why they avoid specific situations. Pam tells me that her mother would never comfort her when she was upset or sad and instead would yell at her to stop crying and go do something more useful with her time. She said the only time she gained her mother’s approval was when she was being a high achiever such as getting all A’s on her report card. The fact that Pam’s mother punished her for expressing negative emotions such as sadness or anger shows that she was not able to give her daughter the comfort and support she needed when she was upset. As a child Pam therefore learned that in order to avoid being yelled at she must suppress her negative emotions and simply not experience them (Maddux & Tangney, 2010, p. 160). Also, Pam’s drive to be successful and high achieving results from her mother only showing acceptance and praise when Pam did something well. Additionally, Pam stated that while she was popular in school as she was the star soccer captain and class president, she did not feel as though she had any close friends. She felt as though she could not depend on others to help her, so she avoided becoming close to other people and never shared how she felt with those around her because she believed that would make her appear vulnerable and weak (Maddux & Tangney, 2010, p. 161). Since she has always had to depend on herself for comfort and support she does not believe that others would be able to provide these for her and thinks that she is the only one who can understand how she is feeling. Exploring past relationships can help the client realize why she acts and feels a certain way when dealing with current relationships.
The Therapeutic Relationship
After attending to a client’s past relationships, the therapist then encourages the client to examine their therapeutic relationship. This allows the client to realize how they may carry over their relationship expectations and assumptions from past relationships to the therapeutic relationship. It also helps the therapist to clarify their client’s internal working model (Hayes, 1999). If Pam is hesitant to express negative emotions while around me and seems to be standoffish and distant then I can show her how she is transferring her past relationship expectations onto our relationship. In addition, this could help her to realize how her assumptions and expectations can be transferred to her current relationships. It shows her that the relationship she had with her mother is affecting the relationships in her current life and how that can be problematic for her future.
Relationship with Parental Figure
The next step is to help Pam realize how her relationship with her mother has continued to influence her current relationships. She is afraid to be vulnerable with others and express negative emotions because as a child her mother always yelled at her for doing so which made her feel as though she needed to suppress those emotions. This may cause Pam to experience strong emotions about her mother as she begins to acknowledge that her mother’s behavior was not normal or healthy. She may feel intense anger towards her mother for the way she treated her as a child or even grief about the close relationships she missed out on with peers and romantic interests (Hayes, 1999). Even though the past has influenced her present, I would remind Pam that she still has the ability to form new relationships with those that she chooses. She does not need to let her past define her future. Does she truly want to be alone for the rest of her life? Does she want to continue to feel isolated and be afraid of expressing vulnerability? Finding the answers to these questions can help Pam realize that she does not have to let her past relationships define what she wants her future relationships to be like.
The Internal Working Model
In order to help Pam learn how to make close and meaningful relationships, I would need to revise her internal working model. Ever since she was young she believed that she needed to be independent and keep others at arm’s length. However, these expectations and assumptions would be inappropriate because as humans we are social creatures who crave attention and intimacy. I would work with Pam to help her learn how to think, feel, and act in new ways that may be uncomfortable for her based on her past relationships. Teaching her how to open up to those she wants to be close with is something that may be awkward for her at first but in the end could provide the emotional release she has been looking for all these years. Also, teaching her that it is alright to depend on others every once in a while for help does not mean that she is weak or vulnerable, it just shows that she has people in her life that care about her and are there to support her when needed. Revising Pam’s internal working model can help her overcome the belief she learned from her mother that she needed to suppress her negative emotions and not depend on anyone for anything which could help her start to form close interpersonal relationships with peers and romantic interests and help her learn how to properly express all of her emotions in a healthy and appropriate manner.
References
Hayes, H. (1999, May). Bowlby: The Five Therapeutic Tasks: Case Study. Retrieved October 13, 2018, from https://www.lifeforcecentre.co.uk/downloads/level4_yr2/session1/bowlby_the_five_therapeutic_tasks_a_summary.pdf
Levy, K. N. (2013). Introduction: Attachment Theory and Psychotherapy. Journal of Clinical Psychology, 69(11), 1-3. doi:10.1002/jclp.22040
Maddux, J. E., & Tangney, J. P. (Eds.). (2010). Social psychological foundations of clinical psychology. New York, NY: Guilford Press.