People with insecure attachment: avoidant, anxious or disorganized, tend to have a much more interesting time in therapy than people who formed secure attachments in childhood. I want to talk about insecure attachment and its affect on therapy, with an emphasis on disorganized attachment since that was with what I struggled. Human beings are born unable to care for themselves in any way; they are totally dependent literally as a matter of life and death on their caregiver, usually their mother, but whomever it is that is responsible for caring for them as a child. (That’s so our heads are small enough so that a baby can be delivered. Can you imagine delivering a child with an adult sized head? Time out for all the readers who have delivered babies to wince and say “OUCH!” Okay, everyone back?) There is a biological imperative for the child to stay close and there is a corresponding biological imperative on the part of the caregiver to respond to the needs of the infant. Thus the two humans, infant and caregiver, form an attachment bond. Humans form attachments throughout their life, but none as profound or far-reaching as the one they experience with their parents. That bond, formed while we are developing, has the power to shape both how we see ourselves and the nature of the universe in which we live.

Human beings are born with a brain and nervous system that are still developing and growing and part of what is necessary for that growth is to be “attuned” with a caregiver so that the needed development growth can take place through an implicit learning system. Explicit learning is you sitting down and learning your times tables or studying history. Implicit learning is the learning we achieve by doing something over and over. There was a time that we might have been conscious of it, but we learn to do it without having to think about it. Think of the act of reading, as you are doing now. Are you thinking of each letter, and each sound it makes? Are you thinking about the meaning of each word, the grammatical structure of each sentence (let’s not look too closely at that, shall we?) or having to parse each syllable to recognize a word? There was a time when you had to do all that, but now you just read. You take in the information without having to “think” about the actual act of reading.

Current research posits two types of memory: implicit and explicit. There was a fascinating case study of a man whose brain was injured in an accident so that he could only retain memories for five minutes at a time; his only long term memories were those that he had at the time of the accident. He could neither form or store long term memories going forward from the accident. If all memory was explicit, stored in such a way that we had to “fetch” our memory to do a skill, then you would believe this man incapable of learning a new skill. But he was taught to braid every day (a skill he did not have before the accident). Through persistent repetition he learned the skill so that when asked if he could braid, he would answer no because he had formed no long term memory of learning to braid, but if three stands were placed in his hands, he could braid because he had the implicit memory created by the training. Such are many of the skills we learn as infants, they are learned by being in the presence of a wiser, stronger, other who repetitively models the behaviors and skills we need to learn until they become part of who we are. Explicit memories cannot be formed until our frontal lobes come “online” which usually happens somewhere around the age of two. Implicit memories, however, are theorized to be held in more primitive areas of the brain that are already operating at birth, so we start to form implicit memories from the get-go. Which is why much of this knowledge is out of our consciousness.

Among the many skills we need to learn are the ability to identify our feelings, use those feelings to understand our needs, act to get our needs met, and regulate our feelings. Even more important is our sense of what kind of place the universe is: do we matter, can we affect what is around us, is it good?

When you have a “good enough” parent, then your attachment figure (AF) is attuned to you. They pay close attention and mirror your responses, they identify your needs and meet them, when you cry out you are attended to, when you are upset they move close to soothe you, if you are in danger, they move to protect you. This teaches you on a fundamental level that the universe is a good place in which you matter, when you express yourself you can reasonably expect to be responded to and most of the time your needs are met in a timely matter. You also learn to understand yourself, your needs and how to go about making them known and getting them met as you move away from people who are attuned enough to not have to ask.

But what happens when your caregiver is not able to be attuned or attend to you as you deserve? It is a biological, life and death imperative to stay close to the caregiver, so a child learns to accommodate themselves to the caregiver in order to stay near them and survive. Which is where the insecure attachment styles come into play.

Some parents do not themselves have secure attachment so they lack the skills to bond properly with their children. If a caregiver is consistently unavailable, or not willing to meet a child’s needs, the child learns through being rebuffed time and again, to keep their needs to themselves because going towards the other leaves them unsatisfied or hurt. If you know the answer is always “no” you stop asking the question. They therefore exhibit no outward stress when an AF departs and do not seek reunion when they return. There is an air of “I’ll do it myself, I don’t need you” that protects them enough to stay close in order to get their physical needs met. In other words, they deny their own feelings and needs in order to be allowed to stay in proximity. (I should note that although outwardly an avoidant child exhibits no distress, physiological factors during attachment testing shows elevated levels of pulse and blood pressure, indicating distress that the child has learned to hide. The appearance of detachment is deceptive.)

Other parents are available at times but at others are not. So the child learns that what they need is only available sometimes, without being able to predict when those times will be. This leads them to an anxious attachment style in which they stay as close as possible to the AF, cutting off the natural exploration and differentiation of normal development, in order not to miss any care they can manage to get. This child exhibits a high amount of distress when separated and is not easily soothed during separation, unlike a secure baby, because they cannot trust the return of the “good” caregiver. They are also not soothed by the return of the caregiver because they can’t be sure what they’re going to get. So they live in a high state of hyper vigilance, ignoring their own needs because they are too busy trying to catch the moments when their caregiver is available.

The last style of disorganized attachment is most common in the event of childhood abuse. Your AF is supposed to be a source of comfort, a refuge of protection, the person who comes alongside you when faced with overwhelming circumstances. When a parent is abusive the same person is the source of being hurt and overwhelmed AND the source of comfort and protection. So do you move towards the person upon whom your life depends or stay away from this overwhelming source of pain? This leads to a child without a consistent attachment style. Sometimes they will use avoidant strategies and at other times behaviors associated with anxious attachment. In addition to both of those though, there is also a “freezing” or disassociation. Because sometimes they took care of you, and sometimes they hurt you, the child is unable to develop a consistent way of dealing with them. That’s what the freezing and/or disassociating is about, the child would literally be at such a loss as to how to handle it that they would just hold still and/or go away so as not to have to make a choice.

When a person with insecure attachment enters therapy, something very powerful can happen. The therapeutic relationship is “a strange duck but closest to a parental one” to quote BN. For the first time in their lives, for some people, we experience a relationship which is focused on our needs, with a person who is attuned to us and is working to understand us. One of the worst byproducts of insecure attachment is that a child “learns” the lie that they do not matter, that their feelings are not important enough to matter and their needs will not be met. The universe is perceived as a hostile place which wounds much more often than it rewards. But now we are faced with a person who is acting as if we DO matter, as if our needs are important. This can awaken our old unmet needs for attunement, for being able to see ourselves clearly reflected, of our unmet desires to be special, loved, admired, and cherished. And because these needs were at their strongest when we first experienced them and we were completely dependent, they are felt with the life and death intensity that was true when we were little.

So we enter therapy unsuspecting of the deep, intense reactions that can be invoked. And for people with disorganized attachment this can feel like you’re going crazy. 🙂 On an adult, cognitive level you can see no reason why this person should stir up such intense emotions, longings and yearnings. You get that you only see them one or two hours a week (and a 50 minute hour at that) so how could they possibly be so important to you? I believe because a therapist is acting as a caregiver and providing the kind of attention and attunement you didn’t get when you should have, these needs burst forth from where they have been suppressed for a life time, responding to the promise held out by the inherent structure of therapy.

So it is in interacting with out therapists that we can learn our unconscious ways of relating. I know with the Boundary Ninja I have exhibited both the avoidant behavior of not wanting him to matter and wanting to flee the relationship alternating with terror that he wouldn’t be there and needing to contact him, sometimes multiple times between appointments to make sure he was still there. These behaviors could flip flop back and forth at a really high rate, sometimes within minutes of each other.

When you are abused, you learn the very difficult painful lesson that to move towards the other brings pain and injury. But humans are built such that we need others, we are formed for attachment. We need others to meet our needs. So you have two imperatives screaming at you “move closer or die” and “move closer, you die.” You can understand why this would feel chaotic and terrifying. But where it really gets difficult is that in order to heal, to learn to move close enough to get your needs met, indeed to learn HOW to get your needs met, you need to move closer. But that is the very thing that the primitive part of your brain, the part responsible for keeping you safe, sees as the most dangerous thing in the world. You must walk into the heart of your terror, again and again, until you have enough good experiences of moving closer to form an implicit memory to counteract your memories of being injured in relationship. This can take a very long time and be very confusing while you’re doing it. BN calls this the “hellish bind” that makes healing such an uphill battle for people abused by a caregiver.

This is why my first rule of therapy when you’re not sure what to bring up in session is to pick the thing that scares you the most and talk about it first.

It is often important for a person with insecure attachment to find a therapist who allows in between session contact. You cannot predict when your need for your AF will arise nor when you will need reassurance to calm your (very reasonable and understandable) fears. I cannot begin to tell you how hard the Boundary Ninja worked to convince me that not only COULD I call but that it was therapeutic to do so, that I needed to learn to ask for what I needed and experience it being met and also experience that there really was a dependable other I could trust. I was so desperate to not be abandoned by BN but was absolutely amazed at my creative abilities in finding reasons I HAD to leave. Every time I moved closer it would rear it’s head and I would have to deal with it. I remember one time being really upset about the thought of leaving therapy but when I really stopped and looked at how I felt, I realized I was terrified to stay. I had never been so close to someone before with intact boundaries and it just didn’t feel right. Either he needed to abuse or abandon me so at least I could know that I was facing something familiar. The fact that he steadfastly calmly refused to do neither scared the socks off me. Part of what I’m trying to convey is that although now I can look back and explain what was happening so clearly, that’s only in retrospect. At the time and as I go through it, it’s painful, chaotic and really confusing.

So its important to talk to your therapist about all these intense feelings that are coming up so that they can help you understand the pattens and belief underlying your behavior towards them. I know how scary it can be to talk to your therapist about this stuff. I am VERY blessed to have BN. He stays utterly calm and accepting no matter what feelings I bring to him. But it’s still been scary EVERY time I’ve talked to him about my feelings for him. But over time, as I’ve experienced him NOT changing no matter what I’ve told him, I’ve really come to understand and believe on a “gut” level that I can talk to him about anything. That he really meant what he said about any and all of my feelings being welcome in his office. They will not be acted on, but all of them can be heard and understood. Another thing I have really appreciated is the fact that he doesn’t like the word transference. He’s always recognized that my feelings about him are real. But at the same time, we can also follow my feelings, and see the pattern in them that allows me to go back and see where and how I learned my beliefs and why I think the way I do. He holds both in place really well. One of the most healing things that he has done for me is to totally understand and accept just how central he is to who I am, how important he is to me, and how deeply I love him. He doesn’t shy away from it, even while he maintains crystal clear boundaries. And it is within this acceptance and understanding that I learned to believe that I do have worth and do matter, so that now I have an “earned” secure attachment. Because our brain is always capable of change and our attachment style is not set in stone. We can heal.