Sep

8

2023

The Impact of Breaks in Therapy & Attachment Styles

Therapy is a dynamic process, typically based on a consistent relationship ultimately resulting in trust and growth. But like all other engagements, there are occasional interruptions, be it due to holidays, illnesses, or other unforeseen circumstances.

How do these breaks impact the therapeutic relationship and the clients’ progress?

And, importantly, how do these impacts differ among clients with different attachment styles?

We explore these issues in this blog, ahead of the upcoming workshop: Breaks in Therapy: dynamics, losses & opportunities on Friday 10th November via Zoom (with catch-up available) with Linda Cundy , Professor Joy Schaverien and Charles Brown.

Understanding Attachment Styles

Attachment theory, initially developed by John Bowlby in the 1950s and 1960s, posits that early childhood relationships with caregivers form ‘blueprints’ that influence our later relationships, including the therapeutic relationship.

The 4 main attachment styles are:

  1. Secure Attachment: People with this style tend to have positive views of themselves and others. They are comfortable with intimacy and autonomy.
  2. Anxious-Preoccupied Attachment: These people are often overly concerned about their relationships. They fear rejection and tend to be ‘clingy’.
  3. Dismissive-Avoidant Attachment: People with this style often deem themselves as self-sufficient and dismiss the importance of close relationships.
  4. Fearful-Avoidant (or Disorganised) Attachment: People with this style have mixed feelings about close relationships, both desiring closeness and being fearful of it.

In Jeremy Holmes’ (2014) book: John Bowlby and Attachment Theory, he summarises attachment theory as follows:

“A securely attached child will store an internal working model of a responsive, loving, reliable care-giver, and of a self that is worthy of love and attention and will bring these assumptions to bear on all other relationships. Conversely, an insecurely attached child may view the world as a dangerous place in which other people are to be treated with great caution, and see himself as ineffective and unworthy of love. These assumptions are relatively stable and enduring: those built up in the early years of life are particularly persistent and unlikely to be modified by subsequent experience.”

Impact of Breaks in Therapy:

It is likely that breaks in therapy such as the weekly time between sessions, as well as holidays and illness (planned and unexpected) will impact people with different attachment predispositions in different ways:

1. Secure Attachment:

  • Between Sessions: Those with a secure attachment style are more likely to understand and cope with the necessary gaps between sessions. They may use the tools and strategies discussed in therapy during these breaks, ensuring continual growth.
  • Holidays & Illness: Extended breaks due to holidays or a therapist’s illness might be met with understanding and patience. They trust the therapeutic bond and believe it can withstand interruptions.

2. Anxious-Preoccupied Attachment:

  • Between Sessions: These individuals might find it hard waiting between sessions. The absence can amplify their insecurities or fears about the therapeutic relationship.
  • Holidays & Illness: Extended breaks might trigger feelings of abandonment or fear that the therapist might not return. Reassurance and planning before breaks can be beneficial for such clients.

3. Dismissive-Avoidant Attachment:

  • Between Sessions: These individuals may appear unaffected by breaks or even appreciate them. They might see it as an opportunity to prove their self-sufficiency.
  • Holidays & Illness: Longer breaks might be met with indifference on the surface. However, it’s important not to mistake this for a lack of need. Underneath, they may grapple with feelings of being unwanted or unimportant.

4. Fearful-Avoidant Attachment:

  • Between Sessions: These clients may have a turbulent response to breaks, oscillating between wanting closeness and fearing it.
  • Holidays & Illness: Extended breaks can be particularly challenging. Feelings of abandonment might clash with a desire for independence, leading to a whirlwind of emotions.
Navigating Breaks in Therapy with an Attachment Lens:

Ideally as Therapists, we should be proactive in discussing potential breaks, preparing clients for them, and validating their feelings upon return. This may involve:

  • Understanding and acknowledging the client’s attachment style.
  • Offering reassurance, especially for those with anxious-preoccupied or fearful-avoidant styles.
  • Providing ‘homework’ or self-help tools that clients can use during breaks. This might include setting aside the usual therapy time and engaging in a writing practice or choosing an act of self-care.
  • Establishing a communication plan in case of unexpected breaks.

Breaks in therapy, whether planned or unplanned, have varied effects on clients based on their attachment styles. Recognising and addressing these impacts is essential to maintain the therapeutic bond and ensure continued growth for the client. By understanding attachment styles, therapists can better navigate these interruptions and offer tailored support to their clients.

Upcoming Workshop: Breaks in Therapy: dynamics, losses & opportunities

Join us for our upcoming workshop: Breaks in Therapy: dynamics, losses & opportunities on Friday 10th November via Zoom (with catch-up available) with Linda Cundy , Professor Joy Schaverien and Charles Brown.

In this workshop with our three expert speakers, we will explore the meaning of breaks in our therapeutic work, and the spectrum of reactions we might receive in response to a pending break in therapy.

We will consider safety and security issues, the experience of those for whom trauma by separation is central to their narrative, profound experiences of loss in the absence of the therapist and creative opportunities for self-development while the therapist is away.

We will also notice the subtleties of different types of breaks: the space between sessions, the therapist’s holiday, ill health of the therapist, breaks due to pregnancy, sudden and unplanned breaks, as well as noticing the difference between in-person and online work.

There will be ample time for questions and discussion, and for us to also examine how breaks in therapy affect the therapist too.

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