Feb

17

2022

Working with Avoidant Attachment in Therapy
Avoidant attachments typically develop in children who have unresponsive or misattuned caregivers. These parents may reject their child’s innate need for a secure, intimate bond. This can lead to difficulties with forming deep, intimate relationships in adulthood, but with the right support in therapy, the trajectory of our attachments can change.

Mary Ainsworth’s groundbreaking ‘Strange Situation’ research in the 1970s observed how young children responded to brief separation from their caregivers. Ainsworth noted three common styles of attachment – secure, ambivalent-insecure and avoidant-insecure. A fourth style of disorganised-insecure was later added by Mary Main. See Support For Anxious Attachment – Brighton Therapy Partnership (2017).

Securely attached children were distressed when separated from caregivers, and reassured when reunited. Children with avoidant attachment, however, did not appear to be distressed when separated from their parents, and often showed no preference between their caregivers and strangers.

Calmness or hidden distress?

The avoidant children’s lack of interest about their parents leaving or returning could be mistaken for calmness, but the heart rates of seemingly relaxed avoidant infants matched those of securely attached children who were visibly distressed (Sroufe & Waters, 1977b), and their levels of the stress hormone cortisol were even higher than securely attached children (Spangler & Grossmann, 1993).
Similarly, in adulthood, avoidant individuals show little outward emotional distress and need for others, but there is often a high level of attachment distress at a deeper, less conscious level (Shaver & Mikulincer, 2002).

To learn more about working with avoidant attachment in therapy, see our online CPD workshop with expert Linda Cundy.

Coping strategy

In the Strange Situation, Ainsworth observed parents at their homes to help her understand the roots of the attachments. Caregivers of avoidant infants often rejected the attempts of their children to connect, and would withdraw when their babies were sad. Mothers also often had limited emotional expression and avoided physical contact.

Avoidant infants sometimes reacted angrily to the rejection – rather than continuing to communicate their need for attachment, and risking further rejection. The avoidant children eventually gave up hope of being cared for, so stopped asking for it to bypass the anticipated rejection and anger.
After separation, when the avoidant children were reunited with their parents, they did not indicate that they needed to be soothed.

Suppressed needs

Later work by Mary Main found that insecurely attached infants not only changed their interpersonal communication patterns with others, but also with themselves. Avoidant infants could not afford to be aware of their deep need for attachment, and would minimise the feelings and move them out of awareness as a coping strategy.

Avoidant attachment seems to often be inherited or ‘borrowed’ across multiple generations.
To survive emotionally, avoidant parents dismiss their own need for intimacy, and in the process fail to respond to their own children’s needs. Their infants then learn to live as if they have none.

Legacy

As avoidant children grow up, their behaviour becomes more subtle. At age six, the avoidant child’s interactions with their parents is described as ‘restricted’ (Main, 1995) – leaving initiative to the parent and keeping topics impersonal. Securely attached children have been shown to go on to have greater self-esteem, emotional health, initiative and social competence, and are treated age-appropriately by teachers.
Avoidant children, on the other hand, have been seen as angry or oppositional, elicited controlling responses from teachers and been shown to victimise peers (Sroufe, 1983; Elicker, Englund, & Sroufe, 1992; Weinfeld, Sroufe, Egeland, & Carlson, 1999).

Adulthood

Avoidant attachment has also been shown to have a profound impact into adulthood, including:

● Higher rate of depression associated with perfectionism, self-criticism and compulsive self-reliance.
● Higher likelihood of substance misuse, anxiety disorders and PTSD.
● Tied to narcissistic, obsessional and schizoid issues.
● Difficulty empathising with others or accepting vulnerability.
● Less able to trust, difficulty acknowledging mistakes, sensitivity to criticism and rejection.
● More likely to be in a relationship with rejecting and controlling partners.

In Relationship

Adults with avoidant attachment can sometimes seem to be social and easy-going, and have lots of friends. They may also seem sure of themselves and to have high self-esteem, often based on achievement. But in relationships, depth is often an issue, as they tend to ‘hit a wall’ when the time comes for vulnerability and closeness.

They may give fewer cues for the need of closeness, and also seem blind to cues from others.
The avoidant adult may view their partner’s need for intimacy as clingy or too demanding, and may then find a reason to end a relationship. If their partner demands closeness, this can trigger defences and distancing from an avoidant individual.

They might convince themselves that they don’t need intimacy at all. This is not because they wouldn’t benefit from closeness and connection, but because they simply do not know how to do it.
See Working Therapeutically With Someone In A Narcissistic Relationship – Brighton Therapy Partnership (2021).

In Therapy

Some studies have found avoidant clients to have more difficulty making a positive bond with their therapist (Byrd, Patterson, & Turchik, 2010; Marmarosh et al., 2009; Bachelor, Meunier, Lavadiere, & Gamache, 2010). But, other research has indicated that avoidant clients are just as capable of change in therapy (Burgess Moser 2015).

In couples therapy, after avoidant clients go through priming procedures to enhance their sense of security, they can be highly compassionate and supportive of their partners (Milkulincer et al., 2001, 2005). When supported by a therapist, it seems an avoidant client can accept vulnerability more openly, connect with their emotions and with their partner’s.

Becoming secure

Research has found that our working models of attachment can even change during therapy (Diamond, Stovall-McCloush, Clarkin, & Levy, 2003).
To help clients develop a more secure attachment style, therapists can mirror behaviours which are common in parents of securely attached children, such as:
● Attuned communication.
● Empathy.
● Ability to cope.
● Appreciation of intersectionality.
● Scaffolding for emerging capabilities.
● Willingness for rupture and repair.
● Willingness to struggle.

Transference and countertransference

Transference and countertransference can play a key role when working with avoidant attachment.
A therapist may feel distant from an avoidant client, and could become reserved. But this could be received by the client in the same way their dismissing parent was – as rejection.

Keeping a client at arm’s length could therefore be colluding with and reinforcing their attachment style. Rather than a bombardment of self-disclosure and honesty, it may be enough to allow a client to know that they make an impact on us. It is also important for therapists to understand their own attachment style, to establish which way they lean and where they might likely collude with clients.

Common transference

There are three other common patterns of transference and countertransference that may play out with avoidant clients (Wallin, 2007).

1. Devaluing
Clients whose parents devalued them may go on to develop a narcissistic personality style as a defence mechanism. They may borrow their parents’ defences, devalue others and outwardly over-inflate their own worth as a strategy to avoid intimacy – and the expected rejection and anger which they anticipate would follow.
This inauthentic view of themselves as ‘special’ is inevitably unfulfilling as a substitute for a loving relationship. But the risks of connection are too high, and when an opportunity arises, the chance of intimacy is often rejected on the basis that the other is not good enough.

An avoidant client may devalue the therapeutic relationship, or even disregard a therapist’s acceptance of them, and believe they are just ‘playing a part’ because they are being paid.
This devaluing transference from the client could be met with a dismissive or angry countertransference from the therapist – which could again reinforce their attachment style.

If therapists can tolerate the potential for further devaluing, and possible discomfort for the client, this could be an important relationship pattern to explore. It could be helpful to highlight that the client does not seem to allow others to become too important to them, which may include the therapist.

2. Idealising
Avoidant clients whose parents were self-absorbed may have a tendency towards idealising transference. These children prioritised protecting their parent’s need to feel special, and idealised them because they felt they needed to do so to get their needs met. They then see their role as to prop up other people’s self-worth.

This client may appear to be more engaged in therapy than a devaluing client, but the behaviour is still a defensive pattern which avoids genuine intimacy. Some therapists may feel inclined to remove themselves from the pedestal, whereas others may feel dismissive of the idealising, or uncomfortable. It may be helpful to explore what it would be like if we were anything other than ideal.

3, Control
With some avoidant clients, a power struggle can emerge. These clients may have controlling parents who had difficulty with making contact, and little tolerance for distress – and responded to both with control. This left their children distancing themselves from their feelings, and avoiding control at all costs. In the transference, the client may see the therapist as a controlling figure. This can surface in disputes around admin, fees or even therapy style.

A battle for control avoids the risks of closeness and attachment, as intimacy is very difficult when we are wrestling for control. It could be helpful to avoid being either dominant or submissive, but instead strike a balance, explore their feelings to try to make sense of them.

Disembodied

Clients who have avoidant styles are more likely to feel disembodied from their physical selves.
They are often disconnected from somatic sensations around stress, and have detuned awareness of their need for closeness. The work can therefore be about reclaiming their ‘feeling selves’. Therapists can pay close attention to the client’s feelings and their body language in a way that the client cannot, to help them integrate their experiences.

It may be useful to inquire about a client’s body language. They may draw a blank at first, but encouraging them to stay in contact with their body, thoughts and feelings in the here-and-now could help them reconnect. See Working With Dissociation – Brighton Therapy Partnership (2021).

Change the path

Unpicking our attachment story can be a huge step towards changing the trajectory of our attachment style. Understanding how experiences impact us today can create more security in ourselves and our relationships. Making sense of our experiences can have a huge impact, and help us to form more secure attachments.

If you are interested in exploring ‘avoidant’ attachment in greater depth, watch our online workshop with trainer Linda Cundy.

We always welcome your feedback, so please leave a comment below or share this article with your fellow therapists.

Our Guest Blogger:

Oli Hamilton is a qualified Psychotherapeutic Counsellor who works from the Palmeira Practice in Hove, UK. Before training to become a counsellor Oli worked as a newspaper and magazine journalist, and also as an English teacher while living in Vietnam.

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