Attachment-Based Therapy

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Attachment-Based Therapy

Joshua Straub, Ph.D. & Gary Sibcy, Ph.D.

Helping people change is no small task. But attachment theory and the secure-base system can help guide you in therapy, no matter what model or techniques you like to use.

Attachment-based therapy is based on six broad principles that spell out the acronym SECURE:

Safety refers to the fact that healthy therapy relationships mirror effective secure-base systems. The therapist becomes a secure-base for the client to acquire new skills for managing strong emotions, participating in intimate relationships, and dealing with life stresses.

The therapist must learn all the components of a secure-base relationship and manage them as they unfold throughout the course of therapy. Ultimately, the goal is to help the client use others as a secure-base and to discover God as the ultimate attachment figure.

Education is an important part of any therapy. Clients must also learn new skill sets including skills for emotion regulation, distress tolerance, relationship enhancement, problem-solving, impulse control, and mindfulness. We also teach clients how to use some of the basic spiritual disciplines.

Containment refers to the counselor’s ability to manage the intense negative emotions that will inevitably emerge in the therapy relationship. It’s like safety, but containment focuses more specifically on how a counselor skillfully manages therapeutic relationship conflicts in a way that is not only safe but ultimately enhances the treatment alliance. This is one of the most challenging therapy skill sets to learn. However, without containment the therapeutic relationship will rupture and treatment will be unsuccessful.

Understanding involves allowing clients to tell their stories and, within well prescribed limits, emote in the expression of those stories. From a secure base, clients can begin to explore and incorporate their memory systems into an integrated, coherent life narrative. This often requires some updating, checking-out, and validating their basic core beliefs. The therapy relationship is the perfect testing-ground for these beliefs, as you help them learn important tasks like empathy, assertiveness, collaboration and working together to solve problems. As a necessary precursor to deeper healing clients need to understand how their stories influence who they are and why they think, feel, behave, and relate the way they do. This sets the stage for healing and change.

Restructuring includes helping clients identify and change maladaptive patterns of thinking, behaving, and relating. This principle builds off of cognitive-behavioral psycho-education, as you help clients take new learning and apply it to day-to-day life experiences.

Engaging involves balancing two important principles of growth: support and challenge. When people are overwhelmed by their feelings—anxiety, anger, depression—they shut-down, avoid, and withdraw. If these strategies do not work, they resort to more destructive strategies designed to avoid pain, such as dissociation or tension reduction behaviors (e.g. cutting, burning, sexual acting-out, addictions, etc).

When clients become emotionally dysregulated, listen to them, take their emotions seriously, and help them learn how to calm their emotions without resorting to self-destructive behaviors. As you skillfully manage their resistance to change, over time insecure models diminish in intensity and secure models can begin to take root. Your goal is to help them anticipate set-back and develop coping strategies that prevent relapsing to insecurity.