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Attachment Styles and How They Affect Relationships

The way we relate to others, including our partners is complex and multi-layered.  It is developed over time and although we can to an extent control what we say and do within our relationships it is more difficult to understand why we behave and feel the way we do in relation to others. 

One way of describing how we function within relationships, is to talk about our style of ‘attachment’. How we attach to others affects everything from the partners we choose, to how well our relationships progress and how they end.  Once we recognise our attachment patterns we begin to understand our strengths and vulnerabilities within our relationships including those with friends and family. 

Attachment patterns are established in early childhood. The developing infant builds up a set of ‘models’ of themselves and others based on repeated patterns of interpersonal experiences with their caregiver (usually the mother and/or father).  These repeated patterns continue to function as ‘internal working models’ for relationships in adulthood. The problem is that much of this is happening at an unconscious level and as such we remain unaware of these models leaving us likely to repeat unhelpful patterns which may, in turn leave us feeling frustrated and hurt.

According to Attachment Theory there are four attachment styles. 

Secure attachment:

Securely attached people tend to have satisfying relationships. Broadly speaking their internal working model gives them a core sense of being safe and secure within themselves.  These people feel more or less good about themselves and their capacity to be effective and create positive relationships. This can also be described as having good self-esteem. This allows them to believe that if they experience a rupture or a falling out with a friend or partner it’s OK. The relationship can be repaired and things will get back on track between them.

Anxious-Preoccupied attachment

These people are often described as being clingy and needy.  Their internal working model does not provide them with a core sense of safety and security.  They look to others to provide this for them. Therefore when they experience a rupture or falling out they feel insecure and unsafe and in their attempt to feel secure and safe again they become demanding and possessive of their friends and partners because they cannot provide themselves with these feelings. Unfortunately this behaviour tends to push people away confirming their worse fear and so the cycle is complete. 

Dismissive-Avoidant attachment

People with this style of attachment tend to distance themselves from others emotionally.  Like people with an insecure-ambivalent attachment style their internal working model does not provide them with a sense of safety and security but they protect themselves from this by becoming ‘pseudo-independent’ and telling themselves that they do not need people.  They have the ability to shut down emotionally and turn off their feelings even in heated arguments with friends or partners. Their relationships often end because their friends and partners experience them as detached and unemotional.

Fearful-Avoidant attachment

A person with this style of attachment fears being both too close or too distant from other people and moves between these two states.  They often feel overwhelmed by their feelings over which they feel they have little control. Their internal working model is that in order to achieve any sense of safety and security they need to move towards people but that if they let people get too close they will get hurt.  This leaves them in a state of confusion as to how to get their needs met although this may not be entirely conscious. What they are conscious of are feelings of being trapped when they get close to people and clinging to people who reject them. Their relationships can end up being abusive.

How psychotherapy can help

By becoming aware of your attachment style, over time you can challenge the insecurities and fears that have formed your ‘internal working model’ and develop new styles of attachment for sustaining more secure and satisfying relationships with others.  This sounds easy but in reality it is more complex. Exploring and understanding your internal working model and resultant core state can be challenging as defensive strategies which have come into play to protect you from psychological pain are hard to change and can leave you feeling vulnerable.

However change is possible within a relationship of trust with a skilled and experienced therapist.  On a very basic level the relationship with the therapist provides a space where repeated patterns of interpersonal experience occur and can be thought about.  The therapist will be able to stand back and reflect what is happening between you with the intention of helping you identify the patterns which so far have remained unconscious and out of your awareness.  In this way over time you are able to choose to do things differently – bit by bit.

 

Anna Reynolds is a UKCP registered Psychoanalytic Psychotherapist qualified to work with a broad range of psychological issues as well as more complex mental health conditions in adults.  Anna works with individuals and couples.  Anna is available at our Lewes Practice.

 

Further reading by Anna Reynolds –

The language of love: how couples communicate

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“Ghosts in the Nursery” – The Power of Family Scripts

 

 

As much as we might fight it, our own experiences of being parented, create within us blueprints or ‘internal working models’ of what it is to be a parent. These models only become fully activated when we become parents ourselves, and often take us by surprise. For instance, we may find ourselves ‘turning into’ our parents in ways we hadn’t intended. Similarly, memories from our past can be unexpectedly invoked in us when our own children reach the same age. 

Selma Fraiberg (1987) emotively referred to this phenomenon as “ghosts in the nursery” – the idea that without conscious effort to alter entrenched family patterns, family life can essentially become a ‘rehearsal’ for the next generation. More commonly, we refer to this phenomenon as the enactment of ‘family scripts’. John Byng-Hall (1985) proposed three ways in which these family scripts may manifest – 

  1. REPLICATIVE SCRIPTS: 

These scripts are a direct replication of the parenting that we received ourselves. They can include replication of positive scripts (e.g. family rituals, ways of nurturing children, ways of enforcing boundaries, certain sayings, etc.). They can also include replicating negative (unresolved) scripts, which may be consciously replicated (e.g. “smacking never did me any harm”) or unconsciously replicated (e.g. needing to hide one’s sad or angry feelings from a parent can make it harder for these children to later recognise or respond to these feelings in their own children).

  1. CORRECTIVE SCRIPTS:

These family scripts are a conscious decision to offer our children a different experience of being parented to what we received ourselves. The danger for this type of script, however, is that because they are driven from an emotional response to our past, there is a risk that we will go too far the other way (e.g. feeling hard done by as an older child, so favouring our own eldest child).

  1. IMPROVISED SCRIPTS: 

These family scripts relate to the ability to flexibly and creatively amalgamate what we most value from our own experiences of being parented, with what we now value and learn from new relationships, education, culture, etc. We generally consider that the most resilient and healthy families adopt this form of script. 

Difficulties can arise when damaging or unhealthy replicative family scripts cannot be consciously thought about by parents. In extreme cases, these can negatively impact upon a parent’s relationship with their child and therefore, their child’s subsequent emotional well-being. For the most part, however, activation of family scripts is normal, inevitable, and actually helps children to become embedded within the familial and social context to which they belong. Indeed, almost all the parents that I meet in my work (myself included), offer a fascinating mix of all three of the above scripts to their children.

References:

Byng-Hall, J. (1985). The family script: A useful bridge between theory and practice. Journal of Family Therapy, 7, 301-305

Fraiberg, S., Adelson, E. & Shapiro, V. (1980). Ghosts in the nursery: A psychoanalytic approach to the problem of impaired infant-mother relationships. Journal of the American Academy of Child Psychiatry, 14, 3.

 

Dr Laura Tinkl is a Senior Chartered Clinical Psychologist, professionally accredited by both the Health and Social Care Professions Council (HCPC) and The British Psychological Society (BPS). Appointments can be made in the Lewes Practice.

 

Further reading by Dr Laura Tinkl –

When praise becomes harmful to children

The role of ‘attunement’ in relationships with babies and young children

What is ‘Blocked Care’ as it applies to parenting?

 

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A consideration of some vital notions connected to Existential Therapies

 

 

This blog follows on from my previous blog – Existential Therapy.  This is how I have interpreted some vital notions connected to existential therapies.

Existential therapy is a diverse approach which is used to understand and clarify a client’s problems and possibilities for living their existence. Below are some more of the vital principles (as I see them) typically considered by existential therapists. I would like to make clear that what I have written is not exhaustive, conclusive or necessarily a general order of things.

1) A belief in the relational nature of being as a central aspect of existence [1].

This suggests two things to me. That we are always in relationship with the world, and how we relate to it is often fundamental in how we are and what we become. It is interesting to note that in therapy the relationship has been continually found to be the key to efficacy whatever the approach.

In contrast to the relational sense of existence some existential philosophers have asserted we are ultimately alone in our existence. For instance, Kierkegaard emphasised the individuality of being human, describing human existence as a solitary affair.

Wherever one falls on this spectrum the discussion of how one is relating to their world can be a fruitful enterprise in existential therapy.

2) Seeking to understand a client’s subjectively lived experience and how it is taking place within a framework of temporality (past, present and future), tensions and contradictions. [2]

For me this means the intention is to understand that human existence is full of paradoxes. The aim is to clarify a client’s life as they have lived it, support them to reflect on what has happened and allow them to determine how they would like to live in the future in line with their values.

For instance, if a client comes to see me I am not going to attempt to fit them into any theory or model. I am also not going to tell them what to do.  I do hope to hold an openness to each client’s way of being-in-the-world and support them to get clarity on what is going well and what needs to be changed. I may employ an exploration of philosophy and other wisdoms as well as psychological theory to support a client’s inquiry, but I will always lean towards emphasising a client’s lived experience as key to the investigation rather than any theoretical understanding.

This leads me to another understanding that frames existential therapy.

3) A consideration and discovery of a client’s freedom and responsibility

For me this element is summed up nicely by Nietzsche’s words  “Follow not me, but you”. [3]

When he said this I think he was responding to people’s attempts to pinpoint his ideas into an all-encompassing approach to life. For me, it feels like a relevant description of every individual’s existential responsibility.

An existential therapeutic perspective typically strives for the clients to take responsibility for their lives and see their very existence, their being-ness, as the source of their potential as well as an opportunity to confront their limitations.[4] This possibility of being also upholds a fluid sense that we are always becoming and not a static substance. It invites a platform from which clients might begin to take responsibility for their existence and what they value. In this movement we may begin to reveal, understand and clarify their choices and actions. This takes courage though. It takes courage to birth and live out one’s potential, especially in the face of adversity and limitation.

This links into another significant understanding or theme underpinning existential therapy: ‘being towards death’.  Please also read my blog on Existential Therapy and Death Anxiety.

Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice and Lewes Practice.

Further reading by Susanna Petitpierre –

Existential Therapy

Being embodied in Therapy: Feeling and listening to your body

 

Resources – 

[1] Spinelli, E. (2007) Practising Existential Psychotherapy. The Relational world. London: Sage

[2] van Deurzen, E. (1998) Paradox and Passion in Psychotherapy: an Existential Approach to Therapy and Counselling. Chichester: Wiley.

[3] May, R., (1958) Origins of the existential movement.  in Existence. (Eds: Rollo May, Ernest Angel & Henri, F Ellenberg) Rowman and Littlefield Publishers: USA.  p. 31

[4] van Deurzen, E. (1998) Paradox and Passion in Psychotherapy: an Existential Approach to Therapy and Counselling. Chichester: Wiley.

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Can psychotherapy or counselling be a business expense?

A question that is often asked of us whether or not psychotherapy, and indeed counselling or clinical psychology, can ever be claimed as a legitimate business expense?

What are business expenses?

Business expenses are classified as allowable expenses which constitute the running costs of your business. These will, obviously, vary from business to business. The question of whether psychotherapy is a legitimate business expense therefore applies to people who are self-employed, ranging from freelance workers through to business owners (although for limited companies slightly different rules apply).

How can psychotherapy ever be a business expense?

The answer to this is yes. For example, any counsellor, psychotherapist or clinical psychologist can legitimately claim their own personal therapy as a business expense. Not only is this appropriate as an expense, but it is arguable that all mental health clinicians should be in their own ongoing personal therapy for self-development and to ensure that they are being appropriately supported in the emotional work they do with their clients.

However, in my own practice I have many clients who claim their personal psychotherapy as a business expense and who work in completely unrelated fields ranging from property development through to creative endeavours such as musicians. So how is this justified?

Therapist's sofa

 

What is psychotherapy?

Counselling, psychotherapy and clinical psychology all wall under the heading of ‘talk therapy’. They are concerned in similar ways with helping people to work through loss and trauma. However, both the concept of ‘talk therapy’ and the idea of ‘working through loss and trauma’ cover an enormously large remit and in many instances, this remit impacts upon our ability to work. Let’s consider an example:

Sarah, a freelance musician, has recently been offered a position playing with a major orchestra. This has come about as a result of many years of hard work and dedication; it offers the potential of being the pinnacle of her career. However, to her utter astonishment she notices that every time she joins the new orchestra for rehearsals, she experiences sleepless nights and strong symptoms of anxiety that impact on her ability to play to the best of her ability. Clearly, in this example, Sarah would both benefit from psychotherapy and it can be legitimately argued that psychotherapy for her performance anxiety is a legitimate business expense.

The reasons for Sarah’s anxiety could be numerous ranging from an unconscious fear of success rooted in her mother’s option of her, through to feelings of inadequacy and shame around ‘being seen’. However, from a business expense perspective, the causes are less important that the manifestation of Sarah’s symptoms – her anxiety is impacting on her ability to ply her trade.

Is psychotherapy only a valid business expense in times of personal crisis?

Many people initially enquire and start psychotherapy when they hit a crisis – in other words when their symptoms become debilitating, or at least too distracting to ignore any longer.

So, whilst the initial part of any psychotherapy process often overtly works with the crisis the client brings, the underlying process will be addressing deeper relational issues. It is not uncommon for clients to expect to undergo a period of psychotherapy which then turns into a deep, meaningful, intimate and ongoing relationship that continues week after week. And, in many instances, long-term ongoing psychotherapy remains a valid business expense.

Most businesses are comprised of relationships. Whether that simply means working on behalf of external clients, through to being a part of a team or leading an organisation. And as psychotherapy is a relational process of deepening ones understanding of self through the unique relationship with a psychotherapist, many clients continue to find that an ongoing process of psychotherapy becomes an asset to how they manage stress and anxiety and in turn their relationships with their colleagues.

 

Can couple therapy be a business expense?

Again, the answer to this depends on how the couple relationship is intertwined with the business.  For couples who run a business together – often a complex and stressful experience – couple therapy or marriage counselling can be both invaluable in stabilising the relationship but also in assisting the couple in improving dialogue with each other so as to improve their working relationship. In such a context couple therapy would be a valid business expense.

What if I am not self-employed?

Business expenses apply to those who work for themselves and submit their own (or company) tax returns. So, if you are employed, clearly psychotherapy cannot be a business expense, however, this does not necessarily mean that you cannot get help or support in attending and/or paying for psychotherapy.

Private health insurance

Increasingly private health insurance is offered as a benefit to salaried workers and most private health insurance providers provide cover for psychological support from appropriately trained and registered counsellors, psychotherapists and clinical psychologists. This cover may be capped in terms of a value amount or in terms of the number of sessions, so it is worth checking with you provider to find out more.

Time off to attend psychotherapy

And lastly, where employers may not choose or be able to offer private medical coverage as a benefit, an increasing number of employers are recognising how important it is to support mental health issues. It is therefore not uncommon for employers to allow staff to attend psychotherapy during working hours (with time made up on another day) or to come to a flexible arrangement with staff, such as working from home, to enable them to attend sessions.

 

All the content on this page has been reviewed and vetted by Mark Vahrmeyer UKCP Registered Psychotherapist, Superviser and Co-Founder of Brighton and Hove Psychotherapy. For any questions or more information about the subjects discussed on this page please contact us.

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Online Therapy

We spend much of our lives online these days and increasingly more services are available online that traditionally would have been conducted face to face. This is the same with psychotherapy and counselling, and there is a growing availability of online therapy services around on the internet. So, is online therapy for you?

There are many ways to engage in therapy online, but for the purposes of this blog I’ll be considering online therapy that uses live video. This can be done with apps such as: Skype, Zoom, WhatsApp, FaceTime, BotIM etc. Whatever app is used, the most important thing to consider is the security. Only use an app that has a secure and encrypted connection.

There are many benefits to having therapy online and the most obvious might be the convenience of it. Rather than having to spend time travelling to a clinic, you can be at a location of your choice where you feel comfortable. This might be at home, in a private office at work during your lunch break, or anywhere where it is confidential and you won’t be overheard or disturbed. However, you will need to consider what you will do after the session has ended. Do you have time to compose yourself before you step outside the room and back to the office or family life?

Another benefit of working online is that you might have a greater choice of therapists available to you. Rather than having to choose those in your local area, you can work with the therapist of your choice wherever they are in the country. This can be particularly beneficial if you live in a remote area, or live abroad and want a therapist who speaks your native language. Additionally, if you travel around a lot, it can make it possible to access therapy wherever you might be.

Another advantage of online therapy is that it can make it easier to engage with therapy if you are anxious about going to a clinic in the first place, or have any difficulties with leaving home or accessing certain locations. Being able to engage with your therapist online can remove any of these potential barriers and you can get the support you need.

A lot of people wonder if online therapy is as good as face to face therapy, and that is an important point to consider. Certainly, there is a big difference. The rapport and connection you have face to face with a therapist will be different to what you build online. Some of the non-verbal clues to communication can be lost online so it’s important to be able to tell your therapist if they haven’t understood you, or if you don’t understand them. However, once you get used to working online with a therapist, the distance and technology can ‘disappear’ and you can feel very connected with your therapist.

Here are a few points you might want to consider if you want to access therapy online:

  • You will need to have a good, stable internet connection for the duration of your session.
  • It is best to have a few connection options available – such as wifi and data, and a couple of different options of apps – such as Skype and Zoom, to allow for tech difficulties.
  • You need to be comfortable working online and familiar with the tech you are using. It’s a good idea to turn off any notifications for the duration of your session as these are very distracting when you are trying to work with your therapist.
  • You need to ensure that the location you are in is private and confidential.
  • You should check the credentials and qualifications of your therapist before you engage in any online therapy. There is a growing number of people setting up online as ‘therapists’ with little or no training. Make sure your therapist is registered with a professional body such as UKCP.

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

Further reading by Dr Simon Cassar –

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

What is an integrative existential therapist?

What is Existential Psychotherapy – Video

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