Thoughts From The Couch – Attachment and trust

Trust is complicated and very difficult to define. It is fundamental to life as without it we live internally isolated and fearful. The parent-child relationship is our first social relationship that teaches us that we can communicate in order to get our needs met as part of our human impulse for survival. When as a baby, we can count on our primary caregiver and trust them to meet our most basic needs for love, food, affection and stimulation we feel secure. As a result, our attachment to our caregiver goes from strength to strength, and we learn to trust not only that person but the world around us. As Winnicott keenly observed, infants cannot exist alone. ‘Sow a thought and you may reap an act; sow an act and you reap a habit; sow a habit and you reap a personality, sow a personality and you reap a destiny.’ ( Holmes 1993 : 210).

John Bowlby formulated the basic principle of attachment theory whilst working as a psychiatrist at the Tavistock Institute. This experience led Bowlby to consider the importance of the child’s relationship with their primary caregiver in terms of their social, emotional and cognitive development. He transformed the thinking about a child’s tie to their primary caregiver and its disruption through separation, deprivation and grief, and led Bowlby to formulate his attachment theory.

Attempting to understand the intense distress experienced by infants who had been separated from their parents, Bowlby witnessed that separated infants would go to extraordinary lengths to either prevent separation from their primary caregiver or to re-establish proximity. Bowlby used the term ‘attachment’ to describe the emotional bond that develops between an infant and their primary caregiver and suggested that to feel attached is to feel safe and secure. He believed that the quality of the attachment evolves over some time as the infant interacts with their caregiver and is partly determined not only by this prime interaction but the past attachment experience of the caregiver herself and the consequent parental behaviours created as a result of that experience.

Mary Ainsworth, first a student and later a colleague of John Bowlby, conducted research based on Bowlby’s theory and herself devised an experimental procedure called the Strange Situation Test. She used this to measure secure and insecure emotional attachments between toddlers and their primary caregiver, which is still used today to assess attachment styles in children. Based on the responses observed by the researchers, Ainsworth described three major styles of attachment: secure attachment, ambivalent-insecure attachment, and avoidant-insecure attachment. Later a fourth attachment style was added called disorganised-insecure attachment, which was based on the research of Main and Solomon.

The human attachment system takes several months to develop. In the first few weeks and months of a child’s life, the caregiver must be at the child’s disposal to fulfil all their needs. If this happens, a healthy sense of self, along with trust in themselves and others, can gradually develop. Over time, the child starts to construct beliefs about the self and others based on its associated experience. As time goes by, children naturally form expectations about the availability and receptivity of their caregivers.

Bowlby theorised about the implication of the infant-caregiver bonding, suggesting that it shapes the quality of our relationships with both ourselves and others throughout our lifespan. He believed that over time these interactions generate internal working models of ourselves and others that influence how we behave and our view of relationships. If we experience consistent and robust support from our caregivers who model to us that the world is safe to explore, we develop a secure sense of self. In addition to starting to understand that we are worthy of love and attention, we learn to combine trust in others with trust in ourselves.

Conversely, if we grow up believing that the world is unsafe, filled with people who cannot be trusted; if we experience loss or separation, or threats of those, this erodes our trust in ourselves and others. As a result, we develop an insecure attachment, often seeing ourselves as worthless and unworthy of love. From this place, it is hard, and sometimes impossible to trust, whether it be ourselves or others causing difficulties in relationships; creating distance between people who might otherwise be close. As a result, we can develop a loss of confidence, anxiety, depression as well as the fear of commitment or resolute independence, all a result of the firmly held belief that people are ultimately untrustworthy.

I believe that the majority of parents hope to provide their children with a secure attachment. What we need to consider is that things happen, which are out of our control. These have the potential to impact our children’s attachment pattern, in the same way as perhaps our parents challenges affected ours. Relationships break down; death occurs, addiction, tragedy, unexpected traumas and stresses that cannot but affect how our caregivers manage to continue with their lives as well as being the best they can be for their children. Thankfully, attachment styles are not fixed.

Although our childhoods are an intense compacted moment of our development, that can have a disproportionate impact on our life; hope lies in the fact that life itself is a process whereby we continuously change and grow. Much of my personal journey towards being a ‘good enough’ therapist has meant looking at my own issues. In therapy and supervision, I have had to consider my own ability to care for and function as a secure base for my clients. Without understanding my own defensive patterns relating to attachment and any resulting unresolved issues, I would not be able to foster secure attachments in my clients who present to therapy with attachment issues. There are many benefits to this both personally and professionally. One of the advantages is my belief that, whilst problems in early years can create unstable attachments, adult attachments can be changed. Through the process of therapy and or through a secondary attachment relationship, we can re-work our internal working models offering us a more connected way of living.

Considering that research on adult attachment recognises that interpersonal functioning has an impact on the quality of relationships formed between therapist and client, I am mindful of what attachment styles my clients have. I see my role as not dissimilar to that of the responsive mother who provides her child with a secure base from which they can explore the world, as the conditions under which an infant develops a secure attachment are not unlike those conditions for effective therapy. Bowlby’s view was that the therapist would be seen as an attachment figure whether the client is aware of it or not. From the therapists perspective, it feels essential to hold this thought.

One of the significant components of therapy is building a strong therapeutic alliance, with trust being an essential part of the foundation. Trust takes time, and understandably many clients who come to therapy will not automatically trust me. Many have had experiences whereby their trust has been broken, and I am well aware that trust needs to be earned. Trust is not black and white, either you do, or you don’t. Some people can trust more easily than others and are, in fact, better at being trustworthy and judging trustworthiness. For some of my clients, they are trusting in some situations and not in others, for others, they start with zero trust. For some clients, an essential part of beginning to trust is recognising sessions ending does not mean that they are being abandoned. An often new and comforting realisation that they can experience being attached and then apart without feeling anger, fear or need.

I aim to offer a therapeutic relationship that teaches my clients what life is like when there is someone there for them, not just in our sessions, but out in the world on whom they can rely. Someone that respects their boundaries and who is a nurturing, empathetic and continuing figure who they can understand and trust as such. From this base, they can explore the way that they regulate themselves in relation to others and can then attempt to reshape old emotional habits, introducing new ones. Guntrip (1975) has well described the therapist’s job: ‘It is, as I see it, the provision of a reliable and understanding human relationship of a kind that makes contact with the deeply repressed traumatised child in a way that enables (the patient) to become steadily more able to live, in the security of a new real relationship, with the traumatic legacy of the earliest formative years, as it seeps through, or erupts into consciousness.’ (Bowlby 2005 : 182)

Trust is a lifeline for any person insecurely and anxiously attached, thus living with the unseen scars that impact their ability to form and maintain healthy relationships. Watching someone tentatively start to put down the roots of trust based on our relationship never ceases to humble and inspire me. Many have to work hard to move through the internalised beliefs that say it is “bad” to trust. Others who have suppressed their feelings of dependency for many years, have to move through feelings of intense shame as they start to re-emerge. What I remind my clients is that there is no rush. We are interdependent, and hopefully, a time might come whereby having learnt to trust in therapy they might be willing to risk trusting others. With courage and willing determination, clients can find a place in therapy to tell their stories and face their individual darkness. Emerging with a new and kinder perspective on the value of relationships, they can start to trust in themselves as well as an other and gain enough of a secure base from which they can throw such a lifeline to others.

Holmes. J. 1993, John Bowly And Attachment Theory. Routledge: London

Bowlby. J. 2005, The Making and Breaking of Affectional Bonds. Routledge: Oxon

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