Working with Avoidant Attachment: Assessment
Why is it important to recognise avoidant attachment patterns early in therapy, and what might we look out for? In her second blog about working with highly defended clients, Attachment-based psychoanalytic psychotherapist Linda Cundy explains why the therapeutic relationship poses such a problem for avoidant individuals – and shares some key features that may show up in assessment.
There are five broad categories of attachment pattern: Secure, Dismissing, Preoccupied, Unresolved and Cannot Classify. This blog series focuses on one – Dismissing – commonly called Avoidant. People who are ‘avoidant’ have a whole array of defences that cut them off from painful (and ‘shameful’) feelings, needs and memories, and also prevent others from getting close.
There are good reasons why it is helpful to recognise this pattern of attachment early on in therapeutic work. These individuals are less likely to consider therapy in the first place than those who are more preoccupied or unresolved. They are more wary and defended, and so less likely to stay. If we recognise their particular struggles we can be more sensitive and skilful.
For any prospective client there are always mixed feelings at the start of a therapy – some hope that it will be useful (even transformative) but inevitably also anticipating that it will be either useless or damaging. From an attachment perspective we see the influence of internal working models, or relational models that develop in early life through experiences with caregivers. These predispose us to believe that other people are either fundamentally well-meaning and helpful, or frustrating, hurtful or downright disturbing.
The problem for avoidant individuals is the therapeutic relationship. The expectation of not being understood, being shamed and rejected is particularly powerful because their attachment figures consistently rejected their needs for comfort, reassurance and affection. Self-sufficiency becomes highly valued and reliance on, or intimacy with, other people is shunned. (It may also be longed-for, but that is deeply buried.)
So when a potential client who is avoidant arrives at the door, the balance of hope and hopelessness will be more heavily stoked on the side of hopelessness. It is our job to provide enough hope to bring the client back next session, to make a connection and engage curiosity but without threatening his or her defences.
So how can we tell if a potential client is avoidant? The points listed here are, of course, stereotypical rather than exhaustive:
- First contact: from my experience, avoidant individuals are less likely to make initial contact by telephone than email, text etc.
- Presenting issue: typically work-related, or an indication that therapy is a last-ditch attempt to save a struggling relationship
- What is wanted: often just a few sessions to focus on a specific issue and provide tools to help the client manage without therapy
- First meeting: the client may either try to control the meeting by steering the focus away from the past and painful issues, or is uncomfortable talking about him- or herself in any detail
- : Bollas (The Shadow of the Object) writes about how the therapist is ‘used’ by clients to recreate certain types of relationship and situations that are familiar from early life. I often notice that my attempts to be helpful are blocked or, in some situations, I am not allowed to be empathic. I assume that this harks back to how things were in childhood. And sometimes I feel like an interrogator trying to extract information from an obstinate prisoner!
Although conducting and coding the Adult Attachment Interview (AAI) requires specialist training, this cornerstone of attachment research suggests further clues to listen out for in therapy. Key features of interviewees classified ‘dismissing’ include:
- Little emotional vocabulary, even when asked to describe distressing experiences (separations, losses, bereavements etc.)
- Little elaboration or detail regarding attachment-related material (AAIs with avoidant people are usually shorter than with other interviewees for this reason)
- Childhood and parents idealised or described as either “fine” or “normal”
- Apparently few or no childhood memories
- Presenting self as competent, independent, not needy
- Past difficulties in life presented as positive experiences
- Little curiosity about internal world and motives – their own or others’ – the ‘unexamined life’
Next time I will write about the early stages of therapy with avoidant clients. If we are able to keep them, help them feel safe enough to benefit from therapy, we will also be rewarded – it is a wonderful privilege to see them thaw, come to life, discover their own emotions and internal worlds, become more playful, spontaneous, creative and relational.