Resolving Alliance Ruptures from an Attachment-Informed Perspective.

In this article, we examine how the different attachment patterns enable or hinder the resolution of ruptures in the therapeutic alliance. We try to show that secure and insecure patients alike may experience ruptures in the therapeutic alliance, but that their ability to participate in resolving such ruptures differ markedly. Recent findings with the Patient Attachment Coding System (PACS) show that attachment classifications manifest in psychotherapy as distinct ways of communicating about present internal experience. Secure patients disclose their present experience openly and invite attunement from the therapist, while insecure patients either minimize their contributions to the dialogue (avoidant) or the contributions of the therapist (preoccupied). Using examples from session transcripts, we demonstrate how secure patients are particularly responsive to resolution strategies that focus on here-and-now experience, while insecure patients' characteristic ways of communicating pose significant challenges to the resolution process

An exploratory study on how attachment classifications manifest in group psychotherapy

Recently, attachment-informed researchers and clinicians have begun to show that attachment theory offers a useful framework for exploring group psychotherapy. However, it remains unclear whether patients with differing attachment classifications would behave and speak in distinct ways in group therapy sessions. Aim: In this study, we conducted an exploratory analysis of the discourse of patients in group therapy who had independently received different classifications with gold standard interview measures of attachment in adults. Each patient participant attended one of three mentalization-based parenting groups. Before treatment, the Adult Attachment Interview (AAI) or the Parent Development Interview (PDI) were administered to each patient, and interviews were transcribed and coded to obtain the patient's attachment classification. Groups included 2, 5, and 5 patients, respectively, and any session was led by at least two co-therapists. A total of 14 group sessions were transcribed verbatim. Sessions were analysed through a semi-inductive method, in order to identify markers that would typify patients of different attachment classifications in session. Through transcript excerpts and narrative descriptions, we report on the differing ways in which patients of different attachment classifications communicate in group psychotherapy, with the therapist and with each other. Our work provides useful information for group therapists and researchers regarding how differences in attachment status may play out in group sessions

Reconceptualizing attachment-related differences: From Proximity-seeking to Epistemic trust

Theoretical models of personality and interpersonal relationships often concern themselves with the impact of early relational experiences on later development. Research inspired by attachment theory has addressed this question by focusing on how early experiences of being soothed when distressed give rise to attachment-related differences of lifelong significance. However, though most psychological researchers and practitioners are familiar with attachment-related differences, we currently do not understand how they influence the breadth of later outcomes with which they are associated. This knowledge gap is increasingly felt by researchers as threatening the validity of the theory. To support the continued vitality of attachment research, we propose a reconceptualization of attachment-related differences as broader differences in epistemic trust, which we define as the expectation that overtly communicated information is relevant to oneself. Our reconceptualization weaves together research on how infants learn from testimony, research in linguistic pragmatics (in particular, Relevance Theory), and attachment research. Specifically, we put forward four related theses: 1) that infant attachment patterns reflect differences in epistemic trust vis-à-vis the caregiver; 2) that these differences contribute to biases in interpreting and producing communication after infancy 3) that the so-called measures of “attachment” after infancy, such as the Adult Attachment Interview, capture a special case of these generalized biases; and finally, 4) that the inter-generational transmission of attachment-related differences can be viewed as resulting from infants adapting their own communication style to the communication style of the caregiver

AAI predicts patients’ in-session interpersonal behavior and discourse:A “move to the level of the relation” for attachment-informed psychotherapy research

There is currently little empirical evidence regarding how patients' attachment patterns manifest in individual psychotherapy. This study compared the in-session discourse of patients classified secure, dismissing, and preoccupied on the Adult Attachment Interview (AAI). Rather than focusing on content or form alone, this study analyzed how patients' discourse elicits and maintains emotional proximity with the therapist. The AAI was administered to 56 patients prior to treatment and one session for each patient was rated with the Patient Attachment Coding System (PACS) by four independent raters, blind to patients' AAI classification. Significant differences were found in the discourse of patients with different attachment patterns. Namely, secure and preoccupied patients showed more contact-seeking behavior than dismissing patients, who avoided emotional proximity more, while preoccupied patients resisted therapists' help more than did secure and dismissing patients. These results suggest that the different attachment patterns may have distinctive manifestations in the psychotherapy process that can be tracked by external observers