Relational Ideas and Attachment

Wallin explicates the dovetailing of Attachment Theory with relational and intersubjective clinical practice. For example, repair of ruptures and negotiation of differences are important both in the clinical situation and in building secure attachment. Development of a healthy, flexible, broadly experiencing, authentic self is an aim of treatment and of the loving caregiver toward the infant.  Relational therapy -- by therapists examining their own participation and influence, and by inviting the patient to aid the therapist’s self reflection-- recognizes the capacities of the adult patient.

Wallin highlights for us some of the important ideas in relational therapies:  Influence in relationship is mutual and reciprocal, though roles may be asymmetric, as with therapist-patient or parent-child. Thus, transference is co-created. Resistance, too, is co-created, and a communication to the therapist that some experiences remain too painful as yet for the patient, reminding the therapist to be more attuned. It is impossible, sometimes even harmful to attempt, to be neutral, abstinent, and anonymous. Mindful of the patient’s best interest, self disclosure can instead be useful, for -- just as it is important for a child to know the mind of the caregiver in order for the child to develop a mind of one’s own -- it is useful for a therapist to feel and contain affective experiences if the patient is to do so as well.

Self disclosure, knowing the mind of one’s therapist, can foster mentaization. Speaking to our affective experience viz a viz the patient experientially communicates to the patient that dissociated thoughts and feelings can be safely owned, discussed, integrated. It can let the patient know of her/his effect on the therapist, bulwarking agency. It can model the link between words, feelings, experience. It can be a step towards finding our way out of enactments.

Enactments are an opportunity to access dissociated experiences. Self states which are rejected by the caregiver tend to be dissociated by the child. Integrating dissociated experiences -- by welcoming in, containing, speaking to our own experience, etc -- are all part of relational therapy and allow the patient to experience the therapist as a new attachment figure.

Wallin, D.J. (2007) Attachment in Psychotherapy Chapter 10. Deepening the Clinical Dimension of AttachmentTheory. (Guilford Press, NY)