Congress on Trauma and Attachment
Alternative Relational Models for Trauma-Informed Psychotherapy: Beyond the Parent-Child Attachment Paradigm
Therapists often experience a major dilemma with traumatized individuals. On the one hand, secure attachment is heralded as the single most essential ingredient in successful therapy, giving clients a chance for relational repair. We are thus taught to develop an attachment on which the client becomes dependent for predictability and consistent repair, a healthy bridge to earned secure attachment. On the other hand, our clients’ unmet dependency needs and insecure attachment patterns can derail the therapy. We are thus taught to prevent the client from becoming “too” dependent on us. Our own implicit belief systems about attachment and dependency, and our own unprocessed relational trauma can play a major role in maintaining overly distant or caregiving stances in therapy. Implicitly or explicitly, much of the literature discusses the therapeutic relationship in the context of a parent-child attachment model, in which the client safely depends upon the therapist’s secure attachment to support developmental repair. Therapists often implicitly use a parent-child model in relating to their clients, and in helping clients relate to their dissociative parts internally. Is this the most effective or only way to help our clients develop secure internal working models? We will examine the pros and cons of this approach. Then we will explore other possible relational models, such as mentor-learners, adult team members, and co-leaders. These emphasize the free agency and collaboration of both parties, who are focused on specific and mutual goals. These models are based on reciprocal adult relationships that can free therapists from an undue burden of “taking care of” clients and violating a helpful treatment frame and boundaries, while remaining deeply connected to those we treat. Treatment implications will be emphasized.