May 18, Morgan Blackledge rated it it was amazing Masterwork!!! Game changer!!! I super love this book!!! Author David J Wallin writes about relational psychotherapy with rigorous honesty, big heart and perspicacious intellect. This book was a revelation for me.

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With this as a foundation, he helps us to see how ideas from attachment theory, intersubjectivity theory and the psychology of mindfulness, can be combined to provide a strong theoretical framework for our clinical endeavors with our patients. In the preface of the book, Wallin states, I aim to convey how therapists can make practical use of three key findings of attachment research.

Accordingly, I focus on the therapeutic relationship as a developmental crucible, the centrality of the nonverbal dimension, and the transformative influence of reflection and mindfulness. Wallin is careful to point out however, that attachment is complicated, and that people are too complex to simply place in a single category.

For example, …a therapist and patient whose predominantly dismissing styles mirror each other, may collude to steer clear of strong feelings. In so doing, they may enact an emotionally distant relationship that is familiar to both.

In such a relationship…vital, but anxiety-provoking issues will continue to be avoided. To be embedded is to be stuck in our experience and at its mercy. Wallin shows how we can liberate ourselves from the trap of embeddedness, through either the use of mindfulness or the use of mentalization self-reflection. Utilizing the relational, intersubjective prospective, he stresses that what occurs in a therapy session, is no less a creation of the therapist, than it is of the patient.

He reminds us that Bowlby theorized that the child excludes from conscious awareness, any thoughts, feelings and behaviors that threaten his attachment relationships. He agrees with many current psychoanalytic thinkers that the patient expresses what he cannot verbalize either through enacting it with others, evoking it in others or embodying it.

To help therapists increase their self-awareness, he suggests that we adopt a stance of mindfulness, i. Wallin feels that focusing on bodily experience is important for many patients, and essential for patients with unresolved trauma. In sum, Attachment in Psychotherapy, not only offers instruction in how to make practical use of attachment theory, but espouses an egalitarian approach to psychotherapy, in which the therapist and patient are viewed as flawed human beings who are continuously engaged in trying to create or reenact certain types of relationships with each other.

Wallin emphasizes the bidirectional nature of projective identification, and cautions therapists that they must be careful about too readily assuming that what they feel the patient has evoked in them belongs to the patient alone. By addressing both the verbal and the nonverbal realms, and rooting his therapeutic interventions in attachment theory, he provides us with a vision of how to conduct a psychotherapy that is comprehensive, liberating and humane. Reading this book can be a therapeutic experience for therapists and a boon to their clinical practices.

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Attachment in Psychotherapy (Book Review)

Complex concepts are carefully elucidated and brilliantly illustrated with clinical examples. This book is an important reference for all clinicians and students. It is a vital resource for those who are interested in how progress in our understanding of attachment processes may be applied in a clinical context. Wallin has written an extremely insightful, broadly integrative, clinically applicable, and highly engaging book. Keeping his personal and clinical experiences coherently in mind and using them as examples, he synthesizes recent literatures on attachment theory and research, mindfulness, mentalization, metacognition, nonverbal communication, intersubjectivity, and mechanisms of therapeutic change. The book moves deftly from clear analyses of contemporary theoretical issues to specific, well-described clinical techniques that can be used with particular clients; for example, those with a particular adult attachment pattern.


Attachment in Psychotherapy

I think this was a powerful lecture, so I wanted to share some points he made and my thoughts about it. This requires the development of a sense of security and trust in the relationship. It is through our attachment style that we interpret and relate to the subjective experience of our clients. Therapists need to be mindful of how their attachment patterns emerge in psychotherapy, as well as become willing to use these patterns as the relationship unfolds. Therapists in a preoccupied state may tend to merge or over-identify with their client, have difficulties setting boundaries and avoid conflict to avoid being abandoned. Therapists in an unresolved state would be more likely to find themselves fluctuating between victim and rescuer roles; they may avoid approaching trauma or push clients to face it prematurely. In my experience, it is clear that my personal attachment style impacts the relationship I develop with my clients.

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