JAY: It sounds as if Bowlby and Weiss shared many beliefs. For example, these beliefs you mentioned as examples: "Am I allowed to exist?", "Am I loveable?" or "Do I need to be invisible?" These are all statements that I hear frequently in EFT sessions, and every person has their own way of saying them. Sue Johnson, who developed EFT, constantly emphasizes the importance of reflecting these sorts of vivid phrases (and, if possible, colorful metaphors) back to clients in their own words, precisely because every person does make sense of these experiences a bit differently.
Maybe one of the differences, however, is that attachment folks tend to describe affects that come with characteristic beliefs, whereas Weiss described similar dynamics in terms of beliefs that come with characteristic affects. Would you agree with that?
CAROL: Yes, the theories are different in that way, although CM is not as formulaic as that sounds. Even though certain common beliefs do often come with certain affects, many are not bound together. Both the beliefs and affects become apparent through the testing process which is also an interactional process between therapist and client. So much of what the client learns is based upon how the therapist is dealing with, and responding to, what the client presents in treatment. In passive-into-active processes, clients are very much hoping to learn from their therapists about different ways of metabolizing uncomfortable feelings, thereby learning more flexible or less pathological ways of thinking about themselves. We are clearly talking about the transferential and counter-transferential experiences of both therapist and client, and the ways these issues are so much of a dance in treatment.
Is there an equivalent way of thinking about transference and counter-transference, and the role of the therapist, in attachment-based therapies?
JAY: It depends upon whom you ask. Bowlby, who always considered himself an analyst first and foremost, would completely and unreservedly agree about the therapist's role in healing. Attachment therapists seeing individuals of course agree with Weiss and Bowlby, and work relationally. On the other hand, Sue Johnson encourages couples therapists to avoid interpreting transferences with the therapist, in order to keep the focus on the dynamics occurring within the couple. This moves the locus from the relationship with the therapist to the relationship with the partner, similar perhaps to how Dennis Zeitlin described paired and unpaired pathogenic beliefs in CM with couples.(6)
For example, I had a 7 year-old client who was selectively mute at school, but not usually with me. In her family, she was expected to obey and not to disagree. One time, we were playing and she was ignoring my questions about school. I started to get very frustrated that she was ignoring me, in much the same way, I realized in retrospect, that she was probably frustrated with me for interrupting our play to talk about things that made her feel bad. Long story short, I wanted to be empathetic, but was also feeling pulled between giving in and standing firm. Eventually, I said that unless we could talk and play both, I might have to put the toys away. Though annoyed, I saw this in terms of reciprocity, the attachment-centered idea that "we both matter." She called my bluff; I put the toys away. She burst into tears and I felt absolutely horrid. She never spoke and so the toys stayed away, though I apologized for that. Then, she started talking in school the very next day. I decided that I had verbalized feeling mad and sorry at the same time while sticking with what I needed, which freed her up to be frustrated and scared while still speaking up for herself.
I just wouldn't have a way to interpret that if not in terms of passive-into-active!
CAROL: Yes, that would be classic example of a passive-into-active test, where the client watches and interacts with the therapist to see how the therapist works things through. You, as the therapist, were experiencing many of the pulls that the child was experiencing. Sometimes in treatment, it's not interpreting or describing what is going on; sometimes the action itself is what becomes important. Clients can learn by watching us, in and of itself. Your client benefited not only from the firm line you took, but also because you revealed your conflict. This freed her up to be more expressive with respect to her own conflict.
In your client's effort to negotiate her place in the world, she hit something that she thought was going to be protective. In her family, quiet was often the best way to proceed, so she became mute. Through your actions you were telling her: "this self-protection might have worked before, but was not working anymore." It was through your actions and not your question, that she had to re-evaluate what she had learned, and take steps in different direction. This story is an example of how much the interactional process between therapist and client leads to change, even when it is not obvious at the time.
JAY: Yes. Sometimes, when we read the attachment literature about children, there is this implicit focus on failures of empathy and parental responsibility at the child's expense, not because attachment theorists favor empathy and enmeshment over other aspects of experience, but rather because that literature is often about very young, and therefore very sensitive, children. With older children and adults, attachment focuses increasingly upon reciprocity, how we interact to co-create relationships in which both people matter, and how that gets communicated, or not.
CAROL: There are many commonalities between Control Mastery and Attachment. I've learned a great deal about those similarities through our work together.
JAY: Thank you! I agree that they fit together wonderfully well. I really do think that Weiss was naming fundamental truths about what makes psychotherapy work, regardless of the kind of psychotherapy being explored, attachment very much included.
We hope you have enjoyed our dialogue, perhaps we will share more in the future!
Carol Drucker, Ph.D. is the Training Director of the SFPRG clinic, faculty at Alliant International University(formerly CSPP) and has a private practice in Berkeley/Albany. She teaches about 'Using the Therapist as a Tool" is psychotherapy.
Jay Seiff-Haron, Psy.D. is in private practice in San Francisco, where he sees couples and parents with preschoolers who have experienced divorce, trauma or separations from loved ones. Jay also specializes in issues facing bicultural or interfaith individuals and families, working from Emotionally Focused Therapy for Couples (EFT), Control Mastery and systems perspectives. He is also the Executive Director of Cross-Cultural Communications, a 501c3 non-profit dedicated to enhancing cross-cultural communications through experiential training.
(1) On 9 attachment subtypes: http://en.wikipedia.org/wiki/Attachment_in_children#Attachment_patterns
(2) Johnson, S. (2009). Attachment theory and emotionally focused therapy for individuals and couples: Perfect partners. In (Eds. J. Obegi and E. Berant), Attachment Theory and Research in Clinical Work with Adults (ch. 16). Guilford: 410-433. Downloaded 7/12/11 from http://www.creatingconnections.nl/assets/files/Sue%20Johnson%20ObegiCh16.pdf
(3) About anxiety and avoidance: http://internal.psychology.illinois.edu/%7Ercfraley/measures/measures.html
(4) Weiss, J. (1990). The nature of the patient's problems and how in psychoanalysis the individual works to solve them. Psychoanalytic Psychology 7(1), p. 108.
(5) Foreman, S. Child psychotherapy: The contribution of Control-Mastery Theory. Downloaded 7/11/11 from http://sfprg.org/control_mastery/docs/ForemanXXXX.pdf
(6) Zeitlin, D. Control mastery therapy and couples therapy. Downloaded 7/11/11 from http://sfprg.org/control_mastery/docs/Zeitlin1991.pdf
