Adult attachment anxiety: using group therapy to promote change

Group therapy can facilitate changes for members with greater attachment anxiety who tend to struggle with negative self-perceptions, difficulties regulating emotions, poor reflective functioning, and compromised interpersonal relationships. A clinical example of a therapy group with members who had elevated attachment anxiety and who were diagnosed with binge eating disorder demonstrates how attachment theory can be applied to group treatment. The clinical material from the beginning, middle, and end of group is presented to highlight how attachment anxiety influences members' emotional reactions and behaviors in the group, how group factors facilitate change, and how the leader fosters the development of a secure base within the group. Pre- to posttreatment outcomes indicate positive changes in binge eating, depressive symptoms, and attachment avoidance and anxiety. To facilitate change in individuals with greater attachment anxiety, group therapists may foster a secure base in the group through group cohesion, which will facilitate down regulation of emotions, better reflective functioning, and relationships that are less preoccupied with loss and more secure.