Attachment style, representations of psychotherapy, and clinical interventions with insecurely attached clients

The primary aim of this article was to demonstrate the clinical utility of an empirically grounded perspective on the complex interplay between patients' attachment style and their ability to create, remember, and use benignly influential representations of their experiences with their therapists. We focused on 2 interrelated questions: Are there significant attachment-related differences in the thematic content of the remembrances and fantasies that patients have about therapy? And, if so, what are the implications for practice? Results of a study of individuals currently in therapy (N = 176) indicated that although all the patients with different insecure attachment styles struggled to evoke positively valenced therapist representations, the specific nature of their representational patterns varied as a function of specific attachment styles. We offer several clinical strategies that may increase insecure patients' abilities to form adaptive representations of their therapist and therapy. We illustrate our recommendations by presenting case material from the psychotherapy of a compulsively self-reliant man.