Helping Adult Client With Old Attachment Issues

Hello,

I am struggling with a situation and would welcome some constructive feedback.

It involves a married female client in her 30's with no children, who entered therapy for depression. She also has PTSD, stemming from abuse and emotional neglect in childhood. She describes her relationship with her parents as superficially friendly, but emotionally distant. Happy but fake.

The client describes a constant tug-of-war between desperately wanting close attachments with others, but at the same time actively prevents it. She interacts in an agreeable way with coworkers and peers, but refuses most social invitations, and rarely initiates socializing herself. When not with her husband, she prefers to be alone.

However, on occasionally, she develops a very strong, intimate friendship with a mother figure, who wants to take her "under their wing." The relationship takes on a kind of mother-daughter dimension, to which the client becomes almost obsessively attached.

I believe she has developed an attachment in therapy as well, although she continues to behave in a very guarded manner. She describes a desperate need for maternal nurturing, which she never got from mom. She has asked several times for a hug from me, but has been too afraid to follow through.

She has no trouble talking about superficial subjects with people she isn't close to. However, talking about her personal feelings has always been a fight. The more attached she feels to a relationship, the harder it is for her to communicate and ask for what she needs.

When therapy first began, she would often write her feelings down rather than speak them. Later, she would leave a voice message. Now, she usually talks face to face in session, although occasionally prefers to speak without being looked at.

I sense her struggle to connect with me, yet resistance to attachment. The time-limited nature of the professional relationship itself triggers her fears of abandonment. Her fear of "losing the relationship" keeps her from being able to fully open up, trust, and work through issues.

Have any of you experienced this dynamic in your practice? And have you read any current literature on adult attachment deficits? If so, please share.

Replies:

A few thoughts about dealing with an "Attachment Issue", by Jim Pretzer, 09/07/02 Re:A few thoughts about dealing with an , by TM, 09/09/02 Re:A few thoughts about dealing with an , by Jim Pretzer, 09/16/02 Re:A few thoughts about dealing with an , by Linda Nauth, 11/10/02

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