Cape Town Clinical Psychologist
Samuel Waumsley M.A. Clin. Psych. (UCT)

Understanding Attachment Dynamics: A Deep-dive into Psychodynamic & Relational Psychotherapy

26.07.23 08:31 PM By samuelwaumsley

Psychotherapy is a process of clarity-making in ourselves, and in understanding our disposition.How do we understand ourselves?

Attachment theory, originally developed by John Bowlby, and expanded by Mary Ainsworth, acknowledges how our early infant relationships with caregivers shape our attachment style and influence our relationships in life. According to Bowlby attachment behaviors in infancy are crucial for survival, and our earliest bond formed in childhood with our caregivers has a tremendous impact throughout life.  A central understanding of attachment theory is that primary caregivers who are more available and responsive to infants' needs lead to a child more easily developing a sense of security. 


Bowlby (1969) demonstrated nurturance and responsiveness to a child are the main influencers of attachment style and a person's sense of security, or confidence. These contexts condition our 'internal working models' he said. In her 1970 'Strange Situation' study Ainsworth found three main styles of child attachment to caregivers: secure attachment; anxious-avoidant attachment -where there is little response to the parent, avoiding them, though with high heart rate; and anxious-ambivalent/ resistant attachment where there can be more distress expressed to the parent. Main and Solomon in 1986 added disorganized attachment. These early patterns we fall into and form are understood to lay the groundwork for how we connect with others as adults, impacting our romantic relationships, friendships, and even professional interactions.


In psychodynamic psychotherapy, figures such as Donald Winnicott (1953) and Melanie Klein (1923) laid some of the groundwork our understanding of early relationships. Winnicott introduced concepts like the 'good enough mother' and the 'transitional object', emphasizing the importance of a secure base from which a child can explore the world. Klein's work on object relations theory explores how internalized early relationships influence our later perceptions and interactions. These theories suggest that the quality and warmth specifically of our early attachments fundamentally shapes our internal world and relational patterns.


Relational psychotherapists like Stephen Stern (2000) and Daniel Stern (1985) have expanded on these ideas, emphasizing the concept of 'implicit relational knowing'. This term refers to the non-conscious, automatic ways we relate to others, rooted in our earliest interactions. According to them these implicit patterns can be transformed through the therapeutic relationship, where new, healthier ways of relating can be experienced and internalized. This process aligns with principles from self psychology, which focuses on developing a cohesive and resilient sense of self through empathic and attuned relationships.


Understanding our attachment styles and how they affect our behavior can allow us to 'own our stuff' - to recognize and take responsibility for our patterns and reactions. Techniques from cognitive therapy like 'metacognition' develop awareness of our thought processes and automatic responses. Mindfulness psychotherapy directs us towards seeking self-knowledge, teaching us to observe our thoughts and feelings without immediate reaction, thereby 'flattening the button' and reducing harmful impulsivity. Relational and psychodyamic theory underlines emotional resonance with the self as well.


Peter Fonagy has significantly advanced attachment theory through his concept of 'mentalization' the ability to understand the mental states of oneself and others. Fonagy's research highlights how secure attachment in infancy fosters strong mentalization capacities, allowing individuals to navigate relationships with empathy and understanding. Conversely, anxious-ambivalent and avoidant attachment styles are associated with difficulties in mentalization, leading to relational challenges. In the realm of psychodynamic therapy, Peter Fonagy has written on the ability of the brain to rewire itself in response to changes in the environment. Recent research shows that therapy can alter neural pathways associated with insecure attachment style towards more secure patterns (Meyer, 2011). 


He says, "the quality of care to which the infant has been exposed, influences that individual’s relational functioning into adult life: an 'internal working model' is developed." Studies show when participants observe a demonstrator modelling a calm response it led a less anxious response in them, as compared to when a model is not present. The importance of social networks then in mental health may be something unappreciated enough. He goes on "attachment as a construct has traditionally always been linked to close relationships, whether between a child and their caregivers or between partners in a romantic relationship. In our view, it should be extended to relationships within the social environment" (even more generally), underscoring how central unconscious attachment styles may be in all facets of human life and society,


Allan Schore integrates attachment theory with neuroscience, emphasizing the critical role of early relational experiences in shaping brain development and emotional well-being, and shedding light on the biological underpinnings of attachment styles. He explains that secure attachment leads to optimal brain development, while insecure attachment (anxious-ambivalent or avoidant) can result in brain and emotional-cognitive 'dysregulation' or distress, and increased vulnerability to mental health issues. Schore's research integrates psychodynamic concepts with neuroscience, providing a deeper understanding of how early attachment trauma can impact emotional regulation negatively, and in turn interpersonal relationships.


Sue Johnson, through her development of Emotionally Focused Therapy (EFT) has highlighted the enduring impact of attachment styles on adult romantic relationships, offering effective therapeutic interventions to foster secure attachments in couples. Johnson's EFT framework offers practical techniques for repairing and strengthening attachment bonds in adult relationships, such as strengthening the self, working to understand and regulate one's feelings with intention, and creating new useful meaning. She identifies how secure attachment in childhood translates to secure bonds in adulthood, while anxious-ambivalent and avoidant attachment styles can lead to later relationship distress. EFT focuses on creating secure attachments between partners by addressing their attachment needs and fears directly.


Individual psychotherapy when successful offers a conducive space for self-exploration and clarity-making.  Next to our own personal introspection,  therapy can assist us in coming to understand ourselves more and how we feel more clearly. Through therapy sessions individuals can explore their attachment styles, gain perspective and self-knowledge, and look to developing healthier ways of relating to themselves and others. 


Understanding our psychological attachment history and 'type', be it anxious-ambivalent, more often secure, or an avoidant style can arguably be crucial. Recognizing your attachment style can provide valuable insights into one's relational patterns and emotional responses. In my private practice in Cape Town, I aim to utilize these insights to help clients explore their unique attachment dynamics -and to train ourselves to listen to our feelings more carefully, and to foster healthier relationships and greater emotional well-being. 


If you're struggling with relationship issues or seeking greater self-understanding, consider reaching out to a clinical psychologist. To schedule a session at my practice please find my contact page here.



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