Attachment: A biological basis for the therapeutic relationship?

Abstract

When faced with loss, illness, distress, or threat, we tend to seek out an attachment figure from which we can obtain comfort and protection. The attachment theory, an evolutionary biosocial theory of development, postulates that the propensity to make strong emotional bonds to a differentiated and preferred person, conceived as stronger and or wiser, is a basic component of the human nature, distinct from feeding and sexuality. Attachment behaviour is present in germinal form in the neonate and continues to be present ''from the cradle to the grave''. On the basis of day-to-day experience of the responsiveness and accessibility of caregivers, children build internal working models of attachment figures and of themselves. Expectations about the likely behaviour of others, initially preverbal, characterize the approach of the individual to other persons. Internal working models are successively modified on the basis of recent experience. The therapeutic relationship can be viewed as the seeking of a secure base, from which the patient and the therapist, in a joint effort, explore the patient's attachment history and the painful feelings associated with it. The therapist, responsive to the patient's verbal and non-verbal attachment signals, is viewed as a supplementary attachment figure.