From Unresolved to earned Secure attachment

Abstract

This chapter documents work done in long-term psychotherapy with a 65-year-old woman first seen as part of a couples’ Therapeutic Assessment (TA) while her marriage of many years was dissolving. The client’s initial Adult Attachment Projective Picture System (AAP), administered during the TA, yielded a classification of Unresolved, with deactivation as her main regulating defense. This fit not only with the client’s acute distress over her marriage ending but also with a severely traumatic childhood she had pushed aside to become a highly successful professional. Following the TA, the client and the author continued to work together in psychotherapy for over three years. As part of our treatment, the author re-administered the AAP two more times, once after one year (classification: Dismissing, Failed Mourning) and again one year after that (classification Secure). The AAP was extremely useful not only in documenting the progress of the treatment and providing guidance of how to intervene but also as a valuable clinical instrument. Repeated discussions of the client’s AAP stories helped her reinterpret her early attachment experiences, grieve her many losses, and modify her internal working model of close-protective relationships. During one session mid-therapy, an Extended Inquiry to the Window picture of the AAP led to a sudden breakthrough in the client’s ability to understand her early attachment trauma and face and tolerate her deep inner pain. The chapter ends with a short poem written by the client about her experience of the therapy.