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|Case Study - Page 2|
Attachment in the Present Moment
Clients’ attachment styles originate in early interactions with primary caregivers and often endure into adulthood. Deficiencies in attachment can be transformed later in life as a consequence of nourishing and attuned relationships with partners, friends, and therapists. However, this type of transformation requires experiential events, not just conversation. One of the most powerful ways for a therapist to establish an experiential, relational state of attunement is through mindfulness—both the clinician’s and the client’s.
Mindfulness starts by attending to the many details that make up the present moment. Unfortunately, most of us can easily be transported away from the experience of the moment, especially by the content of conversation. Studies have shown that 70 to 80 percent of communication occurs through mostly unconscious somatic signals—pace, posture, gestures, voice quality, breathing patterns, changes in energy, and alterations in skin coloration. These signals arise directly from the core beliefs and models of the world that the client holds. By not allowing ourselves to get carried away with the content of clients’ stories, we can notice the other ways in which they communicate. The process of noticing and joining with a client at this level generates the kind of nonverbal attunement—normally supplied by good early parenting—that can build secure attachment and begin to address the early injuries that may have occurred in preverbal life.
During our first session, Jane told me in a flat voice that her husband had decided, without consulting her, to accept a more “responsible position” (code for many more hours away from home) at his law firm. She roughly pulled a tissue from the box. Noticing the vehemence of her gesture, I said, “You’re mad at him, huh?” “Yes,” she replied, “He’s always like this.” A flash of grief crossed on her face, followed by a dismissive movement with her hands as she turned away.
Rather than following the content by asking, “He’s done this before?” I responded by reflecting back her current experience, saying, “You’re pushing away with your hands, huh?” I left it to her to tell me what she was pushing away—her husband and/or her feelings. What she’d offered was a gesture, a demonstration of the impulse to push away and turn inward. It seemed important, since it was performed with some energy and was consistent with her predisposition toward self-reliance.
Focusing on the gesture caught her attention. I suggested that she do it again, but slowly, really taking time to notice the details of her experience, the subtleties that get lost in ordinary consciousness and conversation. As she did so, she said, “You just can’t count on anyone.” She grimaced as if the words tasted bitter.
I responded, “You feel betrayed and bitter, huh?” I wanted to contact what was stirring inside, beneath the impulse to push away. Contacting her emotional experience here opened a door—her eyes welled up with tears and her lower lip began to quiver. I responded, “These are some strong feelings. It looks like you’re fighting with them a bit.” As she tried to answer, something softened inside her and she began to weep.
Part of the process of healing for someone who’s been entranced by a rigidly self-reliant belief structure is learning to risk the emotional vulnerability that can lead to a response from another person that’s different from an earlier experience of childhood neglect. Without pushing in any way for increased abreaction, recognition of the internal battle between expression and containment shifted the balance toward the former, allowing Jane to show me more of her vulnerability.
Much of the impact of trauma stems from isolation. Telling one’s story to an attentive, warm listener will begin to reconsolidate how the memory is held. While therapists can’t change the past, we can offer a place in which it’s no longer held alone, but in relationship. This builds attachment.
Studying an experience while it’s happening presents opportunities absent from ordinary conversation. One important element in Jane’s internal model of relationship was how she held herself apart from others. In a later session, I wanted to construct a therapeutic experience of mindfulness that would enable her to experientially explore the need to be invulnerable.
“Jane, I have an idea,” I said, “I’ll say something to you, and you can notice where it lands inside. Notice the response. It could be a thought, a feeling, a sensation, an impulse, memory, fantasy, music, or nothing at all. Would that be OK?”
Asking permission is always important in establishing a genuinely collaborative relationship based on safety and equality. Once she agreed, I let myself shift into a slower, more mindful state in which I could begin to notice the details of my own internal world and start to track her moment-to-moment reactions even more precisely. With the help of limbic resonance and the activation of mirror neurons, she, too, began to let her attention focus inward.