How Attachment Style Explains Why Some People Choose Therapy—and Others Don’t
The latest data on brain development and function confirms it: The quality of your connection with your primary caregivers determined how you learned to experience and understand feelings in your body, AND how you relate to other people.
Which means: Any relationship and emotional struggles you have today definitely began back in infancy.
Here are some aspects of interest for an infant.
- Do I feel pleasant or unpleasant when I’m held?
- Does anyone share attention with me for long periods of time?
- How quickly are my needs met?
- When I cry, does someone pick me up and comfort me?
- When I am hungry, does someone feed me and seem to enjoy doing it?
Unless needs like these are met—without ambivalence and before undue distress occurs—a baby simply won’t feel more pleasant than unpleasant in its little body most of the time.
Good Enough is Good Enough
If interactions with your caregiver were “good enough,” you learned to experience and manage your arousal in healthy ways. Here, “good enough” definitely doesn’t refer to perfect parenting—if such a thing even exists.
“Good enough” caregivers produce adults who fall anywhere on the spectrum from comfortable, confident, and involved in satisfying reciprocal relationships, to those who are mentally anguished, riddled with self-doubt and self-loathing, and who either seek or avoid relationships as they try to resolve their discomfort.
These styles of relating can be understood in psychological jargon as “securely” or “insecurely” attached.
With a good-enough caregiver, you didn’t have to cry until you collapsed from exhaustion in order to obtain relief from over-arousal. Through every single interaction with your caregiver, your brain was learning to categorize different experiences of bodily regulation as part and parcel of your relationships with people.
Here, bodily regulation really just means: being looked at, getting picked up, hearing your caregiver’s voice directed at you, sharing attention, having your diaper changed, etc. Basically, things that made you feel better.
Based on your environment (which, of course, heavily featured your caregiver), you found out which behaviors were most likely to get you the particular bodily regulation you needed and wanted at that moment.
Not Good Enough
By contrast, if your interactions with caregivers were extremely erratic, inconsistent, or generated over-arousal, then the care you received could be described as “not good enough.”
This will be demonstrated in your life by the fact that you are, without exception, either an emotional “bull in a china shop,” or that you suffer from unrelenting chronic physical illness.
You might already be aware of these traits in yourself. More than likely, however, you’re unaware. You simply live moment to moment, in a sea of physical, emotional, and relational chaos. You might drift among relationships and jobs, leaving confused and unhappy people in your wake.
You weren’t hard-wired from birth to have this “disorganized attachment style,” (which is what it is called in psychological parlance). The current, widely-accepted neuroscience tells us that basically everything humans do is based on learning through experience.
Unluckily, your experiences didn’t teach you that people are (at least most of the time) a source of comfort and solace. Rather, you learned that people are a source of inconsistency and upset. Your current style of relating to others is a reflection of this learning.
If the over-arousal you felt turned you into a screaming mess, your caregivers may have harshly punished or outright ignored you. In response to these results, you might have cried until, exhausted, you stopped.
Alternatively, you might have stopped crying by contracting your muscles, once you gained enough muscular control to do so. This strategy might have worked much better for getting you what you wanted, since crying had only brought you punishment or isolation.
In this and every other cause-and-effect interaction with your caregiver, your brain built the predictions that worked for you in that specific set of circumstances. You arrived at mature adulthood with all those predictions in hand.
Does this mean all is lost for those of us who got unlucky with our primary caregivers? Not at all. Fortunately, the brain is plastic, meaning it’s malleable and changeable over the lifespan. No matter how bad things got with your first caregiver(s), another person later in life can step in to reestablish your capacity for self-regulation.
Theoretically, anyone can provide you with the containing, attuned experience that a caregiver once failed to give you. But therapists are specifically trained to carry out this purpose.
Empathy and Energy
Take Julia (name and other identifying details have been changed), a college student I worked with years ago. As she stared down her impending graduation, Julia had started worrying about everything.
Though she tried to control herself into not feeling the way she was feeling, forcing her emotions in this way only left her even more anxious—and robbed her of the ability to handle everyday situations.
Julia’s uncertainty about the future made her feel hyper-aroused. Julia was in high-alert action mode all the time. She had a ton of energy but no channel for it. Julia needed to adopt some strategies to manage the excess of energy in her body.
The first thing I did with Julia was to synchronize with her emotions. I empathized verbally and nonverbally. My responses helped her believe that I understood her feelings, which acted to slow the pace of her breathing.
She and I came from similar enough cultures that my words and non-verbals were comforting to her. (Across divides of language and/or culture, words and non-verbals can unfortunately have the opposite effect.) I also conveyed to Julia my belief that her reaction was perfectly understandable when facing the uncertainty in her future.
This initial connection helped Julia start functioning in social situations again.
No longer was she alone with her feelings. Now, she understood how the looming uncertainty surrounding her future prevented her from experiencing her high energy as excitement about and celebration of her graduation.
This realization freed her to apply strategic mental and physical mood-altering tools when she became overwhelmed with more problem-solving energy than she needed.
When Other People Help—or Harm
For many (but by no means all) humans, past experience leads us to seek out another person for comfort when we’re upset or afraid.
In other words, for those of us who had “good enough” caregiver experiences, our first line of defense against fearful, overwhelming situations is usually to interact with another person who can help calm us.
By connecting with Julia’s fear and helping her reframe her bodily sensations as appropriate and expected—rather than as a sign that she was losing her mind—I helped her reestablish a sense of emotional equanimity.
Therapy is generally not a go-to for those whose past experience taught them that people don’t help them feel better—and might even make them feel worse.
These folks will not tend to seek help from another person to help them “get back to normal,” because people have never really helped them “get back to normal.”
They fall into what is considered, as I mentioned above, the “disorganized” category of attachment.
Conversely, among those considered to have an “insecure” attachment style, there is a spectrum of willingness to engage in therapy.
The primary factors in the choice to seek help from a stranger (or not) will be the pattern of (un)reliability someone experienced with caregivers and how dire things had to get before help would arrive.
Those predictions informing today’s choices are built during early experiences with other people. Some people will choose therapy quickly, and others will have to be suffering tremendously before they reach out.
