Author: Leslie Becker-Phelps, PhD
Being a therapist is rewarding, but also challenging. With hundreds of diagnoses in the DSM-V, it can be difficult to match the best interventions to the patient in front of you – not to mention learning the treatment approaches for each problem.
However, there is compelling research showing that most diagnoses have a single underlying factor; insecure attachment. Thus, a better understanding of attachment theory can be key in offering an efficient way to treat a wide variety of disorders.
It’s not that insecure attachment directly creates the problems that send most people to therapy – though it sometimes does that – but rather it creates a vulnerability that increases the likelihood and severity of pathology. So, by increasing attachment security, therapists can increase the effectiveness of their therapy, helping their clients to gain greater psychological flexibility, emotional strength and resilience.
One way to develop secure attachment is by nurturing compassionate self-awareness in clients. Together, attachment theory and compassionate self-awareness offer a framework where different therapeutic approaches can be integrated for more effective therapy. They can address most issues, either fully alleviating them, or reducing their severity enough that people are much more open to change.
To clarify, attachment styles are determined by a combination of how people relate to themselves and others. Those with a secure style hold a model of themselves as lovable and worthy. They also hold a model of significant others as emotionally available.
You can help clients make significant progress in developing these models by nurturing compassionate self-awareness. That is, developing self-awareness from the perspective of self-compassion; treating themselves as they would treat a friend facing the same challenges.
See also: Training Self-Compassion in Clinical Practice
5 Steps to Increase Self-Awareness
For practically all therapeutic approaches, increasing self-awareness is key in creating change. To solve any problem, you must get to really know it. But self-awareness is a very broad idea, offering little guidance.
Therapists can help clients gain a richer appreciation of themselves and begin to change by helping them to increase their self-awareness in five basic areas –STEAM
Sensations,Thoughts, Emotions, Actions, Mentalizing. Here, we’ll focus on the last domain.
Mentalizing, is essentially the ability to understand people’s behaviors by understanding and connecting with their mental states – their underlying thoughts, feelings, desires, and other inner experiences. Importantly, therapists can nurture a more secure attachment in their clients by helping them to mentalize themselves and other people.
The beauty of using STEAM to expand self-awareness is that it offers a guide for when to use various interventions.
For instance, consider Anne (not her real name), who entered treatment with high anxiety. When she began therapy, she was driven by catastrophic thinking, which she learned to recognize and manage. Along the way, she gained insight into how she developed such intense anxiety, partly in response to a father who often exploded in rage when she was a child. It became apparent that she continued to hold fear and tension in her body as a default; as a way of being in everyday life. By attending to her body and practicing mindful breathing (a sensation-focused intervention), she learned to relax her body, face the fear that this relaxation prompted in her (because it made her feel vulnerable), and eventually develop a more relaxed way of being in her body.
By encouraging clients to develop self-awareness from a compassionate perspective, you can help them to nurture a more positive model of self, which offers a more accepting, supportive and encouraging view of themselves. They can also learn to be more open to acceptance and support from significant others, which means they will hold a more positive model of others.
Within therapy, your clients will be more open to working with you to face their difficulties with greater self-compassion, more readily forgiving any weaknesses or parts of themselves that upset them. Together, these healthy models of self and others create a more secure attachment style, which will enable your clients to lessen their defensiveness, increase proactive efforts to overcome their current struggles, and experience a greater sense of wellbeing.
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