“May I, through the work on myself, become an instrument for the relief of suffering of all beings.” — Ram Dass

Before moving to England, as part of our training, my colleagues and I not only studied Bowlby’s work extensively and intellectually, but we also underwent an analysis of our own attachment styles. It was clear to us students, and well-supported by research, that attachment provides a fundamental framework for understanding some of the manoeuvres of our subconscious. Our attachment patterns define how we perceive and relate to others (for clients, this includes the therapist) and to the world. As trainee therapists, we were often overwhelmed by the analytic work involved in reconstructing and healing our attachments. It was crucial in helping us understand both our own relational issues and those brought by clients to therapy.

One day, as a young student, I had the privilege of translating from English to Italian during the workshop of a very renowned American professor. He was a leading expert in cognitive-behavioural therapy, a past president of the Association for Behavioral and Cognitive Therapies. He has since passed away, and I won’t reveal his name as I believe he has nothing to gain from this. At one point, a member of the audience asked him how he incorporated attachment theory into his work. We were shocked when he responded, “What’s attachment theory?” At first, we thought he was joking, and I double-checked that I had translated the question correctly. Eventually, he acknowledged recognising Bowlby’s name but admitted he knew little about the theory. As I write this, I realise the urge to write a spin-off of this article based on what I learned from spending a day with him outside of academic work.

This experience highlighted for me something that, although obvious, is sadly not universal: receiving therapy and engaging in personal work is essential for therapists. Later, I realised that many psychotherapists practice without ever becoming conscious of the role attachment plays in the therapeutic dynamic. I am concerned that many therapists have never undergone therapy themselves, and that therapy is not mandatory in their training. Surely, a conscientious therapist should take personal responsibility for their emotional well-being and strive towards a secure state of mind. A therapist should be a safe space for their clients, able to access a wide range of experiences both within themselves and in their clients.

In his book Attachment in Psychotherapy, David Wallin defines four different ways in which therapists approach the clients they treat:

• Therapists in a secure state of mind are able to access a wide range of experience in themselves and in their clients. They are mindful of feelings, thoughts, and bodily reactions.
• Therapists in a dismissive state will likely tend to focus on thoughts rather than feelings, avoiding intimacy with their clients to protect themselves from being rejected or controlled.
• Therapists in a preoccupied state may merge or over-identify with their clients, struggle to set boundaries, and avoid conflict out of fear of abandonment.
• Therapists in an unresolved state are more likely to fluctuate between victim and rescuer roles. They may avoid approaching trauma or push clients to face it prematurely.

The subject is undoubtedly complex, and I am mindful of both its intricacies and the risk of oversimplification. While this may not be the most conventional academic approach, I would like to begin with an example involving a dog. A dog I saw in a YouTube video (link provided below) offers, in my view, a valuable lesson in attachment theory. Despite being non-verbal, the dog’s behaviour provides profound insights, making the video a unique and insightful resource for understanding the concept of a ‘Therapist in a secure state of mind.’

The video features a child named Little Arthur, who, while strolling through the woods with his 12-year-old Shar Pei, Watson, takes a break from walking his dog to play in a puddle. Arthur treks through the puddle before deciding to head back and splash around some more. Before returning to Watson, he jumps in the puddle, runs away, explores the area, and then returns to Watson.

Arthur, symbolically representing the inner child, is having fun and exploring.

Watson remains still, does not interfere, and seems relaxed yet aware, turning his head when Arthur is far away. Watson acts as a safe base.

Little Arthur’s behaviour showcases a healthy sense of exploration and independence as he moves away from his companion, Watson, to play in the puddle. This movement reflects the characteristics of a securely attached individual, demonstrating confidence and a willingness to explore while maintaining a connection with his companion. Watson, in response, serves as a secure base, exhibiting stillness and apparent relaxation while attentively observing Arthur’s activities. The dog’s turning of his head when Arthur is at a distance reveals awareness and a protective instinct, reminiscent of caregiving behaviours associated with attachment relationships.

Importantly, Watson does not interfere with Arthur’s exploration, allowing him the freedom to play and move independently. Despite this non-interference, Watson maintains a relaxed demeanour, indicating trust and comfort in their relationship. This combination of relaxation and attentiveness aligns with the characteristics of secure attachment. While not acting as a therapist in the traditional sense, Watson’s presence offers a supportive and secure influence for little Arthur, akin to the therapeutic benefits found in the unconditional love and companionship.

The Hungarian psychoanalyst Ferenczi took this idea a step further, arguing that ‘it wasn’t only the real relationship that facilitated the process of therapy but also that the patient needs [in order to heal] to feel the love of their analyst and to be aware of the personal characteristics of their analyst’. Personally, I agree with Ferenczi in believing that therapy is about feelings, and the primary emotion is love. If the client and the therapist don’t experience love, don’t have love in their lives, or are disconnected from it, they will have understood little about themselves, life, nature, and the universe.

This is my very subjective way of saying that it is more than a ‘state of mind’; it is, in fact, a ‘state of being’. With this in mind, I ask you to forgive the reductionism of my examples. As you can see, Watson doesn’t speak, but his silence, behaviour, and attitude are far more powerful, revealing profound processes that words can only simplify. So, let’s begin:

Please be mindful that this is an imagery conversation, not representing any client, and any similarity is purely coincidental.

1. Therapist in a secure state of mind:

Client: I feel like I’m not good enough.

Therapist: Thank you for sharing that with me. I can hear that this belief feels very real for you, and it’s important that we explore it together. Can you tell me more about why you feel this way?

Client: I’ve always felt like no matter what I do, it’s never enough. I’m just not as capable as others.

Therapist: It sounds like this has been a difficult feeling for you for quite some time. I wonder if you can remember when these feelings started or if there’s anything that comes to mind about what might have influenced them?

Client: I think it probably started at school. I always felt like I had to work harder than everyone else just to keep up.

Therapist: That sounds really tough, especially at such a formative time. It makes sense that those experiences would leave a lasting impact on how you see yourself.

In this example, the secure therapist validates the client’s experience, offering a safe space to explore the deeper roots of the belief.

2. Therapist in a dismissive state of mind:

Client: I feel like I’m not good enough.

Therapist: That’s not true. You’re clearly capable. Let’s look at the facts: you’ve achieved plenty. There’s no reason to feel that way.

Client: But I still can’t shake this feeling.

Therapist: It’s just an irrational belief. We need to focus on reality. You’ve got the skills and achievements, so let’s focus on those and move past these negative thoughts.

Here, the dismissive therapist focuses solely on logic, minimising the client’s emotional experience and leaving them feeling unheard. Does it sound like CBT? No, it is just bad CBT!

3 . Therapist in a preoccupied state of mind:

Client: I feel like I’m not good enough.

Therapist (calm but inwardly worried): According to the evidence, they should be feeling better by now. Why isn’t this working? “I hear you, and we can explore that together.”

Client: I appreciate you saying that, but it doesn’t change how I feel.

Therapist (calm, but anxious internally): I need to figure this out soon. I’m even extending the time of our sessions, and they’re still not feeling better. Is it me? Am I not being a good enough therapist? “It’s okay that it’s taking time. We’ll keep working on this.” But why isn’t this helping yet? The evidence says they should be improving. What if I’m missing something crucial?

Please note the possible countertransference; the therapist is reacting emotionally to the client’s lack of progress, which may be influenced by their own unresolved issues (e.g., a need to feel competent or successful). The therapist’s internal worry about not being ‘good enough’ or failing to help could reflect their personal insecurities or past experiences, affecting how they engage with the client

Client: I just don’t know why I still feel this way.

Therapist (calm but inwardly frustrated): I’ve extended the sessions, tried every approach I know, but they still feel stuck. What if I’m not a good therapist for them? “We’ll continue working through this together, no matter how long it takes.” But what if they don’t get better? What am I doing wrong?

In this scenario, the preoccupied therapist prioritises emotional support without exploring the roots of the client’s belief, which might prevent deeper therapeutic work, might needing constant reassurance about progress, might difficulty setting boundaries or saying “no”.

4. Therapist in an unresolved state of mind:

Client: I feel like I’m not good enough.

Therapist: I’ve been there. It’s tough when you feel like you’re not enough. But you’ve got to face it head-on. That’s what I did, and it made a big difference for me. You can do the same.

Client: I don’t know if I’m ready for that.

Therapist: Trust me, you are. I’ll help you get through it. The sooner you confront it, the better. We’ll do it together.

Here, the unresolved therapist projects their own experiences onto the client, potentially pushing them towards confronting the issue prematurely, without allowing the client to explore it at their own pace.

The question of whether therapists are aware of their own attachment styles invites deep reflection. What might John Bowlby (Attachment Theory founder), Dan Siegel (Psychiatrist and attachment expert), Gabor Maté (Trauma and addiction specialist), and Carl Rogers (Founder of Person-Centred Therapy) have to say about it?

John Bowlby (Attachment Theory founder): “The therapist’s own emotional patterns can profoundly influence the course of therapy. The more aware we are of our own attachment styles, the more present and attuned we can be with our clients.”

• Reference: Bowlby, J. (1988). A Secure Base: Parent-Child Attachment and Healthy Human Development. London: Routledge.
• Bowlby explores how attachment patterns influence emotional well-being, which therapists should be aware of to provide effective support.

Dan Siegel (Psychiatrist and attachment expert): “Awareness of one’s own attachment style allows therapists to avoid unconscious biases that may affect the therapeutic relationship. This awareness is a form of mindfulness in the therapeutic process.”

• Reference: Siegel, D. J. (2010). The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration. New York: W.W. Norton & Company.
• Siegel extensively discusses the importance of self-awareness and mindfulness in the therapeutic process, including awareness of attachment styles.

Gabor Maté (Trauma and addiction specialist): “In a therapeutic setting, our own unresolved attachment issues can interfere. The more we understand ourselves, the better we can help our clients discover their own truths.”

• Reference: Maté, G. (2003). When the Body Says No: Understanding the Stress-Disease Connection. Toronto: Vintage Canada.

Maté talks about the impact of unresolved trauma and emotional issues on both clients and therapists, particularly focusing on attachment.

Carl Rogers (Founder of Person-Centred Therapy): “What is most personal is most universal. When we become aware of our own vulnerabilities, we open ourselves to a deeper, more authentic connection with those we serve.”

• Reference: Rogers, C. R. (1961). On Becoming a Person: A Therapist’s View of Psychotherapy. Boston: Houghton Mifflin.
• Rogers discusses the importance of authenticity and personal vulnerability in building a deep connection with clients.

I think attachment style is like WiFi: Secure is stable, anxious is always checking the connection, avoidant says, ‘I don’t need WiFi,’ and disorganised just keeps buffering.

Meanwhile, shouldn’t the therapist wonder: “as I am the router, do I need better bandwidth for my own self-awareness?”