Off The Couch #3 Attachment Disturbances

How did Dr. Daniel Brown get involved in treating attachment disturbances? It all started with couples therapy. Research shows that 52% of people who come into psychotherapy are really coming in due to dissatisfaction in relationships. Relational disturbances are associated with attachment based maps. Learn all about attachment disturbances in this interview with Dr. Brown.

Read the Full Transcript:

Dan Brown: I got interested in couples work, in about the 1990s. I think it was after getting married, my first marriage, and trying to think about different models for couples’ therapy. I got interested particularly in what was called experiential couples’ therapy, that is doing live exercises with couples. And then, we started evolving a model for couples, where we would do three-day weekends, intensive weekends, at various growth center sites and offer the best of everything we could do about experiential exercises for couples.

Caroline Baltzer: You mean like psychodrama?

Dan Brown: No, not like psychodrama. But we used some of the Harville Hendrix Imago Therapy stuff because Harville and I were graduate students together in Chicago.

Caroline Baltzer: Harville?

Dan Brown: Yeah. And we used some of the Imago Therapy stuff, we used some of Roger Fisher’s stuff on negotiating conflict, Getting to Yes. We did work on cognitive therapy and on developing belief maps and how the different differences in underlying beliefs affected couples’ relationships. We taught them how to finish unfinished emotional business. We had a skill-based set of exploratory exercises that worked for couples, so they could be more intimate with each other.

Caroline Baltzer: How many exercises?

Dan Brown: Well, we had about seven or eight different things in the workshop that we did on a regular basis that worked.

Caroline Baltzer: To keep a couple functioning optimally.

Dan Brown: Yes. So, preventively before they got to – Most couples come to couples’ therapy when they’re on the way out the door. So, we thought we would try and do something more preventative.

Caroline Baltzer: Wonderful.

Dan Brown: That was another area that we worked a lot in. Then, from the couples work, I got interested in human attachment and relational problems. It started with a research that was done by Larry Beutler, who is the senior editor of The Journal of Consulting and Clinical Psychology for several decades; and that’s the main flagship journal for the American Psychological Association, with all the outcomes and materials put in. And he did a study showing that just about 52% of everybody who comes into psychotherapy doesn’t come in with a DSM diagnosable condition. They come in for dissatisfaction in relationships, or dissatisfaction with the sense of self, or both. Just about half of the variance of why people come into psychotherapy is relational disturbance. It’s not about DSM diagnosable conditions.

So, I think that we gave away our profession to insurance companies by this bad faith of having to say that we only treat medical necessary conditions. But relational disturbances have always been a part of, a legitimate domain, of psychotherapy and always will be. We should have owned that as a profession and said, “This is a legitimate area that needs to be paid for because it accounts for most people’s dissatisfaction and relational dissatisfaction.” We found, in our work, that there were three or two, depending on how you count it, major relational maps.

The first map is an attachment-based map, as you know, which has to do with problems with relationships. So, people can have dismissing attachment, where they disconnect emotionally, or they disconnect entirely from relationships, and just go through the motions of relationships: they have kind of a pseudo-independence. Then, there’s anxious preoccupation, where they get clingy, and they get too much into compulsive caretaking roles and give up their sense of self. They are acquiescing to their partner’s needs, and they are chronically insecure in their relationships. And there is disorganized attachment, where you deactivate both attachment behavior and exploratory behavior and get highly dissociative; and then you get highly inconsistent and disorganized in relationships that get more intimate. Those attachment maps are developed in about 18 months, and they define people who have problems with relationships. In the statistics that we have, about one out of three people will have some variation of insecure attachment. So, it’s a major social problem.


Watch the full clinical interview series:
1. Meet Dr. Daniel P. Brown 
2. Overview of Trauma Treatment
3. Couples Therapy and Attachment Issues 
4. CCRT (Core Conflictual Relationship Themes)
5. Three Pillars Approach (Treatment for Attachment)
6. Teaching Psychology
7. Conversion Disorders 
8. Factitious & Dissociative Disorder
9. Psychological Assessments
10. Bipolar Disorder Treatment
11. Trauma Bonding Maps
12. Conclusion 

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