Since the publication of Judith Herman’s Trauma and Recovery in the early 90s, trauma therapists have emphasized the importance of remembrance and mourning as key elements in the healing of trauma.  Talking about, or journaling one’s personal traumatic experiences, and then looking at them through a different lens is now known to be enormously helpful.  But what do we do when traumatized clients go to lengths to deny and minimize the effects of their cruel past?  How do we reach those individuals who have learned to pretend that everything is okay, when nothing could be farther from the truth?

One client, with a profound history of intra-familial trauma, with whom I had been working for several years, recently described himself as burdened by the role of “guardian of the secret.”  That is, “to the outside world, we pretended everything was normal, but beneath the surface it was anything but. “

Psychiatrist John Bowlby, who developed attachment theory in the 60s and 70s, outlined the ways in which avoidant defences are often used to sidestep painful attachment-related memories and feelings.  Bowlby emphasized the role of actual experiences of harsh criticism and cruelty in interactions with caregivers, and the ways in which such experiences can lead some individuals to disengage from their relational world, to pull away from intimacy.  Our own research, coming out of the Trauma and Attachment Lab at York University, has consistently shown results supportive of Bowlby’s views on the avoidance of attachment.

But what can be done in treatment?  Therapists know how rewarding it can be to have a client who is highly motivated; and by contrast, how very challenging it can be to work with someone who comes across as defensive and reluctant to engage in the therapeutic process.

It turns out that approaches that are highly “activating” tend to work a whole lot better.  Clients who keep their painful attachment-related feelings at bay often use intellectualization as a defence.  They avoid closeness, and can come across as living “in their heads” much of the time.  Approaches that let them circle around painful issues –without addressing them in emotional experience– tend to fall flat.  So, from the beginning of therapy, it is critical to help the individual make a personal and meaningful connection to the treatment process.  Early interviewing should emphasize client motivation around change.  And, middle and later phases of therapy should place the focus on emotional expression and the therapeutic relationship as a direct vehicle for change.

It has been interesting for me to see how people have reacted to the publication of my new book, Trauma and the Avoidant Client:  Attachment-Based Strategies for Healing, where this treatment approach is laid out in detail.  Many of the emails I have received from readers have been from therapists who have seen similarities to their own challenging clients.  But to my surprise, about as many communications have been from people who are struggling to understand the emotional distance that they see in their partners.  Reading these emails clarified something for me:  As hard as it is to work with someone who disengages in therapy, it’s just that much harder to live with someone who disengages from love.  And when clients avoid attachment, what they are avoiding is love –and of course, the pain that comes when we are betrayed by those who are supposed to love us the most.

-Rob Muller, Editor