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Attachment in Therapeutic Practice


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Table of Contents

Background: Attachment Science Introduction Attachment's Principals and Principles Attachment-informed Psychotherapy: Definition and Overview Affect Regulation in Attachment and Psychotherapy Sensitivity, Mirroring, and Play: Foundations of Attachment Security in Caregivers and Therapists The Neuroscience of Parental Sensitivity Mentalising 'Earned Security': Attachment and Resilience 'Organised Insecurity': Fostering Security through Therapeutic Conversations 'Disorganised Insecurity': Attachment Approaches to Complex Disorders From Stasis to Movement: An Attachment Model of Psychotherapeutic Change The Improbable Profession: An Attachment-Bayesian Model of Psychodynamic Change Attachment, Mentalising, and Child Psychotherapy: Working with Parents Attachment in Couples and Families Attachment and Society Epilogue Selected Attachment Bibliography References

About the Author

Arietta Slade, Ph.D., is Clinical Professor at the Yale Child Study Center, and Professor Emerita, Clinical Psychology, The City University of New York. A theoretician, clinician, teacher, and researcher, she has written about the development of parental reflective functioning, the implications of attachment for child and adult psychoanalytic psychotherapy, and for infant mental health practice. She is one of the founders and co-directors of Minding the Baby (R), an interdisciplinary reflective home visiting program for high-risk mothers, infants, and their families, at the Yale Child Study Center and School of Nursing. Dr. Slade is editor, with Jeremy Holmes, of the six volume set, Major Work on Attachment (SAGE Publications, 2013), with Elliot Jurist and Sharone Bergner, of Mind to Mind: Infant Research, Neuroscience, and Psychoanalysis (Other Press, 2008), and with Dennie Wolf, of Children at Play (Oxford University Press, 1994). She has also been in private practice for over thirty-five years, working with individuals of all ages.


Two extraordinary clinicians with decades of research and writing on attachment worked with immense application and skill to distill what is essential in attachment theory and brought it to psychotherapeutic practice. The result is an exceptionally comprehensive and profound work of lasting value for every clinician - regardless of orientation. The book is a guide to improving the practice of the most experienced therapists at the same time as offering the friendliest and most accessible of introduction to this complex field. It is a remarkable achievement from two of the most sophisticated and respected authors on the clinical application of attachment theory. It provides a vivid picture of the process of bonding and lifelong transformation which attachment theory inspired therapy can bring. The book is for everyone who is serious about working psychotherapeutically and will not be bettered as an introduction for many many years to come
-- Peter Fonagy
Holmes and Slade have provided exactly what the mental health professions have needed-a comprehensive examination of how attachment theory informs psychotherapy that is entirely accessible to beginner therapists, but also highly informative to seasoned clinicians. This superb text deserves a place on the shelves of every psychotherapist.
-- Geln O. Gabbard, MD
This book is a ticket to journey along with Jeremy Holmes and Arietta Slade as they describe their sophisticated and creative views on attachment theory, research and the co-created space of the therapist-patient relationship. With the addition of evocative and varied clinical vignettes it's as if one is being personally invited into the consulting rooms of these two gifted clinicians to hear how they use an attachment perspective to inform their work. This book is indispensable to both the clinical apprentice and the seasoned practitioner.
-- Miriam Steele

The authors tell us 'Despite exuberance of theory, once in the consulting room, psychotherapy is a practice in search of a theory.' But we have theory! (I for instance studied first cognitive-behavioural, then systemic, then psychoanalytic theory; all are useful, what more do you want?) Also, as an attachment researcher and writer, I thought I would know the field. But this book draws together the history and cutting edges of attachment in ways that give really fresh angles on clinical experience. Learning attachment interviewing and coding, 25 years ago, added a powerful layer to my listening to patients (and to myself on the couch). Reading this book I am again shown that attachment theory and findings illuminate every other kind of clinical theory we use, and everyday life for good measure.

-- Professor Mary Target
This is a very helpful mini-handbook for students as well as practitioners of attachment-based relational psychotherapy. It is written with many vignettes to explain concepts. -- Gulcan Sutton Purser * New Directions in Psychotherapy and Psychoanalytic Relational Therapy *

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