
How you 'attach' to people may explain a lot about your inner life - fredley
https://www.theguardian.com/science/2020/jan/10/psychotherapy-childhood-mental-health
======
AdamCraven
As someone who didn't have many healthy attachments growing up and has spent a
lot of time with a wide variation of therapies. I agree with the article, many
different therapies can fix people and I’ve found it better to have more than
one type of therapy. I believe at the root of it is a mindset which centres
around the cultivation of self-leadership.

My multi-year long journey of what I learned and getting back to health -
which most visibly manifested itself as CFS symptoms (Post exertional malaise)
- can be summed up as:

Trusting the therapist and understanding they are not perfect humans
themselves. Accepting they are not going to fix me, they are a companion on
the journey, I must fix myself with their help.

Going on a journey through all major points in my past and re-experiencing
what I'd been through. Whilst having the therapist with me to slowly help
unfold the emotions and understand it from a different perspective (i.e. I did
not cause the bad things that happened to me, it was not my fault).

This helped me build a foundation, a place of support that didn't rely on
other people, which gave me self-confidence to listen to the negative self-
talk that I had blocked off for years, because it was too overwhelming to
hear. When I started listening to this self-talk, I could then start to
converse with it. e.g. "You aren't good enough", "Perhaps I'm not, but let's
see what happens when I apply my focus to it", which started taking away its
power and effect over me.

Which led me to realising that my intellect and conscious part of my mind is
probably only in control of 20%-30% of me. That I'm not a fully logically
creature and that I needed to come to peace with my body's needs and messages
from my less conscious mind and work together as an integrated whole, rather
than trying to force my will based on pure 'rational' thought.

Life has been considerably better since and my decades of depression and low
energy have begun to abate.

Whilst the points may seem simple, understanding like this rarely comes from
knowing in the conscious mind. It is understanding that has to be understood
at a deep level, which is why therapy can take a long time. My favourite way
of describing this conscious acceptance but lack of sub-conscious
understanding can be summed up as: “I know that, but try telling me that”.

~~~
chadwittman
Your comment regarding your intellect and the conscious part of your mind only
controlling about 20% - 30% of you is super interesting. I'd love to hear more
specifically what made you come to that conclusion, as I've experienced a
similar insight. Mine came from an overdose of marijuana ironically enough,
but it gave me just enough perception of the feeling of two minds. I don't
think I'll ever forget that experience.

~~~
AdamCraven
The concious mind controlling 20-30%, in itself was not that much of a
realisation, I would suspect a lot of people could agree they are not fully in
control of themselves. So the understanding of that I'd known for a long time
came from many sources.

But the difference in understanding that at superficial level vs being able to
experience that at a deeper level, is what caused changes to my behaviour at a
deeper level and is the real revelation.

As to how I experienced that, I would preface this by saying that this is
going to be very unique for everyone depending on how your mind communicates
with itself so I won't go into the exact process for fear of someone trying to
emulate my path exactly (self-leadership is more important than being led). It
is something I came up with myself rather than a specific therapy (again,
self-leadership)

After many many sessions of eventually being able to see and feel the parts of
myself pushing against each other. I began to see the person that I thought
was me, which was the 'cleverest part', that was centered in the front part of
my brain and that denied listening to the rest of my body. Was really a small
piece of a whole. When I realised I could move my observation and inhabit
different parts of my mind and body that is when I knew I wasn't leading the
show in the way I believed I was.

I could see I didn't have control of the other voices or feelings that were
inside of me. They would express what they wanted. I could either deny, accept
them or attempt to change it if I thought that part was maladjusted and needed
help. An example of a maladjusted response might be wanting to apologise for
being abused or feeling shame for things that I had no control over.

~~~
ctack
Can you elaborate on identifying the various parts that push against each
other? What are these parts? Voices or something more subtle like desires or
aversions?

As an aside, based on various therapies I’ve worked out my method of emotional
acceptance of past events and traumas which has and is helping me to accept
and integrate them, but it still feels crude. I catch any strong emotion and
then observe it and allow it and accept it. Sometimes it’s tied to a seemingly
trivial memory(my mind trick is that the memory is not actually trivial) which
I can look at and integrate and accept as well.

------
throwaway28191
I had three different therapies in my life so far. The first one was a bad
experience, the other two helped me a lot. I like both therapists but never
felt like we are close or connected in any way this article writes about.

Always I knew I'm dealing with a professional. I saw other patients leave the
room before my session started. We needed to look for an appointment because
of vacations and stuff, it was always just a person doing his job.

And I'm fine with that. I also think it is necessary to have a person who is
not too close to you helping you some times. Family members and friends want
you to have as little pain as possible and doing better as fast as possible
which is natural but often not the right thing.

"On this view, the good therapist becomes a temporary attachment figure,
assuming the functions of a nurturing mother, repairing lost trust, restoring
security, and instilling two of the key skills engendered by a normal
childhood: the regulation of emotions and a healthy intimacy."

The therapist can't repair lost trust or security, only you can. A good
therapist will help you do that.

~~~
LandR
A personal question, if I may.

I think seeing a therapist would be good for me, I have issues I'm struggle to
fix myself but how does the conversation even start ?

What I mean is, I can go to a regular doctor for a regular problem and he will
say "what is the issue?" and I can explain it pretty clearly even if I don't
know the underlying cause. e.g. "My leg hurts here when I move it in such a
way"

But I can't imagine how this conversation starts with a therapist. If they
asked me what is wrong, I genuinely don't know. I don't know where to point to
the pain. Then I just see myself sitting there with someone awkwardly, them
thinking I'm an idiot.

~~~
bitcurious
Are you familiar with rubber duck debugging?

The idea is that when you (as a developer) run into a software bug you can't
fix, you try to describe it out loud to a rubber duck. It turns out that the
act of formulating these thoughts into speech is massively effective as a
debugging method.

So my challenge to you is to revisit this statement:

>If they asked me what is wrong, I genuinely don't know.

Instead of shutting down because you don't know, just start speaking. Keep
speaking. Deliberately turn off your filter. If that's hard, narrow the
question. Instead answering "what's wrong?" answer "what's wrong today?" or
"what's the strongest emotion you felt last week" or etc. And then expand
around it. Describe the experience. Etc.

~~~
quercusa
RDD works because talking is really powerful. Ever had to teach a class on
something you thought you knew? The act of turning an amorphous blob of
'knowledge' into a linear presentation will often show you that you didn't
understand things as well as you thought. The therapist's "Tell me more"
forces you to tease out of the blob the distinct threads of the issue.

Journaling can also be useful in forcing you to produce words that describe
what's going on, but it's also easier to slack off when there's nobody else in
the room. If you worry about what you'll say in a therapy session, start
writing and you'll likely come up with plenty to talk about.

~~~
heavenlyblue
RDD works because most of the people really don’t understand what they don’t
understand without a direct linear thinking about the problem. They have this
blob in their head that creates an illusion of knowledge.

I have the same thing. Every time I start thinking “big” I need to consciously
stop myself and ask “what do you not know?”/“what needs to be measured?”
Instead of continuing making assumptions.

You don’t need to speak to a duck to do that though. Speech has got nothing to
do with your ego/laziness that makes you believe there’s nothing to be done
and everything can be solved by thinking.

------
planck01
"To complicate matters, numerous studies over the past few decades have
reached what seems a counterintuitive conclusion: that all psychotherapies
have roughly equal effects."

The article gives a number of possible explanations for this, but not the
obvious one: that the effect of psycho-therapy right now might not be more
than a placebo effect. I wonder why this could not be the case.

~~~
trabant00
I can understand the relationship between the two is what makes the
difference. But the framework and the tools must as well.

Given the same level of trust, empathy, communication, etc, one form of
therapy should give different results than other. They can't all be equal.

Unless ofc none of them do anything. I can find no other possible
explaination.

~~~
kennywinker
> They can't all be equal Unless ofc none of them do anything.

I often think of my therapist like a personal trainer. If you get a personal
trainer, and go regularly, you will get fit. The particular workout they use
does not matter so much as just going. Maybe one trainer would improve my
cardio more, another would make me better at lifting weights and burst
strength. Either way I am going to be healthier for going.

~~~
trabant00
Running and weighlifting clearly net different results. So no.

~~~
kennywinker
Weightlifting increases your resting metabolism, while cardio burns more
calories per session. If you were doing either of these in the right ratio,
and sampled weekly for total calories burned, you would not be able to tell
the difference between the two.

Similarly, I'm not arguing that there is no difference between different
therapies, just that the way we measure is only able to say the equivalent of
"most types of regular exercise result in increased burning of calories"

~~~
trabant00
Calories burned is just such a small part of exercising, weightlifting and
running have massive differences in results in all other areas. Saying you
can't tell the difference between the two is just ridiculous, I'm sorry.

But ok, let's just focus on the single aspect that makes your argument hold a
drop of water: calories. If you try to burn as much calories with
weightlifting you will end up at least overtrained if not injured (thousands
of calories per day eaten by PED users does not count). Running on the other
hand can get you to Auschwitz physique pretty safely.

Which brings me to another massive difference: the failure scenarios of both
techniques. You can get injured and harm your health in completely different
ways. Weight lifting has vastly higher injure rates. What about therapy? There
is something that can influence you but only in a good way? No way to over do
it or do it wrongly? And all techniques are equal in this regard as well? I
can tell you another thing which has these properties of "all are equal,
nothing can harm you": homeopathy. Because again, it doesn't do anything.

------
obiefernandez
Really long article but this is the crux:

> The emotional bond and the collaboration between client and therapist –
> called the alliance – have emerged as a strong predictor of improvement,
> even in therapies that don’t emphasise relational factors.

> Until recently, most studies of this alliance could show only that it
> correlates with better mental health in clients, but advances in research
> methods now find evidence for a causal link, suggesting that the therapy
> relationship might indeed be healing. Similarly, research into the traits of
> effective therapists has revealed that their greater experience with or a
> stricter adherence to a specific approach do not lead to improved outcomes
> whereas empathy, warmth, hopefulness and emotional expressiveness do.

~~~
scottlocklin
>The emotional bond and the collaboration between client and therapist –
called the alliance – have emerged as a strong predictor of improvement, even
in therapies that don’t emphasise relational factors.

Yeah, OK, I might buy that as much as I might buy any result associated with
something as nebulous as psychotherapy. How do they characterize this,
exactly?

Having good feelings about a therapist you got better from ... you probably
have better feelings about a podiatrist associated with fixing your foot pain
than the one who didn't as well. That doesn't mean your feelings are causal of
your foot getting better. In fact the podiatrist (or therapist) might not have
done anything real either; sometimes you just get better.

~~~
woodandsteel
As the article makes clear, it is not just general good feelings, but the
specific, back-and-forth interactions between the therapist and the patient.

~~~
scottlocklin
That's great: how are these specific interactions measured? Without that being
something actually measurable in the corporeal world, it's just gibberish and
assertions.

~~~
woodandsteel
Very detailed observation, in particular using video tapes.

~~~
scottlocklin
That's not a helpful answer. What's the scoring system? What are the visual
cues used, and how is it used in a linear regression model? The article is
making strong claims: it never tells us what the data are, and how they differ
from "well that's just your opinion, man."

~~~
woodandsteel
The reason that the article doesn't go into that sort of thing is it was
written for the general public. I am not expert in this area. I do know that
over the years I have read a great many articles for the general public that
refer to scientific study of infant-mother interaction. If you are seriously
interested, do some research and read up about it.

Let me add that, I do understand that people in the therapy field often make
claims that are unsupported by scientific research, and so I can understand
that you are suspicious in this case. But this field is different, there is
lots of sound research.

~~~
scottlocklin
>I am not expert in this area

> But this field is different, there is lots of sound research.

Come on man: pick one. I read the article as you did, and it seems like a big
pile of moosh, just as most things in psychology that don't involve large sums
of money. If you know something about it: share why I should trust this shit
other than "trust me, the non expert." If not; not saying anything is an
option.

------
donatj
> Things get even more puzzling if you consider the sheer number of therapies
> on offer and the conflicting methods that they often employ. Some want you
> to feel more (eg, psychodynamic and emotion-focused approaches); others to
> feel less and think more

They all share being heard, raw, and I believe that is key.

I spent time talking with a consoler years ago to work through some personal
issues, and I genuinely feel having someone there to listen in a way where I
knew judgements on their part would never threaten our relationship was the
true value. Being able to just tell someone how I felt about things, clearly
and honestly, without the need to self censor or sugar coat - particularly in
the way I would with a friend - helped more than anything else.

------
cloogshicer
If this resonates with you, or you're thinking about therapy, I recommend
reading 'The Drama of the Gifted Child', by Alice Miller.

Don't be put off by the title, it's a great read regardless if you're think
you're gifted or not. Gifted in this context means something closer to
'sensitive'.

This, together with therapy, has significantly improved my life.

------
snappieT
It's so sad to hear about mom/mother/maternal so much in that article, and so
little about the father's side of things. I want to believe that I can be an
emotionally-nurturing influence on my kids, it feels like such a shame that
there was zero mention that a male can fulfill this role - does the science
say it's not possible at all?

Otherwise a great article and some sections certainly did resonate.

~~~
tropdrop
There was a halfhearted attempt to remind that this figure doesn't have to be
the mother:

"By contrast, children of unresponsive or insensitive caregivers form insecure
attachment. They become anxious and easily distressed by the smallest sign of
separation from their attachment figure... Finally, children with abusive
caregivers become disorganised: they switch between avoidant and anxious
coping, engage in odd behaviours and, like Cora, often self-harm."

So this is an implicit acknowledgement that the gender of that early caregiver
matters less than that they are nurturing.

But I agree, the article is remiss in explicitly making mention that the
gender of the early caregiver does not matter - especially given that the
other half of the article is devoted to a male-female relationship (Cora and
her therapist) which _clearly_ contradicts the assumption that this needs to
be a mother-child.

Personally, I would have loved to see mention that even those with one stable
caregiver can still develop issues when the other caregiver is _not_ stable,
or worse: that the other caregiver does not care. That often results in a
person forming good relationships with their friends, but having a different
(worse) standard of conduct towards their romantic partner - e.g. a child who
sees their same-gendered parent [physically or verbally] abused, and once an
adult, enters into an abusive relationship because that is what is normal to
them in regards to the "other" gender.

------
viburnum
Probably a mistake to treat parenting styles as exogenous. Parents respond to
their child’s temperaments too. It’s easy to be attached to an easy-going
child. A kid that’s always crying is going to wear you out.

~~~
caleb-allen
Perhaps a kid that is always crying is attempting and failing to communicate
pain or discomfort.

I've been told that I was a miserable newborn--I cried nonstop for months and
months and my screams made everybody around me miserable too.

My mother was told by family that I needed to cry it out, but 6 months on
there was no difference. I was taken in to the hospital and was found to have
had a hernia which required surgery.

After surgery, I'm told, I was absolutely quiet and unproblematic. Through the
rest of my childhood and teenage years I was the 'easy-going' kid of the
family. Through therapy I have learned that my attachment style is avoidant,
and I have no doubt that this early experience (among others) heavily
influenced the way I process emotions and feelings.

It isn't that I was a naturally 'easy-going' kid, or that I didn't have the
troubles that my siblings had. I felt things, but my experiences taught me not
to express them. I formed a tendency to over-intellectualize my experience
and, in retrospect, heavily suppress negative emotions and even physical pain.
My nature was not to seek out help when I felt immense pain, but to persist
with self-reliance, at all costs.

Like the commenter above, therapy has done wonders for me in learning to
recognize my feelings and having the capability in processing them in a
healthy way.

I am not a parent and so I can't speak to the difficulty of a child's
temperament; I have no doubt that one child's personality might be much more
difficult to handle than another. A parent is clearly going to be affected to
their children's temperament, but the parent is also responsible for teaching
the child how to process those emotions, and is significantly more equipped in
dealing with how the child affects them than the child is at dealing with how
their parent affects them.

------
kqr
This is a good and interesting read regardless, but I'll just point out that
when studies are properly controlled for confounders, the "relationship with
the early caregivers" matters much less than we want to think. Maybe not even
at all.

What shapes us are our interactions with our early peers. This makes sense
from a hunter-gatherer point of view too; those are the people we will spend
almost all our life with.

I highly recommend reading _The Nurture Assumption_ for more on this. The
author effectively argues with evidence for why relationships with parents are
nothing more than relationships with parents.

It really opened my eyes both for things that went on in my upbringing, the
upbringing of people I know, and taught me what is going to be important as I
raise my son.

~~~
isoprophlex
The existence of several attachment disorders, where insecure parenting styles
and resulting poorly developed attachment has been irrefutably shown to be the
cause of the disorder, refutes any claims that "the relationship with early
caregivers might not matter at all"

For an extreme result of poorly developed attachment see
[https://en.m.wikipedia.org/wiki/Reactive_attachment_disorder](https://en.m.wikipedia.org/wiki/Reactive_attachment_disorder)

Several comments here are dismissive of attachment theory and the importance
of proper development of attachment. I don't really know why but it might be
the unfortunate existence of the pseudoscientific "attachment therapy" which
has nothing to do with what the article is about:

[https://en.m.wikipedia.org/wiki/Attachment_therapy](https://en.m.wikipedia.org/wiki/Attachment_therapy)

~~~
kqr
How does one go about irrefutably showing insecure parenting leads to
attachment disorders that affect people outside of the home? Genuine
curiosity.

~~~
isoprophlex
I was too brash, of course there's no 100% guaranteed proven causality.

But "experiments", or rather observations, on for example Romanian orphanages
show such strong evidence that, in my experience, this has become child
psychology dogma

------
Nav_Panel
> _All of this suggests a tantalising alternative to both the medical
> professional’s and the layperson’s view of therapy: that what happens
> between client and therapist goes beyond mere talking, and goes deeper than
> clinical treatment. The relationship is both greater and more primal, and it
> compares with the developmental strides that play out between mother and
> baby, and that help to turn a diapered mess into a normal, healthy person._

Oh man, pop culture is rediscovering the use of psychoanalysis, finally!
Transference is so important!

> _I am referring to attachment._

Oh. God dammit.

Can't escape the vortex of "science", leading to the massive fragmentation of
psychological frameworks, destroying the field's credibility.

~~~
diffrinse
I'd argue pop culture started catching on when The Sopranos aired

~~~
Nav_Panel
Well, Freud was big back in the day, and then fell out of favor. And
psychoanalytic theory still gets used in media and lit crit (and in writing
the shows themselves), but... not in what it was built for, therapy.

~~~
greenshackle2
Last I checked it does about as well as all other types of therapies in
studies.

What does it say about the theories of mind underlying the different schools
of therapy that they all work about equally well?

~~~
Nav_Panel
Ah, "Studies" whose language and inventories are already rooted in particular
paradigmatic understandings of psychology. I would expect psychoanalysis to do
worse, in the studies, than "regular" psychology! Damning that it doesn't!

------
getpost
(Restatement from a comment I posted previously[0] in a related thread.)

My go-to reference is

Attachment Disturbances in Adults: Treatment for Comprehensive Repair by
Daniel P. Brown PhD & David S. Elliott PhD. [1]

[0]
[https://news.ycombinator.com/item?id=21739622](https://news.ycombinator.com/item?id=21739622)

[1] [https://www.amazon.com/Attachment-Disturbances-Adults-
Treatm...](https://www.amazon.com/Attachment-Disturbances-Adults-Treatment-
Comprehensive/dp/0393711528/)

------
cradra
About age of 20 I suddenly became unable to pee in urinals. Can't pee in
aircraft toilets either or anywhere I feel like I'm under scrutiny in some
way. I've endured what felt to me like severe physical pain on long haul
travel. I can't persuade my subconscious to let me pee even though I really
want to. No idea why this happened to me, having previously had no problems
whatsoever. The only thing that I can think of was getting a gay approach at
about that age but I can't say that was the cause of it though I think it
might have been.

~~~
throwaway543645
I also have trouble with this. It helps if I pretend that I'm somewhere else,
where I'd be comfortable doing my business. I think, "I'm at home, in my own
bathroom. I was playing a video game and I paused it to take a quick leak."

~~~
cradra
Yes I've tried that but I can't seem to fool my subconscious it seems.

------
rocqua
This really resonated with me

------
Nasrudith
I wonder if one alternate explanation for the "dodo theory" is like
antidepressants in that the average level of effectiveness in aggregate is
fairly low but each individual patient usually has several which work for
them. I am not an expert admittedly.

------
carlsborg
Summary:

"... the deeper reason why no single psychotherapy seems to provide unique
advantages over any other is that they ALL work because of shared elements.
Chief among these is the therapeutic relationship, connected to positive
outcomes by a wealth of evidence."

"The emotional bond and the collaboration between client and therapist –
called the alliance – have emerged as a strong predictor of improvement, even
in therapies that don’t emphasize relational factors..." cites co-author of
the book "Attachment in Therapeutic Practice" (2018).

".. what if, attachment theory asks, therapy gives you the chance to reach
back and repair your earliest emotional bonds, correcting, as you do, the
noxious mechanics of your mental afflictions?"

------
mwexler
Like clockwork, every decade or so, someone says "Hey, we haven't looked at
attachment theory in a while! We can get a few pubs and a book out of it.". A
bunch of studies later, we see the repeat of all the previous findings:
inconclusive, some interesting patterns, nothing super repeatable with strong
effects.

It's fine to revisit and revise past theory work. It's just surprising that
after 70 years, this theory that should explain so much, after scrutiny,
just... doesn't.

Looking forward to the latest revisions to see how to apply attachment
patterns to our modern world. I have popcorn in hand.

~~~
sjg007
Well if you want to make the argument that attachment theory is junk then you
should provide some evidence.

~~~
mwexler
That's not really the way science works. The theory drives testable
hypotheses. We look at data to feel some confidence that the hypotheses are
correct. If we don't find that data, we can continue to believe in the theory,
but with less and less confidence. If a theory cannot be supported, then I can
make the claim that its not correct in its current form. I don't think it's
junk, but more that it's causal impact may be less than the theory purports.

And sure, we can have an alt theory that goes against Attachment theory, and
generate hypos from that, and put them to the test. Answering a different
question, but same problem: can't just say "won't work", need to generate
specific testable hypotheses.

I'm just pointing out that the theory is nice and should have more provable
(and supported) predictions, but it keeps having limited support from
research, fades from view, comes back around, history repeats.

After a while, our confidence goes very low. But it's not zero, and the fact
that it keeps showing up again provides new hope. The theory is attractive so
I hope we find its proper alignment through this latest iteration. But it has
a tough road to hoe.

~~~
sjg007
Right now the scientific consensus is in for attachment theory.. I asked you
to provide evidence or an alternative that it is not. What is the experiment
that proves the null hypothesis? You claim it does not replicate? Ok, show me
some papers.

"That's not really the way science works. The theory drives testable
hypotheses."

Aside from the ethical considerations of using human subjects to test
hypotheses, you also won't like genomic/bioinformatics/physics, if you
faithfully adhere to the Popper doctrine.

~~~
mwexler
Perhaps we follow different sources. Bowlby and Ainsworth suggest that att
drives many, many behaviors and thought processes. Clinical psych has found
situations where the theory applies and some therapies have had success. Yet
social psych, for example, has not found similar success using this basis to
predict behaviors or mental processes, for example, on relationship behaviors
as adults. Since so many other theories do drive predictions across branches
of science, then it's hard to believe that this theory, even after all the
evolution its had, is as general as it should or could be. Not to say it won't
get there, or that it's wrong, but that it gets at something without quite
getting there (to put it very vaguely).

I'm not sure I get your final point: while Popper was never a fan of social
sciences, psychologists have spent years running testable hypotheses and
experimenting with them. Att is just a preexisting condition, and therefore
should drive a repeatably different response to certain stimuli; I don't think
anyone was suggesting we try raising babies in diff att styles.

But yeah, if you take Popper at his word, lots of work goes out the window (I
avoided saying "pops"). I'm gonna choose a middle ground here, and see where
att theory goes. I have high hopes!

------
aszantu
stuff makes sense now

------
mlindner
TL;DR having personal bonds helps you be a normal person. If you didn't have
them in early life a therapist can act as someone forms bonds.

In general though psychotherapy is a bunch of quack, as stated in the article
the only thing that really matters is the patient and shrink working together.

~~~
sjg007
The point is to get the tools to develop a secure attachment with yourself
with the end goal of developing an integrated emotional response.

