Therapeutic Attachment Relationships: Interaction Structures and the Processes of Therapeutic Change

The 75 years that span the writings of Sigmund Freud and John Bowlby—two minds that have significantly shaped thinking about the processes of change in psychotherapy and psychoanalysis—have yielded dramatic changes in the ways in which we conceptualize human relationship as curative. Their different positions reflect changes in our culture, in the philosophy of science, and in contemporary views of human subjectivity. Heisenberg's uncertainty principle—the principle that the position of an electron cannot be determined because the observation of its position affects its position in an indeterminate way—has been appropriated as a metaphor for human interaction. Freud's foundational, technical recommendations, such as abstinence and neutrality, have yielded to mutuality and subjectivity within the therapist-patient dyad. Attachment theory and research have begun to specify the variety of therapist-patient interactions and the relation between the quality of these interactions and patient outcomes. The goal of this book is to contribute to our understanding of these interaction structures and their influence on therapeutic changes in the patient. Geoff Goodman invites the reader to consider the attachment relationship as an often-overlooked specific factor that nevertheless plays a key role in all therapeutic processes. Therapeutic Attachment Relationships explores the attachment relationship as an effective ingredient in all therapeutic change.

About the Author :
Geoff Goodman, PhD, is associate professor of psychology at Long Island University. He is also a licensed clinical and school psychologist with a private practice in Manhattan and New City, New York, and is certified by the American Board of Professional Psychology (ABPP). He is the author of more than a dozen articles on the development of psychopathology in high-risk infants, children, and adults, as well as The Internal World and Attachment (2002).

Review :
Starting with a provocative analysis of how Freud's own attachment problems limited his ideas on technique, Goodman reviews the psychotherapy literature through the lens of attachment theory, then proposes an integrative model of why some patients and therapists just seem to 'click.' This book is a sequel to Goodman's two-volume Transforming the Internal World and Attachment (2010), in which he reviews theoretical and empirical perspectives of therapeutic change and linked psychodynamic and attachment perspectives in an effort to clarify processes involved in patient-therapist interaction. Here Goodman (Long Island Univ.) looks at how the attachment history of the therapist may play a key role in the therapeutic process. The book starts with a review of a selection of Freud's writingsand his personal history, making the case that Freud's predominant attachment relationship contained dismissing features that became components of his model for conducting psychoanalysis. Goodman then presents the caregiver-infant attachment relationshipas a metaphor for the therapist-patient relationship. He introduces the principle of noncomplementarity as a potential means for the therapist to provide a 'gentle challenge' that assists the patient in developing new modes of regulating affect and relating to others. The author addresses empirical means of assessing the effectiveness of this strategic approach. In sum, Goodman presents a model for understanding how four potential interaction structures, which develop from the secondary attachment strat Geoff Goodman is that rare psychologist-psychoanalyst who imbues a rich understanding of the clinical process with a skillful working knowledge of clinical research for conceptualizing attachment theory and its therapeutic implications. Attachment theoryis arguably the most important new development in contemporary psychoanalytic thinking, and Therapeutic Attachment Relationships and its related volumes are superb examples of the most creative clinical thinking in this field. Building on his earlier book on object relations and attachment theories, Goodman here extends the model of the caregiver-infant attachment relationship to explain how dissimilar, noncomplementary attachment configurations in therapist-patient relationships may promote more favorable treatment outcomes than closely matched attachment patterns between therapists and patients. He demonstrates how therapists' and patients' complementary and noncomplementary deactivating and hyperactivating attachment strategies produce four distinctive therapist-patient interaction structures that are clinically important to recognize and understand, while at the same time serving an important heuristic purpose for empirical examination. This is a creative and bold conceptualization of attachment Geoff Goodman is that rare psychologist-psychoanalyst who imbues a rich understanding of the clinical process with a skillful working knowledge of clinical research for conceptualizing attachment theory and its therapeutic implications. Attachment theory is arguably the most important new development in contemporary psychoanalytic thinking, and Therapeutic Attachment Relationships and its related volumes are superb examples of the most creative clinical thinking in this field. Building on his earlier book on object relations and attachment theories, Goodman here extends the model of the caregiver-infant attachment relationship to explain how dissimilar, noncomplementary attachment configurations in therapist-patient relationships may promote more favorable treatment outcomes than closely matched attachment patterns between therapists and patients. He demonstrates how therapists' and patients' complementary and noncomplementary deactivating and hyperactivating attachment strategies produce four distinctive therapist-patient interaction structures that are clinically important to recognize and understand, while at the same time serving an important heuristic purpose for empirical examination. This is a creative and bold conceptualization of attachment theory and treatment process that is simultaneously sophisticated and rich. It represents one of the most important formulations in the field today. This book is a sequel to Goodman's two-volume Transforming the Internal World and Attachment (2010), in which he reviews theoretical and empirical perspectives of therapeutic change and linked psychodynamic and attachment perspectives in an effort to clarify processes involved in patient-therapist interaction. Here Goodman (Long Island Univ.) looks at how the attachment history of the therapist may play a key role in the therapeutic process. The book starts with a review of a selection of Freud's writings and his personal history, making the case that Freud's predominant attachment relationship contained dismissing features that became components of his model for conducting psychoanalysis. Goodman then presents the caregiver-infant attachment relationship as a metaphor for the therapist-patient relationship. He introduces the principle of noncomplementarity as a potential means for thetherapist to provide a 'gentle challenge' that assists the patient in developing new modes of regulating affect and relating to others. The author addresses empirical means of assessing the effectiveness of this strategic approach. In sum, Goodman presents a model for understanding how four potential interaction structures, which develop from the secondary attachment strategies of both members of the therapeutic dyad, may have a profound impact on the outcome of therapy. Recommended.