Spring Conference with David Wallin a Successby Eric Sherman, LCSW
CPPNJ is used to people coming from all over the metropolitan area to attend its events. But from St. Louis?
Among the 167 people who filled Fairleigh Dickinson University's Lenfell Hall on March 20, 2011 for CPPNJ's Spring Conference was a woman who had flown in from Missouri just for the symposium. I doubt she was disappointed. The audience, representing a wide cross-section of the therapeutic community, heard David Wallin give a thought-provoking presentation, "How the Attachment Patterns of Patient and Therapist Interlock: Nonverbal Experience, Mindfulness, Mentalizing and Change."
Wallin, author of "Attachment In Psychotherapy" (Guilford, 2007), used case material and videos to show how attending to the attachment patterns of both the patient and therapist in interaction can help work through impasses and deepen the treatment. By being reflective of her own complex states of mind as they are stirred up in the therapeutic interaction, the therapist can utilize these reactions to deepen her understanding of herself and also of the patient, leading to growth and healing in both participants.
Wallin summarized the four main attachment styles. An individual with secure attachment has the ability to confidently depend upon others, yet remain self-reliant. In contrast, people with avoidant attachment (or dismissing states of mind) have enormous difficulty trusting others. They come across as self-involved, devaluing, and cut off from their feelings. Only one person can exist in any relationship, Wallin noted -- the self. Conversely, anxious (preoccupied) individuals are easily overwhelmed by feelings and afraid of abandonment. They devalue their own needs in an attempt to remain connected at all costs. Only one person can exist in any relationship -- the other. The fearful-avoidant (unresolved) person oscillates between both positions, appearing particularly disorganized. He or she often survived early, unresolved trauma, and constantly re-creates this trauma in the present with others. People with borderline, dissociative, and posttraumatic stress phenomena frequently fit into this category.
Interestingly however, Wallin asserted that the actual facts of a person's history are less predictive of their adult attachment security than the stance of the person toward their experience. A securely attached person has developed the ability to reflect on their mental states -- what infant researchers Fonagy and Target termed mentalization. This reflective stance contrasts with insecure individuals who minimize their experience (in the dismissive state of mind) or are overwhelmed by it (in the preoccupied state of mind).
Wallin also highlighted the importance of a stance of mindfulness in which we deliberately attend to the experience of the present moment without judgment or evaluation. This is the stance that is formally exercised through meditation. In Attachment in Psychotherapy, Wallin described mindfulness and mentalizing as the “double helix of psychological liberation.” He pointed to research suggesting that mindfulness practice produces many of the same outcomes—capacities for affect regulation, insight, empathy, and so on—that are associated with histories of secure attachment.
A goal of therapy, then, is to help the patient cultivate the capacity for mentalization and mindfulness. However, doing this is dependent upon the therapist's own ability to reflect and be mindful of his own internal states, particularly as they interact with the patient's.
According to Wallin, attachment research shows that the parent's security, insecurity, or trauma is unavoidably transmitted to the child, and that the same is probably true of the therapist in relation.