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Phobias of Attachment‐Related Inner States in the Psychotherapy of Adult Survivors of Childhood Complex Trauma
Author(s) -
Liotti Giovanni
Publication year - 2013
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.22041
Subject(s) - phobias , psychology , attachment theory , psychotherapist , psychological intervention , interpersonal communication , clinical psychology , anxiety , social psychology , psychiatry
The clinical case described in this article illustrates the value of taking into account the dynamics of disorganized attachment in the assessment of attachment‐related phobias (phobia of attachment and phobia of attachment loss) during the psychotherapy of chronically traumatized patients. These seemingly opposite phobias typically coexist in the same patient, appear as phobias of both inner states (affect phobias) and relational experiences, and are linked to dissociated representations of self‐with‐other. Theory and research on attachment disorganization provide a clinician‐friendly conceptual framework for capturing both the intrapsychic (e.g., intrusive and nonintegrated mental states) and the relational (e.g., dramatic unsolvable dilemmas in interpersonal exchanges) aspects of the attachment‐related phobias. The therapeutic strategy and the key interventions that logically follow from a case formulation based on this conceptual framework are examined.