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by Mike Fisher

The increase in research and understanding about “attachment” and the later life manifestations of unresolved insecure attachment will probably be the single most significant factor to influence future approaches to therapy.

The insights from attachment theory are, and will, be key to work with the issues of addressing both early life trauma and dissociation. However one area that particularly benefits from the understanding of attachment theory is in the whole appreciation of dependency and the possibility of more enlightened (and hopefully more humane) approaches to the management of the often inevitable, experiences of dependency that survivors encounter on the road to recovery.

TAG Newsletter vol.1 no.2 described the five types of attachment response in infants. Jeremy Holmes in his book “The Search for a Secure Base” describes the adult attachment interview classifications from the corresponding patterns of infant strange situation behaviour, which utilises Grice’s Maxims of conversation as part of the measure. See table 2.1 and also Grice’s maxims.

What starts to be evident is the impact of unresolved attachment on later life’s responses and relationships. When this is also considered alongside the consequences of early life trauma and abuse, together with the dissociative conditions that so often accompany such experiences it becomes clear that dependency is going to be an inevitable part of recovery.

What is required from therapy is the creative, supportive and containing elements from the therapist to enable survivors to be “accompanied” on their journey without either “fear” or “avoidance” by either the counsellor or the client of the dependency element of the relationship.

Two very helpful graphs taken from “The Journal of Trauma and Dissociation” (the official journal of the international society for the study of dissociation) in an article on “Dependency in the Treatment of Complex Posttraumatic Stress Disorder and Dissociative Disorder” by Kathy Steele, Omno van der Hart and Ellert Nijenenhuis offer a useful analysis to aid therapuitic understanding.

The first compares the characteristics of “Extreme Dependency”, “Counter Dependency” and “Secure Dependency” in relation to the different attachment types of behaviour.

The second contrasts the Countertransference Positions in relation to Dependency from an “Enmeshed”, “Distanced” and “Balanced” position.

It is well worth consulting the full article for a detailed examination of the issues, particularly in relation to DID, which this very brief reflection can not do justice to. What is clear though, is that to collude with resisting dependency is as obstructive to therapeutic recover as over enmeshment with clients can be.

Given that most counsellors (and some training courses) are preoccupied with avoiding dependency at all costs, this article provides some food for thought, and some possible guidance in considering the handling of the inevitable dependency issues that do occur in therapy and counselling particularly with survivors of early life trauma, sexual and ritual abuse.


Holmes, Jeremy (2001) The Search for the Secure Base – Attachment Theory and Psychotherapy. Brunner-Routledge

Steele K, Van der Hart O, Nijenhuis ERS. 2001 Dependency in the Treatment of complex Posttraumatic Stress Disorder and Dissociative Disorders. The Journal of Trauma and Dissociation.