Attachment safety in psychotherapy

Safety is generally considered a fundamental ingredient of the psychotherapeutic encounter. Theoreticians and clinicians of a variety of psychotherapy modalities and formats agree on the importance of the client feeling safe for positive therapeutic outcomes. Over the course of psychotherapy, clients start to view their therapist as an attachment figure, which makes the issue of attachment safety in therapy particularly relevant. This article presents two subthemes of a qualitative study on the client's experience of safety in psychotherapy that focus on attachment-related aspects of this phenomenon: (a) The attachment language of safety and (b) The therapist as attachment figure. Semi-structured interviews carried out on 10 Irish psychotherapy trainees to explore their experience of safety as a client were analysed using interpretative phenomenological analysis and showed that attachment processes and nonverbal language exchanged between client and therapist played an important role in the client's overall experience of safety in psychotherapy. In addition to traditional attachment theory, polyvagal theory provides a solid framework for understanding and working with attachment-based processes in psychotherapy, which are a major factor in the client's experience of safety. The recommendation is for psychotherapy training programmes to include both of these fields in psychotherapeutic theory and practice.