The Applications of Attachment Theory to Psychotherapy

What is to be done? Mindfulness and mentalizing in action: exploring interacting attachment patterns as they unfold

In this final session, David Wallin begins by focusing on enactments that play out around the boundaries of treatment, suggesting that our attachment history shapes all aspects of our relationships, including our relationship to money, time keeping and other therapy transactions. He juxtaposes to the patient’s emotional dependence upon the therapist with the therapist’s economic dependence upon the patient, proposing that the traumatized or insecure therapist is vulnerable to experiencing care-giving and fee-taking as contradictory processes. He proposes that mindfulness enables us to become aware of and to explore what we are doing with the patient while we’re doing it and suggests that we hold three questions in mind as we work: What am I actually doing with this patient? What are the implicit relational meanings of what I’m doing? What might be my motivations for doing what I’m doing? David conveys how mindfulness and mentalizing must be enlisted to identify and understand enactments, and to transform treatment impasses into opportunities for insight and new experience, not only for the patient but for the therapist as well.