Attachment and Intimacy

Is intimacy possible with an insecure level of attachment?

Posted Sep 03, 2019

A few days ago, I read an interview with Allan Schore about the neuroscientific underpinnings of psychotherapy. Part of his discussion was about the relationship between affect dysregulation and psychopathology. Dysregulation is the inability to manage the intensity and duration of negative emotions such as fear, sadness, or anger. He said that affect dysregulation is the result of insecure attachment and the two major ways that people try to regulate themselves when they suffer from insecure attachment is by over-regulating their affect (i.e. avoidance strategy) or under-regulation (anxiety strategy).

Soon after I read the Schore interview, I was in a phone session with a patient, Jonathan, who had had his secretary call me and cancel four sessions in a row. I felt angry that he did not communicate with me himself because we had discussed having his secretary communicate with me at other times.

I also felt frustrated that he had canceled so many sessions when in the sessions before that, he had been feeling unusually connected to me. I wondered if that had frightened him and perhaps caused him to create distance. I was thinking about his fear of intimacy.

João Silas/Unsplash
Source: João Silas/Unsplash

When I asked Jonathan what he thought it meant that he had canceled so many sessions and had had his secretary communicate it to me. He said he was frightened of having to give an important talk at a conference and did not want to speak to me because he felt so fragile. I immediately realized that this was not about intimacy, but about attachment. Attachment issues are more primitive than intimacy issues—they have to do with psychic survival.

I said, "You felt that talking to me would make you feel upset."

He agreed. "I didn't want to talk to anyone. I am feeling calm about the talk and didn't want to take a chance."

"It sounds like when you are frightened, you don't expect that connecting with me will make you feel better."

"No, it's funny. I know that in reality, I feel better after I talk to you," Jonathan said. "But I always expect it to make me feel worse. I've been in a state of terror about the talk and I just want to be alone."

"What do you make of that?" I asked.

"I never felt I could go to my parents when I was worried or afraid," Jonathan said tearfully.

"You feel like you're drowning," I said, "and no one can help you, you just keep flailing to try to get a breath."

"Yes, exactly," he cried.

Because I had just read Allan Schore's interview, I immediately understood Jonathan was probably describing a disorganized-disoriented state of insecure attachment. The issue wasn't that he was withdrawing because of being afraid of intimacy with me—that requires a much higher level of development of the self. Rather, Jonathan cannot generate an active coping strategy to confront subjectively perceived overwhelming, dysregulating events, and thus he quickly accesses the passive survival strategy of disengagement and dissociation.

Having problems with attachment prevents intimacy: Jonathan is incapable of maintaining intimacy because of his insecure attachment. He could not think about talking to me when he was struggling with what he perceived as an overwhelming event.

This happens with women he gets involved with as well. He cannot maintain the connection to them when work or life events overwhelm him. The affect dysregulation that results from insecure attachment leaves no room for providing comfort, give-and-take or consistent commitment. Since an intimate relationship is mutual, affect dysregulation limits or precludes intimacy.