CC08 Workshop 14 - Addiction to “Alone Time”: Avoidant Attachment, Narcissism, and a One-Person Psychology within a Two-Person Psychological System - Stan Tatkin, PsyD

Description:

Comparisons have been made between severe avoidant attachment and disorders of the self such as antisocial personality, schizoid personality, and narcissistic personality. Each of these disorders, including avoidant attachment, can be grouped together as one-person psychological organizations in that they operate outside of a truly interactive dyadic system, and primarily rely upon themselves for stimulation and calming via auto-regulation. The chronic need for “alone time” can take many surprising forms throughout the lifespan, directly impacting romantic relationships.

Educational Objectives:

1. To describe an appropriate intervention for keeping an avoidant patient in treatment.
2. To identify physical approach and avoidance behaviors that often accompany attachment organization.

*Sessions may be edited for content and to preserve confidentiality*

Outline:

Introduction and Separation-Reunion Patterns

• Video demonstrates separation-reunion dynamics (e.g., angry, resistant, avoidant).

• Fussiness and clinging in children illustrate early attachment behaviors.

• Secure reunions involve ventral-to-ventral contact and quick soothing.

Translating to Adult Therapy

• Adult clients mirror child behaviors: difficulty with separation, fussiness, resistance.

• Examples show resistance, impoverished play, and lack of engagement.

• Avoidant behavior stems from dismissive parenting and leads to neglect patterns.

Auto-Regulation and Avoidance in Adults

• Avoidant individuals prefer solitude, self-soothing, and dissociation.

• High difficulty shifting from auto-regulation to interpersonal connection.

• Interactive regulation is critical for attachment and intimacy.

Therapeutic Approaches for Couples

• Long sessions help identify body language and affective states.

• Face-to-face seating and co-regulation techniques are emphasized.

• Pseudo-secure couples may mask secrets and show dysregulation.

Dysregulation and Arousal Profiles

• High-arousal couples: intense but lack soothing.

• Low-arousal couples: detached, lack physical engagement.

• Tailoring treatment to attachment and arousal profiles is key.

Attachment Interview and Observation

• Initial sessions include attachment history and diagnostic interviews.

• Observing posture, language, and affect helps define relational style.

• Physical cues (e.g., proximity, eye contact) offer therapeutic insight.

Live Demonstration Techniques

• Therapist demonstrates exercises with volunteers: eye contact, physical proximity.

• Observations focus on body movement, muscle tension, and emotional cues.

• Exercises reveal subconscious reactions and underlying attachment behaviors.

Memory and Visual Processing

• Couples often pause or resist movement without knowing why.

• Visual relief and proximity enhance emotional clarity.

• Fast-acting body reactions reflect internal attachment states.

Adult Attachment Interview (AAI)

• AAI uses autobiographical memory to provoke emotional responses.

• Questions about parental care illuminate adult regulation patterns.

• Early care quality shapes emotional and relational functioning.

Parental Influence on Couple Dynamics

• Understanding childhood care informs therapy with adult couples.

• Patterns from early attachment repeat in adult relationships.

• Therapy works to update maladaptive regulatory habits.

Therapy Engagement and Avoidance

• Avoidant partners are harder to engage in therapy.

• Creating curiosity and mild confusion disrupts resistance.

• Therapist offers new narrative to shift entrenched beliefs.

Physical Contact and Emotional Regulation

• Physical proximity calms the HPA axis and enhances bonding.

• Avoidant individuals may resist touch, impairing regulation.

• Therapy must normalize and reintegrate physical closeness.

Substances and Attachment Substitutes

• Alcohol and drugs can mimic attachment functions, undermining intimacy.

• Down-regulation of bonding mechanisms is common with substance use.

• Therapy must address these dynamics with both partners.

Attachment in Child Development

• Early attachment impacts child emotional development.

• Family-inclusive approaches address intergenerational patterns.

• Addressing these early experiences improves later relational regulation.

Therapeutic Techniques and Goals

• Techniques include observational tasks, posture changes, and narrative work.

• Therapy must target both emotional and behavioral regulation.

• A comprehensive, tailored approach fosters healthy relationship dynamics.