DARREN SHARPE: Gav who's both a counsellor and tutor and we're going to be about something that comes again and again in ⁓ trauma and attachment ⁓ and how the two are inseparable. This episode is aimed at counsellors in training as well as qualified practitioners and our goal is to keep it grounded, practical and clinically useful. whether you're sitting with clients who with trust, ⁓ closeness, emotional regulation or relationship patterns that stuck, this one's for you. Gav, welcome, it's great have you here. ⁓

Gav: Hey Darren, it's real good to see you. Thanks for having me

DARREN SHARPE: So you're a tutor ⁓ and a attachment-based psychotherapist yourself. you've loads of experience in subject. ⁓ In your experience, ⁓ when people hear about and attachment, ⁓ do they usually imagine?

Gav: Yeah, I think people want to hear trauma. They quite often think about these kind of big obvious events that happen, know, violence, war, road traffic accidents, terrorism, know, sexual abuse, these kind of big things. imagine people who are kind of visually, you know, visibly kind of ⁓ ⁓ ⁓ all kind of things, maybe diagnosis, know, PTSD, personality disorders. I think that's what comes to mind a lot when people think about trauma. most people think ⁓ something terrible which has happened, you know, and of course all of those things are absolutely traumatic and we know we get that. ⁓ I guess in attachment based psychotherapy, I suppose we broaden that a bit more to include what didn't happen that needed to. So not just what happened, but what didn't. So not just the moments of harm, but moments where maybe safety, protection, emotional and regulation were missing. particularly in childhood, as that sets the ways we think about relationships, our internal working models, the way we see ourselves, other people and the world around us. So yeah, we take a slightly different approach when it comes to trauma. And in terms of attachment, you asked about that as well. So I think people think about attachment, they think about maybe parenting styles a little bit, and ⁓ think about the labels which we have of attachment, know, secure, ⁓ ⁓ almost like their personality or traits. But I think what I'd like to get across, attachment isn't really about a label and it's not a diagnosis either. It's more like an internal map. The set of expectations we have about ourselves, others and the world and our needs are gonna be acceptable to other people, whether closeness feels risky whether it feels safe. So there's more to it, I think, than what people sometimes imagine when they say those words.

DARREN SHARPE: Wow, when I hear you say all of that, it just makes me realise just how wide subject of trauma is. And ⁓ looking at it through that attachment lens, ⁓ sounds absolutely fascinating to me. The bit I've picked up on is that not necessarily what did happen, but it's what didn't happen. ⁓ I that fascinating. ⁓

Gav: Yeah, that's it. It's quite, I guess we look at it as slight, like a deficit model in a way, you know, it's all the things we didn't have in childhood. So when we look at children who more maybe securely attached, you know, they had all the love, compassion, ⁓ attunement that they needed, but more people who are more insecurely attached, you know, some of that stuff wasn't there. You know, there's maybe inconsistency in caregiving or maybe even, you know, neglect. They just didn't get the emotional attunement they have. And sometimes when we think about trauma as well, and more extreme cases, it's those people who are meant to keep us safe and look after us and are tuned to us are the ones who are actually frightening and maybe the cause of some of the distress. So yeah, then that can cause real problems and that's when any kind of way of dealing with that, any kind of organized strategy just doesn't exist anymore. So yeah, it's definitely about kind of what wasn't there, the unmet needs.

DARREN SHARPE: just amazes me ⁓ is much like you've what you've just described there about you know were you neglected or were you abused? It shows up in the various attachment styles and actually we can see it in adulthood, can't we? We can see it play out. And the same patterns, the messages we've received as kids, become ⁓ inner working model. So when I think about it showing up in adulthood and inner working model we have, ⁓ does lead ⁓ onto the obvious, which is what are the different attachment styles? So ⁓ obviously we know ⁓ someone that's had their needs met majority of the time, ⁓ they generally secure. But the there's more to that, isn't there Gav?

Gav: So, you we spoke about before that this isn't a diagnosis. We're not fixed into these boxes and, you know, the we respond to people can change depending on how safe we feel and secure we feel at that particular moment. It's how much can be different with different people. ⁓ But kind of think of attachment as being ⁓ like a continuum. So you might have at one end someone who's quite anxious, who doesn't really trust relationships too much because of what they've been through with them when they were younger. know, the caregivers were slightly inconsistent. it can never really guarantee on getting the ⁓ the emotional attunement that they needed. So they can be more, that's what we call them, more the anxious attachment. And at the other end of that continuum, you get an avoidance. Somebody who's just learned that they can't trust or rely on other people at all, and they're relying on themselves. So we see other people as, you more of weak or needy. They have to really rely on themselves. So that continuum goes right across and somewhere in the middle. is secure, as you said. So secure isn't something different. It's just a blend. It's a way you can balance closeness and autonomy as well. You can have a good mix of the two. And all of those along that continuum is kind of what we call insecure attachment, but it's an organized. It's an organized approach, an organized strategy that we develop depending on what we've learned. So if a caregiver is consistently inconsistent, then we're more on the anxious side. If they're consistently neglectful, we're more. the avoidance side but we do that because we know what works and what keeps us safe in that moment in time.

DARREN SHARPE: It's quite a lot to break down in the room isn't it, when someone's been doing something for all their life to keep them safe and to some extent often it's really worked for them. It's got them where they are. They might be successful, they might have a family, they're a member of their community but yet that insecure attachment is with them so when they show up in the room it could be quite a lot to unpick I find.

Gav: Yeah, that's it. You know, we learn as young children how to be in the world and how to be with other people. And those internal models are really like ⁓ they're ingrained at that point. That's how we've learned through all the kind of a childhood. So really hard to change in And a lot of the things that are more unconscious, the way we react to people are just set down through those early experiences. But as we talked about, there can be like an organized way of dealing with people and dealing with strategies because of, you know, the fears we have. But there's also something we call disorganized style. ⁓ that kind of sits beneath that continuum and it relates to kind of more traumatic events which have happened. And we think a classical example here is when the caregiver or the parent themselves was the source of safety because we go to them as young children, but they're also a source of fear. They're also the people who are doing, know, responsible for neglect or the abuse. So we have a complete conundrum within ourselves. You want to go towards them as children who want to go towards the caregivers for safety, but at the same time, we're scared of them. So because of there's no way of organizing that. How do we cope with that? There's no organized strategy. It's almost like, you know, imagine being outside your house and a big storm comes along. You think, right, I want to get back into a house where it's safe. And in an organized strategy, you know, we'd go back in there, we'd be close the doors, shut it down and, know, okay. We're away from a storm and disorganized strategy, that storm comes with you in the house. So all of a sudden you're somewhere you should be safe and you're just still in the storm as well and you can't escape from it.

DARREN SHARPE: Gav, your analogies are so visual. I absolutely love as you were talking about the storm, ⁓ I was reflecting on when I've had clients in the room who've got disorganized traits. I'll be honest with you, sometimes I feel like I'm in that storm and I really to two feet on the floor, ground myself in and remind myself I'm me I'm okay I'm there to help but not getting dragged into that storm I don't know maybe I'm taking a metaphor a bit far but for me I find it can feel really destabilizing in the room

Gav: I think a big part of working in attachment-based psychotherapy is the self-awareness, is understanding what's going on with ourselves. Because we're all human and we all have our own different attachment styles and the way we relate to other people. And that'll come into the therapy room as well. And there's a lot of kind of transference and kinds of transference which can happen. So what you're picking up there is all that kind of countertransference. You're feeling it yourself. And that's a really good sign that you can recognize that in yourself.

DARREN SHARPE: Absolutely. Yeah.

Gav: Definitely. ⁓ so yeah, it happens for everyone. And I think, you know, that's why personal therapy is so important because we have to understand ourselves before we can start fully understanding other people.

DARREN SHARPE: Yeah, that notion of self-care, I we talk about it all the time, don't we, as therapists? Sometimes we can be a bit hypocritical. Well, I can, if I speak for myself. I talk about self-care with others, and then I think, naturally, I ⁓ need to put my clients in back-to-back, or should I give myself a bit of a break to decompress between them? and maybe I don't take enough days off throughout the year. I don't know, it me to that place of ⁓ talking about that self-awareness and how we meet our needs. Yeah, just not sure. It's not easy, is it? ⁓ It's not.

Gav: No, I think you're talking there a bit about, you know, burnout, isn't it? It's quite easy to get into our situation, especially when you're taking on so much of a client's material, which is quite a relational way of working in attachment-based psychotherapy that, you know, we're really kind of being with the clients emotionally as well as physically. And, know, and you can bring a lot of that stuff back and you can feel that, you know, an obligation to kind of, you know, meet their needs, maybe more than your own needs as well, but your needs are just as important because if you're not.

DARREN SHARPE: YUM

Gav: Your own analogy, it? Of putting your own oxygen mask on before you put someone else's on. You've got to look after yourself of ways you become burnt out and then, you you're not looking after yourself or your client at that point. So yeah, it's a big part, I think, of the work is to have self care.

DARREN SHARPE: we've been about trauma and actually we've kind of veered in different directions there. ⁓ The one thing we haven't come at is ⁓ when trauma shows up in room, what do we do and how do we work with it? ⁓ What are thoughts?

Gav: Yeah, well, that's a great question, isn't it? when it shows up in the room, it can show up in so many different forms, I guess. ⁓ we're talking about ⁓ it affects adults, then, know, there can be a whole load of kind of defenses which come up. So basically with the trauma, it's a situation where relationships feel both safe and dangerous at the same time. So we can see lots of things happening when they can sort of want closeness. towards us, but then also pulling away really quickly as well. And this kind of to and fro, that push and pull can happen an awful lot. What I'd say is like these these attachment styles, they developed in relationship. And so the healing happens in relationship as well. Might sound a bit corny here, but that's kind of like what we're doing. We're offering them a new experience. Yeah, that's it. So I don't see it as any big kind of.

DARREN SHARPE: But that's it, that's the work, that's the work. It's happening.

Gav: tool or technique. I mean, there's some things you have to do. If someone's emotionally dysregulated, we want to sort of ground them and regulate them. That's kind of the obvious stuff to do. You know, we want to increase awareness by exploring their past attachments. So as we know kind of they've been through and they get an understanding that they're not being pathologized here. You know, what they have are defenses, natural adaptions from what they've been through. So there's nothing pathologizing around this. But then beyond that, we just want to be sort of... present with them, offering them a different experience, a different experience where they don't have to have their defenses up, but they're not expecting to be judged or rejected, where there's more consistency, more attunements from us. And sometimes just offering that can be enough.

DARREN SHARPE: I know about you, when I think of all what you've just described, it's not quick work this, it? When we're working, especially with someone with maybe a disorganised attachment. It takes while, doesn't it? And for me, it's in the relationship. ⁓ It's in building the trust and feeling safe. ⁓ And we can get that, then the can begin. But that building the trust, for me, that sometimes ⁓ maybe only take couple of sessions and people really take to it and they're ready. ⁓ But for others, can take ⁓ many, many sessions and lots of ways in. And yeah, I've had clients in the past where sometimes I just get out a pack of cards and for 10 minutes we'll just play a game of cards or something just to build that relationship and just to calm things down. I don't know you have similar experiences.

Gav: Bye. Well, I've never done that, but that's a great idea to, you know, get out of the cards. It's something to just make it more, you know, real and relatable. And so as you can get to know each other and relax. you said like it might have taken a long time and like it definitely does because you know, a lot of our clients have learned these ways of being these ways, these adaptations, these defenses throughout childhood. When our brains are growing through our brains are kind of malleable at that time, you know, where all these connections are being made and it's kind of in hardwired within our brains at that point. And you know, okay, we might think childhood's only what, know, 10, 18 years long and you think, oh well, you know, some adults might be, you know, coming to us in their fifties or so. And they might be beating themselves up thinking, well, that was such a long time ago, but it's hardwired in. Unless you have some experience to change that, then that's just the way that unconsciously we're gonna react and we're gonna repeat patterns because familiarity. feel safe as well. So we get a lot of kind of people who maybe experienced abuse the past, maybe in childhood would naturally kind of gravitate towards those relationships because even though it's dangerous and harmful, it's familiar. And the nervous system thinks, okay, I know this, I'm kind of associating this with love and connection. Even though, know, ⁓ it just seems wrong, but it's just subconsciously how our nervous system works. So it takes an awful long time to sort of, yeah, build up a different relationship and there might not be. great deal of trust first of all. So we have to build that and what you're doing, your example I think is great, know, something I might try myself.

DARREN SHARPE: Yeah, I was really, I'm really struck by the notion that how long it can take. And like you said, like about a client who's lived for 50 years. and then you feel like, okay, they've held these defenses and they've kept them going. They're still here 50 years down the line, but they're in your counseling room. And then they might have 30 sessions with you they might feel like that's a lot sometimes. And they might even comment on that. I've had this before. ⁓ answer has been you spent 50 years building these defenses and we 30 hours ⁓ just sitting unpicking them. Isn't that incredible? how far you've come. And I think sometimes the use of review really useful with some way for disorganized attachment because it just helps them organize the therapy in their own mind and understand the process they've been on. think being really explicit is really important.

Gav: Yeah, definitely. think you need to sort of, because people might have different expectations of therapy, as you say, when they come into it. They might expect some work sheets to come out, you to tell them how to think differently. Like in ABC, you do this and off you go and you're going to be better. But if we're going to work with the root cause of your issues, these attachment wounds, which developed early in life, then that takes time to get down there. And the thing is, it's hard to get down there as well because of all the defenses which have been built up. to prevent those attachment wounds being touched. It's a bit like having a wound on your arm or something. The last thing you want to do is someone come along and touch it, because it hurts. What you want to do is push them away. And that's what happens. That's why when our wounds are hurt, we can respond with anger, aggression. Push people away who we actually want close to us, the people we want to help us. We push away unconsciously because it hurts. We don't want those wounds to be touched. But to get to those wounds, you've got to have trust.

DARREN SHARPE: Mmm. Yeah!

Gav: You gotta work with the client where the client is, allow them to gradually drop some of those defenses or least let them, you know, not be so rigid with those defenses so we can get that in underneath. And that takes time and it takes trust. it's a long, it can be a long process.

DARREN SHARPE: Our clients don't know ⁓ what they're coming for but they know they need something ⁓ and what we're to offer them ⁓ is exactly ⁓ their needs but takes time you we need to get through those defenses in exactly the way you've described. Yeah ⁓ it's not easy work.

Gav: Mm-hmm. That's great. And yeah, what happens, you know, when clients get triggered, we talk by triggering about those wounds maybe being touched or they're going to be touched. the thinking brain kind of goes offline, but overtaken by emotions and we just want soothing as quick as we possibly can. And, know, that's when things like addictions ⁓ can happen quite quickly because they you a

DARREN SHARPE: Mm-hmm.

Gav: an instant kind of release from that emotional pain or self harm. It takes away from the emotional pain to the physical. All these things which we do to kind of just get some relief in that moment. We're not quite sure what we need. We just need relief. But what we're offering, I guess, in therapy is a healthier way of getting that relief. So understanding what's happening, being able to pause, take a step back, regulate ourselves to get the thinking brain back online, and then find out, okay, what do I need in this moment?

DARREN SHARPE: Mmm.

Gav: you it might not be, you know, alcohol at that point. It's kind of like, what do I need to actually regulate myself? Just all about regulation. Just ways we're trying to soothe ourselves when we become dysregulated.

DARREN SHARPE: really like that and I like that's a really lovely point for us to finish on. Let's people sooth themselves and ⁓ regulate themselves for giving the tools to help them. thank you so for that discussion, Gav. ⁓ You're going to stay me. We're going to have break now and then we'll be back with a counsellor dilemma. Welcome back. We've had a counselor written in with a which is, I've got client who very keen to be contact between sessions. I'll be honest, I worried about them and really wasn't sure. Part of my heart wanted to keep in touch. and make sure they're okay. ⁓ head and my mind just wasn't sure. What do think? So I will that an answer. ⁓

Gav: Yeah. An interesting dilemma we have there, Darren. Yeah. So think like if we're thinking about attachment here, that clients wanting to keep in touch between sessions would be more likely to be someone who's more anxious, preoccupied attachment style, ⁓ who's kind of really, ⁓ who closeness but doesn't rely on it fully, doesn't trust it's going to be there. So they might be reaching out for those purposes where someone on more avoidant end would be more self-sufficient, probably. You know, they're the type of people who, you want the quick fix, you know, don't want to delve too deep into the emotions. So yeah, we might see this more with, you know, disorganized attachment or anxious attachment. And I guess my first question would be, you know, to understand what the client is seeking from that contact before we can understand like how to progress with that. So are they seeking, they need some reassurance? Are they just... to be just having thoughts between sessions which they wanna get down so they don't forget about them. I've had a client who's done that before, which I think is totally fine. Said, you can email your thoughts to me and we will pick it up at the next session. So it's really understanding what we need is. Rather than pathologizing or coming down to kind of strict boundaries and ethics, I think first of all, we have to understand the clients.

DARREN SHARPE: I really like that you've allowed the client to email you because some counselors and psychotherapists would see that as an absolute no, wouldn't they? But for me, actually, if it helps soothe the client and helps keep them regulated, that's the aim. And we're showing them a new way of having a secure base. And that starts with the therapy and then evolves into finding that within themselves. That's the aim, isn't it? I've definitely used objects before and allowed them to take something from my room ⁓ they then ⁓ back at the next session. ⁓ it's almost like a ⁓ I'll my item back. So it might just be like a small trinket that I've got on the side or I've got of little plants and things. People can take that away and just keep it alive for me and bring that in. And that's worked really well, I have to say. ⁓

Gav: Yeah. And that's great. What it sounds like you've done there is you've had the conversation with the client, which is so important. I think sometimes in, in counseling, we can say, well, you know, I've been taught this is a rigid boundary that I shouldn't cross there for, you know, I will never be no contact, but you, what we need to do is explore. need to bring these things into room. That's where attachment based therapy is so relational that we bring the things into the room. We discuss it together. So it's a new experience. You know, we're discussing.

DARREN SHARPE: Mmm.

Gav: Why is it that the client needs contact between them and whatever options are there? And I think your example there of giving an object is excellent. That's the way maybe they can feel connected to you outside of a sessions.

DARREN SHARPE: And that you mentioned the relational and that actually takes me on to the other thought that I had, which was you've so rightly said, let's look at the attachment style of the client. What about the therapist? What's their attachment style? ⁓ Because wonder ⁓ if with many avoidant traits as a counselor. ⁓ is going to be more inclined to just shut off that request. ⁓ someone who is preoccupied themselves might mull that over because they're living with the same preoccupations and the insecurities ⁓ and wanting from ⁓ So I think therapists we've really got check in with what's going on with us because that's the danger.

Gav: That's a great point that is, yeah, definitely. Because as we talked before, you know, we're bringing our own attachments into the room as well. ⁓ and we can collude if we have similar attachment styles as a client, you know, there's a risk we can conclude with them or a risk, you know, we don't fully understand their needs. And I think, yeah, that's a great example, you know, someone who's dismissing and has a client who wants contact between could be very much inclined just to switch it off and not explore that, you know, and just know that's my boundary. I'm not going there. Whereas maybe someone, a therapist with a more anxious preoccupied attachment could just feel the need to do whatever their client wants to keep them happy and needy. They could let those boundaries go too much. What we need is a mix in the middle. We need to be secure in the therapy room. need to, even if we're not fully secure outside in life, we need to learn how to be secure within that therapy room and understand what's going on.

DARREN SHARPE: possible. Mm-hmm. Absolutely, because we are the secure base. ⁓ guess in summary, ⁓ answer the counsellor question, ⁓ there's few tips there, such as the object, this conversation with the client, really working with that request. But also taking a step back and reflecting on your own ⁓ processes and what's going on. wish you all the best luck with it for sure. So that brings us to the end of today's episode of Attached Together. A huge thank you again to Gav for such a thoughtful and grounded conversation. ⁓ enjoyed the back and forth, exploring the relationship between trauma and attachment ⁓ in way that's practical in the counseling room. ⁓ Cheers, ⁓ And if you're a counsellor in training, newly qualified or an experienced practitioner wanting to deepen your understanding, there's so much more to learn in this area and it really can transform the way you work with clients. If you'd like to explore the subject further, including how to train with us, you can find out more about our Level 5 and Level 7 in attachment-based psychotherapy at optimahealthservices.co.uk, you'll also find details on how to sign up. Thanks listening and we'll you next time on Attach Together.