Patterns of Attachments and the Assessment of Interpersonal Schemata: Understanding and Changing Difficult Patient-Therapist Relationships in Cognitive Psychotherapy

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Abstract
The results of empirical studies of attachment behavior in children provide the cognitive psychotherapist with powerful conceptual tools that may be profitably used in some puzzling instances of patient’s behavior within the therapeutic relationship. Some patients ask energetically for the therapist’s reassurance and at the same time resist the therapist’s comforting responses. Others seem compelled to avoid any expression of personal vulnerability as soon as they perceive the therapist’s empathic availability to listen to their painful emotional experiences. Other patients utter their requests for help in a most confused, mutable and contradictory way. When the therapist deals with such kinds of therapeutic relationship, the knowledge of the representational models of self and the attachment figure that may be inferred from abnormal patterns of attachment (anxious-resistant, avoidant and disorganized/disoriented attachments) guides the assessment and change of the patient’s interpersonal schemata in a most profitable way.

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