Using Self-Report Romantic Attachment Measures in Therapeutic Practice.

Richard J. Atkins - 27th August, 2006

Over the seven plus years since I began hosting this website I have been contacted a number of times by therapists, often couple therapists, asking which self-report measure of attachment they should use to assess the underlying attachment characteristics of their clients.  Based on the comments I have made here, I do not believe self-report measures of adult attachment are appropriate as measures of attachment per se in therapeutic practice.

The evidence (and indeed the names of many measures) indicate these measures primarily describe current or most recent relationship functioning. However results from these measures describe individuals in terms of their attachment characteristics (secure, avoidant, anxious etc.).  Attachment is generally understood as being about persisting trait-like individual differences in relationship-related cognitions (and consequent behaviours) that were formed during the early years and then affected by subsequent experiences.  It is far too easy to make the leap from 'slightly above average on avoidance and/or anxiety' which may well be a product of the current state of a relationship that has been brought to counselling because (presumably) communication is somewhat lacking, to 'emotionally crippled, under/overexpresses affect, unable to experience secure intimacy, probably experienced neglectful/overinvolved parenting and unlikely to ever be able to sustain a genuine relationship'. Obviously this is a completely inappropriate interpretation.  There is little doubt that current relationship functioning is affected by persisting working models and early experiences but results using these instruments are much more closely associated with, and tell us much more about the former, not the latter.

I should add that I am particularly driven to write this note because in more than one case, it is clear that the therapists seeking my advice have already made this misinterpretation themselves as they specifically wanted to use these instruments to measure clients' underlying traits.

On the more general point, I am not entirely convinced that romantic attachment concepts, let alone measures, should be used in therapeutic practice at all.  While I acknowledge the excellent reintegration of 'developmental' attachment theory into the psychodynamic therapeutic movement, psychodynamic therapists and counselling psychologists will generally have a thorough and extensive grounding in the psychology behind attachment theory with detailed exposure to Bowlby's theories and Ainsworth's mother-infant research as well as later therapeutic integrations such as Object Relations theory.  My concern here is more with the use of attachment theory concepts by counsellors and psychotherapists who have minimal exposure to the underlying theory or whose main exposure is to the personality/social psychology approach.

Unlike systems such as Transactional Analysis with it's ego-state model and 'OK corral,' and systemic theory with it's inclusion/affection/control model, since its terms were first established, attachment theory has developed in such a way that the common meanings of its value-laden terminology are no longer adequate or even appropriate.   Furthermore the apparent simplicity of categorical models and early ideas such as individuals having a definate 'attachment style' encourages labelling with these easily misunderstood terms and this leads to the misrepresentation and misuse of attachment concepts.  To my dismay (and despite my best efforts) more than once I have been in the refectory after delivering a lecture on romantic attachment and have overheard students using attachment concepts as weapons with which to assassinate the characters of their mutual acquaintances and (more especially) their friends' relationships and partners.  It is interesting to note that in every case, the assassinators have claimed the labels 'secure' or 'anxious' for themselves and have damned others with the label 'avoidant'.  Adopting the Karpman (1968) drama triangle model, it appears that the self-labelled 'secure' individuals are often acting as rescuers, individuals labelled as 'anxious' (the socially acceptable form of insecurity?) are viewed as the victims of their 'avoidant' persecutors (avoidance being the socially unacceptable form of insecurity).  Obviously this is a wildly inaccurate oversimplification of attachment theory and one which facilitates potentially unhelpful interpretations, yet it appears to be an interpretation of attachment 'styles' that is commonly and readily adopted.

In summary, unlike other models that have genuinely accessible, readily understandable and easily applied terminologies and models, attachment theory has a genuinely misinterpretable and readily misunderstood but unfortunately an easily remembered terminology and it is for this reason I am hesitant about its presentation to clients as an easily grasped model that can be used for personal insight and as a context for understanding their relationships, particularly when working with vulnerable individuals and couples experiencing problems in their relationships.