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Abstract

This chapter explores the relationship between attachment theory and treatment of perpetrators of domestic violence. First, the authors present a brief overview ofattachment theory. This is followed by a discussion of how domestic violence research findings suggests that attachment theory is a good paradigm to understanding the phenomenonof intimate violence. Lastly, the authors describe the elements of attachment-oriented psychotherapy as they might apply to working with perpetrators of domestic violence.
Treating Assaultive Men
from an Attachment Perspective
Daniel J. Sonkin
Donald Dutton
SUMMARY. This chapter explores the relationship between attach-
ment theory and treatment of perpetrators of domestic violence. First, the
authors present a brief overview of attachment theory. This is followed
by a discussion of how domestic violence research findings suggests that
attachment theory is a good paradigm to understanding the phenomenon
of intimate violence. Lastly, the authors describe the elements of attach-
ment-oriented psychotherapy as they might apply to working with perpe-
trators of domestic violence. [Article copies available for a fee from The
Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address:
<docdelivery@haworthpress.com> Website: <http://www.HaworthPress.com> © 2003
by The Haworth Press, Inc. All rights reserved.]
KEYWORDS. Attachment theory, attachment, psychotherapy, domes-
tic violence, perpetrator treatment
Address correspondence to: Daniel J. Sonkin, PhD, Independent Practice, 1505
Bridgeway Suite 105, Sausalito, CA 94965 (E-mail: daniel@daniel-sonkin. com); or
Donald Dutton, PhD, Professor of Psychology, University of British Columbia, 2136
West Mall, Vancouver V6T 1Y7 (E-mail: dutton@interchange.ubc.ca).
[Haworth co-indexing entry note]: “Treating Assaultive Men from an Attachment Perspective.” Sonkin,
Daniel J., and Donald Dutton. Co-published simultaneously in Journal of Aggression, Maltreatment &
Trauma (The Haworth Maltreatment & Trauma Press, an imprint of The Haworth Press, Inc.) Vol. 7, No. 1/2
(#13/14), 2003, pp. 105-133; and: Intimate Violence: Contemporary Treatment Innovations (ed: Donald
Dutton, and Daniel J. Sonkin) The Haworth Maltreatment & Trauma Press, an imprint of The Haworth Press, Inc.,
2003, pp. 105-133. Single or multiple copies of this article are available for a fee from The Haworth Document Deliv-
ery Service [1-800-HAWORTH, 9:00 a.m. - 5:00 p.m. (EST). E-mail address: docdelivery@haworthpress.com].
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2003 by The Haworth Press, Inc. All rights reserved.
10.1300J146v07n01_06 105
In a landmark series of studies entitled Attachment and Loss, Bowlby
(1969, 1973, 1980) outlined a remarkable theory that posited that early
attachment had sociobiological significance and constituted a powerful
human survival motive. The theory has implications for anger in inter-
personal relationships and for the seemingly irrational outburst that ac-
company real or imagined separation. Primary attachment (usually to
the mother1) is governed by three important principles: first, alarm of
any kind, stemming from any source, activates an attachment survival
system in an infant that directs and motivates it to seek out soothing
physical contact with the attachment figure. Second, when activated,
only physical attachment with the attachment figure will terminate it.
Third, when the system has been activated for a long time without
soothing and termination, angry behavior appears; if soothing and
protection is not eventually found, the system can then become sup-
pressed. Bowlby reported observations he made of young children
(15-30 months) separated for the first time from their mothers. He wit-
nessed a three phase behavioral display: anger, despair, and detach-
ment. He concluded from these observations that the primary function
of anger was to generate displays that would lead to the return of the ab-
sent mother. Anger is thus an attempt to recapture the object that can
soothe tension and anxiety at a developmental stage where the child
cannot yet self soothe through signaling the mother that she is wanted
and/or needed. Anger is an emotion “born of fear” of loss. Dysfunc-
tional anger, occurring later in adult affectional bonds, was defined as
anger that distanced the attachment object instead of bringing (her)
closer.
Subsequent empirical studies by Ainsworth and her colleagues (1978)
showed that different “attachment styles” existed for infants. Initially these
were classified as “secure,” anxious-avoidant, and anxious-ambivalent. A
fourth category emerged in their research that was eventually called disor-
ganized. Subsequent terms for the three insecure patterns were dismiss-
ing, preoccupied, and fearful (see Figure 1). The pre-occupied and fearful
types sought attachment but experienced anxiety as a consequence of at-
tachment. Also, both experienced anxiety at the disappearance of the
mother and were difficult to soothe upon reunion. The fearful children
were particularly ambivalent upon reunion with their attachment figure,
both approaching and avoiding contact. Dutton cites Bowlby (1969) as
describing these children as “arching away angrily while simulta-
neously seeking proximity” (Dutton, 1995, p. 113) when re-introduced
to their mothers. Interestingly, although the avoidant or dismissing chil-
dren seemed content in the absence of their attachment figure and not
106 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
Is the attachment
figure sufficiently
near, attentive, and
responsive?
...ahierarchyof
attachment behaviors
develop due to increasing
fear and anxiety (visual
checking; signaling to
reestablish contact,
calling, pleading; moving
to reestablish contact).
...thechild becomes
preoccupied with the
attachment figure,
clinging, and anxious
about separation and
exploration.
...thechild becomes
defensively avoidant of
contact and appears
indifferent about
separation and reunion.
...andisplayful,less
inhibited, smiling,
exploration-oriented,
and sociable.
...thenthechild
feels security, love,
self-confidence . . .
If consistently no . . .
If no,
If yes,
YES
N
O
If consistently no . . .
FIGURE 1. The Development of Attachment
107
particularly interested in reconnecting upon reunion, when physiologi-
cal measures were taken, these children were quite anxious during sepa-
ration, but somehow learned to repress their feelings (Karen, 1977).
In 1987, Hazan and Shaver published a landmark study that showed
that adult “attachment styles” resembled infant attachment styles.
(The spate of research that emerged on adult attachment styles is too
voluminous to review here; however, the interested reader is referred
to Karen (1977) or Sperling and Berman (1994) for a discussion on the
history of attachment theory.) Assessment of adult attachment can be
done through interviews (Main & Goldwyn, 1998), projective tests
(West & George, 1999) or self reports (see http://psychology.ucdavis.
edu/Shaver/lab.html). Sperling and Berman (1994) define adult attach-
ment as “the stable tendency of an individual to make substantial efforts
to seek and maintain proximity to and contact with one or a few specific
individuals who provide the subjective potential for physical and/or
psychological safety and security” (p. 8).
One of ways attachment styles have been deconstructed involves
what are called representational models of self and other (Bartholomew &
Horowitz, 1991). Each of these representations is a network of beliefs
and expectancies about how the relationship will function. It is a cannon
of attachment theory that these representational models are internalized
through the attachment process. They include positive and negative
views of self, expectancies about what will be received from another
and generalized projections about relationship outcome. Bartholomew
(1990) systematized these into a 2 2 arrangement for each of four at-
tachment styles, each having a positive or negative self-concept and
expectation of another (via relationships). These beliefs present an-
other aspect of attachment that is open to therapeutic intervention. In
Bartholmew’s schema, Preoccupied attachment styles have negative
self-images, while Dismissing attachment styles have negative other
images. Fearful attachment styles have both negative self and other im-
ages. Fearful attachment styles also expect the worst from an intimate
relationship but need such a relationship to heal their damaged
self-image. Hence, they are thrown into an ambivalent double avoid-
ance (aloneness versus engulfment) that may serve as the basis for bor-
derline alternation (see Dutton, 1998).
Dutton, Saunders, Starzomski, and Bartholomew (1994) attempted
to relate attachment style in adults to abusive behaviors. In a sample
of 120 men in treatment for wife assault and 40 demographically
matched controls, they assessed men’s attachment style using a self
report measure called the Relationship Style Questionnaire (Griffin &
108 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
Bartholomew, 1994) and abusiveness through wives’ reports using the
Psychological Maltreatment of Women Inventory (PMWI; Tolman,
1989). A Fearful attachment style in the male perpetrator was highly re-
lated to abusiveness, correlating +.46 with the Domination/Isolation
subscale of the PMWI, and +.52 with the Emotional Abuse subscale.
These relationships were highly significant. To a lesser extent, an at-
tachment style called Preoccupied also correlated significantly with
abuse. Fearfully attached men also reported high levels of chronic anxi-
ety and anger. Bartholomew, Henderson, and Dutton (2001) also found
that women in shelters escaping abusive relationships could be classi-
fied with Preoccupied (53%) or Fearful (35%) attachment styles. These
styles were related to the woman’s difficulty in leaving the relationship.
Dutton (1998) described what he called the “abusive personality,” a
constellation of psychological traits that, when assessed in males, are
highly related to partners’ reports of abusiveness. Fearful attachment
was an important component of this personality constellation and, ac-
cording to Dutton, directed the anger to an intimate target. Men whose
violence was predominantly or exclusively in intimate relationships
probably have an attachment disorder. This disorder may be related to
personality disorder diagnoses such as Borderline or Dependent person-
ality; however, it has an attachment aspect to its origin and plays itself
out in intimate relationships. Dutton has suggested that such men have
both a public and private (intimate) personality that may be quite dis-
similar.
Typically, batterer treatment has not included specific work on at-
tachment (but see Coleman, 2002 and Leisring et al., 2002), yet thera-
pists regularly hear of delusional construals of or pre-occupation with
the spouses’ behavior (deemed “conjugal paranoia”). For example, one
of the authors (Don Dutton) had a client who was convinced that his
wife was having an affair when he found “a key with a man’s name on
it” (the key manufacturer). Many batterers present as cold, unemo-
tional, and non-empathetic, similar to persons with avoidant attachment
and those suffering from psychopathy. Likewise, it is common for
batterers to show patterns of approach/avoidance as seen with disorga-
nized attachment and borderline personality disorder. Spousal homi-
cide committed by males is frequently in response to real or perceived
abandonment (Dutton & Kerry, 1999). Browning and Dutton (1986)
obtained pronounced anger/arousal responses in batterers who witnessed
a videotape depiction of an “abandonment” (a woman unilaterally decid-
ing to visit another city with female friends and join a woman’s con-
sciousness-raising group). Their anger/arousal scores were significantly
Daniel J. Sonkin and Donald Dutton 109
higher than control groups of men, and were especially pronounced on
this “abandonment” scenario. The relationship between fear of aban-
donment and rage thus appears strong in this group of partner abusive
men. The conversion of fear to rage could occur because the latter is
more consistent with male sex role conditioning. Regardless, the con-
frontation of this emotional contribution to abuse deserves therapeutic
attention.
These data suggest that incorporating attachment theory into batterer
treatment is well founded. First, it can enable batterers to perceive a
broader pattern in their reactions to loss and separation in their intimate
relationships. Second, this theory supports the prevailing notion that
clients need to learn emotion self-regulation during periods of attach-
ment-anxiety. Third, attachment theory suggests that through altering
the internal working models of self and other the client can break a per-
ceptual mold in which attachment-anxiety is reduced to either distanc-
ing, clinging, or approach/avoidance.
THEORY TO PRACTICE:
ATTACHMENT THEORY INFORMED PSYCHOTHERAPY
Although psychotherapy with adults from an attachment perspective
is still in early development, some significant clinical ideas and applica-
tions exist. Some clinical scholars have incorporated attachment theory
into other theories (Masterson & Klein, 1995; Schore, 1994), which has
served to enhance general psychoanalytic theory and practice. How-
ever, other psychoanalytically oriented theorists have criticized this
theory based on its interpersonal versus intrapsychic focus and the cate-
gorical, mutually exclusive attachment categories (Fonagy, 1999). To
date, there exists little (Slade, 1999) or no specific models of attachment
theory informed psychotherapy with adults. It is beyond the scope of
this chapter to debate the strengths and weaknesses of attachment the-
ory as it applies to psychotherapeutic intervention, but regardless of the
final outcome of such a debate, Arietta Slade sums up the controversy
by stating, “In essence, attachment categories do tell a story. They tell a
story about how emotion has been regulated, what experiences have
been allowed into consciousness, and to what degree an individual has
been able to make meaning of his or her primary relationships” (p. 585).
Given this perspective, let’s first look at the road map Bowlby has laid
out when applying his theory to clinical practice.
110 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
Bowlby explicitly saw the therapist as a surrogate mother who en-
couraged the client to explore the world from a secure base he or she
creates. In the context of therapeutic work with individuals, Bowlby
(1988) defined five tasks:
1. Create a safe place, or Secure Base, for client to explore thoughts,
feelings and experiences regarding self and attachment figures;
2. Explore current relationships with attachment figures;
3. Explore relationship with psychotherapist as an attachment fig-
ure;
4. Explore the relationship between early childhood attachment ex-
periences and current relationships; and
5. Find new ways of regulating attachment anxiety (i.e., emotional
regulation) when the attachment behavioral system is activated.
Each of these five tasks is described in detail below.
Creating a Secure Base
The primary task that Bowlby states as necessary to addressing at-
tachment in psychotherapy is the development of the secure base. In this
section, we will define the secure base, and discuss its development and
function in the therapeutic relationship.
What Is a Secure Base?
In order to understand Bowlby’s concept of the secure base in psy-
chotherapy, one must look at how this is developed between the mother
and child. The infant’s inability to communicate in adult terms makes
parenting a challenging task. Parents (and mothers in particular) must
develop skills in empathy and attunement in order to understand the
needs of the developing child. An attuned mother (or father) can tell the
difference between a full diaper cry, a hungry cry, and a tired cry. Even
if they can’t tell the exact difference, they are quick to assume that the
baby is distressed and in need of some form of caretaking, and if in their
response one strategy does not work, they quickly employ another.
Compare this to an insensitive or misattuned parent, who either ignores
that child’s needs altogether, considers the crying a problem and loses
sight of the underlying needs, or is overwhelmed by the baby’s needs.
The attachment behavioral system, according to Bowlby, however,
does not just activate when the child is hungry or needs a diaper change.
Daniel J. Sonkin and Donald Dutton 111
The attachment system activates when there is fear or vulnerability for
some reason. Perhaps the baby heard a loud noise or woke up in the
dark. These experiences activate the attachment system, which serves
to motivate the infant to seek protection from threatened danger. The in-
fant is like, as Cassidy (1999) describes, a heat-seeking missile, looking
for an attachment object (typically the parent) that is sufficiently near,
available, and responsive. When this attempt for protection is met with
success, the attachment system de-activates, the anxiety is reduced, the
infant is soothed, and play and exploration can resume. When these
needs are not met the infant experiences primal anger accompanied by
extreme arousal and terror. These reactions, according to Bowlby, set a
template for later adult reactions to abandonment.
The parental caretaking system compliments the infant’s attachment
behavioral system. It is the caretaking system that responds with the
goal being to protect and reassure in order to reduce the child’s anxi-
ety. Behaviors that can accomplish this goal can range from the practi-
cal (e.g., putting the child down for a nap, or feeding or removing a
child from a dangerous or frightening situation) to the more compli-
cated process of mirroring the child’s inner life in words that help the
child to learn self-reflection and understanding. For example, for the
two-year-old who is involved in a full-fledged tantrum, the parent may
reflect the child’s feelings (e.g., “you must be so tired,” or “I know it
hurts when I say no sometimes”). As the child gets older, this mirroring
process becomes more complex reflecting the child’s more sophisti-
cated understanding of their feelings, needs, and relationships.
No parent always knows how to respond, or even how to respond
constructively. Misattunements are an inevitable part of the parenting
process. This is beneficial for the child, because if a child grew up with a
perfectly attuned parent, they would not be prepared for the vicissitudes
of life. They would be sadly disappointed to discover that other people
in the world did not provide the same sensitivity as their mother or fa-
ther. Mis-attunements are opportunities for the child to develop realis-
tic expectations about the world in response to their needs. These
mis-attunements and attunements are also an opportunity for parents to
help children learn about the give and take of relationships. Through the
rupture and repair process, children learn about how people become in-
timate in spite of differences and conflict. They develop a sense of poi-
gnancy and tolerance for the ambiguities of intimate relationships.
This process of the activated attachment behavioral system and the
complimentary caretaking system helps to create the secure base neces-
sary for healthy development, exploration, and play. According to
112 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
Bowlby’s theory, this healthy developmental process gets derailed
when the parental caretaking system is not adequately or appropriately
near, attentive, or responsive to the child’s attachment behavioral sys-
tem.
The Secure Base in Psychotherapy
The parent who provides a secure base for their child through attune-
ment, sensitivity, caring, setting limits, and teaching helps the child to
learn to soothe the anxiety generated by the activated attachment sys-
tem, and hence return to exploration and play. It is through this explora-
tion and play process that the child is developing a sense of self. In the
case of psychotherapy, the clinician is the caretaking figure who
likewise provides a secure base so that the client’s attachment sys-
tem is sufficiently deactivated and the client is free to explore and
play. In therapy, however, the exploration is the inner world of feelings,
thoughts, and experiences, and the play is, for example, trying on new
identities and responses to stress and conflict.
Developing a secure base in psychotherapy would be very easy if it
were as simple as therapists being available, attentive, responsive, and
attuned. Unfortunately, it is not so elementary (see Wallace & Nosko,
2002). What is interesting about psychotherapy is that, like the strange
situation (Ainsworth et al., 1978), it too creates a degree of emotional
stress, can be threatening emotionally to clients, and can be detected by
observing the coherence of the client’s stories about their attachment
experiences (Main & Weston, 1981). Sitting in the room with a stranger
and talking about emotionally laden material can be quite anxiety pro-
voking and likely to activate the attachment behavioral system right
from the start of therapy. Unlike the infant whose attachment experi-
ences are not yet solidified into firmly established working models of
self and others, the adult client has already developed a response set to
stress and vulnerability within the interpersonal context. That set, de-
pending on the attachment style, will be similar to responses to other in-
terpersonal relationships in their life, behaviors that contribute to
problems that they are seeking help for in the first place. Those attach-
ment behaviors may be obvious, but can also be so subtle that the thera-
pist will not recognize that they are present and interfering with the
change process. So on one hand the client is seeking help, yet on the
other hand the client’s attachment behavioral system may be the very
thing that presents obstacles to actually receiving assistance from the
therapist.
Daniel J. Sonkin and Donald Dutton 113
Research in domestic violence suggests that male batterers represent
all three insecure attachment classes: avoidant, pre-occupied, and disor-
ganized or fearful (Holtzworth-Monroe et al., 2000). Each form of inse-
cure attachment has particular defense mechanisms as a method of
coping with attachment anxiety. Batterers with an avoidant style pre-
sent as disconnected emotionally, lacking empathy, cold, and uninter-
ested in intimate relationships. They can vacillate between being distant
and cut-off emotionally to critical and controlling. These clients need to
incorporate an emotional soundtrack, as one client put it, into their life.
Batterers with a pre-occupied style try to please others in order to re-
ceive approval. They can present as extremely self-controlled except
when experiencing loss anxiety, when they can become extremely
clingy and angry. When experiencing emotion, these clients are over-
whelmed by their attachment needs and are often unable to contain
themselves. Unlike their avoidant counterparts, these clients need cog-
nitive structures necessary to contain their intense emotional reactions.
The fearful, or disorganized, batterer can manifest elements of both the
avoidant and pre-occupied batterers. They experience attachment anxi-
ety, and fear of rejection or being hurt if they are too close and anxiety if
they are too distant. Like the disorganized children in the strange situa-
tion, these clients do not have an organized strategy for dealing with at-
tachment anxiety. Dutton (1998) has written extensively about the
fearful/disorganized or borderline batterer.
How the therapist proceeds in the early stages of therapy with domes-
tic violence clients is critical to the creation of the secure base. If the
therapist fails to notice the client’s strategies and their psychological
function, the therapist’s responses will most probably confirm the cli-
ent’s inner working models of self and others and reinforce the attach-
ment behavioral system as it currently manifests. However, if the
therapist responds with empathy and attunement, two things can hap-
pen. First, the client gets a different experience of him/herself. The at-
tuned therapist, like the attuned parent, will look beyond the client’s
response set and help them recognize their unconscious motivations,
needs, and emotions. The therapist also helps the client view their re-
sponse set (attachment behaviors) from a different perspective–how
they undermine their getting their needs met in interpersonal relation-
ships. This rudimentary process is the beginning of the client altering
their inner working models of self.
The second possible outcome of therapist empathy and attunement is
that the client experiences the therapist in a positive way, in that they
feel understood, seen, and cared for by the therapist. When the client
114 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
feels understood and not judged, that experience in and of itself can be
relieving and soothing, thereby beginning to alter their inner working
models of others. These processes, feeling understood and recognizing
underlying needs and feelings, is the rudimentary beginning of the cre-
ation of a secure base in psychotherapy, a necessary first step in the pro-
cess of altering the attachment behavioral system so that it is not likely
to wreak havoc in interpersonal relationships.
However, like parenting in the real world, even the most sensitive
and talented therapists are not always going to be perfectly attuned;
therefore, clients are likely to experience ruptures in this state of under-
standing and perfect attunement by the therapist. Like with the develop-
ing child, these ruptures are not only inevitable but necessary to the
process of therapy and the development of a more adaptive attachment
behavioral system. We will discuss these opportunities later in the sec-
tion on utilizing the therapeutic relationship to effect change.
However, most batterers present in therapy with severe acting-out
problems. These can range from physical or non-physical abuse to-
wards their family members or others to substance abuse, missing ses-
sions, hostility toward the therapist, or other oppositional behavior. The
therapist is confronted with the following dilemma. On one hand, the
client requires understanding and support for the pain they are experi-
encing that leads to these behaviors. On the other hand, continued act-
ing-out will interfere with the client benefiting from the therapeutic
experience. Therefore, a combination of interpretation, which is neces-
sary to facilitate the development of a secure base with the therapist,
and confrontation, which is also necessary in setting limits on the self or
other destructive acting-out behaviors, is needed.
An Empirical Description of Secure Base Priming
The idea of creating a secure base in psychotherapy sounds good, but
is this a real concept or just another variation of the therapeutic alliance?
Researchers in adult attachment have been able to empirically test the
notion that creating a secure base experience for individuals may tem-
porarily alter an individual’s inner working models of others and there-
fore change behaviors or emotional states. The idea of “secure base
priming” has been gaining attention in the adult attachment literature.
Mario Mikulincer and Phil Shaver (2001) examined the effects of se-
cure base priming on intergroup bias. They hypothesized that having a
secure base could change how a person appraises threatening situa-
tions into more manageable events without activating insecure attach-
Daniel J. Sonkin and Donald Dutton 115
ment-like behaviors such as avoidance, fear, or preoccupation. They
utilized a series of well-validated secure base priming techniques (de-
scribed below) that have appeared to create in subjects a sense of secu-
rity one would find in individuals who would otherwise be assessed as
having a secure attachment style. These techniques were quite creative
and had powerful effects on subjects.
One group was primed using subliminal presentation of words that
exemplify a secure schema (e.g., love, support) within a word relation
task (Arndt, Greenberg, Pyszczynski, & Solomon, 1997). This is not
unlike the therapist who gives verbal as well as non-verbal messages to
clients communicating support, caring, and empathy. In another study,
participants performed a guided imagination task in which they visual-
ized an interpersonal episode containing the prototypical if-then se-
quence of the secure base schema (Mikulincer & Arad, 1999). This
method seemed close to the process of helping clients imagine a situa-
tion with positive outcomes, such as one used by cognitive-behaviorists
called rehearsals with a positive outcome. What would it be like if they
got the love and support that they deserve? The third priming technique
was Baldwin, Keelan, Fehr, Enns, and Koh Rangarajoo’s (1996) visual-
ization task, in which participants visualized a real person who served
as a secure base for them. Here again, it is not unusual to ask clients to
talk about positive experiences in their life, or for the client to report
thinking about the therapist (or another positive attachment figure such
as a peer in the batterer’s group) outside of the session as a means to
self-soothe, feel reassured, or bolster confidence.
In all five of these studies, those subjects exposed to secure base
priming acted in the experimental condition similar to securely attached
individuals who did not receive priming but were nevertheless exposed
to similar conditions assessing intergroup bias. The authors suggest that
secure base priming enhances motivation to explore by opening cogni-
tive structures and reducing negative reactions to out-group members or
to persons who hold a different world view. The observed effects of se-
cure base priming may reflect cognitive openness and a reduction in
dogmatism and authoritarianism (Mikulincer & Shaver, 2001). Other
similar studies have found that secure base priming will have a positive
effect on cognitive and affective states (Mikulincer, 1998). Although
these studies are not meant to be applied to clinical situations, they have
powerful implications for the clinical setting. Aspects of the psycho-
therapy process are similar to these descriptions of secure base priming
and through that process clients may begin to change their internal rep-
resentations of self and others or attachment styles.
116 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
Exploring Current Relationships with Attachment Figures
As the therapy proceeds and the therapist works to create the secure
base environment, Bowlby’s second task eventually begins to become
a focus of the psychotherapy: exploring current relationships with at-
tachment figures. These attachment figures include family members,
friends, relatives, partners, and spouses. Here the client is exploring pat-
terns in their close relationships, while the therapist is listening for pat-
terns of relating that suggest secure or insecure attachment patterns, and
if the latter, which particular insecure attachment style. The exploration
of these relationships helps the therapist understand the client’s attach-
ment style as it manifests in the significant relationships of his or her
life. Research suggests that people may demonstrate different attach-
ment styles in different relationships (Feeney, 1999). This makes a cer-
tain amount of sense. Since the attachment system is closely tied to the
attachment figure’s caretaking system, then how the attachment figure
responds to the client will in part determine the client’s response to at-
tachment system activation. In addition, in adult relationships (unlike a
child-mother relationship) both adults are acting in the capacity of care-
taker and seeking attachment for their own needs. This fact is likely to
complicate the issue of stability of attachment style within differing
contexts.
It is not completely clear how attachment style correlates with the is-
sue of personality disorders (Dozier, Stovall, & Albus, 1999). It is gen-
erally thought that people suffer from one personality disorder rather
than multiple personality disorders. Neither attachment theory or the
empirical literature on personality disorders can say they have spoken
the final word on this issue. What is seen clinically, however, is that
people do seem to have consistent core issues, but these issues may
manifest differently in different contexts. Like attachment relationship
dynamics, personality disorders are likely to manifest differently de-
pending on the context or relationship. It is believed that attachment
styles are not so much categorical as much as degrees; hence, different
client-attachment figure relationships are likely to evoke different de-
grees of insecurity. For example, one relationship may generate a mild
avoidant response by the client, whereas another relationship may
evoke an extreme avoidant reaction. Even in the same relationship, dif-
ferent degrees of avoidance or anxiety may be evoked depending on the
situation. The same can be said about personality disorders. Therefore,
determining the attachment style of a particular client is only part of the
goal of this process; more importantly, assessment is also done on how
Daniel J. Sonkin and Donald Dutton 117
the attachment system is being activated with the client in a particular
relationship or context.
Domestic violence perpetrating clients spend a great deal of time
talking about their experiences with the partner they have abused. The
tendency to focus on the relationship or partner is great in this popula-
tion. These clients grew up in families where the attachment figure was
not sufficiently present, attentive, or responsive; therefore, a great deal
of personal energy was expended focusing on the attachment figure–are
they present? Are they going to respond positively? Are they even go-
ing to know what I need? These same questions are evoked in their adult
relationships, either consciously or unconsciously. Directing the clients
to their inner experience is key to turning this pattern of externalizing
behavior to one of personal awareness and responsibility. Because so
much focus in traditional domestic violence treatment is on anger man-
agement and power and control dynamics, therapists do not pay enough
attention to the client’s inner psychological experience of relationships.
Here attachment theory can enhance the current domestic violence
treatment paradigms. By exploring the unconscious internal working
models of self and other, clients can begin to understand why they may
have the difficulties in regulating affect or why they experience a need
to control others as a means to regulate attachment-related affect.
Exploring the Relationship Between Early Childhood Attachment
Experiences and Current Relationships
An important and necessary aspect of psychotherapy from an attach-
ment perspective is the exploration of early childhood experiences and
their effect on the inner experience of self and others. Those experi-
ences with caregivers formed the representational models of self and
others from which the client views self and the significant attachment
relationships in their life. Although Bowlby’s description of this pro-
cess seems primarily cognitive in nature, there is a significant emotional
component to this task of psychotherapy. In many cases, domestic vio-
lence perpetrators present with unresolved trauma, loss, and other emo-
tionally laden relationship experiences that must be worked through
cognitively, emotionally, and physically. Victims of physical, sexual,
and psychological maltreatment will experience a range of emotional
reactions to this exploration process from depression to rage. The thera-
pist must be willing to work these painful minefields with the client.
Much has been written on addressing childhood abuse in psychotherapy
(e.g., Herman, 1992; Van der Kolk, McFarlane & Weisaeth, 1996), a
118 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
topic that is beyond the scope of this paper. But even with clients whose
experiences would not be classified as “abuse,” painful recollections of
subtle and no-so-subtle rejections and misattunements by parents evoke
powerful feelings of sadness, loss, and anger. Research in domestic vio-
lence treatment outcomes suggests that some perpetrators may need to
address unresolved trauma before, or at least concurrently to, address-
ing violent acting-out behavioral patterns.
An important part of this process involves the exploration of the rep-
resentational models of self and attachment figures that resulted from
these experiences with the goal being to reappraise them and restructure
them in light of the understanding and insight gleaned from this process.
Most often children’s strategy for dealing with unpleasant experiences
is to put them out of mind. In psychotherapy, the client can revisit these
experiences but with the benefit of having an adult mind that can under-
stand the reasons for their experiences and how they affected them psy-
chologically. Where the therapist has the most leverage in assisting the
client in changing these representational models is through new rela-
tional experiences that the client has in therapy with the therapist
him/herself. The goal of this historical exploration is helping the client
to be less “under the spell” of historical experiences with attachment
figures. In doing so, current relationships with attachment figures will
be less charged.
Another important aspect of this process is to explore the more
pathological aspects of insecure attachment. Jealousy in batterers was
first described by Walker (1979) and reiterated in Sonkin, Martin, and
Walker (1985). It was described as taking the form of frequent question-
ing of whom a spouse has been with or where she has been, accusations
of her attraction to other men, and suspiciousness that she is being flirta-
tious with other men. In extreme cases, this serves as a motive for
“pseudo-incarceration,” the literal isolation and confinement of the
woman to the home and monitoring of her phone contacts. It can also in-
volve frequent phone calls to her place of work and insistence upon
picking her up from work. Duluth Model “explanations” for these be-
haviors has been to label them as “Power and Control.” Dutton (1998)
pointed out that the use of power and control was relationship-specific
to batterers, and that people exercise control most when they are anx-
ious and afraid. The control of batterers is exercised because of a fear,
the same anger “born of fear” that Bowlby described. Because men of-
ten look to external causes of their discomfort, they assuage the fear and
anxiety within themselves by controlling their partner, who is the per-
ceived source of their anxiety.
Daniel J. Sonkin and Donald Dutton 119
Although insight into attachment patterns is an important task in
treating male batterers from an attachment perspective, the strong agent
of change in this form of psychotherapy is the development of new
strategies for coping with attachment related anxiety. On a practical
level, one immediate therapeutic objective is developing the ability to
recognize an anxious reaction to loss and the ability to self-soothe.
However, because this ability should have developed through sensitive
attunement by the attachment figure as a child, it now must also be
learned through the attunement of an attachment figure such as a thera-
pist. The therapist must be that soothing voice until the client learns to
find that voice within him or herself.
In an group psychotherapy format, this could be established through
the introduction of a topic such as “fear of losing her,” in which “aban-
donment” scenarios are described (e.g., you call and she’s not home,
she’s late returning from work or shopping, or she pursues a job or
hobby that takes more of her time). It is possible to have men generate
loss-fear diaries the same way they would generate anger diaries. A dis-
cussion of the timing and frequency of daily contact might help estab-
lish a pattern: Who initiates the contact? Is it by phone? How frequently
does it occur? What are the reactions to a failure to establish contact?
In a more unstructured domestic violence therapy, the client will
eventually bring in material where attachment or separation anxiety has
been triggered and the therapist can be a soothing voice with a more ob-
jective perspective that helps the client learn to do similarly for him or
herself. It is also possible to structure systematic desensitization exer-
cises to loss-fear in the same fashion as any other fear based cogni-
tive-behavioral intervention (e.g., fear of flying), where an anxiety
gradient is established with the most fear-inducing scenarios at the top,
less serious at the bottom. The client then visualizes the less serious sce-
narios and is taught relaxation techniques to extinguish the anxiety at
the lower levels. When these are mastered, the therapist proceeds to a
more anxiety-producing level.
Clulow (2001) discussed working with insecure attachment in a cou-
ples therapy context. In this context the focus is on establishing a secure
base in the couples relationship. Although couples therapy is not advis-
able in some domestic violence situations, attachment theory can pro-
vide a valuable perspective to understanding and treating domestic
violence with couples as well as individual or groups.
The secure base relationship creates the safe container from which
representational models of the client and his attachment figures can be
120 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
explored. Bowlby (1988), in one of his last papers, outlined this surro-
gate task as follows:
A therapist applying attachment theory sees his role as being one
of providing conditions in which his client can explore his repre-
sentational models of himself and his attachment figure with a
view to reappraising and restructuring them in the light of the new
understanding he acquires and the new experiences he has in the
therapeutic experience. (p. 138)
The therapeutic alliance appears as a secure base, an internal ob-
ject as a working, or representational, model of an attachment fig-
ure, reconstruction as exploring memories of the past, resistance
as a deep reluctance to disobey the past orders of parents not to tell
or not to remember. (p. 151)
Exploring the Relationship with the Psychotherapist
In any ongoing psychotherapeutic process, the client may begin to
consciously or unconsciously view the therapist as an attachment figure
(Farber, Lippert, & Nevas, 1995). If this indeed occurs, there is a great
possibility that the attachment behavioral system will activate at vari-
ous points in the therapy process. Although talking about events and
relationships outside of therapy is helpful, therapy from an attachment
perspective must include, at some point, a discussion of the attach-
ment dynamics between the therapist and the client–Bowlby’s third
task for the attachment informed psychotherapist. Psychotherapy may
be viewed as common place for many people who have participated in
the process, particularly for therapists who live and breathe the profes-
sion. However, for most domestic violence clients, the act of entering a
therapist’s office and disclosing private thoughts and feelings is likely
to raise a degree of attachment-related anxiety. Therefore, it is impor-
tant that therapists pay close attention to their client’s verbal and
non-verbal behaviors from the moment they make contact to begin to
hypothesize how their particular attachment behavioral system is acti-
vated.
Most clients rarely readily admit to having feelings about their thera-
pist, or at least being in therapy. Their rational mind takes over and they
tell themselves, “Of course I feel comfortable with my therapist,” or
“Why would I be here if I didn’t feel comfortable?” In reality, however,
it would be considered highly problematic if the client only had positive
Daniel J. Sonkin and Donald Dutton 121
feelings while in therapy. Not all clients will be able to directly confront
their feelings about the therapy and therapist early in the therapeutic re-
lationship. Individuals with some attachment styles are not likely to ad-
mit that the relationship is significant, let alone admit that they have
deep emotional reactions to the therapist. Just as differential diagnosis
guides the clinician about treatment planning and pacing, so does un-
derstanding a client’s particular attachment style inform the attach-
ment-oriented psychotherapist about how and when to address the
therapeutic relationship with a particular client.
Addressing the therapeutic relationship from an attachment perspec-
tive is important for a number of reasons. First, it is through the intimate
relating that occurs within the clinical hour that there is the opportunity
to explore and hopefully change the representational models that de-
termine a client’s attachment style. Second, working with the client
when feelings arise in therapy helps him/her find ways of regulating
attachment anxiety and patterns of avoidance when attachment system
is activated. Viewing attachment from the perspective of anxiety and
avoidance (Hazan & Shaver, 1987) suggests that changing attachment
styles involves the client learning to regulate attachment anxiety and/or
finding other means of expressing attachment needs other than through
avoidance. Lastly, there is some evidence that long term psychotherapy
can affect the neuro-circuitry that gives rise to attachment related repre-
sentations as well as emotion regulation (Perry, 1995; Vaughan, 1997).
Regulating Attachment Anxiety When Attachment System
Is Activated
As mentioned above, the activation of the attachment behavioral sys-
tem in the therapeutic hour can be the most effective way to address at-
tachment anxiety with the client. The distancing of the dismissing
attachment style, the pleasing and idealizing behaviors of the preoccu-
pied attachment style, and the erratic dependency and distancing of the
fearful attachment style will eventually manifest in therapy in subtle
and no-so-subtle ways. When the therapist develops a secure base rela-
tionship with the client and the client has some of the above mentioned
insight into his/her attachment relationships, the ground is set to address
these behaviors as they manifest in the relationship with the therapist.
Through both the interpretation and confrontation of these behavioral
manifestations of the activated attachment system, the client can learn
to face the pain and vulnerability that underlie these defenses. This
approach also allows the clients to be understood and supported by
122 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
the therapist, and eventually develop within themselves new skills in
self-soothing, reassurance, and relaxation. The net result is the client is
able to reduce the reactivity and sensitivity to perceived cues of threat-
ened safety or protection.
Much of what’s published in the domestic violence field speaks to
this task of the attachment-oriented therapist. Education, cognitive in-
terventions, and behavioral therapy all focus their efforts at assisting the
client (or student in the case of educational based programs) in learning
new methods of coping with anger, conflict, or any emotionally diffi-
cult situations. Although some programs address childhood abuse is-
sues (Bowlby’s fourth task), it has been promulgated by leaders in the
domestic violence field that it is more effective to focus on the here and
now and less on childhood abuse experiences, which can be addressed
later in the treatment process. This mythology seems to contradict re-
search that suggest otherwise (Saunders, 1996). Saunders found that
some batterers may actually improve faster by focusing on childhood
abuse issues earlier in psychodynamically oriented treatment. Addi-
tionally, Dutton’s (1998) research on male batterers suggests that for a
significant percent of men, childhood trauma has led to borderline per-
sonality organization. Thus, it appears that addressing childhood abuse
issues is a necessary element of the treatment process. Although cogni-
tive and behavioral interventions are an important element in domestic
violence treatment, they clearly are not sufficient given the fact that a
significant percentage of persons who complete domestic violence
treatment do seem to re-offend. In addition, even though physical rates
of violence do significantly decrease post treatment, psychological or
non-physical violence do persist at relatively high rates (Rosenberg,
2001). Dutton (1998) found a 21% arrest rate for an eleven-year follow-up,
with partner interview violence rates at approximately 16%. These data
suggest that at least 20% of persons completing treatment will re-of-
fend. Higher rates of physical and non-physical violence have been
found in other studies (Gondolf, 1997).
Taken together, this data suggests that the treatment programs devel-
oped to date may still be missing important elements necessary to long
term cessation of physical and non-physical abuse. Cognitive and be-
havioral interventions are necessary but not sufficient for long-lasting,
successful treatment. Treatment of domestic violence from an attach-
ment-informed perspective may include the missing elements that can
ultimately lead to lasting change with clients, manifested not only by
the cessation of violence but also by a significant change in their experi-
ence of close relationships in general.
Daniel J. Sonkin and Donald Dutton 123
Dutton’s research suggests that batterers will present with all three
types of insecure attachment styles in similar frequencies (Dutton,
Saunders, Starzomski, & Bartholomew, 1994). However, Fearful, and
to a lesser extent Preoccupied, styles are correlated with partner’s re-
ports of abuse. These findings suggest that the subcategories/typologies
of batterers are sufficiently different enough to justify therapists ap-
proaching treatment from an assessment based perspective, as opposed
to using a cookie-cutter approach to treatment whereby all batterers are
treated as if their violence has a single origin or etiology. In addition,
studies on drop-out rates of individuals in domestic violence treatment
(Daly & Pelowski, 2000) suggest that one factor, psychopathology,
may be related to this phenomenon. Therapists who begin to recognize
that they will need to vary their conceptualization and intervention with
different clients may be able to reduce the drop-out rates in their treat-
ment program. Attachment informed psychotherapy recognizes that
different attachment styles may need different therapeutic conceptual-
izations and interventions (Slade, 1999).
THE ASSESSMENT OF ADULT ATTACHMENT STATUS
Numerous measures of adult attachment have been developed over
the past ten years each with their own strengths and weaknesses
(Crowell & Treboux, 1995). Generally, these measures fall into two
categories: self-completed questionnaires (questions or statements re-
sponded to with a Likert-type scale) and those administered by a
trained evaluator. We would like to discuss three of these instruments
because each one deconstructs attachment somewhat differently, and
we believe that each method has clinical relevance to treating domestic
violence clients.
The Adult Attachment Interview. Main and Goldwyn (1998) devel-
oped the Adult Attachment Interview (AAI), as system based on the
structural qualities of narratives of early experiences. The interview
consists of eighteen questions about childhood experiences with attach-
ment figures. The trained evaluator is not so much interested in the con-
tent, as much as the coherence of the interviewee’s narrative. Arieta
Slade (1999) explains Main’s definition of coherence as the following:
For Main, the capacity to represent past experiences in a coherent
and collaborative fashion is the most significant and compelling
aspect of adult security, and is clearly the most predictive of infant
124 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
security. A coherent interview is both believable and true to the
listener; in a coherent interview, the events and affects intrinsic to
early relationships are conveyed without distortion, contradiction
or derailment of discourse. The subject collaborates with the inter-
viewer, clarifying his or her meaning, and working to make sure he
or she is understood. Such a subject is thinking as the interview
proceeds, and is aware of thinking with and communicating to an-
other; thus coherence and collaboration are inherently intertwined
and interrelated. (p. 580)
While autonomous individuals value attachment relationships and are
able to integrate memories into a coherent narrative, insecure individu-
als are poor at integrating memories of experience with the meaning of
that experience. Those persons classified as having a dismissing attach-
ment style tended to deny negative memories, and idealize early rela-
tionships. Their stories were very brief, general, and often full of
contradictory data (e.g., describing negative experiences but talking
about the parent in a positive light). Preoccupied individuals tend to be
preoccupied with childhood attachment experiences, often still com-
plaining of childhood slights, echoing the protests of the resistant in-
fant. Their stories are often long and grammatically entangled with
vague usages (“dadadadada,” or “and that”). Unresolved individuals
give indications of significant disorganization in their attachment rela-
tionship representation via either semantic or syntactic confusions in
their narratives concerning childhood trauma or a recent loss (Fonagy,
1999). These individuals show striking lapses in monitoring of reason
or discourse (George, Kaplan, & Main, 1996).
The relevance of the AAI to clinical work with batterers is that cli-
nicians can listen to their client’s narratives from the beginning of
treatment so as to begin to form hypotheses about attachment status.
Additionally, as the narratives begin to evidence certain forms of inco-
herence, the clinician can also strategize treatment interventions that
specifically address the client’s defensive patterns that have led to the
particular form of incoherence. For example, for the avoidant or dis-
missing client who presents little data, idealizes their attachment expe-
riences, and is unable to express affect, the therapist can begin to
formulate strategies that help draw out the client’s story, listen for in-
consistencies in their recollections of childhood experiences and begin
to point them out, and slowly help the client connect with the emotional
track of their narratives. The pre-occupied client, whose narratives are
convoluted and saturated with uncontained affect about attachment ex-
Daniel J. Sonkin and Donald Dutton 125
periences, will need to learn how to better self-soothe so that their narra-
tives will have a certain degree of objective distance or cognitive
structures that contain the appropriate degree of affect. With the fearful
or disorganized batterer, the therapist will need to address the early
childhood trauma experiences, whose resultant repressed affect leads to
dissociation and other forms of maladaptive emotion regulation. When
treating domestic violence perpetrators, it would be our hope that as the
client learns more about himself and his attachment relationships and
becomes more effective at modulating attachment anxiety, his/her nar-
ratives will become more coherent.
Experiences in Close Relationships Questionnaire. Brennan, Clark
and Shaver (1998) developed the Experiences in Close Relationships
(ECR) questionnaire, a self-report measure that assesses adolescent and
adult romantic-attachment orientations (secure, anxious, and avoidant–
the three patterns identified by Ainsworth, Blehar, Waters, & Wall,
1978 in their studies of infant-caregiver attachment). They deconstruct
attachment on two continuums: anxiety (need for approval, preoccupa-
tion with relationships, fear of being abandoned) and avoidance (dis-
comfort with intimacy and closeness). Persons with low anxiety and
low avoidance are within the secure range. Those with high anxiety and
low avoidance are within the preoccupied range, while those with low
anxiety and high avoidance are within the dismissing range. Finally,
persons with high anxiety and high avoidance are within the fearful
range. Clients can fill out the 36 questions fairly quickly. The client is
asked to read each statement and answer to what degree it reflects how
they see themselves. They can even take the test online and receive the
results immediately (http://www.geocities.com/research93/). Unlike the
AAI, the ECR scores the person in degrees of avoidance and anxiety,
and therefore is somewhat less categorical in nature.
The Relationship Questionnaire. Another self-report adult at-
tachment measure is the Relationship Questionnaire, developed by
Bartholomew and Horowitz (1991). This measure, although similar in
form to Brennan, Clark and Shaver’s (1998), conceptualizes attach-
ment in terms of internal working models of self and others. This de-
construction of attachment is based on Bowlby’s (1973, 1979) original
conceptualization of attachment. Bartholomew provides two theoreti-
cally unrelated dimensions giving four quadrants or categories. Positive
working models of the self and positive working models of others give
rise to the secure attachment status. Negative working models of the self
and positive working models of others give rise to the preoccupied at-
tachment status, while positive working models of the self and negative
126 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
working models of others give rise to the dismissing attachment status.
Finally, negative working models of both the self and others give rise to
the fearful attachment status.
Understanding attachment from the internal working model perspec-
tive helps to explain many of the behaviors evident in perpetrators of
domestic violence. The pre-occupied client who is trying to please or re-
ceive validation from the therapist, or his partner, is avoiding experi-
encing the sense of defective self or self-hatred that would result from
focusing on himself. Addressing issues of self-esteem is critical with
this client, whereas the avoidant client has learned to protect himself
from others by distancing and may experience his partner or the thera-
pist as intrusive and/or controlling and may act out violently or ag-
gressively in retaliation. An important issue being discussed among
researchers developing these methods of measuring or identifying at-
tachment styles is the notion of categorical typologies versus dimen-
sions of security or insecurity. In the real world, clients present with
varying degrees of mental illness. Therefore, it would be expected that
attachment status would be no different. The strength of the ECR and
the Relationships Questionnaire is their use of the Likert-type scales
that allow respondents to rate themselves in degrees of similarity or dis-
similarity to each attachment related statement, rather than the categori-
cal nature of the AAI.
Discussion of Adult Attachment Measures. Each of these models of
adult attachment (coherence, anxiety/avoidance, and internal working
models of self/others) can be useful in understanding psychotherapy
with perpetrators of domestic violence. Although there is considerable
overlap in how each of these attachment categories manifest interper-
sonally, they each suggest unique treatment goals. Based on the AAI,
the goal of therapy is helping the client reduce their anxiety sufficiently
to reconstruct a coherent narrative of their attachment-related experi-
ences, both in the past as well as currently. As Jeremy Holmes (2001)
suggests (2001), attachment based psychotherapy is a process of
story-making and story-breaking. One needs to break the rigid, unemo-
tional, and unrelated story of the avoidant individual and create a story
with greater emotional content, better balance of positive and negative
experiences, and a more descriptive and realistic narrative description
of relationships. With the pre-occupied individual, one must break the
emotional dysphoria by creating one that is also infused by logic and
perspective and balance of affect and reflective understanding.
Similarly, the Brennan, Clark, and Shaver (1998) model suggests
that by learning to self-soothe attachment anxiety and find other mecha-
Daniel J. Sonkin and Donald Dutton 127
nisms besides avoidance to deal with the fear and vulnerability that can
be activated within close relationships, clients can begin to develop
more secure relationship experiences. The Bartholomew and Horowitz
(1991) model suggests that working more on improving self esteem and
reassessing feelings of distrust and fear of others will ultimately allow
the client to experience relationships from a secure perspective. There
is some question as to whether or not Bowlby’s concept of “internal
working models” is the same as attachment styles described in the cur-
rent literature. At a recent meeting of the American Psychological As-
sociation, Adult Attachment Discussion, the issue of working models
attachment styles or attachment representations were explored among
researchers in the field and the following was noted (Adult Attachment
Lab website, 1998):
There was some initial disagreement over the use of the terms
“working models,” “attachment styles,” and “attachment repre-
sentations.” It was generally agreed that the term “attachment
style” is best reserved for describing observable or manifest pat-
terns of behavior, and the term “working models” is best reserved
for describing the latent mental structures giving rise to variability
in attachment styles.
It was suggested that the concept of working models is of
relatively little use in describing the psychological dynamics of
attachment because the concept brings to mind conscious-evaluative
belief systems (positive/negative models of self/others) operating
with little input from motivational and defensive goals or over-
learned strategies of behavioral and emotional regulation. In con-
trast, but also speaking to the limitation of the concept of working
models, it was suggested that the concept was broad enough to re-
fer to both declarative and procedural aspects of cognition and be-
havioral/emotional regulation.
It was generally agreed that the concept of working
models is most useful when referring to organized strategies for
regulating emotion, attention, and behavior with respect to attach-
ment concerns. It was also suggested that a number of social-
cognitive techniques exist that can be exploited to investigate
the procedural and unconscious aspects of working models.
Main (1999) notes that there is research that suggest there are in fact
neurological correlates to internal working models as either neurologi-
cal circuits or patterns that are ingrained from experience or a function
128 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
of working memory. In either case, understanding the neurological ba-
sis of internal representations of self and others may be an important
element to understanding attachment patterns in children and adults.
CONCLUSIONS
Psychotherapy with perpetrators of domestic violence from an at-
tachment perspective involves creating a secure base environment so
that clients can explore their current and past attachment relationships
within the safety of the therapeutic relationship. Safety is critical, be-
cause many insecure batterers have experienced tremendous loss, hurt,
and disappointments within their close relationships; they therefore en-
ter therapy with fears and anxiety about opening up to someone who is
perceived as having power over them. This is particularly true for the
court-mandated client, where the therapist may indeed have a great deal
of influence over their criminal justice experience. For these reasons,
creating a secure base environment is a critical first step to achieving
therapeutic goals, such as learning emotional self regulation or re-
solving childhood trauma. Another critical element to attachment
oriented psychotherapy with perpetrators of domestic violence is the
“not-one-size-fits-all” maxim. Different attachment styles need differ-
ent interventions and approaches. The batterer with the overly struc-
tured dismissing attachment style needs to connect to their emotional
life and acknowledge the importance of attachment in their lives. They
need to learn that attachment relationships do not need to be exploitative,
hurtful, controlling, or rejecting. The batterer with the preoccupied at-
tachment style needs structures necessary to contain their emotional reac-
tivity in attachment interactions, while learning greater self-sufficiency
and less dependency on attachment figures for self-definition and secu-
rity. The batterer with the fearful attachment style likewise needs to heal
the split that exists within them from childhood trauma and losses so
that they can both learn to self-soothe their attachment anxiety through
means other than avoidance or pushing others away through anger and
violence.
Using the therapeutic relationship (or peer relations when utilizing a
group intervention modality) is the most powerful means to highlight-
ing attachment behavioral system patterns in psychotherapy. Through
these in-the-moment experiences, therapists can help raise the client’s
awareness of these patterns, but most importantly strategize more adap-
tive responses to attachment anxiety. This process takes therapists out
Daniel J. Sonkin and Donald Dutton 129
of their heads and challenges them to work within the here and now with
clients. Quick thinking, self-awareness, and sensitive attunement to the
client are critical to making use of these “now-moments” (Stern, 1998).
Making use of them on a continual basis gives the client the message
that he/she and the therapist can go to that frightening place of emotions
and the meaning of intimacy.
Because domestic violence clients are a heterogeneous population,
clinicians are likely to encounter all three insecure attachment styles.
An assessment of the client’s attachment status is necessary to under-
stand how the client’s attachment behavioral system activates and the
mechanisms they use to cope with the anxiety associated with attach-
ment. Understanding the client’s attachment status helps us to form
some hypotheses about the etiology of the client’s violence. Psycho-
therapy offers the domestic violence client the opportunity to learn
more adaptive methods of regulating attachment anxiety, reevaluate in-
ternal models of self and others, and experience intimate relationships
(with the therapist or fellow group members) in new and positive ways.
Through long term exposure to these therapeutic experiences, changes
in the internal working models and attachment style is not only possible
but inevitable.
Although John Bowlby began his work on attachment theory over
fifty years ago, there are still varying ideas about how one approaches
psychotherapy from an attachment perspective. Unlike most clinical
theories, attachment theory has had the benefit of more than forty years
of empirical research before discussions even began on the clinical ap-
plications to adult psychotherapy. So as the clinical application of this
theory evolves, clinicians will have at their disposal a continually grow-
ing body of empirical data that will hopefully meld with clinical experi-
ence. Through a positive attachment between clinicians and academics,
the application of this theory will unfold in the years to come.
NOTE
From his early writings, Bowlby used the terms “principal attachment figure” or
“mother figure” rather than the word “mother.” This usage underscored his belief that
although the principal attachment figure is often the mother, it may also be another per-
son (such as father or grandparent). For the purposes of this paper, we shall use the term
“principal attachment figure” keeping in mind that although for most of our patients
this is the biological mother, it is not necessarily so.
130 INTIMATE VIOLENCE: CONTEMPORARY TREATMENT INNOVATIONS
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... Perpetrators of IPV are often focused on their partners' behavior as a justification for violence, but an attachment framework can help them take responsibility for their behaviors by recognizing how their internal working models create difficulties in emotional regulation and underlie desires to control (Sonkin & Dutton, 2003). Furthermore, attachment is inherently a relational process, and couples therapists' use of a relational framework for IPV can help account for both perpetrator and victim factors (Kuijpers et al., 2012). ...
... Clinicians can validate both partners in their needs while condemning violent strategies for meeting those needs. By assessing attachment factors, clinicians can better predict how partners' anxious or avoidant attachment might relate to their communication or emotional expression and adapt their treatment and interventions accordingly (Sonkin & Dutton, 2003). ...
... Attachment theory can help clinicians conceptualize their own role with clients as that of a secure base from which clients can explore new, non-violent ways of relating to the self and others (Sandberg et al., 2019). Sonkin and Dutton (2003) suggest that the therapist recognize the anxiety created by therapy itself and its likelihood of activating clients' attachment systems, understand clients' tendencies toward relating with the therapist according to internal working models, avoid falling into patterns that can confirm clients' attachment insecurities, and respond with attunement to provide clients security. More detail should be devoted to describing ways of creating this secure base when IPV is present, especially with aggressive or challenging clients. ...
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Working with intimate partner violence (IPV) can be a daunting task for systemic therapists. Nevertheless, research establishing a connection between attachment and IPV suggests that systemic therapists may be particularly well-suited to the task. Due to the high clinical prevalence of IPV, therapists should understand how it presents in session and how it can be addressed, and attachment theory can be helpful in such conceptualization and treatment pursuits. Although some therapy models draw upon attachment theory when working with couples, concerns about safety have been raised when using attachment-based models with IPV. In this article, a review of the research linking attachment and IPV is presented, along with limitations of attachment conceptualizations of IPV. The case is made for safe use of attachment-based treatments of IPV through previously developed best safety practices as well as the integration of contextual factors, such as gender and power, that help create a more comprehensive, ecological view of violence. Specific ideas are presented to help therapists conceptualize and intervene with IPV using an attachment-based lens.
... Being avoidant or unable to trust others affects treatment engagement in a negative way, whereas being able to build a therapeutic relationship facilitates treatment engagement (Tetley et al., 2012). Especially in group therapies, which are a common treatment form in correctional facilities, the attachment style determines not only the relationship to the therapist but also to the other group members (Jennings et al., 2021;Sonkin & Dutton, 2003). The higher the attachment-related anxiety, the more negative the assessment of one's own person; the higher the attachment-related avoidance, the more negative the assessment of the other participants (Rom & Mikulincer, 2003). ...
... As previous research emphasises, the attachment patterns can vary greatly depending on the reference person (Asendorpf, 2018;Caron et al., 2012). Additionally, the clients' attachment styles not only influence the relationship to the therapist but also to the other members of the therapeutic group (Jennings et al., 2021;McKillop et al., 2016;Rom & Mikulincer, 2003;Sonkin & Dutton, 2003). Nevertheless, it is still open to question whether or not the use of the ECR-R is appropriate to capture the relationship to the therapist and other members of the therapeutic group in forensic settings. ...
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According to the Risk-Need-Responsivity (RNR) model, treatment effectiveness increases when treatment addresses all three associated core principles. While researchers have focused on the risk and need principles, responsivity remains under-investigated. The theoretical foundation of the RNR model and former research indicates low perceived self-efficacy and inadequate adult attachment styles as potential responsivity factors that can impede treatment of the underlying risk factors. This study assesses firstly whether these factors predict treatment attrition, and secondly changes in the assessed risk of sexual reoffending. Participants were N = 146 men sentenced for sexual offences in a German social-therapeutic correctional facility. Younger age, higher number of previous convictions, and higher scores on the interpersonal facet of the Psychopathy Checklist-Revised are associated with a higher risk of treatment attrition. Unemployment prior to incarceration was found to be an aggravating factor, whereas substance abuse emerged as a mitigating factor, according reducing the risk of reoffending. Neither pre-treatment self-efficacy nor attachment styles revealed as responsivity factors in this study. Future studies should examine if the consideration of these factors during treatment might impact treatment outcomes.
... Monsieur L présenté plus, haut, il est évident que cette personne pourrait tirer des bénéfices d'un travail thérapeutique centré sur l'attachement, en revanche il ne serait pas suffisant pour l'aider à trouver un équilibre de vie satisfaisant et surtout à prévenir la récidive d'infractions à caractère sexuel.2. Implications pour la pratique thérapeutique D'aprèsSonkin et Dutton (2003), les problématiques d'attachement rencontrées par les auteurs de violences intimes peuvent être travaillées en thérapie non pas par la mise en application de techniques thérapeutiques à proprement parler mais via la relation d'attachement qui se crée avec leur thérapeute. Ils suggèrent pour cela que le thérapeute prête une attention particulière au style d'attachement du patient afin d'orienter leur posture de manière appropriée. ...
... D'après lui, le fait de s'extraire du travail intrapsychique à proprement parler pour démontrer une préoccupation sincère quant aux conditions matérielles de vie de son patient aurait permis à ce dernier de se sentir réellement considéré par son thérapeute. Lui qui se montrait évitant dans la relation et peu compliant depuis le début de la thérapie, aurait par la suite investi peu à peu la relation au point de continuer à informer le thérapeute des étapes importantes de sa vie bien après la levée de l'obligation de soin.On retrouve dans ce témoignage une autre des indications préconisées parSonkin et Dutton (2003) dans la prise en charge des auteurs de violences, à savoir de se centrer sur le moment présent avec le patient dans un premier temps afin de créer avec lui un environnement faisant office de base de sécurité, favorisant l'engagement dans la thérapie, mais qui se révèle thérapeutique en soi également. Les auteurs insistent tout de même sur la nécessité de travailler par la suite sur les expériences vécues durant l'enfance pour une meilleure efficacité thérapeutique sur le long terme. ...
Thesis
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The scientific literature has highlighted that a significant proportion of perpetrators of interpersonal violence exhibit an insecure attachment style. Here we conducted a study aiming, through the use of adapted tools, to assess the proportion of disorganized / fearful attachments, but also the rigidity of attachment patterns within this population. Our results do not support the conclusion that perpetrators of sexual and domestic violence have more fearful attachments than among the general population. In contrast, the data obtained via this protocol indicate that this population could show some rigidity in the ability to develop different schemas depending on the attachment figures.
... 31,32 According to Dutton and colleagues observations, childhood neglect disrupts child's affection to parental figures leading to insecure adult attachment styles, ultimately marital violence in an attempt to control partner, and prevent threats of abandonment. 33,34 This emotional deregulation may make person culpable to be an IPV victim. ...
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Background Sexually transmitted infections (STIs) have complex relationship with mental health and intimate partner violence (IPV) causing community health concern among adolescents and young adults. Women encounter behavioral, psychological, and reproductive health consequences of violence affecting across their lifespan. Aim To determine IPV anxiety and depression in women with STIs. Methods and materials It is a hospital-based cross-sectional study. A total of 115 consecutive females between 18 and 45 years of age who attended STI clinic were enrolled. Sociodemographic details were collected by semi-structured pro forma. IPV was assessed by World Health Organization violence against women instrument; Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale were applied to assess severity of anxiety and depression. Results Mean age of subjects was 31.21 ± 9.08 years. About 55% of the patients had history of IPV. Psychiatric comorbidities noted in 66% of patients. The odds of IPV were more with history of child abuse, suicidal ideation, and substance abuse in husband. Conclusion IPV, anxiety, and depression in STI are in the primitive stage of validation due to associated stigma and lack of awareness. It is high time to divulge dormant triggering factors to protect vulnerable population. Current research should focus on education and women empowerment to prevent STI and mental health issues.
... Information is given on the way systems tend to resist change, and how to best address this problem. Special attention is paid to insecure attachment dynamics, and how they can lead to violence (Sonkin & Dutton, 2003). Additional suggestions are presented for 8 conducting effective case management (e.g., referrals to substance abuse treatment, mental health resources), helping clients establish personal goals, and how to benefit for the use of CBT progress logs. ...
... Step 1: Notice the specific situation or event, Step 2: Notice your emotions, Step 3: Identify your thoughts. Therefore, it is critical for domestic violence offenders who have been ordered to receive institutional treatment to realize that domestic violence is a punishable crime and to recognize the reality of violence [9]. Therefore, this study examined how Burns' 7 irrational thinking frameworks have changed before and after measuring the effectiveness of the Social Group Work intervention focusing on the participants' awareness of violent behavior. ...
... Studies have shown that male-to-male violence and male-to-female IPV share similar risk factors, such as growing up in a violent homes, substance abuse, social isolation, gendered disposition for aggressive behavior, poor behavior controls, and low sense of self-worth (Ambramsky et al. 2011). The limited research on adult IPV offenders demonstrates that most of these offenders experienced chronic childhood ETV not only in the home but outside the home (Moffitt et al. 2000;Sonkin and Dutton 2003). However, little to no research has examined the relationship between childhood ETV to future IPV perpetration and/or IPV victimization in males and no studies have specifically examined this among serious youthful offenders. ...
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Early exposure to violence (ETV) has been repeatedly linked to violence in intimate relationships later in life. However, this association has rarely been explored among young men involved in the justice system, a group that is of significant policy concern. Methods. Drawing from four waves of data collected from 808 young men with histories of serious offending, this study examined rates of physical and emotional intimate partner violence (IPV) victimization and perpetration. Next, the rates of IPV victimization-perpetration overlap were examined. Lastly, the associations between IPV in young adulthood and ETV in early adolescence were explored using standard difference-in-means tests. Findings show that victimization and perpetration of emotional IPV are common experiences among the men. Seventy-three percent of the sample report emotional IPV victimization and 70% report emotional IPV perpetration. Physical IPV is less common than emotional IPV with 44% of young men reporting being victims of physical IPV and 29% reporting perpetration of physical IPV. Strong linkages were observed between IPV victimization and IPV perpetration. Lastly, associations exist between exposure to violence as a witness or a victim and both emotional and physical IPV victimization and perpetration. IPV involvement as a victim and/or perpetrator is more common than not among young men involved in the justice system. Both emotional and physical forms of IPV are associated with witnessing and experiencing violence during adolescence. Intervention during adolescence is critical to avoid IPV during young adulthood.
... These same men reported feeling great relief from the opportunity to purge long-held secrets and perceptions of shame from their childhood (e.g., see Manning, 2010;Pennebaker & Smyth, 2016). However, to our knowledge, most BIP in the United States do not include trauma-focused content in their curricula because they believe perpetrators use childhood abuse as an excuse for their own behavior (e.g., Pence & Paymar, 2011) or they believe trauma processing can only be achieved through individual therapy (e.g., Sonkin & Dutton, 2003). In a recent review of BIP research, Aaron and Beaulaurier (2017) contend that current models of BIP produce inconsistent results because they do not successfully account for individual differences among IPV perpetrators. ...
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Perpetrators of intimate partner violence (IPV) are more likely to have been exposed to adverse childhood experiences (ACES) than the general population (e.g., Whitfield, Anda, Dube, & Felitti, 2003). Despite this association, occurrence of ACES does not necessarily lead to the development of patterned abusive behavior (Godbout et al., 2017). To understand the link between ACES and IPV perpetration, Godbout et al. (2017) suggest that research must consider a complex array of intra- and interpersonal experiences. For this project, we used ethnographic methods, including participant observation at a local batterer intervention program (BIP) and semi-structured interviews with 15 male IPV perpetrators to explore the individual experiences in greater detail. The data were analyzed using a combination of concept-driven, open, and axial coding, creating an inductive and iterative process for interpretation (e.g., Manning & Kunkel, 2014). Participants’ reports revealed high frequency of often co-occurring ACES, with patterns of negative messages about self-worth, beliefs about personal responsibility for experiences of abuse, and both feelings of powerlessness in the face of abusers and the need to feel powerful. Results are discussed regarding the theoretical understanding of individual differences among IPV perpetrators. Specifically, we address the practical need to expand our investigation of ACES, as experienced by IPV perpetrators, to include more varied types of abuse and household dysfunction.
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Social support is crucial for adapting to stress and trauma, processing adverse emotions, developing better mental health, and garnering relationship success. Yet, social support may not always be accessible to those who need it the most. Through participant observation and in-depth interviews, this study examined how men who have perpetrated intimate partner violence (IPV) perceived the availability and adequacy of social ties, as well as how they discursively constructed social support during times of childhood adversity. Results indicated a prevalence of trauma in attachment relationships, a lack of perceived social support, and persistent messages that discouraged help seeking and engendered masculine norms (e.g., self-reliance, aggression, rejection of femininity, restrictive emotionality) and communication styles. The current study illustrates how the effects of adverse childhood experiences may be exacerbated by the absence of positive social ties and adherence to masculine gender norms governing communication. Thus, the protective benefit (or the "buffering effect") of social support appears to be inaccessible for this specific population. Findings suggest so-called "batterer intervention program" groups could provide measures to increase perpetrators' sense of social support during the intervention process and work to deconstruct additional masculine gender beliefs (i.e., in addition to power and control) to alleviate some of social and psychological effects of early childhood adversity.
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The phenomenon of lesbian battering challenges mainstream assumptions about battering and defies traditional ways of defining and understanding domestic violence. This article identifies and illuminates variables critical to understanding and treating lesbian batterers. in particular, intrapsychic factors in the treatment of lesbian batterers are considered via an integration of the theoretical constructs of personality development with attachment theory, state and affect regulation, shame, pathological vindictiveness, and variables specific to lesbian domestic violence. Finally, two case examples and treatment considerations are discussed.
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Five studies examined the effects of priming the secure base schema on intergroup bias. In addition, Studies 1-2 examined the effects of dispositional attachment style, Studies 2-5 examined a mood interpretation. Study 3 examined the mediating role of threat appraisal, and Studies 4-5 examined the effects of secure base priming while inducing a threat to self-esteem or cultural worldview. Secure base priming led to less negative evaluative reactions toward out-groups than positive affect and neutral control conditions. In addition, whereas the effects of secure base priming did not depend on attachment style and were not explained by mood induction, they were mediated by threat appraisal and occurred even when self-esteem or cultural worldview was threatened. The discussion emphasizes the relevance of attachment theory for understanding intergroup attitudes.
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The Straus Conflict Tactics Scale (CTS) has been used frequently in past research to assess incidents of assault between spouses. The majority of these studies have relied on CTS scores from only one member of a couple. Szinovacz (1983) corrected this shortcoming by administering the CTS to 103 nonassaultive couples. In the current study the CTS was administered to 30 assaultive couples where the husband was undergoing treatment for wife assault. Differential reporting was found whereby husbands tend to view their marital relationship as mutually violent, while wives view it as husband-violent. Except when weapons were implicated, the husband-wife correlation on specific items of the CTS ranged from +.32 to +.57, indicating considerable disparity in recall for violence. The methodological and clinical implications of these findings are discussed.
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The authors offer a social group work model for working with abusive men. They integrate affect and attachment theory in their exploration of the theoretical linkages between shame and anger. Through exploring the ways in which group structure and processes evolve, they demonstrate that group provides a framework through which men's shame and anger can be unlinked. They also demonstrate that the social relatedness group generates can help repair earlier attachment anxieties. This permits men to acquire non-violent means of dealing with the shame-based responses that are at the core of violent and abusive behavior. The authors also provide a description of the interventions used to detoxifyshame in a group context.
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The aims of this study were (1) to test for independence in the quality of the infant's attachment to each parent, (2) to test the concept of security by viewing infants judged secure versus insecure with mother in a situation designed to arouse mild apprehension, (3) to examine the effects of existing infant-parent relationships upon positive social responsiveness to new persons, and (4) to identify characteristics of infants judged unclassifiable within the Ainsworth system. In the first part of the study 61 infants were seen with different parents in the Ainsworth strange situation at 12 and 18 months. Classifications with mother and with father were independent; father as well as mother categories were stable over an 8-month period. 44 infants were additionally seen with mother at 12 months in a play session in which an adult actor attempted to establish a friendly relationship. Conflict behavior occurred in infants judged nonsecure with mother. The relationship to father as well as to mother appeared to affect friendly responsiveness to the adult actor. Infants unclassifiable within the Ainsworth system (12.5%) showed conflict and little positive responsiveness to the adult actor.