Friday, October 7, 2011


Using AT in constructing hypotheses for clients also helps shorten therapy time. When clients are in jail, therapists usually do not have much time to affect therapy before inmates are transferred to another prison or released to go home. Therefore, an expedited form of psychodynamics, focusing on AT, can help therapists working with criminals devise significant treatments and interventions to help quickly alleviate some of their clients’ symptoms and ameliorate some of their issues.

AT is a natural outgrowth of psychodynamic theory. Some clients in jail will have the time to engage in the longer therapy that psychodynamic therapy recommends (16 weeks). My practicum used mainly brief and solution focused therapies that took much less time due to the obstacle of therapists only seeing clients for a few sessions. Yet an ever-present awareness of the important of attachments in clients’ lives still serves to put pieces of the puzzles together quickly when used along with these briefer therapies.

Therapists need to understand transference issues and repetition of client patterns to break their criminal cycle. This understanding can be supported by viewing client issues from an AT perspective. However, even within AT, controversy and debate on how much time it takes to develop disorders due to poor attachment, if and to what extent attachment styles can be changed still exists. 

To help therapists understand how AT can be used, they can begin by envisioning attachment styles on a continuum, and offering a logical and reasonable explanation of how different influences in clients’ lives can create different degrees of dysfunctional attachments. Using this continuum concept offers hope for reasonable change in clients. In turn, hope helps avoid therapist cynicism and burnout.

I try to keep an attachment continuum in mind when treating the women in jail. Most are antisocial but they do not all have Antisocial Personality Disorder. When conceiving their issues on a continuum with knowledge of the severity of their attachment disturbances, I can target more easily and quickly the types of interventions that may be most helpful for each individual client.

Bowlby (1988) also believed firmly that mothers have an enormous and crucial impact on the health of their children’s future attachments. Although the role of the mother vs. the father, the timing of absence from their children, the age of vulnerability to attachment damage is still hotly debated, most theorists ultimately agree that basic attachments need to be protected in order to create healthy adults. When treating the women in jail, I need to know if they have children to help them minimize attachment issues with their children. In this way, I hope to make small steps in moderating the cycle of criminality and mental illness in their families.

Even though therapists may not want to use or are limited in using psychodynamic or psychoanalytic therapy, the basis of both these theories can always positively influence therapists’ decisions for treatment, regardless of which modality they use, regardless of the length of treatment.

Because attachment theory naturally evolves into cognitive behavioral theories (Bowlby, 1988), the transition from perceiving clients’ issues from poor early relationships to implementing cognitive treatment to challenge faulty thinking has been found to be optimal when working with criminals. Rather than trying to do therapy with one hand tied behind the back, therapists can perceive of clients’ issues as an outgrowth mainly of attachment issues, more quickly understanding the foundation of their dysfunctions.


Bowlby (1988) strongly believed that anxious attachment issues affect everyone, not only clients. This certainly seems to be true when realizing that anxious attachments, whether ambivalent or avoidant, tend to help create criminal mentalities and therefore, negatively affect society in general. Karen (1998) believes that without understanding and valuing attachment issues, therapists will hamper the effect of their therapeutic relationships. Therefore, another way AT can be useful is to use transference of client attachments onto therapists to expedite progress in therapy.

However, different in technique and theory, “psychoanalysis” and “psychodynamics” are theories that both begin with the same premise: that people’s characters and lives are formed by their early relationships and experiences and that unconscious drives or motives create transference in clients’ relationships. AT takes the above theories and focuses it in such a way that makes a psychoanalytic/psychodynamic perspective useful, efficient, and productive for both clients and therapists.

Not only does the concept and awareness of AT help me in therapy with my clients, but it also is commensurate with my own personality. I have always considered myself introspective and analytical, with a desire to probe deeply into the family histories of others and myself to understand relationships and behavioral patterns. The compliments (and complaints!) of others in my life regarding my penchant for digging for psychological answers also act as testaments to these aspects of my character. I believe strongly that using a therapeutic approach that suits therapists’ temperaments and talents supports successful outcomes in therapy.



Yun Yi said...

Psachno, this is so interesting!
I had for very very long time wanted to be a psychologist but my fate did not cooperate. But my interest about human mind is always there.

Reading your posts is very educational to me, especially on profession of psychotherapy. I think you are in a such good stand on this profession and will do lots of good other your client.

I have watched TV show "In Treatment". Have you watched it? After reading your post I realized there is some Attachment Theory displayed in that show.

Yes, I fully agree with the tenant of Psychoanalysis and Psychodynamic, that our earlier experiences has dominating power to our life. I had read several self-helping books ("Toxic Parents", "Feeling Good", etc. ) and they helped me to dig deep into the childhood so that I could understand myself much better.

I am so glad you share this so I could have chance to learn lots of knowledge on psychology, especially psychotherapy.

Kevin Goodman said...

Interesting and informative posts.

According to some sociopath researchers, upwards of twenty percent of incarcerated persons are sociopaths. A lot of experts on sociopathy claim that therapy does not help them but even enables them as they learn to earn the therapists trust. What are your thoughts?

I realize a lot of incarcerated people just didn't have the proper upbringing or got messed up with the wrong influences.

I don't know much about attachment theory but I'm guessing it relates to enculturation and social learning theory.

It's really amazing how much a difference an upbringing can make. I'm thinking of examples of extreme depravity such as feral children. I'm sure you know that such cases result in permanent mental retardation with the victim never able to learn language.

I can only imagine that cases of mild abuse lead to life long cycles of self abuse.

Thanks for the informative posts...

PSACHNO said...

Yun Yi, I am so happy that you enjoyed the AT posts! Yes, I have seen "In Treatment". Both seasons. I love that show!! I remember seeing the one about AT, too. It is so gratifying to hear when someone gains from these posts. That is, for me, mission accomplished! Thanks so much for the comment.

While I don't believe in fate, I do believe in a kind of destiny...maybe you were meant to do something else with your life.

I think (the right) self-help books are wonderful! I have learned so much from some of them myself. Keep reading...

Thank you for your kind words. Unfortunately, my health does not allow me to practice anymore; I'm thinking of doing some coaching on line, though. (I don't have my license.) That was my was a difficult one to accept!

PSACHNO said...

Hi Kevin, So cool to have you comment on my post! I admire your mind and your education.

When you say "Sociopath" do you mean someone with Anti-social personality disorder (as there the diagnosis of sociopath is not in the DSM)?

Yes, I don't doubt that figure. And, on the Anti-social continuum, (those that don't quite have all the symptoms to fulfill the requirement for an Anti-social diagnosis), there are many more. I'm not a researcher, so I don't want to hazard a guess.

I did discover that some anti-socials seem to calm down as they grow older and become less criminal (that is, not acting out).

Yes, those theories overlap and cross AT. However, they do not account for the tenacity of the criminal brain.

I believe that early abuse impacts brain development. If the abuse is great enough, the damage may become irreversible--as you say, in feral children. Great example! There are so many factors, however, that determine whether a person will turn out a full-blown antisocial personality. Genetics comes to mind. Under the same severe abuse, some children do not develop antisocial tendencies. So interesting...

Thank goodness, our brains are plastic and we can repair damage and repair/change neural connections through education, care, nurturing, cognitive adjustment and behavioral changes and other aspects of therapy.

We used to teach them that they can change habits at fast as 21 days because the neural connections change. We taught them the rudimentary functions of the brain so they could understand. I liked that approach. It gave them hope at the very least, and that, as we all know, is so important. The recidivism rate dropped drastically in that program. (The program actually emphasized decision-making skills. Very cool.)

As anecdotal evidence, having worked years with criminal teens in a substance abuse program, I totally agree that if a child was well on the road to anti-social behavior, the things we taught them only helped them become better criminals! Legally, of course, we couldn't diagnose them anti-social until they were 18. But the really oppositional ones were well on their way. It was a conundrum, like so many aspects of institutionalized treatment!

Thanks for the comment! I'm so glad you enjoyed the post. I think understanding attachment theory is crucial to good therapy and encourage you to look into it. We are all affected by it and it explains so many aspects of our relationship patterns and behavior (e.g. choice of mate).

PSACHNO said...

I forgot to add that the psychoanalytical/psychodynamic mode of therapy is only effective with people who are intelligent and/or highly educated.

I have come to the conclusion that a very high number of criminals are exceptionally intelligent and talented. This discovery amazed me. They were very high functioning in some ways which may part of the reason they became criminals. They get bored easily, therefore, find it difficult to keep a job; to keep an income they steal, sell drugs, commit fraud (very common)--and breaking the law is exciting.

In addition, to complicate matters, many criminals also had borderline PD, driving them to substance abuse to block out the pain. The estimates on committing crime while under the influence are anywhere from 60-80%! Interesting, no?

Kevin Goodman said...

I do know some people that have been through a lot in their childhood and do well as adults--that to me is amazing.

Yea, sociopathy was replaced by antisocial behavior in the DSM but a few researchers insists it is something different. Antisocial, I believe, is much broader while sociopathy requires a (complete?) lack of remorse and empathy.

The Hare checklist for sociopathy is the main diagnostic criteria and in the UK a minor criminal offense with a sociopathy diagnosis is potentially life incarceration in a psychiatric unit.

I read an account of a man in the UK who beat a homeless man pretty hard for insulting his friend's girlfriend. He spent years in a psychiatric prison for that and faced potential life because he was diagnosed a sociopath. I think he eventually got out. While the crime was horrific, in the United States, most people would probably walk free the next day on bond and face a few months probation or short jail time following court.

On another note, it's interesting to see the success rate of criminal rehabilitation in countries that commit to that--such as the Scandinavian countries.

PSACHNO said...

Thanks for your comments, Kevin. Very informative. I didn't know all that...

There are several different theories on Anti-social PD. I do hope that research will help us understand the nuances.

Our prison systems suck. As we all know, there is no real rehabilitation there. The worst latest development? Privately owned prisons.

There is just no room and no money for the would-be killer...seeing as the prisons are packed with drug users and pushers. Now that's a priority to think about!

Kevin Goodman said...

Bizarre--I've not heard of private prisons but I suppose it should come as no surprise with private military companies being fairly central to the wars in Afghanistan and Iraq.

Yun Yi said...

Sorry to hear that your health did not allow you practice. I suppose it does take lots of courage and energy to do therapy for prisoners. I used to read some mysteries with such kind of stories and it was one of most fascinating jobs in the world. At least to me it is.

I do not know what kind of health problem you have, but it resonates my own health condition. I was a chronic health "issue" sufferer, just recently in a wonderful up climbing path to new life:-) The reason I use "issue" is because non of doctors could find anything wrong with me, yet I was deadly ill for years. That's how I started a blog for my physical part of my life.

Having been through this trouble water, I realized that our physical and mental health had a very tight connection. Of course I am sure you are not foreign with this concept as you are psychologist, and it has been quite a "fashion" nowaday to people to acknowledge how much our mental problems can do to our body. However what I mean is quite opposite: the impact our physical condition made to our mental condition is way more powerful than the other way around.
Of course I could be wrong. But it at least is my own experience. I used to underestimate my body problems, almost ignore its needs completely, until it was too late. And I paid a huge price, more than I could imagine before. But I do not have regret for the past. And the price I paid, might be just exactly how much my new life worth.:-)

However I hope your health gets better:-) . And I hope your online coaching prosperous. It sounds like a wonderful idea.


Most interesting blog. Put me down as a follower!

PSACHNO said...

@Kevin, yes, privately owned prisons are bizarre. They are a business; and the point of business is to make money. Imagine how that impacts the number, the need, to keep prisons filled! So, unethical.

PSACHNO said...

Yun Yi, thank you for your sympathetic post and for your good wishes. You make some excellent points.

Absolutely, the mind-body connection goes both ways. More and more research confirms this.

I am glad to hear you are on your way up. That you did something constructive with your life, despite your suffering is commendable!

I also don't regret how things turned out. I certainly don't regret my education and experience in the field of counseling, whatever happens. That knowledge is so valuable and practical. (By the way, I cannot call myself a psychologist; only people with a Ph.D. in psychology can do so.)

Thanks so much for your comment!

PSACHNO said...

Count Sneaky, I appreciate your comments! Thank you.