Pablo crash lands on the therapist’s sofa. He smiles widely, and comments on how beautiful the ZZ plant (Zamioculcas zamiifolia) next to the sofa is.

“Have you been working out of here long?”, he asks.

Pablo doesn’t look like a man with a problem.

“What is it that you need my help with, Pablo?”, asks the therapist.

That’s it. This is the moment when the attachment relationship is activated.

If you are the therapist (or the ZZ plant), you can see it. He starts blinking. His shoulders tighten. He begins to rub his hands together. 

Pablo starts talking quickly, still smiling widely. His anxiety has been out of control, he dreads going to work, he makes frequent trips to the loo, he…

“Can I interrupt you Pablo?”

“Yes, sorry I know a I talk a lot, hehe”.

“Did you notice that when I asked you what you need my help with your anxiety shot up?”

“Uhm, no. Maybe?”

Pablo has within 5 seconds let the therapist know that:

–              He is unaware of when he becomes anxious. It is very likely that by the time he notices it the anxiety is huge.

–              He unconsciously manages the anxiety by distracting attention away from himself (defence), talking over himself quickly (defence), laughing his anxiety off (defence).

But most importantly that the idea of forming a dependent relationship is stirring up feelings that trigger a surge of anxiety.

“I noticed that you started to blink, your shoulders tightened, and you started to rub your hands together”.

“I did, didn’t I? Hehe. Yeah, I do actually feel quite tense, hehe.”

“Pablo, do you notice that when we pay careful attention to you and your anxiety you laugh it off?

Pablo goes quiet. He starts to look away (defence). He has been spotted. He starts tapping his feet fast. The anxiety is rising.

The therapist decides to take a risk.

“Pablo how do you feel about being here with me today, underneath the anxiety?”

There is a moment when the therapist holds his breath. He knows he’s pushed back against what might be a lifelong habit of self-neglect. This is the spirit of attachment Based ISTDP. You are trying to reach the person underneath the defences, underneath the anxiety, the person who wants to connect, to be seen, and to be known, the person who wishes to feel his feelings deeply and fully in the presence of another person.

Pablo’s eyes water up.

“I don’t know what’s happened to me sorry, hehe”. He wipes his eyes.

“There is a rise of feeling inside”, says the therapist.

You can almost see Pablo’s unconscious mind spinning, wondering whether this guy is for real. Whether he really wants to know what Pablo feels inside.

Today we’re a bit lucky.

Pablo’s eyes well up again.



What do you think happened here? Leave comment below, or here 😊


Photography by @mtchllhrtly