How secure is the secure base? Romantic attachment, emotion regulation, and psychotherapists’ role as secure base figures

Submitted: October 27, 2023
Accepted: March 20, 2024
Published: April 22, 2024
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In 1988, Bowlby posited that the emotional availability of psychotherapists in establishing a secure base environment is influenced by their personal relational history. Despite the acknowledged influence of the therapist’s attachment on therapeutic processes and outcomes, the therapist’s role as a secure base figure has received insufficient attention. This study delves into the connection between psychotherapists’ attachment organization and their self-perceived roles as secure base figures within clinical contexts. Additionally, we explore the mediating role of emotion regulation processes in this context. The dataset comprises self-reports from 384 psychotherapists with diverse theoretical orientations. Our analysis reveals both direct and indirect effects of psychotherapists’ attachment on the provision of a secure base. Emotion regulation, specifically through the dimension of clarity, emerges as a significant mediator in this relationship. This study offers a distinctive contribution to deepening our understanding of the relational dynamics inherent to psychotherapeutic practice. It sheds light on the nuanced relation between attachment and emotion regulation, influencing the psychotherapist’s role as a secure base figure in psychotherapy. The discussion of the results additionally emphasizes key implications for clinical practice and therapists’ training.

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Anderson, T, Finkelstein, J. D., Horvath, S. A. (2020) The facilitative interpersonal skills method: Difficult psychotherapy moments and appropriate therapist responsiveness. Counseling Psychotherapy Research, 20, 463–469. https://doi.org/10.1002/capr.12302 DOI: https://doi.org/10.1002/capr.12302
Ávila, M., Cabral, J., & Matos, P. M. (2012). Identity in university students: The role of parental and romantic attachment. Journal of Adolescence, 35, 133–142. https://doi.org/10.1016/j.adolescence.2011.05.002 DOI: https://doi.org/10.1016/j.adolescence.2011.05.002
Barreto, J. F., & Matos, P. M. (2022). Attachment mismatches and alliance: Through the pitfalls of mentalizing countertransference. Psychoanalytic Psychology, 39, 276-279. https://doi.org/10.1037/pap0000410 DOI: https://doi.org/10.1037/pap0000410
Barreto, J. F., Nata, G., & Matos, P. M. (2020). Elaboration of countertransference experience and the workings of the working alliance. Psychotherapy, 57(2), 141–150. https://doi.org/10.1037/pst0000250 DOI: https://doi.org/10.1037/pst0000250
Batson, C. D., Fultz, J., & Schoenrade, P. A. (1987). Distress and empathy: two qualitatively distinct vicarious emotions with different motivational consequences. Journal of Personality, 55(1), 19-39. https://doi.org/10.1111/j.1467-6494.1987.tb00426.x DOI: https://doi.org/10.1111/j.1467-6494.1987.tb00426.x
Bennett, S. C. (2008). The interface of attachment, transference, and countertransference: Implications for the clinical supervisory relationship. Smith College Studies in Social Work, 78(2-3), 301-320. https://doi.org/10.1080/00377310802114635 DOI: https://doi.org/10.1080/00377310802114635
Bentler, P. M., & Chou, C. P. (1987). Practical issues in structural modeling. Sociological Methods & Research, 16, 78–117. DOI: https://doi.org/10.1177/0049124187016001004
Black, S., Hardy, G., Turpin, G., & Parry, G. (2005). Self-reported attachment styles and therapeutic orientation of therapists and their relationship with reported general alliance quality and problems in therapy. Psychology and Psychotherapy, 78(3), 363-377. https://doi.org/10.1348/147608305x43784 DOI: https://doi.org/10.1348/147608305X43784
Bowlby, J. (1973). Attachment and loss: Volume II: Separation, anxiety and anger. In Attachment and loss: Volume II: Separation, anxiety and anger (pp. 1-429). London: The Hogarth press and the institute of psycho-analysis.
Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. Basic Books.
Carvalho, H. M. (2010). In the search for the secure base: contributions from psychotherapists’ professional and developmental history. Doctoral dissertation. Faculty of Psychology and Sciences of Education University of Porto, https://hdl.handle.net/10216/131534
Carvalho, H. M. & Matos, P. M. (2016). Being and becoming a psychotherapist in Portugal: A dialogue between personal and professional experiences. In L. Jennings & T. M Skovholt (Eds.), Expertise in Counseling and Psychotherapy: Master Therapist Studies from around the World (pp. 93-126). Oxford University Press http://dx.doi.org/10.1093/med:psych/9780190222505.003.0004 DOI: https://doi.org/10.1093/med:psych/9780190222505.003.0004
Carvalho, H. M., & Matos, P. M. (2021). Psychotherapist as a secure base figure: Validation of the Secure Base Questionnaire (SBQ). Professional Psychology: Research and Practice, 52(4), 396-405. https://doi.org/10.1037/pro0000366 DOI: https://doi.org/10.1037/pro0000366
Cassidy, J. (1994). Emotion regulation: Influences of attachment relationships. Monographs of the Society for Research in Child Development, 59(2-3), 228-249. https://doi.org/10.1111/j.1540-5834.1994.tb01287.x DOI: https://doi.org/10.1111/j.1540-5834.1994.tb01287.x
Clark, G. I., Rock, A. J., Clark, L. H., & Murray‐lyon, K. (2020). Adult attachment, worry and reassurance seeking: Investigating the role of intolerance of uncertainty. Clinical Psychologist, 24(3), 294-305. https://doi.org/10.1111/cp.12218 DOI: https://doi.org/10.1111/cp.12218
Cologon, J., Schweitzer, R. D., King, R., & Nolte, T. (2017). Therapist reflective functioning, therapist attachment style and therapist effectiveness. Administration and Policy in Mental Health and Mental Health Services Research, 44(5), 614-625. https://doi.org/10.1007/s10488-017-0790-5 DOI: https://doi.org/10.1007/s10488-017-0790-5
Crowell, J. A., Treboux, D., & Waters, E. (2002). Stability of attachment representations: The transition to marriage. Developmental Psychology, 38, 467-479. https://doi.org/10.1037/0012-1649.38.4.467 DOI: https://doi.org/10.1037//0012-1649.38.4.467
Daniel, S. I. (2006). Adult attachment patterns and individual psychotherapy: A review. Clinical Psychology Review, 26(8), 968-984. https://doi.org/https://doi.org/10.1016/j.cpr.2006.02.001 DOI: https://doi.org/10.1016/j.cpr.2006.02.001
Degnan, A., Seymour-Hyde, A., Harris, A., & Berry, K. (2016). The role of therapist attachment in alliance and outcome: A systematic literature review. Clinical Psychology and Psychotherapy, 23(1), 47-65. https://doi.org/10.1002/cpp.1937 DOI: https://doi.org/10.1002/cpp.1937
DiStefano, C., & Hess, B. (2005). Using confirmatory factor analysis for construct validation: an empirical review. Journal of Psychoeducational Assessment, 23, 225-241. https://doi.org/10.1177/073428290502300303 DOI: https://doi.org/10.1177/073428290502300303
Dozier, M., Bernard, K., & Roben, C. (2018). Attachment and biobehavioral Catch-up. In H. S. M. Steele (Ed.), Handbook of Attachment-Based Interventions. The Guildford Press.
Dozier, M., Davis, K., & Barnett, L. (1994). Clinicians as caregivers: Role of attachment organization in treatment. Journal of Consulting and Clinical Psychology, 62, 793-800. https://doi.org/10.1037//0022-006X.62.4.793 DOI: https://doi.org/10.1037//0022-006X.62.4.793
Fabi, S., Weber, L. A., & Leuthold, H. (2019). Empathic concern and personal distress depend on situational but not dispositional factors. PLOS ONE, 14(11), e0225102-e0225102. https://doi.org/10.1371/journal.pone.0225102 DOI: https://doi.org/10.1371/journal.pone.0225102
Farber, B. A., & Metzger, J. A. (2009). The therapist as secure base. In J. H. Obegi & E. Berant (Eds.), Attachment theory and research in clinical work with adults (pp. 46-70). The Guilford Press.
Fuertes, J. N., Moore, M., & Ganley, J. (2019). Therapists’ and clients’ ratings of real relationship, attachment, therapist self-disclosure, and treatment progress. Psychotherapy Research, 29(5), 594-606. https://doi.org/10.1080/10503307.2018.1425929 DOI: https://doi.org/10.1080/10503307.2018.1425929
Goldfried, M. R. (2001). How therapists change: Personal and professional reflections. American Psychological Association. https://doi.org/10.1037/10392-000 DOI: https://doi.org/10.1037/10392-000
Goodwin, I., Holmes, G., Cochrane, R., & Mason, O. (2003). The ability of adult mental health services to meet clients' attachment needs: The development and implementation of the Service Attachment Questionnaire. Psychology and Psychotherapy: Theory, Research and Practice, 76(2), 145-161. https://doi.org/10.1348/147608303765951186 DOI: https://doi.org/10.1348/147608303765951186
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2, 271–299. DOI: https://doi.org/10.1037//1089-2680.2.3.271
Heinonen, E., & Nissen-Lie, H. A. (2020). The professional and personal characteristics of effective psychotherapists: a systematic review. Psychotherapy Research, 30(4), 417-432. https://doi.org/10.1080/10503307.2019.1620366 DOI: https://doi.org/10.1080/10503307.2019.1620366
Hiebler-Ragger, M., Nausner, L., Blaha, A., Grimmer, K., Korlath, S., Mernyi, M., & Unterrainer, H. F. (2021). The supervisory relationship from an attachment perspective: Connections to burnout and sense of coherence in health professionals. Clinical Psychology & Psychotherapy, 28(1), 124-136. https://doi.org/10.1002/cpp.2494 DOI: https://doi.org/10.1002/cpp.2494
Holmes, J. (2011, 2011/06/01). Attachment in the consulting room: towards a theory of therapeutic change. European Journal of Psychotherapy & Counselling, 13(2), 97-114. https://doi.org/10.1080/13642537.2011.570013 DOI: https://doi.org/10.1080/13642537.2011.570013
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55. https://doi.org/10.1080/10705519909540118 DOI: https://doi.org/10.1080/10705519909540118
Jackson, D. L. (2003). Revisiting sample size and number of parameter estimates: Some support for the N: q hypothesis. Structural equation modeling, 10(1), 128-141. DOI: https://doi.org/10.1207/S15328007SEM1001_6
Jackson, D. L. (2001). Sample size and the number of parameter estimates in maximum likelihood confirmatory factor analysis: A Monte Carlo investigation. Structural Equation Modeling, 8, 205–223. DOI: https://doi.org/10.1207/S15328007SEM0802_3
Kanninen, K., Salo, J., & Punamäki, R. L. (2000). Attachment patterns and working alliance in trauma therapy for victims of political violence. Psychotherapy Research, 10(4), 435- 449. doi: 10.1093/ptr/10.4.435 DOI: https://doi.org/10.1093/ptr/10.4.435
Kline, R. (2016). Principles and practice of structural equation modeling (4th ed.). Guilford Press.
Kunce, L. J., & Shaver, P. R. (1994). An attachment-theoretical approach to caregiving in romantic relationships. In K. Bartholomew & D. Perlman (Eds.), Advances in personal relationships: Attachment processes in adulthood (Vol. 5, pp. 205-237). Kingsley.
Lance, C. E., Butts, M. M., & Michels, L. C. (2006). The sources of four commonly reported cutoff criteria. What did they really say? Organizational Research Methods, 9(2), 202-220. https://doi.org/10.1177/1094428105284919 DOI: https://doi.org/10.1177/1094428105284919
Levy, K. N., Ellison, W. D., Scott, L. N., & Bernecker, S. L. (2011). Attachment style. Journal of Clinical Psychology, 67(2), 193-203. https://doi.org/10.1002/jclp.20756 DOI: https://doi.org/10.1002/jclp.20756
Levy, K. N., & Johnson, B. N. (2019). Attachment and psychotherapy: Implications from empirical research. Canadian Psychology / Psychologie Canadienne, 60(3), 178–193. https://doi.org/10.1037/cap0000162 DOI: https://doi.org/10.1037/cap0000162
Ligiéro, D. P., & Gelso, C. J. (2002). Countertransference, attachment, and the working alliance: The therapist's contribution. Psychotherapy: Theory, Research, Practice, Training, 39(1), 3-11. https://doi.org/10.1037/0033-3204.39.1.3 DOI: https://doi.org/10.1037//0033-3204.39.1.3
Lu, Y., Kivlighan Jr, D. M., Hill, C. E., & Gelso, C. J. (2021). Therapist initial attachment style, changes in attachment style during training, and client outcome in psychodynamic psychotherapy. Journal of Counseling Psychology, https://doi.org/10.1037/cou0000557 DOI: https://doi.org/10.1037/cou0000557
Mallinckrodt, B., Anderson, M. Z., Choi, G., Levy, K. N., Petrowski, K., Sauer, E. M., Tishby, O., & Wiseman, H. (2017). Pseudosecure vs. individuated-secure client attachment to therapist: Implications for therapy process and outcome. Psychotherapy Research, 27(6), 677-691. https://doi.org/10.1080/10503307.2016.1152411 DOI: https://doi.org/10.1080/10503307.2016.1152411
Matos, P. M., & Costa, M. E. (2001b). Questionário de Vinculação Amorosa [Romantic Attachment Questionnaire]. Unpublished manuscript. Faculty of Psychology and Sciences of Education University of Porto.
Mikulincer, M. (1997). Adult attachment style and information processing: Individual differences in curiosity and cognitive closure. Journal of Personality and Social Psychology, 72(5), 1217–1230. https://doi.org/10.1037/0022-3514.72.5.1217 DOI: https://doi.org/10.1037//0022-3514.72.5.1217
Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics and change. Guilford Press.
Mikulincer, M., & Shaver, P. R. (2019). Attachment orientations and emotion regulation. Current Opinion in Psychology, 25, 6-10. https://doi.org/https://doi.org/10.1016/j.copsyc.2018.02.006 DOI: https://doi.org/10.1016/j.copsyc.2018.02.006
Mikulincer, M., Shaver, P. R., & Berant, E. (2013). An attachment perspective on therapeutic processes and outcomes. Journal of Personality, 81(6), 606-616. https://doi.org/10.1111/j.1467-6494.2012.00806.x DOI: https://doi.org/10.1111/j.1467-6494.2012.00806.x
Miller-Bottome, M., Talia, A., Safran, J. D., & Muran, J. C. (2018). Resolving alliance ruptures from an attachment-informed perspective. Psychoanalytic Psychology, 35(2), 175-183. https://doi.org/10.1037/pap0000152 DOI: https://doi.org/10.1037/pap0000152
Mueller, R. O. (1997). Structural equation modeling: Back to the basics. Structural Equation Modeling, 4, 353–369. DOI: https://doi.org/10.1080/10705519709540081
Najavits, L. M. (2000). Researching therapist emotions and countertransference. Cognitive and Behavioral Practice, 7(3), 322-328. https://doi.org/https://doi.org/10.1016/S1077-7229(00)80090-5 DOI: https://doi.org/10.1016/S1077-7229(00)80090-5
Newman, D. A. (2014). Missing data: Five practical guidelines. Organizational Research Methods, 17(4), 372-411. https://doi.org/10.1177/1094428114548590 DOI: https://doi.org/10.1177/1094428114548590
Palmer, B., Gignac, G., Bates, T., & Stough, C. (2003). Examining the structure of the trait meta‐mood scale. Australian Journal of Psychology, 55(3), 154-158. DOI: https://doi.org/10.1080/0004953042000298612
Parada-Fernández, P., Herrero-Fernández, D., Oliva-Macías, M., & Rohwer, H. (2021). Analysis of the mediating effect of mentalization on the relationship between attachment styles and emotion dysregulation. Scandinavian Journal of Psychology, 62(3), 312-320. https://doi.org/https://doi.org/10.1111/sjop.12717 DOI: https://doi.org/10.1111/sjop.12717
Pistole, M. C. (1999). Caregiving in attachment relationships: A perspective for counselors. Journal of Counseling & Development, 77(4), 437-446. https://doi.org/10.1002/j.1556-6676.1999.tb02471.x DOI: https://doi.org/10.1002/j.1556-6676.1999.tb02471.x
Romano, V., Fitzpatrick, M., & Janzen, J. (2008). The secure-base hypothesis: Global attachment, attachment to counselor, and session exploration in psychotherapy. Journal of Counseling Psychology, 55(4), 495-504. https://doi.org/10.1037/a0013721 DOI: https://doi.org/10.1037/a0013721
Rubino, G., Barker, C., Roth, T., & Fearon, P. (2000). Therapist empathy and depth of interpretation in response to potential alliance ruptures: The role of therapist and patient attachment styles. Psychotherapy Research, 10(4), 408-420. https://doi.org/10.1093/ptr/10.4.408 DOI: https://doi.org/10.1093/ptr/10.4.408
Ruiz-Aranda, D., Cardoso-Álvarez, S., & Fenollar-Cortés, J. (2021). Therapist attachment and the working alliance: The moderating effect of emotional regulation. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.784010 DOI: https://doi.org/10.3389/fpsyg.2021.784010
Salovey, P., Mayer, J. D., Goldman, S., Turvey, C., & Palfai, T. (1995). Emotional attention, clarity and repair: exploring emotional intelligence using the Trait Meta-Mood scale. In J. W. Pennebaker (Ed.), Emotion, disclosure and health (pp. 125-154). American Psychological Association. DOI: https://doi.org/10.1037/10182-006
Sauer, E. M., Lopez, F. G., & Gormley, B. (2003). Respective contributions of therapist and client attachment orientations to the development of the early working alliance: A preliminary growth modeling study. Psychotherapy Research, 13(3), 371–382. https://doi.org/10.1093/ptr/kpg027 DOI: https://doi.org/10.1093/ptr/kpg027
Schauenburg, H., Buchheim, A., Beckh, K., Nolte, T., Brenk-Franz, K., Leichsenring, F., Strack, M., & Dinger, U. (2010). The influence of psychodynamically oriented therapists' attachment representations on outcome and alliance in inpatient psychotherapy. Psychotherapy Research, 20(2), 193-202. https://doi.org/10.1080/10503300903204043 DOI: https://doi.org/10.1080/10503300903204043
Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of- fit measures. Methods of Psychological Research Online, 8(2), 23-74.
Shaver, P. R., Schachner, D. A., & Mikulincer, M. (2005). Attachment style, excessive reassurance seeking, relationship processes, and depression. Personality and Social Psychology Bulletin, 31(3), 343-359. https://doi.org/10.1177/0146167204271709 DOI: https://doi.org/10.1177/0146167204271709
Shaver, P. R., & Mikulincer, M. (2014). Adult attachment and emotion regulation. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 237–250). The Guilford Press.
Shrout, P. E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422- 445. https://doi.org/10.1037/1082-989X.7.4.422 DOI: https://doi.org/10.1037//1082-989X.7.4.422
Slade, A., & Holmes, J. (2019). Attachment and psychotherapy. Current Opinion in Psychology, 25, 152-156. https://doi.org/https://doi.org/10.1016/j.copsyc.2018.06.008 DOI: https://doi.org/10.1016/j.copsyc.2018.06.008
Steel, C., Macdonald, J. and Schroder, T. (2018). A systematic review of the effect of therapists’ internalized models of relationships on the quality of the therapeutic relationship. Journal of Clinical Psychology, 74, 5-42. https://doi.org/10.1002/jclp.22484 DOI: https://doi.org/10.1002/jclp.22484
Stricker, G. (2002), What is a scientist-practitioner anyway? Journal of Clinical Psychology, 58, 1277-1283. https://doi.org/10.1002/jclp.10111 DOI: https://doi.org/10.1002/jclp.10111
Talia, A., Miller-Bottome, M., & Daniel, S. I. F. (2017). Assessing attachment in psychotherapy: Validation of the Patient Attachment Coding System (PACS). Clinical Psychology & Psychotherapy, 24(1), 149-161. https://doi.org/10.1002/cpp.1990 DOI: https://doi.org/10.1002/cpp.1990
Talia, A., Taubner, S., & Miller-Bottome, M. (2019). Advances in research on attachment-related psychotherapy processes: seven teaching points for trainees and supervisors. Research in Psychotherapy: Psychopathology, Process and Outcome, 22(3), 405. https://doi.org/10.4081/ripppo.2019.405 DOI: https://doi.org/10.4081/ripppo.2019.405
Talia, A., Muzi, L., Lingiardi, V., & Taubner, S. (2020). How to be a secure base: therapists' attachment representations and their link to attunement in psychotherapy. Attachment Human Development, 22(2), 189-206. https://doi.org/10.1080/14616734.2018.1534247 DOI: https://doi.org/10.1080/14616734.2018.1534247
Thompson, R. A. (2008). Attachment-related mental representations: Introduction to the special issue. Attachment Human Development, 10(4), 347-358. https://doi.org/10.1080/14616730802461334 DOI: https://doi.org/10.1080/14616730802461334
Tyrrell, C. L., Dozier, M., Teague, G. B., & Fallot, R. D. (1999). Effective treatment relationships for persons with serious psychiatric disorders: the importance of attachment states of mind. Journal of Consulting and Clinical Psychology, 67(5), 725. https://doi.org/10.1037//0022-006x.67.5.725 DOI: https://doi.org/10.1037//0022-006X.67.5.725
Vieira, J., Ávila, M., & Matos, P. M. (2012). Attachment and parenting: The mediating role of work-family balance in Portuguese parents of pre-school children. Family Relations 61, 31–50. https://doi.org/10.1111/j.1741-3729.2011 .00680.x DOI: https://doi.org/10.1111/j.1741-3729.2011.00680.x
Waters, E., & Cummings, E. M. (2000). A secure base from which to explore close relationships. Child Development, 71(1), 164-172. https://doi.org/10.1111/1467-8624.00130 DOI: https://doi.org/10.1111/1467-8624.00130
Weston, R., & Gore, P. A. (2006). A brief guide to Structural Equation Modeling. The Counseling Psychologist, 34, 719–751. doi:10.1177/0011000006286345 DOI: https://doi.org/10.1177/0011000006286345
Woodhouse, S. S., Powell, B., Cooper, G., Hoffman, K., & Cassidy, J. (2018). The circle of security intervention: Design, research, and implementation. In H. Steele & M. Steele (Eds.), Handbook of attachment-based interventions (pp. 50–78). The Guilford Press.

How to Cite

Carvalho, H., Nata, G., & Mena Matos, P. (2024). How secure is the secure base? Romantic attachment, emotion regulation, and psychotherapists’ role as secure base figures. Research in Psychotherapy: Psychopathology, Process and Outcome, 27(1). https://doi.org/10.4081/ripppo.2024.733

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