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Attachment Disturbances: Treatment for Comprehensive Repair
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Winner of the 2018 International Society for the Study of Trauma and Dissociation (ISSTD) Pierre Janet Writing Award.
A comprehensive treatment approach for the repair and resolution of attachment disturbances in adults, for use in clinical settings.
With contributions by Paula Morgan-Johnson, Paula Sacks, Caroline R. Baltzer, James Hickey, Andrea Cole, Jan Bloom, and Deirdre Fay.Attachment Disturbances in Adults is a landmark resource for (1) understanding attachment, its development, and the most clinically relevant findings from attachment research, and (2) using this understanding to inform systematic, comprehensive, and clinically effective and efficient treatment of attachment disturbances in adults.
It offers an innovative therapeutic model and set of methods for treating adult patients with dismissing, anxious-preoccupied, or disorganized attachment. In rich detail, it integrates historical and leading-edge attachment research into practical, effective treatment protocols for each type of insecure attachment. Case transcripts and many sample therapist phrasings illustrate how to apply the methods in practice.
Part I, "Foundational Concepts," features a comprehensive overview of the field of attachment, including its history, seminal ideas, and existing knowledge about the development of attachment bonds and behaviors.
Part II, "Assessment," addresses the assessment of attachment disturbances. It includes an overview of attachment assessment for the clinician and a trove of practical recommendations for assessing patients' attachment behavior and status both outside of and within the therapeutic relationship.
In Part III, "Treatment," the authors not only review existing treatment approaches for attachment disorders in adults, but also introduce an unprecedented, powerful new treatment method. This method, the "Three Pillars" model, is built on three essential clinical ingredients:
- Systematically utilizing ideal parent figure imagery to develop a new positive, stable internal working model of secure attachment
- Fostering a range of metacognitive skills
- Fostering nonverbal and verbal collaborative behavior in treatment
Used together, these interdependent pillars form a unified and profoundly effective method of treatment for attachment disturbances in adults―a must for any clinician.
In Part IV, "Type-Specific Treatment," readers will learn specific variations of the three treatment pillars to maximize efficacy with each type of insecure attachment.
Finally, Part V, "A Treatment Guide and Expected Outcomes," describes treatment in a step-by-step format and provides a success-assessment guide for the Three Pillars approach.
This book is a comprehensive educational resource and a deeply practical clinical guide. It offers clinicians a complete set of tools for effective and efficient treatment of adult patients with attachment disturbances.
- ISBN-100393711528
- ISBN-13978-0393711523
- PublisherW. W. Norton & Company
- Publication date
2016
September 13
- Language
EN
English
- Dimensions
8.3 x 1.8 x 10.4
inches
- Length
752
Pages
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Editorial Reviews
Review
― PsychCentral
"I thoroughly recommend reading this book. . . . [F]ull of practical detail about the three-pillars method, and sample ‘scripts’ and sessions, which I found extremely valuable. I intend, when appropriate, to put the elements that I have described into practice."
― Human Givens Journal
"A masterpiece of integration, creativity, and clinical wisdom, Attachment Disturbances in Adults stands out as a vibrantly innovative treasure that will endure, one of those rare trail-blazers. Mental health professionals across disciplines will delight in the rich depth and breadth of this essential book, which seamlessly interweaves research, theory and treatment. Brown, Elliott and colleagues have written a tour de force that is surely destined to become an instant classic."
― Kathy Steele, MN, CS, Clinical Director, Metropolitan Counseling Services, and author of Coping with Trauma-Related Dissociation
"This is an incredibly important volume that makes a stunning contribution to the field. It spectacularly achieves an integration of the lifespan literature on attachment and its sequelae with intervention. Rarely does a scholarly work contribute to the understanding of the processes underlying attachment and its dysfunction while simultaneously providing a clearly delineated prescription for treatment. Practitioners will profit from the detailed clinical vignettes and researchers will gain many ideas warranting empirical investigation."
― Dante Cicchetti, PhD, McKnight Presidential Chair, Professor of Child Psychology and Psychiatry, Institute of Child Development, University of Minnesota
"This is an extraordinary achievement. The must-have book on attachment, it includes everything you need to know about attachment, and then some―history, research, typology AND treatment! Richly comprehensive, precise, and wise, it is honed by real clinical experience, with step-by-step treatment protocols tailored to each attachment classification. This book should be required reading for all graduate students in clinical programs, be they clinical psychology, psychiatry, counseling, or social work. It should be a sine qua non for all attachment researchers. It is a book that any clinician who works with trauma and attachment disturbances―which means all clinicians, for attachment disturbances underlie most major syndromes―should have and master."
― Diana Fosha, PhD, developer of AEDP, author of The Transforming Power of Affect, Director of the AEDP Institute
"Attachment Disturbances in Adults is a book of genius, an unequalled account of how far the attachment field has evolved since Bowlby's groundbreaking studies of attachment bonds. It presents an outstanding, encyclopedic, and integrative overview of theoretical understanding, assessment, and treatment. All this leads to a highly inspirational and effective treatment model, consisting of three "pillars": The Ideal Parent-Figure Protocol, Metacognitive Interventions for Attachment Disturbances, and Fostering Collaborative Capacity and Behavior. These pillars not only include the best of what has been written before in the attachment field, but also integrate the authors' wonderful work from other domains. This extraordinary book will set the bar for many years to come."
― Onno van der Hart, PhD, Emeritus Professor of Psychopathology of Chronic Traumatization, Utrecht University, and author of The Haunted Self
"Attachment Disturbances in Adults is a comprehensive resource for understanding attachment, its development, its dysfunctions, its assessments, and its treatments. It covers relevant research in all these areas, grounding it in evidence-based actualities. But it is the book's comprehensiveness, its thorough inclusiveness―not only with regard to all the important aspects of attachment but to the full field of treatment approaches available for each aspect, drawn together into a coherent and compelling synthesizing framework―that make it clearly the exemplary and definitive book to date on this extraordinary topic. A brilliant must-have for clinicians, therapists, and interested laypeople alike."
― Ken Wilber, Integral Psychology
About the Author
David S. Elliott, PhD, is a clinical psychologist and former president of the Rhode Island Psychological Association. He is on the faculty of the International School for Psychotherapy, Counseling, and Group Leadership, in St Petersburg, Russia, and teaches internationally on attachment, personality, and psychotherapy process.
Product details
- Publisher : W. W. Norton & Company (September 13, 2016)
- Language : English
- Hardcover : 752 pages
- ISBN-10 : 0393711528
- ISBN-13 : 978-0393711523
- Item Weight : 3.89 pounds
- Dimensions : 8.3 x 1.8 x 10.4 inches
- Best Sellers Rank: #242,796 in Books (See Top 100 in Books)
- #265 in Medical Psychotherapy TA & NLP
- #316 in Popular Psychology Psychotherapy
- #867 in Interpersonal Relations (Books)
- Customer Reviews:
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About the authors

Caroline R. Baltzer, Ph.D. practices Psychology based in Cambridge, Massachusetts. She uses Attachment theory and the methods outlined in this book in her work both as a psychotherapist and as a consultant in entrepreneurial settings.

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Deirdre Fay, MSW is a thought leader invested in helping people move their lives forward to Live, Work, and Love UnTriggered. She has 35 years of experience exploring the intersection of trauma, attachment, yoga and meditation which she calls a “Modern Day Bodhisattva Training.” A Bodhisattva is someone who transforms suffering into compassion. Healing then is not an accident but the sure result of consistent and persistent practice to develop a Solid, Steady, Secure Self.
Having meditated since the 70’s, then living in a yoga ashram for six years in the 80’s and 90s Deirdre brings a unique perspective to being in the body. In the 90’s Deirdre was asked to teach yoga and meditation to those on the dissociative unit at a major teaching hospital. Having amassed skill sets in trauma treatment (as a supervisor under the guidance of Bessel van der Kolk at the Trauma Center), attachment theory (13 years of training with Daniel Brown, PhD), embodying compassion (Compassion Focused Therapy; Mindful Self Compassion), body therapy (as a trainer in Sensorimotor Psychotherapy and LifeForce Yoga Practitioner) Deirdre uses an integrative approach which Chris Germer calls “a radically positive approach to healing trauma.” Her best-selling third book Becoming Safely Embodied (2021) is based on the life-changing skills groups for clinicians and clients. Deirdre is also the author of Attachment-Based Yoga & Meditation for Trauma Recovery (W.W. Norton, 2017), Becoming Safely Embodied Skills Manual (2007), and co-author of Attachment Disturbances for Adults (W.W. Norton, 2016) as well as the co-author of chapters in Neurobiological Treatments of Traumatic Dissociation. https://dfay.com/safeguide

Discover more of the author’s books, see similar authors, read author blogs and more

Discover more of the author’s books, see similar authors, read author blogs and more

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Top reviews from the United States
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After finding Dr. Brown while listening to an amazing interview and podcast, I dove right in. So much makes sense. Why are therapists using EMDR ( some improperly) as the new thing to attempt to heal trauma? Dan addresses reasons why interventions do not work without digging in first to the bone. Attachment trauma, relational trauma, attunement, formation of the various systems in the body-- how can you do therapy without addressing the foundational hurts?
Time to rethink things.
Telling your patients to read the Enneagram or Women Who Runs With Wolves-- not cutting the mustard
Top reviews from other countries
This book is huge, but every sentence is gold.
I needed this book.
I have many books on attachment theory. And books on how it relates to addiction, and even personality disorders.
But this book actually gives instruction on how to repair a disturbed attachment.







