Attachment in Therapy: How the Therapeutic Alliance Affects Attachment Repair
Understanding and repairing attachment insecurities isn’t easy. When your own patterns feel confusing, it can be hard to imagine that anyone else could really “get” you. This is exactly why therapy for attachment issues begins with the bond you build with your therapist. Without this relationship, the rest of the work has nothing solid to stand on.
Repairing insecure attachment takes time, understanding, consistency – and healing experiences. A mental health professional knows how to structure therapy to ensure that you get the most out of the therapeutic bond. This page can help you better understand this relationship for getting the most out of therapy for attachment issues by considering:
- What attachment theory is
- What a therapeutic alliance is
- The importance of the therapist-client attachment relationship
- How the therapeutic alliance can support attachment repair
- Attachment ruptures and how they can be learning curves for future relationships
- What you should be looking for in the right therapist for you
- How Mission Connection can help you find the right therapist
What Is Attachment Theory?
Before considering the therapeutic alliance, it may be worth taking a moment to learn, or refresh, what attachment theory is all about. Attachment theory focuses on how the bonds we form early in life shape the way we connect in relationships throughout our development – even into adulthood.
There are four attachment styles: one secure and three insecure. These styles are not diagnostic, but they are useful ways of understanding our mental blueprints of our self-beliefs and beliefs of the world around us.
The following are brief descriptions of these four styles:
- Secure attachment: Those with a secure attachment are generally comfortable with closeness and trust that people will be there for them. This is usually developed early in life if caregivers consistently and sensitively meet their childrens’ needs.
- Avoidant attachment: This is when closeness may feel threatening, causing those with it to withdraw from or keep people at arm’s length. It can stem from needs (especially emotional ones) being rejected or punished during childhood.
- Anxious attachment: People with anxious attachment typically deeply desire closeness but worry it might disappear at any given point. This could lead to a fear of abandonment and a constant search for reassurance that current relationships won’t slip away. This may stem from inconsistent or unreliable caregiving in childhood.
- Disorganized attachment: Known as fearful-avoidant attachment in adulthood, this style can make someone feel as though they’re being pulled in two directions at once: wanting intimacy but fearing it at the same time. This style often stems from early experiences of trauma or fear.
You might recognize these attachment patterns in your life and decide to turn to therapy, either to understand their roots or to begin the process of repairing them. If so, a key part of that repair is the therapeutic alliance between you and your therapist.
What Is a Therapeutic Alliance?
At its core, the therapeutic alliance is the working relationship between a therapist and client. It’s built on trust and the shared understanding that both involved are working toward change. The alliance shouldn’t be viewed as a friendship; rather, a reliable partnership, one where you feel supported enough to face challenges and explore vulnerable parts of yourself.
Psychologist Edward Bordin states that in order to keep the therapeutic work on track, three main elements of treatment must be considered. These include:1
- Goals: Therapy works best when both people are clear about what they’re aiming for. What matters most is that the therapist and client agree on the direction they want the therapy to go and feel they’re moving forward as a team.
- Tasks: Once the goals are set, the work is focused on how you’re going to get there. This could come in the form of talking through difficult experiences or looking closely at patterns of your behavior. When the set tasks for achieving a goal make sense to you and feel relevant to your life, progress should happen more naturally.
- The Bond: Goals and tasks are important, but there’s also the emotional side of it all: the bond. When you believe your therapist is on your side, the hard work you need to put in might not feel so taxing. Yet, without this sense of connection, even the clearest goals and best tasks won’t carry much weight.
When these three elements come together, the alliance becomes a stable base for therapy. It creates the conditions where attachment repair can actually take place, making the relationship itself a central part of the healing process.
The Importance of the Therapist-Client Attachment Relationship
Out of the three core elements of the therapeutic alliance, the bond is often seen as the most important part.2 This is why therapists put so much focus on building real rapport, adjusting how they work so patterns of relating fit the person sitting in front of them.
When a bond is strong, certain aspects of therapy and the therapy room itself start to change. These include:
Feeling Like the Therapy Room Is a “Secure Base”
When the therapeutic bond is strong, the therapy room itself can begin to feel like a “secure base.” The regularity of sessions, the reliability of your therapist being there each week, and the steady attention they offer can give you something solid to lean on. This sense of stability may be new and refreshing for someone trying to repair deep-seated attachment issues, as consistency and secure bases may have been something they lacked.
The Therapist Becomes a “Safe Haven”
While the therapy environment becomes a secure base, therapists often act as a kind of “safe haven.” This means that, when distress rises, you have somewhere to turn for regulation and reassurance. You’re not being “rescued,” but you have someone in front of you that you can automatically view as “safe.” This facilitates a sense of safety in exploring past traumas, knowing that you won’t be judged or rejected for doing so.
It’s reasons like these that make the therapist–client relationship so central to healing or repairing attachment issues. The attachment bond in the relationship becomes a living example of security, trust, and repair, possibly experiences that many people missed in their earlier lives.
How the Therapeutic Alliance Supports Attachment Repair
When we look into the research behind how a strong therapeutic alliance helps with attachment repair, its importance becomes clear.
For instance, in a study of more than 3,000 people,3 those who already felt secure in their attachments tended to respond in therapy. Yet, interestingly, as long as there was a strong therapeutic alliance, people with an insecure attachment also responded well. So, in both cases, outcomes improved when the bond with the therapist was solid, which raises the real question: “Why does this relationship matter so much?”
Think of it like this: If a challenge or misunderstanding happens in sessions and they’re worked through together, you’re actively strengthening your own capacity for secure attachment outside of it. You’re also enabled to see others as trustworthy and reliable when it comes to accepting your emotions.
But of course, therapy isn’t a perfect science, and even strong alliances can hit bumps along the way. This is where ruptures enter the picture, and understanding them is key to seeing how repair really happens.
Ruptures in the Therapeutic Alliance When Working on Attachment Repair
Even though the therapeutic alliance provides a powerful pathway for healing attachment wounds, it doesn’t always unfold smoothly. Moments of tension or disconnection, often referred to as “ruptures,”4 are a natural part of the process.
A rupture might happen if a client feels misunderstood by a therapist’s comment, or if a therapeutic task feels unhelpful or uncomfortable. When these feelings are expressed openly, they can be addressed directly: the therapist may clarify, adjust the task, or acknowledge the client’s frustration. This kind of back-and-forth is a key part of repair.
Not all ruptures are voiced so clearly, though. Many people protect themselves from showing their distress outright. Instead, they might give “rupture markers,”5 subtle signs that something in the relationship feels strained. Rupture markers can take two main forms. First, some clients may “move away” from the rupture, disconnecting from their emotions or offering overly compliant reassurances (known as “withdrawal markers”).
Second, others may “move against” the therapist or the therapy itself, making critical or dismissive remarks that signal dissatisfaction (confrontation markers). Both types of responses reflect an awareness that something feels off, even if it isn’t spoken aloud.
Researchers have looked closely at these rupture moments and found that the way they play out often depends on a person’s underlying attachment style. In fact, a study that examined therapy transcripts during these moments of rupture markers found that different attachment styles created different kinds of communication outcomes.4
We provide a brief overview of these forms of communication below.
Communication Patterns in Attachment Styles:4
Based on the outcomes of the previous study, the different attachment styles tend to respond to ruptures in therapy in the following ways:
- Patients with secure attachment were typically able to express their feelings openly, which fits naturally with the work of repairing ruptures and moving forward
- Avoidant clients often minimized their own role in difficulties, leaving little space for genuine dialogue
- Preoccupied (anxious) clients tended to minimize the therapist’s role, which created another barrier to mutual repair
What this research highlights is that the very patterns clients struggle with outside therapy often reappear inside the therapeutic relationship. But this shouldn’t necessarily be viewed as a negative. Although avoidance and preoccupation can complicate the rupture resolution, they are actually opportunities to confront attachment dynamics directly.
In other words, if these communication patterns appear within therapy sessions, it gives both the therapist and patient a chance to practise new, healthier ways of relating. This is why the therapeutic alliance is vital in attachment repair: it not only supports the work of therapy but also reshapes how we relate to others in our lives.
Characteristics to Look For in a Therapist That’s Right for You
Therapists are human, too. No matter how professional or well-trained, they all bring their own style, strengths, and limitations into the room. Some may excel in certain areas of therapy but might be less suited to work that focuses on repairing attachment. This is where you get to flip the perspective back onto yourself. A therapist may be assessing you, but you should also be checking whether they tick the boxes for the kind of support you need.
Consider the following traits when looking for the right therapeutic fit for your needs:
Empathy and Genuineness
Research consistently shows that empathy and genuineness are two of the strongest qualities a therapist can bring.6 When you feel truly understood and accepted, trust can begin to grow, and this is essential when the aim is to repair attachment wounds.
Responsiveness
Difficult times in the alliance are inevitable, but how a therapist responds can make all the difference. Those who recognize moments of tension and meet them with care help you experience that relationships can be repaired rather than lost.7 This lived experience of repair can reshape how you approach closeness in everyday life.
Emotional regulation
A therapist’s ability to stay calm and grounded during difficult sessions provides a reliable base for you to lean on. In fact, research has found that a therapist’s ability to control their emotions was key to the alliance quality.8 When they stay calm and grounded in difficult sessions, it gives you the chance to reshape expectations of what safe relationships can feel like.
When you’re thinking about the right therapist for you, these are the qualities worth keeping in mind. After all, the alliance is a joint effort, and if it’s just not working between you, there are options.
Finding the right support with Mission Connection
Choosing the right therapist can feel daunting, but you don’t have to navigate it on your own. Mission Connection provides certified and experienced therapists who are carefully matched to each person, ensuring you work with someone best suited to your needs. If you’re looking for attachment repair, this means being placed with a therapist who has a wealth of experience in this area.
We also recognize that attachment issues rarely stand alone. Many people come to us with co-occurring concerns, and it’s important their care reflects the full picture of what they’re facing.
For this reason, Mission Connection offers treatment for a wide range of challenges, including:
- Trauma-related issues
- Depression
- Bipolar disorder
- Anxiety
- ADHD
- Schizophrenia
- Psychosis
- Self harm
- Anger issues
No matter what brings you to therapy, our approach centers on building strong therapeutic relationships for attachment healing while also addressing the other difficulties that may be impacting your life. With options to meet in person at one of our locations or connect remotely from home via telehealth, we make sure the process is flexible and designed to meet you where you are.
If you’re ready to take the next step, Mission Connection can connect you with the right therapist and the right setting for your journey. Reach out to our team today if you’re ready to get started.
References
- Ardito, R. B., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2, 270. https://doi.org/10.3389/fpsyg.2011.00270
- Opland, C., & Torrico, T. J. (2024). Psychotherapy and therapeutic relationship. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK608012/
- Levy, K. N., Kivity, Y., Johnson, B. N., & Gooch, C. V. (2018). Adult attachment as a predictor and moderator of psychotherapy outcome: A meta-analysis. Journal of Clinical Psychology, 74(11), 1996–2013. https://doi.org/10.1002/jclp.22685
- 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
- Samstag, L. W., & Muran, J. C. (2019). Ruptures, repairs, and reflections: Contributions of Jeremy D. Safran. Research in Psychotherapy: Psychopathology, Process and Outcome, 22(1), 376. https://doi.org/10.4081/ripppo.2019.376
- Yao, L., & Kabir, R. (2023, February 9). Person-centered therapy (Rogerian therapy). In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK589708/
- Levy Chajmovic, M., & Tishby, O. (2024). Therapists’ responsiveness in the process of ruptures and resolution: Are patients and therapists on the same page? Psychotherapy Research, 35(1), 1–12. https://doi.org/10.1080/10503307.2024.2303318
- 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, 784010. https://doi.org/10.3389/fpsyg.2021.784010
