Gaining awareness of attachment dynamics can empower individuals with rare diseases to enhance their emotional and relational well-being. The following strategies can help them cultivate healthier relationships and improve their psychological resilience. 

1. Recognize Emotional Responses 

Cultivating self-awareness about emotional responses is vital. Understanding how attachment styles influence reactions can help patients navigate relationships more effectively. For instance, recognizing anxious behaviors can prompt patients to communicate their needs openly rather than relying on others to intuit them. 

2. Communicate Openly 

Clear communication is critical in mitigating misunderstandings rooted in attachment dynamics. Patients should express their feelings using “I” statements to foster understanding and reduce defensiveness in conversations. For example, saying, “I feel anxious when my symptoms flare up, and I need you to listen” can clarify needs without placing blame. 

3. Seek Support Networks 

Engaging with support networks can alleviate feelings of isolation. Sharing experiences with others who understand the challenges of living with a rare disease can reinforce a sense of belonging and mitigate the effects of insecure attachments. 

4. Establish Boundaries 

Setting healthy boundaries is crucial for both patients and caregivers. Clients should recognize when emotional demands become overwhelming and communicate these limits to others, fostering healthier relational dynamics. 

5. Practice Self-Compassion 

Cultivating self-compassion is essential for emotional resilience. Recognizing that struggles are valid and allowing space for grief over lost normalcy can promote healing and self-acceptance. This practice can also counteract the negative self-talk often associated with insecure attachment styles. 

6. Embrace Narrative Flexibility 

Patients can benefit from reframing their narratives to focus on resilience and growth. Acknowledging challenges while also recognizing strengths can shift perspectives and enhance emotional well-being. 

7. Seek Professional Support 

Clients are encouraged to seek professional support tailored to their unique experiences. Mental health professionals can provide insights into attachment dynamics, helping individuals navigate their relationships and develop healthier coping strategies. Therapy can also help address cognitive distortions and enhance emotional regulation skills. 

The interplay between attachment theory, the complexities of rare diseases, and the psychological dynamics at play illustrates how attachment styles profoundly influence emotional and relational well-being. By understanding how their attachment dynamics shape their experiences, individuals can enhance their emotional resilience and foster healthier relationships. Ultimately, these considerations, combined with professional support, can lead to improved mental health outcomes and a more fulfilling life, despite the challenges posed by rare diseases. 

Iguaraya (Igua) Morales, Psychological Associate (Supervised Practice), is a bilingual psychologist (English and Spanish) with over 30 years of experience. She provides psychological services to adults, families, and communities, addressing challenges such as behavioral issues, emotional regulation, and psychosocial difficulties. Iguaraya uses an integrative approach, combining Humanistic (Person-Centered, Emotion-Focused) and Cognitive-Behavioral techniques, tailored to the unique needs of her clients. She also incorporates mindfulness and yoga practices to promote holistic well-being. In addition to her clinical work, Iguaraya Morales has a distinguished career as a professor, mentoring students and professionals in psychology and research. Based in Ontario, she is registered with the College of Psychologists of Ontario. 

References 

Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Erlbaum. 

Bowlby, J. (1982). Attachment and loss: Vol. 1. Attachment (2nd ed.). Basic Books. 

Understanding the psychological dynamics at play can provide deeper insights into how attachment styles manifest in the context of rare diseases. By examining these patterns, individuals can take proactive steps to strengthen their emotional and relational well-being. 

Emotional Regulation 

Individuals with secure attachments typically possess better emotional regulation skills, which enable them to cope with the stress of chronic illness. In contrast, those with insecure attachments may struggle to manage their emotions, leading to heightened anxiety, depression, or anger. This emotional dysregulation can negatively affect their relationships, as they may react disproportionately to perceived threats or misunderstandings. 

Fear of Intimacy and Trust Issues 

Patients with avoidant attachment styles may have difficulty trusting others and fear intimacy, leading to a reluctance to seek help or share their experiences. This fear can prevent them from forming meaningful connections and hinder their ability to communicate needs effectively, creating a cycle of isolation and emotional distress. 

Cognitive Distortions 

Insecurely attached individuals may be prone to cognitive distortions, such as catastrophizing or black-and-white thinking. For example, they might view a partner’s inability to understand their illness as a personal rejection rather than recognizing it as a limitation of the partner’s understanding. These distorted perceptions can fuel conflict and deepen relational rifts. 

How Therapy Can Help 

Therapy can be instrumental in identifying and restructuring maladaptive thought patterns and emotional responses. By working with a therapist, individuals can: 

• Develop healthier coping strategies to manage emotional dysregulation. 
• Challenge cognitive distortions and reframe negative thought patterns. 
• Build trust and intimacy in relationships by addressing attachment-related fears. 
• Strengthen communication skills to express needs and emotions more effectively. 

Iguaraya (Igua) Morales, Psychological Associate (Supervised Practice), is a bilingual psychologist (English and Spanish) with over 30 years of experience. She provides psychological services to adults, families, and communities, addressing challenges such as behavioral issues, emotional regulation, and psychosocial difficulties. Iguaraya uses an integrative approach, combining Humanistic (Person-Centered, Emotion-Focused) and Cognitive-Behavioral techniques, tailored to the unique needs of her clients. She also incorporates mindfulness and yoga practices to promote holistic well-being. In addition to her clinical work, Iguaraya Morales has a distinguished career as a professor, mentoring students and professionals in psychology and research. Based in Ontario, she is registered with the College of Psychologists of Ontario. 

Attachment theory, developed by John Bowlby and Mary Ainsworth, posits that the quality of early caregiver relationships profoundly influences an individual’s emotional and social development. Secure attachments promote emotional regulation and resilience, while insecure attachments characterized by anxiety, avoidance, or ambivalence can impair relational functioning and emotional well-being (Bowlby, 1982; Ainsworth et al., 1978). Understanding these dynamics is crucial for individuals facing the challenges of rare diseases, as their experiences may shape and reinforce particular attachment patterns in significant ways. 

The Unique Challenges of Rare Diseases 

Individuals diagnosed with rare diseases encounter specific challenges that can significantly influence their attachment styles and relational dynamics. These challenges often stem from the uncertainty, social impact, and caregiver relationships that accompany their condition. Below are some of the key ways in which rare diseases may interact with attachment dynamics: 

1. Chronic Uncertainty and Anxiety 

The unpredictable nature of rare diseases often leads to chronic anxiety. Patients may develop an anxious attachment style, marked by hyper-vigilance and a constant fear of abandonment. This anxiety can manifest in relationships as a heightened need for reassurance or an over-dependence on caregivers, leading to a cycle of anxiety and relational strain. 

2. Social Isolation and Stigmatization 

Many individuals with rare diseases experience profound social isolation due to a lack of understanding from others. This social withdrawal can reinforce an avoidant attachment style, where patients may distance themselves emotionally or physically from others to protect their feelings. This avoidance can create barriers to building and maintaining supportive relationships, further exacerbating feelings of loneliness and unworthiness.

3. Caregiver Dynamics and Attachment Disruptions 

The emotional toll on caregivers can create complex relational dynamics. Caregivers may experience burnout, leading to either enmeshment (where boundaries become blurred) or emotional withdrawal. For instance, a caregiver may become overly involved, inadvertently fostering dependency and inhibiting the patient’s autonomy. Alternatively, if the caregiver withdraws emotionally due to their own distress, the patient may feel abandoned, reinforcing insecure attachment behaviors. 

The Role of Therapy in Addressing These Challenges 

Therapeutic interventions can help individuals with rare diseases recognize and address attachment-related challenges. Therapy provides a safe space to explore relational patterns, develop healthier coping mechanisms, and foster emotional resilience. Through approaches such as Emotion-Focused Therapy (EFT), Cognitive-Behavioral Therapy (CBT), and mindfulness-based practices, individuals can work toward: 

• Identifying attachment patterns and their impact on relationships.
• Developing secure relational strategies to navigate uncertainty and social isolation. 
• Enhancing communication skills to express needs effectively. 
• Supporting caregivers in setting healthy boundaries while maintaining emotional connection. 

Iguaraya (Igua) Morales, Psychological Associate (Supervised Practice), is a bilingual psychologist (English and Spanish) with over 30 years of experience. She provides psychological services to adults, families, and communities, addressing challenges such as behavioral issues, emotional regulation, and psychosocial difficulties. Iguaraya uses an integrative approach, combining Humanistic (Person-Centered, Emotion-Focused) and Cognitive-Behavioral techniques, tailored to the unique needs of her clients. She also incorporates mindfulness and yoga practices to promote holistic well-being. In addition to her clinical work, Iguaraya Morales has a distinguished career as a professor, mentoring students and professionals in psychology and research. Based in Ontario, she is registered with the College of Psychologists of Ontario. 

 The idea of being ‘authentic’ pops up often in popular psychology. It’s now common parlance to say, ‘just be yourself’. But if you are like me, at some point, you might have frustratingly wondered what does that mean? And what does it mean when we are not being authentic?   

Dr. Donald Winnicott’s theory of true and false self is helpful in answering these questions. In his work as a pediatrician and psychoanalyst, he saw infants as essentially a ball of needs and desires that expresses themselves spontaneously through cries, laughs, screams, and bites. Healthy development, in his view, requires a period when the child doesn’t have to be concerned with the worries and expectations of those who are taking care of them. This requires caregivers to adapt and create a holding environment that allows them to express themselves however they wish. This period of authenticity is the foundation for building a self that knows what I like what I don’t like, what my interests and passions are, and a sense that my needs are legitimate, and I can reasonably expect others to respond to them. 

We run into trouble when we are required to comply to the demands of others far too early and not having experienced much of that holding environment that allowed us to be ourselves. Perhaps a parent was depressed and overwhelmed, or a parent was often annoyed or in a rage. In these circumstances the child would have to prematurely comply, to take care of others, and to be another version of themselves—a false self. In adult life, we may become very good at taking care of others’ needs but struggle to feel satisfied in relationships. We might excel at work but find it unfulfilling. We might find ourselves having the right ‘things’ in life but lacking vitality. 

Psychotherapy is almost like a second chance for us to be in a holding environment where we can reconnect with thoughts, feelings, desires, physical felt sense that has been put away and forgotten. To be able to experience joy, anger, aggression; to scream and to laugh without being punished or shamed. From there, a more authentic sense of ourselves filled with vitality can be grown. 

Clinicians at CFIR take an integrative approach that incorporate multiple approaches such as psychodynamic, emotion-focused, and cognitive-behavioural therapies to help you reconnect with your authentic self and foster vitality in your life. 

Shaofan Bu is a Doctoral Candidate at McGill University studying Counselling Psychology. He is a Registered Psychotherapist (Qualifying) under the supervision of Dr. Dino Zuccarini. 

Attachment – One of our most fundamental basic needs as a human being. Attachment, in its simplest form, is contact, connection, to belong, to love and be loved. 

When a child is born, they have two primary needs. Their first need is attachment and they simply do not survive without it. Attachment remains important throughout our lives and continues to have survival implications as we need it to form societies and communities. The second need is the need for authenticity. At its core, this is the ability to know what we feel, to be in touch with our bodies, to trust our “gut feelings” and instincts. Authenticity is also to be able to identify and express who we are and manifest it in our activities, relationships, and day to day lives. Authenticity is also a survival need as we need to be in touch with our bodies and instincts to navigate potential threats. However, what may often happen, especially during our formative years is that our need for authenticity might conflict with our need for attachment: if I express my true emotions, wants, needs, I may sacrifice or lose out on my attachment need and thus not feel loved, worthy, or connected to those around me. This does not mean that it was done on purpose or that your caregivers did not love you or think you were worthy, but they might have had their own difficulties, stress, hurt, and were also suppressed. This is not about blame or figuring out who is at fault. Their distress and your distress can coexist and there can be space for both! 

As a child, when we experience this conflict, we ultimately learn that we need to suppress our authenticity and thus our emotions for our attachment that our life depends on. As adults, this might look like not knowing what we feel, what we want, or how to express ourselves. These experiences might have taught us that being authentic is too costly and thus we suppress those parts of us and over time lose touch with ourselves. This may then manifest in various forms of mental health and/or relational difficulties. Therapy can help you rediscover, connect and express these suppressed parts of ourselves and help regain your authenticity and identity while maintaining our forever important relationships! 

Kadir Ibrahim, M.Sc., M.A., R.P. (Qualifying) is a clinical psychology resident at CFIR. Kadir provides psychological services to adults experiencing a wide range of psychological difficulties related to mood and anxiety, trauma, grief and loss, and interpersonal relationships. 

Complex post-traumatic stress disorder (C-PTSD) is a relatively new diagnosis for understanding how past events can impact our mental health in the present. If you’re struggling with difficult symptoms, you might have wondered if they could be due to complex trauma. 

Complex trauma involves experiencing a series of events of a threatening or horrific nature, where escape is difficult or impossible. These events overwhelm an individual’s capacity to control or cope with the stressor. They can occur in childhood or adulthood, and could include (but aren’t limited to):

• Domestic violence
• Physical abuse
• Sexual abuse, harassment, or assault
• Neglect or abandonment
• Racial, cultural, religious, gender, or sexual identity-based oppression and violence
• Bullying
• Kidnapping
• Torture
• Human trafficking
• Genocide and other forms of organized violence

Those with complex trauma develop post-traumatic symptoms such as flashbacks, avoiding reminders of the events, and feeling constantly “on edge” or hypervigilant. But due to the prolonged and pervasive nature of the trauma, those with complex trauma develop additional symptoms that are important to recognize.

The first is trouble with affect regulation. This means they might have trouble calming down after a stressor or have strong emotional reactions. On the other end of the scale, they may often feel emotionally numb, or not able to experience positive emotions such as joy. 

Secondly, individuals with complex trauma struggle with negative self-concept. This means they often have strong beliefs that they are worthless, or a failure. They might feel intense guilt or shame in relation to these beliefs.

Finally, individuals with complex trauma often have issues in relationships with others. They might have trouble sustaining relationships and feeling closeness to other people. They might have short, intense relationships, or avoid relationships altogether.

Complex trauma often occurs across generations (sometimes referred to as intergenerational trauma), due to a lack of resolution of previous traumas and prejudice and discrimination that results in the oppression of entire families and groups.

Always consult with an experienced mental health professional if you believe that you may have complex trauma or another condition. Regardless of the cause of your symptoms, there are many treatment options available that can help you achieve your goals and feel better. 

Camille Labelle, BSci, is a therapist working at the Centre for Interpersonal Relationships (CFIR) under the supervision of Dr. Lila Hakim, C.Psych. They provide individual therapy to adults who have experienced single-incident or complex trauma or are seeking support for other mental health conditions such as anxiety or depression. They use an integrated approach including emotion-focused therapy (EFT) and cognitive behavioural therapy (CBT) to empower people to process their experiences, understand their reactions, and change their lives. 

References

Ford, J. D. & Courtois, C. A. (2020). Treating Complex Post-Traumatic Stress Disorders in Adults, 2nd ed: Scientific Foundations and Therapeutic Models. New York, NY: The Guilford Press. 

World Health Organization. (2019). International Statistical Classification of Diseases and Related Health Problems (11th ed). https://www.icd.who.int/  

By: Katherine Van Meyl, M.A.

“We keep having the same fight over and over again.” 

“I feel so angry when he doesn’t listen to me, I feel out of control!” 

“Sometimes when we are talking, I just zone out and think of other things.”

“When I feel this way, I actually hate her, which is crazy, because I love her!”

I’ve noticed that people attend relationship therapy when they feel “stuck,” and are having the “same fight” repeatedly with their partner(s), leaving them feeling angry, resentful, hopeless, sad, and alone. I have seen people experience this regardless of their relationship structure (monogamous, non-monogamous, kinky), gender identity, and/or sexual orientation. You’re not alone! This is more common than you might realize.

Usually, something real is happening in the moment. For example, you might feel rejected and/or angry because your partner “cut you off” during a conversation. When you try to address this with your partner, your partner becomes defensive (“that wasn’t my intent!”), which further angers you. As a result of this experience, maybe you feel the need to “escape,” shut down, or get so angry you threaten to end the relationship. The depth of your emotions, how much you feel whatever you’re feeling, is often an indication that something deeper is going on. 

This is the work of therapy, figuring out all the textures and layers of what is happening “beneath the surface” in our relationships and learning to differentiate our past experiences from our present.

If you and/or your partner(s) identify with some of what is written here, you may benefit from Developmental Couple Therapy for Complex Trauma (DCTCT). This treatment was developed by Dr. Heather MacIntosh, C. Psych., to help couples cope with the long-term impacts of childhood trauma, including emotional, physical, and sexual trauma. Many clinicians at CFIR-CPRI have been trained in this approach.

The goal of DCTCT is to help couples learn how to tolerate, understand, and manage their own and their partner’s emotions, how to understand each other’s perspectives, and how to be present and engaged to meet one another’s emotional and attachment needs. 

The treatment involves four stages. In Stage One, the focus is on establishing a relationship with your therapist and understanding how trauma impacts relationships, attachment styles, sexuality, and shame. In Stage Two, the focus is on skill building, particularly mentalizing capacities and emotion regulation capacities. In Stage Three, the therapy moves towards understanding how you and your partner may be re-creating certain traumatic “scenes” from childhood (the vignettes above likely have elements that can be traced back to early childhood experiences). Without the ability to mentalize and regulate our emotions, stage three would be too triggering for couples. Finally, in Stage Four, learning is consolidated and treatment ends. I will expand more on this in a future blog post! Keep an eye out for it in early 2023.

As with most treatment models that have “stages,” people in relationships weave in and out of these stages at different times throughout treatment. That’s normal! This treatment model is a guide, but every relationship is different and therefore, may need more time in certain stages than others.

If you and/or your partner(s) are interested in learning more about trauma, how it impacts our relationships and how it can be treated, please get in touch. 

With guidance, it’s possible to start shifting these patterns in our relationships.

Katherine Van Meyl, M.A., is a trauma-focused psychodynamic therapist at the Centre for Interpersonal Relationships. Katherine works with individuals, couples and families with a specific focus on relational distress, trauma and PTSD. Katherine is supervised by Dr. Dino Zuccarini, C. Psych., for adults & couples and Dr. Lila Hakim, R.P., C. Psych., for families. 

By: Dr. Sara Antunes-Alves, C.Psych.

Human beings are hardwired for connection. Unlike other mammals, we rely absolutely on our attachment figures for survival, for an extended period of time, from birth. Without secure connection, our health is at risk. 

When we experience trauma, the wiring for connection is disrupted and we develop adaptations in order to feel safe. It is important to note here that trauma needn’t necessarily be a “Big T” trauma, which include disturbing experiences that happened to you, such as sexual abuse, loss of a loved one, and violent crimes, but also “little t” traumas, especially ones that repeat throughout our development. “Little t” traumas are ones that cause us distress and uncertainty and can also include experiences that didn’t happen to you but should have. A lack of emotional availability from an attachment figure – even if they had the best of intentions – can be traumatic. 

Our attachment style refers to the behaviours we engage in to feel safe with others. Attachment exists on a spectrum, and we may be a mix of different attachment styles, and with different people. Disruptions in attachment tend to originate from our early developmental years, within our families, but can also be affected by harmful experiences later on, such as with a painful romantic relationship or being bullied in school.

There are four attachment styles, and they are briefly described below:

Secure Attachment:This is the “ideal” attachment leaning, manifesting as a healthy level of interdependence with another and comfort expressing emotions openly; relationships are a place of thriving, but being alone is also not necessarily a distressing place. You feel comfortable relying on another for support and having them rely on you.Avoidance and anxiety are low.

There are three forms of insecure attachment:

Dismissive-Avoidant:This attachment leaning manifests as (emotional) distance from others, valuing a high level of self-sufficiency and independence; closeness feels threatening and efforts to push another away can be prevalent; emotions are generally suppressed and denied. You feel triggered by closeness and intimacy. Avoidance is high and anxiety is low. 

Anxious/Preoccupied:This attachment leaning is characterized by high needs for intimacy and a fear of abandonment and rejection. These are managed by high attunement to another’s emotions and pronounced efforts to meet the other’s needs, often at the expense of their own. Eventually, protest behaviours to feel reassured may occur. You feel triggered by distance and uncertainty. Avoidance is low and anxiety is high. 

Fearful-Avoidant/Disorganized:This attachment leaning manifests in a push-pull dynamic. The individual desires connection with another and simultaneously fears it, leading to inconsistent and ambiguous behaviours in social bonds. Emotions are not regulated well and a sense of shame is prevalent; both closeness and distance can feel triggering. Here, anxiety and avoidance are both high.

The above insecure attachment styles represent clever adjustments as a result of important developmental needs not being met. They reflect humanity’s impressive propensity for survival through adaptation. However, at some point, you may find that these adaptations are no longer useful to you and may in fact be causing you or your relationships harm. 

The good news is, attachment styles are not fixed; they can change. 

If you find yourself identifying with an insecure attachment style, there is hope. It is not a life sentence. With greater awareness of your attachment style with another, what makes you feel threatened and how you find safety, you can learn to pause and choose to respond in more adaptive and secure ways. It is an effortful and sometimes lengthy process of re-learning, but it is never too late to choose. 

Dr. Sara Antunes-Alves, C.Psych. is a psychologist at the Centre for Interpersonal Relationships (CFIR). Sara provides therapy to individuals experiencing a range of psychological difficulties, and especially enjoys helping others understand their relationship to self and others, and how attachment (trauma), especially in formative years of development, affects adults in their current functioning. Her approach to therapy begins with building self-awareness, which she believes is necessary for meaningful change. Sara makes efforts to highlight the importance of having a more integrated perspective of one’s functioning, including one’s intellectual, emotional, and physiological states of being. She incorporates interpersonal and psychodynamic psychotherapies, emotion-focused therapy (EFT), and cognitive-behavioural therapy (CBT) to help clients achieve their therapeutic goals.

By: Anya Rameshwar, B.A., R.P. (Qualifying)

Please note that the worry and sadness associated with a long-distance relationship can vary significantly from person to person — and no two experiences are exactly alike. For more, we recommend consulting with a mental health professional. You can find resources at the bottom of this post. 

A long-distance relationship is a romantic relationship between people who live far apart and cannot meet frequently. Most couples have been confronted with this dilemma at some point, whether it be ongoing, temporary, unexpected, or anticipated. The experience brings heartache, sadness, and even anxiety in any scenario, with doubts, fears and “what will become of us” questions. 

But don’t let those lingering worries and late-night ruminations overwhelm you. Having to separate from your romantic partner(s) means learning to navigate long-distance relationships. 

Focus determines direction. Focus on maintaining your relationship(s) while apart, and you’ll be successful. 

To help you navigate these changing dynamics, here are relationship cornerstones you can focus on when building up and strengthening your partnership(s).

The 4 pillars of a long-distance relationship. 

1. Passion – Nourish the passion in your relationship(s). This contributes to greater fulfilment – both in and out of the bedroom – as well as happiness and well-being. 
2. Romance – Enhance the romance in your relationship(s). Preserve some of the elements that were present from the early stages of your attraction. 
3. Communication – Share what you need, what you want, and what you don’t want with your partner(s)— actively discussing the relationship(s) and assuring ongoing commitment. 
4. Trust – Be honest and forthcoming. Be transparent and allow space to explore topics that might trigger your mistrust. Keep and follow through on commitments you make. 

Does love lead to lust? Can lust lead to love? And how does all of this somehow end up in our developing an attachment bond with someone else? This is Part 2 of my blog series on adult romantic passionate love, lust, and the formation of attachment bonds in couples.

Passionate Love, Lust, and Attachment: The Neurochemical Relationship Between Romantic Passionate Love, Sex, and Attachment (Blog 2 of 2)

In the early days of passionate love, sexual desire is increased due to increasing levels of dopamine and testosterone. This increased sexual activity may then also be implicated in the development of our attachment bonds. Should you worry that, despite your efforts at restraint, your repeated lustful nights with a new love interest might turn into passionate love and attachment? Can falling in love lead to lust, or can lust lead to love and bonding?

Both women and men have sexual cravings fueled by testosterone. Higher testosterone levels create greater lustful possibilities and motivate us to seek out others for sexual play. Sexual desire is recognized as different than adult passionate romantic love in different cultures and it has been shown to light up different regions of the brain in fMRI studies. In my previous related blog post titled “Passionate Love, Lust, and Attachment: The Neurochemistry of Romantic Passionate Love,” I referred to Fisher’s (2004) work linking higher levels of dopamine with romantic passionate love and how these higher dopamine levels increase the release of testosterone, the hormone of sexual desire. As a result of the romantic novelty, a new partner automatically drives up our testosterone levels because of the related increase in dopamine levels. However, Fisher notes that the reverse may also be true: sexual activity raises testosterone, which also increases dopamine and norepinephrine in our brains, which means you could end up creating a more stable attachment bond and falling in love with a casual sexual partner.

Eventually, romantic passionate love moves into the attachment phase of love. For some couples, this will mean the chemically-induced romantic passionate phase with its more energetic and exciting versions of their sex lives will begin to wane as the comfort, calm, and relaxation of attachment security sets in. With the ensuing shift in neurochemicals, the exaggeration of similarities and the obscuring of differences between partners will also wane and the realization that differences exist may become a source of conflict and diminished connectedness. For some partners, a feeling of sameness and oneness was an important driver of their passion in the first place. For others, these newfound differences will not threaten each partner and can instead become a place of intrigue, curiosity, and new learning. At this stage, secure attachment might provide couples with the best possibilities for navigating the recognition of self-related differences as partners feel enough safety and trust in the relationship to tolerate and explore the difference.

Once the attachment phase of the relationship settles in, Esther Perel (2006), author of Mating in Captivity, notes that couples can struggle to reclaim the passion of these earlier days as it is difficult to reconcile the safety and security of long-term attachment with the excitement of eroticism. For Perel, the erotic is the exotic, meaning desire requires risk-taking, novelty, and space, which can certainly oppose the safety and security focus of the attachment phase of the relationship. Some partners who are securely attached continue to keep a healthy level of desire in their sexual relationships because secure attachment allows them to take sexual risks and create sexual novelty without the fear of rejection. The securely attached are, therefore, able to continue to explore the sexual, erotic, and novel, within the context of a safe, secure, and nurturing relationship (Zuccarini, 2004; 2008; Johnson & Zuccarini, 2010; 2012).

Further neurochemical action tethers together passion, sex, and attachment. Oxytocin is the attachment-related neuropeptide that may be physiologically implicated in the process of moving us from passionate love and lust to an attachment bond with our beloved. For instance, oxytocin increases dramatically during sexual arousal and orgasm, as well as in pair-bonding (Hazan & Zeifman, 1999). What this means is that, while we are lustful, we also benefit from the attachment neuropeptide, which results in a sense of calm, safety, security, and relaxation. We are then motivated to seek out the pleasure of sex and the ensuing sense of calm and relaxation caused by oxytocin. Over time, sexuality becomes a space that can deepen our attachment to another as a result of the release of oxytocin involved in our sexual interactions. In this way, we are tethered together through passion, sex, and attachment in a neurochemical manner!

Clinicians at CFIR work to support clients to develop passionate relationships within the context of secure attachment bonds. The more securely attached you are with your loved one, the more you can take risks to share your passions, fantasies, and explore the erotic without fear of judgement, rejection, and abandonment. At CFIR we recognize that sexual desire that includes novelty and risk-taking can solidify secure attachment, while at the same time understanding that secure attachment can facilitate the risk-taking and novelty required for a relationship of romantic passionate love.

Dr. Dino Zuccarini, C.Psych. is CEO and co-founder of the CFIR. He has published book chapters and peer-reviewed journal articles on the subject of attachment, attachment injuries in couples, and attachment and sexuality. He has taught courses at the University of Ottawa in Interpersonal Relationships, Family Psychology, and Human Sexual Behaviour. He has a thriving clinical practice in which he treats individuals suffering from complex attachment-related trauma, difficult family of origin issues that have affected self and relationship development, depression and anxiety, personality disorders, sex and sexuality-related issues, and couple relationships. At CFIR, he also supports the professional development of counsellors, psychotherapists, and supervised practice psychologists by providing clinical supervision.