Part I: Complex Trauma & Relationship Distress

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. 

Attachment Styles – Why Are They Important?

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.

Long-distance relationships: Four pillars to boost the possibility of success

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. 

Passionate Love, Lust, and Attachment: The Neurochemistry of Falling in Love, Bonding, and Staying Lustful! (Pt.2)

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.

Passionate Love, Lust, and Attachment: The Neurochemistry of Falling in Love, Bonding, and Staying Lustful!

We are all hardwired to fall in love, share lustful moments, and bond with others. In fact, there are complex neurochemicals that are released during all of these different phases of relationship development. In this 2-part blog series, I will share important information with you about the neurochemistry of falling in love, how falling in love influences lust, how lust influences falling in love, and how all of this leads to attachment bonding in relationships!

Passionate Love, Lust, and Attachment: The Neurochemistry of Romantic Passionate Love (Blog 1 of 2)

Have you ever found yourself tightly gripping and constantly checking your cellphone awaiting contact from your new love interest? If so, you may be in the phase of the universal experience of adult romantic passionate love. Across history and cultures, we have fallen in love, lusted for others, and attached to them as a result of innate emotion-motivation systems in the brain that drive us to create relationships. In her book Why We Love: The Nature and Chemistry of Romantic Love, Helen Fisher (2004) describes the adult romantic passionate love phase as an initial phase in the formation of an adult attachment bond. Read on to find out how the neurotransmitters in our brain – dopamine, norepinephrine, and serotonin – are implicated in you falling in love.

First, Fisher described the universal experience of romantic love based on her research. When falling in love, our new partner is imbued with special meaning (i.e., unique, all-important, novel). We also develop strong focus as our beloved becomes the centre of our attention and we pay special notice of our shared events, messages, music, etc. During this period, we also aggrandize our new love. We may magnify positive aspects of our adored one while minimizing flaws and exaggerating our similarities. We experience intrusive thoughts as we just cannot stop thinking about our new loved one. Emotionally, Fisher describes us as being “on fire.” We experience intense emotions and find ourselves feeling anxious, shy, and awkward at times. We have an increase in energy as well. All of a sudden we find ourselves staying up late, having sex all night, and still making it to work … then doing it all over again the next day. This energy burst also comes with a loss of appetite and sleeplessness. Driven by a deep stirring to connect, our moods can shift rapidly from ecstasy to despair depending on whether our beloved is as responsive to us as we would like. We also become hypersensitive looking for clues about whether our beloved is into us or not! Finally, Fisher noted that when we are infatuated, we are more likely to change elements of our personal identity like clothing and music preferences, alter our mannerisms and habits, and even take on new values, all to win over our new love interest.

Once you fall in love, it is hard to turn back, as a result of the numerous neurotransmitters at play. Fisher’s research using fMRI studies found that dopamine, serotonin, and norepinephrine are the neurotransmitters at the root of passion for our new love. She found elevated levels of dopamine, which is at the root of the hyper focus, high motivation, high energy, and exhilaration, sleeplessness, and loss of appetite. She claims that this neurotransmitter, when heightened during romantic passionate love, creates something within us similar to an addiction process, intense dependency, and cravings to be with our lover. High levels of dopamine are also found in fMRI studies of individuals experiencing a drug addiction. Love becomes so addictive at this point that when you do not have access to your new loved one, more dopamine is released to energize you to focus on further pursuing the reward of being with them. Testosterone, the hormone at the root of sexual desire, is also increased in our bodies as a result of the higher levels of dopamine. In other words, increases in dopamine come with novelty and passionate love, which then increases sexual desire through a heightening of testosterone.

Finally, the neurotransmitters norepinephrine and serotonin are also implicated in romantic passionate love. Increased norepinephrine adds to the high, exhilaration, energy, and sleeplessness we experience, and fuels us to remember the smallest details about our lover. Serotonin is lowered, which results in the obsessiveness and racing thoughts we experience. With increases in dopamine and norepinephrine, and decreases in serotonin, we enter into positive states of mind about the other and obscure negative aspects of the beloved. We are neurochemically primed through these transmitters to also experience a sense of oneness based on exaggeration of similarities and minimization of difference. These effects facilitate a sense of symbiosis, which eventually wanes after about 8 to 12 months when the tidal wave of neurochemicals subsides. At this point, we begin to realize our differences with our beloved, which can then bring on more conflict for some couples. Fisher’s conclusion based on fMRI studies was that adult romantic passionate love is a primary motivation system in the brain and stems from the changes in neurotransmitters summarized in this blog post.

Fisher’s research studies explain why in the early stages of a relationship, particularly during the adult romantic passionate love phase, many partners will describe having had “tons of great sex” and then later wonder “where did it go?!” For those of you who wondered, this chemically heightened period that revs your sexual motor only lasts for about one year. After this period, sex within the context of an attachment bond becomes motivated by different goals. See my other blogs on attachment and sex, including Part 2 of this blog series, to see what happens to couple sexuality once couples move from romantic passionate love to a more stable long-term bond.

Clinicians at CFIR work to support clients to develop passionate relationships and secure attachment bonds. We recognize that novelty and a connection are important contributors to a lifetime of passion. We also support our clients to recognize that falling in love might be a different experience from the process of establishing a secure attachment bond with a partner. Once the adult romantic passionate love phase ends, usually within one year, the dust settles and our self and relationship experience can shift. Learn how to recognize the telltale signs of whether you have found Mr./Ms. Right in a future blog post titled “Is This Mr./Ms. Right or Wrong?: Consider This Dating and Relationship Screener Before You Say ‘I Do’”, so that when the adult romantic passionate love phase settles, you will be ready for a lifetime of 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.

The Hardest Part of an Argument

by: Valery Vengerov, M.Psy. R.P.(Qualifying)

One of the most common experiences that couples report having after an unresolved argument is the daunting, heavy silence that follows. The lack of resolution of an argument leaves each partner feeling misunderstood and often in a state of resignation. Each partner might think: “I give up. He/she will never understand me. Why even bother? I’ll deal with this on my own.” This lingering silence can be a protest. The longer and more frequently couples remain in this space of estrangement from one another, the more stressed and dissatisfied they become with their relationship as a whole (Liu & Roloff, 2015). Resentment builds, and distance develops as the ‘couple’ unit starts to feel unsafe. 

In therapy, couples have the opportunity to safely share the accumulated hurt and resentment that underlies and results from these silences, and that threatens their relationship. They can experience the relief that comes with being heard and listened to. They also find out more about their partner, who becomes more accessible and available to them as a result of therapy. Couples can learn how to repair conflict faster and more effectively in therapy, and reduce the amount of time they spend feeling disconnected and resentful of one another (Gordon & Chen, 2016).

Whatever challenges you and your partner want to address in couples therapy, improving communication is vital.

Evidence- and science-based couples therapy will help both of you to define your thoughts, feelings, and desires to each other with openness and empathy.

A therapist in CFIR’s Relationship and Sex Therapy team can also help you to arrive at a better understanding of each other’s point of view. You can collaboratively set your treatment goals to ensure that you or you and your partner’s concerns and needs are adequately addressed.

References

Gordon, A. M., & Chen, S. (2016). Do you get where I’m coming from?: Perceived understanding buffers against the negative impact of conflict on relationship satisfaction. Journal of Personality and Social Psychology, 110, 239-260.

Liu, E., & Roloff, M. E. (2015). Exhausting Silence: Emotional Costs of Withholding Complaints. Negotiation and Conflict Management Research, 8, 1, 25-4.

Valery Vengerov, M.Psy., R.P. (Qualifying), is a Registered Psychotherapist (Qualifying) at the Centre for Interpersonal Relationships (CFIR) in Toronto. She works with individual and couples clients, to help them resolve a wide range of difficulties related to depression, stress and anxiety, trauma and loss, and relationship conflict and betrayals.

Attachment Styles in the Workplace

by: Edgar Prudcoi, B.A. 

Do you often struggle with specific difficulties at work and have a hard time understanding where they stem from? Whether it is a consistent difficulty saying ‘no’ to a superior when you feel overworked or having challenges sharing your ideas in a meeting, how we experience and relate to ourselves and others within the workplace affects our overall well-being and career satisfaction. Workplace stress and difficulties we face can be influenced by our unique levels of attachment anxiety and avoidance. 

From a young age and into adulthood, we develop an attachment style that serves as a subconscious mental program that influences the way we perceive and relate to ourselves and others. Our attachment styles shape our thoughts, emotions, and behaviours automatically and often without much conscious awareness. Our attachment style ultimately presents itself in the workplace in various ways; knowing our style can help us improve our work-related functioning and overcome the difficulties we have while at work.

Here are descriptions and tips on how to deal with attachment anxiety and attachment avoidance in the workplace:

1) Anxious Attachment:

Anxiously attached individuals fear upsetting or disappointing people and have doubts about their worth or capabilities. This fear-based attachment style can show up at work through actions such as compulsively checking your email to make sure nothing is wrong, worrying about being liked or valued by colleagues, and seeking frequent feedback or reassurance about your performance. When you worry, the fight or flight mode generated by your nervous system hijacks you in those moments and makes it difficult to focus on accomplishing your work or feel positive emotions at work. 

How to manage anxious attachment at work:

Begin to work on creating a more positive and nurturing relationship with yourself and remind yourself of your abilities, worth, and accomplishments. Explore the parts of yourself that you, your colleagues, and superiors value about you and the evidence that you are an asset at work. 

Take a step back and approach circumstances and interactions at work by developing a positive and realistic self-dialogue rather than taking a critical view of yourself. Doing so may sound like, “the constructive feedback I received isn’t because I am a bad employee, I am doing my best, and now I know what I can improve on to become even better.” 

2) Avoidant Attachment:

Dismissive avoidant individuals may have a positive self-evaluation and a negative view of others as less capable, less intelligent, or unreliable. A fearfully avoidant person will have a fear of an attachment relationship and also a negative view of others as being undependable or untrustworthy. This fear can be experienced in the workplace by avoiding forming relationships because of mistrust or perceptions that you cannot rely on or depend on others. This also may lead to tendencies of micromanaging and monitoring employees and more likely dismissing input from others. If you have a fearfully avoidant attachment style, you may feel “stuck” with your work when you do not trust yourself or others with it. This feeling may show up as not getting started on a project because you feel incapable of completing it and lacking trust in sharing your difficulties with others, which may lead to developing a ‘why bother trying’ mentality. 

How to manage avoidant attachment at work: 

Acknowledge that others may also have valuable ideas or contributions. Approach colleagues and yourself with curiosity rather than judgment or defensiveness. Notice the tendency to put achievements ahead of relationships at work and be mindful of tending to both. Make sure to encourage yourself to communicate with others and develop trust to delegate work and ask for help. Be cautious of thoughts that suggest, “It will be better if I do it.” 

For fearfully avoidant attachments, try some tips discussed to manage the anxious attachment style while also making small and manageable steps to work through what it is you’re avoiding.

Are you ready to better understand and master the mental and emotional parts of striving for a successful career and a balanced life? CFIR’s mental health professionals can help! 

Edgar Prudcoi, B.A. is a therapist at the Centre for Interpersonal Relationships (CFIR) in Toronto and is working on completing his Masters degree in Clinical Psychology at the Adler Graduate Professional School. He supports individual adults and couples to deal with difficulties related to emotion (e.g., depression, anxiety, anger), the effects of trauma, loss and grief, conflict resolution, and relationship functioning.

Attachment Style and Couple Sexual Issues

According to attachment theory, as a result of early year interactions with caregivers, we either become securely attached or insecurely attached—either anxiously or avoidantly attached.  Attachment style then influences sexuality in complex ways. Anxiously attached partners in the bedroom might be seeking out sex for reassurance of self or attachment fears.  For example, they may feel less positive about themselves (e.g., undesirable or unattractive), and/or have worries about the availability, accessibility, and responsiveness of their partner.  Strong sexual desire is fuelled by the need for self and attachment reassurance. Avoidantly attached partners are not motivated sexually in the same way.  These partners are more likely to focus on the pleasure-oriented aspects of sex only and have difficulties with feelings of closeness.  Some avoidantly attached partners will have sex for duty’s sake. Arousal and desire problems arise when anxiously or avoidantly attached partners are unable to fulfill these goals.  

The clinicians at CFIR support couple partners to discover the multiple ways in which securely attached partners experience and explore sexuality. The couple and sex therapy clinicians at CFIR use a wide variety of strategies to support couple partners to build more confidence in their sexuality, greater eroticism, and desire.

How We Approach Treatment Options at CFIR

At Centre for Interpersonal Relationships (CFIR), we believe it is important for your clinician to be flexible in offering a variety of scientific, evidence-based treatments to address the cognitive, emotional, behavioural and relational aspects of your concerns. Providing you with different possibilities for change is fundamental to us because we know that no one treatment fits all!

Different treatments focus on various aspects of your concerns, including behaviours, cognitions, emotions, perceptions, and relationships. We’ve compiled a list of a few scientific, evidence-based psychological treatments available at CFIR along with the focus of the treatment approach:

Acceptance and Commitment, Compassion & Mindfulness-based therapies (ACT, MBSR)

Acceptance and Commitment, Compassion & Mindfulness-based therapies (ACT, MBSR) are forms of psychotherapy that support an individual to learn how to observe, be less reactive, accept and be non-judgmental of internal thoughts or emotional reactions. ACT helps you to act from core values as opposed to being entangled in the thoughts and emotional responses that are at the root of your concerns. Developing a more compassionate outlook towards your self is also essential for remediation of various mental health concerns. Treatment focuses on developing the capacity to observe, adopt a non-judgmental stance toward thoughts and feelings, and diminish reactivity while anchoring the self in core values to promote clarity in thinking and action.

Cognitive-behavioural therapy (CBT)

Cognitive-behavioural therapy (CBT) is a form of psychotherapy that addresses psychological issues by focusing primarily on the cognitive and behavioural dimensions of your emotional and behavioural concerns (i.e., the way that your thoughts, beliefs or thinking influences your emotional and behavioural responses). CBT also focuses on problem-solving, finding solutions, improving coping, helping you to challenge distorted cognitions (e.g., thoughts, beliefs) and change problematic behaviours. Your emotional or behavioural responses transform through exposure to specific situations, cues, narratives or places that trigger distress and maladaptive responses. Homework is often assigned.

Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing is a form of treatment that came to be from a context of treating patients to deal with and process distressing memories of past traumatic experiences. It’s currently used to treat a broader range of psychological issues. Treatment involves visual or auditory bilateral stimulation with a primary focus on the integration of distressing aspects of past, and present experiences and increasing adaptation and resilience by building inner resources to address these experiences.

Motivational Interviewing 

Motivational interviewing is a form of counseling that helps individuals achieve changes by increasing their motivation to change difficult behaviours. Treatment targets ambivalences about changing, and becoming increasingly aware of the problems, consequences, and risks of these behaviours. Motivation is increased to create a better future consistent with an individual’s values and principles.

Psychodynamic, Attachment-based, Mentalization therapies 

Psychodynamic, attachment-based, mentalization therapies focus on how past and current relationship experiences have influenced a person’s present patterns (i.e., thoughts, thinking about self and other, emotional reactions toward self and others, and behaviours) and relationships. Psychoanalytic-oriented approaches have a rich, historical tradition beginning with Freud and Jung to present-day scientifically validated psychodynamic approaches. The goals of psychodynamic-mentalization and attachment-based therapies are to increase an individual’s self-awareness about these patterns to promote change in the present-day. 

Concerns flow from internal conflicts, dynamics, and patterns that create difficulties for our self and block us from building meaningful lives and relationships. Defenses and self-protective strategies that prevent access to earlier emotionally overwhelming experiences are diminished over time to promote more adaptive functioning, self-growth, and change. Treatment focuses on cognition, emotion, and interpersonal dimensions of your difficulties. Your interpersonal relationships, both with your therapist and others, are explored to understand and change how one experiences oneself and relates to others in interpersonal relationships. These approaches tend to focus on the self and relational issues underlying your symptoms and distress, as opposed to targeting symptoms directly.

Systemic therapy 

Systemic therapy is a form of psychotherapy that understands problems evolving in interactions and interaction patterns with other individuals and systems. Treatment focuses on the impact of your couple partner, children, family, work and socio-cultural system on your self and your relationship with others.

Clinicians at CFIR can help you or someone you care about address the concerns, issues or struggles that life may occasionally present. 

Most private extended insurance plans, as well as Medavie/BlueCross (RCMP, Veterans Affairs, Canadian Armed Forces) and CUPE, cover CFIR services. 

Contact us today. Help is available right now for you and your loved ones! We also offer video-based appointments.

Sex and Attachment

by: Dr. Dino Zuccarini, C.Psych and Dr. Marie-Pierre Fontaine-Paquet, Psy.D., C.Psych.

Are you struggling with sex in your relationships

How you relate to your partners sexually is affected by how you relate to each other outside of sex.

In the CFIR blog post ‘Anxiety and Your Relationships’, we describe how attachment theory may help you to understand your experience of your self and others in your relationships. We also talk about the concept of attachment style, which includes ways of seeing your self (“Am I worthy of love and care?”) and others (“Are you there for me, will you respond when I need you?”) in your close relationships. Sex can be viewed as an attachment behavior, and thus your attachment style affects how you engage in sex. Attachment anxiety and avoidance can interfere with enjoying sex and creating an enriching and fulfilling erotic life.

If you are anxiously attached, you might have doubts about your self-worth and attractiveness, and about your partner’s availability to meet your feelings and needs. Sex can be a way to obtain reassurance about these things – about whether your partner finds you beautiful or sexy, and about whether your partner loves you, cares about you and wants to be close to you. When sex is a way for you to obtain reassurance and to soothe your deep fears about your self or your relationship, you may become demanding and critical of partners when they do not respond to you sexually in the ways that you hoped.

If you are avoidantly attached, you might find it difficult to be close to your partner during sex because you fear rejection by your partner. You might tend to keep more distance during sex and be more focused on tasks and duties, and on performing in such a way that is pleasing to your partner. It might be difficult for you to access your true desires, feelings, and needs and to share these with your partner. You might also struggle with understanding and being attuned to your partner’s feelings and needs when you are so focused on performance and tasks during sex.

When sex becomes a place filled with fear, it may be difficult for both partners to be in touch with, explore and share their erotic potentials and all that sex has to offer.

Here are some tips on how to deal with attachment anxiety and avoidance during sex:

For the anxiously attached:

  • If you have doubts about your self-worth and attractiveness, start working on nurturing a more positive relationship with yourself and your body – as opposed to overly relying on your partner’s responses to reassure you. Try to explore what makes you feel sexy and nurture these parts of yourself.
  • Try not to over-interpret your partner’s cues as being related to you, how much they care about you and your relationship. Learn to calm yourself and to take a step back to notice all of the other factors that may be influencing your partner’s responses to you.

For the avoidantly attached:

  • Develop more awareness of your true desires, feelings, and needs. Try to take a risk to share these with your partner and talk about what interests and excites you in sex – instead of avoiding taking risks by distancing yourself during sex or even avoiding sex altogether.
  • Learn to be more present to your own and your partner’s desires, feelings, and needs during sex. Recognize when you are distancing from yourself and your partner, and remember that the more you distance, the more you can create distress in your relationship.

A psychologist can:

  • help you find and create a more fulfilling sex life by working with you individually and/or as a couple.
  • assess your attachment style and its impact on your sex life, help you understand your sexual desires, emotional reactions, and needs, and help you communicate these to your partner more effectively.
  • help you learn how to respond to your partner’s desires, feelings and needs to help you build a more secure and satisfying sexual relationship.

Especially when couples feel stuck in constant negative interactions as a result of fears that block sexual fulfillment and erotic exploration, a psychologist can help you better understand these moments and help you create more security in your relationship. Over time, sex can feel less dangerous and become a space to explore and connect in movement, touch and shared emotions of excitement and joy.

Read more about our Relationship & Sex Therapy Treatment Service.

THE CBT CLINIC and CPRI (Centre pour les Relations Interpersonelles – services in French) Grand Opening is January 2023!