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.

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.

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.

Written by Dr. Dino Zuccarini and Tatijana Busic

Welcome to our third blog on anxiety! Today, we’ll be sharing some interesting information about anxiety and your relationships to others, such as your partner and children.

Several decades ago a British psychiatrist, John Bowlby, developed attachment theory, which provides a framework to understand how we experience our self and others in our relationships. Attachment theory helps explain the anxiety we can experience in relationships.

Attachment theory suggests that as human beings we are biologically hard-wired to seek out others and to connect to them—emotionally, psychologically and physically. These connections provide nurturance, soothing, contact and comfort to help us ease distress in everyday life.  Attachment is from the ‘cradle to the grave’—-beginning with the soothing, non-verbal communications between a mother and child (e.g., comfort of a mother’s sound, smell and gaze to newborns) through to the nurturing, caring and intimate moments in our adult relationships with our partners (e.g., emotional, physical and sexual intimacy). Our experiences in these close relationships—from childhood and throughout our lives—play a role in determining something psychologists refer to as our attachment style.

When we have experiences in which our primary attachment figures (i.e., mother, father or whomever took care of us when we were younger) have been generally responsive to our feelings and needs growing up, we learn to be securely attached to others.  In these circumstances, we develop a positive sense of our self— we see ourselves as competent, worthwhile, and lovable. We are also more likely to see other people in a positive light— reliable, dependable, and trustworthy. Early attachment relationships are the primary mechanism for developing our capacity for healthy relationships with others. We learn how to tune into our own feelings and needs and express them to others. We also learn how to empathize with others — the ability to tune into what others are feeling and respond appropriately. We also discover how to create closeness with others, while being independent and tolerating distance from our loved ones. 

When we are raised in inconsistent environments — too much or not enough attention from our caregivers — then we might become anxiously attached to others.  An anxiously attached person may have a negative sense of self —and may see themselves as unlovable or unworthy of care — while continuing to hold out hope that others are trustworthy, reliable and will eventually respond to their connection needs.  An anxiously attached individual may experience fear about the availability of important people in their lives—they become preoccupied with how available their partner, friends or family members are to respond to their feelings and needs. These individuals may express a lot of emotional distress to communicate their feelings, needs and concerns to others, and at times, may come across as demanding in their efforts to solicit attention, care and support—this kind of anxious attachment can be overwhelming for others. 

When you are anxiously attached, you also tend to overly rely on your children and partner for reassurance, affirmation and validation.  You overly seek out others to reassure you and to soothe your anxiety about others not being available to you. You may need too much closeness and those around you might feel smothered. Your children and partner may get a sense that there is not a lot of room for them in the relationship — and stop sharing with you as a result — or they themselves might have to increase their expressions to been seen and heard. 

If we are raised in environments where others were harsh and rejecting, we may become avoidantly attached to others. This attachment style makes expressing needs or feelings really hard—the other person is viewed negatively as unreliable and undependable during a moment of need. Avoidantly attached people  experience significant amounts of anxiety as a result of the unavailability of their caregivers—however, their strategy is different than the anxiously avoidant—they learn how to avoid emotions to deal with emotional distress. 

When distressed, avoidantly attached individuals struggle to express their feelings and needs—and, dependency on others for care and support does not seem possible during these moments. When dealing with difficult life moments they dismiss their own and others’ emotions as a strategy to cope—expressing themselves feels risky and may subject them to painful rejection once more.  As a result of this strategy, children or partners may feel that you are unavailable or unable to tune into or attend to their emotional needs while you seek even more distance to avoid difficult feelings. Given these difficulties avoidantly attached individuals often over focus on tasks, rules and duties in their relationships—while struggling to understand others’ feelings and needs. This avoidance often results in significant others becoming anxious and distressed because they feel you are unavailable and unable to connect with them. 

Here are some tips on how to deal with attachment anxiety or avoidance in your relationships:  

For the anxiously attached:

• If you are anxious and preoccupied in your relationships, start working on developing a greater sense of yourself — learn how to enjoy a good book, find a hobby, keep yourself busy with activities—as opposed to being overly preoccupied with your children and partner.
• When you are worried about whether or not others are there for you, remember a time that you felt connected to others. Reframe how you think about the absence of loved ones. Try not to get overwhelmed by negative thoughts about their absence (e.g., I’m alone, I miss them), and focus on positive thoughts and feelings (e.g., I look forward—and feel excitement—thinking about my beloved returning home).
• Try to notice when you may be seeking too much closeness or reassurance from others and try to slow this process down. Although you are feeling fearful or doubtful about whether those closest to you love you—the more you do this, the more they might push you away. Learn to recognize themental and physical cues of anxiety and learn to calm yourself prior to communicating to others.

For the avoidantly attached:

• Notice what you are thinking and feeling in these situations. Practice giving your feelings and needs a label—What do you feel and need? Take a risk to express these feelings and needs to a close friend or your partner. 
• Learn how to recognize and attune to others’ feelings and needs. If you are not sure, ask them what they need or how they feel. Remember that the more you distance in moments of distress (yours or others), the more distress you create in your relationships.
• Recognize when you are distancing from yourself and others. Try to observe yourself inmoments of emotional discomfort and to catch yourself in this distancing strategy. 

A psychologist can help you assess your attachment style and its impact on important relationships (i.e., relationship with family, partner, children, friends and colleagues). After identifying your attachment style, a psychologist can help you to understand your own emotional reactions and needs and communicate to others more effectively. A psychologist can also help you learn how to respond to others’ feelings and needs so your relationships feel more secure and more satisfying. 

Read more about CFIR’s Anxiety, Stress & Obsessive-Compulsive Treatment Service.