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The Role of Attachment Functions in Psychotherapy

Received June 22, 1999; revised September 3, 1999; accepted October 4, 1999. From the Department of Psychiatry, University of New Mexico School of Medicine. Address correspondence to Dr. Severino, Department of Psychiatry, University of New Mexico Health Sciences Center, 2400 Tucker NE, Albuquerque, NM 87131.

The authors propose to clarify concepts of emotional attunement and failures of attunement in early development derived from theoretical and clinical work (Kohut) and infant psychiatry (Stern). Early attunement failures are experienced as shameful by the infant/child, and without repair they form a nidus for later destructive adult interpersonal relationships, "social blindness," and depression. The authors present a case illustrating these ideas. The role of empathic attunement experienced in the unique setting/structure of psychotherapy emerges as the single critical variable for a successful outcome.

Key Words: Attachment • Shame • Development, Child/Infant