Abstract
Different types of client attachment insecurity may affect the psychotherapeutic process in distinct ways. This exploratory study compared the in-session discourse of clients with dismissing and preoccupied attachment states of mind on Adult Attachment Interviews conducted prior to therapy in the context of a randomized clinical trial of psychoanalytic and cognitive–behavioural psychotherapy for bulimia nervosa. In a subsample of six sessions from each of eight therapy dyads, preoccupied clients were found to talk more and have longer speaking turns than dismissing clients, who in turn generated more pauses. Using the Narrative Processes Coding System, preoccupied clients were found to show more narrative initiative; whereas, differences in terms of narrative process modes were not as clearly interpretable. Contrary to expectations, the two insecure states of mind were equally different in the relationship-focused psychoanalytic therapy and in the symptom-focused cognitive–behavioural therapy. Suggestions for further investigations of the in-session discourse of clients with different attachment states of mind are given. Copyright © 2010 John Wiley & Sons, Ltd.
Key Practitioner Message:
• Client adult attachment patterns are likely to affect psychotherapeutic processes.
• Client insecure dismissing and insecure preoccupied attachment may be detectable in distinct in-session discourse styles.
• More research is needed on in-session manifestations of client attachment patterns and their relation to therapeutic outcome.