Ah, love, that magical mix of butterflies, late-night texts, and pretending you actually like their favorite band. At first, everything feels cinematic. But somewhere between “I can’t stop thinking about you” and “Why do you breathe so loud?” something shifts. You might find yourself falling out of love, and it can feel confusing and painful.

It’s not that you suddenly stop caring, it’s that your brain chemistry changes. Falling out of love isn’t just an emotional story; it’s also a biological one rooted in neuroscience and attachment patterns.

The Brain on Love: Nature’s Most Addictive Drug

When you first fall in love, your brain throws a full-blown chemical party. Dopamine (the “pleasure” chemical) lights up your reward system every time you see or hear from your partner. Add a dash of norepinephrine (the excitement hormone) and a heavy pour of oxytocin (the cuddle chemical), and suddenly you’re in the throes of what scientists call “romantic love”, and what your friends call “being obsessed.”

Research published in the journal Brain Sciences confirms that the coordination of oxytocinergic and vasopressinergic pathways, coupled with the dopaminergic reward system, contribute to the formation and maintenance of both maternal and passionate love. Basically, early love is the brain’s version of a chemical binge, all thrill, no chill.

The Come-Down: When the High Wears Off and You Start Falling Out of Love

Unfortunately, the brain can’t keep partying forever. Over time, it adapts, dopamine receptors stop firing at full blast, and that rush of excitement begins to fade. This is called hedonic adaptation, which is science’s polite way of saying, “you got used to it.”

What once made your heart skip now just… exists. You start noticing little annoyances (why do they breathe so loud again?) because your brain isn’t running on pure dopamine anymore. This biological shift is a primary reason why people experience falling out of love, even when they still care deeply about their partner.

Feeling emotionally disconnected from your partner? Learn effective strategies with our article on what couples who stay together do every day to maintain emotional connection.

Stress Enters the Chat: Cortisol Crashes the Party

As the honeymoon glow fades, real life rolls in, bills, chores, emotional baggage, and along with it comes cortisol, the stress hormone. When stress rises, oxytocin (your bonding hormone) drops. The brain’s alarm system, the amygdala, becomes more active, and suddenly your partner’s quirks start feeling like personal attacks.

This isn’t because love disappeared, it’s because stress hijacked the chemistry that keeps you connected. Studies suggest that chronic stress (via cortisol) may disrupt oxytocin and bonding pathways, weakening emotional closeness.

Serotonin and the End of Obsession

When you first fall in love, serotonin levels drop, making you think about your partner constantly. (Yes, love makes you a little obsessive, it’s biology, not madness.) But as the relationship settles, serotonin balances out. The fixation fades, and you start noticing other things: your needs, your goals, your sleep schedule.

That shift can feel like falling out of love, but in many cases, it’s your brain just finding balance again. Understanding this biological reality can help couples normalize what they’re experiencing rather than interpreting it as relationship failure.

Withdrawal: When Love Ends (and It Feels Like You’re Dying)

Breakups, or even emotional distance, can feel physically painful because your brain goes through withdrawal. Those same dopamine and oxytocin pathways that once fired with joy suddenly go quiet. It’s why we crave contact, even when we know it’s not healthy.

But here’s the hopeful part: your brain heals. Through neuroplasticity, the brain’s ability to rewire, new sources of connection and joy eventually form. Research on neuroplasticity demonstrates that you really can feel that spark again, sometimes even with the same person.

How Therapy Can Help When You’re Falling Out of Love

Here’s the part many people don’t realize: therapy isn’t just for breakups, it’s for makeups. When you’re experiencing falling out of love, professional support can be transformative.

A good couples therapist can act like a guide for your nervous systems, helping you both learn to connect again instead of defaulting to old defenses. Emotionally Focused Therapy (EFT), which is grounded in attachment theory, has been shown to be highly effective for couples experiencing emotional disconnection.

In therapy, partners experience emotional safety, and that’s when oxytocin (the bonding hormone) starts flowing again. Therapy also helps reduce cortisol (stress) by teaching better communication and emotional regulation skills. Small moments of eye contact, shared laughter, or even vulnerability can reignite dopamine, reminding your brain why you fell in love in the first place.

The Role of Attachment in Falling Out of Love

Research shows that early caregiving experiences shape adult romantic attachment styles (secure, anxious, avoidant, disorganized), which influence how people think, feel, and relate in relationships.

Therapy helps couples move from insecure attachment patterns toward earned secure attachment, where both partners feel safe expressing vulnerability and responding to each other’s needs. This transformation doesn’t just improve feelings, it literally changes brain structure through repeated positive interactions.

The Takeaway: Falling Out of Love Doesn’t Mean Failure

Falling out of love doesn’t mean you’ve failed, it means your brain is doing what it’s designed to do: adapt and seek balance. But just as the brain can unlearn closeness, it can relearn it, too.

With care, curiosity, and sometimes the guidance of a good therapist, the chemistry of love can evolve, not back to the dizzying early rush, but toward something deeper, calmer, and more real. Couples counseling offers multiple pathways to rebuild connection, from improving communication to addressing underlying trauma.

Because love isn’t just a feeling, it’s a relationship between two nervous systems learning to feel safe again. And with the right support, that safety can be rebuilt, one moment of connection at a time.

When we talk about attachment wounds in therapy, most people think of early childhood dynamics, moments when caregivers couldn’t show up consistently, or times when love felt conditional. But for many queer and trans people, Attachment-Focused EMDR healing addresses challenges magnified by something larger than family: society itself.

If you’ve tried active listening, “I” statements, and communication workshops but still struggle with your partner, you’re not alone. Many couples discover that communication skills alone can’t fix deeper relationship issues.

While the belief that “communication is the key to a successful relationship” is widely accepted, this view oversimplifies the complexity of romantic partnerships. Poor communication is often a symptom of deeper, unresolved issues such as insecure attachment styles, unmet emotional needs, trauma, and misaligned values.

This article argues that focusing solely on communication techniques can mislead couples and therapists alike. Instead, the foundation of healthy relationships lies in emotional safety, value alignment, and mutual trust. Drawing on empirical research, attachment theory, and clinical insights, this article explores the underlying dynamics that frequently masquerade as communication problems.

The Communication Myth: Why “Better Talking” Doesn’t Always Work

Dr. John Gottman’s decades of research into marital stability challenges the notion that poor communication is the leading cause of divorce. Gottman and Silver (1999) found that many couples who ultimately divorce actually communicate in similar patterns to those who stay together. What separates the two is not how well they speak, but how deeply they remain emotionally connected.

Effective communication is often seen as the cure-all for relationship conflict. But communication devoid of emotional safety or trust becomes performative rather than healing. When partners feel disconnected, threatened, or unseen, even skillful dialogue can result in misunderstanding or defensiveness.

Moreover, it’s possible to communicate “well” while still engaging in harmful dynamics like manipulation, gaslighting, or passive aggression. Thus, the content of communication matters far less than the emotional intent and context in which it occurs.

The Real Root Causes of Relationship Problems

Attachment Wounds: How Your Past Shapes Your Present

Attachment theory, developed by Bowlby (1982) and extended to adult relationships by Hazan and Shaver (1987), provides a valuable lens for understanding relational conflict. People with different attachment styles express needs and process emotions in vastly different ways.

For example, individuals with an anxious attachment style may engage in protest behavior—over-texting, emotional outbursts, or accusations—not because they are poor communicators, but because they fear abandonment. Conversely, avoidantly attached individuals may withdraw or shut down during emotional conversations, not due to a lack of interest, but due to fear of engulfment.

Simpson and Rholes (2015) assert that insecure attachment styles are a leading cause of communication breakdowns in romantic relationships. The words used may be clear, but the intent and emotion behind them are filtered through layers of personal insecurity and unresolved wounds.

In this context, improving communication skills without addressing attachment needs is like repainting a house with a cracked foundation—it may look better temporarily, but the underlying problems will resurface.

Unmet Emotional Needs: The Hidden Language of Conflict

All human beings have core emotional needs: to feel loved, respected, secure, and significant. In romantic relationships, these needs often become amplified. When partners do not feel their needs are acknowledged or met, frustration builds—and is frequently expressed as a communication issue.

For instance, a partner may say, “You never spend time with me,” when what they mean is, “I feel lonely and unimportant.” Without understanding the emotional layer beneath the words, the receiving partner may respond defensively, triggering a cycle of argument rather than connection.

Johnson (2008), in her development of Emotionally Focused Therapy (EFT), emphasizes that emotional responsiveness is more important than verbal clarity. She argues that the goal of healthy communication is not merely the exchange of information, but the reassurance of emotional connection.

Values and Belief Systems: The Hidden Divide

Even when couples are emotionally attuned and capable of effective conversation, persistent conflict may arise from fundamental differences in values. Topics like parenting, religion, career ambition, and finances reflect deeply held beliefs that are not easily negotiated.

Perel (2006) points out that many couples clash not because they cannot talk to one another, but because they are “speaking different dialects”—shaped by culture, upbringing, and personal philosophy. For example, a partner raised in a family that prized individual success may struggle to connect with a partner raised in a communal, family-centered environment.

When partners’ values are misaligned, communication becomes strained—not because of delivery, but because of conflicting worldviews. No amount of communication technique can reconcile opposing core values without mutual understanding, compromise, or acceptance.

Emotional Safety: The Foundation for Real Dialogue

One of the most under-discussed but critical factors in communication is emotional safety—the sense that one can speak openly without fear of judgment, punishment, or ridicule. Emotional safety enables vulnerability, which is essential for intimacy and conflict resolution.

Zilcha-Mano and Errázuriz (2020) found that emotional safety is a better predictor of relationship satisfaction than communication frequency or skill. Partners who feel safe are more likely to speak openly, listen non-defensively, and repair conflict effectively.

Without emotional safety, even well-intentioned messages are often misinterpreted as attacks. Safety allows space for mistakes, learning, and emotional risk-taking. Communication thrives in its presence and deteriorates in its absence.

When Communication Problems Are Really Symptoms

From a clinical perspective, what presents as a communication problem is often rooted in:

• Unprocessed trauma: Unhealed past wounds that color current interactions
• Power struggles: Efforts to control, dominate, or resist perceived control
• Resentment: Built-up emotional pain from unmet expectations
• Fear of vulnerability: Avoidance of emotional openness due to fear of rejection or hurt

Therapists often observe that once these core issues are addressed, communication naturally improves—even without explicit training. In this way, communication is not a primary intervention but a byproduct of relational healing.

A Better Approach: Therapy That Goes Deeper

What Effective Couples Therapy Actually Does

Therapists should resist the temptation to begin treatment with communication skills training. While helpful, such skills can be superficial if not grounded in emotional attunement and psychological safety.

Instead, the therapeutic process should include:

• Attachment repair: Understanding how each partner’s attachment history shapes their behavior
• Emotional attunement: Teaching partners to recognize and respond to one another’s core emotional states
• Trauma-informed care: Addressing past relational wounds that impair present-day connection
• Values clarification: Exploring compatibility around life goals and beliefs

Only after this foundation is laid should traditional communication techniques—such as reflective listening or structured dialogue—be introduced.

The EFT Difference

Emotionally Focused Therapy has shown remarkable success because it addresses the emotional bonds that drive communication patterns. Research shows that 70-75% of couples move from distress to recovery using EFT, with 90% showing significant improvements.

EFT works by helping couples:

1. Identify negative interaction cycles
2. Access underlying emotions and attachment needs
3. Create new positive interactions based on emotional connection
4. Consolidate new patterns of bonding

5 Signs Your Relationship Problems Run Deeper Than Communication

1. You’ve tried communication techniques but keep having the same fights
2. One partner shuts down or becomes defensive when difficult topics arise
3. Past hurts keep resurfacing despite “talking them through”
4. You feel like you’re speaking different languages even when using the same words
5. There’s an underlying feeling of emotional unsafety or walking on eggshells

If these patterns sound familiar, it may be time to look beyond communication skills and address the deeper emotional dynamics at play. If you and your partner feel stuck in recurring arguments, consider exploring the emotional roots of your communication. Find a qualified couples therapist near you on GoodTherapy.

Frequently Asked Questions

Is communication important in relationships?

Yes, communication is important, but it’s not the root cause of most relationship problems. Effective communication naturally improves when underlying issues like attachment wounds, emotional safety, and value misalignment are addressed first.

What are the real causes of relationship problems?

The deeper causes include insecure attachment styles, unprocessed trauma, lack of emotional safety, conflicting core values, and unmet emotional needs that manifest as communication difficulties.

How can therapy help beyond communication skills?

Effective therapy addresses attachment repair, emotional attunement, trauma-informed care, and values clarification before introducing traditional communication techniques. This creates lasting change rather than surface-level improvements.

When should couples seek professional help?

Consider therapy when communication techniques haven’t worked, when the same conflicts keep recurring, or when there’s emotional withdrawal, defensiveness, or a sense of walking on eggshells in the relationship.

Can relationships improve without focusing on communication?

Absolutely. When couples address emotional safety, attachment needs, and core compatibility issues, communication often improves naturally as a byproduct of deeper healing and connection.

Key Takeaways: Beyond Communication to Real Connection

Communication plays a vital role in relationships, but it is not the most important element. Focusing on communication without addressing emotional safety, attachment dynamics, trauma, and values can be both misleading and ineffective. These deeper forces often drive what appears on the surface as a communication breakdown.

For lasting relational health, individuals and couples must look beneath the words and examine the emotional frameworks that shape them. When emotional connection, mutual respect, and personal healing are prioritized, communication naturally becomes clearer, more honest, and more effective.

The bottom line: If you’re struggling with relationship communication, the problem likely runs deeper than speaking and listening skills. Consider working with a therapist trained in attachment-based approaches like EFT to address the root causes of your relationship distress.

Additional Resources

• Find a Couples Therapist Near You
• Learn More About Emotionally Focused Therapy
• Understanding Attachment Issues
• How Trauma Impacts Relationships

References

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

Gottman, J. M., & Silver, N. (1999). The seven principles for making marriage work. Crown Publishers.

Hazan, C., & Shaver, P. R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52(3), 511–524. https://doi.org/10.1037/0022-3514.52.3.511

Johnson, S. M. (2008). Hold me tight: Seven conversations for a lifetime of love. Little, Brown and Company.

Perel, E. (2006). Mating in captivity: Unlocking erotic intelligence. Harper.

Simpson, J. A., & Rholes, W. S. (2015). Attachment theory and research: New directions and emerging themes. Guilford Press.

Zilcha-Mano, S., & Errázuriz, P. (2020). Emotional safety in romantic relationships: How it predicts relationship outcomes. Couple and Family Psychology: Research and Practice, 9(1), 21–34. https://doi.org/10.1037/cfp0000125

Addiction is an attachment disorder.  Human beings, addicts or not, only know and repeat what was modeled for them during childhood.  I like to call ages 0-10 healthy narcissism given that the world, as it should, revolves around the child.  If the child is not fed, he/she will be hungry; if the child is not given shelter, he/she goes without shelter; and if the child’s diaper is not changed, he/she will be wet.  Moreover, if, for example, the child’s parents divorce, who is at fault in the child’s mind?  Obviously, given that the world revolves around the child, the child believes he or she is to blame.  ‘If I just would have cleaned my plate’, ‘If I would have been a better boy…’, ‘If I just would have kept my room clean.’  These types of messages form the messages or models for future behavior of the child.    

 Part I of this article provided a definition and basic framework for Attachment Theory. Attachment theory provides that most individuals did not grow up with a model for secure attachment; thus, treatment for addiction requires providing a model of secure attachment so that individuals can practice healthy behavior in response to pain and discomfort other than acting out in addictive behavior.    

Theoretically, Mary Ainsworth PhD (1969) defined secure attachment as developing when a caretaker shows awareness of a child’s emotions and quickly attends to the child when distressed.  The child’s perception is that the caretaker is consistent in presence and provision; thus, the child feels safe in exploring their world because of their sense of certainty that their caretakers will be there for them in a nurturing manner if needed.  Overall, attachment theory assumes that the experiences of childhood relationships shape adult attachment style; thus, for example, the reason why adults who were physically abused as children have a high propensity for abusing their children.  This is the behavior that was modeled and typically the only mode that the adult has for responding to anger. 

The Scientific Link Between Attachment and Addiction: 

Attachment theory posits that an infant learns necessary skills for survival and the development of an Internal Working Model (IWM) whereby the definition of how the person views the world, themselves, and others is defined.  “Attachment representations show predictive associations with a wide range of pathological behavior including personality disorder(s), mood disturbance, [substance dependence] and psychopathology” (Caspers, Yucuis, Troutman, & Spinks, 2006).  Therefore, the authors conclude that childhood attachment styles (secure or insecure) have a direct impact on the prevalence of Substance Abuse Disorders.    

Researchers Kendler and Prescott (2006) reviewed the findings of the Virginia Twin Study of Adolescent Behavioral Development (VTS) for the purpose of exploring the depth of influence between genetics and environment as it relates to addictiveness and mental health disorders.  VTS had a sample size of 2,762 white twins between the age of 8-16 years old and their families.  Kendler and Prescott concluded that there are no genes specifically responsible for Substance Use Disorder, but rather, there are genes that an individual can inherit that predispose them to patterns of behavior closely associated with Substance Use Disorder.  Additionally, the authors concluded that if children are brought up in “protective environments”, even though genetically they are predisposed to patterns associated with Substance Abuse Disorder, the environment has a likely potential to be a protective factor against Substance Abuse Disorder.  

The Brain: 

Finally, researchers have directly correlated neurobiology of the human brain and the importance of caregiver attachment relationships during childhood to mental health in adulthood (Miehls, 2011, p. 82).  Additionally, the research has indicated that insecure attachments during childhood affects, negatively, the development of certain areas of the brain.  Moreover, Miehls states “relationships have the capacity to rebuild certain parts of the brain that influence our social and emotional lives,”) (Miehls, p. 81).   

 The benefit of the connection between neurobiology and attachment is that brain neuroplasticity (the ability of the brain to be re-formed) allows for a corrective experience or secure attachment model during adulthood leading to positive changes in the patient; thus, lessening the need to utilize addictive behavior to deal with abandonment, trauma, abuse, and emotional pain etc.  Moreover, the implication for treating substance dependence indicates the importance of a secure attachment relationship between the clinician and the patient to provide a baseline model or definition.   

Addiction as an Attachment Disorder 

The attachment system of a person is developed as a child in proportion to the relationship between the child and the caregiver; thus, if the attachment process is deficient, the child will have issues related to emotional regulation.  Therefore, as an adult, the person is likely to utilize drugs and other substances to regulate emotions as a means of adapting to an inability to regulate emotions learned as a child (Kohut 1977).   

Drugs create an ability for a person to have the illusion of self-esteem, self-confidence, worthiness and “increase feelings of being alive” (Kohut 1977).  An addict attempts to define comfort and security (missing in their vocabulary) through the use of addictive substances or behavior; however, outside sources other than secure modeling will lead to continued dysfunctional definitions and continued addictiveness.   

Treating Addictiveness and Substance Dependence through Attachment Theory:  

Recent studies have positively confirmed that a direct link exists between insecure attachment and substance dependence (Schindler, Thomasius, Sack, Gemeinhardt, 2007; Schindler, Thomasius, Sack, Gemeinhardt & Eckeert, 2005).    

“Attachment Oriented Therapy” (AOT) has been described as “a way of eliciting, integrating and modifying styles represented within a person’s internal working model” Flores (2004) p. 214).  Flores (2001, 2004) goes on to explain that the IWM must be changed or addiction will continue or substitution of one addiction for another will persist.  The key point is that when an individual begins to learn (which requires a model) how to self-soothe, thus, learning how to regulate emotions and feelings, they will avoid seeking outside sources as a means of managing these emotions (Blaine & Julius, 1977; Flores, 2001; Flores, 2004).  

The vast majority of individuals in treatment today have been exposed, multiple times, to the treatment experience; Therefore, what is missing?  Why the extreme difficulty in remaining sober?  Haven’t they been taught well?  Has the education system (the treatment industry) failed them?  The answer is not black and white, but rather, exists within the statement:  We must begin to treat patient’s differently.  The idea that we are able to teach patient’s how to stay sober doesn’t equate to their ability to apply what they have learned or feel safe enough to explore the deeper problem of why they continue to utilize addictive behavior to escape emotional pain. 

AOT is rooted in providing a “secure base” for an individual so that they may begin to explore themselves from the inside out.  Attachment theory correctly posits that by providing a model in treatment of a safe, secure base, the patient will have the ability to cease seeking answers outside themselves (drugs, alcohol, sex, food etc.) and begin to heal from the inside out.  Moreover, by providing this safety, patient’s have the ability to express and feel emotions in a vulnerable and authentic capacity; thus, the willingness to address the problem, rather than the solution (the addictive behavior).    

“A Different Way to Treat People”  

Conclusion 

Overall, what is missing in treatment today is the understanding and compassion of being relational with patients.  The irony in this statement is that AA promotes compassion and being relational with individuals; however, this is the part that most traditional treatment misses. Alternatively, traditional treatment provides an education as opposed to modeling behavior that provides the ability to develop secure attachment needed for change.   

Unfortunately, most addicts (probably most human beings in general) have not had a model for secure attachments, thus, leading to substance abuse and addictive behavior as a means of avoiding emotional pain. For treatment and thereafter, AA and therapy to be effective, the following suggestions are necessary: 

1. Treatment must be focused on modeling secure attachment.  This requires risk on the part of the treatment provider and a demonstration of self-disclosure and identification from the treatment team as opposed to a one-up position of authority; 
2. Development of trust and alliance with the patient is critical if the patient is going to address and change learned abusive and dysfunctional patterns during childhood; thus, leading to the need to utilize addictive behavior as a means of avoiding emotional pain; 
3. Continuation of care is critical.  Thirty days in treatment merely scratches the surface.  Without a long-term aftercare plan, i.e., Partial Hospitalization, Intensive Outpatient and therapy, that focuses on abuse, attachment, and secure attachments, we can expect relapse rates after inpatient treatment to remain near 5-7% within one year of inpatient treatment; and 
4. “A different way to treat people” must become the norm as opposed to the exception in treatment. 

 

“what am I missing; I keep relapsing and don’t know why I have such a difficult time remaining clean and sober?” 

 How we treat addiction in treatment must change.  The idea that we can provide information and teach an individual how to remain clean and sober is a fallacy.  Most addicts and alcoholics are above average in intelligence and the question is “Don’t you think if they could be taught how to stop destroying their life they would merely read a book and the problem would be eliminated?”  The answer is “Of Course.” Who would choose to drink, drug, or addictively act out knowing their life is over if they do?”  Nobody.  Thus, people know and they still partake in these behaviors.   

 Therefore, the answer is not merely education.   

Facts: 

• 9% of the U.S. population meets the criteria for substance use disorder (SUDs) (Substance Abuse and Mental Health Services Administration 2010); 

• Drug-related suicide attempts increased by 41% from 2004-2011 (Drug Abuse Warning Network (DAWN);

• Therapeutic alliance is one of the greatest predictors of positive treatment outcomes (Straussner, 2012). 

“Until an addict or alcoholic develops the capacity to establish mutually satisfying relationships, they will remain vulnerable to relapse and the continual substitution of one addiction for another (Phillip Flores)  

What is Attachment Theory? 

“Most of the psychopathology seen in the alcoholic is the result, not the cause of alcohol abuse.” (Valiant, 1983). 

If we don’t begin treating the problem, which quite possibly stems from a lack of secure attachment modeled during childhood, as opposed to the solution, addictive behavior, we can count on continued treatment failure, often called resistance to treatment.  Resistance to treatment seems to be a way of saying it’s the patient’s fault not ours.  Therefore, we put the cart before the horse. 

The result of putting the cart before the horse is the following: 

• We admit a patient to treatment with distorted definitions of concepts learned as a child, i.e., honesty, hope, faith, courage, integrity, willingness, humility, brotherly love, discipline, perseverance, awareness, service 

• The patient learned these definitions from their caregiver or parent from the models presented to them as children.   

• How would the patient know these definitions are potentially dysfunctional if it is all they know?

• How effective will step work be if the patient doesn’t have a model or healthy definition of what the principles of the steps espouse?   

Attachment theory assumes that the experience of childhood relationships shapes adult attachment styles.  These experiences create the road map or internal working model for how the individual will perceive himself and others relationally (Bowlby, 1973).   

The basic premise is that we only know what we know.  For example, two men are sitting in the park discussing zoo animals.  The one man asks the other if he has ever seen an elephant, to which the other man replies ‘no, what does it look like?’  The man states, ‘it is a large grey animal that has four hoofs, rough skin, floppy ears and trunk in the front’.  The other man states ‘you mean like the tree trunk outside?’  The man replies ‘no, not a tree trunk’.  To which many asks ‘You mean like the trunk of my car?’  The point is that the man will only know what an elephant looks like if he sees a picture or goes to the zoo.  Similarly, if a child grows up with caregivers who are physically present although not emotionally present, thus, lacking a functional definition of emotional availability and intimacy, the child is more likely to have a stunted view of being emotionally present for others in their life.  It is very possible that when this child becomes an adult, their innate need for secure attachment will not be met unless they see a model of what healthy attachment looks like. 

The basic principle of Attachment Theory is that those with secure attachment (stronger emotional relationship with caregiver) are better able to regulate emotions and have fewer relationship problems.  However, disruptions in the attachment system (insecure attachment) can lead to vulnerabilities in the sense of self and others as well as relationship problems; thus, leading to shame, co-dependency, and a need to numb pain via addictive behavior.  Therefore, if we don’t address and model secure attachments to patients, they will stay stuck in the solution of continuously seeking to avoid and discharge pain through addictiveness.   

 Research suggests that relationships influence brain development and “relationships have the capacity to rebuild certain parts of the brain that influence social and emotional lives; clinicians can help clients to alter their attachment patterns with a secure clinical relationship.  (Miehls, 2011, p. 82).   

The bottom line in defining Attachment Theory is that the goal of treatment needs to be focused on changing the definition and model of what it means to feel included, loved, and secure.  “The inability to establish healthy relationships is a major contributing factor to relapses and the return to substance use.”  (Flores, 2004).  Thus, the answer to “sh*t what am I missing?” is: Not having had a clear model of secure attachment because it was partially or completely missed during childhood.  As Flores stated: 

“Therapists must be able to challenge, soothe, care, love, and if necessary, fight with a patient if they are able to provide a full range of emotional experiences that can potentially come alive in an authentic relationship. (Flores, 2004, p. 259).  

To sum up part one of this article, unless we provide a solid definition of concepts that we see as normal (based on definitions that were modeled) albeit dysfunctional and damaging, the way we work the 12 steps will be flawed and based on dysfunctional definitions, lacking much change in behavior.  Alternatively, we can utilize the 12 steps as a corrective experience by interpreting each step as follows: 

 Interpreting the 12 Steps from an attachment perspective: 

Step 1:     The experience of abandonment; 

Step 2:     Permission to hope; integration to others; 

Step 3:     Taking a risk (vulnerability) to attach 

Step 4:     Taking a risk to attune with self 

Step 5:     Taking a risk to attach to another person 

Step 6-7:  Correcting and repairing relationship with self 

Step 8-9:  Correcting and repairing relationships with others 

Step 10:   Personal responsibility for securely attached relationships in my life 

Step 11:   Solidifying a secure attachment to my Higher Power 

Step 12:   Increasing my ability to model securely attached relationships to others