Developing a Secure Self

An Attachment-Based Approach to Adult Psychotherapy

Developing a Secure Self

Developing a Secure Self (DSS) is an attachment-based, ego-state approach to adult psychotherapy that I created in the early 2000’s, in response to the needs of my clients.

Drawing on attachment theory and research, DSS works with the therapeutic relationship, ego states (younger aspects of self), externalization, and guided imagery to address insecure attachment.

As an infant and/or child, the client may have missed out on the sensitive, attuned, and loving presence and responsiveness needed for healthy development. This deficit may lead to problems in adulthood such as low self-esteem, anxiety, depression, and if there is also a history of abuse, it can result in complex PTSD and dissociative disorders.  Such clients may suffer from impaired emotional skills, addictions, and eating disorders.

Developing a Secure Self is not just for clients who have “attachment issues.” Rather the approach provides an attachment-based context for therapy and is an ideal complement to trauma work as well as being valuable for those not stable enough to tolerate trauma processing. It directly addresses an aspect of the client’s problems (insecure attachment) that tends to underlie other issues.

Developing A Secure Self

Generations
Sculpture by Kathy Klein

Goals

The goals of the Developing a Secure Self approach are:

  • strengthening a sense of self and self-structure
  • developing a new relationship with self and increasing self-esteem
  • enhancing emotional skills
  • deepening and enriching the effects of trauma processing
  • developing the security from which a client can comfortably explore the world, engage in healthy relationships, and blossom into the person who they have the potential to be.
Developing A Secure Self

Who can benefit

This approach is appropriate for all adult clients and with some minor adaptations for younger teens. Clients who can especially benefit may have one or more of the following problems:

  • little sense of self
  • low self-esteem
  • a sense of alienation
  • inability to regulate emotions
  • affect intolerance
  • inability to empathize
  • impaired interpersonal relationships.

They may suffer from:

  • depression
  • anxiety problems (including obsessions and compulsions)
  • addictions
  • eating disorders
  • a tendency towards dissociation that has left them vulnerable to PTSD.

For one reason or another, the infant/child missed out on the relatively consistent, loving, attuned presence and responsiveness needed for healthy development.

The three major components of Developing a Secure Self

The therapeutic relationship as an attachment relationship

A warm, attuned, and responsive relationship provides the context for the work of therapy.

Having an awareness that the relationship between therapist and client is one of attachment allows the therapist to address attachment issues at an implicit, as well as an explicit, level.

This understanding gives us a deeper awareness of the dynamics in the therapeutic relationship and promotes an optimal response to the individual client’s needs through each phase of therapy. The perspective also requires that, as therapists, we look at our own attachment pattern recognizing that it too will impact the therapeutic relationship.

In the DSS approach, it is important to recognize that the therapist has a relationship with the young parts (ego states) of the client as well as with the adult.

Imaginal Nurturing

The client develops a new relationship with themselves through the externalization of younger parts of self. They bring the child out of a disturbing memory into the present (a “retrieval”), and the therapist talks directly to the child, welcoming them and offering validation and nurturance.

The focus is on the here and now, not on the disturbing memory (which is left to process with EMDR). The client witnesses the child being treated with kindness, compassion, and respect that provides a model for their honouring activity and twice daily check-ins with the child between sessions.

As this Imaginal Nurturing process is woven through the therapy, the client develops a new relationship with self through the externalized younger self.

More information is available on the Imaginal Nurturing page.

Emotional Skills

Emotion regulation and tolerance skills are rooted in early development in the relationships between infant and care-givers.

As the young ego states come to know that the adult is here now (and that they are here now), significant emotional skills follow.

When distressed, clients learn to reassure the younger parts of self (since it is often those young parts who are experiencing the distress) which grounds the younger parts in the present, promotes the relationship, and addresses the feelings. I believe this is a healthier response than effectively abandoning the “child” and using a dissociative technique such as going to an imaginal safe place.

Body-oriented and energy-based emotion regulation techniques are also congruent with this DSS.

At a training I gave in San Diego some years ago, one of the participants very kindly shared with us a poem that expresses beautifully what Developing a Secure Self is about. Love after Love was written by West-Indian writer Derek Walcott who won the Nobel Prize for Literature in 1992.

Book & Therapeutic Toolkit

Developing a Secure Self

Therapeutic Toolkit

The Developing a Secure Self Therapeutic Toolkit consists of the book as described below and all four Imaginal Nurturing soundtracks on mp3 files: “I’m So Glad You’re Here!” and Adventuring Spirit (each for men and for women respectively).

The Therapeutic Toolkit provides you with an opportunity to expand the learning from the book to experience Imaginal Nurturing guided imagery yourself.

The recordings were developed for clients to use between sessions and can be shared with them (without violating the copyright). Many therapists have found them restoring and healing to use themselves. Information about these soundtracks along with audio clips are available on the Soundtracks page of this site.

Developing a Secure Self:

An Attachment-Based Approach to Adult Psychotherapy

This book presents an approach that evolved from my search to find a focused way in which to address directly the needs of my clients that were rooted in early insecure attachment relationships. It provides an attachment context for EMDR trauma work, as well as being of value in and of itself.

This 2020 edition is available in a spiral-bound format or as a pdf file. With the former, a “Talk to the Child” bookmark with reminders of Imaginal Nurturing elements will be tucked inside. There is also a balanced affect scale and VoC scale for the ease of your clients.

Book Table of Contents

Introduction

Background – 1
Developing a Secure Self Components – 5
Imaginal Nurturing Concepts  – 6

Attachment, Exploration, and Intersubjectivity

Concepts – 11
Attachment Research – 13
Clinical Indicators of Insecure Attachment v18
Continuum of Organized Attachment – 22
Attachment and the Therapeutic Relationship – 24

Organizational Tools

Case Conceptualization Guide – 36
Attachment-Focused History – 38
Nurturing and Encouraging Messages Sheet – 42
Therapy Lifeline – 44
Client Sheet – 46
Balanced Affect Scale and Validity of Cognition Scale – 48

Imaginal Nurturing

The concept – 51
Who’s who in Imaginal Nurturing – 51
Fundamentals of Imaginal Nurturing – 55
Language – 66

Imaginal Nurturing in Practice

Introducing Ego State Work – 73
Memory-Based Imaginal Nurturing – 73
Inspiration-Based Imaginal Nurturing – 86
Variations of Inspiration-Based Imaginal Nurturing – 95
Exploration Imagery v98
Incorporating I-N and DSS into therapy – 104

Problems That May Arise in Imaginal Nurturing

Problems That May Arise in Imaginal Nurturing – 107

Emotional Skills

Enhancing Skills Through Working With Structure – 117
The Imaginal Home – 120
Further Emotional Skills Enhancement – 123

Conclusion

In Conclusion – 137

Bibliography

Bibliography – 139

Appendix A: Sample Scripts

Appendix A: Sample Scripts – 143

Appendix B: Clinical Forms

Case Conceptualization Guide – 163
Attachment-Focused History
Nurturing and Encouraging Messages Sheet
Therapy Lifeline
Client Sheet

I’ve been studying and using the DSS materials you sent last month, and my clients are simply loving the I-N work. It fits in perfectly with my theoretical base of the attachment relationship between client and therapist….. Anyway all this to just say this is terrific, deep sophisticated work and the clarity of your presentation in written form is truly amazing. I’ve been a therapist now for 24 years, and this discovery has been nearly as fruitful as learning EMDR. That says a great deal about the power of your creation, April.

Mary Kay Neumann

LCSW

Some responses from therapists using the Developing a Secure Self approach

I have found opportunities with almost every client to bring in the adjunctive nurturing, and the results have been profound for both myself (as a witness) and my clients. They are so excited to be in the nurturing role, and feel it so deeply – it is very different than any other parts work I have tried. Best of all, they report a continued felt sense of the child they have brought forward to the present, a tenderness and joy that is an honor to behold…. A client found it to be ‘the most incredibly moving experience of my life – I have never, ever gone so deep emotionally’

Maggie Vlazny

MSW, LCSW

I want to give you the glowing feedback that my clients have given me this week: ‘What do you say to someone who has given me my life back? In the 50 or more sessions we have had, which have been great, this is equal to all the others.’ Another, a physician with a serious diagnosis, said, “Now you are really understanding me!
Dana Terrell

MS

…. With one of my highly traumatized clients (severe abuse and neglect), I used I-N to work on recurring nightmares related to a childhood memory. She reported having a good night sleep the same night!! Both she and I were thrilled. It’s really an important addition to my clinical work. And two weeks later I attended a full-day workshop with Dr Allan Schore and it definitely validated (and supported with neuroscience knowledge) what April taught us.
Philippe Gauvreau

PhD

Imaginal nurturing is intentionally focused on the experience of attachment, whereas the other sorts of affect relief imageries we use seem more about detachment. In essence, it is the difference between getting a big hug after a scary experience versus acknowledging safety but finding yourself by yourself…. For many who have not had a healthy attachment experience to draw upon, the ability to connect to self and the truth and goodness of self is not available. For those folks, getting the distance from the [trauma] experience, which has often defined them, leaves an emptiness and an aloneness that can be profound. I-N addresses this aloneness better than any tool I have used so far. For many this is about experiencing the affect of love which is an experience many have no context for.
Ava Schlesinger

MSW, LCSW

I’m using what I learned in Toronto a lot, and it’s been a breath of fresh air for me, not only in direct Imaginal Nurturing applications, but in other interventions that I’m finding much informed by the attachment material and the nurturing/exploring perspective.
Peter Taylor

PhD. CGP

You have made an incredible contribution to our field. Thank you!
Sherri Gonzales

MA MFT