Anxious attachment style is a term used in psychology to describe a pattern of behaviour that develops when an individual experiences inconsistent or unreliable caregiving during childhood. Individuals with an anxious attachment style often have difficulty forming secure relationships and may experience intense anxiety and fear of rejection in their romantic relationships. Psychoanalytic psychotherapy and Cognitive Behavioral Therapy (CBT) are two approaches to addressing the anxious attachment style. While both methods share the same goal of improving relationship functioning and reducing anxiety, they differ in their theoretical frameworks and therapeutic techniques.

Psychoanalytic psychotherapy is a long-term, insight-oriented therapy that emphasises the role of early childhood experiences in shaping an individual’s attachment style. According to this approach, the anxious attachment style arises from unresolved conflicts and traumas that occurred during childhood. The therapist aims to uncover these unconscious conflicts and help the patient resolve them through insight and understanding. The therapeutic process involves exploring the patient’s past experiences, childhood traumas, and interpersonal relationships to identify the sources of their anxious attachment style. Through this process, patients gain insight into their motivations, desires, and unconscious conflicts, which helps them improve their relationship functioning.

CBT, on the other hand, is a short-term, goal-oriented therapy that focuses on changing maladaptive thoughts and behaviours that contribute to an anxious attachment style. CBT assumes that individuals have the power to change their thoughts and behaviours, even if they cannot change their circumstances. CBT therapists work with patients to identify and challenge negative, self-defeating beliefs and replace them with more adaptive ones. For example, a patient who experiences anxiety and fear of rejection in their romantic relationships may be asked to challenge the belief that they are unlovable by identifying evidence to the contrary and practising more positive self-talk. By challenging these negative beliefs, patients can reduce their anxiety and improve their relationship functioning.

While both psychoanalytic psychotherapy and CBT address anxious attachment styles, they differ in their underlying theoretical frameworks and therapeutic techniques. Psychoanalytic psychotherapy emphasises the role of early childhood experiences and unconscious conflicts in shaping an individual’s attachment style, whereas CBT focuses on changing maladaptive thoughts and behaviours. Psychoanalytic psychotherapy is typically long-term and involves exploring past experiences to uncover unconscious conflicts, whereas CBT is short-term and goal-oriented, focusing on changing specific thoughts and behaviours.

In terms of effectiveness, research has shown that both psychoanalytic psychotherapy and CBT are effective in addressing anxious attachment styles. However, CBT is typically more effective in the short term, while psychoanalytic psychotherapy is more effective in a long time. Additionally, CBT may be more appropriate for individuals who prefer a more structured, goal-oriented therapy. In contrast, psychoanalytic psychotherapy may be more suitable for individuals who prefer a more experimental, insight-oriented treatment.

One way psychoanalytic psychotherapy and CBT differ is in their approach to the therapeutic relationship. Psychoanalytic psychotherapy emphasises the importance of the therapeutic relationship in addressing the anxious attachment style. According to this approach, the therapeutic relationship is a safe and nurturing space where patients can explore their unconscious conflicts and develop more secure attachment styles. The therapist serves as a secure attachment figure, providing emotional support and helping patients develop more adaptive coping strategies. CBT, on the other hand, tends to focus more on teaching patients specific skills and techniques to reduce anxiety and improve their relationship functioning. While the therapeutic relationship is still essential in CBT, it is not emphasised as much as in psychoanalytic psychotherapy.

Another way psychoanalytic psychotherapy and CBT differ is their emotion regulation approach. Psychoanalytic psychotherapy emphasises the importance of exploring and processing emotions to develop more adaptive coping strategies. According to this approach, individuals with anxious attachment styles often have difficulty regulating their emotions, leading to intense anxiety and other emotional disturbances. Psychoanalytic psychotherapy helps patients understand the underlying emotional conflicts contributing to their cognitive dissonance and develop more adaptive ways of managing their emotions.

In contrast, CBT places more emphasis on cognitive restructuring and behavioural change than on emotion regulation. CBT therapists work with patients to identify negative thoughts and beliefs that contribute to cognitive dissonance and help patients challenge and replace these thoughts with more positive and adaptive ones. This approach may be less effective for individuals with anxious attachment styles, who may have difficulty regulating their emotions and require more intensive emotion-focused interventions.

Both psychoanalytic psychotherapy and CBT are effective approaches to addressing cognitive dissonance. However, they differ in their underlying theoretical frameworks, therapeutic techniques, and approaches to the therapeutic relationship and emotion regulation. The choice of therapy will depend on the individual’s preferences, needs, and specific cognitive dissonance concerns. It is essential to consult a qualified mental health professional to determine the most appropriate approach to addressing cognitive dissonance and related emotional disturbances.

By Ari Sotiriou M.A. psychodynamic psychotherapist co-founder Online Therapy Clinic