Growing up, we all unconsciously develop an operating system of default instructions for navigating relationships. It functions automatically, outside our awareness, and we can't help responding the way we do. Sometimes this causes us to suffer to the point that it drives us to therapy.

In attachment-based therapy, felt safety and security in relationship with the therapist is an essential means of updating that operating system. It's both healing in itself and required before any deeper work can happen.

The therapist must also know how to facilitate new and different experiences that specifically target implicit beliefs about self and other. Things that we learned when we were very young. To do this, we tend to stay away from narrative content, away from talking about what happened or problem-solving. Instead, the focus is on the right-here, right-now experience of relationship.

In individual therapy, attachment work can involve being in felt relationship with parts of self, it can involve role-playing connection with important figures from one's life, or it can mean direct present-moment engagement with the therapist in the room. This can include mindful, sustained, face-to-face contact, physical touch or physical distance, while paying attention to experiences and impulses that are related to the client's self and to the connection between us. Different clients have different needs at different times and will do best with different kinds of attachment work.

When we are little, we need ongoing safety and security from caring adults who stay with us over time. To grow up with secure attachment, we need not only food and shelter, but also for someone to be delighted in us and to adequately respond to our emotional needs. We need affection, comforting, respect, and protection. We need support for our emotional development. We need our adults to not intimidate, humiliate, exploit, or harm us. We need the experience that when something goes wrong in relationship, it can be actively repaired, not just moved on from.

No parent is perfect, of course, and nobody survives childhood without some wounds. We might start calling it "trauma" when, for whatever reason, our experiences of safe loving relationship as a child were so disrupted or absent that our whole sense of self got built around self-doubt, self-blame, having to work hard to deserve love, never being good enough, always feeling abandoned, being generally afraid of people, always fighting in relationships, and similar difficulties.

Sometimes, this doesn't even have to do with parents doing anything wrong. There can be social or medical circumstances in very early life that make it difficult for the child to feel safe - and so the natural bonding that might have happened with a perfectly good enough parent, is unfortunately disrupted.

Childhood relational trauma can make it difficult to manage your emotions, causes low self-esteem, difficulty trusting, and problems with intimacy. It might lead to anxiety, depression, or other mental health issues.

No, not at this time. I specialize in work with individual adults and groups. If you’re looking for couple work, I recommend finding people who are trained in Emotionally Focused Therapy for couples.

You never “have to” anything. You may want to at some point. But you also may not want to, and it's not even always necessary. If your past is really fraught and even thinking about it sends you spinning and wanting to go away, or it brings up the kinds of emotions that you can't easily bear, then we will focus on working on your capacity to feel safe in the present and become able to be with feelings. We never want you to go too far beyond your comfort zone. At some stage in the process, it may come naturally to you to want to weave in and integrate memories from the past – but even without ever exactly knowing what happened or having all the pieces of the story, effective therapeutic work is still possible.

I think of shame as a negative attitude towards self, ranging from a healthy "I'm ashamed that I didn't act in alignment with my values", to the more harmful ever-present background hum of some version of "I am a bad person", to the even deeper shame of not having a sense of self in relationship, and other patterns that play out outside of awareness.

Shame, by its nature, wants to hide. If we get to the point of being overloaded by shame, it shuts us down and drains our aliveness, our ability to feel. It's a big step to even own it and say "I feel ashamed."

When people carry these more damaging types of shame, I know that it's not because they are actually bad people. It's because they've experienced relational trauma and this is a symptom. In the shame place, there is badness: either I'm bad or someone else is bad or certain experiences that trigger shame are bad. It seems like reality, but it's just a symptom of the trauma that the person carries.

Sometimes shame has to be worked with indirectly because it so much wants to hide. If a person can own it, we talk about it as a normal part of human experience and recognize the purpose it's trying to serve. Nobody chooses to have lots of shame unless at some point in their development it was their only choice. When it becomes observable like this, we curiously, slowly, mindfully, and compassionately explore what is actually happening there, what parts might be present, what their roles are, get to know them and know their stories, we study the body-based expressions of shame and gradually explore new options and new meanings. We work on shifting your identity - from being the person who is bad, to being the person who can see, understand and have compassion for some part that thinks you're bad and has learned to hide in self-defense. Shame gradually becomes something that can be safely related to rather than being all-consuming.

There is lots of material all over the internet that will readily give you a definitive answer to that, though I would advise you take any finality with a grain of salt.

If in a given moment, in a given relationship, you find it easy to feel "I'm an okay human and you're an okay human, I care about me and I care about you, I can comfort myself and I can be comforted by you, we can come together as well as move apart, and it’s safe", then I would say you're probably experiencing attachment security.

Attachment is formed in a dance of repeated connection and disconnection. It's a natural rhythm, like everything in the universe is a coming and a going, and both are necessary.

There are several flavors of attachment insecurity, depending on which aspect of the connection-disconnection dance of attachment you are saying No to:

• it's uncomfortable to disconnect/be in autonomy (often called "anxious")

• it's uncomfortable to connect/be in intimacy (often called "avoidant")

• it's uncomfortable to connect and disconnect (often called "fearful avoidant")

Keep in mind that, while it's possible that you may have one pattern that defines your life, many of us pull on several different styles in different circumstances and at different times. I believe that you cannot be reduced to a single label.