The Attachment Lineage
The idea that changed everything: we are wired for connection, and relationships shape the brain
Clinical and evidence statements in this lineage remain under review. The source checks below apply only to their stated treatment, population and outcome.
Guideline sources for approaches in this lineage
EFT for Couples
Guidelines and official sources (2)
1 clinical guideline check · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Emotionally focused couples therapy
Discussed in the source
The archive gives Strong research support under 1998 criteria; it is not a CPG grade.
Scope: Relationship distress with a spouse or intimate partner
- Management of Major Depressive Disorder
Discussed in the source
VA/DoD suggests couples-focused therapy as a category (weak for), without preferring a model. Assess partner involvement and safety; this is not a separate endorsement of this named protocol.
Scope: Adults with mild-to-moderate MDD and significant relationship distress.
Mentalization-Based Tx (MBT)
Guidelines and official sources (3)
1 clinical guideline check · 1 research recommendations check · 1 professional reference check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- CG78: recommendations for research
Research recommendation
MBT is named as an example in a research question about structured psychological programmes. This is not a named recommendation to offer MBT in CG78’s clinical recommendations.
Scope: Comparative research on psychological programmes for people with BPD.
- CG78: 2018 surveillance, Appendix A
Discussed in the source
NICE surveillance explicitly notes that CG78 does not currently recommend MBT by name. Discussion of evidence is not a recommendation to offer it.
Scope: People with BPD
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
MBT is named among recommended specialist BPD treatments.
Scope: BPD; treatment delivered as described and studied
Transference-Focused (TFP)
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Treatment of patients with borderline personality disorder: Guideline Statements and Implementation
Discussed in the source
APA discusses TFP within structured psychotherapy for BPD. Statement 5 gives the structured-psychotherapy class a 1B recommendation; it does not assign TFP a separate grade.
Scope: Patients with BPD receiving literature-supported structured psychotherapy
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
TFP is named among recommended specialist BPD treatments.
Scope: BPD; protocol delivered as described and studied
Child-Parent Psychotherapy
Guidelines and official sources (2)
1 clinical guideline check · 1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Child-Parent Psychotherapy: program ratings
Not a treatment recommendation
CEBC rates CPP 1 for infant and early-childhood mental health, and 2 for child/adolescent trauma and domestic-violence services. These are topic-specific registry ratings, not clinical guideline recommendations.
Scope: Children aged 0–5 who have experienced trauma and their caregivers.
- Children’s attachment (NG26)
Discussed in the source
NICE says to consider parent–child psychotherapy based on the Cicchetti and Toth model. This specified model should not be assumed equivalent to every intervention called CPP.
Scope: Preschool attachment difficulties where parents have maltreated or are at risk of maltreating their child; safeguarding concerns must be addressed.
Theraplay
Guidelines and official sources (1)
1 evidence registry check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Theraplay: program ratings
Not a treatment recommendation
CEBC assigns a rating of 3, promising research evidence, in this topic. The rating is a registry assessment rather than a clinical guideline recommendation.
Scope: Infant and early-childhood mental-health topic; the broader program serves children and caregivers.
PCIT
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Antisocial behaviour and conduct disorders in children and young people (CG158)
Discussed in the source
The recommendations specify parent training and its delivery; they do not name PCIT. A mention elsewhere in an evidence review would not by itself be an endorsement.
Scope: Parents of children aged 3–11 with specified conduct-problem risks or diagnoses
Attachment-Focused EMDR
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Post-traumatic stress disorder (NG116)
Discussed in the source
The recommendation specifies EMDR delivered using a validated manual. It does not name attachment-focused EMDR or validate automatic transfer to this adaptation.
Scope: EMDR for adult PTSD after non-combat trauma; validated manual required
Schema Therapy
Guidelines and official sources (2)
2 clinical guideline checks
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Psychotherapie bij persoonlijkheidsstoornissen
Recommendation for the stated population
Schema therapy is named among recommended specialist BPD treatments.
Scope: BPD; protocol delivered as described and studied
- Borderline personality disorder: recognition and management (CG78)
Discussed in the source
CG78 recommendations do not name schema therapy; general programme guidance does not create a named endorsement.
Scope: Psychological programmes for people with BPD
Sensorimotor Psychotherapy
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
Discussed in the source
The guideline includes a named discussion of sensorimotor psychotherapy. It offers expert practice guidance without a separate evidence grade or a general recommendation for PTSD.
Scope: Sensorimotor work within phase-oriented treatment for adults with dissociative identity disorder.
Structural Dissociation
Guidelines and official sources (1)
1 clinical guideline check
Read the recommendation and its scope. A source may discuss an approach without recommending it.
- Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision
Discussed in the source
Structural dissociation is discussed as one etiological model. This does not make it a separately recommended treatment or the sole basis of the guideline.
Scope: Conceptual models of adult dissociative identity disorder.
Attachment theory is arguably the single most influential framework in contemporary psychotherapy. John Bowlby proposed that human beings are biologically wired to seek proximity to caregivers — and that the quality of early attachment relationships shapes personality, emotion regulation, and relational patterns throughout life. Mary Ainsworth gave the theory empirical teeth. Mary Main added disorganized attachment and intergenerational transmission. Allan Schore and Daniel Siegel brought neuroscience, showing how attuned relationships literally shape brain development. From these foundations, an entire tradition of attachment-based therapies emerged — all sharing the conviction that healing happens in relationship.
Full Contents
Read all 10 entries as a single page
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John Bowlby
Broke with Freudian drive theory to propose attachment as a primary biological need. Infants seek proximity to caregivers for safety, and disruptions produce predictable patterns of anxiety, protest, and despair.
Concepts: Attachment behavioral system · Internal working models · Secure base · Safe haven · Separation protest
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Mary Ainsworth
Designed the Strange Situation (1969), operationalizing attachment patterns. Identified secure, anxious-ambivalent, and avoidant patterns. Maternal sensitivity predicted attachment security.
Concepts: Strange Situation · Secure attachment · Anxious-ambivalent · Avoidant · Maternal sensitivity
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Mary Main
Discovered disorganized attachment (Type D) and created the Adult Attachment Interview. A parent’s narrative coherence about their own history predicts their child’s attachment pattern — the transmission mechanism.
Concepts: Disorganized attachment · Adult Attachment Interview · Narrative coherence · Unresolved loss/trauma · Intergenerational transmission
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Allan Schore
Integrated attachment with developmental neuroscience. Right-brain-to-right-brain communication between caregiver and infant shapes the orbitofrontal cortex and affect regulation circuits.
Concepts: Right-brain affect regulation · Orbitofrontal development · Implicit relational knowing · Interactive repair
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Daniel Siegel
Created interpersonal neurobiology (IPNB). Popularized the window of tolerance, mindsight, and the hand model of the brain. Integration as the mechanism of mental health.
Concepts: Interpersonal neurobiology · Window of tolerance · Mindsight · Integration
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Sue Johnson
Created EFT for couples (1988). Identifies pursue-withdraw as attachment protest and helps partners access primary emotions beneath reactive positions.
Concepts: EFT for couples · Pursue-withdraw cycle · Attachment injuries · Bonding events · Hold Me Tight
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Peter Fonagy & Anthony Bateman
Developed MBT for BPD. Mentalizing — understanding behavior in terms of mental states — develops through secure attachment and fails under attachment stress.
Concepts: Mentalizing · Reflective functioning · Epistemic trust · Pretend mode
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Alicia Lieberman
Created CPP, the most evidence-based dyadic treatment for young children (0–5) exposed to trauma. Building on Fraiberg’s "ghosts in the nursery."
Concepts: Ghosts in the nursery · Angels in the nursery · Dyadic treatment · Reflective functioning in parenting
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Diana Fosha
Created AEDP, making the therapist’s emotional presence the primary vehicle for "undoing aloneness." An innate healing drive (transformance) is released through corrective emotional experience.
Concepts: Transformance · Undoing aloneness · Core affective experience · Metatherapeutic processing
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Cooper, Hoffman & Powell
Created Circle of Security (1998). The Circle shows the child’s need for secure base and safe haven. "Shark music" names the caregiver’s triggered defensive responses.
Concepts: Circle of Security · Shark music · Bigger, stronger, wiser, kind · Safe haven and secure base