What does a Harm Reduction Model Do?

The harm reduction model helped medical and mental health professionals incorporate the reality that drugs are available and being used despite laws and guidelines trying to control their spread and ingestion. Harm reduction also highlights and respects an individual’s autonomy, which is something that everyone deserves when receiving care. Harm reduction approaches are now used to promote safer sex, reduce the transmission of viruses through intravenous drug use, and decrease the number of drug (especially opioid) overdoses. 

Emerging Evidence Related to an Increase in Psychedelic Use and Psychotherapy

Unlike substances such as heroin, cocaine, and alcohol – that facilitate the numbing out and avoidance of painful feelings and memories – psychedelics appear to be being used more than ever by individuals to confront and overcome the uncomfortable and challenging aspects of their experience. An ever-growing body of academic research is consistently showing that psychedelics and non-ordinary states of consciousness can support the reduction of symptoms associated with common mental health disorders, as well as the existential distress that may be part of being human. 

What is the Research on Psychedelic-Assisted Therapy?

Psychedelic-assisted therapy that is done in research settings, or with regulated substances such as ketamine, is legal and rigorously controlled. However, we know that people also use psychedelics in other settings such as spiritual or religious ceremonies, or even in more casual settings, such as with a group of friends or alone. In all of these environments, people are turning to psychedelics because they are seeking meaningful healing and transformation. In a society where people continue to have unmet needs around their mental health and well-being – especially following the COVID-19 pandemic, curiosity, rather than moral judgment, is a valuable tool to examine the possibility of psychedelic medicine to meet those needs. We can turn towards psychedelic harm reduction for a better framework to understand and work with all possible choices that people might make regarding their psychedelic use. 

 If you’re interested in learning more about how psychedelic harm reduction can help you reach your goals in therapy, you can book a complimentary 30-minute consultation with me today.

The field of mental health still has a long way to go in our general understanding of trauma. Trauma-based disorders are one of the few conditions that require a life-changing event for a diagnosis to be made. And unfortunately, many of our diagnostic understanding of trauma is looking at it after the fact. Mental health professionals typically explore the symptoms and functioning of people who have already endured a traumatic experience. But very little is said for the people who are still actively enduring traumatic situations, some even in their daily lives.

As with most things in healthcare, our current models of diagnosing and treating trauma are mostly during the post-traumatic phase.

Post-traumatic stress disorder has been the landmark understanding of trauma for decades. We know now these symptoms are only one possible presentation of trauma. Complex PTSD provides a deeper understanding of what it can look like for someone to endure chronic exposures to distress and overwhelm and helps paint a broader picture of symptoms that individuals may face

But there is an overwhelming need for us to examine what it looks like for people who are currently surviving adversity- understanding how symptoms present when exposed to active threats and how to better prioritize prevention. As with most things in healthcare, our current models of diagnosing and treating trauma are mostly during the post-traumatic phase. Protecting people from post-traumatic symptoms is an important part of this work, and we can best do that if we intervene as soon as possible- and we can only intervene if someone is capable of seeing that they are living through active distress.

What Happens When You Are in Active Distress?

Stress is psychological and physiological. It impacts you in your body and your brain- and the process by which this happens is a universal, neurobiological experience for everyone. In essence

• You are exposed to a demand or a threat that you perceive to be challenging or overwhelming
• This stressor is then processed by your body as a “bad thing” and a dangerous thing
• Your body communicates to your brain via the vagus nerve that you are now in the presence of danger and must shift into self-preservation mode
• This then puts you into fight or flight, and you shift out of your thinking brain
• Reflexively and automatically, you become more aware of how bad the stressor feels and you become fixated on how you can get relief from the stress
• Your body starts to feel uncomfortable because your heart is racing, your muscles are tense, your stomach hurts, and you have too much adrenaline and/or cortisol in your bloodstream
• It becomes harder to focus, to feel comfortable, to feel motivated and your behaviors shift into self-protective behaviors to get away from the stressor. You may:
  • Fight: Become self-defensive or conflictual
  • Flight: Try to avoid or escape the stressor
  • Freeze: Become paralyzed or stuck
  • Fawn: People-please or drop your boundaries
  • Flop: Submit and give up
  • Fright: Panic and explode
• You stay stuck in these behaviors until it feels like you have adequately dealt with the stressor
• Your body produces adrenaline and cortisol and then you crash into a low period so you can recuperate

This neurobiological process works great when presented with acute threats such as a bear in the woods. These processes do not work as great, however, when you are trying to function at work or in a relationship and you are stuck in a state of distress.

The longer you are in distress, the more damage your stress chemicals do to your brain and body. The more frequently you are exposed to distress, the more your ability to tolerate erodes away. The more intense or threatening the distress, the more you develop complicated or harmful coping strategies. When you are flooded with stress due to active crisis, your capacity to function becomes highly dysregulated. This regulation must be intervened before it becomes ingrained in us as a post-traumatic symptom of distress.

What Does Active Distress Mean?

While life almost always guarantees adversity, not everyone is exposed to the same intensity or frequency of adversity. And even fewer people are exposed to what would be considered true threats to their survival. When you have active threats of harm facing you, you move through the world differently than your peers. When exposed to intense, frequent, or harmful threats, you spend more resources in self-preservation and survival mode and therefore have fewer resources to expend on other parts of your life.

Systemic distress can look different to different individuals. For example:

• Financial insecurity is distressing because it poses a threat to housing or food.
• Housing insecurity is distressing because it poses a threat to safety and protection.
• Food insecurity is distressing because it poses a threat to survival and nourishment.
• Community violence is distressing because it poses a threat to safety and connections.
• Harsh political climates are distressing because they pose a threat to policy-driven needs and access to resources.

Some groups of people are more greatly impacted by these threats than others.

On a smaller scale, many people are exposed to threats of safety within their own homes. They may be exposed to

• An abusive partner, parent, sibling, or family member.
• High conflict or high control groups.
• Neglect or abandonment.
• Loss or grief.
• Substance use or harmful mental health challenges.

When Does Distress Become Trauma?

When someone is exposed to frequent, intense, and unsupported experiences of distress, it can become “toxic”. Your body is designed to only handle so much turmoil before it makes you sick. Trauma is psychological and physiological injury due to repeated or intense exposures to unregulated stress. Quite literally, trauma is when your stress exposure is so strong and so unmediated that it alters the way you feel and function.

From a behavioral perspective: if you are exposed to so much stress that it is harming you, your behaviors are going to become hyper-fixated on getting relief from the distress. This might lead to the development of relief-seeking behaviors that often exist within self-harm: non-suicidal self-injury (NSSI), eating disorders, substance use, etc. People might also develop compulsive behaviors to get relief which can develop into obsessive-compulsive disorders. On a more surface level, someone may also spend so much time and energy on surviving (working too much, protecting themselves from harmful people, etc.) that they can’t do anything else.

From a neurobiological perspective: chronic and uninterrupted exposure to adrenaline and cortisol causes damage to your brain and body. Your amygdala grows, your hippocampus shrinks, and you have less activation in your PFC. This changes how you experience and process emotions, how you access memories, how you think, and how you make decisions. This changes your capacity to make good, healing choices.

When you are flooded with stress due to active crisis, your capacity to function becomes highly dysregulated. This regulation must be intervened before it becomes ingrained in us as a post-traumatic symptom of distress.

From a physiological perspective: adrenaline and cortisol are also degrading to your digestive systems, pulmonary systems, cardiac systems, and endocrinological systems. Stress chemicals degrade you from the inside out which is one explanation behind why trauma survivors have worse health outcomes. This changes how much you can rely on your body to move you through life.

From an evolutionary perspective: you are moldable so you can adapt to your environments. You adapt in spaces of hostility so you can ensure your survival, but those adaptations do not easily apply to worlds outside of your trauma. These changes can be hard to get away from, causing repeated patterns of pain even when trying to heal from past trauma.
In short- when distress is too much, too intense, or too frequent, you can develop symptoms of traumatic stress. And trauma is complicated because it compounds. When this compounding is complex and chronic, it can change the trajectory of development, play a hand in the worsening of mental health conditions, and change the way you perceive and interact with your world.

Does Everyone Realize They Are Developing Trauma?

When your world is so overwhelming and chaotic that the distress could be damaging, it also interrupts your ability to assess what’s going on. Your situation might be so familiar or so normal you don’t even know it could be harmful. It could be so overwhelming and consuming you don’t have the space to realize what’s happening. It can be so shameful or hard to look at that you ignore or deny it.

It is often difficult for people who are in active distress to act in ways that are healing enough to protect themselves from trauma. The way that we talk about trauma is so focused on how to identify it once you have survived. The gap in identifying how to know when you’re actively living it is so important for survivors to get help as soon as possible, to better prevent the establishment of long-term, chronic symptomatology. It also helps inform providers on how to best address symptoms of distress.

Your Turn: Do you have signs or symptoms of active distress? What does this look like to you? How have you found healing? Share in the comments below.

If you’ve lived or socialized in New York City for any length of time, you’ve probably had someone ask, “What do you do?” The culture is fixated on work – what it is, how it’s going, what successes or headaches you’ve experienced there, how much of a monster your boss is, the amount of your paycheck, etc. A common response is, “I’m a…” Continuing the theme of fixation, we use the verb “to be” in relation to our work. We are our work, and it is us.

But in truth, despite it often being placed at the very center of our lives and identity, work is only one part of our experience and does not need to be a part of our identity. Who we are outside of work, and all its complexity, is often left unexplored, unnourished, and undeveloped.

The Psychology of Career and Identity

As an adult living in the US, you are more likely to spend the majority of your waking hours at work than anywhere else. (According to the Bureau of Labor Statistics, those working outside the home averaged 7.9 hours of work per day, which does not include getting ready for work or commuting). Your sense of self and identity can easily become fused with, or overwhelmed by, where you are spending so much time.

This tendency is turbocharged by the social significance given to work-related ideas like productivity, working hard, getting ahead, chasing promotions, having to “hustle,” and consumerism. While this can feel uplifting for those experiencing a highpoint in their work, any changes in your ability to be optimally productive (such as getting sick, being fired, or leaving the workforce) can lead to big questions.

Who are you outside of work? What is important to you? For some, these questions may be accompanied by feelings of depression, anxiety, isolation, grief, feeling lost, and more.

If you seemingly are your work, some of the below experiences may sound familiar:

• • Not having much to talk about other than work or colleagues

  • Difficulty identifying your likes, dislikes, or interests

  • Relating everything back to work (ex: positive qualities are those that allow you to succeed at work)

  • Belief that the next title bump, raise, or job will give you a sense of fulfillment or satisfaction

  • No sense of play (ability to do something simply for the sake of enjoyment, rather than for financial or professional purposes)

Who we are outside of work, and all its complexity, is often left unexplored, unnourished, and undeveloped.

I often work with clients to explore the impact that the internalization of capitalism has on their self-worth, goals, and identity. If the above experiences resonate with you, it may be a sign that you’re ready to challenge the status quo and break free from some of the capitalistic ideals that you’ve bought into for so long. So, let’s help you discover who you are outside of work.

How to discover who you are outside of work

The importance of exploring your core values and purpose

If your sense of self and identity are consumed by work, imagining anything else or thinking about where to begin may seem daunting. This is extremely common and understandable – you’re challenging yourself to grow in new ways that aren’t often talked about or encouraged. So, how can you start to discover who you are outside of work? One way to begin is by thinking about your values, interests, hopes, and dreams.

Understanding these things can help you recognize the parts of yourself unrelated to job titles and salary brackets. Here are some questions I invite you to reflect on:

• How do I like to spend my free time? (this can help illuminate any areas of enjoyment, hobbies, or potential passions that you may want to lean into)
• Do I have any interests or talents that I haven’t explored (or given myself permission to explore) yet?
• What aspects of my character do I appreciate? (if this is difficult to answer, ask yourself
• what do others appreciate about you?)
• What values do I hold dear in life?
• What are my strengths? What are my areas for growth?
• What drives my behavior and how do I make decisions?
• Who have been the most influential people in my life and why?
• How can I be a better friend, partner, or person to those around me?

If reflecting on the above questions truthfully, some of your answers may be uncomfortable. The purpose of thinking about them isn’t to have everything precisely figured out, but rather to serve as a starting point for learning more about yourself. For many, acknowledging the less comfortable parts of yourself or areas of life you’d like to be different is an important step toward growth and change.

You are a whole person outside of work, deserving of rest and fulfillment

How capitalism keeps us stuck

In the United States, work and profit are valued above all else. We are taught from a very young age that to be unemployed or “unproductive” are among the worst things a person can be (just think about how intense the fear of being perceived as “lazy” is). Inevitably, this means many of us are consumed by work as we strive to be the most productive.

The fact that this constant striving leaves little time for the development of personhood is not by accident. People who are too tired and beaten down from work don’t have an opportunity to develop passions, break out of their isolation, organize with others to address their grievances and fight for change, or generally challenge the status quo. Keeping you focused on work affects things from the macro (national, state, and community level) all the way down to you.

For many, acknowledging the less comfortable parts of yourself or areas of life you’d like to be different is an important step toward growth and change.

So, how could you start to break out of this very intentional cycle and begin to get to know yourself better? In addition to reflecting on the questions above, having various building blocks in place can be helpful. Tending to things like your mental health, physical health, and your relationships can go a long way to having you feel supported as you push yourself to grow in new and exciting ways.

You Are More Than Your Job

I’m here to remind you that you are not your job. It may take up significant amounts of your time, energy, and attention, but at the end of the day, it is what you do, not who you are. Exploring your interests, values, and passions can be a great way to begin to untangle work from the parts of your life and identity that are just waiting to be cultivated. You deserve to rest and discover who you are outside of work. Embarking on this journey of growth and development with a trusted professional can be an especially rewarding and fulfilling experience. Regardless of how you get there, though, my hope is that the next time a New Yorker asks you about yourself, you will have more to say than you are your job.

Your Turn: Have you taken time to explore your values, passions, interests and who you are outside of work? Do you find it challenging to give yourself permission to rest? What has your experience been? Share in the comments below.

As life demands become more complex, ADHD symptoms may often become more prominent and a diagnosis is made later in life.

It’s a common myth that ADHD is primarily experienced in childhood. It’s estimated that around 8 million adults in the U.S. experience ADHD.

A trained professional can help you tap into your inner strengths and improve how you manage unwanted ADHD symptoms.

Boundary setting is a keystone to a healthy relationship- do you struggle to set boundaries or follow boundaries set by others?

Maybe you act clingy towards your partner. Maybe you spend too much time alone. You might constantly seek validation and approval, or you might tend to remain aloof and not dependent on anyone — even your partner.

These behaviors all stem from people’s individual attachment style. Identifying your own attachment style may help you figure out (and solve) your problems with setting boundaries.

What Is Attachment?

Attachment is how you securely connect with others, and the degree to which you feel safe in your relationships. You can think of it as how you interact and connect with the people around you, especially those you love.

Attachment is the level of closeness you feel with others: it’s how you show love, care, and affection. But it is also how you interpret or understand others’ affection towards you. The degree to which you feel comfortable in vulnerability is strongly determined by attachment.

Have you ever felt fear or anxiety over your partner leaving you, or how your friends and family truly feel about you? Have you ever struggled to balance time with yourself versus with others? Are you unsure of how to determine how close to get to others? These are likely influenced by your attachment style.

What are attachment styles?

Attachment styles are the pattern of behavior or traits you develop when dealing with people — especially those with whom you have a strong emotional connection.

Basically, your attachment style is what shapes and influences your behaviors when it comes to relationships. That includes setting and following boundaries.

Although we call them styles, they’re actually more like “attachment states” simply because you can’t change them according to your whim — like how you can with your fashion style. Unless you dig deep, identify, and actively work on your attachment style, it will remain how it is, likely for the rest of your life.

The Attachment Theory

The concept of attachment styles was first developed by psychiatrist John Bowlby back in the 1950s when he came up with what we now call the attachment theory.

Everyone forms their attachment styles early on — during their first five years as a child, in fact. Which attachment style you develop depends on your primary or earliest caregivers. This means your parents, your aunts or uncles, your grandparents, or other guardians.

Your earliest relationships set the stage for the relationships you later have in life. It impacts what you view as safe, what you think is possible, how you connect with others, how you trust others, and much more.

Whether you feel safe, loved, and fully secure in your adult relationships depends on whether you were able to feel the same way as a child.

Identifying Your Attachment Style

There are two main attachment styles based on the attachment theory: secure and insecure. However, the second one can be further divided into three types: anxious, avoidant, and disorganized. This gives us four separate attachment styles.

Out of these four, the secure attachment style is the healthiest and most stable.

The remaining three insecure attachment types are often rooted in poor relationships, some form of insecurity, or even childhood trauma. In turn, these usually result in negative patterns of behavior when you get into relationships as an adult.

Secure Attachment

A secure attachment style is born from a safe, visibly loving, and of course, secure relationship with your earliest caregivers.

You don’t need to grow up in a perfect environment to form a secure attachment. What’s important is you can trust your parents or guardians to tend to your needs — both physical and emotional.

Which attachment style you develop depends on your primary or earliest caregivers.

As a child, you didn’t have any anxieties or worries that you’ll be left to fend for yourself. You felt secure in your relationships with your parents or caregivers, and knew they truly loved you, supported you, and would come back for you even if they left.

Additionally, you were given both freedom and safe, firm limits.

What does having a secure attachment style look like as a grown adult?

• You maintain a sense of independence.
• You learn to appreciate your own self-worth.
• You have a positive view of yourself or have self-esteem and self-confidence.
• You have high closeness desires while still feeling comfortable alone.
• You can maintain a healthy balance of “me time” and “connected time” with your partner.
• You are not afraid of intimacy.
• You have low avoidance or feel comfortable being with others.
• You can reliably self-reflect and manage your emotions.
• You can trust others and give your trust in return.
• You feel confident in starting new relationships even after one ends.
• You feel comfortable depending on others and being relied on by your partner.

A great way to figure out if you have a secure attachment style is to think back on whether or not you fear or get anxious about being on your own.

Anxious-insecure Attachment

Also known as anxious-ambivalent or anxious-preoccupied, this is the likely attachment state of those who need a lot of reassurance to feel safe in their relationships. Like the name implies, you have high anxiety about being abandoned.

Anxious attachment is formed when the support, love, and care your parents or guardians provided were inconsistent. When you don’t know when your needs will be met, you feel as if you need to strongly hold on to, cling to, or make a scene to be noticed by your primary caregiver.

This also results in you constantly craving for emotional intimacy and validation. As adults, this can turn into acting “needy” or clingy. As a child, this worked, as it forced the adults to attend to your needs. In adult relationships, however, it can lead to ruptures in the relationship.

Other ways anxious attachment can look like for adults in relationships are:

• You can become too fixated with your partner.
• You feel anxious when your partner is away.
• You want to be close with others but at the same time are reluctant to fully do so.
• You constantly worry about what your others really think about you.
• You try to read between the lines too much.
• You often seek approval or support from your partner.
• You can become too demanding or controlling towards your partner.
• You feel less positive about yourself or have lower self-esteem.
• You have a tendency to overreact, especially to what you may consider threats to your relationship.
• You may struggle to maintain other close relationships, outside of your partner.
• You feel as if you won’t survive without your relationship and fear you’ll end up alone forever.

The ambivalent side of the anxious attachment style comes into play when you’re unable to fully trust or rely on the intimacy and love you receive. This is why relationships with anxious attachment people can still feel cold and distant, despite the clinginess.

This can often result in the end of relationships — turning your worries into a self-fulfilling prophecy.

Avoidant-insecure Attachment

Similar to people with an anxious-ambivalent attachment style, avoidant attachment also stems from feeling unsafe in relationships. If you have an avoidant attachment style, you still have high anxiety regarding being potentially abandoned.

However, instead of clinging to others, you feel wary of others, of forming connections, and especially of relying on other people. As a result, you do the complete opposite and simply avoid or push them away first.

Relationships with anxious attachment people can still feel cold and distant, despite the clinginess.

This is why it’s also called the dismissive attachment style. “They can’t leave me if I leave them first,” or even worse, “They can’t abandon me if I never let them in.”

Avoidant attachment usually forms if you were left to fend for yourself at a young age. You learn early on that it’s hard to trust and depend on others — and that it’s ultimately easier and safer to simply depend on yourself.

If you were reprimanded or even rejected by your primary caregivers for showing emotions, expressing your needs, or depending on them, then you likely be an avoidant type as an adult, too.

In adults, the some signs of having an avoidant or dismissive attachment style are:

• You avoid physical or emotional intimacy or both.
• You feel more comfortable alone.
• You believe you don’t need others to survive.
• You are dismissive of other people or of their concerns and feelings.
• You find it hard to trust others, even without any reason to distrust them.
• You don’t want to depend on others or have others to depend on you.
• You don’t feel comfortable sharing your thoughts and feelings.
• You often don’t feel desire for relationships.
• When in a relationship, you keep your partner at arm’s length.
• You prefer more casual relationships than long-term ones.
• The romantic relationships you form feel shallow or lacking deep emotion.

Although this attachment type doesn’t seek the approval of others, that doesn’t necessarily mean they have high self-esteem or a positive view of themselves. In fact, many are the opposite. Instead of having high self-esteem, you might simply not care about what others think.

Disorganized Attachment

Disorganized attachment — also called fearful-avoidant attachment — is usually formed when kids grow up in unpredictable, highly chaotic, or even risky environments. It can often stem from some sort of childhood trauma or abuse.

As a result, you also didn’t learn how to trust and rely on others, or even yourself. You want to love and be loved. However, you also don’t know how to show and accept love offered to you in a safe or healthy way.

Not only do you have a high anxiety about being abandoned, you also have conflicting wants; you have high avoidance but also have high enmeshment. You might want to be left alone or you may insert yourself into others’ life with ease. You might really struggle with boundary setting.

This attachment style can manifest as the following:

• You’re fearful of being left behind yet tend to start conflicts.
• You find yourself emotionally shutting down and pushing your partner away.
• You tend to not take responsibility for your actions.
• You often blame yourself when fights happen.
• You have a highly negative view of both yourself and your future.
• You can become overly involved in your partner’s life.
• You find it hard to depend on others.
• You struggle with independence due to a lack of skills or self-esteem.
• You struggle with regulating your emotions and can be volatile.
• You find it hard to communicate, or you have unhealthy communication behaviors.
• You can be insensitive or unnecessarily hard on your partner.
• You’re prone to dangerous or risky behaviors when under extreme stress, such as violence, self-harm, or substance abuse.

Avoidant attachment usually forms if you were left to fend for yourself at a young age.

Do Certain Attachment Styles Gravitate Towards Each Other?

Any attachment style can be paired with each other, and since these are usually unspoken patterns in relationships, you might not even be aware of your partner’s attachment style.

Having a secure relationship does not mean it will be perfect or last forever, but there will usually be healthier management if it does end. Additionally, two insecure attachment styles together doesn’t always mean the relationship will be unhealthy or end badly — though there might be a higher risk for rupture.

Though attachment styles may have certain distinguishing traits, each person is still different. Their growth and overall journey and life will still shape their attachment style — or even shift it as they grow older and wiser.

Still, there is a lot of information we can infer from two different attachment styles getting together.

• Secure and secure: This is the winning combination, generally leading to healthy relationships and positive, healthy changes individually.
• Secure and any insecure attachment: The secure attachment can potentially help heal their partner and serve as a positive impact. At the same time, they might not tolerate crossed boundaries and unhealthy relationship signs and simply step away.
• Anxious and anxious: This is generally only good at first as both heavily prioritize the other. The downside is the lack of independence from both makes it an unsustainable dynamic.
• Anxious and avoidant: The anxious attachment often gets the short end of the stick. They tend to prioritize their partner and seek reassurance, which is great for the avoidant. However, as the avoidant attachment fails to give reassurance and instead pulls back, this raises the other’s anxiety and risk for unhealthy behavior.
• Anxious and disorganized: This is usually a chaotic pair. The relationship tends to be an endless loop filled with insecurity and stress for the anxious attachment while their disorganized partner goes back and forth between wanting and not wanting intimacy.
• Avoidant and avoidant: This is most likely to end early, as both feel at ease walking away.
• Avoidant and disorganized: While the disorganized attachment can match their partner’s avoidant behavior, they are also prone to pushing for a closer relationship, which can potentially cause chaos.

How Can You Tell if Your Attachment Style Is Insecure or Impacted?

One of the easiest ways to tell if your attachment style is insecure is to think back to how you think and act towards your partner or loved one.

Do you thrive only when you’re in a relationship and not when you’re single? Do you heavily depend on your partner? Do you constantly seek approval of others?

Do you feel extremely anxious about being left alone? Do you find being on your own uncomfortable? Do you find the need to insert yourself thoroughly in all aspects of your partner’s life — just to reassure yourself of their love and trust them?

How about worrying about what others really think about you? Do you stress about oversharing your real thoughts and feelings, thinking you’d be judged for them?

If your answer to these questions are “no” then you most likely have a secure attachment. If you answered yes to a couple (or even just one) of these questions, then your attachment style has most likely been impacted by your life experiences.

How Do Different Attachment Styles Impact How You Express and Receive Love?

Different attachment styles can dictate how comfortable you are with expressing love and receiving love, affection, and trust.

Secure attachments basically don’t have any problem with giving and receiving love. They do both in healthy, positive ways — making it easier for their partner to also feel secure, heard, and seen.

If you have an anxious-insecure attachment style, you find it hard to trust your partner and the security of your relationship. You tend to question and second-guess the love you give, as well as the love you receive. Many are also more reactive — rather than taking initiative, you take first then reciprocate.

For avoidant attachment types, there’s often a deep struggle with showing meaningful love. You tend to make shallow gestures instead. In many cases, avoidant partners may feel pressured to give more than they are comfortable.

With disorganized attachments, it’s basically both anxious and avoidant behaviors combined. You crave intimacy and seek love but often push others away or find it hard to express love in return.

If you experience a disorganized attachment style, you may feel insulted or threatened by your partner’s boundaries.

How Does Attachment Impact Our Ability To Set Boundaries?

From the examples of behaviors we gave for the four attachment styles, you can already start to see how each one sets and recognizes boundaries.

Secure Attachments and Boundaries

Secure attachments are generally the best at both setting and receiving boundaries.

In many cases, avoidant partners may feel pressured to give more than they are comfortable.

You know your limits, what feels comfortable for you, and most importantly, what you deserve. As such, you can set healthy boundaries accordingly.

You’re also able to communicate these boundaries well with your partner. If one of your boundaries is crossed, you’re confident and secure enough to walk away.

Moreover, because you know the value of boundaries and can set them accordingly, you are also able to receive and respect your partner’s boundaries.

All three insecure attachment types struggle with boundaries — but in very different ways.

Anxious Attachments and Boundaries

Anxious attachment finds it hard to set boundaries. When they do set boundaries, they struggle with following through on them. The fear of being abandoned plays a huge part in this.

Because of fear and anxiety, you’re more likely to let crossed boundaries slide. You’re also less likely to set conditions because of this fear. On the other hand, you’re also more likely to receive your partner’s boundaries well — also due to your fear and anxieties.

Avoidant Attachments and Boundaries

Meanwhile, avoidant attachment styles are actually good at setting boundaries — maybe a little too good.

If you’re an avoidant type, you’re more likely to set overly rigid or strict boundaries. Your desire to avoid dependence on others (and others’ dependence on you) can push you to make extreme boundaries designed to push your partner away.

When it comes to a partner’s boundaries, avoidants respect and recognize them well. Again, you may push this to the extreme and use it as an excuse to end a relationship. This can make it hard for your partner to set boundaries.

When you know the value of boundaries and can set them accordingly, you are also able to receive and respect your partner’s boundaries.

Disorganized Attachments and Boundaries

Disorganized styles are the ones who struggle most with setting boundaries. It’s usually because they don’t know what they want in the first place. It might also be easy to feel insulted or threatened by your partner’s boundaries.

Another thing that can make setting boundaries difficult for you if you’re a disorganized attachment is your difficulty in expressing yourself. Even if you know what you want, you struggle with communicating it with others.

Additionally, disorganized styles are less likely to steadily uphold boundaries — both your own and other people’s.

How Can You Improve Your Boundary Setting Skills?

There are several ways to improve your boundary setting skills. Knowing your attachment style and how it affects your abilities to set and receive boundaries goes a long way.

After all, recognizing the problem is always the first step to arriving at the correct solution. Knowing where you may be faltering will help you address it better.

Other tried and true ways to help you improve your boundary setting skills are:

• Improving your communication style
• Improving your beliefs about yourself and others
• Improving your understanding of other people’s needs
• Improving your understanding of your own needs
• Improving tolerance when faced with conflicts and loss of relationships

The exact way of how you can improve all these will depend on your attachment style, too!

Knowing your attachment style and how it affects your abilities to set and receive boundaries goes a long way.

Taking Steps To Repair Your Attachment Style

Perhaps repair might be too strong a word. After all, your attachment style isn’t “broken” — it may simply be unhealthy for your mental, emotional, and social well-being.

That being said, what can you do about it? Are there any ways to correct, improve, or change your attachment style? Yes, there are!

The following steps can greatly help you:

• Improve your fear of abandonment or judgment

• Find balance between isolation and enmeshment

• Improve desires for closeness

• Manage mental health or physical health challenges that are hurdles

• Enhance your overall relationships

• Find better support systems in life

• Grieve damaged and lost relationships in a healthy manner

• Improve emotional safety

• Heal from your past trauma, neglect, abuse, or betrayal

When you know your attachment style, you can start to work on it. You may be one of the insecure types today, but by addressing the issues you struggle with, you can eventually gain a secure attachment style some day.

As a licensed psychotherapist who is trained in Accelerated Resolution Therapy (ART) and prioritizes trauma-informed care for my clients, I’m dedicated to helping people create meaningful change in their life in a way that feels safe for them.

I specialize in working with clients who have experienced various forms of trauma, including abuse or bullying during childhood, narcissistic relationships, sexual violence, car accidents, systemic oppression, and more. The list of possible trauma-inducing experiences is almost endless. Oftentimes, people may not even be fully aware that they’ve experienced trauma.

For example, in situations such as childhood emotional neglect, where essential emotional connection with a caregiver was missing, or emotional abuse from a romantic partner disguised as jealousy, it can be difficult to pinpoint exact memories that one would label as a typical ‘trauma’. Still, the suffering is immense.

A therapist’s firsthand experience with ART

Because ART is an effective short-term approach, I’m glad to see the majority of my clients experience relief from troubling symptoms typically in one to five sixty-minute sessions. While I’ve witnessed the significant and positive impacts this approach has on clients firsthand, it’s also a newer form of therapy. Many clients who seek therapy to heal trauma have heard of Eye Movement Desensitization and Reprocessing (EMDR) which has gained attention in recent years. However, most clients aren’t aware that they can attain healing for the same presenting problems with ART.

Accelerated Resolution Therapy (ART) and Eye Movement Desensitization and Reprocessing (EMDR) are two different types of evidence-based therapy that are both effective in treating trauma-related conditions such as post-traumatic stress disorder (PTSD), anxiety, and depression. While both ART and EMDR utilize bilateral stimulation in their techniques, there are some key differences between these two therapies which we’ll explore together in this blog.

What is Accelerated Resolution Therapy (ART)?

ART is proven to be effective for the treatment of anxiety, trauma, phobias, and more.

Accelerated Resolution Therapy (ART) is a relatively new evidence-based therapy that combines principles from several traditional forms of psychotherapy to reduce the effect of trauma and other psychological disorders. ART was created in 2008 by psychologist Dr. Laney Rosenzweig, who was originally trained in EMDR.

It uses eye movements and visualization techniques to help the client replace negative images in the mind that cause the symptoms of Post-Traumatic Stress (or other distressing mental health problems) with positive images of the client’s choosing. This is often done quickly: it is expected that most traumatic memories or images can be processed in a single session. This means that the client starts to feel better right away, and can feel safe moving on to addressing the next troubling memory or presenting concern. ART is an evidence-based therapy that can create dramatic improvements in a variety of mental health concerns such as phobias, anxiety, trauma, depressive symptoms, and more.

Who can benefit from Accelerated Resolution Therapy (ART)?

Can a therapist who doesn’t have specialized training in ART administer the treatment?

In order for ART to be effective, it must be administered by a mental health professional who has at least completed the Basic level training in the technique. The Basic training allows clinicians to start using ART immediately and successfully. Part of the training includes the clinicians stepping into the client role and receiving an ART session themselves, which creates a deeper understanding of the intervention and what is happening internally for the client. With enough hours of real world experience facilitating ART sessions, Basic-level trained clinicians can obtain formal certification from the Rosenzweig Center for Rapid Recovery, and move onto more advanced training levels.

Engaging in ART with an officially trained mental health professional is crucial for ensuring client safety, and maximizing likelihood of positive outcomes.

How is Accelerated Resolution Therapy (ART) different from EMDR?

One of the main differences between ART and EMDR is the length of treatment. ART is typically shorter in duration than Eye Movement Desensitization and Reprocessing (EMDR), with many clients experiencing relief from symptoms after as few as one to five sessions. EMDR, on the other hand, typically requires at least seven or eight sessions for clients to see significant improvement, with more sessions needed for complex trauma.

Given that ART can be scheduled one session at a time instead of a course of treatment lasting weeks or months, ART is more flexible to suit each individual’s schedule and financial situation. ART will still be effective for most issues even if the client does not want to or cannot commit to sessions every week. This also makes it a great cost-efficient option at a time when many people are concerned about their expenses.

Research shows that people with post-traumatic stress disorder (PTSD) who undergo ART often experience symptom improvement over one to five one-hour sessions, on average.

While both EMDR and ART attend to emotions and physical sensations that come up when processing memories and images, ART emphasizes reducing negative feelings as soon as possible. This helps the client with overall feelings of distress during each session, and even allows opportunities to enhance positive emotions and sensations when they start to occur.

Another difference is that ART places less emphasis on the content of the traumatic memories than EMDR. Instead, the focus is on identifying and reprocessing the negative emotions, sensations and images associated with the trauma. With ART, clients are guided to replace unpleasant imagery, whereas with EMDR clients are primarily desensitized to the images.

The client does not need to verbalize more of the details of their painful experiences than they feel comfortable sharing. In fact, with ART, the clinician may redirect the client to return to inner processing after brief periods of talking to ensure the session moves along smoothly and to completion.

For this reason, according to its creator and some providers who have been trained in EMDR report that ART is easier on both the client and the provider. Providers perceive specific benefits of ART over other therapies, such as the fact that ART is very direct and efficient, while putting the client in control of the session. And while ART is delivered in a systematic manner, no two sessions are the same.

Research shows that people with post-traumatic stress disorder (PTSD) who undergo ART often experience symptom improvement over one to five one-hour sessions, on average.

If you’re looking for a treatment that can help you resolve trauma and reduce symptoms of anxiety, ART is a great option.

I’ve personally witnessed the positive impact of ART on clients, and the change from the start of a session to the end never ceases to amaze me. The improvement is evident in clients’ more positive facial expressions, relaxed body language, and optimistic way they speak.

Clients are often surprised at how much calmer they feel before even reaching the end of the ART session. The majority of clients who have experienced ART with me have shared that their stress levels are significantly reduced, if not eliminated, by the end of a session. It’s quite common for clients to share that it feels like a weight has been lifted off their shoulders, or that the memory is “over” and safely in the past after experiencing ART.

A particular client, who after ART was able to see connections between how his family treated him in the past and how he treats himself now, expressed to me that he wished he had learned about this treatment a long, long time ago.

The bottom line

Both ART and EMDR are effective when administered by trained professionals who know how to use them properly. No one intervention or technique will work for every single person, so it’s ideal to explore your options with a qualified professional. Individual differences between clients may lead to a preference for ART over EMDR, or vice versa.

It’s worth trying different forms of trauma therapy to see what works best for your individual needs. If you’re interested in learning more about how ART works, I encourage you to schedule a complimentary phone consultation with me today. 

Your Turn: Have you ever received EMDR Therapy or ART? Share your experience in the comments below.