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Inferring Attachment Trauma from Clinical Symptoms and Dynamics: A Challenge for Scientists, a Gift for Therapists and Their Patients

M. Dorahy

Published 2025 in Clinical Neuropsychiatry

ABSTRACT

Farina and Schimmenti bring together a wealth of research data and clinical experience to link the attachment trauma literature with specific symptoms and dynamics in adult patients. Of their many observations and insights, they suggest that attachment trauma should be inferred by clinicians in cases where patients present these specific phenomenological markers, even if the patients’ themselves are not aware of such historical experiences. This theorizing provokes a research agenda that challenges scientists to carefully investigate its veracity, to guide accurate clinical reasoning. From the perspective of a therapist with their patient, the framing of attachment trauma as the etiological foundation of a specific collection of complex symptoms and dynamics offers a relational buffer in what is often a very complicated therapeutic journey. The gift of such theorizing is particularly evident in managing ruptures and countertransferential reactions to facilitate relational repair and re-instigate of empathic attunement. This commentary explores the challenge to researchers and the gift to therapists’ and their patients’ that Farina and Schimmenti’s causal inference provides.

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