ABSTRACT
This chapter unpicks some major clinical challenges of working with clients who present with deactivated dampened down and avoidant attachment styles. The chapter uses clinical examples of work with children and young people as well as neurobiological, psychoanalytic, and attachment thinking to explore these issues. There is a specific focus on the kinds of embodied countertransference responses that can get stirred up with such patients, and how easy it is as therapists to feel deadened and shut down ourselves in their presence. The chapter suggests that the effects of neglect and emotional cut-offness are in many ways more pernicious and worrying than overt trauma and abuse, but that the issues are less known about and understood because people with more “deactivated” presentations gain less attention and evoke less strong feelings than more reactive or acting out patients. Clinical examples give pointers about how we need to shift our clinical technique when working with this group.
