ABSTRACT
The first section of this chapter focuses on the anxiety of being “seen”, and describes a myriad of defences that may be employed to keep the other at bay. The concept of secondary defences is introduced, and the impact of unresolved trauma on “avoidant” individuals briefly outlined. The sequelae of rejection, criticism, intrusion, or neglect found in the early lives of dismissing individuals shapes their relationships with other people as well as their internal worlds and relationship with the self. Defensive measures also protect against the intrusion of painful memories and shame. Clinical vignettes are used to illustrate this. The second part of this chapter reflects on clinical issues and challenges in working with this client group. Drawing on contemporary understanding of secure attachment, specific areas of therapeutic focus are proposed.
