"Forty-two lives as therapists”: The influence of therapists’ attachment and personality on therapeutic relationship

Preliminary evidences suggest that more securely attached therapists form stronger alliances with their patients (Degnan et al., 2016), while therapists’ insecure attachment seems related to lower level of alliance quality and lacking countertransference management capacities (Mohr et al., 2005) due to the reactivation of their attachment-related worries or defences. However, there is a call for more systematic studies to strengthen the existing literature. Furthermore, the therapist’s personality remains an under-researched area despite its clinical relevance. The aim of this study is to investigate the influence of the therapists’ attachment style and personality on factors related to therapeutic relationship, such as alliance and countertransference patterns (Gelso, 2014). Forty-two novice clinicians recruited via several Italian school of psychodynamic psychotherapy were interviewed using the Clinical Diagnostic Interview (Westen, Muderrisoglu, 2003) followed by an evaluation with the Adult Attachment Interview (George et al., 1985) and the Shedler-Westen Assessment Procedure-200 (Westen, Shedler, 1999a; 1999b; Shedler, Westen, Lingiardi, 2014). They were also asked to complete the Therapist Response Questionnaire (Zittel, Westen, 2003) and the Working Alliance Inventory-T (Horvath, Greenberg, 1989). In order to compensate the underrepresentation of specific AAI classifications, a well-established dimensional approach (Waters et al., 2005) for describing attachment representation has been employed. Results show a prevalence of securely attached and high level of personality functioning therapists, both related to a positive average quality of the components of therapeutic relationship. However, dimensional therapists’ attachment insecurity and personality disturbances seem to influence their emotional response. The present study gives a first empirical evidence about those characteristics that account for therapists’ effects in the psychotherapy process