Attachment disorganization and the controlling strategies: An illustration of the contributions of attachment theory to developmental psychopathology and to psychotherapy integration.

Attachment theory may be instrumental in providing a framework for psychotherapy integration, but to cope with the complexities of clinical realities it should be considered within an overall evolutionary approach to the basis of human interpersonal behavior and also in the perspective of developmental psychopathology. To illustrate these premises with materials that can be of immediate interest to practicing psychotherapists, this article focuses on the example of the clinical applications of research findings on attachment disorganization and its developmental sequels. The controlling strategies that usually follow in the preschool years infant disorganized attachment illustrate the relevance of considering the dialectics and the dynamic tensions between attachment motives and other evolved motives such as caregiving and dominance‐submission. The role played by the disorganized-controlling strategies in psychopathological developments and in the relational dilemmas that often characterize the psychotherapy of difficult patients is discussed and exemplified through two clinical vignettes. It is argued that the model based on attachment disorganization and controlling strategies relies on concepts that are understandable and potentially acceptable to psychotherapists of different orientations.