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This is a well-researched and articulate account of Rhona Fear's long and diligent search for the crucial ingredient(s) for effective psychoanalytic psychotherapy with “insecurely attached (avoidant or ambivalent)” clients who have suffered early developmental deficits. The author describes how she came to develop, within the framework of attachment theory, a new integrative theory of “learned security”. She illustrates this with case studies of work with four long-term clients and examples from her own ongoing therapy of over twenty years, and hopes “that this book may help other therapists to develop such a way of working” (p. xxiii).
Fear has drawn on the work of John Bowlby and succeeding attachment theorists; as well as concepts of “empathy” from Heinz Kohut's Self Psychology, and the three types of transference he describes by the client towards the therapist as “selfobject: twinship, idealising and mirroring”. Fear adds to her therapy mix the “intersubjective perspective” of Stolorow, Atwood and Brandchaft; and the core conditions central to Carl Rogers' Person-Centred Therapy of “unconditional positive regard”, “empathy” and “congruence”.
I am left puzzled by Fear's deep conviction that the concept of “learned security” is a new one, and her creation. Surely, this is what attachment-based psychoanalytic psychotherapists—amongst other “relational” schools—all seek to foster from what is more commonly known as “a secure base” for their clients. In the author's words:
While I am patently aware that many therapists pay lip service to the concept of the therapist acting as a secure base, I firmly believe that the majority do not adhere to the principle that every therapeutic hour of every day one must remember to apply oneself to the task of enabling the client to experience what it means to have a secure base.
The theory of learned security requires that the therapist enter into a contract with the client where she gives of herself to an unprecedented extent … it re