Attachment and the Defence Against Intimacy: Understanding and Working with Avoidant Attachment, Self-Hatred, and Shame, edited by Linda Cundy.  Routledge, 2019,  113 pp.

The four essays in this exceptional volume convey the thrust of the title, “Attachment and the Defence Against Intimacy,” although “Attachment” in the title refers to avoidance of attachment, that is, “the shell of pseudo-self-sufficiency.” The defensive significance of this avoidance and its myriad manifestations are illustrated and explored by each of the authors. Clinical vignettes and the countertransference

challenges in dealing with such highly defended patients bring these concepts to stirring life.

In Chapter 1, Graham Music, a child psychotherapist, discusses the emergence of the avoidant attachment pattern in children as a consequence of parental failure to satisfy the child's emotional dependency needs, citing A. Alvarez's construct that such children are not so much withdrawn as “undrawn” and “require a particular kind of ‘reclamation’ or ‘live company’ to come alive and grow a mind.” Treating such deadened, inhibited, passive children and adults in psychotherapy requires awareness of one's own “listlessness, boredom and dullness” in session with them, to be alive to and to bear one's “hate in the countertransference,” as described by D. W. Winnicott. Infants are born “other-centered” and require a “companion in meaning making”; in the absence of such companionship, infants adapt to their reality, however bleak, and can retreat to cut off emotional styles, that is, avoidance. The author reports the case of Lucy, a 14-year-old girl, as an example of attachment avoidance who responds favorably to the interest shown in her by her therapist and cautiously opens up to him. The author refers to such avoidant attachment styles as schizoid defenses and suggests a dominance of certain brain regions and networks usually associated with the left hemisphere, citing the work of Iain McGilchrist, Michael Gazzaniga, and Antonio Damasio.

In Chapter 2, Andrea Oskis, a research psychologist and attachment-based psychoanalytic psychotherapist, explores the use of two diff