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This article begins with a reflection on the tensions that have existed at the intersection of attachment theory, psychoanalysis, and the use of empirical research methods. This discourse is described as having evolved considerably, involving some elements of intellectual détente and other elements of entrenchment (on both sides). It is suggested that future debate may revolve around the idea that many forms of psychopathology may be understood as fundamentally social in nature. Recognizing the salience of the communication of social knowledge—transmitted via epistemic trust—may be key to reconceptualizing both the origins of psychological disorder, and the processes that underlie effective treatments.