'Attachment is such a core issue': Therapist perspectives on attachment injuries in marriages in India

BackgroundMarital distress is a risk factor for a panoply of mental and physical health disorders. One of the causes of marital distress that is increasingly gaining relevance is attachment injuries in the marital relationship. Emerging from the confluence of adult attachment theory and emotionally focussed couples therapy, attachment injuries refer to tears in the relationship bond caused by abandonment or betrayal in the marriage, especially at times of critical need when attachment needs are salient.ObjectiveThe objective of this study was to investigate how therapists in India conceptualise and assess attachment injuries in marital relationships.MethodA qualitative design was used, whereby in-depth interviews were conducted with 13 therapists and the transcripts were analysed using thematic analysis.ResultsThe analysis resulted in two overarching themes. The first was 'Attachment Injuries are a Common Phenomenon in Couples undergoing Marital Distress', which included themes related to markers of attachment injuries, injurious events, the gendered nature of attachment injury experiences and the impact of attachment injuries. The second overarching theme was 'Therapists Utilize Diverse Methods for the Crucial Process of Identification of Attachment Injuries', which included themes related to the methods used for assessment, the significance of attachment lens, the role of early experiences and the utility of identifying attachment injuries.ConclusionThe results highlighted how attachment injuries, originating from various injurious events, are often a component of marital distress in couples accessing therapy. The findings also pointed towards the need for therapists to develop competency in assessing and addressing attachment injuries, irrespective of their primary therapy orientation.