Dr. Diamond Replies.

The Letter to the Editor by Verhees et al. raises interesting questions about how to potentiate the mechanism of change in attachment-focused therapies. The basic assumption of attachment theory is that that children who grow up with insensitive or inconsistent parenting or trauma internalize a view of the world as unsafe and view themselves as unworthy of love and protection. These early relational experiences lay down the foundation of one's view of oneself and expectation of others. This schema, combined with temperament and biology, inform and influence future relationships and experiences. But for Bowlby, because the internal working model is shaped by relational experience, it is continually open for revision if the environment were to change. As psychotherapists, we aim to facilitate that revision.