Starting the article
What is Attachment? 5 | What I've Learned from Over 20 Years of Treating Children 6 | Attachment: The Power That Protects Me from Anxiety 8

Chapter 1: Why Attachment Matters
Case 1: A seventeen-year-old girl who attempted suicide several times 17 | Two wounds received from her biological mother 19 | What was different about that day's interview 22 | Finding her adoptive parents and stopping her wandering 24 | A safe base, the key to stabilizing attachment 25 Returning to her previous life is more important than improving symptoms 27 | The problem is unstable attachment 30

Chapter 2: The Medical Community Focuses on Attachment
Case 2_ Why a Kind and Competent Girl Got Depressed 35 | Physical Symptoms and Mental Problems Are Different 36 | How Wounded Attachment Detects Anxiety 39 | Improving Symptoms Alone Won't Get You Better 40 | Changing the Relationship Between Diagnosis and Treatment 43 | An Attachment Model Effective for All 'Mental Illnesses' 46 | People Forced to Play the Patient Role 47 Case 3_ A Fifth Grader Who Compulsively Pulled Out His Hair 49 | Children Just Want to Be Loved 50 | Wounded Attachment Paralyzes Daily Life 54 | Some Treatments Become Abuse 56 | When Home Fails to Be a Safe Base 58 | It's Not the Patient's Personal Problem 60 | For the Medical Model to Function Properly 62 | The More Complex the Case, the More We Need to Examine Attachment 65
Chapter 3: How Attachment Developed into Attachment Theory
John Bowlby Discovers Attachment 71 | Mary Ainsworth's Four Attachment Types 73 | Secure, Avoidant, Ambivalent, and Disorganized 75 | How Parental Personality Affects Attachment Types 78 | Attachment is Engraved Like Time 82 | Attachment Styles Are Inherited 84 | Metacognition Determines Reflective Ability 86 | Oxytocin, the Hormone That Strengthens Attachment 89 | A New Understanding of Abuse and Attachment Disorders 92

Chapter 4: Stabilizing Wounded Attachments
How to Approach Insecure Attachment 97 | Attachment Restorative vs.
Attachment Security Approach 99 | Counseling and Treatment Are Not Essential 101 | It Starts with a One-on-One Relationship 103 | Symptoms Are Signals from the Body 105 | Case 4_ Why Couldn't Naho Stop Overeating and Vomiting 106 | Case 5_ A Student Who Was Unable to Study Because of Her Obsession with Sentence Structure 113 | Regaining a Secure Base Is Reclaiming Meaning in Life 118 | Overcoming Developmental Disabilities with Secure Attachment 122 | Case 6_ A Woman in Her 30s Who Gave Up on Finding a Job Due to Asperger Syndrome 124 | "No One Ever Asked Me How I Feel" 126

Chapter 5: Everything About the Safe Base
Do You Have Your Own Safe Base? 137 | Ten Principles for Building a Safe Base? 140 | Case 7: The Mother Who Was Urgently Exploring Her Daughter's Wounds? 162 | Have You Ever Experienced Being Completely Understood? 165 | Too Much Narcissism Can't Be a Safe Base? 166 | Case 8: Why a CEO Mom Treated Her Daughter Like a Subordinate? 168 | Wounded Attachment Is Passed Down to the Next Generation. 170 | Too Much Obsession Can't Be a Safe Base. 171 | Good Communication Makes for a Good Safe Base. 173

Chapter 6: Coping Methods According to Attachment Type
Understanding Anxious Attachment 181 | Understanding Avoidant Attachment 190 | Case 9: A Nineteen-Year-Old Man with Delusions of Grandeur 207 | Understanding Unresolved Attachment 210 | Case 10: A High School Student Who Became an Adult Child Due to His Mother's Depression 214

Chapter 7: Breaking Free from Wounded Attachment
Everyone Can Change 219 | Is My Safe Base Really Safe? 221 | Characteristics of People with Secure Attachments 222 | Changing Your Thinking Style Changes Your Attachments 224 | Case 11: A Counselor Who Tried to Change a Client's Cognitive Style 226 | Secure Attachment Strengthens the Ability to Reflect 227 | Connecting the Past, Present, and Future with MBT 229 Breaking Vicious Cycles with Mentalizing 231 | Analytical Mentalizing vs.
Empathic Mentalizing 233 | Role-playing and role-lettering to increase empathy 234 | Mindfulness, not judging things as good or bad 237 | Practice accepting unforgivable people 239 | It's not a bad thing if things don't go your way 241 | Anyone can become a safe base for a loved one 242 | Case 12_ A woman in her 30s who thinks about dying every day 245 | Love yourself even if you're not a top student 248 | Don't obsess over the past 250 | How Dostoevsky became a great writer 252 | Case 13_ Rebuilding relationships with parents through childbirth and childcare 257 | Work and hobbies can also become safe bases 260 | Case 14_ A woman who overcame her longing for her father through divorce 261 | Safe bases are close by 266

In closing
Medicine Can't Save People 269

Misconceptions, biases, and new discoveries about attachment

Misconceptions about attachment: Is attachment only important in infancy?
Insecure attachment is a common cause of all psychological problems.

Attachment develops in the early years of life from the relationship with the mother.
If you form a good attachment with your mother during this period and feel a sense of security, you will be able to feel secure when forming relationships with various people as you grow up.

Many people know this.
As a result, many people misunderstand attachment as a concept that appears in parenting or child psychology.

However, attachment is a very powerful psychological factor that cannot be dismissed as a concept that is only valid during childhood.
Many of today's rapidly increasing mental health problems, including depression, mood swings, anxiety disorders, anger management issues, various dependencies, family breakdown, isolation, and loneliness, are largely related to attachment.
One of the common causes of most psychological problems is ‘insecure attachment.’
These problems often do not respond to medication or cognitive behavioral therapy, leaving both patients and medical professionals at a loss.

Secure attachment alleviates anxiety, brings joy and happiness to interpersonal relationships, and allows for long-lasting, intimate relationships.
Therefore, stable attachment serves as a fundamental factor for smooth sociality and happiness.
People with secure attachments can overcome difficulties in life and maintain a happy life.
However, those who are not like that are not only easily swayed, but are also more likely to have difficulties adapting to society.
In fact, many people who suffer or are seriously troubled by not being able to get along well with people around them have insecure attachments.


In the medical model, people who are judged to need treatment do not have the root cause of the disease, but rather simply express the various emotions they feel as symptoms.
The ones who really need treatment are either the invisible entity causing the disease, or sometimes the parents or primary caregivers who protect the patient with affectionate expressions.
So, if you try to cure symptoms by only referring to the existing medical model, you will inevitably end up making mistakes.

Chapter 1: Why Attachment Matters (30p)


Prejudice about attachment_Is attachment simply a psychological relationship between parents and children?
Attachment is a product of biological structure.

The person who first discovered and named the concept of attachment was British psychiatrist John Bowlby.
While researching children orphaned after World War II, Bowlby discovered that the loss of their mothers left them profoundly traumatized.
Even with adequate nutrition and care, the children suffered from various problems in physical, emotional, and behavioral development, including stunted growth.

Bowlby coined the term "maternal deprivation" because existing theories could not explain this phenomenon, and later confirmed that the devastating shock that occurs when the mother-child relationship is broken occurs not only in humans but also in animals.
We also began to understand the mother-child relationship as a biological phenomenon.
After his research, he became convinced that the relationship a child forms with a particular caregiver plays a crucial role in emotional development and stability, and he called it "attachment." (p. 72)
Since Bowlby discovered attachment, he has always believed that attachment is not simply a psychological relationship but a product of biological structure.
However, it was not possible to prove what mechanism maintained this structure.
However, the principle has been revealed through recent experiments.


In 1955, prairie voles, known to mate once and remain together for life, were injected with a drug that suppresses the secretion of oxytocin. However, even after mating, they did not remain together and instead sought out other partners.
This experiment confirmed that suppressing oxytocin secretion can control romantic feelings toward a partner.

Another experiment conducted in 1979 demonstrated a new utility for oxytocin.
A study found that administering oxytocin to the brains of field mice increased maternal behaviors such as caring for their young and behaviors that promote consideration and intimacy with other individuals.
Until now, oxytocin was known as a hormone that promotes lactation, induces labor, and makes you feel romantic and loved towards your partner.
However, the results of this experiment revealed that oxytocin secretion also affects the way mothers care for their young.

Several subsequent studies have also shown that oxytocin not only enhances parenting and maternal behavior, but also enhances sociality and suppresses stress and anxiety.
It has been proven that the reason we become dependent on the object of our affection is not a simple psychological problem but a physiological principle. (p. 90)

Recently, another study has been published proving the efficacy of oxytocin.
A representative example is that 'dysfunction of oxytocin is related to some autism' and 'administering oxytocin helps improve autism'.
In fact, there are cases where people are diagnosed with autism as children, but their symptoms improve as they grow up to a degree that makes it hard to believe that they actually have autism.
In all cases, the patient's attachment was stable, and the parents and others around them supported the patient's growth. (p. 91)
However, there are concerns that excessive administration of oxytocin as a drug may suppress the secretion of oxytocin that should be secreted naturally in the body.
Therefore, when treating various mental illnesses including autism, it is most desirable to induce the natural secretion of oxytocin in the body.
This means that a better treatment is one that allows the patient to naturally feel attached to the person they rely on, thereby activating the natural secretion of oxytocin in the body.


The SMART function, which British psychoanalyst Peter Fonagy considered an important characteristic of secure attachment, was thought to be ineffective for autistic patients.
However, in some cases, mentalizing functions were found to recover as the attachment relationship became stable.
Of course, it wasn't completely cured, but it was possible to recover to a level where it didn't interfere with social life.

Oxytocin administration has been reported to be effective in treating depression, anxiety disorders, addiction, and overeating in addition to autism.
The reason oxytocin is effective for such a wide range of conditions, regardless of the diagnosis, is because it not only has anti-stress effects but is also broadly involved in attachment stability.
No matter how good the treatment is, if the parents treat the child irritably, the effect will be reduced.
How Attachment Developed into Attachment Theory, p. 91


New Discoveries About Attachment 1
Secure attachment can improve developmental disabilities.

Developmental disabilities are one of the most rapidly increasing mental illnesses in recent years.
In the past, late marriage and advanced childbirth were considered the main causes, but recently, there have been reports that the number of patients with developmental disabilities is increasing due to poor lifestyle habits and unstable attachments caused by child abuse.
The biggest problem with developmental disabilities is the lack of treatment and support.
If the patient is young, special education can sometimes help, but it is still not clear which treatment is most effective.

The author emphasizes that, in relation to developmental disabilities, it is more important to consider whether the patient enjoys the treatment and whether the medical staff or teachers in charge are stabilizing the patient's attachment than whether the treatment is administered.
In cases where the patient's condition has significantly improved, these two conditions have always been well met.
This applies not only to children but also to adults, and a secure attachment is also an important factor in helping adults with developmental disabilities adapt well to society.
Even if the symptoms themselves are not completely cured, the ability to accept and cope with the situation may vary depending on the stability of the attachment.



Based on my clinical experience of over 20 years, children with secure attachments to their parents are more likely to adapt well to society, even if they have some developmental disabilities.
Training to secure attachment with parents protects children better than special education or therapy.

In fact, special education and treatment are more effective when attachment to parents is a prerequisite.
No matter how good the treatment is, if the parents treat the child irritably, the effect will be reduced.

Chapter 4: Stabilizing Wounded Attachment (p. 124)

New Discoveries About Attachment 2
Work and hobbies can also help stabilize attachment.

Many people confess that no matter how many different psychology books they read, they still suffer from the same problems.
Many of their sufferings are that they have difficulty socializing with people or that their relationships bring more pain than joy.

Many psychology books published so far mention the 'wounded inner child' in this case and convey messages such as 'make peace with your past self', 'accept and love your shortcomings', and 'you are enough just as you are'.
The problem is that this advice doesn't offer any practical solutions to people who are suffering in their relationships right now.

The author tells these people, "If you don't like your family, friends, or lover, you can easily stabilize your attachment with work, hobbies, or activities you like."
If you are uncomfortable with interpersonal relationships, there is no need to feel pressured to form relationships, as the very situation of having to receive help from someone puts a greater burden on you.


Famous writers such as Natsume Soseki, Tanizaki Junichiro, Kawabata Yasunari, Dazai Osamu, and Mishima Yukio suffered from severe attachment disorders.
It could be said that he wrote the work to overcome attachment disorder.
Perhaps he focused on writing because he couldn't find anyone to attach himself to outside.
Of course, writing can't help you overcome all the conflicts in your heart, but it can at least help relieve some of the pain.
Dostoevsky and Hermann Hesse also overcame attachment disorders through writing.
They got a perfect fit by writing.
You can also heal emotional wounds by pouring your heart and soul into something.
Therefore, hobbies and special skills can be very helpful in overcoming attachment disorder.
Chapter 7: Breaking Free from Wounded Attachment (p. 256)