by Jon G. Allen

Key words: attachment, care, mentalizing, trauma, trust

Benedetto Farina and Adriano Schimmenti have synthesized the burgeoning literature on attachment trauma to draw attention to its prevalence and pervasive role in the development of diverse forms of severe and chronic psychopathology. These sequelae call for a multidimensional approach to treatment that is evidenced by a spate of trauma-related psychotherapies as well as biological interventions. While respecting the sheer complexity of attachment trauma, this commentary offers an integrative perspective for therapists of different orientations. Relying on decades of research on contributors to the effectiveness of psychotherapy, the author provides a distinctive view of the role of common factors that cut across the wide varieties of therapy. These factors pertain largely to qualities of patient-therapist relationships that are especially crucial in the treatment of attachment trauma. This commentary highlights five such common factors: attachment, mentalizing, trust, care, and—not least—the therapist. As Farina and Schimmenti’s review attests, understanding the complexity and severity of illness associated with trauma requires a great deal of knowledge; concomitantly, establishing therapeutic relationships requires an exceptional level of interpersonal skill: skill in being human, to put it simply.