John Jeremiah Ahearne

COUNSELLING AND PSYCHOTHERAPY IN Angel Islington, HOLBORN,

Bond Street, Harley STreet, Cavendish Square, oxford street, and Marylebone


Relational Therapy – using an attachment-based methodology

Relational therapy recognises that we are relational beings. From the moment we’re born, we learn who we are and how safe the world is through our connection with others. If those early relationships were nurturing, consistent, and attuned, we’re more likely to develop a stable sense of self and the capacity to form secure relationships. But if love came with conditions, if needs were met unpredictably or dismissed entirely, then we may carry into adulthood a sense of not being safe, not being good enough, or needing to earn closeness.

So many people come into therapy carrying relational wounds—feeling misunderstood, mistrustful, overly dependent, chronically isolated, or caught in painful dynamics that seem to repeat themselves. In relational therapy, I’m not only interested in what the client says, but how they relate - to me, to themselves, and to the world around them. It’s not about offering a fix from the outside. It’s about co-creating a new kind of relationship within the therapy that might allow for healing, for reflection, and eventually, for transformation.

One of the most helpful ways I’ve found to understand these relational patterns is through attachment theory. I don’t introduce it right away, and I certainly never use it to label someone. But over time, it can be an incredibly useful framework for helping clients make sense of the deeper structures that shape how they connect—or disconnect—from others.

Attachment theory, originally developed by John Bowlby, suggests that the quality of our early relationships with primary caregivers shapes how we relate to others throughout our lives. These early “attachment styles” are not fixed or pathological, but rather adaptations—clever, often unconscious strategies we’ve developed in response to the emotional environment we grew up in.

There are four main attachment styles that I sometimes talk about in therapy:

Secure, anxious, avoidant, and disorganised.

None is good or bad—they each tell a story - and each has many tributaries that run off of the main river...

When it comes to attachment styles, I believe that we have main attachment style that is dominant but we have small percentages of all the other attachment styles based on many factors.

A client with a secure attachment style may have had caregivers who were emotionally available, responsive, and consistent. In adult life, they may feel reasonably comfortable with intimacy and independence. Therapy with securely attached clients can still go deep—especially if a trauma or recent loss has disrupted their sense of safety—but there’s often a solid foundation to build from.

Clients with an anxious attachment style, by contrast, may have experienced inconsistent caregiving—sometimes loving, sometimes distant or rejecting. As adults, they may fear abandonment, become preoccupied with others’ approval, or struggle with intense feelings of not being enough. In therapy, they might need a lot of reassurance, or worry about how I perceive them. Rather than pathologising this, I see it as a communication—an emotional echo from the past. The task is not to fix it, but to gently explore it, staying consistent and attuned so that new patterns of safety and trust can begin to form.

Those with an avoidant attachment style may have grown up in environments where emotional expression was discouraged or where their needs weren’t reliably met. As a result, they may have learned to rely only on themselves. In therapy, this might show up as difficulty opening up, emotional detachment, or an emphasis on independence. With avoidant clients, I try to honour their need for space while slowly inviting emotional contact, without rushing, and without trying to “get through” their defences. Often, those defences kept them safe once. Therapy respects that history.

Disorganised attachment, perhaps the most complex, is often rooted in traumatic early relationships, particularly when the caregiver was also a source of fear or threat. Clients with this style may oscillate between seeking closeness and pushing it away. Their relationships may feel confusing or unsafe, and therapy can evoke powerful responses of mistrust, idealisation, or fear of being harmed. Here, I aim to create a steady, transparent, and boundaried therapeutic relationship, one where safety can gradually be established. Ruptures may be more frequent, but they also offer profound opportunities for repair—something the client may never have experienced before.

But attachment theory is only one lens among many in relational therapy. I’m always paying attention to how the client and I are co-creating the space together. Are they taking care of me emotionally, or are they allowing me to care for them? Do they expect me to know what they need without asking? Do they shut down if I get something wrong, or do they feel able to tell me? These patterns—sometimes subtle, sometimes dramatic—are significant. They often mirror what has happened in the client’s relationships beyond the therapy room.

One of the most powerful aspects of relational therapy is the opportunity for repair and growth. In ordinary life, when relationships go wrong—when there’s misunderstanding, disappointment, or rupture—we often retreat, retaliate, or bury the feelings. But in therapy, we can slow it down. If I say something that lands badly, and the client feels hurt or disconnected, that becomes part of the work. Not something to avoid or sweep away, but something to name, explore, and understand. And when the client sees that I don’t punish them for bringing it up—or abandon them emotionally—it can be deeply reparative. It’s not the absence of rupture that matters most, but the presence of repair.

This kind of work takes time. It can be slow, subtle, and sometimes messy. But it’s also deeply hopeful. Over time, the client may begin to internalise a new way of relating—a sense that they can be held emotionally, that they can express needs without fear, that they don’t have to manage everything alone. This internal shift often begins to ripple outward: relationships outside therapy start to change, self-worth strengthens, and old patterns begin to loosen.

Relational therapy also asks something of me. It requires that I bring not just my training, but my whole self, my presence, my attention, my capacity to feel and reflect. It’s not about self-disclosure or blurring boundaries, but about being real, authentically engaged, emotionally available, and reflective about what’s happening between us. That’s what gives the work its depth and its integrity.

In the end, relational therapy is about the relationship as the healing agent. We use the therapy relationship not as a neutral backdrop, but as the ground on which the client can begin to trust, to grieve, to feel, and to grow. It’s through being seen, held, challenged and cared for—often in ways that were missing before - that healing becomes possible.

And for me, there’s something profoundly moving about that. Not because I’m the one doing the healing, but because the relationship itself becomes a space where the client can become more fully themselves. That, to me, this is the essence of relational therapy 🙂


© John Jeremiah Ahearne

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