When starting a psychological treatment with children, we initially encounter a set of symptoms, such as childhood fears, rituals, disruptive behaviors… which are the reason why the initial demand for help is made. It should be noted, however, that these symptoms are not the real child’s problem, but only the expression that the child does not live in a situation of internal balance.

In order for the child to be able to resume his homeostasis and guarantee his harmonious development, although in a first phase of stabilization we will apply techniques that make the symptoms less disruptive, it will be necessary sooner or later to address the situations that have caused this symptomatology. Ultimately, and as part of an intervention based on John Bowlby’s Attachment Theory, most symptoms of a child, if not all, are based on insecure elements in their attachment style, which is why we will work to create a more secure base in the child.

The foundations of a secure base in childhood take place in the framework of the relationship with the most relevant protective figures, in most cases the mother and father, and are characterized precisely by providing security to the child, both in the exploration of the world, as in self-perception. The secure or insecure base develops in the first years of life, although this does not necessarily remain unchanged throughout life. Most symptoms and psychopathological disorders are associated with attachment styles or insecure internal operating patterns. Within the framework of a psychotherapeutic intervention, elements can be introduced that promote the creation of a safe base where initially there was an insecure one, thus achieving not only a decrease in symptoms, but also preventing the possible appearance of psychopathological disorders, and enhancing resilience and facilitating child development.

In this sense, according to John Bowlby’s Attachment Theory, a secure attachment is based on (1) feeling supported in the exploration of the world by mother and father and other attachment figures, so that the child perceives the world as non-dangerous. An anxious parenting style can trigger the presence of anxious attachment elements.

In addition, (2) the child should be able to feel that the mother and / or father attachment figures stay close in this scan.

Finally, (3) the child must be able to feel accepted by the attachment figures. The rejection by the protective father / mother figures affects the presence of elements of avoidant clinging.

For all the above, it is important to treat the children’s bond with their protective figures mother and father in the framework of the intervention, since in case of not tackling the root of the problem, the absence of secure base, symptoms may recur or psychopathological disorders may develop later.

Thus, when considering psychological treatment with a child, addressing their relationship with each of their parents becomes essential. I like to make it clear, though, that this is not at all to blame parents for their children’s symptoms, parents do what they can, and no one has been taught to be a parent. In this sense, follow-up sessions with parents, and those together with parents and children, are rather an opportunity to help them improve their bond with their children, and provide safety elements to this. In this way, if the child has developed an insecure attachment style or operating model in the first years of life, which is the ultimate cause of most disruptive symptoms, we will help him to introduce security elements in their relationship with the environment and with themselves.

Of course, it is necessary to clarify what we have just pointed out in the case of children with disorders with an organic basis, although advances in the framework of epigenetics indicate that environmental factors are crucial in the development of psychopathological disorders.

Bibliographic references:

Bowlby, J. (1989). Aplicaciones clínicas de una teoría del apego. Barcelona: Paidós Ibérica.

Crittenden, P. M. (1995). Apego y psicopatología. Santiago de Chile: Sociedad de Terapia Cognitiva postracionalista.

Hernández, M. (2017). Apego y psicopatología: la ansiedad y su origen. Conceptualización y tratamiento de las patologías relacionadas con la ansiedad desde una perspectiva integradora. Bilbao: Editorial Desclée de Brower.

Main, M. (2001). Las categorías organizadas del apego en el infante, en el niño, y en el adulto: Atención flexible versus inflexible bajo estrés relacionado con el apego. Aperturas psicoanalíticas8.

Marrone, M., Diamond, N., Juri, L., & Bleichmar, H. (2001). La teoría del apego: un enfoque actual. Madrid: Psimática.

Tuber, S. (2008). Attachment, play, and authenticity: A Winnicott primer. Jason Aronson, Incorporated.

Tuber, S., & Caflisch, J. (2011). Starting treatment with children and adolescents: A process-oriented guide for therapists. Taylor & Francis.

Wallin, D. (2012). El apego en psicoterapia. Bilbao: Editorial Descleé de Brouwer.

Winnicott, D. W., Johns, J., Shepherd, R., & Robinson, H. T. (2009). Acerca de los niños. Buenos Aires: Paidós.

Winnicott, D. W. (2008). Clínica psicoanalítica infantil. Buenos Aires: Ediciones Hormé.


Creating a secure base in the framework of a psychotherapeutic intervention with children