Abstract
Attachment is permanent emotional bond developing in early childhood based on the quality of care provided by the main relational figure and is characterized by the need to seek and maintain proximity to a person, especially in conditions of stress. There are distinguished four basic types of attachment in adult age (secure, anxious-preoccupied, dismissive-avoidant and fearful-avoidant).
Risk substance use is often associated with insecure attachment. In the present case study is described a four-year of psychotherapeutic work with a man with alcohol use disorder.
The client shows pattern of fearful-avoidant attachment, which, combined with the dominant defense mechanism devaluation and idealization refers to the narcissistic personality structure. In the psychotherapeutic process the attention was focused on three main thematic levels, excessive alcohol use, intimate relationships and professional area.
Alcohol use helped him to cope with feelings of loneliness, supported his ability to be more open in relationships and helped to regulate unpleasant emotional states. Client found very hard to establish a good intimate relationship, because he feared injury, but on the other side suffered from feelings of loneliness.
Similar dynamics was observed in the work area. The main therapeutic interventions were the acceptance and support in the therapeutic relationship supplemented with the systematic confrontation especially of his defense mechanisms of idealization and devaluation.