By Barbara Winter PhD, PA

Addictions Are an Attachment Disorder

When I think of addiction, I think of attachment deficits. When we have no one to reach for, to soothe us, and help us stay grounded and safe and secure, we reach elsewhere—often to an addictive substance or behavior. When our childhoods are chaotic, neglectful, or abusive, they create a tear in our ability to bond and we develop an insecure or anxious style of connection. When that happens, we have no one to safely reach for, so we turn to an addiction.

Group Therapy for Attachment Deficits and Addictions

Group therapy has long been an effective modality for working with attachment and addictions. Simply stated, healing childhood attachment trauma requires healthy adult connection. Thus, a group format for healing is indicated.

I trained in group psychotherapy in the mid/late 1980s, so Irvin Yalom was my guide. Here is how his teachings apply to group therapy for attachment deficits and sexually addicted and/or compulsive behaviors.

  • Installation of Hope: With the support of others in the group, some at the same place and some further along in their process of healing, the helplessness and hopelessness reverse. The group becomes a space for empathetic connection and healing.
  • Universality: Sharing and being heard in group therapy can be healing. One learns that regardless of how alike or different one member is from the next member, he/she is not alone. Unlike 12-step groups, group therapy is all about cross-talk. With active validation and ongoing feedback, there is a real sense of belonging.
  • Information Giving: Through the exchange of information, group members learn that their behavior is not unique. At the same time, they come to understand the nature of addiction and relationship dynamics.
  • Altruism: Sharing with and helping other group members enhances one’s self-esteem and sense of connection.
  • Corrective Recapitulation of the Primary Family: It is within the group context that early-life relationships are played out, but in healthier ways. As such, group therapy is a corrective experience where members work through their childhood attachment issues.
  • Improved Social Skills: With attachment deficits and addiction, social skills are often lacking. The authentic connection that occurs in group therapy provides an opportunity for improving social behaviors (via group feedback).
  • Imitative Behavior: Through the observation of other group members’ communication and behavior and the role-playing of the group’s leader (the therapist), one learns new ways of expressing one’s emotions, thoughts, requests, needs, etc.
  • Interpersonal Learning: Group therapy uncovers all kinds of relationship dynamics. By looking at micro-moments of traumatic connection, members have an opportunity to soften that pain and learn new ways of connecting.
  • Group Cohesiveness: As there is often a disconnect with addicts, particularly men, group members are able, over time, to learn authenticity through the alliance that is naturally established with other members.
  • Catharsis: Through the examination of the ‘space between,’ group members have a space to grieve and release pain from their past and present.

It is essential that each therapy group is appropriate for each member and there is a well-qualified and experienced therapist with knowledge of group work, attachment issues, and addictions—process and substance alike (given the incidence of co-occurring addictions).


Dr. Barbara Winter is a licensed Psychologist, Sexologist, and Certified Sex Addiction, Group, and EMDR therapist trained in Hypnosis, Emotionally Focused Therapy (EFT), Parenting Coordination/Mediation, and Discernment Counseling. She has been a leading provider in Boca Raton since 1988, where she specializes in working with teens and adults with sexual issues, behavioral addictions, infidelity, trauma, divorce, and couples counseling. She has been quoted extensively in various media outlets and has written for other major blog sites as well. You can visit her website at, and you can find her on Facebook, Twitter (@DrBarbaraWinter), and LinkedIn, posting resources and support that can help others with their relationships, in and out of the bedroom. Check out her blog, Sex, Love & Light, here.