Short case example
After a helpful session, a patient cancels follow-up and says they do not need help, despite worsening loneliness.
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Formulation mechanism
A relational strategy of down-regulating attachment needs, dependence, and emotional closeness to preserve autonomy or reduce vulnerability.
What matters now
Fit, function, and alternatives
Use sequence, function, patient language, and disconfirming evidence to decide whether this hypothesis adds explanatory value.
Across the formulation
Short case example
After a helpful session, a patient cancels follow-up and says they do not need help, despite worsening loneliness.
Formulation language
Attachment avoidance may protect against vulnerability by creating distance, but it also limits support and repair.
Treatment implications
Offer predictable, autonomy-respecting support and track closeness-distance shifts without shaming.