When Trust Is the Treatment, explores the clinical impasses that arise when patients abruptly disengage, criticize the therapy, or struggle to remain in treatment. Drawing on Control-Mastery Theory, this workshop examines how ambivalence toward trust—common in patients with attachment wounds—is not resistance, but a meaningful enactment of deeply held beliefs shaped by earlier relationships. Participants will learn how the therapist’s consistent, empathic attitude becomes a central vehicle for disconfirming pathogenic beliefs and restoring the therapeutic process.

For patients with attachment wounds, the construct of psychotherapy presents an inherent tension. On the one hand, the process depends on the patient’s capacity to establish at least a minimal degree of trust in the therapist. This trust is not absolute, nor is it necessarily present at the outset; rather, it represents a working hypothesis — that engaging with the therapist may not be harmful and might even be helpful. Without such a foundation, patients are unlikely to seek treatment or remain in it long enough for meaningful work to occur.