The need to attach and have relationships is a human need, not an add-on, so regular contact with other people, as close to in person as possible, is part of treatment. When old relationships were not safe or revolved around using, the work is to find or build new ones, often through shared activities.
Why it matters
Bowlby's work showed that the attachment system and the need for relationships is a human need, not just an add-on.
“John Bowlby's work showed that the attachment system and the need to attach and have relationships is, as you mentioned, a human need. It's not just an add-on thing”
20:35Beyond Medications: The Best Lifestyle Treatments for Mental HealthFeb 2025 Work and school seem to have an automatic protective effect because of their baked-in socialization.
“I have noticed, I think there's a Automatic protective effect because of the baked in socialization for people who are engaged with work and school”
24:26Beyond Medications: The Best Lifestyle Treatments for Mental HealthFeb 2025
How we use it
Aim for regular experience with other people that is as close as possible to in person. Chatting and commenting on social media does not count.
“Anything that can be done to get you, the patient or your patient, the person to, uh, an experience with regularity with other people that is as close as possible to in-person that's what we want you know chatting commenting social media doesn't count”
28:14Beyond Medications: The Best Lifestyle Treatments for Mental HealthFeb 2025 If existing or past relationships were not safe enough or not giving the person what they need, the work eventually is to find new relationships or build new ones. Shared activities are one way to do it.
“if your existing or past relationships were not safe enough or not giving you what you need, then the work has to be done eventually to find new relationships or build new ones. One way to do that is through shared activities”
19:18Beyond Medications: The Best Lifestyle Treatments for Mental HealthFeb 2025 Ask the patient to identify for themselves something objectively safe that they trust: people who are at least basically not aggressive and basically OK to spend time with.
“the number one thing is I want them to identify for themselves something that is objectively safe, that they trust effectively. The people to be at least basically not aggressive and basically OK to spend time with”
22:53Beyond Medications: The Best Lifestyle Treatments for Mental HealthFeb 2025 Reconnecting helps: with old friends from college, a church, a meditation center, a sports group.
“I've seen people reconnect with old friends, their college friends, reconnect with their church, reconnect with Reconnect with their meditation center. Reconnect with a sports group”
46:44What Patients Should Know When Diagnosed With DepressionSep 2026
Pearls
If someone's past relationships are all with people who habitually use substances, going back to those relationships carries a huge risk.
“If your past relationships are all with people who habitually use substances, there is a huge risk in engaging in that kind of relationship again, unfortunately”
26:27Beyond Medications: The Best Lifestyle Treatments for Mental HealthFeb 2025 An exercise partner can be the only thing that keeps an exercise routine going.
“the only thing that allowed me to keep up with an exercise routine was was an exercise partner”
17:26Beyond Medications: The Best Lifestyle Treatments for Mental HealthFeb 2025
It also comes up on
- Borderline personality disorderBorderline problems stem from attachment and bonding, which come earlier in development than problems of the self.
- Personality developmentBorderline problems stem from attachment and bonding, which come earlier in development than issues of the self and of how we see ourselves and others.
- SSRIsThe attachment system is mediated partly by serotonin, so SSRIs help with anxiety and depression that come from separation.
- AnxietyThere are two anxiety centers in the brain: Panksepp's fear system, and the panic-grief system, which is the attachment system.
From these episodes
- What Patients Should Know When Diagnosed With DepressionSep 2026 · 1 point
- Beyond Medications: The Best Lifestyle Treatments for Mental HealthFeb 2025 · 7 points
Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.