Journal of Bisexuality

ISSN: 1529-9716 (Print) 1529-9724 (Online) Journal homepage: https://www.tandfonline.com/loi/wjbi20

Addressing Attachment Injuries with Bisexual

Clients and their Monosexual Partners during the
Coming out Process

Jennifer L. Cannon & Peter J. Boccone

To cite this article: Jennifer L. Cannon & Peter J. Boccone (2019): Addressing Attachment Injuries
with Bisexual Clients and their Monosexual Partners during the Coming out Process, Journal of
Bisexuality, DOI: 10.1080/15299716.2019.1567434

To link to this article: https://doi.org/10.1080/15299716.2019.1567434

Published online: 22 Feb 2019.

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JOURNAL OF BISEXUALITY
https://doi.org/10.1080/15299716.2019.1567434

Addressing Attachment Injuries with Bisexual Clients

and their Monosexual Partners during the Coming
out Process
Jennifer L. Cannona and Peter J. Bocconeb
a
Department of Counseling and Special Education, DePaul University—Lincoln Park Campus,
Chicago, Illinois, USA; bCounselor Education, West Chester University, West Chester,
Pennsylvania, USA

ABSTRACT KEYWORDS
Individuals who identify as bisexual, a marginalized sexual Attachment injuries;
minority group different from lesbian women or gay men (LG), bisexuality; coming out
face complex challenges from the heterocentric society and
members of the LG community. One of the challenges that
leads to discrimination and mental health issues for bisexual
people occurs during the coming-out process. This article
examines attachment injuries that may occur during the bisex-
ual coming-out process, when their partner identified as
monosexual, and how the attachment injury resolution model
(AIRM), which stems from emotionally focused couple therapy
(EFT) may be used to address the early stages of these injuries
through couple’s counseling.

Individuals who identify as bisexual, a marginalized sexual minority group

different from lesbian women or gay men (LG), face complex challenges
from both the heterocentric society and members of the LG community
(Boccone, 2016; Bostwick, 2012; Roberts, Horne, & Hoyt, 2015). The com-
ing-out process in particular can set the stage for a variety of difficulties.
When bisexual individuals identify themselves as bisexual, they can face
discrimination and rejection from their monosexual partners (i.e., solely
heterosexual, solely lesbian, or solely gay) that affect their relationships and
attitudes toward self and others (Bostwick, 2012; Bostwick, Boyd, Hughes,
West, & McCabe, 2014; Roberts et al., 2015).
Attachment injuries are negative events such as betrayals or abandon-
ment in close relationships that can damage the affective bond between
partners (Johnson, Makinen, & Millikin, 2001). This article examines
attachment injuries that may occur during the bisexual coming-out process
and how the attachment injury resolution model (AIRM), which stems
from emotionally focused therapy (EFT) for couples, may be used to

CONTACT Jennifer L. Cannon, j.cannon@depaul.edu Department of Counseling and Special Education,

DePaul University—Lincoln Park Campus, Chicago, IL, USA.
ß 2019 Taylor & Francis Group, LLC
2 J. L. CANNON AND P. J. BOCCONE

address the early stages of these injuries through couples’ counseling.

Although this article focuses primarily on utilizing the AIRM with bisexual
individuals and their monosexual partners, the authors believe that the
AIRM may also work with individuals who endorse other plurisexual
(Mitchell et al., 2015) identity labels (e.g., queer, pansexual, fluid), if an
attachment injury occurs during their coming-out process.

Bisexual relationships and issues

Historically, researchers have not focused on bisexual individuals as they
have often been lumped into a general “nonheterosexual” category by
researchers conforming to the sexual binary (Bostwick & Hequembourg,
2013). More recently, however, researchers have taken a more intentional
look at this population and show that individuals who identify as bisexual
face complex challenges from the heterocentric society and the LG commu-
nity at large (Boccone, 2016; Bostwick, 2012; Bostwick & Hequembourg,
2013). This sexual minority group also faces various forms of discrimination,
stigma, and binegativity that can lead to mental health issues (e.g., anxiety,
depression, addictions; Bostwick et al., 2014; Dodge et al., 2016). One of the
challenges faced by bisexual people face is the coming-out process. During
the coming-out process, bisexual people are dually discriminated against and
face antibisexual attitudes and experiences (Boccone, 2016; Bostwick, 2012;
Friedman et al., 2014; Roberts, Horne, & Hoyt, 2015). This dual discrimin-
ation as well as antibisexual experiences bisexual individuals’ face come from
not only heterosexual people but from lesbian women and gay men as well.

Community issues
When coming out to lesbian and gay communities, bisexual people often
are categorized as confused, in denial, too scared to identify as lesbian or
gay, or wanting to keep their heterosexual privileges (Roberts et al., 2015).
Although bisexual individuals face discrimination from their LG partners
and community members, they face even more discrimination from hetero-
sexual partners and communities (Roberts et al., 2015). Because bisexuality
is outside of the sexual orientation binary, bisexual individuals often face
pressures to identify as either lesbian, gay, or heterosexual. The pressure to
conform to one sexual orientation group or the other causes negative
impacts on bisexual individuals (Roberts et al., 2015; Rust, 2000). One of
the negative impacts bisexuals experience is internalized binegativity.

Internalized binegativity
When lesbian women or gay men come out, they often face an internalized
homonegativity due to the stigma associated with existing in a heterocentric
 JOURNAL OF BISEXUALITY 3

society (Rowen & Malcolm, 2002). Similar to experiences gay and lesbian
individuals face during the coming-out process, bisexual individuals face
stigma not only from their heterocentric society, but also from lesbian and
gay communities that can create a sense of internalized binegativity
(Boccone, 2016; Dodge et al., 2016; Roberts, Horne, & Hoyt, 2015).
According to Dodge et al. (2016) “Biphobia derives in part from heterosex-
ist reaction to sexual expression that is not heteronormative (same-gender
sexual expression), as well as monosexist reaction to sexual expression that
is not monosexual (e.g., sexual expression with more than one gender)” (p.
2). Bisexual individuals’ who are embraced by their heterosexual, lesbian,
or gay partners with acceptance are less likely to face complex challenges
such as internalized binegativity internally and within the relationship.
However, bisexual individuals who come out and face rejection from their
partners are more likely to face internal and external negative consequen-
ces. Accordingly, the purpose of this article is to explore attachment inju-
ries faced by bisexual individuals and the amelioration of these injuries
with the primary romantic partner using the AIRM within EFT.

Attachment theory
Attachment theory provides a framework for romantic relationships.
Attachment theory addresses the affective bonds people make with others
early on in life and how those bonds can impact psychological functioning
throughout the life span (Ainsworth & Bowlby, 1991; Bowlby, 1989).
Attachment theory offers a framework for exploring how the attachment
system affects the development of individuals and how they form and
maintain relationships, including romantic relationships. Attachment
behaviors, which are a response from the attachment system, are self-pro-
tective behaviors in response to stressors and are activated when an indi-
vidual is needing to reestablish proximity (Hazan & Shaver, 1994) and may
be helpful information for clients to be aware of if an attachment injury
has occurred. According to Hazan and Shaver (1994), as individuals’ age,
they begin to transfer their attachment behaviors from their parents to
their peers and overtime develop an attachment bond relationship (e.g.,
proximity maintenance, safe haven, and secure base) with their partner.
Attachment anxiety and attachment avoidance are two features of the
attachment system that affect individuals and their relationship bonds
throughout the life span and help to explain adult attachment strategies.
“Adult attachment strategies” refer to individuals’ relationship behaviors
and tendencies based on a range of attachment anxiety and avoidance.
Ranges of anxiety and avoidance are measured on a two-dimensional scale.
Historically, the levels of attachment anxiety and/or avoidance that were
4 J. L. CANNON AND P. J. BOCCONE

measured were used to determine whether a person had a secure or an

insecure attachment style. However, being that individuals can exhibit dif-
ferent attachment strategies with different people, categorizing people into
specific styles is not a true representation of the person and may not be the
best way to examine ones’ attachment anxiety and avoidance (Fraley &
Waller, 1998; Roisman, Fraley, & Belsky, 2007). Recognizing that attach-
ment security can explain how partners interact in relationships when faced
with distress (i.e., possibly the coming-out process) and the cycles of
approach versus avoidance they may experience when faced with an attach-
ment injury, may be important for counselors to consider when working
with these couples. Being that romantic partners may become attachment
figures and a place for comfort and support, it is important to maintain
trust and security in these relationships. When trust and security are nega-
tively affected in relationships, attachment relationships can be damaged
and attachment injuries may occur. Once an attachment injury occurs, the
attachment bond is damaged and the relationship may suffer.

Attachment injury
Attachment injuries (AIs) are negative events such as betrayals or abandon-
ment in close relationships that can damage the affective bond between
partners (Johnson et al., 2001). In contrast to attachment strategies that
develop in response to long-term patterns of interaction with attachment
figures, AIs occur in response to a limited number of experiences or, in
many cases, a singular experience. These injuries can leave long lasting
emotional wounds that affect couples’ relationships (Zuccarini, Johnson,
Dalgleish, & Makinen, 2013). A partner may experience a specific event as
a violation of trust and see it as abandonment (Johnson & Whiffen, 1999).
As mentioned above, during the coming-out process, bisexual individuals
may face rejection from their monosexual partners (Bostwick, 2012;
Bostwick et al., 2014; Roberts et al., 2015). The rejection bisexual individu-
als face from their partners, during this coming-out process, may create an
attachment injury that, in turn, creates an emotional wound in the relation-
ship. It is also possible that when a bisexual individual comes out to his or
her monosexual partner, an attachment injury may also occur for the
monosexual partner and feelings of betrayal may occur. It is important,
then, to explore possible AIs for both partners.

Addressing attachment injuries in bisexual relationships using EFT

If bisexual individuals are welcomed with support and love from their part-
ner during his or her coming out process, the attachment system remains
 JOURNAL OF BISEXUALITY 5

intact. If one or both the partners experience a sense of abandonment and/

or betrayal during the coming-out process, however, the result may be an
attachment injury (or injuries) that potentially damages the relationship.
Once an attachment injury takes place among intimate partners, the rela-
tionship can become unsafe (Brubacher, 2015). To address attachment inju-
ries and heal relationship wounds using EFT, Johnson et al. (2001) created
an AIRM. This model is briefly described below to illustrate important ele-
ments from the model that counselors may use to help couples identify
and begin to take the necessary steps to resolve an attachment injury that
occurs during the coming-out process for bisexual individuals and their
monosexual partners.

Attachment injury resolution model and what counselors should know

The AIRM consists of three stages. In Stage 1, the attachment injury needs
to be identified and the couple’s current behaviors that led to distancing
must be deescalated before an injury can be healed (Brubacher, 2015). To
identify the attachment injury, during Stage 1, the attachment injury must
be (1) differentiated from a gradual erosion in the relationship and (2) rela-
tional traumas must be distinguished from traumas that take place outside
of the relationship (Brubacher, 2015; Johnson et al., 2001). Deescalation
measures happen after the attachment injury is identified. During deescala-
tion,(1) the injury must be stated as an issue that is causing the couple to
get into a negative cycle and (2) the cycle that is inhibiting the healing
must be tracked (e.g., triggers identified, identify the core of the injury, val-
idation of difficult emotions) before healing is addressed (Brubacher, 2015;
Johnson et al., 2001).
When the coming-out process contributes to the development of an
attachment injury, the first step when using the AIRM involves helping the
couple identify the attachment injury specifically (e.g., sense of betrayal dur-
ing the coming-out process for the monosexual partner, lack of safety in the
relationship for either partner, sense of abandonment by either partner).
This step is strengthened by the counselor helping the couple identify the
core of the injury that is causing a negative cycle and thus hindering the
healing process. Although the attachment event may be the coming-out pro-
cess itself, the injury may consist of feelings associated with the event (e.g.,
sense of betrayal that leads to fear of abandonment and/or loss of their per-
ceived relationship together). Injuries may look different from one couple to
another. As such it is important that counselors are informed about issues
that may occur for either partner during the sexual identity enactment and
the coming-out processes. This makes it possible to identify the root of the
injury and elements that feed any negative cycles related to it.
6 J. L. CANNON AND P. J. BOCCONE

Once the core injury is identified, reframing the negative cycle must occur
and the couple will need new effective coping skills to move forward (Johnson
et al., 2001). The counselor is then tasked with helping the couple step away
from being stuck in a negative cycle. This can be done by the counselor help-
ing the couple learn skills that help them deescalate when the attachment
injury flares up or when one or both of the partners become triggered.
Learning deescalations skills can help the couple start to treat one another
more effectively when triggered, in hopes that the couple can step away from
reinjuring one another. Once the couple has developed more effective coping
skills, they can move onto the second stage of the resolution model.
In Stage 2, the counselor helps the couple work toward resolving the
attachment injury by learning how to reengage effectively with one another
in a positive bond (Johnson et al., 2001). During the second stage of the
AIRM, the couple (1) accesses their internal working model as well as
needs and fears, (2) the offending partner aims to show his or her accept-
ance of the other, and (3) bonding events are promoted and emotional
engagements are enacted to strengthen the relational bond (Brubacher,
2014). Regardless of sexual orientation in couples, learning to reengage
effectively with one another in a positive bond will look different for every-
one. Providing couples with a safe space and guidance as they learn to con-
nect and attune to one another is important for counselors at this stage.
Providing various activities that promote bonding events is also important
for counselors to offer couples as they relearn to trust their partners and
feel safe again with them. After issues related to each member’s personal
schema have been addressed, a truer acceptance of one another is estab-
lished, and the relational bonds between the couple are strengthened, the
couple can move on to the final stage of the model.
The third and final stage of the resolution model is where the new, more
positive cycle is consolidated and utilized to address (1) old problems with
new solutions and (2) new stories of attachment security (Brubacher,
2014). Helping bisexual clients and their monosexual partners who have
experienced an attachment injury build attachment security again can be
rewarding for the couple and the counselor. During this final stage, new
solutions may vary (e.g., helping couples learn to positively reframe their
situation; helping couples learn to acknowledge, understand, and accept
their emotions; helping individuals validate their partners emotions and
accept their own). Helping these couples reestablish their attachment secur-
ity with one another is essential when it comes to creating healthy and
effective attachment bonds. When working with couples where the attach-
ment injury event occurred during the bisexual partners coming-out pro-
cess, the second and third stages of the AIRM are presumably the same as
a monosexual, heterosexual, lesbian, or gay male couples, and with the
 JOURNAL OF BISEXUALITY 7

counselor’s guidance, healing may begin to take place. When addressing

attachment injuries with bisexual individuals and their monosexual partners, it
is important for counselors to be aware of issues related to both their sexual
minority group as well as all three stages of the AIRM. Having knowledge in
both areas may help counselors understand unique issues these couples face
(intra- and interpersonally), which may better help them guide the couple
through understanding, addressing, and overcoming attachment injuries.

Conclusion
Attachment injuries happen during times of uncertainty and can cause injured
partners to question their beliefs about relationships, others, and themselves
(Chapman & Caldwell, 2012). Recognizing that disclosing one’s bisexuality to
a monosexual partner can evoke a sense of uncertainty in the relationship and
create an attachment injury, it is important for counselors to be aware of chal-
lenges sexual minority members face, attachment injury activating events, and
how the AIRM may help repair any injuries that occur during the coming-out
process for bisexual individuals and their monosexual partners. Once a coun-
selor can help a couple to identify their attachment injury, counselors can
work on helping the couple utilize more effective coping skills to process the
injury, identify new positive cycles to engage in, strengthen the attachment
bond, and consolidate these changes in the relationship to prevent future
attachment injuries. By effectively identifying and addressing the attachment
injury caused by the coming-out process in Stage 1, essential healing may
begin to take place in Stages 2 and 3. Overall, it may be important for coun-
selor to be aware of the unique challenges bisexual individuals and their
monosexual partners face to better serve this population.

References
Ainsworth, M. D., & Bowlby, J. (1991). An ethological approach to personality develop-
ment. The American Psychologist, 46(4), 333–341. doi:10.1037/0003-066X.46.4.333
Boccone, P. J. (2016). Embracing the whole self: Using the empty chair technique to pro-
cess internalized biphobia during bisexual identity enactment. Journal of LGBT Issues in
Counseling, 10(3), 150–158. doi:10.1080/15538605.2016.1199291
Bostwick, W. B. (2012) Assessing bisexual stigma and mental health status: A brief report.
Journal of Bisexuality, 12(2), 214–222. doi:10.1080/15299716.2012.674860
Bostwick, W., & Hequembourg, A. L. (2013). Minding the noise: Conducting health
research among bisexual populations and beyond. Journal of Homosexuality, 60(4),
655–661. doi:10.1080/00918369.2013.760370
Bostwick, W. B., Boyd, C. J., Hughes, T. L., West, B. T., & McCabe, S. E. (2014).
Discrimination and mental health among lesbian, gay, and bisexual adults in the United
States. American Journal of Orthopsychiatry, 84(1), 35–45. doi:10.1037/h0098851
Bowlby, J. (1989). The making and breaking of affectional bonds. London: Routledge
8 J. L. CANNON AND P. J. BOCCONE

Brubacher, L. (2015). Working with an attachment injury in stage one. EFT Community
News. Retrieved from http://carolinaeft.com/pdf/Attachment_Injury_in_Stage_One.pdf
Brubacher, L. (2014). Eft’s attachment injury resolution model (airm): The path to repairing
broken bonds and rebuilding trust. Retrieved from https://www.ccpaaccp.ca/wpcontent/
uploads/2015/06/2015conf.BrubacherEFTAttachmentInjuryRepair.pdf
Chapman, D. M., & Caldwell, B. E. (2012). Attachment injury resolution in couples when
one partner is trans-identified. Journal of Systemic Therapies, 31(2), 36–53. doi:10.1521/
jsyt.2012.31.2.36
Dodge, B., Herbenick, D., Friedman, M. R., Schick, V., Fu, T. J., Bostwick, W., …
Sandfort, T. G. (2016). Attitudes toward bisexual men and women among a nationally
representative probability sample of adults in the United States. Plos One, 11(10), 1–18.
doi:10.1371/journal.pone.0164430
Fraley, R. C., & Waller, N. G. (1998). Adult attachment patterns: A test of the typological
model. In J. A. Simpson, & W. S. Rholes (Eds.), Attachment Theory and Close
Relationships (pp. 77–114). New York, NY: Guilford Press.
Friedman, M. R., Dodge, B., Schick, V., Herbenick, D., Hubach, R. D., Bowling, J., &
Reece, M. (2014). From bias to bisexual health disparities: Attitudes toward bisexual men
and women in the United States. LGBT Health, 2, 1–10. doi:10.1089/lgbt.2014.0005
Hazan, C., & Shaver, P. R. (1994). Attachment as an organizational framework for research
on close relationships. Psychological Inquiry, 5(1), 1–22. Retrieved from https://eds-
b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid¼13&sid¼eee0f194-
0233-4ddf-b3f4-01c7b8b2830d%40pdc-v-sessmgr02
Johnson, S. M., & Whiffen, V. E. (1999). Made to measure: Adapting emotionally focused
couples therapy to partners’ attachment styles. Clinical Psychology: Science and Practice,
6(4), 366–381. doi:10.1093/clipsy.6.4.366
Johnson, S. A., Makinen, J. A., & Millikin, J. W. (2001). Attachment injuries in couple rela-
tionships: A new perspective on impasses in couples therapy. Journal of Marital and
Family Therapy, 27(2), 145–155. Retrieved from https://eds-b-ebscohost-com.ezp.walde-
nulibrary.org/eds/pdfviewer/pdfviewer?vid¼11&sid¼eee0f194-0233-4ddf-b3f4-01c7b8b2830
d%40pdc-v-sessmgr02
Mitchell, R. C., Davis, K. S., & Galupo, M. P. (2015). Comparing perceived experiences of
prejudice among self-identified plurisexual individuals. Psychology & Sexuality, 6(3),
245–257. doi:10.1080/19419899.2014.940372
Roberts, T. S., Horne, S. G., & Hoyt, W. T. (2015). Between a gay and a straight place:
Bisexual individuals’ experiences with monosexism. Journal of Bisexuality, 15(4),
554–569. doi:10.1080/15299716.2015.1111183
Roisman, G. I., Fraley, R. C., & Belsky, J. (2007). A taxometric study of the adult attach-
ment interview. Developmental Psychology, 43(3), 675–686. doi ¼ 10.1037/0012-
1649.43.3.675 doi:10.1037/0012-1649.43.3.675
Rowen, C. J., & Malcolm, J. P. (2002). Correlates of internalize homophobia and homosex-
ual identity formation in a sample of gay men. Journal of Homosexuality, 43(2), 77–92.
doi:10.1300/J082v43n02_05
Rust, P. R. (2000). Heterosexual gays, homosexual straights. In P. R. Rust (Ed.),Bisexuality
in the United States: A social science reader (pp. 279–306). New York, NY: Columbia
University Press.
Zuccarini, D., Johnson, S., Dalgleish, T., & Makinen, J. (2013). Forgiveness and reconcili-
ation in emotionally focused therapy for couples: The client change process and therapist
interventions. Journal of Marital and Family Therapy, 39(2), 148–162. doi:10.1111/j.1752-
0606.2012.00287.x