Early attachment experiences with our primary caregivers shape the adults that we become. The goals of attachment-based psychotherapy are to address the limiting effects of negative early attachment experiences and to strengthen the capacity for secure relationships and adaptive actions in the world. To do this, the therapist first establishes a security-engendering therapeutic relationship with the patient and then within that relationship helps the client to elaborate and express the types of communications, emotions, perceptions, and behaviors that were defensively excluded in earlier, formative relationships with attachment figures. As a result, the client becomes better able to communicate openly and accurately and to access more adaptive feelings, thoughts, and behaviors in his or her own life. In this video, Dr. Peter C. Costello discusses the theoretical basis of attachment-based psychotherapy, and explores with a client the origins of her inability to communicate her needs and fears to those on whom she most depends.