Failure to develop a secure attachment leads to rigid and insecure internal working models, increasing the risk of developing personality disorders, such as avoidant personality disorder, in adulthood. This disorder is characterised by a consistent pattern of avoidance of relationships and situations in which the individual may be subject to evaluation by others, feeling constantly inadequate and exhibiting an intense fear of criticism and disapproval from others.

These characteristics are summarised in the clinical case described in this paper, in which intervention was carried out using a new cognitive-behavioural psychotherapeutic approach: treatment focusing on ‘leverage points’.