Therapy for Attachment Issues: Attachment Theory & Evidence Based Therapy

Have you noticed patterns in the behaviors you experience in your platonic, familial, and romantic relationships? Perhaps you find yourself cutting ties and emotional bonds when connections get serious or crave more profound emotional intimacy and feel uncomfortable being alone. 

• According to attachment theory, your relationship habits may be due to your innate attachment style. 
• If you desire to change your relationship patterns through therapy, attachment-based therapy and online therapy for attachment disorders may be able to help. 
• Research shows that online therapy effectively reduces symptoms of depression, OCD, interpersonal sensitivity, and anxiety in people with all attachment styles. 
• In online therapy, a supportive online therapist may help you learn strategies to create healthier relationships and assist you with mental health challenges.

Attachment therapy can help you improve your relationships

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Understanding attachment theory

Attachment theory is a concept in human development that suggests that the relationships formed in childhood with primary caregivers, like parents, may impact how we interact with others throughout our lives. When attachment theory was first theorized in the 1960s, it was only applied to the behavior of young children, but in the 1980s attachment theory was expanded to include adult behavior as well.

Children who experience a maladaptive childhood characterized by either emotional abuse or neglect may cope with this experience by learning maladaptive survival skills. For example, children who experience early childhood trauma may cope with negative feelings about attachment by emotionally distancing themselves from relationships. Over time, the social, emotional, and mental skills these children develop may become destructive to their adult relationships and significantly impact daily life.

Four attachment styles: In therapy for attachment issues

Researchers have identified four categories of attachment styles: secure attachment, anxious attachment (sometimes called preoccupied attachment), avoidant attachment (sometimes called dismissive attachment), and disorganized attachment (sometimes called fearful-avoidant attachment). Based on an individual’s relationship patterns, researchers may be able to determine their individual unhealthy attachment styles.

By understanding your attachment style, you may be able to learn how to change unhealthy attachment patterns. In the past decade, researchers have come to agree that the most effective treatment program for children with attachment disorders and adults experiencing insecure attachment is a specific type of psychotherapy called attachment therapy. If you are facing or witnessing abuse of any kind, the National Domestic Violence Hotline is available 24/7 for support. Call 1-800-799-SAFE (7233) or text “START” to 88788. You can also use the online chat.

Identifying signs of insecure attachment: Therapy for attachment issues

Attachment theory posits that the attention and safety you experience during the first few years of life may influence your view of relationships throughout your life. Those who struggle to form a strong early attachment with a caregiver might later have trouble developing a healthy attachment with a romantic partner. For example, if you were frequently left alone as an infant, you may experience difficulty building trusting relationships as an adult.

People with unhealthy attachment patterns may be able to trace their experiences to their childhood memories with their primary caregiver. They may notice the following symptoms present in their daily lives: 

• Difficulty dealing with conflict
• Use of manipulation or hostility to control others
• Impulsive behavior
• Difficulty controlling or expressing emotions
• Trouble receiving and giving love
• Feelings of isolation
• Difficulty showing remorse or empathy
• A tendency to deny responsibility in conflicts
• Argumentative and destructive behavior
• Addictive behavior
• A feeling of helplessness
• Difficulty concentrating
• Hypervigilance
• Frequently angering others
• Inconsolable crying
• Anxiety
• Difficulty maintaining trusting or stable relationships
• Neglectful behavior

Note that these common symptoms may appear differently in adults and children. If you experience any or all of these common symptoms, attachment-based therapy may help you overcome them.

Adult diagnosis and treatment through DSM-5

Attachment disorders are mental health conditions characterized by difficulty developing healthy connections with one’s primary caregivers. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), therapists cannot diagnose an attachment disorder in adults. A formal diagnosis of two childhood attachment disorders can be made in children with attachment issues, including disinhibited social engagement disorder and reactive attachment disorder. Childhood attachment disorders like disinhibited social engagement disorder, a rare condition, may form in the early years of a child’s life when a child does not form a healthy or proper attachment with their caregivers or parents. Adopted children are considered particularly at risk for developing disinhibited social engagement disorder.

Although an attachment disorder in adults cannot be diagnosed through the Diagnostic and Statistical Manual, attachment theory focuses on how insecure attachment patterns and the impact of childhood attachment disorders can affect adults throughout their lives. Such attachment wounds can influence areas such as emotional intimacy, connection with romantic partners, and adherence to cultural norms. Studies have found that adults struggling with adult attachment concerns can change their attachment style with the appropriate treatment, education in positive emotions and behavioral patterns, and support through emotionally challenging times.

Attachment-based therapy

Attachment psychotherapy, or talk therapy, is a research-based treatment for adult attachment challenges. In attachment therapy, an attachment-based therapist can help a client consider their healthy attachments and learn strategies to modify their innate behaviors. 

Several different techniques can be utilized in attachment therapy. Each technique may work well for different individuals, but they all have one thing in common: their emphasis on the therapeutic relationship. As therapists and clients build a close relationship in therapy, the partnership becomes an example of the trust-based connections that the client can create. Once trust is established in therapy, the therapist and client may work together to uncover the genesis of maladaptive behaviors and begin rebuilding trust in their other relationships. 

Psychotherapy techniques based on attachment theory

Couples and family therapy for attachment issues

During attachment-based therapy, therapists may use attachment theory in therapy sessions to help clients recognize attachment patterns and build trusting relationships within the family. Unlike individual counseling, a family approach to attachment therapy involves those who may live and regularly interact with the client. 

• Since mental health challenges can impact your partner, child, or family, including your family in therapy may help you explore the effects of your attachment challenges. 
• Attachment-based family therapy may also be helpful for families with young children who may be at risk of facing attachment challenges or developing certain mental health conditions. For example, according to researchers in one study (Diamond, G.S. et al, 2014), an attachment-based approach to family therapy can reduce depression symptoms in teens. 
• Attachment-based therapy can help you improve parenting techniques, create a supportive relationship with your child, and change negative attachment patterns that formed when in your own childhood. 

Experiential techniques in therapy for attachment issues

In experiential therapy, the therapist helps the client deepen their understanding of the underlying motivations that are provoking specific attachment-based challenges by using role-play, art, and other forms of expressive activity in therapy sessions. 

How Gestalt counseling helps with attachment issues

Gestalt therapy aims to help the client recognize their responsibility in everyday interactions by focusing on why their behaviors trigger specific events. Because many attachment problems may stem from a denial of personal liability, Gestalt therapy can be a helpful attachment-based treatment modality for adults with insecure attachment styles.

The role of cognitive counseling in treating attachment issues

Cognitive therapy is one of several talk therapies used to address attachment concerns. In cognitive therapy, therapists may help the individual recognize faulty logic and unwanted behaviors so that they can work toward modifying their beliefs. As the client gains greater self-awareness, the therapist may help them acquire skills to manage symptoms of their condition, test their beliefs, and learn new ways of understanding situations that have triggered maladaptive behaviors in the past.

Behavioral approaches in therapy for attachment issues

Behavioral therapy focuses on identifying self-destructive behaviors and using specific techniques to control unwanted attachment-based behavior. Once the client can identify the actions that lead to maladaptive behaviors they adopted as a young child, they may be able to use specific techniques learned in therapy to overcome them and foster meaningful connections. 

Holistic methods for healing attachment issues

Holistic therapy involves the use of multiple psychotherapy techniques at once. A therapist using the holistic method may create a custom therapeutic approach for each client to help them move past unhealthy attachment styles and behaviors. For instance, one or more psychotherapy techniques may be used to identify the problems at hand and completely different methods may be used to create a plan for healing. In holistic therapy, the focus is on the result, not on the treatment modality.

The role of humanistic counseling in attachment-based therapy

In the humanistic approach, the therapist works with the client to discover the cause of maladaptive behaviors. Humanistic therapy drives the client to acquire more profound wisdom and self-awareness. Adult attachment challenges often develop in childhood. The humanistic approach may help clients reach back to those past events and discover new ways to change harmful attachment-based behaviors.

Online therapy with BetterHelp

Online therapy is an evidence-based treatment method for relationship struggles, including for those living with attachment challenges. Online therapy has been proven to help develop a strong, trusting therapeutic alliance between the therapist and client, which may help drive treatment outcomes. 

Online therapy makes it possible to connect with a therapist via messaging, which may cause some people with insecure attachments to feel more trusting of their therapist. Your therapist can also connect you with useful resources, such as up-to-date informational articles on attachment-based topics. 

Online therapy can be a viable option for those struggling with attachment and other mental health concerns. One study found that online therapy participation successfully reduced participants’ psychiatric symptoms, including a reduction in depression, anxiety, and loneliness, and an increase in self-esteem. Researchers also saw a “change in the attachment dimension,” including decreases in attachment anxiety and avoidance.