Understanding Attachment Theory: How Can Early Care Affects Child Development?

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated May 16, 2024by BetterHelp Editorial Team
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For decades, many mental health professionals have theorized that the care children receive from infancy through childhood can influence how they form relationships for the rest of their lives. Our emotional connections are defined by many as  an attachment style—which can have implications on your experience and the experiences of your children, should you choose to have them. 

Read on to learn about attachment theory and how it can impact child development.


What is attachment theory?

Psychologist John Bowlby first proposed attachment theory in the 1940s, possibly in an attempt to help explain how people can form relationships. According to Bowlby’s psychological evolutionary theory, humans developed the capacity and desire for emotional attachments to ensure the species’ survival—a concept that can date back to some of the earliest generations. 

Furthermore, this theory further highlights how parents and guardians meet the needs of children in their care—suggesting that the level of affectionate connection with them can serve as the foundation upon which they might build relations with other people throughout their lives. 

Bowlby later worked with psychologist Mary Salter Ainsworth to refine the theory into four attachment styles, which have helped to classify the characteristics. 

Attachment styles

In this theory, there are four main attachment styles mentioned. We do want to note that this is a theory, and that people may feel as if their experience is truly unique—meaning that they might believe they identify with a single style, a mix or multiple, or none at all. 

We’ve summarized the styles below: 

  • Secure

Children of parents and guardians who provide responsive care and emotional warmth may develop a secure attachment style. Reliable care and support can give these children a positive view of themselves and others, possibly empowering them to healthfully depend on others in a healthy way as needed while simultaneously offering reciprocal care. 

  • Dismissive (avoidant)

When caregivers fail to show emotion or emphasize independence as a desirable trait, children may develop a dismissive or avoidant attachment style. These children might feel as if they must rely on themselves, which can lead to trouble trusting others later on. For example: They may see themselves in a positive light while viewing others negatively, which can possibly further fuel their drive for independence. 

  • Fearful (disorganized)

If parents or guardians fail to meet a child’s emotional and physical needs consistently, the child may develop a fearful or disorganized attachment style. In this attachment style, Children may experience ambivalent emotional responses—such as fear, harsh criticism, abuse or neglect. These children might have a negative view of themselves and others, which can possibly lead to them finding it challenging to believe others will love and support them. 

  • Preoccupied (anxious)

Inconsistent care from parents or guardians can lead to children developing uncertainty about whether their needs will be met, which can lead to a preoccupied or anxious attachment style. 

We do want to note: Inconsistency in this context can look different across different experiences and cases. For example: Caregivers may alternate between loving warmth and distant disapproval. Children may also receive “love withdrawal” as discipline, where parents use disappointment, ridicule and other negative emotions to convey their attitudes about the child. This treatment can lead to abandonment anxiety, as well as the possibility that these children may view themselves negatively while trusting others to be competent. 

No matter what attachment style you believe you may have experienced, it can be helpful to keep a few things in mind. Generally speaking, no single attachment style is perfect—as all humans have the capacity for different inherent needs and expectations. Online therapy and other supportive measures can be useful tools to help you to seek a higher quality of life.
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Stages of attachment

Ainsworth, along with other authors, published further research into attachment theory in 2014, yielding landmark findings about the crucial stages of attachment during infancy and expanding Bowlby’s findings. 

Pre-attachment: Birth through the first weeks

Infants respond to people but don’t yet distinguish between them. Around six weeks, babies will display social smiles at the sight of human faces, which Bowlby said may be an evolutionary response to increase the chances of positive attention, furthering emotional attachments. Infant behaviors such as crying, grasping, babbling, and sucking bring caregivers into close contact, which promotes the growing bond and emotional investment. Phase one ends when the infant begins to distinguish between people, particularly the mother figure or primary caregiver. 

Indiscriminate attachment-in-the-marking: Six weeks to seven months

Babies can consistently differentiate between multiple people and unfamiliar faces. Attachment should be seen in the preference for close proximity to parents or guardians, who regularly know how to appease attachment behaviors like crying. Infants expand their repertoire of learned behaviors to elicit responses from caregivers but are not yet able to form genuine attachments. 

Discriminate attachment: Seven months to three years 

Now that motion is a part of the equation, babies may physically show their preference for attachment figures. When the element of self-control over behavior and company is introduced, children gravitate toward preferred people. Between 7-8 months, infants may begin to fear unfamiliar faces. Children should have a working model of their favored caretaker by one year, including expected reactions. 

Goal-corrected partnership: Age three and up 

Children can form reciprocal attachments to multiple people, such as parents, siblings, grandparents, extended relatives, and friends. They begin to understand that their caretakers have their own plans and goals, allowing them to display less concern during a period of absence. 

Factors affecting attachment

Any abuse, trauma, neglect, or maltreatment may impact emotional attachments. These adverse situations can result in removal from the home and familiar caregivers. When parents have substance use disorders or mental health conditions, the child’s needs are often not the priority, and they may develop attachment issues. Children may go through multiple placements, unable to form deeper connections and learning that care is unreliable. 

“Young children, who for whatever reason are deprived of the continuous care and attention of a mother or a substitute-mother, are not only temporarily disturbed by such deprivation, but may in some cases suffer long-term effects which persist,” Bowlby and co-authors said in a 1956 paper about caregiver attachment.

Long-term emotional effects

Psychologist R. Christ Fraley studied how the processes outlined in attachment theory affect the way adults form relationships, applying the same motivational systems used during childhood to emotional attachments. 


Secure attachment is generally considered the ideal style with the healthiest outcome. These adults value close relationships and typically find it easier to maintain healthy connections with other people based on mutual trust and support. 


They may crave emotional intimacy with others as adults while simultaneously avoiding it. Adults with dismissive attachment styles often disregard the value of close relationships, preferring to remain rigidly self-sufficient. They may view others as untrustworthy and unreliable. 


These adults may desire relationships as they age while simultaneously fearing the developing emotional intimacy. A fearful attachment style in adult relationships may be observed in disorganized, unresolved, or ambivalent feelings. 


Childhood experiences may leave these adults feeling inadequate and constantly worried about their partner’s love enduring. A preoccupied attachment style may result in fear that one mistake will end the relationship, showing intense jealousy, or being excessively clingy. They may feel unworthy of their partner or the love and support of loved ones. 

“Adults value attachment relationships and seem to be able to deal effectively with potentially invasive feelings about the past or future,” stated researchers in a paper on the topic


Childhood attachment disorders

Disinhibited social engagement disorder (DSED)

Children experiencing inadequate care early in life because of neglect or absence may develop disinhibited social engagement disorder (DSED). These children often wander away from caregivers and show no concern about leaving with strangers. They may also act overly familiar with strangers, such as seeking hugs and other physical contact. 

Reactive attachment disorder (RAD)

Abused or neglected children may develop RAD, though it doesn’t always occur. These children often experience extreme anxiety. They may exhibit abnormal social behavior, like a strong reluctance to seek comfort from anyone or a tendency to seek comfort from people other than caregivers. 

Overcoming unhealthy attachment issues

In general, the most effective way to overcome unhealthy attachment issues is a comprehensive treatment plan including therapy, case management, counseling, and parent education. 

Attachment-based therapy

Attachment-based therapy is an approach to therapy that specifically targets those thoughts, feelings, communications, behaviors, and interpersonal exchanges that patients have learned either to suppress and avoid or to amplify and overemphasize because of early attachment experiences,” said Peter C. Costello, Ph.D., author of Attachment-Based Psychotherapy in Practice.

Cognitive behavioral therapy

This therapy centers on recognizing harmful or unhealthy behaviors, thoughts, and attitudes and replacing them with positive, constructive patterns. 

Family therapy

Family therapy is a valuable resource to learn parenting skills, educate yourself on what your child is experiencing, and develop the skills to be a better parent in the future. 

Therapy may help build parenting, communication, and coping skills

If your child shows signs of attachment issues or an attachment disorder, therapy will likely be part of a comprehensive treatment plan. Working with licensed therapists through virtual therapy platforms like BetterHelp can make adding therapy to your busy schedule more manageable. With convenient and flexible options you can do from home, reduced costs, and professional support and guidance, therapy may be a beneficial solution for your family. 

Recent research shows that online attachment-based therapy and online cognitive behavioral therapy, which are often used to treat attachment issues, can be as effective in the online setting as in person. Therapy can help identify and replace unhealthy thought patterns and behaviors while working to strengthen family dynamics and build communication and coping skills. 


Establishing a solid emotional foundation to build a lasting connection with your child will help teach them how to relate to others in the future. The information outlined in this article may help you understand attachment theory and how early care can have lifelong impacts.
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