Attachment disorders, as listed in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, can only be diagnosed in children. However, adults may experience disorders with similar symptoms to those diagnosed in children, including personality disorders and post-traumatic stress disorder (PTSD). In addition, theories like attachment theory by John Bowlby and Mary Ainsworth describe four distinct attachment styles that can be present throughout life.
What Is Attachment Disorder?
Attachment disorders are conditions diagnosed in children as young as or younger than five. They can result from severe neglect, abuse, or other childhood trauma that may impact a child's ability to form a secure attachment. The two attachment disorders children can be diagnosed with include the following:
- Reactive attachment disorder (RAD)
- Disinhibited social engagement disorder (DSED)
Teens and adults cannot be diagnosed with an attachment disorder. However, they may be diagnosed with conditions that have similar symptoms to the above attachment disorders, including the following:
- Post-traumatic stress disorder (PTSD)
- Borderline personality disorder (BPD)
- Dependent personality disorder
- Narcissistic personality disorder (NPD)
- Antisocial personality disorder (ASPD)
Adults can also struggle with an insecure attachment style, which is not a disorder but is thought to be caused by attachment trauma in infancy and young childhood.
What Causes Attachment Disorders?
There are several possible contributing or causative factors to attachment disorders. Children may develop an attachment disorder when they cannot bond with a caregiver. For example, a parent or caregiver may not meet a child's social interaction or affection needs. They may also be absent or classified as neglectful.
Alternatively, this condition can be more prevalent in those who experience displacement in their youth, such as foster care or adoption.
What Are The Risks Of A Childhood Attachment Disorder?
Although attachment disorders are not often diagnosed after puberty, there's compelling evidence that untreated attachment disorders can lead to problems later in life. Reactive attachment disorder can be linked to a higher likelihood of clinical depression and substance use in adulthood. As adults with an insecure attachment style may unwittingly recreate unhealthy patterns from their family of origin, they can have the potential to pass their range of experiences along to their children.
What Are Insecure Attachment Styles?
According to attachment theory, there are three insecure attachment styles that adults can have based on their attachment to their parents or caregivers as an infant or child. Secure attachment is the fourth attachment style, categorized by secure and healthy relationship patterns. Below are the three insecure styles.
Anxious Attachment Style
An adult experiencing an anxious attachment style may have a severe fear of abandonment and under-appreciation. This style can result from a caregiver who ran "hot and cold," such as switching from warm affection to cold rejection for no apparent reason while a child grows up. This caregiver may have also been emotionally needy, only showing love when it was in their interest. As a result, the anxious adult can distrust relationships but feel that they must live their life for the appreciation and support of others.
Someone with an anxious attachment style may analyze the behaviors of others obsessively, replaying the same themes in their minds. In addition, someone with an anxious attachment style may crave control of each situation and relationship to avoid further feelings of nervousness or disconnection. They may be sensitive to rejection or idealizing others, which can lead to the potential for a preoccupation or dependence on their significant other.
Extreme emotions or bouts of jealousy and possessiveness may also be common experiences of an adult experiencing an anxious attachment style.
Avoidant Attachment Style
An avoidant adult may have learned to detach from others in childhood when primary caregivers were distant, absent, or critical. The child may have done this out of the concern that they could not trust adults to meet their needs, which may have prompted them to learn to shove those needs out of sight.
As a result, an adult experiencing avoidant attachment disorder may not express their needs to others or ask them for help, and they may also feel contempt for others who do express their needs.
This manifestation can result in nervousness surrounding relationship intimacy or a negative view of others. Those with avoidant attachment disorder may view others as untrustworthy or undependable while viewing themselves as "better" for not being "as emotional." They may use this mindset to defend themselves against perceived threats or dynamic instability.
Disorganized Attachment Style
Someone with a disorganized attachment style may crave affection and intimacy but fear it simultaneously. They may show signs of anxious attachment when their partner is distant or trying to leave them and may show signs of an avoidant attachment when their partner wants to connect more profoundly. Switching back and forth between a desire to connect deeply and a desire to run away, these individuals may feel contradictory to themselves.
A disorganized attachment style is often associated with experiences of prolonged childhood abuse or neglect and a disorganized parent. These experiences can lead those with this style to feel they cannot have healthy relationships.
Symptoms Of An Attachment Difficulty
Although adults cannot be diagnosed with an attachment disorder, below are a few signs they may be struggling with an insecure attachment pattern:
- Isolation and avoidance of the warmth and affection of others
- Difficulty acknowledging or processing positive emotions
- Rigidity in social situations
- Potential substance use
- Numbness or difficulty experiencing empathy
- A possible lack of concern or respect for authority or rules
- Distrust of others
Attachment disorders can be diagnosed and treated during childhood. However, even if childhood AD has been left untreated, there may be hope for adults to treat insecure attachment styles. Studies have found that insecure attachment styles can be changed to secure with time, education, and professional support.
How To Find Treatment
One of the most effective ways to treat adult attachment issues is therapy to help one come to terms with their past's painful and traumatic events. Part of this work may consist of building a narrative explaining the causes of events and the safety of their current life.
Children can derive their sense of self through their caregivers' perception of them. For example, if a parent has conveyed the story that they are innately flawed and unworthy of love, the child may believe this story and carry it into adulthood, whether the parent meant to convey this message or not.
The therapeutic task of adulthood, for some, is to create a new story that involves moving forward from the choices of one's caregiver. By evaluating the past hurt through this lens, those experiencing attachment challenges can choose to learn new patterns and behaviors that reflect healthy relationship patterns and desires.
Alternative Support Options
Living with an attachment difficulty as an adult can be challenging, as it may impact every relationship you form and your relationship with yourself. If you struggle to find support in your area, online therapy platforms like BetterHelp can offer support from home or any location with an internet connection.
With online therapy, professionals can help you address childhood trauma, support you in building coping skills and help you learn to reframe negative thought patterns so that you may experience a higher quality of life. In addition, you can choose between phone, video, or chat therapy session formats, allowing you control over how you receive support.
Recent literature suggests that singular and family therapy sessions can be comparably effective when done virtually compared to more traditional, in-person formats. One study also noted possible benefits of affordability and inclusivity to those experiencing financial or family distress.
What are the signs of attachment disorder in adults?
Adult reactive attachment disorder usually begins in childhood and can develop due to the type of care provided (or not provided) by the primary caregiver. Adults with reactive attachment disorder may display the following signs:
- Challenges with boundaries in relationships
- Avoidance of social interactions
- Irritability, impulsivity, and mood swings
- Depression, anxiety, and/or low self-esteem
- Difficulty trusting other people
It’s usually necessary to speak with a licensed mental health professional to receive a formal attachment disorder diagnosis. Once you’ve received a diagnosis, you can then pursue the appropriate treatment and begin to learn how to maintain healthy attachments in which you feel safe.
What does disorganized attachment look like in adults?
Disorganized attachment, sometimes referred to as fearful-avoidant attachment, generally refers to an attachment style characterized by inconsistent behavior typically stemming from childhood trauma. This behavior can lead to chaotic relationship patterns.
An adult with disorganized attachment might seek close relationships but unpredictably lash out at others who care about them. This generally happens because they desperately want to connect with others, but, at the same time, they have an intense fear of being close to other people.
While disorganized attachment in adults refers to issues with attachment displayed during adulthood, these challenges usually begin much earlier and can sometimes be seen in two childhood attachment disorders: reactive attachment disorder and disinhibited social engagement disorder. When symptoms present chronically, a diagnosis of one of these childhood attachment disorders can be made by a professional. It can be ideal for attachment difficulties to be addressed during childhood so that treatment can help children develop proper attachment styles.
What causes attachment trauma in adults?
Attachment trauma usually happens during early childhood. When a child is abused, neglected, or offered inconsistent care, they may form an insecure attachment style.
If you or a loved one is witnessing or experiencing any form of abuse, please know that help is available. You can call the National Domestic Violence Hotline anytime at 1-800-799-SAFE (7233).
What personality disorder has attachment issues?
One of the hallmarks of borderline personality disorder tends to be difficulties with attachment. Many people with BPD live with insecure or disorganized attachment styles.
Those living with dissociative identity disorder (previously referred to as multiple personality disorder) may also experience difficulty forming secure attachments to others.
As disorganized attachment can be linked with dissociative symptoms, it’s possible that people with dissociative disorders may be likely to struggle with healthy attachments as well.
In addition, it’s thought that there could be a link between eating disorders and insecure attachment styles.
What does BPD attachment look like?
While each individual with BPD tends to be unique, people with borderline personality disorder usually demonstrate a strong longing for intimacy. At the same time, they may greatly fear dependency on others and rejection by those they care about. These characteristics can make it challenging for those with BPD to maintain healthy relationships.
What triggers reactive attachment disorder?
Abuse, neglect, inconsistent treatment, and abandonment during childhood may trigger attachment disorder.
What does attachment anxiety look like?
Attachment anxiety may display itself through clinginess, intense jealousy, preoccupation with relationships, low self-esteem, and neediness.
What does insecure attachment look like in adulthood?
Insecure attachment in adulthood can come in multiple forms (ambivalent, anxious, or disorganized), each of which may present differently. In general, people with insecure attachment tend to lack trust and a sense of security in their relationships. They may be needy, clingy, and suspicious of those they care about, and they may act in unpredictable ways as a result.
What does unhealthy attachment feel like?
In many cases, unhealthy attachment can involve relying on relationships to provide you with a sense of self-worth.
How do I know if I have attachment issues?
Fears of abandonment, trouble trusting others, difficulty bonding with other people, challenges with boundaries, strong reactions to criticism, and a need for frequent reassurance may indicate problems with attachment.
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