Adult attachment disorders refer to the various difficulties associated with reading emotions, showing affection, and trusting others. These disorders often start in childhood, and they can affect everything from someone’s self-esteem to relationship satisfaction. Treatment can help people become more aware of their attachment styles and learn how to communicate their needs with others properly.
What Is Attachment?
Attachment refers to how we connect, trust, and otherwise attach to other people. This theory focuses on relationships, such as the dynamics between a child and a caregiver or two romantic partners. Within the therapeutic context, therapists may explore the attachment between the client and themselves.
There are four types of attachment styles:
- Secure attachment: Generally positive emotional bonds with self and others
- Anxious attachment: Desire for intimacy, anxious in relationships, feel like others are emotionally unavailable to them
- Avoidant/dismissive attachment: Struggle with intimacy, feel uncomfortable with closeness, seek high levels of independence
- Disorganized attachment: Intense, chaotic relationship patterns that typically consist of a combination of desiring closeness while subsequently pushing people away
These attachment styles emerge in childhood. They continue to impact the types of relationships people have throughout their lives.
Types of Attachment Disorders in Adults
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists two childhood attachment disorders. Like all mental illnesses, symptoms can ebb and flow over time. However, an adult who suspects having an attachment disorder must indicate having had symptoms first emerge between ages nine months to five. In some cases, children receive appropriate treatment. If not, the individual may suffer long-term self-esteem and relationship consequences persisting into adulthood.
Reactive Attachment Disorder in Adults
Reactive attachment disorder (RAD) is a rare condition that starts when a child does not maintain healthy attachments with caregivers. Those struggling with RAD find little to no comfort in other people. Subsequently, they rarely show positive emotion when socializing with their caregivers (instead, they may present as sad, irritable, or unhappy).
This lack of proper attachment often happens when the child doesn’t have their needs met consistently. Most research on RAD focuses on symptoms present in young children. The DSM-5 states that signs must be observed before five years old.1
Common symptoms of RAD include:
- Rarely seeking or reacting to comfort when distressed
- Lacking the ability or willingness to express positive emotions
- Intense irritability, fear, or sadness towards caregivers (seen in young children)
- A history of childhood neglect, abuse, or long-term separation from caregivers
- Witnessing abuse happening to other people
Disinhibited Social Engagement Disorder in Adults
Disinhibited social engagement disorder (DSED) is a disorder that affects one’s ability to form meaningful, sustained relationships with others. Children with this condition do not show the normal fear associated with strangers. Instead, they tend to be overly friendly or preoccupied with gaining the stranger’s attention.2
DSED emerges in childhood and is often a response to lacking a consistent caregiver. Some children with this condition come from settings like orphanages or shelters and receive very little one-on-one attention.
Common symptoms of DSED include:
- Overly reactive excitement when interacting with new people
- Excessively friendly, chatty, and wanting to touch strangers (in ways that are outside of age-appropriate or cultural norms)
- Lack of concern about being left alone with a stranger (and feeling safe leaving with them)
- Little interest in checking in with caregivers during emotionally challenging times
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How Do Attachment Issues Develop?
Attachment disorders typically develop during childhood based on the quality and quantity of caregiving a person receives. When someone receives care, love, and support, they will likely have secure attachments. If there were problems with inconsistent, unsupportive, or unfulfilling care, an attachment issue could develop.
Attachment issues could develop or present into adolescence and adulthood if someone experiences a string of unhealthy or problematic relationships.
Is It Possible to Change Attachment Styles?
Attachment styles are different from attachment disorders. According to attachment theory, most people fit within a particular attachment style. But attachment disorders are rare and often require clinical attention. To date, there is no formal diagnosis for attachment disorders in adults, and although attachment styles can be challenging to change, it’s possible to move towards more secure attachment.
How Are Adult Attachment Disorders Treated?
Attachment-based therapists agree that it’s possible to become more aware of triggers that provoke withdrawal or anxiety. By understanding these triggers, you can learn how to change your responses. You can also learn how to resolve traumatic wounds that might be stunting your ability to attach securely to others.3
Attachment-based therapy helps clients express emotions, rebuild intimacy with others, and increase an overall sense of trust. This approach can be used in conjunction with other therapeutic models, such as cognitive behavioral therapy or psychodynamic therapy.
In general, therapy aims to provide a safe and trusting relationship between therapist and client. This kind of relationship can be invaluable for someone who struggles with attachment.
How to Cope With Attachment Issues
You cannot undo the relationship and attachment issues of your past, but you can explore healthier ways to cope with your attachment issues.
Here are some ways to start coping with your attachment problems and changing your behaviors:
- Understand your attachments. Each person has an attachment style. Do work to acknowledge yours and how it may have developed.
- Identify your patterns. Reflect on your past relationships to discover patterns and trends that have happened throughout your life.
- Consider a different type of partner. Think about what type of partner would be the best option moving forward. It could be very different from the type you’ve been attracted to.
- Be intentional in relationships. Some may think that being impulsive and spontaneous in relationships is fun, but it could lead to more pain than pleasure. Be intentional and thoughtful about your goals.
- Stay open and communicative. Let the person know what you are experiencing in the relationship and work as a team to find appropriate solutions.
How to Help a Partner With an Attachment Disorder
As a loved one, you are not responsible for ‘fixing’ your partner’s disorder. That said, you can be a supportive, compassionate anchor as they work through their recovery. Practicing patience and empathy are vital for offering support.
It’s important to check in with your partner and maintain open communication to determine what is (or isn’t) working.
With that in mind, here are some tips for helping a partner with an attachment disorder:4
- Commit to learning more about attachment styles and attachment disorders
- Listen actively and openly when they express their feelings
- Avoid harsh accusations or name-calling
- Specifically ask your partner how you can best support them
- Set healthy boundaries that honor your integrity and personal needs
- Express routine gratitude for your relationship and your partner’s attributes
- Engage in intimacy-building exercises
- Consider seeking couple’s counseling
It’s also important to be aware of your part in the dynamic. Self-awareness allows you to recognize your behaviors and interpret how your partner might respond to them.5
For instance, certain patterns, such as withdrawing if you’re stressed or lashing out when you become angry, may trigger unhealthy dynamics. It can cause excess tension and strain. However, by focusing on how you can both grow as individuals, you might be able to achieve greater relational satisfaction.
Attachment disorders can be challenging, but treatment can help. You can learn how to build meaningful, wholehearted relationships with others. It’s also possible to learn how to start trusting people again- even if you’ve always struggled with it. Therapy can make a profound difference in helping you take the first step in the right direction.