Child and Adolescent Psychotherapy, Mental Health

A Deep Dive into Attachment Styles and Disorders

A deep dive into attachment styles and disorders

Written By: Sarah Kelly, LSW, CADC

While this article is related to attachment and attachment-related disorders, it holds a special place in my mind. Before being a therapist at Clarity Clinic, I worked at a Chicago-based non-profit called Mercy Home for Boys and Girls. Mercy Home serves youth and families across Chicago who are in crisis. 

Often youth in a crisis, similar to the youth at Mercy Home, children in underserved communities, and children in the foster care system experience challenges in the areas of bullying, poverty, systemic racism, crime, violence, lack of access to resources, etc. This can result in problems with attachment. 

Working with a therapist and accessing needed resources is important so that children with attachment problems can heal. As a youth care worker at Mercy Home, I was able to witness this healing process and was inspired to become a social worker to continue being a part of healing. 

The mission of Mercy Home is so important to me that I have chosen to run the Chicago marathon to raise funds for the organization. If you want to support the healing of youth and families in Chicago, please consider donating here.

What Is Attachment Disorder?

Before we begin a discussion of attachment styles and disorders, it is important to define attachment. Attachment theory was developed by psychiatrist John Bowlby in the 1950s. He defined attachment as, “Lasting psychological connectedness between human beings.” Per Bowlby’s framework, attachment develops between caregiver and child as the child needs the parent or caregivers to survive. 

Essentially, how a child relates to their caregiver is often indicative of their attachment style. If a child’s caregiver is responding to the child’s needs for survival, the attachment relationship will likely be healthy. If the caregiver is unable to or inappropriately responds to a child’s needs, an unhealthy attachment style will likely develop. 

What Is Attachment Disorder?

Different Types of Attachment Styles and Disorders

Now that we have defined the concept of attachment, let’s talk about attachment styles. The four prevalent attachment styles are described below:

  • Secure – Secure attachment is indicative of healthy relational patterns between caregiver and child. Someone with secure attachment is comfortable building intimate relationships and does not fear rejection or abandonment. Someone with secure attachment can depend on others and is comfortable with others  –  on them.
  • Avoidant – Avoidant attachment is indicative that there may have been some problems with the caregiver/child relationship. Someone with avoidant attachment values independence and is often uncomfortable with closeness. If someone has an avoidant attachment style, they may have had challenges depending on their caregiver in childhood or feeling unable to explore independence in childhood.
  • Anxious – Anxious attachment indicates that there were likely challenges in the caregiving relationship in childhood. People with anxious attachment styles often feel insecure in their intimate relationships and require significant reassurance due to fear of abandonment and rejection. This often occurs in caregiving relationships in which a child experiences neglect.
  • Disorganized – disorganized attachment also is representative of problematic relational patterns between caregiver and child. Disorganized attachment styles often include features of both anxious and avoidant attachment Someone whose attachment style is disorganized may not be able to engage in close intimacy and also fears rejection and abandonment. Disorganized attachment is often related to unresolved abuse or trauma in the caregiving relationship or other close intimate relationships. 

A secure attachment style is the attachment style that naturally results from a healthy caregiving relationship between parent and child. However, people with anxious, avoidant, and disorganized attachment are capable of building healthier attachment styles through therapeutic interventions. 

Having a healthy supportive bond with mentors, teachers, coaches, and clinical providers can often support children in improving their attachment relationships. Unfortunately, these supportive bonds are not always available and unhealthy attachment styles can result in attachment disorders.

Common Attachment Disorders Seen In Children

Common Attachment Disorders Seen In Children

Two common attachment disorders are seen in children and adults: Disinhibited Social Engagement Disorder (DSED) and Reactive Attachment Disorder (RAD). Below, a more general description of each disorder is presented.   

  • Disinhibited Social Engagement Disorder (DSED) is an attachment disorder that is diagnosable in children under the age of 18. Children and adults with DSED are unable to form healthy, meaningful relationships with others. Instead, a child with DSED lacks inhibition when interacting with those who are unfamiliar. This child will often be willing to leave an area with a stranger and/or will not consult with a safe adult before leaving their environment. Children who exhibit DSED are at high risk for danger due to their openness to connect with unfamiliar people. Children who meet the clinical criteria for DSED often come from backgrounds with high levels of trauma, abuse, and neglect.
  • Reactive Attachment Disorder (RAD) is an attachment disorder that can often seem to be composed of DSED. RAD too is diagnosable in children under the age of 18. Children and adults with RAD experience challenges when trying to connect with others and manage their emotions. Someone who has RAD will typically not seek support when they are in distress due perceived lack of safety. Additionally, children and adults with RAD are typically withdrawn and emotionally distant from others. They usually have high vigilance and may become aggressive if they feel others are too close to them. As with DSED, children with RAD likely experienced high levels of abuse, trauma, and neglect.
How To Help Someone With Attachment Disorder

How To Help Someone With Attachment Disorder

If someone you know has an attachment disorder, it is important to address and support it as soon as possible. Below are some guidelines on how to support someone with disordered attachment:

  • Hold firm boundaries
  • Be a safe container when the person is upset
  • Be present as soon as possible to repair after conflict
  • Take ownership of personal failings to begin repair
  • Maintain structured schedules and routines

Disorders of attachment are disorders in how we connect with others, but they are treatable and manageable. Building safe and stable connections are needed for healing which all who have disordered attachment deserve.

Getting Help For An Attachment Disorder

At Clarity Clinic, we have highly trained staff who specialize in therapy and psychiatry services. To learn more about how we can support your mental health, call Clarity Clinic on (312) 815-9660 or schedule an appointment today.

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