Understanding Attachment Disorder in Adults

If an individual struggles with maintaining healthy familial and romantic relationships, this may be because an attachment disorder impacts their ability to make these connections. Attachment disorders develop at some point during early childhood and, if left unresolved, can later reflect in the individual’s emotions and behaviours as an adult.

In this article, we will define what attachment disorder in adults is, explain the different types they may experience and outline the signs and symptoms of the disorder and how it can be treated.

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What is Attachment Disorder in Adults?

The term attachment disorder refers to the emotional and behavioural issues that develop in children who have difficulty forming a secure bond with their primary caregiver, which is often their parents. This connection may not be formed for various reasons, including an absent caregiver, neglect or abuse. In some situations, the caregiver may not be able to physically be with their baby or child, such as if either one is unwell and has to stay in hospital for a sustained duration. This may result in the child not receiving the care and attention needed to form a close attachment with their parents or caregiver. For most people, the experience with their parents or other caregiver is their first example of a secure, loving and trusting relationship. If a child doesn’t have this experience, they may grow up with different expectations of what relationships are like and struggle to form and maintain healthy relationships as an adult.

Although attachment disorder can only be diagnosed in children, adults can experience attachment issues resulting from untreated or undiagnosed attachment disorders from their childhood. For example, someone with attachment disorder may, as an adult, feel as though they cannot trust a romantic partner and struggle to communicate their emotions in an effective way. This can result in them being unable to form meaningful relationships and may cause them to experience commitment problems.

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Types of Attachment Disorders in Adults

Different types of attachment disorders may develop as a result of an individual not forming a strong attachment to their primary caregiver as a child. As mentioned, attachment disorders are not formally diagnosed in adults. However, if attachment disorder is left unresolved as a child, they may experience significant difficulties relating to this in adulthood.

Reactive Attachment Disorder (RAD)

Reactive attachment disorder (RAD) is a rare condition that can result from neglect or mistreatment during early childhood. It can persist in adulthood if the individual is not successfully treated for the condition in their early years.

Signs and symptoms of RAD in adults may include having difficulty with the following:

• Forming attachments with other people and maintaining relationships.
• Showing or accepting affection.
• Trusting others.
• Understanding how others are feeling.
• Controlling feelings of anger.

Someone with RAD may also experience feelings of low self-esteem, display impulsive or detached behaviours and have issues with control. They may be more at risk of developing a mental health condition, such as anxiety or depression.

Disinhibited Social Engagement Disorder

Disinhibited social engagement disorder (DSED) is a type of attachment disorder which tends to develop as a result of neglect or unsuitable care during the first two years of an individual’s life. A child may try to gain the attention of strangers and not display the usual fear associated with being introduced to new people. If left untreated, DSED can result in the individual struggling to create and maintain healthy long-term relationships with other people.

Signs and symptoms of DSED in adults may include:

• A limited understanding of social boundaries, such as excessive friendliness or touching strangers.
• Quickly placing trust in people they do not know well.
• Hyperactivity and becoming overly excited when meeting new people.
• Acting impulsively or showing a lack of inhibition.
• Displaying other behaviours that are not considered to be socially acceptable.

In some cases, RAD or DSED can result in someone developing an obsessive love disorder (OLD). This is an intense fixation with someone that can result in thoughts and behaviours that can be damaging to both people involved. Symptoms and behaviours may include extreme jealousy, controlling behaviour, possessiveness and an inability to accept rejection. Untreated, it can result in extremely serious behaviours such as abuse, stalking and violence. It’s worth noting that clinicians do not widely recognise obsessive love disorder, and there is discussion over whether it can be considered a mental health condition. However, attachment issues that aren’t resolved can manifest in various ways in someone’s emotions and behaviours, including those associated with OLD.

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Signs and Symptoms of Attachment Disorder in Adults

Unresolved attachment disorder in childhood can lead to adults experiencing a range of symptoms and behaviours. These can vary depending on factors, including the reason for the attachment not forming as a child (for example, abuse), as well as individual differences. Although research into attachment disorder in adults is limited, there is strong evidence that certain family problems in early life can have a significant, lasting impact on an individual.

Some of the common signs and symptoms of attachment disorder in adults include:

• An inability to form and maintain healthy romantic relationships.
• Difficulty with responding to their emotions.
• Mood swings.
• An inability to trust people.
• Avoidance of intimacy.
• A feeling of low self-esteem.
• Withdrawal and avoidance of social events.
• Difficulty in certain social situations and interpreting social cues.
• Mental health conditions, including anxiety, depression or post-traumatic stress disorder (PTSD).

It’s important to recognise that attachment problems may make mental health conditions such as depression or anxiety worse rather than be a direct cause, though many mental conditions are linked.

An adult with attachment disorder will likely experience challenges with relationships. They may find it difficult to communicate effectively and voice their feelings to a romantic partner, resulting in feelings of paranoia, insecurity, jealousy and anxiety. If these feelings aren’t discussed and resolved healthily, the individual may express their feelings in an unproductive manner, such as through anger and accusations. Some people may become withdrawn and find commitment challenging, while others may feel that they need excessive attention and validation from their partner.

Someone with an attachment disorder may also find other relationships difficult, such as those with friends and family. If the individual experienced significant trauma as a child and continues to see those involved as an adult, these relationships can be strained and difficult. This will depend on the specific circumstances, but these interactions can cause stress and anxiety. Many of the signs and symptoms people experience can make it difficult to form and maintain any type of relationship. Someone may find it challenging to maintain strong friendships if they tend to withdraw from social situations or their mental health makes it difficult for them to function well.

Attachment disorder can affect all aspects of someone’s life, from their ability to work effectively to everyday interactions. It can be very difficult for someone to get the help they need, but if these problems aren’t addressed, the individual’s mental wellbeing can rapidly decline.

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How to Treat Attachment Disorder in Adults

If an attachment disorder isn’t addressed and resolved during childhood, support can be sought in adulthood. Often, a form of therapy or counselling is an effective approach to managing attachment disorder and the behaviours and conditions that can result from it.

Psychotherapy, also referred to as talking therapy, is a type of psychological treatment for mental and emotional problems. Working with a qualified therapist can help someone identify and understand their thought patterns and behaviours. Attachment-based therapy is a specific type which is intended for children, adolescents and adults who have an attachment disorder. For adults, it involves discussing their childhood and past experiences and identifying unresolved trauma impacting their lives. This can help them to understand why they feel or act a particular way, particularly when in romantic relationships. For example, they may find it difficult to trust their partner and receive and/or reciprocate affection.

By addressing these issues, an adult with attachment disorder can work with their therapist to overcome the impact of their early experiences. They may be able to change these aspects which are affecting them negatively by developing techniques and strategies that work for them, such as establishing clear boundaries with their parents.

Alongside therapy tailored to the individual, couple therapy can also be an effective way to treat attachment disorder in adults. Or, some people may find it beneficial for their partner to attend some of their personal therapy sessions. Most people with attachment disorder will benefit from focusing on themselves and considering why they think and behave the way they do independently before introducing their partner to later sessions once they feel comfortable in doing so. Involving a partner in these discussions can help them to understand why their partner behaves in certain ways. As a result, they will likely want to be more accommodating and encouraging of their partner’s circumstances and support them in developing positive thoughts and behaviours. Together with the therapist, couples can build on techniques to strengthen their relationship, supporting the individual with attachment problems to overcome these issues.

Another type of talking therapy that could be useful for someone with attachment disorder is cognitive behaviour therapy (CBT). CBT can be an effective tool to enable someone to understand and change how they think about their life and manage any unhealthy behaviours. Evidence shows it can be an effective treatment for mental health conditions, including depression, anxiety, post-traumatic stress disorder (PTSD) and more. As attachment issues may worsen someone’s mental health, CBT can be used to help manage and treat both their attachment disorder and some conditions exacerbated by it. CBT involves a series of sessions with a therapist during which milestones may be set, and the individual may be required to complete tasks between the sessions.

Conversations about conditions and disorders can be difficult to broach. However, it is important that these topics are talked about and that other people understand what these experiences can be like for someone as best as possible. Our article here provides some conversation topics and tips on talking about mental health, which you may find useful.

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If someone you know or care for is experiencing difficulties that you think may result from attachment disorder as a child, medical advice should be sought, such as through a GP or a therapist. It’s important to remember that attachment disorder is only clinically recognised in children, and adults are unlikely to be given this diagnosis. However, if attachment disorder as a child isn’t treated, it can result in various difficulties in later life, predominantly with relationships and social interactions. Addressing this as an adult can result in an individual developing positive thought patterns and behaviours, enabling them to successfully form long-lasting, happy relationships.

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Further Resources:

• Health and Social Care Courses
• Promoting Effective Communication in Health and Social Care
• How to Help Someone With Loneliness