As therapists, a strong understanding of attachment theory can inform nearly every aspect of your clinical practice, since attachment informs adult behaviors and relationships. How we respond to trauma often depends on attachment history and emotional resources developed early on, and can include medical conditions, birth trauma, or temperament. 

We are looking here mostly through the lens of caretaking patterns in early childhood. However, with a solid understanding of attachment injury and how to move toward healthy attachment, we can heal at any age and experience deeply satisfying lives, even in the wake of traumatic experiences.

While we will focus on characteristics of secure attachment and attachment adaptations, it is often the case that we have a mix of attachment styles that manifest situationally or due to specific scenarios. If you have not already, you can take the Attachment Quiz on the website.

An Overview of Attachment Styles

Attachment development occurs in early childhood and is based on the care environment of the child. Parents’ and caregivers’ relational behaviors toward the child inform their attachment style and whether they have healthy attachment or attachment injury. 

One of the challenges of the pandemic is that we are afraid of the illness, which heightens our sense of fear on one hand, but on the other hand, we are not able to seek out or have enough access to others who regulate us and help us feel safe – physically or in our normal regular interactions. From Stephen Porges’ Polyvagal theory research, we understand that we need close connections in order to mitigate staying too long in a debilitating threat response – that this pandemic engenders. 

Another challenge is that therapists, coaches, and most clients are relatively new to online therapy taking place through our computers. We have been trained to use computers as a distraction for entertainment, and we often multi-task while on them – which can further break an attempted connection and thwart healing.

Let’s look at how we can help from understanding attachment patterns that can aid us as we make the best of the situation. 

Secure (Healthy Autonomy) Attachment

Parental behaviors: Parents and caregivers are tuned-in to the child’s needs and respond when the child wants warmth, connection, and physical contact. Children are confident that the parent will respond to their cries and so they feel safe and loved in their presence. Parents let the child explore and make themselves available as a “home base” when the child needs to reconnect for security.

Secure attachment in adults – called Healthy Autonomy, are able to connect with their partners, friends, and coworkers. They are comfortable asking for and giving help when needed and can self- and co-regulate easily. They are protective of self, other, and the relationship. 

Most often, adults with secure attachment resolve conflict easily without taking things personally and refrain from blaming or shaming their partner. They are confident in relationships and give and receive affection, love, and comfort from their partners when needed. While no human is immune to emotional difficulties and loss, those with secure attachment embody more resilience.

Avoidant Attachment (Dismissive)

Parental behaviors: Parents are tuned out, not present, neglectful, or rejecting because of their own attachment injury, work commitments, physical illness, mental illness, or due to familial restrictions and challenges. The child is left to their own devices too much of the time without attunement. Their needs are often not seen or met.

Avoidant attachment in adults is called “dismissive” – Adults with this attachment injury are often overly independent. They find it difficult to ask for help or support when needed, as they have learned that their needs are often not met, and admitting they have needs feels risky.

They tend to isolate and feel more relaxed in activities alone. It can be stressful to move from aloneness to connection and they need time to transition. They can seem shut down and find it difficult to talk, or even feel emotions. They may look to sex as a way to connect. They are often overly critical in relationships. Co-regulation is difficult. This does NOT mean they don’t want to connect or love their friends, family, and partners, but that they have adapted to the lack of ‘other’ early on by turning down, or off, their attachment system. They have to find the nourishment in intimacy again when it is safe enough, which is our job, as therapists, to help facilitate.

Their unique gift is that they are very left-brained and task-focused so they really get the job done! When they find access to their right brain, which is more relational, they are the full package.

Ambivalent (Anxious) Attachment (Preoccupied)

Parental behaviors: Parents are inconsistent – as in, off-again and on-again. This intermittent reward can lead to an obsessive focus on the ‘other.’ They sometimes respond to the child’s needs, but often with caveats. They may respond to the child mostly when their signal cry becomes loud, extreme, or when the child acts out or is ill. 

Often, this unreliable behavior comes from unfinished healing from their own history, as attachment patterns are easily transmitted through the generations. 

Ambivalent attachment in adults is called “Preoccupied” – Adults with this attachment injury can become extremely demanding in relationships because of the over-focus on the other and under-focus on the self. 

They may end relationships first, feeling like they will eventually be abandoned. As in childhood, those with an ambivalent attachment adaptation may communicate through complaining as they too often orient toward what they feel is missing in their relationships, even when their partner is very attentive. 

They may ignore caring behaviors because keeping the signal cry or negative focus on is linked to survival. They need reassurance until they can build trust and take in the love that is actually there for them. Their love can feel smothering. Self-regulation is difficult. The gift of their hypersensitivity heals into a very refined attunement, whereby they can really empathetically understand themselves and others in an empowered way.

Disorganized Attachment (Disoriented, Type D)

Parental behaviors: Parents are often abusive or scary, causing the child to feel traumatized with interactions. The field of fear, chaos or anger blocks bonding and creates dis-attachment. When parents are too scary, the child has no one to turn to when they are scared or in trouble, so they lose their primary attachment person, as well as any chance of safe haven. 

Often, parents are dealing with their own unresolved trauma, and may not have the tools to provide security and safety for the child until, or unless, they have the opportunity to heal.

Disorganized attachment in adults is called Disoriented, Type D – Individuals with this attachment injury often waver between avoidant and anxious concerns. They also often have traumas and abuse to contend with. They have difficulty self- and co-regulating and struggle to maintain close connections or to feel secure in intimate relationships. 

This is the most complicated situation for therapy, but often makes up a large portion of our client base. The need for safety in relationships is paramount. Chronic, or situational disorganized adaptation, is triggered by yelling or conflict but can be otherwise secure.  

Partners need to learn self-regulation and co-regulation. After healing, or learning skills to mitigate the disorganized adaptation, a person is usually a great protector of self and others and very attuned to safety. Learning to regulate oneself and others in high-stress situations is a true gift.

Trauma and the Attachment Styles

Our attachment styles can influence how we manage trauma. Even in cases where healing of attachment injury has begun, trauma can trigger old feelings and behaviors. The situation might be new, but often, our responses are similar to what was used in the past.

Secure Attachment and Trauma

It makes sense that those with secure attachment have more resources to heal from traumatic experiences. Secure attachment is biological and we truly are naturally disposed to secure attachment. They often have a solid support group of friends, coworkers, and family, as well as a stable sense of self. They readily share their needs with their intimate partners and can ask for help when they need it – and reciprocate generously when they can. Because they feel securely attached, they may often be the first to seek and flourish with therapy. We might even call them “unflappable.” Securely attached people often recognize the value of therapy and, since their relationships are usually in good shape, they may come to therapy for an empty nest, car accidents, and other typical life circumstances.

Avoidant Attachment and Trauma

Stuffing feelings and emotions down deep may come naturally to people with avoidant attachment. They may have deeply held feelings of trauma, but are afraid to talk about it – even with those closest to them because of guilt or shame. They also feel their cries for help might be rejected, so they decide to manage trauma on their own in isolated activities; worst case, they may turn to substance abuse, porn, or gambling. They need our understanding and compassion to be able to reach out and discover their sense of belonging and desire to connect. We can also help them feel welcomed and supported in their verbal and emotional communications.

Ambivalent Attachment and Trauma

People with ambivalent attachment may desperately want help, but communicate their needs in an overwhelming, or negative way. They may act out in anger when their loved ones do not respond exactly how they envisioned and place enormous expectations on those who love them. They expect and fear abandonment and often don’t realize that they also reject caring behaviors. They need to practice staying present when good things are happening and not default to feeling slighted. They pursue their loved ones’ support relentlessly and fear that they are damaged, unlovable, and will eventually be abandoned. This can be overcome when they practice receiving.

Disorganized Attachment and Trauma

Individuals with disorganized attachment may feel an easily-triggered tug of fear or overwhelm, and then retreat or explode emotionally. As with every human, they desire to connect and ask for help with their traumas, but because needing and wanting intimacy and honesty is scary, they disconnect or act out due to the biological threat-response being entangled with the embodied instinct to connect. They may have angry outbursts due to frustration, confusion, and heightened dysregulation. They need safety and to work with managing flight-fight-freeze with their partner or in therapy. Their trauma makes them feel less sure-footed with others.

Healing Attachment and Healing Trauma – There Is Hope

No matter where your client starts, healing is possible. As therapists, being reliable, consistent, and providing a container of safety for clients to explore new behaviors is essential. Often, finding secure partners or friends can help those with attachment injury heal by example. Patience is essential as they learn and practice new behaviors. It will mean plenty of practice – perhaps even for a lifetime. Stress, trauma, exhaustion, and illness may re-trigger old behaviors, but even small steps toward secure attachment can teach clients that there is always hope.

As we move toward secure attachment, our natural capacities come to the forefront. We are more compassionate toward ourselves and others and develop a healthy sense of self. We are more capable of attuning to our own needs and those of others, and as our prefrontal cortex matures and becomes more developed, that newfound sensitivity is good for all of us.

How different would the world be if every leader, parent, teacher, and partner had some understanding of secure attachment, how to treat others with respect and dignity, and how to resolve conflicts for all of our mutual benefit.

We are all designed for connection and intimacy, even when managing trauma. As therapists, we help with healing that we provide our clients can support them to live to their potential more fully and become everything they hope to be.