What to Know Anxious Attachment and Tips to Cope

Anxious Attachment and Tips to Cope

Anxious attachment is one of four attachment styles that develop in childhood and continue into adulthood. These attachment styles can be secure (a person feels confident in relationships) or insecure (a person has fear and uncertainty in relationships).

Also known as ambivalent attachment or anxious-preoccupied attachment, anxious attachment can result from an inconsistent relationship with a parent or caregiver.

Adults who are anxiously attached may be considered needy or clingy in their relationships and lack healthy self-esteem.1

Through approaches such as therapy, it’s possible to change attachment styles or learn to have healthy relationships despite attachment anxiety.

What’s Your Attachment Style?

There are four main attachment styles. The following are some of the ways they may manifest in relationships:1

  • Secure attachment: Able to set appropriate boundaries; has trust and feels secure in close relationships; thrives in relationships but does well on their own as well
  • Anxious attachment: Tends to be needy, anxious, and uncertain, and lacks self-esteem; wants to be in relationships but worries that other people don’t enjoy being with them
  • Avoidant-dismissive attachment: Avoids closeness and relationships, seeking independence instead; doesn’t want to rely on others or have others rely on them
  • Disorganized attachment: Fearful; feel they don’t deserve love

History of Attachment Theory

British psychiatrist John Bowlby developed the foundations of attachment theory from 1969 to 1982.2

Attachment theory suggests that early life experiences, particularly how safe and secure you felt as a young child, determine your attachment style as an adult. These events shape your ability to develop trust, boundaries, self-esteem, feelings of security, and other factors at play in relationships.3

Developmental psychologist Mary Ainsworth built upon Bowlby’s theory with her “strange situation” test to determine the nature and styles of attachment behavior. The assessment consists of a mother leaving her infant alone with a stranger for a few minutes. The infant’s response is observed and coded when they’re reunited with their mother.2

Exploration of adult attachment began in the mid-1980s by researchers such as Mary Main, Phil Shaver, and Mario Mikulincer.

Attachment theory’s principles are currently supported by hundreds of studies on bonding between child and parent and between adult partners.4

How Closely Linked Are Childhood and Adult Attachment Styles?

While it’s generally accepted that early attachment experiences influence attachment style in adult romantic relationships, the degree to which they are related is less clear-cut. Studies vary in their findings on the source and degree of overlap between the two.5

Characteristics of Anxious Attachment

Anxious attachment is an insecure attachment. Insecure attachment can take one of three forms: ambivalent, avoidant, or disorganized.1

It’s believed that anxious attachment in childhood is a result of inconsistent caregiving. More specifically, the children are loved but their needs are met unpredictably. A parent or primary caregiver may respond immediately and attentively to a child sometimes but not at other times.6

This inconsistency can be a result of factors such as parental substance use, depression, stress, anxiety, and fatigue.

Children raised without consistency can view attention as valuable but unreliable. This prompts anxiety and can cause a child to perform attention-seeking behaviors, both positive and negative.

Adults with anxious attachment often need constant reassurance in relationships, which can come off as being needy or clingy.1

One study showed that anxious attachment can affect trust in a relationship. Further, those who are anxiously attached are more likely to become jealous, snoop through a partner’s belongings, and even become psychologically abusive when they feel distrust.7

Recognizing the Signs in Yourself

Some indications that you might be experiencing anxious attachment include:

  • Worrying a lot about being rejected or being abandoned by your partner
  • Frequently trying to please and gain approval from your partner
  • Fearing infidelity and abandonment
  • Wanting closeness and intimacy in a relationship, but worrying if you can trust or rely on your partner1
  • Overly fixating on the relationship and your partner to the point it consumes much of your life
  • Constantly needing attention and reassurance (can be viewed as needy or clingy)
  • Having difficulty setting and respecting boundaries
  • Feeling threatened, panicked, angry, jealous, or worried your partner no longer wants you when you spend time apart or don’t hear from your partner during what most would consider a reasonable amount of time; may use manipulation to get your partner to stay close to you
  • Tying self-worth in with relationships
  • Overreacting to things you see as a threat to the relationship

Recognizing the Signs in Someone Else

A partner who is anxiously attached may exhibit similar behaviors as those listed above, but you can’t know for sure how they are feeling unless they tell you.

Signs of Anxious Attachment in a Partner

  • Regularly seeks your attention, approval, and reassurance
  • Wants to be around you and in touch with you as much as possible
  • Worries you will cheat on them or leave them
  • Feels threatened, jealous, or angry and overreacts when they feel something is threatening the relationship

Strategies for Coping

While anxious attachment can be challenging in a relationship, having a loving, healthy relationship is possible. There are ways to address and get beyond attachment problems in your relationship, including:8

Short Term

  • Research: Learn about attachment styles, which ones best apply to you and, if applicable, your partner.
  • Keep a journal: Keep track of your thoughts and feelings in a journal. This is a helpful exercise for getting out your emotions, and it may help you recognize some patterns in your thoughts and behaviors. It may be worthwhile to bring your journal to therapy sessions where you can unpack its contents with your mental health professional.
  • Choose a partner who has a secure attachment: The chances of success in a relationship for someone with anxious attachment are higher if they are paired with someone who is securely attached.
  • Practice mindfulness: Regularly engaging in mindfulness exercises can help you learn to manage your emotions and your anxiety.
What is Emotional Dysregulation?

What is Emotional Dysregulation?

Emotional dysregulation refers to difficulty in managing emotions or in keeping them in check. These may also be thought of as mood swings or labile moods. It can involve experiencing intense emotions such as sadness, irritability, frustration, or anger that are comparatively more heightened than expected, relative to the situation that triggered them.

What is emotional dysregulation?

Emotion dysregulation involves difficulties with negative affective states e.g., sadness and anger.

Emotional dysregulation might affect children or adults. Adolescents may be particularly at risk due to this developmental period in a person’s life being recognizably a time of increased stress due to puberty and peer context. Although it is a common perception that children learn to manage their emotions as they grow up, for some effectively managing emotions continues to be problematic well into adulthood.

Those with emotional dysregulation might not easily recognize their own emotions and can become confused or guilty about emotions experienced such that behavior is not readily controlled and decision making becomes a challenge.

Experiencing intense emotions can lead to situations in which a sufferer is unable to calm down easily. People with emotional dysregulation might try to avoid difficult emotions and when experiencing them they can easily become impulsive. Another example is that those with emotional dysregulation might be overly negative. As a result, there is a risk for:

  • Anxiety
  • Depression
  • Substance abuse
  • Suicidal thoughts
  • Self-harm

Other symptoms include high-risk sexual behaviors, extreme perfectionism, and eating disorders.

In children emotional dysregulation exhibits itself through temper tantrums, crying, and refusing to talk or to make eye contact.

Over time the condition may interfere with the quality of life leading to interpersonal problems, issues at home and work, or, in the case of children, at school.

Causes of emotional dysregulation

Scientists believe that in the experience of emotional dysregulation there is a problem with the emotional braking mechanism in the brain caused by a reduction in the response of certain neurotransmitters. This leads an individual to experience an ongoing “fight or flight” response whereby the pre-frontal cortex shuts down in times of heightened stress.

There a several possible reasons why a person may develop this condition and it is often co-morbid with another larger mental health problem (see below). Possible causes are:

1. Child neglect

In the case of neglect, there is a failure on the part of the caregiver to cater to the basic needs of the child. Here the caregiver does not provide adequate levels of physical and or emotional care.

2. Early childhood trauma

Whereby traumatic events are experienced early on in life during the critical period of a child’s development.

3. Traumatic brain injury

Brain dysfunction is caused by a dramatic blow to the head, for example.

4. Chronic invalidation

When a person’s thoughts and feelings are repeatedly ignored, rejected, or else judged.

Comorbid ADHD Complicates Most Diagnoses and Treatment Plans

Comorbid ADHD Complicates Most Diagnoses and Treatment Plans

An accurate ADHD evaluation must screen for far more than ADHD. Though 60 percent of people with ADHD have some co-existing psychiatric condition1, comorbidities rarely factor into the evaluation — leading to an incomplete diagnosis. You have ADHD, but what else might you have? Or, no, you do not have ADHD but rather some other condition that explains the symptoms that led you to seek help.

This is why checklist evaluations, while helpful screening tools, are inadequate by themselves. You need to sit down and talk to a human being and tell your story. In medical parlance, this is called sharing your history, and your history is the most revealing and useful test in all of medicine. While most mental health professionals do not perform a physical exam, the “history and physical” remains the cornerstone of a medical evaluation.

Whether you’ve yet to undergo an ADHD evaluation, or you’ve already been diagnosed with ADHD, be sure to ask your doctor if you might have any of the following comorbid conditions often seen with ADHD:

ADHD and Common Coexisting Disorders

1. Learning differences

About 30 to 50 percent of people with ADHD have a learning disorder (LD) 2 3. These include most of the “dys-eases”.

  • Dyslexia. The most common learning disability, dyslexia makes you slow to learn to read and spell your native language. I have both ADHD and dyslexia, which can manifest quite differently and change over time. For example, I majored in English in college and now make my living with words, even though to this day I am a painfully slow reader.
  • Dyscalculia is sometimes called “math dyslexia.” A person with dyscalculia has trouble with math facts, with counting, with computation, and with word problems. But, just as the dyslexic individual may turn out to be gifted with words, the child with dyscalculia may mature into a gifted mathematician.
  • Dysgraphia includes trouble with handwriting, an awkward way of gripping a pen or pencil, trouble spacing written words or letters, frequent need to erase, and an awkward body position while writing.
  • Dyspraxia, or Developmental Coordination Disorder (DCD), denotes clumsiness, lack of coordination, a tendency to drop or spill things, awkwardness in movement. DCD often leads to tremendous problems with confidence and self-esteem in childhood and adolescence, when athletic prowess and physical fluidity are so highly valued among peers.
  • Dyslexia. The most common learning disability, dyslexia makes you slow to learn to read and spell your native language. I have both ADHD and dyslexia, which can manifest quite differently and change over time. For example, I majored in English in college and now make my living with words, even though to this day I am a painfully slow reader.
  • Dyscalculia is sometimes called “math dyslexia.” A person with dyscalculia has trouble with math facts, with counting, with computation, and with word problems. But, just as the dyslexic individual may turn out to be gifted with words, the child with dyscalculia may mature into a gifted mathematician.
  • Dysgraphia includes trouble with handwriting, an awkward way of gripping a pen or pencil, trouble spacing written words or letters, frequent need to erase, and an awkward body position while writing.
  • Dyspraxia, or Developmental Coordination Disorder (DCD), denotes clumsiness, lack of coordination, a tendency to drop or spill things, awkwardness in movement. DCD often leads to tremendous problems with confidence and self-esteem in childhood and adolescence, when athletic prowess and physical fluidity are so highly valued among peers.

Treatment for all of these LDs includes specialized tutoring (like Orton-Gillingham, Wilson, or Lindamood-Bell for dyslexia) or coaching; occupational therapy; and counseling to help with the attendant emotional problems.

2. Behavioral or conduct problems

The diagnostic terms for these include oppositional defiant disorder (ODD); conduct disorder (CD); and anti-social personality disorder (ASPD). Without intervention, a child may move from ODD to CD to ASPD as they age (though these conditions are more common in males). It’s critical to get help early on, and treatment is best undertaken by a team of providers.

3. Anxiety disorders

Sometimes anxiety occurs in the wake of untreated ADHD. Once an individual takes stimulant medication and gains focus and control, the anxiety wanes.

However, sometimes an individual has a freestanding anxiety disorder, which needs to be treated with a combination of education, counseling, cognitive behavioral therapy (CBT), physical exercise, positive human connection, and, perhaps, medication, such as an SSRI or an anxiolytic.

4. Mood problems

  • Depression. Once again, what looks like depression may occur in the wake of untreated ADHD. If the person responds well to ADHD medication, performance improves and the “depression” disappears. However, sometimes an individual has primary (not secondary) depression as well, which requires its own treatment.
  • Dysthymia. The sadness and low mood of dysthymia is less severe than with depression, but it lasts longer.
  • Lifelong low mood. Historically, there have been many terms for this, but a common clinical observation is that some people who have ADHD struggle with low mood and emotional dysregulation.
  • Bipolar disorder (BD). Up to 1 in 13 patients with ADHD has comorbid BD, and up to 1 in 6 patients with BD has comorbid ADHD4 .

5. Substance use disorder

SUD is common with ADHD, as are behavioral addictions or compulsions. Do not let shame hold you back from talking with your doctor about them. There are treatments other than willpower and white knuckling.

What is Hyperacusis?

What is Hyperacusis?

Hyperacusis is a hearing condition that causes a heightened sensitivity to sound, making everyday noises, like running water, seem extremely loud.

This can make it difficult to carry out daily tasks in common environments, such as chores at home or workplace responsibilities. In turn, you might try to avoid social situations that could lead to anxiety, stress, and social isolation from exposure to noise.

About 8 to 15 percent of adults have hyperacusis. This condition often affects people who have tinnitus, or ringing in the ears.

Read on to learn more about the symptoms and potential causes of hyperacusis. We’ll also cover treatment options and how each one works.

Hyperacusis is a low tolerance for sound in one or both ears. It’s also known as an increased sensitivity to sound.

The condition affects the way you perceive loudness. It makes ordinary sounds, such as car engines, seem extremely loud. Even your own voice might seem too loud to you at times.

The perception of excessive loudness may cause pain and irritation, resulting in high levels of stress. It can also make it difficult to be in public settings like work or school. This can lead to:

Hyperacusis primarily affects people who:

Adults are more likely to develop hyperacusis since aging is associated with this condition. However, it can affect children, too.

Hyperacusis symptoms can vary. Mild symptoms can include:

  • ordinary sounds seeming too loud
  • your own voice sounding too loud
  • discomfort in your ears
  • difficulty concentrating

Severe symptoms can include:

In children, discomfort due to hyperacusis may cause symptoms like crying or screaming.

Hyperacusis is also associated with conditions like:

It’s worth noting that hyperacusis is different from phonophobia — the fear of loud sounds.

Hyperacusis affects the way you hear sounds. Phonophobia is a psychological condition that involves an emotional response to sounds. It doesn’t involve auditory issues.

However, hyperacusis can lead to phonophobia due to the perceived excessive loudness of certain sounds, so the two conditions may appear together.

Possible causes of hyperacusis include:

  • High noise exposure. Loud noise is a major cause of hyperacusis. Exposure can happen over time (like playing loud music for many years) or a single occurrence (like hearing a gunshot).
  • Head injury. An injury involving the head, jaw, or ear can lead to hyperacusis. One example is getting hit with an airbag in a car.
  • Viral infections. Viral infections that affect the facial nerve or inner ear may lead to hyperacusis.
  • Jaw or face surgery. Hyperacusis can happen if the inner ear or facial nerve is damaged during surgery.
  • Some medications. Certain medications, like some cancer drugs, can cause ear damage and hyperacusis.
  • Autoimmune disorders. Hyperacusis can be caused by autoimmune conditions, such as systemic lupus erythematosus.
  • Temporomandibular joint disorder. The temporomandibular joint attaches your lower jaw to your skull. Problems with this joint may increase your risk of hearing issues, like hyperacusis.
  • Autism. Autism or autism spectrum conditions can cause hearing sensitivities, including hyperacusis. According to 2015 research, about 40 percent of autistic children also have hyperacusis.
  • Emotional stress. High levels of stress, including post-traumatic stress disorder (PTSD), can increase your risk of hyperacusis.
What Is Reactive Attachment Disorder?

What Is Reactive Attachment Disorder?

Reactive attachment disorder, also known as RAD, is a mood or behavioral disorder that affects babies and children. It involves difficulties with bonding and forming relationships, as well as having social patterns that are not appropriate, but without an intellectual disability or pervasive developmental disorder (such as autism ) to explain these characteristics.1

Additionally, reactive attachment disorder is caused by some type of issue with care, such as caregivers being unable to fully provide for the needs of the child, not fulfilling physical and emotional needs, inconsistency, or too many primary caregiver changes.

The term “reactive attachment disorder” is sometimes shortened to “attachment disorder,” but reactive attachment disorder is actually a type of attachment disorder, aquaARTS studio / Getty Images Reactive Attachment Disorder vs. Disinhibited Social Engagement Disorder

Attachment disorders are sometimes described as being inhibited or disinhibited. These terms are used to describe the behaviors of babies and young children.

Children who fall into the category of inhibited struggle to regulate their emotions, do not prefer any specific adult or caregiver, do not seek caregiver comfort, or do not show much affection, or they display a combination of these behaviors.2 On the other hand, children who fall into the category of disinhibited may engage or overly engage with all adults evenly, including strangers, and they do not prefer primary caregivers.

Reactive attachment disorder is the inhibited type of attachment disorder. There used to be only one diagnosis for both inhibited and disinhibited attachment, but that has changed with more recent research. The disinhibited type of attachment disorder is called disinhibited social engagement disorder, or DSED.1 Characteristics

The characteristics of reactive attachment disorder are the inhibited type, meaning that the child behaves in ways that show little or no attachment to parents or other caregivers. This is seen in babies and young children. They are not able to bond with their parents or primary caregivers in a way that is healthy and secure.3 Reactive Attachment Disorder Symptoms

Symptoms of RAD include:

  • Avoidance of comfort when distressed
  • Avoidance of physical touch
  • Difficulty managing emotions
  • Not being affected when left alone
  • Not making eye contact, smiling, or engaging
  • Emotional detachment
  • Excessive rocking or self-comforting Inability to show guilt, remorse, or regret
  • Inconsolable crying Little or no interest in interaction with others
  • Need to be in control
  • Tantrums, anger, sadness

Diagnosis Reactive attachment disorder can be diagnosed by a mental health professional such as a psychiatrist or psychologist specializing in children. They do this by assessing the child based on the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders” ( DSM-5 ) diagnostic criteria. Then they assess the child in terms of how the symptoms affect their ability to function.4 […]

What Is Family Therapy?

What Is Family Therapy?

Family therapy is a type of psychotherapy, or talk therapy, that looks at the entire family, including the relationships between the individual members of the family.1 This is a treatment used to address the mental health challenges of one or more family members, address relationship challenges between two or more family members, and improve family dynamics as a whole.

Family therapy is sometimes known as marriage and family therapy, couples and family therapy, and family counseling.

Family therapy is used to treat a wide variety of mental health conditions of one or more members of the family. It can also be used to support the emotional side of physical health conditions, relationship and bonding challenges, and overall family well-being.

Sometimes this is used to help support one member of the family who is struggling with a mental health diagnosis by addressing their interactions and relationships with other members of the family. Other times, there is more of a focus on the family as a whole.

For example, a family struggling with frequent disagreements may seek support through family therapy, even without a specific diagnosis, to improve communication, strengthen their connection, and navigate stressful situations.2

Conditions Treated With Family Therapy

Family therapists can address a variety of situations and conditions, including:

  • Addiction
  • Adoption
  • Anger
  • Attachment disorders
  • Behavioral challenges
  • Blended family
  • Communication challenges
  • Conflict
  • Death
  • Disability
  • Divorce or separation
  • Domestic violence
  • Eating disorders
  • Emotional challenges
  • Grief
  • Infertility
  • Marital conflict
  • LGBTQ challenges
  • Physical health concerns
  • Race, ethnic, or cultural challenges
  • Relationship difficulties
  • Religious challenges
  • Self-harm
  • Transitions
  • Unemployment

The process of family therapy depends on the situation, why the family is seeking support, and the family members involved. It also may depend on the ages of the children and the abilities and willingness of each family member.

Typically, the process begins with an evaluation or assessment. The provider may speak with the family as a group, members individually, or both individually and as a group. Children could take part in play therapy, which is a form of therapy that involves playing together to learn about the thoughts and feelings of the child.

Objectives of Family Therapy

Some of the objectives of family therapy sessions include determining how well the family expresses thoughts and emotions and solves problems, looking at the rules, roles, and behavior patterns of the family that lead to problems, and evaluate the strengths and weaknesses of the family.2

From there, the therapy sessions can focus on how to work through issues, strengthen relationships, and function better together. This happens with conversations between the provider and the family members, either one-on-one or in a group.