Questions & AnswersAttachment Disorders

Please note: Dr. Litton only works with adults. She does not work with children with attachment disorders.

QUESTION: What's the definition of an attachment disorder?

ANSWER: Attachment disorders stem from infants who experience some kind of disruption in the bond with their primary caretaker and as a result are unable to form a secure, loving, attached relationship. Such children typically become anxious, depressed or apathetic and fail to follow normal patterns of physical, emotional, social and intellectual development. As adults, people with attachment disorders have great difficulty in interpersonal relationships. Some need almost constant contact and reassurance, others primarily need to be left alone and can't tolerate much intimacy and still others go back and forth between the two extremes.

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QUESTION: What's the best treatment for an attachment disorder?

ANSWER: Therapy can help enormously with attachment disorders, although it's not a quick or easy fix. It's essential to find a therapist who's knowledgeable about attachment disorders and with whom you feel comfortable. Much of the work will be between you and the therapist — dealing with feelings that arise in you over the course of your work together. In a nutshell, your job with the therapist is to work through the issues that arise as you try to attach to them.

People experience attachment problems in a variety of different ways, depending on the nature of the early experiences that interrupted the normal attachment bond. They may experience the therapist as not being there, not caring, caring too much, trying to hurt them, pulling away from them, being disgusted with them, etc. Likewise, the client may feel disinterested and bored, empty, panicky, depressed, sexually attracted to the therapist, in love with the therapist, hatred of the therapist, rage toward the therapist, etc. There's no right or wrong set of feelings because each will reflect, in some way, the client's earliest experiences — the things that prevented a secure attachment. The important thing is that the client be allowed to explore whatever feelings arise in a safe and stable environment.

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QUESTION: I've been acused of deliberately pushing people away. Is that a symptom of an attachment disorder?

ANSWER: It can be. People with attachment disorders often play 'come here, go away' without meaning to and often without even realizing they're doing it. They often vascilate between the panic of being suffocated or engulfed by the other person and the panic of feeling abandoned by them. During periods of feeling engulfed, pushing the other person away is quite common.

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QUESTION: I like to spend a lot of time alone. Does that mean I have an attachment disorder?

ANSWER: Not necessarily. Many people, especially introverts, genuinely enjoy spending time alone — it's a positive reinforcement for them. People with attachment disorders may experience themselves as enjoying time alone, but the satisfaction isn't because they relish being by themselves. The good feeling comes from relief at being able to avoid dealing with something aversive, namely the anxiety they feel in relationships.

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QUESTION: I'm a highly successful professional and have always been very competent and fulfilled in my work. However, in my personal life, my relationships seem superficial and/or don't last long. I never really felt I needed a relationship but I'm beginning to see a pattern and it makes me wonder if I'm deluding myself.

ANSWER: People who have the combination of being very bright, highly motivated and having issues with attachment often end up the way you describe yourself. They learn to hide behind their intellect as a defense against feelings. Relationships are often somewhat shallow because that's the only kind of relating that feels safe. People like this may or may not be aware of the fact that something's missing in their lives. It's a good sign when they do have this awareness because it means they'll be more open to treatment.

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QUESTION: My boyfriend seems "clingy". He doesn't want me out of his sight and I end up feeling suffocated. What's wrong?

ANSWER: All of us can get clingy occasionally such as when we're sick or hurting in some way. However, chronic clinginess is generally a sign of an attachment disorder. What it means is that the individual lacks the ability to soothe him or herself or feel OK in the world unless they have someone they can sort of go through life "in tandem" with. Often, individuals who are in relationships with people like this will start off by trying to reassure the person — give in to their intense needs for closeness and reassurance. However, that approach never works in the long run because the problem lies within the one who's clingy — it's not something their partner can fix for them. A combination of individual therapy for him and couple's therapy for both of you may help.

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QUESTION: I feel uneasy and anxious when I can't talk to my partner fairly often or if I think she's mad at me. I'm afraid I'm driving her away, but the panic I feel without her is overwhelming at times.

ANSWER: People with attachment disorders lack the ability to self-soothe. Instead, they look to another person for reassurance. The panic you describe is very real because on some level, the issue is perceived as a psychological struggle to survive. All of us get pretty panicky if we're facing the psychological equivalent of falling off a cliff or getting run over by a truck. Also, since wounding from attachment disorders happens at a very early age, words of reassurance from the other person often aren't as helpful as non-verbal things such as voice tone, facial expression, gestures and actions.

You might want to consider getting some therapy. Right now it probably seems as if things were more stable in your relationship everything would be OK. However, working through your issues in therapy would help you get stronger within yourself, which would leave you less vulnerable to the inevitable ups and downs that occur in any relationship.