Understanding Attachment
Humans are meant to function best as trusting social creatures. This statement inherently makes sense and is obvious to most (not all) of us out there trying to make and keep friends, stay connected to (or tolerate) our family, and maintain healthy relationships with co-workers/bosses/spouses/significant others/etc. However, just because we can be successful social creatures does not mean that forming healthy attachments and relationships comes automatically or easily. In fact, given the importance of all kinds of relationships in our daily lives it is surprising that more attention is not paid to learning about and discussing attachment in our society. Although we cannot control our exposure to experiences as children we can do things differently as adults and work to address the underlying reasons that many children do not develop healthy attachment at young ages.
The term ‘Attachment’ is actually a subset of relationship theory that involves ‘…how humans respond within relationships when hurt, separated from loved ones, or perceiving a threat’ (Wikipedia, Attachment Theory, 2017). Your relationships may be different from mine, but based on that criteria attachment is involved in almost all of my relationships. So, to keep our relationships healthy it is critical to understand how attachment develops and what it means for you today.
In early childhood, humans are dependent on caregivers to meet basic needs (think; food, water, and safety). Depending on the temperament of the child and caregiver IN COMBINATION WITH external stressors like availability of resources and stress in the environment we form different types of attachment. These early experiences carry forward into adolescence and adulthood to form the basic structure underlying our relationships.
Humans evolved living in small groups that relied on each other to survive in stressful situations. It was important and common for children to grow up knowing all of the people around them and develop relationships with them. Our brains are wired to learn and grow in social situations where we are reinforced frequently with positive attention and safety provided by caregivers. A host of recent research on this topic demonstrates the link between caring relationships and brain development. In the absence of safety and emotional connection from caregivers we see deficits in the development of neural networks, trust, capacity for creativity, empathy/compassion, etc (Cozolino, 2013). To develop a healthy and creative mind that can easily adapt to changes in the environment and work well with others it is critical for healthy attachment to develop early and be nurtured throughout life. For those that did not develop these brain circuits at an early age there is the potential for re-wiring to happen later in life but it takes conscious energy and effort with lots of assistance from others.
Types of Attachment:
-Secure: This type of attachment is generally considered the preferred gold-standard since it involves the greatest emotional stability and trust between people. The formation of this type of attachment happens as a result of children feeling confident and safe in knowing that their needs will be met and they are freely able to explore the world around them with a solid base to return to. Caregivers provide consistent support and emotional regulation while encouraging children to explore.
-Avoidant: This type of attachment is characterized by showing minimal emotions and even avoiding or ignoring the caregiver. This can develop when children’s needs are not met and they learn that communicating distress is not helpful in getting support. Over time children will stop reacting or seeking help/attention when needed. Later in life people with this attachment style can isolate themselves from others and have greater risk for depression, anxiety, and stress-related mental illness.
-Ambivalent: This is a challenging type of attachment to understand because typically children will demonstrate distress when left alone by caregivers but then appear uncaring when they return. Children exhibiting ambivalent attachment are often wary of strangers, are not very interested in exploring their environment, and have often been exposed to inconsistent (or abusive) caregivers. They have learned that they are helpless and powerless to control their environment and do not seek to make changes in their life and in their interpersonal relationships.
-Disorganized: This is the least well defined and understood type of Attachment but can also be easily recognized. Children that do not behave expectedly in relationships or their actions are inconsistent fit in this category because they seem to act haphazardly and without clear plan. These children do not respond consistently to different situations. As adults these people may experience ups and downs in relationships and be unable to reflect on or understand why they are disconnected from others and fluctuate from feeling safe in relationships but being hurt to avoiding others and becoming isolated.
-At the extreme end of the Attachment spectrum comes Reactive Attachment Disorder (RAD). RAD is the only recognized attachment disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and is classified as a Trauma and Stressor-Related Disorder. Its inclusion in this DSM category reflects that exposure to some type of trauma during early childhood (0-5) is necessary for this diagnosis. Trauma can include but is not limited to sexual/physical/emotional abuse, lack of any consistent caregiver, malnutrition, etc. The features of RAD are summarized by, “…a pattern of markedly disturbed and developmentally inappropriate attachment behaviors, in which a child rarely or minimally turns preferentially to an attachment figure for comfort, support, protection, and nurturance” (APA, 266). Children who have suffered an early trauma and/or inconsistent or damaging relationships with expected caregivers, can display symptoms such as inhibited or withdrawn behavior towards caregivers and limited positive affect. These children may no longer seek out comfort or respond to comforting attempts by caregivers. In fact, children may actively repel attempts by others to offer comfort or develop emotional relationships. Attempts by caregivers to form relationships may be met with hostility, distrust, sadness, or other unexpected reactions given the circumstances. Depending on how the child reacts to being neglected or exposed to trauma before age 5, different symptoms like difficulty or inability to regulate emotions and atypical responses to caregiver attempts to comfort or develop a trusting relationship can occur. It is not uncommon for children to display extreme mistrust and avoid/mistrust/misinterpret attempts by adults to comfort or calm them. Children diagnosed with RAD face a much higher risk of mental illness later in life such as depression, OCD, Bipolar, etc.
What this Means for Relationships in Adolescence and Adulthood:
Now that we know the impact of early attachment experiences on brain development and relationships we can address what this means for adolescents and adults. Given that we now live in a world that has more and more people living in highly populated urban areas combined with increased internet and social media usage it is more important now than ever to educate ourselves about attachment. At a time when more and more people report feeling disconnected from their community and at a loss for how to maintain social connections it is critical that we better understand how attachment is maintained across the lifespan. The importance of exercise and mental activity is widely known and cited by doctors and medical professionals but what is not as widely discussed is the importance of maintaining healthy relationships. In fact, an incredibly important longitudinal study conducted over 80 years by Harvard researchers finds that it is love, joy, and human relationships that are most responsible for long and fulfilled lives (Landes, Ardelt, Vaillant, & Waldinger, 2014). So, as adolescents and adults how do we change the attachment style that was developed during our childhood years? This is where the research needs to be supplemented and built upon over the course of future studies. However, despite the gap in current research we can make progress on changing attachment styles based on what we know is effective in Cognitive Behavior Therapy. For example, we know that over time people are able to build their capacity to overcome childhood experiences, develop trusting relationships, and overcome anxiety. By building on these skills and specifically addressing attachment in a meaningful way by challenging distorted or negative thoughts, providing positive reinforcement, encouraging meaning making thru self-reflection and journaling, and using exposure techniques throughout the process it is absolutely possible to change engrained brain structure and teach people to build secure attachments. More recent work conducted on mindfulness and meditation practices offers more evidence for the ability of humans to change their ability to connect with others and develop healthy attachment in their relationships. These practices have been shown to increase empathy, compassion, and kindness towards self and others that contributes to the development of trust in relationships. As the self-help industry matches established research on therapeutic techniques in this area it is becoming increasingly apparent that it is possible to overcome early childhood experiences and develop secure and trusting attachment later in life thru hard work and dedication in self-work, therapeutic experiences, and mindfulness practice.
In my work as a Therapist in various settings (community mental health in impoverished urban areas, K-12 schools, online therapy with adults, and residential treatment centers for child and adolescent survivors of trauma) I have seen incredibly impaired, isolated, and hyper-vigilant people change over the course of time and treatment to trusting and caring individuals that can be successful community members. This work takes time and patience but is worthwhile and powerful to behold.
These experiences have sharpened my belief that the human brain is wired to adapt to experiences across the lifespan and that early childhood attachment issues do not mean that neural pathways are unalterable. More energy needs to be spent on longitudinal research and intervention techniques to impact attachment across the lifespan so that fewer children are left to become depressed and isolated adults. Fostering genuine connections between people and across communities can be healing for all involved and lead to a more socially conscious world if time and energy is invested to shape the development of healthy attachment from birth to old age.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Attachment Theory. (n.d.). In Wikipedia. Retrieved December 7, 2017, from https://en.wikipedia.org/wiki/Attachment_theory
Cozolino, L. (2013). The social neuroscience of education: Optimizing attachment & learning in the classroom. W.W. Norton Company: New York.
Landes, S., Ardelt, M., Vaillant, G., & Waldinger, R. (2014). Childhood adversity, midlife generativity, and later life well-being. Journals of Gerontology Series B: Psychological Science and Social Sciences. 69, 6, 942-952.