Attachment-based therapy is a type of talk therapy that may help a person manage attachment issues that began in childhood. This may help the person develop more secure attachments with others.
Attachment theory stems from the idea that caregiver relationships in early childhood shape how people relate to others emotionally. According to this theory, challenging attachment experiences in early life may cause people to have difficulty connecting with others.
Attachment-based therapy aims to help people learn to form secure attachments. This may include developing trust in romantic partners and friends, managing relationship anxiety when it arises, and processing traumas that may have occurred.
This article describes attachment-based therapy, how it works, what to expect in a session, and how to find an attachment-focused therapist.
Attachment-based therapy differs from attachment therapy, the pseudoscientific child mental health practice that resulted in the maltreatment and deaths of various children between the 1970s and early 2000s.
Attachment-based therapy is a type of psychotherapy that aims to help a person form secure relationships with others. Practitioners of this kind of therapy believe childhood experiences influence a person’s ability to make meaningful connections in adulthood.
Attachment theory
Attachment-based therapy draws on attachment theory, which the British psychoanalyst John Bowlby developed.
“Attachment” refers to a deep, emotional bond between two people, involving strong feelings of closeness, and security. Children seek comfort and reassurance from attachment figures, typically their primary caregivers, when they experience distress.
Children who do not receive the reassurance they require or experience difficulties with attachment can develop feelings of distrust and insecurity. These feelings may shape their social and emotional development, potentially persisting into adult relationships.
Bowlby suggested that relationships with caregivers in childhood can lead people to develop different attachment styles, including:
- secure attachment
- preoccupied attachment, where a person experiences doubt in their own competence
- dismissive or avoidant attachment, which involves a strong sense of independence, to the point of detachment
- fearful attachment, which involves conflict between a deep desire for intimacy and a fear of being close to others
Attachment-based therapy aims to promote secure attachment, helping people develop healthy relationships.
The practice provides an interpersonal approach with a clear structure for coming to terms with past traumas that may have disrupted the ability to form secure attachments.
Attachment disorders
Attachment-based therapy may help with conditions a doctor may diagnose based on persistent difficulties with attachment, such as:
Reactive attachment disorder
A child who has experienced neglect or maltreatment in early childhood
- difficulty forming an emotional attachment to other people
- a reduced ability to experience positive emotions
- reacting violently to physical touch, such as cuddling
- a need to control their environment
- difficulty being consoled
Disinhibited social engagement disorder
Disinhibited social engagement disorder may lead a child to exhibit a reduced level of awareness of social boundaries. For example, they may engage in behaviors such as:
- hugging people they do not know
- wandering away from a caregiver
- willingness to depart with a stranger
Learn more about attachment styles.
Attachment-based therapy is based on the belief that human connection and relationships are essential to a person’s growth and development.
People with attachment issues may find it hard to maintain or develop interpersonal relationships. Attachment-based therapy aims to help a person understand how attachment issues first developed and help them explore and process past traumas that may have occurred in a secure, safe space.
Attachment-based family therapy can help adolescents and their families explore and work on healing attachment issues, such as distrust. Within this setting, and with the support of a trained practitioner, an adolescent may be able to discuss their thoughts and experiences with family members.
In attachment-based therapy, people can expect to:
- uncover and discuss childhood experiences, such as trauma, abuse, or neglect, in a safe space
- understand how these experiences may be affecting current relationships
- do exercises and tasks that help with fostering meaningful connections with others
- process and understand their current relationships
- learn skills to help with conflict resolution and emotional regulation
Symptoms of attachment issues or disorders may include difficulties with the following:
- regulating and expressing emotions, such as anger
- trusting others enough to form secure attachments
- developing self-esteem and confidence
- showing affection
A person with attachment challenges may also engage in attention-seeking behaviors, drug misuse, or self-harm.
Attachment-based therapy may help people navigate and manage these symptoms.
The benefits of attachment-based therapy may include:
- increased ability to make and maintain meaningful connections with others
- increased stability and security in oneself and one’s relationships
- improved emotional regulation and more regular experiences of positive emotions
- a reduction in symptoms of related conditions such as anxiety and depression
Attachment-based family therapy can also help an adolescent develop a sense of trust in caregivers’ commitment to repairing familial relationships. This form of family therapy is a proven treatment for depression in adolescents.
Attachment-based therapy may help people with experience of challenging familial relationships or childhood trauma, such as neglect, abandonment, and abuse. It may be particularly helpful if a person is experiencing trust or abandonment issues or unhealthy relationships.
This type of therapy may also benefit people experiencing certain mental health conditions that may relate to adverse childhood experiences and attachment difficulties, such as:
A person can look for a therapist who specializes in attachment-based therapy or trauma-based therapy. The Attachment Trauma Network has more information and a resource directory of therapists and counselors.
Qualified therapists may include:
- psychologists
- family therapists
- psychotherapists
- clinical social workers
Attachment theory suggests that adverse childhood experiences can cause ruptures in attachments with parents or caregivers, potentially leading to difficulty making and maintaining relationships later in life.
Practitioners of attachment-based therapy believe it can help a person establish security and stability within themselves, which, in turn, can help them develop and maintain close and meaningful relationships with others.
