What is attachment disorder?

Attachment disorder is a broad term used to describe the developmental, behavioural and emotional challenges that arise in children who do not form expected bonds with their parent or primary caregiver.

In children, attachment disorder is usually diagnosed before the age of five but sometimes at school-age.

Attachment disorder can result when the necessary environment to create a secure and healthy attachment is not present. This can be due to abuse, neglect, abandonment or a stressful home environment. Children inherently look to those close to them for love and security; when these needs aren't met, the world can feel like an unsafe place.

Symptoms of attachment disorder in children

the child is inconsolable when they cry and they cry repeatedly
lack of eye contact
difficulty expressing anger
seeking comfort from strangers
difficulty monitoring or rectifying their own behaviour
showing a lack of affection towards caregivers
being hesitant in social situations
an aversion to physical touch and affection

Types of attachment disorder in children

1. Reactive attachment disorder (RAD)

Children with reactive attachment disorder struggle to self-soothe when they are stressed. They do not look to their caregivers for comfort and may generally be withdrawn in social situations.

2. Disinhibited social engagement disorder (DSED)

Children with disinhibited social engagement disorder may be overly friendly with strangers, allowing them to pick them up and offer them toys. They may walk up to strangers of their own accord and not check in with their caregivers.

These conditions can usually be diagnosed very early, often by the child's first birthday. In children who are showing signs of attachment disorder, play therapy and/or family therapy may be used to help them. Without treatment, the impact of attachment disorder can be seen in adulthood.

What is attachment theory?

A healthy attachment to our primary caregiver in childhood is thought to set a good foundation for all our future relationships. A secure, healthy attachment to our caregiver in childhood is formed if we learn that we can trust our caregiver to respond to our needs and keep us safe. It provides a safe base, from which a child can confidently explore the world, knowing that should anything go wrong, their caregiver will be there as a source of support and comfort.

Attachment theory was developed by John Bowlby. The different attachment styles are: secure, avoidant, anxious, and disorganised. These styles are not disorders in themselves, but are often spoken about in relation to attachment disorders.

1. Secure attachment

likely to have had a strong bond with their caregiver
is comfortable in their relationships
feels little anxiety in relationships

2. Anxious

may have had a caregiver who was inconsistently available to them
do not feel secure in their relationships
crave intimacy and closeness
tendency to experience jealousy and/or idealise romantic partners
require frequent reassurance

3. Avoidant or dismissive-avoidant

caregiver may have not been attuned to their needs
uncomfortable with closeness
value on independence
struggle to be dependent on others

4. Disorganised

may have been subject to abuse or trauma
chaotic relationship patterns, for example seeking closeness and then pushing away

The good news is, you can work on and develop your attachment style. If you recognised yourself in any of the insecure attachment styles above, psychotherapy can help you increase your self-awareness, learn about your triggers, find self-compassion, and build a healthier attachment style and sense of self.