Question 1

If a client grows an awareness their early attachments were not ideal, do they go on and change behaviours or are they broken.

Helen Dent · Accepted Answer

If a client develops awareness of their early attachment style, this is an excellent step on the journey to making changes. Research shows that our attachment style can be modified throughout our lives through relationships with key individuals. A fuller discussion of this issue can be found in my article in The Conversation, ‘Why Everyone Should Know Their Attachment Style’:

https://theconversation.com/why-everyone-should-know-their-attachment-style-105321

It is possible to deliberately work on modifying and improving our primary attachment style. My book Why Don’t I Feel Good Enough was written to help people understand their attachment style and to take them on the journey of changing their attachment style through personal growth, relationships or using therapy:

https://www.waterstones.com/book/why-dont-i-feel-good-enough/helen-dent/9781138943513

Question 2

Is there an online quiz you'd recommend that's a good starting point to give clients when you're wanting to unpack their attachment style with them in a future session?

Helen Dent · Accepted Answer

There are several attachment style quizzes on the internet, which may be useful as a starting point, but the only one I can definitely recommend as reliable was developed by Dr Chris Fraley, based directly on his and colleagues’ research:

http://labs.psychology.illinois.edu/~rcfraley/resources.html

Fraley’s quiz has shorter and longer versions to opt for, and his website is helpful and informative. The longer version is more thorough, but in order to access it, you have to agree to be part of his research database.

Some other internet attachment style questionnaires function as a way of getting potential client details. This doesn’t necessarily mean that they are not reliable tools, but your contact data (which you have to give in order to get your result) is then used for advertising services. So I would advise clients to be cautious about giving contact information.

Chapters 6, 7 and 8 in my book also provide tools for working out your attachment style:

https://www.waterstones.com/book/why-dont-i-feel-good-enough/helen-dent/9781138943513
https://www.amazon.com/Why-Dont-Feel-Good-Enough-ebook/dp/B07MF92K5X

Question 3

Is there any tips on how to decide if your worries of being left, deceived or rejected is due to your insecure attachment style or due to actual/realistic signs/behaviors in the relationship?

Helen Dent · Accepted Answer

Fear is at the heart of both these situations, and it is important to be able to distinguish between them.

Fear based on your attachment style can be recognised because it is familiar, it arises from inside you, and you will recognise it, even if you try to put the blame on your partner. You may be irritated or angry with your partner because they are not responding in the way you want them to, or that helps make you feel secure.

Fear caused by an emotionally abusive partner can be identified by these signs:
- Partner’s possessive behaviour, isolating you from friends and family either by criticising them or accusing you of preferring them. 
- Partner’s constant criticism, sometimes for things you haven’t done 
- You feeling scared to tell anyone because your partner would be angry 
- You feeling very confused and alone.

An emotionally abusive partner tries to control you. Such behaviour often starts in an endearing way, for example, by claiming they can’t bear to spend time away from you. However, it can then develop into putting up barriers between you and other social contacts and even taking control of your phone and your finances, so you are totally dependent. Making you feel stupid, insults or physical assaults may also occur.

Do not allow anyone to separate you from friends and family. You may feel the need to distance from family or friends with the support of a loving partner, but this is quite different from a controlling partner separating you from sources of support that can protect you.

There are many helpful websites if you search for Domestic Abuse or Victim Support, such as:

UK
https://www.victimsupport.org.uk/wp-content/uploads/2020/11/Surviving-Domestic-Abuse-Leaflet.pdf
https://www.nhs.uk/live-well/healthy-body/getting-help-for-domestic-violence/

Elsewhere
https://en.wikipedia.org/wiki/List_of_domestic_violence_hotlines

Question 4

How to be good at dating while having an anxious/ambivalent attachment style?

Helen Dent · Accepted Answer

Some helpful ways of managing dating if you have an anxious/ambivalent attachment style are:

* Learn some anxiety management techniques. Those based on breathing can be used unobtrusively and wherever you are. Moreover, according to current neurological research, breathing strategies are most likely to be effective in turning off the ‘panic/ anxiety button’ in your brain. For an accessible summary of the neurology, see chapter 13 in The Body Keeps the Score by Bessel van der Kolk: 
 
https://www.waterstones.com/book/the-body-keeps-the-score/bessel-van-der-kolk/9780141978611
https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/0143127748

* Tell yourself before a date that this person is probably not THE ONE and that there are definitely other potential dates out there who may be THE ONE. This can help take the pressure off your need to talk and/or be hypervigilant about whether your date is being sufficiently attentive.

* Be aware that your date may have an avoidant attachment style and so may retreat or withdraw a little when you are looking for signs of commitment. If this causes you distress, recognise what is happening. You will feel better if you are proactive and directly address the issue rather than putting up with it.

* People with avoidant and anxious styles are often not compatible because their expressed needs are aversive to each other - an unhealthy spiral is generated in which an anxious person’s desire for commitment makes the avoidant person retreat, which in turn makes the anxious person express their need more strongly and the avoidant person retreat further… 
 
* If this happens to you, recognise it is not because you are unlovable but because your date’s attachment style is somewhat incompatible with yours. Working on resolving this element of incompatibility is possible but can be challenging and will only be successful if your partner is willing and able to collaborate. If this is neither possible nor successful, you may need to end the relationship for the sake of your own mental health.

* Recognise when your date is taking advantage of your need for reassurance. Some people seek out individuals who have a high level of expressed anxiety because their needs are met by being in a caring role. This can be mutually beneficial as long as your partner doesn’t exacerbate your anxiety and make you dependent on them. If you find yourself becoming scared you couldn’t cope without this person, as opposed to thinking you would be sad if the relationship ended, it is time to evaluate whether this is a healthy relationship for you.

* Recognise these signs of a secure attachment in your date, they are good signs of someone who is likely to be compatible with you: 
- Not being put off when you talk about commitment
- Not feeding your anxieties and making you over-dependent  
- Gently distracting you into something interesting

For a fuller discussion, see  Attached by Amir Levine & Rachel Heller, a research based book which focuses wholly on attachment styles and romantic relationships:

https://www.waterstones.com/book/attached/amir-levine/rachel-heller/9781529032178
https://www.amazon.com/Attached-Science-Adult-Attachment-YouFind/dp/1585429139

Question 5

Which caretaker behaviors are most likely to lead to an anxious/ambivalent attachment style? And is your attachment style always formed by your early childhood experiences?

Helen Dent · Accepted Answer

Our primary attachment style is formed by early care givers during the first three years of life. However, this primary style can be modified by subsequent key relationships, which is usually good news!

Behaviours that are likely to lead to an anxious/ambivalent attachment style are those in which the care giver is able to be attuned to an infant and to meet their needs some of the time, BUT not enough of the time. This may be due to factors such as mental health issues, poverty or lack of support.

No carer is perfect and able to fully meet their child’s needs one hundred percent of the time. It is difficult to quantify an exact amount of time needed for good attunement, but a good rule of thumb is that a carer needs to be able to prioritise their dependant children’s needs most of the time.

If a carer is less able to meet their infant’s needs for a brief period of time due to bereavement or other life events, this is unlikely to change an attachment style, particularly if other friends or family can step in to help.

It is also important for carers to take time to look after themselves, as long as they ensure their child receives good quality care during these periods.

For a fuller discussion of these issues, see chapters one to five in my book Why Don’t I Feel Good Enough:

https://www.waterstones.com/book/why-dont-i-feel-good-enough/helen-dent/9781138943513
https://www.amazon.com/Why-Dont-Feel-Good-Enough-ebook/dp/B07MF92K5X

Question 6

Is it possible to relieve an anxious/ambivalent attachment style? If so, how?

Helen Dent · Accepted Answer

Yes, it is. Infants develop this style with carers who show a fairly constant pattern of behaviour - sometimes meeting the infant’s needs, but not often enough. It is easier to resolve than a disorganised attachment style which develops in circumstances which are traumatic for the infant.

The first step on the path to change is acceptance and understanding of your current emotions and behaviours, followed by a desire to change coupled with sufficient motivation to keep working at it. Next, you need to work out the fundamental cause of your anxiety (see the answer to question two) and learn to use basic anxiety management strategies:

https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/self-care/

Help and support from friends, family members, or a therapist will make this journey easier.

For more in-depth explanation and guided help to resolve your attachment style, see my book, Why Don’t I Feel Good Enough, which contains guidance about self-help, how to tell when you need a therapist and how to choose a good one:
 
 https://www.waterstones.com/book/why-dont-i-feel-good-enough/helen-dent/9781138943513
https://www.amazon.com/Why-Dont-Feel-Good-Enough-ebook/dp/B07MF92K5X

Question 7

What disorders are commonly misdiagnosed instead of attachment difficulties?

Helen Dent · Accepted Answer

Neurodiversity, such as Autism Spectrum Condition (ASC), is the most common condition or difference confused with attachment related difficulties. The Coventry Grid is designed to help with distinguishing between the two:

https://www.oxfordshire.gov.uk/sites/default/files/file/virtual-school/coventrygrid.pdf

It is important to bear in mind that there will be an interaction between different conditions, for example ASC in either a parent or a child could lead to insecure attachment in the child.

Some other diagnoses have strong links with attachment difficulties, which may be missed if insufficient care is given to investigating life history. Medical assessment and an investigation of life history will be particularly important in working out which parts of a person’s difficulties are likely to be attachment based or due to other factors. Examples of these are Fragile X Syndrome; Foetal Alcohol Syndrome (FAS); Oppositional Defiant Disorder (ODD):

https://www.hopkinsmedicine.org/health/conditions-and-diseases/oppositional-defiant-disorder

and Borderline Personality Disorder (BPD):

https://www.nhs.uk/mental-health/conditions/borderline-personality-disorder/overview/

Question 8

Is it known what impact adoption has on attachment style?

Helen Dent · Accepted Answer

Some research shows that the attachment style of adoptive carers affects whether or not the placement will be successful. Other research has shown that although our primary attachment styles endure to a greater or lesser extent, these are modified by key relationships throughout life. These modifications can be in a more secure or a less secure direction. So the attachment style of adoptive carers will have an impact upon the children they adopt.

Many other variables such as the age at adoption, the ratio of adults to children, the child’s original attachment style, the presence of siblings and the amount of external support received by adoptive carers will also have an impact.

For further information, see websites from relevant organisations such as:

https://www.adoptionchoices.org/attachment-issues-adopted-infants/

Or purchase scholarly articles such as Feeney and colleagues (2007) ‘Adoption, attachment and relationship concerns’:

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1475-6811.2006.00145.x

and Escobar and colleagues (2013) ‘Attachment in adopted adolescents’:

https://www.sciencedirect.com/science/article/abs/pii/S0190740913000054

Question 9

I have always felt relatively secure in my long-term romantic relationships but anxious and sometimes avoidant in friendships and social and work relationships. How would attachment theory explain this?

Helen Dent · Accepted Answer

There are a few possible explanations. It is possible that you have been luckier in your choice of romantic partners than your friends. Perhaps you need to review whether or not your friends/colleagues really have your best interests at heart.

It is possible that you feel more comfortable in one-to-one social contexts than with a group of people. Such a situation might be the result of shyness, neurodiversity, or just personal preference. Context is a more powerful influence on our behaviour than most of us intuitively realise.

If you are female, there is a likelihood you will experience overt or more subtle forms of discrimination or patronising behaviour at work, which could be part of the reason for your anxiety.

We develop attachment styles in relationships with different key figures in and throughout our lives. Carrying out an investigation of your formative and significant relationships may help you to decide whether or not there is an attachment based explanation for what you are experiencing.

For a fuller discussion of these issues, see chapters 9, 10 and 11 in my book Why Don’t I Feel Good Enough:

https://www.waterstones.com/book/why-dont-i-feel-good-enough/helen-dent/9781138943513
https://www.amazon.com/Why-Dont-Feel-Good-Enough-ebook/dp/B07MF92K5X

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