The Spectrum of Attachment
Written by, Kate Oliver, MSW, LCSW-C
When we look at children’s attachment styles, they typically fall into one of three categories, secure, insecure and disorganized. I explained some about these categories in my post, “What is Attachment Disorder?” This post will go more into attachment disturbance and how to tell the difference between an attachment “issue” and an attachment “disorder” and some of the symptoms you might see from a child (or adult) with attachment issues. If you are interested in learning about attachment disorders, you can find the diagnostic criteria here. I personally do not find it helpful to diagnose a disorder vs. disturbance of attachment unless I need to as a means for getting insurance reimbursement because if you look at attachment across the spectrum, you would find that we all have attachment issues.
In my world, where I see many actions through the lens of attachment, I think of it like this: picture the security of a person’s attachment on a scale from 1-10. A person with a 1 would be a person who feels worthless and unlovable in all situations across the board. They do not believe they have the power to make any positive changes in the world, nor do they believe that anyone cares about or wants to help them to make positive changes. This person would constantly live in the moment, since they do not feel as though planning helps anything and would constantly look to meet his or her own needs (without distinguishing between wants and needs) by whatever means necessary. A person operating at a “one” steals and lies constantly, manipulates with as much sophistication as possible for their developmental level, does not seem capable of forming any lasting relationships, etc. A” 10” would be a person who never worries about rejection or abandonment from the people they love, knows they are loving and loveable at all times, and understands that all problems can be solved, etc.
The way I see it, most of us fall between a 4 and an 8. From 1-4, I would say you have a disorder: an attachment style that presents major problems in your day to day life that requires specialized therapeutic treatment. A 5-8 is what I would call a good, healthy neurotic: while therapy is an option for difficult times, the gaps and insecurities in attachment are manageable most of the time as long as life is relatively stable for you. Yes, you worry about people leaving you sometimes and might avoid conflict when it might be healthier for you to confront an issue, or make a confrontation out of something that really could have been a constructive conversation, but, overall, life feels manageable and you have areas you do well in even if there are parts where you feel you struggle.
All of our internal feelings and perceptions about ourselves can be seen through behaviors. To figure out if someone has serious attachment issues, we need to look at what the symptoms are of an attachment disturbance. Here are some of the things practitioners who see people with attachment disturbance look for:
Difficulty maintaining eye contact with primary caregivers (especially when someone is saying something loving)
- Constant lying
- Manipulating situations
- Lack of language to express feelings
- Lower developmental age than chronological age
- History of multiple primary caregivers (foster care, adoption at an older age, frequent changes in child care providers)
- Identification with the villain in movies
- Playing with fire
- Bullying and/or blindly following others who are a bad influence
- Abusing animals
- Seeming lack of remorse or conscience
- Difficulty empathizing with others
- Lack of understanding of cause and effect
- No trust in authorities
- A constant seeking for control of every situation
Now, before you start worrying that you and your child will be featured on the next segment of “Kids who Kill” on 20/20, let me point out that it is a combination of all of these features that would point toward a diagnosis of attachment disorder. Even though headaches are associated with brain tumors, you would not automatically assume you have a tumor every time you have a headache. Also, it is not only the presence, but the severity and consistency of the symptoms that informs the diagnosis. For example, we have all probably lied a few times this week. We said we were fine, or even great when asked “how’s it going?” rather than saying, “Well, everything’s going well except for my job.” Or maybe a telemarketer called and asked you for a few minutes of your time but you said you were busy when really you were not.
Just like with attachment being on a spectrum, so are the symptoms. If you stole $20 out of your mother’s wallet once when you were 13 and felt awful about it, that is very different than being 13 and stealing from your mother, your brother, and the teacher’s desk at school whenever you get the chance, and your stealing includes anything from candy and treats to money, toys, and clothes. Also, when you were 13 and stole that time, maybe you had a specific purchase in mind or something you were going to do with the money. That too is different from stealing whenever the chance presents itself as if you needed to fill a perceived lack with any and every chance that comes along.
I have mentioned before Daniel Hughes book, “Building the Bonds of Attachment.” This, to me, really is the best book with the most readable format* that explains what happens with a child with attachment disorder, while simultaneously showing how secure attachments are made. You can easily link to find his book, and other books about attachment that I recommend on Amazon by clicking on the “Amazon widgets” link at the top right corner of my webpage.**
Something that can make an attachment related diagnosis difficult to make, is differentiating it from other diagnosies, such as post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), or even early bipolar disorder or schitzophrenia. That is why, this post should never substitute for seeing a mental health practitioner. It is possible for children and adults to have any or all of those issues and each needs to be carefully treated. If you are concerned that your child needs therapy for attachment disorder, please find a mental health practitioner. I give tips on how to do this here. I give tips on how to get insurance to reimburse specialiazed therapy here.
What are your questions about attachment? Do you have a question about something that your child does and whether it is attachment related? Please feel free to ask here or comment. Or you can contact me directly, email@example.com.
*If you are not a practitioner, I would suggest that you skip or skim the first 50 pages of the book. Even as a practitioner, I found them difficult but I am glad I kept reading after that.
**see disclaimer page
- What is attachment disorder? (help4yourfamily.com)
- An Attachment Therapist on Attachment Parenting (help4yourfamily.com)
- Finding a Therapist for Your Attachment Disordered or Traumatized Child (help4yourfamily.com)
- How to Know if You or Your Child Need Therapy (help4yourfamily.com)
- Getting Insurance to Finance Specialized Therapy (help4yourfamily.com)
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Kate Oliver, LCSW-C (Licensed Clinical Social Worker) has been a clinician working with traumatized and attachment-disturbed children for the last thirteen years. She is co-owner of A Healing Place, a successful private practice in Columbia, Maryland, since 2007.
Kate earned her BA from Goucher College in 1997 and her Master’s in Social Work from the University of Maryland in Baltimore in 2000. Kate first worked with the Sexual Trauma, Treatment, Advocacy and Recovery Center (STTAR Center) working with abused and neglected children in Columbia, Maryland. While working for the STTAR Center, Kate found that while some children responded to traditional child therapy practices, there were a significant number of children who showed little or no improvement in their overall emotional well-being. Kate sought out specialized training to learn more about attachment, the bond between parents and children, and found that by using attachment-based strategies built upon research by John Bowlby, and Mary Ainsworth, and models that foster parent/child attachment, even the most challenging children and their parents, saw major, life-changing shifts, not only for the children she was working with, but the parents as well.
After the STTAR Center, Kate accepted a position with Tamar’s Children, a program that took pregnant, incarcerated women from prison to a treatment facility that worked on teaching the women to bond with and attach to their babies, while also helping the women to heal their own broken attachments, and history of trauma and addiction. Kate was quickly promoted to Clinical Director of Tamar’s Children. The program was internationally recognized for having a successful, evidence-based practice using an attachment-based model. From working with some of the most severely disenfranchised parents, Kate received important information about how to help all parents maintain a happy, healthy relationship with their children with little or no additional financial investment for the parents.
In 2007, Kate co-founded A Healing Place, a mental health private group practice in Columbia, Maryland, where she focuses on working with families with children who have a history of trauma and/or attachment disturbances. A board certified supervisor, Kate has been an invited presenter to teach continuing education courses for other social workers and psychologists. In her courses, Kate teaches attachment-building techniques and presents about her sub-specialty, working with families headed by gay and lesbian parents.
Kate is a former board member for the organization COLAGE, a non-profit group that works toward community building for people with gay, lesbian, bisexual and/or transgender parents. She is currently a member of Attachment Disorders Maryland, a group that works to educate parents and professionals about working with children with attachment related issues.
Kate lives in Columbia, Maryland is the mother of two amazing daughters, the partner to a fantastic husband, and the daughter of one mother and two gay dads. She loves to read any book that crosses her path, write (of course), and she recently started dancing again, a passion she has had since her youth.
- Making Peace With Your Inner Critic
- Happy Parent Tip #1
- Why Sexual Abuse is Never a Child’s Fault…Not Even a Teenager
- Naming Patterns Changes Patterns
- This is your brain on attachment
- Last Chance for Two Great Opportunities
- Mother’s Retreat Weekend- It’s Really Happening!
- Stopping the Parent Shame and Blame Game
- Making Peace With Your Inner Critic
- Putting together something fun for you!
- Quick Jobs for Kids
- Staying Strong as a Couple
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