Create the family you want to have

The Spectrum of Attachment

This picture by Sovanna Ly -csc- can be used f...

This picture by Sovanna Ly -csc- can be used for any purpose, provided that his name is credited. (Photo credit: Wikipedia)

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)
  • Stealing
  • 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,

*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

June 8, 2012 - Posted by | attachment, attachment disorder, help for parents | , , , , , ,


  1. Kate, this is an excellent blog! Thank you for sharing this information to professionals as well as parents who are trying to understand attachment disorders. I stand behind your passion and your gift when it comes to healing and educating folks about this very specialized area in the field of mental health.

    Comment by Gina Cerminara | June 10, 2012 | Reply

    • Thank you so much Gina, for your support. I’m so glad you find the blog helpful 🙂

      Comment by help4yourfamily | June 10, 2012 | Reply

  2. Love your explanation using the scale of attachment!

    Comment by Kim Peterson, MA, LPC-S, RPT | June 12, 2012 | Reply

    • Why thank you! I’m a huge fan of looking at things on a spectrum since so few things are all or nothing 🙂

      Comment by help4yourfamily | June 12, 2012 | Reply

  3. […] for any parent, for this post, I am focusing on those parents with a child on the far end of the attachment disordered spectrum.  All children test limits sometimes and may engage in some of these behaviors, but attachment […]

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  4. Hey admin, very informative blog post! Pleasee continue this awesome work..

    Comment by Garmin 1490t | June 17, 2012 | Reply

    • Thank you 🙂

      Comment by help4yourfamily | June 25, 2012 | Reply

  5. I completely uraenstdnd about medication issues. We experienced times when Chris had to change his medication. Those were stressful times. They also provided opportunities to learn. We learned that sometimes all it takes is a minor adjustment to medication such as supplementing the current meds. with a small dose of something, tweaking the dosage, or changing the time of day specific medication is administered. We also learned that specific dietary habits can profoundly affect mood and behavior not the typically thought of sugar, but rather caffiene, dyes, and carbohydrates.Chris is now 31 yrs. old. The Lord faithfully protected my sanity throughout all the turbulent times.“The peace of God, which surpasses all uraenstdnding, will guard your hearts and minds through Christ Jesus.” Philippians 4:7

    Comment by Arman | June 22, 2012 | Reply

  6. Thank you for your response, I agree, medication can be a very tricky issue and I have found many children with attachment issues have atypical responses to medications. It is important to find a provider who understands about these issues.

    Comment by help4yourfamily | June 25, 2012 | Reply

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