Anxious Preoccupied Attachment: Spot the Causes, Behaviors, & Daily Impacts

Let's define somebody who would most likely have been raised with an anxious, preoccupied attachment style. — Okay, so in the original Mary Ainsworth study, these were babies who when their even when their mother was in the room, they still seemed kind of clingy and distressed. And so once the mother left, it was like all hell broke loose. They were very stressed out. They would be probably crying the entire time that the mother was gone. And once the mother came back, they were not easily soothed. I mean, they of course were happy to see the mother, but despite the mother saying, "I'm here. I'm with you. " They're still crying and they have a really hard time being able to return to independent activity. And as adults, these individuals will oftenimes have a great difficulty navigating relationships. They tend to be really needy. Um, they tend to ask for a lot from their partners in terms of nurturance. In some ways, they don't have a stable self-esteem internally. So they have to keep getting validation from people and it's like almost few minutes later they forgot that validation they have to seek it again. — So often times these individuals will end up in relationships in which they're not very happy. They've given up all kinds of their own needs and wants to satisfy the other person's needs and wants and they still feel like they're left out in the cold. And these individuals are also more at risk for abusive relationships because again their need for nurturance is so high that they're willing to succumb themselves to extremely distressing situations to not be alone. And these individuals oftentimes adults you'll see them kind of hop from relationship to relationship. They're serial daters. They have a hard time being alone. And when they're alone they become very distressed. And it goes for friendships as well. So they prefer to be with their friends instead of by themselves and they will put themselves in uncomfortable situations just to not be alone. So even if all of their friends are doing something that they really don't want to do, they'll go along with the group as opposed to staying home alone. — Let's go back to the study. — How much of the child's reaction do you think is from just their personality they were born with as opposed to how they're being influenced by the parents? — So I think it's a combination. Um, sometimes there are children with temperaments that are a little bit more anxious to begin with, clingy, but also parents can produce that behavior in their child if they're kind of unpredictable in their parenting. Meaning, sometimes they are there, they're very sensitive to their child. And other times they're nowhere to be found. And I think sometimes parents unwittingly provoke this type of attachment style in their child. For example, very busy parents, you know, they're actually working very hard to make ends meet. But as a little child, you don't realize that your parent was gone for 10 hours because they were working. So when they're home, they're actually pretty engaged with you and they are there to meet your needs. But then there's other days where they come home and they're exhausted. And so then you have a lot of needs and the parent says, "You know what? I just need a few minutes alone. " And then they take that — to personal fence. And so [clears throat] you can see how sometimes very well-meaning parents can accidentally cultivate a preoccupied child um just because again of their own needs and them being busy, — right? Would you say someone with borderline personality disorder has a high likelihood of [snorts] having parents who really fostered this type of attachment style? I think that the most common attachment style that's linked to borderline is actually the fearful avoidant attachment style because the parent is even more erratic and this would be parents themselves who are erratic for really no good reason. I mean the kind of scenario I propose are the kind of parents who they just get busy or they have their own needs and they're trying to deal with themselves and self soo and they sometimes neglect the child. the parents that tend to provoke a fearful avoidance style, sometimes they're a little bit more conscious of it and they still do it because [clears throat] they're just not well themselves, — right? — So, I think that borderline is more associated with that attachment style, although I can also see some of it coming from this one. Um, the fear of abandonment is much greater for a fearful avoidant child than it is for an anxious preoccupied child. And I think oftentimes children who are anxiously preoccupied throughout their life, they get sort of reexperiences that strength and that type of attachment style like maybe the relationship that they choose as adults. They keep choosing dismissive partners or partners who can't meet their needs. And so then they keep reinforcing that belief about themselves that maybe they're unlovable and they don't want to like sit with that. And that's why they have a hard time being alone. So with no awareness, are we most likely to mimic the attachment style we were raised? — Yes. — In. Okay. — Yes. And I think that there's a theory that you end up seeking partners that are kind of similar to your parents and you basically reenact the same thing over and over again whether it's some type of a trauma or not. And so if you were a child who felt like you were

constantly reaching for your parent for support and they were sometimes there and sometimes not, as adults, you're attracted to people who also sort of have those tendencies where they kind of get busy with their own lives and again maybe they love you but you know they just don't have a lot of bandwidth to be dealing with your insecurities all the time. And so I don't really find for example that many people who have the preoccupied attachment style actually end up being with each other. Although sometimes that does happen, they tend to seek out partners that are different from them in terms of their attachment styles and oftentimes replicating the parenting style of their caregivers. — Got it. Now, it's important to mention here though that although my question was the potential causes or correlation between attachment style and personality disorders, there's not just one cause for any of those. I mean, it can be a hodgepodge of things, but I think it helps people — kind of see where what parts of their history might be influencing their current behavior today. — Absolutely. And it does play such a role, not even just in intimate relationships, but even the career you choose. People who have an anxious, preoccupied attachment tend to be in jobs where they're part of a pack. they feel much more comfortable sort of blending into a pack as opposed to even being the leader of the pack in the group dynamic. They tend to be the followers and they tend to really avoid conflict because to them conflict might mean rejection and so they t kind of tend to do roles in life that are more passive because they're trying to make sure that they don't lose any nurturance that they can get from someone and they also need a ton of validation. So they find themselves in jobs where they seek a lot of that validation. And it's interesting because some anxiously preoccupied individuals actually end up getting in jobs where validation is few and far between. Like for example, acting. — Oh, right. — Um it's really interesting. I've worked with a lot of actors um who have said, "You know what? I think this might be my attachment style. " And weird, I chose a job where I literally have to deal with that attachment issue every day. — Yes. Um, if you recognize these patterns in yourself and you want to change, what do you do? — Well, if you know that you're probably an anxiously preoccupied person and you want to change that, I think the first thing is really establishing a stronger sense of self. You know, one easy way to do this would be just to start developing a hobby where you basically do it on your own. It's not a [clears throat] hobby that you have to do with other people, — right? And just starting from there. For a lot of my patients who have anxiously preoccupied attachment styles, I challenge them to go out to coffee by themselves and then go out to lunch by themselves. Like get used to spending time by yourself and even in a public environment where you might be afraid of other people's judgment like who is this person who is you know eating by themselves. Nobody cares by the way. — Nobody is thinking about you. — Just the other day I was stuck in so much traffic that I ended up going to this really nice restaurant and I had a five course meal by myself. — Dang, good for you. like 2 and 1 half hours and it was great cuz by the time I was done I um there's no traffic. Yeah, it was lovely. But as I was there I was thinking about how that would be such a challenge for somebody whose main attachment style is probably anxious preoccupied the whole time. They're probably thinking other people are judging them. They think that they're loners. losers, right? And it's nobody's thinking about you. That's the funny thing. Everybody's thinking about themselves most of the time. So I just challenge them to do more independent activities and like to sit with that distress and to really start getting comfortable with themselves. Basically start to learn the technique of self soothing, right? As opposed to looking for others to soothe your distress. — Excellent. So for somebody who just, you know, started shaking when you said go out to lunch by yourself. Yeah. — Where could they start that isn't that? — I think starting a hobby that's more independent. I mean, even just sitting at home and saying, "You know what? I'm going to do this jigsaw puzzle by myself and without calling a friend and talking to them at the same time. " Like, really just sit by yourself — or putting it on social media, — right? Exactly. Like just do it on your own and also do it in a time limited way. So, I'm going to do this for 30 minutes today. And that's why I say, you know, go to coffee for 30 minutes and then if you can do that, then do lunch for an hour. you know, work your way up to being more independent and having your identity and life outside because what happens with people who are anxious preoccupied is they lose their sense of self. They're so passive and they're so busy dealing with other people's needs and wants that they don't even know what they want anymore. But it actually ends up creating the abandonment they fear because people are like, "Well, you're uninteresting. You're too clingy. " So, by developing your own hobbies and having a good sense of independence, you actually attract the kind of partners that you want. You have things to talk about, you know, when you're with your partner. Yeah. — For the person who's recognizing these symptoms in themselves, but they're also a parent or a caregiver, — how do they start to shift the attachment style so that their child or the person they're caring for is being raised with that secure attachment? — Yeah. I think for an anxious preoccupied parent, it's important for them to modulate their own anxiety and realize that some of that anxiety might be warranted and some of it's not rooted in

reality. And for those that are not rooted in reality, they have to learn to step aside, deal with their anxiety, take some deep breaths, do the coping strategies, and go back in the room with your child and present calmly. Because if you present in front of your child that's super anxious, you might raise an anxious child. And so you definitely need to say, "Okay, do I need to be anxious here? If not, then I'm going to step away, deal with my own emotions, come back and be calm, and also use it as a teaching moment. " If you do end up getting really anxious in front of your child later on in an age appropriate way, have a discussion. So sorry, mommy looked like she was having a nervous attack. Mommy's fine, but she just got really worried for a second. And when that happened, mommy started to do some breathing exercises and now I feel better. So engage your children in that conversation so they can realize, hey, my parents not perfect, but they're actually doing things to try to foster resilience in themselves and I can follow that template. And what's really cool about that is then the child sees the parent being self-aware. — Yes. — And so hopefully the child grows up understanding that they too can be self-aware. I didn't learn self-awareness until I don't even I mean late late I forgot that I could be aware of my own emotions. I just let them go however they wanted to. Uh be before we wrap up this session. What are some good coping mechanisms when those parents who have this type of attachment style start to feel really anxious in front of their kids, but they want to calm down? — Honestly, breathing is the first thing that they should do because when you get anxious, you start to really activate the fight orflight system, the sympathetic nervous system. And so the deep breathing brings you back to that center of, hey, there's nothing to worry about. I can relax. I can let go of that whole fight orflight response. And so take some deep breaths and then check your thoughts. You know, check your thoughts and say, do these thoughts have any bearing in reality? — And if they don't, — do the diffusion technique that we've talked about in some of the other series. You know, attach a sentence before your negative thought or fear. I'm having the thought that — I'm not going to finish my work before the deadline, right? I'm having the thought that — my husband isn't home and it means something nefarious, right? and letting yourself understand that there's so many thoughts that can come through our heads that don't have any meaning. So, don't attach yourself to them and start to get yourself worked up. — Yes. Was that in the CBT series? — That was in the acceptance and commitment. — Acceptance and commitment therapy. Yes. One of our favorites. So, uh if you have not watched that series, it is available on Med Circle. It's called acceptance and commitment therapy. One of my all-time favorite therapies. Uh but since we're talking about therapies and we do have a little more time on this uh session, the uh what type of therapies would be best in treating or improving these types of attachment style? — I think really it's about therapies that really do bring you some sense of awareness. So some of the more introspective therapies are helpful, but then you have to pair that with actual skill sets. Yes. — And so once you have that introspection, it's really about learning skills to self soo, learning skills to tolerate distress. very important for the anxious preoccupied person. So, uh techniques such as distress tolerance or emotion regulation from the DBT literature is really helpful. Behavior activation and interpersonal effectiveness from CBT would be really helpful too so that these individuals can learn to communicate their needs in a more assertive fashion and also be able to self-start. You know, some of sometimes these individuals have a hard time doing things on their own. They don't want to do anything on their own. And so it will be really helpful for these individuals to learn how to set up their life in a way where they can selfinitiate as opposed to waiting for somebody else to take care of their problems. — Excellent. Good stuff. DBT, dialectical behavior therapy and cognitive behavioral therapy, CBT, all available at medcircle. com. In our next session, we'll talk about demissive dismissive avoidant attachment style.