Attachment Is the Fifth Element.

Why is attachment so important and special? A perspective from social neuroscience and relevance for psychotherapy.

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Co-written Ana x Dr Pascal Vrticka

In the 1997 sci-fi movie "The Fifth Element" the protagonists, a 23th century cabbie and a mysterious extraterrestrial, embark on the quest to find the fifth element. They don't know what the fifth element is but they know that it complements the four elements of fire, earth, water and air, and is needed to maintain harmony in the human world. 

Last week, we explored the ’attachment shadow’ – i.e., how the meaning of attachment concepts can get lost in translation and how they are often mingled with lots of neurobollocks. We did so because the ‘bright side’ of attachment is so important and we don’t want to see it tainted. And we did so to set the stage for today as we would now like to turn our attention to exactly this ‘bright side’ of attachment, trying to make the case for why we think attachment could just be the Fifth Element.

Social neuroscientist Dr Pascal Vrticka (his bio is at the end of this post) has kindly agreed to play with this idea, and share with us why he thinks attachment is as important for survival as any other fundamental biological need.  In the process, he shares a treasure trove of information. So, all of you attachment aficionados out there, please take time to read as you will learn about some fascinating facts and research from the social neuroscience of attachment (and you might have to come back several times to soak it all in...). Amongst other things, we talk about:

• Mismatch between the physiology and behaviour in avoidant attachment

• How social neuroscience captures the neurobiological signals of attachment

• Brain activation in relation to attachment

• Changes of brain structure and connectivity linked to attachment

• Epigenetics of attachment

• Attachment as a mechanism for social survival

• Concepts of 'individual fight' and 'social flight'

• The ‘behind the scenes’ of a social neuroscience lab

• How can insights from the social neuroscience of attachment be useful in therapy

• Depathologizing attachment

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As we have seen last week, there currently is a lot of confusion and doubt about attachment theory. And, as we have also seen, some of this confusion and doubt is completely justified. Attachment theory is not a single and tidy framework. It is very diverse and quite messy. However, once we can look beyond this apparent untidiness and grasp its true essence, then I believe that attachment theory has an enormous potential to inform and transform our lives. 

For me as a social neuroscientist, what makes me think that attachment could just be  the fifth element – employing that cinematic metaphor to say that something is as essential for surviving and thriving as the material conditions for physical survival– is what I can observe when I  objectively investigate its neurobiological underpinnings. 

Why can attachment be confusing? Because it involves the entire body and brain, because it affects our feelings, thoughts and behaviours in multifaceted ways. And it often does so in ways that don't tell a coherent story. Such a discrepancy was already observed by Spangler & Grossmann in their seminal study (1993). In this study, the authors for the first time measured heart rate (i.e., physiology) and salivary cortisol (i.e., endocrinology) in 12-months old infants undergoing the Strange Situation Procedure to assess their attachment orientation. One of the main findings was that although insecure-avoidant infants showed no overt signs of stress in their behaviour, their physiology and endocrinology told a very different story – one of being stressed and having difficulty regulating such distress. 

For the last (almost) twenty years, I have been working – together with many students and colleagues – on expanding such an investigation of the objectively measurable neurobiological correlates of human attachment. And in doing so, we discovered many novel neurobiological patterns that added substantially to our understanding of how attachment works and why it does what it does. For example, we can nowadays see how different attachment orientations are associated with distinct patterns of brain activation, structure and connectivity, how they are related to epigenetic modifications of genes involved in a range of biochemical pathways, and how they are linked to bio-behavioural and interpersonal neural synchrony.

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Are you saying that attachment is one of those psychological and behavioural characteristics of humans that are so strong that are able to produce their distinct neurobiological signals?

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Everything we experience, do and think is based on neurobiological signals. Attachment is no exception. Attachment is orchestrated by many different players within the body and brain to give rise to the complex feelings, behaviours and thoughts we usually associate it with. The important thing is that nowadays, by combining the traditional attachment measures of behavioural observation, interviews and self-reports with state-of-the-art neuroimaging methods, we can actually see and quantify how all of this is unfolding within the body and brain and what it all means for our mental health and wellbeing. 

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And when you say brain activation, what does that mean, in layman’s terms?

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It means that we can see where and how in the brain certain information is processed and how information processing differences are related to individual differences in attachment. For example, in a recent study, we used electroencephalography (in short EEG) to measure brain activity in 9-11 year old children while we showed them happy and angry faces of either their mother or a female stranger. We found that children classified as insecure-avoidant (and thus using deactivating attachment strategies) initially had higher brain activity to all angry faces, meaning that they very quickly detected and neurally processed angry, and thus potentially hostile, faces. However, in the same children, very shortly thereafter, brain activity strongly decreased to all faces, including to happy mother faces. We could thus see that an insecure-avoidant attachment orientation did not just ‘shut down’ the neural processing of attachment-related information from the beginning. Instead, attachment-related information was first processed more readily, only to thereafter be somehow ‘suppressed’. This so-called ‘two-stage processing model’ reveals crucial insights on how insecure-avoidant individuals process information from their surroundings. 

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And when you talk about changes in structure and connectivity, can you also give us an idea of what that means?

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Besides looking at associations between attachment and brain activation – i.e., how the brain responds to certain kinds of information –, we can also investigate whether there are associations between attachment and brain structure and connectivity – i.e., how the brain is physically made up and how different brain parts are connected with one another. For example, in another recent study, we looked at the association between self-reported attachment and cortical thickness (i.e., the depth of the grey matter that is made up by cell bodies, dendrites and synapses) by means of magnetic resonance imaging (in short MRI) in almost 100 adolescents over a period of up to four years. 

What usually happens during adolescence is so-called ‘neuronal pruning’, which is a natural process that involves the elimination of unnecessary or weak synapses between neurons. This process is essential for refining the brain's connections and optimising its function, and can be measured by a decrease of grey matter volume. What we observed in relation to attachment, was that those adolescents with more insecure-avoidant and -anxious attachment showed stronger grey matter volume decrease, and particularly so if they were younger at study onset. Our results thus revealed that individual differences in attachment were associated with brain maturation during adolescence, and that insecure attachment may have somewhat ‘accelerated’ it.

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You also mention attachment and epigenetic modifications. In the therapy world, we love epigenetics but mainly in the context of transgenerational transmission of trauma. Are you referring to that specific context when you talk about epigenetics of attachment?

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Epigenetics is an umbrella term that refers to reversible changes in gene expression that happen without any alteration of the underlying DNA sequence itself. All cells in the body have the same DNA, yet they don’t express the same genes. For example, brain cells have the exact same DNA as, say, blood cells, but they look very different and have very different functions. Thus, the only difference between them is epigenetic, relating to which genes are ‘turned on’ and expressed and which genes are ‘turned off’ and silent. Epigenetic modifications also happen in response to external conditions and are essential to the capacity of the organism to adapt to a change in circumstances. 

In our work on epigenetics, we don’t look at transgenerational transmission (yet). To do so, we would need to assess epigenetic changes in the first generation’s germline cells (i.e., cells that eventually develop into gametes – sperm or eggs) and then see whether the same changes are also present in the second generation’s cells throughout the body. 

Instead, we investigate whether there is an association between individual differences in attachment and current epigenetic modifications in the periphery (i.e., cells from blood or saliva). For example, in a study that we published in 2018, we looked at epigenetic modification in the oxytocin receptor gene and glucocorticoid receptor gene – two genes important for the social regulation of stress – in the saliva of 109 young adults as a function of their attachment orientation. We found that there was epigenetic modification in both of these genes but only in participants who scored high on insecure-avoidant (and concomitantly low on insecure-anxious) attachment. This is interesting, because insecure-avoidant attachment most consistently shows links to diminished social responding and support-seeking under stress.

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A New Perspective On an Old Mechanism for Survival

Attachment is our primary social survival strategy. We depend on the support and co-regulation provided by others. This is because our brain and body treat our own bioenergetic resources and the resources provided by significant others interchangeably. If we have a strong and supportive social network of attachment figures, our own energy levels are not only conserved but they are literally increased.

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This perspective seems systemic, as if there is an organism and a super-organism formed by the people around us. Attachment serving as a sort of invisible, non-physical connective tissue for that super-organism, if I understand correctly? If we can count on super-organism in times of need, it makes sense that our energy levels are heightened.

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Yes, absolutely. Our primary attachment strategy associated with a secure attachment orientation is the one of proximity-seeking under stress. We naturally and automatically reach out to others for help and support if we face a significant challenge. Activation of our attachment system ensures that we can easily communicate when we need help and that our significant others, our attachment figures, can promptly and appropriately respond. Therefore, it is our brain’s and body’s ‘default’ or ‘baseline’ state to assume the presence and availability of others in times of distress. 

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To me, this perspective on attachment is really new. Sometimes, people can feel embarrassed or ashamed for needing help from others. However, viewing others as an extension of oneself to meet one’s needs seems to be a natural mechanism in light of this understanding of attachment. I am looking forward to seeing how we can leverage it in therapy.

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I think this is a crucial point. We all need help when we are facing a significant challenge. There is nothing wrong with asking for help and no need to be ashamed for doing so. We are neurobiologically just not made for coping completely on our own. This can work for some time and to some degree if absolutely necessary, but in the long term, it uses too much energy and leads to wear-and-tear and thus the emergence of mental and physical health issues.

 Modern attachment science can help us understand what happens if our social resources are decreased, or we feel as if they are decreased. Under such circumstances, we need to start employing compensation strategies to minimise the risk for the above-described wear-and-tear effects. Either we become more self-dependent and employ more self-regulation – what we call “individual fight” associated with attachment avoidance. Or we start signalling others more loudly that we want and need their help – what we call “social flight” associated with attachment anxiety. 

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Can you say a bit more about concepts of 'individual fight' and 'social flight'?

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As we point out in our just published ‘narrative on the neurobiological roots of attachment-system functioning’, attachment does involve some elements of a classical ‘fight-or-flight’ response. 

Avoidantly attached people usually up-regulate their own defences and energy to fend for themselves – and thus ‘fight’. After all, if nobody is around to help, the only choice is to stand up and fight on one’s own. However, there also is an element of ‘running away from help’. Avoidance often involves an active decision not to ask for help and instead to face challenges alone. And this goes beyond a ‘simple’ fight response that is triggered by an immediate threat where there often is no other choice than to stand up and act alone. 

For attachment anxiety, we could say that there is an element of a classical ‘flight’ response. However, this ‘flight’ has the special property to be directed towards one’s attachment figures. Therefore, we call it ‘social flight’. In other words, when anxiously attached people face a challenge, they don’t just run away from it, they run towards their attachment figures as their ‘safe haven’. 

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Would you be so kind as to let us in on a few secrets from behind the scenes of a social neuroscience lab? How do you assess the patterns of activation and deactivation in individuals with avoidant attachment orientations? What about those with anxious orientations? And how do you ensure these experiments are realistic enough to reflect someone's behaviour in 'the wild'?

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First of all, we need a measure of our participants’ attachment orientation, which we can obtain in many different ways. Sometimes we ask participants to fill in self-report questionnaires, such as the Experiences in Close Relationships (ECR) questionnaire. At other times, we invite participants to get interviewed by using the Adult Attachment Interview or a story completion task for children. And at even other times, we video-record participants’ behaviour and then code it with the help of attachment theory inspired coding schemes. We always try to use more than one way of assessing participants’ attachment orientation, as this allows us to compare the different outcomes with one another. However, this is not possible at all times because some attachment measures are much more time-consuming and/or expensive than others.

Second, we need our objective neurobiological measure. Again, there are many different options for obtaining the latter. Sometimes, we show our participants images or short movie clips while we measure their brain activity in isolation – i.e., participants are alone in the lab or the fMRI scanner. At other times, we invite two or three participants to the lab at the same time and have them interact with one another while we measure their brain activations and heart rates and video-record everything they do.

Of course, some of the procedures that I just described are more ‘controlled’ than others. And some are quite different from what would normally happen in ‘the wild’. But by combining all of the different measures and scenarios, and by always checking what other researchers find in their studies, I am quite confident that we can get a realistic idea of what is going on overall.

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But can the cold reality of a neuroscience lab relate in any way to what we do in therapy?

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In science, including the science of attachment, we want to be able to make generalisable predictions that apply to as many people as possible. To answer such questions, we need to obtain data from large groups of people, and the thereby obtained results can only say something about attachment on the level of these groups, not for separate individuals. In therapy, the story is very different, because the main focus is on one specific individual and one specific relational dynamic between the therapist and client. The central question thus is how an individual with a unique personality and personal circumstances, including attachment, can best be helped by the therapist. Unsurprisingly, these two approaches can easily feel miles apart.

I nonetheless think that attachment science can be very helpful in a therapeutic context.

For example, our results show that attachment is everywhere in the brain, that it affects activity in, as well as the structure and connectivity of, almost all brain areas that are organised into complex interdependent networks. Thus, when working on attachment with a client, there should be some elements that target emotions, both positive and negative, and other elements that target thoughts and mentalisation/mental representations. And the focus should be on restoring an optimal balance between all of these processes.

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This is great news for therapy. Can you give us one more example of what you think can be useful for therapists to know from your research on neuroscience of human attachment?

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Maybe that our body and brain is highly adaptive, and that our reactions to certain events should therefore always and foremost be understood as meaningful and appropriate. If there is nobody around to help us cope when we are stressed, it makes perfect sense to up-regulate our own and thus ‘individual fight’ responses. Conversely, if we need and want to obtain help from others but cannot really predict whether they will be available or not, it makes perfect sense to up-regulate our ‘social flight’ responses to signal them more loudly that they should come and assist us. In other words, there is nothing intrinsically ‘bad’ about the neurobiological patterns and the corresponding feelings, thoughts and behaviours associated with insecure-avoidant and -anxious attachment. 

Very often, these mechanisms work well and help us function quite nicely within specific attachment relationships. Understanding the intricate ways in which attachment works within our body and brain thus has a healing and soothing element, because it makes us realise that insecure attachment is not some sort of disorder or a mental health condition. It helps us depathologize attachment insecurities. This does, of course, not mean that we should disregard the risks that come with high attachment insecurity, which still need to be attended to, ideally through professional help. But it can put some things into perspective by appreciating that our body and brain is responding in neurobiologically predictable and appropriate ways to specific, often challenging, environmental demands.   

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That is all for now. Lot to take in, so maybe just:

Read. Think. Sleep. Repeat.

And, have we convinced you that attachment is the Fifth Element? It is for you to decide. 

As always, thank you for reading. If this piece sparked your interest, reflection of your own or you have any questions, please share it in the comments.

To follow Pascal on social media, where he makes concepts and research findings from attachment theory and neuroscience accessible, you can follow him on BlueSky, X, LinkedIn or Instagram.

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Dr Pascal Vrticka is an Associate Professor in Psychology at the University of Essex (Colchester, UK) where he leads the Social Neuroscience of Human Attachment (SoNeAt) Lab. He has been studying the neurobiological basis of human attachment for almost 20 years and published the first neuro-anatomical models of human attachment (NAMA and NAMDA). Dr Vrticka furthermore recently started three attachment series on Instagram to dissolve the most prominent confusion and misconceptions about attachment, one of them specifically dedicated to Attachment Myth-Busting.