The neglected attachment style needs a little TLC. Spread the word.
Fearful-avoidant attachment is the lesser-known, fourth adult attachment style. In this blog post, I explore what it is, what makes it unique, and why raising awareness of this attachment style is important.
What is the fearful-avoidant attachment style? In a nutshell, individuals with a fearful-avoidant attachment style view themselves as unlovable and perceive others as untrustworthy and unreliable.
The fearful-avoidant attachment style reminds me of the character Edward Scissorhands from the eponymous Tim Burton movie. He craves closeness and intimacy but is too wary and distrustful of humans to get closer. His scissor hands, which are meant to protect him, ultimately keep him at a distance from others.
There is sometimes confusion between this attachment style and disorganised attachment. Disorganised attachment is an infant attachment category, whereas fearful-avoidant attachment is an adult attachment style. These two concepts are distinct and represent unrelated constructs.
Not only is this attachment style the least known among therapists, but it is also the least researched. Attachment theory's (metaphorical) “neglected child”!
To me, the best way to understand the concept of fearful-avoidant attachment is to shift how we think about attachment categories. Traditionally, attachment is viewed as a set of distinct, separate categories: Secure, Anxious, and Avoidant. However, more recently some researchers have proposed that attachment is better understood as a two-dimensional space with Avoidance and Anxiety axes—a perspective first introduced here.
I love this idea. It is elegant and makes sense clinically. If there were a Mendeleev-style periodic table for attachment, this model would be it. Just as the periodic table predicted the existence of yet-to-be-discovered elements, this model anticipates the presence of the fearful-avoidant attachment style.
Let’s take a closer look at this using the diagram below.
While fearful-avoidant attachment style can be seen as a combination of anxious and avoidant attachment style, it presents its own set of challenges in therapy. From my experience, establishing a relationship of trust is a major stumbling block.
I would also like to shine a light on some intriguing features of the fearful-avoidant attachment style that could help generate useful idea nuggets for therapy work.
The original way to assess attachment in infants was the Strange Situation Procedure (SSP). In this procedure, a 12 to 14 month-old infant and their mother are placed in a welcoming room with toys and a new person they haven’t met before. The mother and the stranger take turns leaving and returning, which creates different scenarios for the child. By observing the child's behaviour in a codified manner, researchers are able to determine one of four attachment styles: secure, anxious-avoidant, anxious-ambivalent, or disorganised.
The first three categories correspond very broadly to the Secure, Avoidant and Anxious adult attachment categories.
Later studies have looked at the overt distress versus the physiological signs of distress while infants undergo the Strange Situation Procedure. One of the fascinating discoveries, evidenced from variations in their heart rate, was that the avoidant children experience as much physiological distress as secure children, despite the apparent composed and dismissing behaviour.
One possible interpretation: avoidant children experience as much emotional distress as other children when faced with attachment challenges, but they are already little masters at disguising their true feelings and reactions.
The story told by cortisol levels as a measure of physiological distress seems to be little more complicated.
Let’s return to the fearful-avoidant attachment style and look at a study that explored how attachment styles relate to physiological arousal in adults. This research measured how distressing thoughts about abandonment and loss affect people, using skin conductance response (GSR) as an indicator of physiological arousal. The study found that avoidant and fearful-avoidant individuals experienced just as much physiological distress as everyone else, even if they didn’t show it through their behaviour or self-reports. But for me, the most juicy twist of this study came when the participants were told to suppress the distressing thoughts.
Avoidant individuals could successfully suppress both their physiological distress and the distressing thoughts. Fearful-avoidant individuals, however, had difficulty doing this. This distinction beautifully illustrates the core difference between these two attachment styles.
It is important to note, however, that physiological arousal does not necessarily equate to the feeling of anxiety. Anxiety, as an emotional experience, is a conscious and subjective state. This distinction opens up another Pandora's box of affective neuroscience, a complex topic better suited for separate blog post.
To sum-up, from a clinical perspective, to me at least, the existence of the fearful-avoidant attachment style is undeniable. Learning about it provided me with the missing piece of the puzzle. Some clients simply never quite fitted into the three categories of Secure, Anxious and Avoidant.
After reading this, when a new client walks into your therapy room and wants to discuss their attachment pattern, before defaulting to the familiar Anxious or Avoidant attachment, will you consider whether the Fearful-Avoidant attachment style might be the best match for them?
I will be shining some light on the fearful-avoidant attachment style in the next Neuroscience Of Attachment Workshop, next Tuesday.
If this article sparked some ideas for you, please share as I would love to hear about it.
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