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America’s Attachment Crisis

“America is in its insecure-attachment era,” proclaimed Faith Hill in The Atlantic in April. “Discomfort with intimacy seems to be on the rise—and no one’s quite sure why.”

Some time ago, social psychologist Sara Konrath found that narcissism rates seemed to be increasing among Americans and empathy decreasing, Hill reported, so about a decade ago, Konrath “decided to look more deeply into the state of Americans’ connections—and in order to do so, she turned to attachment theory.”

Attachment theory is a psychological, evolutionary, and ethological theory concerning relationships between humans. The most important tenet is that young children must develop a relationship with at least one primary caregiver for normal social and emotional development. 

British psychiatrist John Bowlby first formulated the theory. He described attachment as a “lasting psychological connectedness between human beings.” Bowlby was interested in understanding the anxiety and distress that children experience when separated from their primary caregivers.

“The central theme of attachment theory is that primary caregivers who are available and responsive to an infant’s needs allow the child to develop a sense of security,” explained Kendra Cherry on Verywellmind.com. “The infant learns that the caregiver is dependable, which creates a secure base for the child to then explore the world.”

There are four types of attachment:

  • Ambivalent attachment: Children become very distressed when a parent leaves. This attachment style is considered uncommon.
  • Avoidant attachment: Children with this attachment pattern avoid parents or caregivers, showing no preference between a caregiver and a stranger.
  • Disorganized attachment: These children display a confusing mix of behavior, seeming disoriented, dazed, or confused. 
  • Secure attachment: Children who can depend on their caregivers show distress when separated and joy when reunited.

“Children diagnosed with oppositional defiant disorder (ODD), conduct disorder (CD), or post-traumatic stress disorder (PTSD) frequently display attachment problems, possibly due to early abuse, neglect, or trauma,” writes Cherry. “Although attachment styles displayed in adulthood are not necessarily the same as those seen in infancy, early attachments can have a serious impact on later relationships.”

Konrath’s team analyzed nearly 100 other studies, completed from 1988 to 2011, that assessed the attachment styles of college students. They found a 15 percent decrease in secure attachment, a 56 percent spike in avoidant attachment and a nearly 18 percent increase in the disorganized style—the two types associated with lack of trust and self-isolation. “Compared with college students in the late 1980s,” the researchers wrote in their 2014 meta-review, “a larger proportion of students today agree that they are comfortable without close emotional relationships.”

From 2011 to 2020, secure-attachment rates dropped even further, and fearful (disorganized) attachment continued to rise, reported Hill. Konrath’s team and others primarily tracked changes among college students simply because those data are more readily available—but that doesn’t necessarily mean that discomfort with intimacy isn’t spreading among older people as well. 

Michael Hilgers, a New Mexico–based therapist who’s been counseling for more than 20 years, told Hill that he’d seen a notable increase in clients—adults of various ages—dealing with dismissive or fearful attachment. “It’s painful to watch just how disconnected people are,” he told Hill. Even when he can sense that these clients do, deep down, want connection, “there’s a lot of confusion and fear in terms of how to get there.” 

Indeed, US Surgeon General Vivek Murthy just published an 81-page report declaring loneliness the latest public health epidemic. 

“The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day and even greater than that associated with obesity and physical inactivity,” Murthy warned. “And the harmful consequences of a society that lacks social connection can be felt in our schools, workplaces, and civic organizations, where performance, productivity, and engagement are diminished.”

“We now know that loneliness is a common feeling that many people experience. It’s like hunger or thirst. It’s a feeling the body sends us when something we need for survival is missing,” Murthy told The Associated Press in an interview. “Millions of people in America are struggling in the shadows, and that’s not right. That’s why I issued this advisory to pull back the curtain on a struggle that too many people are experiencing.”

“Loneliness hangs over our culture today like a thick smog,” wrote Johan Hari in his 2018 book Lost Connections, in which he sought to uncover “the real causes” of depression. Among nine causes of depression and anxiety, Hari listed being disconnected from other people, meaningful values, and the natural world. He also cited childhood trauma as a major driver of anxiety, depression, and substance misuse. 

“Why do so many people who experience violence in childhood feel the same way? Why does it lead many of them to self-destructive behavior, like obesity, hardcore addiction, or suicide?” he asked in the book. 

Traumatic experiences during childhood—often categorized as adverse childhood experiences or ACEs—typically have a strong impact on the ability to form secure attachments. This, in turn, can lead to maladaptive coping attempts, such as numbing emotional pain with psychoactive substances.  

“Attachment trauma forces the child into a developmental dilemma with no way out, a constant ‘horror without resolution’: Traumatic anxiety, fear, or panic is associated with the presence of a central attachment figure,” wrote Lahousen, Unterrainer, and Kapfhammer in their 2019 study on the psychobiology of attachment and trauma. “Neurobiological research approaches have so far been performed mostly in adults who had severe trauma either in early developmental stages or later on in life, often in adolescence or adulthood; they exhibited a series of mental disorders that were to be conceptualized as associated clinical sequelae, such as a PTSD, complex PTSD, dissociative disorders, serious personality disorders, in particular of the borderline-type, but also variants of chronic depression, anxiety, somatization syndrome, chronic suicidal behavior or substance-related disorders.”

New Paradigm Recovery clinicians often encounter and help clients with unidentified and unresolved trauma stemming from attachment problems in childhood and adolescence. Family system work, as well as individual client work, is often essential to successfully addressing the complex implications of attachment disorders. A key focus is educating clients about the causes and effects of attachment traumas, helping them process trauma and reframe their interpretation of the adverse effects of these problems, and finding healthy ways to self-regulate emotional responses. In addition, helping identified family members understand that their loved one is experiencing the effects of attachment issues can be beneficial, and helping family members find treatment and support and family therapy can help restore relational health and communication. 

“Attachment disorders have always been prevalent among our clients and generally among people experiencing dual-diagnosis conditions. Attachment can create problems throughout one’s life that can eventually lead to depression, anger, anxiety, and other mental health problems that lead people to self-medicate with substances. We try to identify potential attachment-related problems in someone’s early life so that we can help them understand the issue clinically and how this may be working against their wellness. Once we know that an attachment issue is present, we can use therapy to help,” says New Paradigm Recovery Chief Operating Officer Joshua Cagney. 

“But learning how to develop trust-based relationships and friendships is also important. Feeling isolated and alone takes more than therapy. It takes the ability to find belonging and friendship. So we spend considerable time helping clients develop the ability to be vulnerable and to show up for people in their lives with genuine sincerity and presence to develop healthy, profound, and meaningful attachments. Fortunately, recovery community members are well-versed in the importance of authentic connection. They support one another’s openness and vulnerability, which is why we strongly encourage clients to find a support group that resonates with them and stick with it. It is also why we strive to encourage connections between clients.” 

As a private multidisciplinary outpatient practice, New Paradigm Recovery clinicians can take the time needed to help with complex issues like attachment-related disorders and provide trauma and family therapy. Through careful case management and aftercare support and communication, New Paradigm can also help clients throughout the ongoing process of managing and improving their mental and relational health.

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