Residential Treatment for Attachment Disorder

One thing that has stood out to me working with teenagers in Residential Treatment is that humans crave and need connection. At the surface some of our clients present as defiant, acting out or attention seeking, but often these negative behaviors are an attempt to connect and seek support. Understanding this helps me have more compassion and patience with our clientele. People need other people. Now this isn’t a new idea, but how people go about filling that need varies and that variance depends greatly on their attachment style.

Every person has an attachment style that affects the way they interact with others. This plays out in their behavior and impacts close relationships. John Bowlby and Mary Ainsworth were both influential in helping recognize these patterns in early childhood and believed that the establishment of that pattern would be a framework to how we interact in relationships throughout our lives.  I recently read a book that described this impact in romantic relationships for adults.  Levine and Heller explored these patterns and how it can make or break relationships. While working with teenagers, it has been important to point out these styles of attachment, help them become more aware of their style, so they can better understand their behavior and how they attempt to connect. Although the girls we work with  are not involved in romantic relationships while in treatment, their patterns still play out in their close relationships with family members and also with anyone they get close to in the treatment setting.

“Adult attachment designates three main attachment styles…which parallel those found in children:

  • Secure
  • Anxious
  • Avoidant

All people in our society fall into one of these categories, or, more rarely, into a combination of the latter two (anxious and avoidant)” (Levine & Heller, 2010, p. 8).  Basically, if individuals have a secure attachment style they are comfortable with relationships, are warm, loving and confident. If they have an anxious attachment style, they are typically preoccupied with relationships and tend to worry about others’ ability to love them back. If they have an avoidant attachment style they see intimacy or relationships getting in the way of independence, and they will consistency try to minimize closeness.

Now, when someone experiences a threat, their attachment system will activate. Some examples of a threat are being rejected, being bullied, failing an assignment, getting yelled at or anything that a person perceives as threatening. Once the attachment system activates, the individual will seek support, if support is available, they will come to a resolve and gain confidence that others will be there when they need them. If they seek support and support is not available, they will experience increased insecurity and distress. They do not experience a resolve and therefore may use protest behavior to be heard. This protest behavior varies on whether someone is anxious or avoidant. Typical protest behavior for anxious individuals could be calling or texting multiple times, excessive social media activity, making threats to leave, excessive attention to outer appearance, self-injury, or sexually seductive behavior.  It could be any behavior that overtly attempts to get a response from an attachment figure. If an individual is more avoidant, their behavior could be excessive use of alcohol or drugs, isolating, self-injury, denial, a pattern of holding it all together and then having major emotional explosions, lack of empathy or any behavior that allows them to disconnect or keep them safe from needing others.

The good news is that attachment styles aren’t permanent. Anyone can shift to becoming more secure as long as they have consistent support and responsiveness. Levine and Heller point out that the more effectively dependent people are on one another, the more independent and daring they become. They explain that when one’s emotional needs are met, they usually turn their attention outward. Helping our residential treatment clients understand their patterns, why they do what they do, and what they need from others allows for increased awareness.  It will also build their confidence that they can learn skills to improve the way they communicate and seek support.

-Blog written by Brittany Olson, CSW, Therapist

-Reference – Levine, A. & Heller, R. (2010), Attached: The new science of adult attachment and how it can help you find-and keep-love.  New York, NY: Penguin Group