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What Are Avoidant and Anxious Preoccupied Attachment Styles?

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What does attachment mean, in the context of mental health? Attachment is trusting that we can count on another person for a sense of safety, connection, and belonging. It’s rooted in our experiences with our primary caregivers in infancy, long before we developed conscious awareness. And it sets the stage for how we approach our most important relationships throughout life, from romance to the workplace to parenting. If our childhood experiences caused us to develop an “anxious preoccupied attachment style,” those relationships may feel insecure. If we learned in childhood that we can’t count on other people to meet our needs, we may have developed an “avoidant attachment style.”

What prevents secure attachment in childhood? A caregiver who fails to give their child the emotional support they need may have their own wounds. If they do not have a secure attachment style themselves, they may lack the empathy or knowledge to be able to provide that for their children. Substance abuse, mental or physical illness, or domestic abuse can interfere with a parent’s ability to be adequately attuned to their child.

So, are we doomed to repeat those relationship patterns forever? Not at all. With awareness and effort, we can heal the attachment wounds that may be keeping us stuck in the past emotionally.

What Is Attachment Theory?

Attachment theory describes the lasting emotional connections that form between two people, usually a parent and child or romantic partners. British psychiatrist and psychoanalyst John Bowlby pioneered the field of attachment research. He studied children who had experienced separation from their primary caregivers during World War II. Attachment, Bowlby realized, did not result from simply meeting a child’s basic needs for physical survival, like food, water and shelter. 

Rather, attachment forms as a child learns from experience that a sensitive and responsive caregiver will consistently meet their emotional needs. The child gains confidence to explore, learn, and develop in healthy ways. Bowlby argued that this biologically driven attachment behavioral system was a function of the evolutionary drive for survival. In other words, a securely attached child who sought proximity with their caregiver when threatened would be more likely to survive.

American psychologist Mary Ainsworth expanded attachment research in the 1970s with her “Strange Situation” experiments. She observed the reaction of infants after brief separations from their primary caregivers. As a result, Ainsworth noted three distinct types of reactions. “Securely attached” infants happily explored as long as the caregiver was near, became upset when they left, and were easily soothed upon their return. Children with an “ambivalent attachment” style did not explore the room even when the caregiver was nearby. They were very upset when the caregiver left and were either angry or ignored them when they returned. And children with “avoidant attachment style” showed no preference between a caregiver and a stranger. They revealed no emotion when the caregiver left or returned. Some children varied between these three responses, known as a “disorganized attachment” style. 

Know the Facts

42% of American college students reported having secure attachment style in 2011, as compared to 49% in 1988, according to a meta-analysis of student surveys.

How Parenting Styles and Early Childhood Shape Adult Behavior

It’s tempting to believe that we leave our childhood baggage behind once we cross the threshold into adulthood. In his attachment theory, Bowlby explained that we form long-lasting concepts about ourselves and others by age 3. These “internal working models,” as he called them, are based upon the experiences of early childhood. And they can unconsciously affect the way we approach people and situations for the rest of our lives. 

Caregivers’ parenting styles have a significant impact on the attachment style an individual will have as a young adult and beyond. Research shows that children who were raised with an authoritative parenting style (warm and responsive, while also setting clear boundaries and expectations) have a higher likelihood of experiencing secure attachment in adult relationships. Neither the permissive parenting style (lenient and unwilling to set limits) nor the authoritarian parenting style (strict and disciplinarian) were associated with secure attachment in children.

Ultimately, a person’s adult attachment style is shaped by our concept of ourselves and our concept of others. These can be either positive or negative. We can see ourselves as worthy of love and support, or not worthy. And we can see others as trustworthy and available, or as unreliable and rejecting. The two concepts combine in four different ways to create four adult attachment styles, as summarized by the authors of the meta-analysis study:

Secure attachment style 

This style forms when a person has positive internal working models of both themselves and other people. “It is easy for me to become emotionally close to others. I am comfortable depending on others and having others depend on me. I don’t worry about being alone or having others not accept me.”

Dismissive avoidant attachment style

This type of avoidant attachment style forms when a person has a positive concept of themselves but a negative internal working model of others. “I am comfortable without close emotional relationships. It is very important for me to feel independent and self-sufficient, and I prefer not to depend on others or have others depend on me.”

Anxious preoccupied attachment style

Anxious preoccupied attachment style forms when a person has a negative internal working model of themselves but a positive model of others. “I want to be completely emotionally intimate with others, but I often find that others are reluctant to get as close as I would like. I am uncomfortable being without close relationships, but sometimes worry that others don’t value me as much as I value them.”

Fearful avoidant attachment style

This style forms when a person has negative internal working models of both themselves and others. “I am uncomfortable getting close to others. I want emotionally close relationships, but I find it difficult to trust others completely, or to depend on them. Thus, I worry that I will be hurt if I allow myself to become too close to others.”

The last three types of attachment are collectively known as insecure attachment styles. They are related to relationship challenges and lower levels of well-being in adulthood. 

How Insecure Attachment Styles Lead to Mental Health Disorders

Research shows that insecure attachment, whether anxious or avoidant, is associated with increased rates of mental health disorders. Both anxious and avoidant attachment styles are common among people with depressionanxiety, Obsessive-Compulsive Disorder, Post-Traumatic Stress Disordersuicidal tendencies, and eating disorders. Severe personality disorders and schizophrenia are also closely linked to attachment issues.

An insecure attachment style does not usually cause a mental health disorder in and of itself. But it can exacerbate other vulnerabilities, such as genetic factors, adverse childhood experiences, stressful life events, or the chronic stress of poverty. Furthermore, young adults who did not form secure attachments in early childhood often fail to learn emotional regulation strategies from their caregivers. That leaves them vulnerable to the harmful effects of stress and generally weakens their resilience. 

Moreover, insecure attachment styles affect the way a person interprets others’ behavior and intentions. Hence, they may repeatedly experience unsupportive relationships that do not offer the protective factors of secure connection. In this way, an insecure attachment style can be reinforced over time.

Attachment Styles: Foundation Not Fate

Attachment styles are closely tied to the quality of attention a person received from their primary caregiver during infancy. However, they are not fixed in stone. Some people with attentive caregivers grow up to have insecure attachment styles. And many people who have insecure attachment in early childhood are able to develop secure attachments later on in life. 

Thanks to the neuroplasticity of the brain—its ability to change and make new connections—the inner working models established in early childhood can be rewired. This rewiring typically takes place through a trusting relationship. That might be with a therapist, a friend, or a romantic partner.

5 Ways to Heal an Avoidant or Anxious Preoccupied Attachment Style

Young adults with insecure attachment styles can build what’s known as “earned secure attachment.” Thus, they establish the authentic connections they didn’t have as children, by doing their own inner work. This work can include the following approaches:

  1. Practice self-compassion: A negative self-concept is a component of two forms of insecure attachment. Hence, self-compassion practices can help counter poor self-esteem, over-dependence upon other people’s approval, and self-criticism.
  2. Develop emotional regulation skills: It’s ideal to learn critical emotional regulation skills from an attuned caregiver in early childhood. But it’s not the only way. Mindfulness exercises can support the ability to feel your emotions while remaining calm and balanced. 
  3. Identify what happened in your family of origin and how it impacts your adult relationships. Understanding your past and how it affects your present can help you move forward with greater awareness and empowerment.
  4. Avoid toxic relationships: Identifying your attachment style can help you recognize unhealthy relationship patterns. Instead, cultivate authentic relationships with people who have secure attachment styles.
  5. Seek help from a mental health professional: One of the most important benefits of therapy can be learning what a secure relationship feels like. Moreover, therapy can help you uncover and heal attachment wounds.

Early experience influences later development, but it isn't fate. Therapeutic experiences can profoundly alter an individual's life course.

Daniel J. Siegel, MD
author of The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are

How Newport Institute’s Clinical Model Addresses Underlying Attachment Wounds 

Newport Institute’s philosophy of care views depression, anxiety, and other mental health issues as manifestations of underlying attachment wounds. Our approach allows young adults to experience trusting connections with peers and mentors. Moreover, we use Attachment-Based Family Therapy to help young adults and their families repair ruptures in the original parent-child relationship. 

To learn more about how treatment can support young adults to strengthen their relationships with others and build self-acceptance and self-esteem, contact Newport Institute today.


Curr Opin Psychol. 2019 Feb; 25: 26­–30.

 Pers Soc Psychol Rev. 2014 Nov; 18(4): 326–48.

 World Psychiatry. 2012 Feb; 11(1): 11–15.

Mental Health / July 21, 2022

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