Attachment disorder

Attachment disorder is a mental health condition, mostly diagnosed in young children. It is characterised by abnormal attachment behaviours and disrupted interactions between the child and their primary caregivers.

While the deep connection and lasting bond between a child and their parents or caregivers is usually established within the first six to twelve months after birth, instances of neglect, abuse or abandonment can lead to young children failing to develop these close connections.

If a child does not receive the expected love and care that would be usual in a typical family unit, then continued problems with behaviour, dealing with emotions, and trusting people can lead to the development of attachment disorder, which can negatively impact their childhood and even later life.

Attachment disorder can only be diagnosed in children, and features of the disorder develop within the first five years of life. The diagnosis is not usually made before the age of one year, and not usually diagnosed if the child has autism.

Those with attachment disorder show abnormal attachment behaviours: inhibited or emotionally withdrawn behaviour.

Some of the signs and symptoms that a child with attachment disorder may demonstrate include:

• Minimal seeking of comfort when distressed - the child may not seek out their primary caregivers when upset, and security-seeking behaviours towards any adult may be absent
• Difficulty expressing anger - attachment disorder can cause appropriate social cues to be distorted, with children struggling to control or express feelings of anger. This may involve the child throwing tantrums or being aggressive, with an inability to regulate their own emotions
• Lack of eye contact - this can indicate problems with attachment, although it is not diagnostic alone
• Seeks affection from strangers - one of the more vital signs of a child developing attachment disorder is their need to seek sometimes inappropriate levels of affection from strangers outside the family unit, indicating that they might not be getting the appropriate affection to develop attachment with their caregivers
• Disorganised attachment - a child may ignore a caregiver when they have been briefly separated and then reunited, or return to the caregiver but then become distressed or refuse to interact, or at other times, persistently cling to them
• Lack of affection towards parents or caregivers - another important sign that a child may be developing attachment disorder is an inability to show affection to their parents or caregivers, highlighting that the bond may either be insecure or not there at all
• Lack of response to affection when it is offered - even when comfort is offered, the response from the child may be minimal or completely absent

In the majority of cases, attachment disorder is typically caused by some form of neglect or abuse from a primary caregiver. Any situation where a child has been unable to form a bond, or has been separated from their parents, can lead to attachment issues.

Examples of children that are most at risk of attachment disorder include:

• Children who have been neglected or abused, physically or emotionally
• Children who have been placed and raised in care institutions
• Children who have moved between a series of different carers or adoptive parents
• Children who have been separated from their parents
• Children whose parents abuse drugs or alcohol

A child inherently desires love and affection, as well as trust and reliance on their caregivers to provide them with their basic needs. The negative impact of the environments and situations described above  can leave them feeling abandoned and unable to trust adults. This may lead them to fear that the world is an insecure place, without developing the understanding of the attachment they need to forge strong relationships in the future.

The purpose of attachment disorder treatment and therapy at Priory is to address and nurture the emotions that are needed for appropriate attachment. This is achieved by essentially ‘re-wiring’ the brain, and replacing negative thought processes which may be blocking the path to healthy attachment, with more positive and healthier alternatives.

It's important to obtain professional psychological support for attachment disorder as early as possible, because the longer this condition is left untreated, the greater likelihood that further behavioural problems will appear. That being said, it's never too late to seek treatment, as people can still respond to the right treatment at any stage of their life.

There are two distinct goals of attachment disorder treatment in children. These are:

• Making sure that the child and the rest of the family unit are operating safely, particularly if the child’s attachment issues have been caused by abuse or neglect
• Ensuring that treatment has encouraged the child to form a positive and strong connection with their parents, or with the appropriate caregiver

Therapy sessions at Priory are tailored to the specific needs and experiences of children with attachment disorder. Our dedicated attachment disorder services are led by specialist therapists, who possess a wealth of experience in dealing with young people’s mental health. We are able to provide day and outpatient care, offering flexible treatment that fits in around school hours and other commitments. 

Play therapy and family therapy are often used when treating children with attachment disorder, with both approaches aiming to strengthen the bond between the child and their parents. Therapy is also designed to help children to cope with the symptoms of attachment disorder by providing a familiar and comfortable setting, primed to help them to overcome their attachment difficulties.    

Play therapy - this is a useful and engaging form of therapy for children, particularly in young children and in those who are often withdrawn. Our dedicated therapists ensure that therapy, and emotional/social skills teaching, is fun and accessible, helping to hold children's attention spans for longer.   

Family therapy – while much depends on the specific circumstances and reasons behind a child’s attachment disorder, family therapy will often include parents or caregivers and the child, and works by reinforcing positive interaction through games and activities to help to form a more significant bond.

Social skills interventions - this can help the child develop appropriate social skills, and learn how to interact appropriately with others again.

Parents or caregivers may also benefit from seeking their own support, particularly if their difficulties have contributed towards the development of the attachment disorder. Through therapeutic sessions, they will be able to learn how to best support their child. Parenting a child with attachment disorder can be stressful, so it's key to ensure parents or caregivers have adequate support themselves.