Pathological Attachment: Characteristics Of Psychological Alterations
We understand attachment as the emotional bond that is created between a living being and another individual of the same species, for example a child and its mother, which has the purpose of seeking contact and communication to achieve secure support.
There are different types of attachment that depend to a greater extent on how the caregiver meets the child’s needs. Likewise, alterations in this bond can give rise to a pathological attachment, which is classified into two different types. On the one hand, reactive attachment disorder, characterized by showing inhibited, depressive and withdrawn behavior; and on the other hand, the disorder of uninhibited social relationships, where excessively familiar behavior is observed with unknown adults.
In this article We will see what the concept of pathological attachment is explaining the different types of attachment that exist and what disorders are related to a pathological bond.
Attachment, or attachment in English, is the emotional bond that appears between a person or animal and another living being of the same species. The main objective of this bond is to provide security to the child, who seeks physical contact and communicate with her attachment figure. This process begins at 12 months of age and persists throughout life.
One of the main representatives of the study of attachment was John Bowlby, who pointed out that the child is especially sensitive to separation from the security figure between 6 months and 2 years, which can generate different physiological and psychological effects if it occurs. . This greater vulnerability coincides with the period of establishment of attachment that goes from 7 to 24 months, the bond intensifies and greater discomfort appears in the face of separation and anxiety in the face of strangers.
Shortly after separation, the child may show stress, agitation, and depressive symptoms. First there is a phase of protest at the departure, then there is a phase of ambivalence towards the new caregivers and towards the old one if he or she returns and finally the phase of acceptance of the new bond. In the long term, when the lack of attachment persists, the effects that a bad separation can cause are more serious, such as intellectual deficit, problems in social interactions or even death.
Another relevant author in the study of attachment was Mary Ainsworth, who carried out an experiment known as a strange situation, which poses different situations such as the presence of a stranger, separation from the mother or the return of the attachment figure, this last situation being which Ainsworh gives special importance to determine what type of attachment each child presents.
In the same way also The sensitivity that the mother shows to the baby’s needs will be essential, thus providing security to explore. With the results obtained, he proposed three basic types of attachment, present in all cultures: the secure one, which is the most prevalent, the child complains when the mother leaves but is comforted when she returns and explores when she is present.
On the other hand, the two insecure ones are: the avoidant or avoidant one, where there is no perceived discomfort in the face of separation, the child ignores the mother when she returns and is very sociable with the stranger; and the ambivalent or resistant one, in which the child shows great discomfort at the separation and cannot be consoled when the mother returns, resists it.
Subsequently, he signed up another type known as disorganized or disoriented which consists of a mixture of the two insecure ones, presenting incoherent and contradictory behaviors, is the least safe.
Attachment disorders and pathological attachment
Now that we know how attachment is defined and what types of attachment exist, it will be easier to understand the disorders that can appear if there are alterations in the bond. As we already pointed out, Bowlby considers the first years essential for the correct establishment of attachment, in particular, social neglect, which refers to a lack of caregiver during childhood, is decisive for the development and diagnosis of pathological attachment.
The fifth edition of the Diagnostic Manual of the American Psychiatric Association classifies attachment disorders within the chapter of disorders related to trauma and stressors. It also divides pathological grief into two diagnostic categories: reactive attachment disorder, which stands out for presenting internal symptoms such as depression or withdrawal, and disinhibited social relationship disorder, characterized by showing externalized symptoms, with greater disinhibition.
In reactive attachment disorder a withdrawn and inhibited behavior is shown with respect to the environment and even with respect to the attachment figure, accompanied by two main symptoms. Thus, when the child feels stressed or distressed, he does not seek or ask for comfort, and if he is comforted or reassured, the child does not show a response.
Also social and emotional alteration is observed which is expressed by two or more of the following symptoms: minimal emotional and social response towards others, low positive affect or feeling of sadness, irritability, shyness that appears even in front of the support figure.
Another criterion to meet is the presence of a pathological upbringing due to one of the following characteristics: the adult does not meet or ignores the child’s basic emotional needs; dismissal of the child’s basic physical needs or repeated changes in the support figure, which makes it difficult for the proper bond to form.
The prevalence of reactive attachment disorder is unknown, but it is suspected to be rare, since in situations where the child has not received adequate care it only occurs in less than 10% of the subjects. It is believed that if the child with this disorder does not receive adequate intervention, the symptoms tend to persist.
2. Disorder of uninhibited social relationship
The disinhibited social relationship disorder is another alteration linked to pathological attachment, this is characterized by a pattern of behavior where the child interacts with strange adults and is excessively sociable plus two or more of the following symptoms: does not show reluctance to approach strangers, shows excessively familiar behavior with strangers, does not check or value the opinion of his caregiver when approaching the stranger, or goes with an unknown adult without hesitation.
The behaviors observed are uninhibited, but they are not only due to impulsivity. At least one of the alterations in the way of care must be present: basic emotional needs are not covered, the child is not stimulated or consoled; repeated changes of caregivers; or upbringing in unusual places that make bond formation difficult, such as institutions where the number of caregivers is insufficient. Alterations in uninhibited behavior are due to impairments in the formation of the bond.
It is also noted that the child must be at least 9 months old, so that the development of attachment has begun. It can be specified whether it is persistent if the symptoms are shown for more than 12 months and the current severity of the disorder is severe when all the symptoms are present with a high level of involvement.
Unnormal social behavior is typical considering the subject’s culture, where the child continually tries to attract attention and both emotional and behavioral alterations may occur, with difficulties relating to peers.
Although we can make the diagnosis of disinhibited social relationship disorder and attention deficit hyperactivity disorder (ADHD) together, it is necessary to differentiate them. In the case of disinhibited disorder, despite being able to show impulsive behaviors, we will not observe attention deficit or hyperactivity.
As occurred in the other pathological attachment disorder, the prevalence of disinhibited disorder is unknown, although it is believed to be rare, Even in situations with inappropriate parenting styles, only around 20% of the subjects show this alteration.
Regarding the course of the psychological alteration, it remains stable with some variations depending on the age of the subject. For example, when he is two years old, he shows non-selective bonding behavior, that is, without differentiating between known and unknown subjects; At 4 years old they seek affection indiscriminately; During middle childhood they require constant affection and in adolescence they express uninhibited behavior and interpersonal conflicts. This effect has not been observed in adults.
