Adult Separation Anxiety Disorder and Attachment Style

Last week, when his wife left home for a two-week cruise with her best friend, Robert Sollars stocked up on hamburger meat and peanut butter, then settled into a weekend of football on cable TV. And he cried.”

So begins “When It Never Gets Easier to Say Goodbye” by Dr. Elizabeth Bernstein.

Mr. Sollars, 51 years old, owns a workplace security consulting firm in Mesa, Arizona. He hates being away from his wife, even when she is just going to work. When she is away for a longer time he feels nauseated and finds it hard to concentrate. He can’t sleep and worries that she will have an auto accident, get sick or hurt, or will find someone else. He says, “I firmly believe that my worry is based in fantasy land. But I am still deathly afraid of losing the woman I love.”

What’s going on here? Sollars certainly is not a wimp. Is he just being immature, clingy or over emotional? Or is he suffering from Adult Separation Anxiety Disorder and a dysfunctional attachment style?

What is Adult Separation Anxiety Disorder?

Extreme anxiety, fear and avoidance of being alone

The possibility that adults might experience Separation Anxiety Disorder was not recognized in the psychiatric community until relatively recently. It was first researched by Vijaya Manicavasagar of the Psychiatry Research and Teaching Unit, Liverpool Hospital, New South Wales, Australia. He said in 1997 that:{{1}}

[A]dults may experience … wide-ranging separation anxiety symptoms, such as extreme anxiety and fear, when separated from major attachment figures; avoidance of being alone; and fears that harm will befall those close to them. … Separation anxiety disorder may be a neglected diagnosis in adulthood.

The current “bible” of psychiatry, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) doesn’t mention that an adult can experience separation anxiety.{{2}} Fortunately, the new DSM-5 – to be released in May, 2013 – specifically includes adults in its section on Separation Anxiety Disorder.{{3}}

What is attachment style?

Attachment style is a learned behavior that determines how we relate to other people, particularly in intimate relationships.

45% have a potentially dysfunctional attachment style

Dr. Hal S. Shorey, psychologist and assistant professor for the Institute for Graduate Clinical Psychology at Widener University, says that there are three attachment-style types: secure, anxious and avoidant. Those with a secure attachment style make up about 55% of the population. The other 45% have a potentially dysfunctional attachment style: anxious, avoidant or a combination.{{4}}

People with a secure attachment style likely were reared by a consistently caring and responsive mother or parental figure. They typically are warm, loving, and comfortable with intimacy. Anxious people who worry about whether their partner loves them often had parents who were not or were not consistently nurturing. Avoidant people, also called “dismissive,” attempt to minimize closeness and often had parents who didn’t tolerate neediness or insecurities.{{5}}

We learn attachment styles in childhood

Attachment styles are established in childhood by the relationship a child has with its parent(s) or caregiver. Dr. Benjamin Le, associate professor of psychology at Haverford College, states that:{{6}}

The attachment style is ingrained in the child and can be carried on to romantic partners. If the parent was not consistently nurturing or there for the child, the child will have expectations that their partner can’t be relied upon. Studies show people will choose dissatisfaction if it’s consistent with their expectations, versus things that make them change the way they see the world.

The connection between ASAD and a dysfunctional attachment style

Author Elizabeth Bernstein, who is a clinical psychiatrist in Miami, believes that Mr. Sollars is experiencing Adult Separation Anxiety Disorder (ASAD). She holds that ASAD can be aggravated by a dysfunctional attachment style. She states that,{{7}}

The way we cope with separation is determined by something psychologists call our attachment system… Although it’s partly genetic, much of our lifelong “attachment style” is determined by how as young children we learned to relate to our parents.

Adults with an anxious or avoidant attachment style are often troubled by ASAD. And because anxious people and avoidant people tend to attract each other, the connection between a dysfunctional attachment style and ASAD is strengthened. Dr. Benjamin Le, says that:{{8}}

It’s actually quite common to have a couple where one person is avoidant and the other is anxious and very worried and jealous. Those relationships tend not to have a lot of satisfaction, but they’re tremendously stable and common.

ASAD coping skills

So if you have been diagnosed with ASAD or recognize those symptoms in yourself, what can you do? Dr. Bernstein says that there are several basic coping skills that are effective:{{9}}

• First and foremost, acknowledge that you have symptoms of ASAD and/or a problem attachment style and that you will have to deal with it yourself. Your partner cannot fix it for you.
• Realize that ASAD and your attachment style are hardwired into you. They were set in childhood and are a part of your psychological makeup. But that doesn’t mean that your situation is hopeless or cannot be improved.
• Recognize that your fears and anxieties are not real, but are just fantasies of the imagination.
• Accept that you have to regulate your own emotions, and not drive your partner crazy.
• Keep reminding yourself that your partner is not abandoning you, and has their own attachment style and way of relating to you. Don’t think: “My husband is going on a business trip and I will be alone.” Think: “I have a wonderful husband. I will have time to catch up on things and plan a lovely reunion.”

What can you do when you are alone?

That’s all well and good, but what can you do with all that time alone when your partner goes on a week-long business trip? Here Bernstein has some advice as well:{{10}}

• Reframe your negative thoughts as positive. Instead of letting your imagination run wild with negative fantasies, use it to think of positive things. Remember positive stories of your relationship. Think of the opportunities you have for your “alone” time. Imagine what a great reunion you will have.
• Keep busy with the things you like. Plan to be with friends, get in some physical exercise or enjoy a favorite hobby. Dr. Hal Shorey advises that “If you can keep yourself from thinking about what is scaring you, your anxiety will go down and you won’t behave in a way that will make you feel worse.”{{11}}
• Recognize that your emotions are overly sensitized and may pick up false positives. Your partner hasn’t forgotten you – they just may be busy.
• Stop asking for reassurance. It may backfire and get the very response you fear the most: rejection.
• Keep a journal. Writing is a good way to express and defuse your thoughts and feelings without damaging your relationship.

Separation anxiety that is under control can be good thing. Research shows that people who miss their partners when apart are more committed to the relationship, work harder to take care of it, and avoid damaging behavior such as cheating. Dr. Benjamin Le, leader of that research, says that, “Missing prompts you to maintain your social connection.”{{12}}

Of course, if your anxiety is out of control and interfering with your life, it’s time to seek professional help. And that does not always mean medication. Talk therapy is proven to be of immense help in calming anxieties and a runaway imagination.

In summary…

A person’s attachment style is learned in childhood and carries over into adulthood. It can be a major factor in Adult Separation Anxiety Disorder if dysfunctional. There are many general and specific coping skills and activities that can help to quell your anxiety and fear and enhance your relationship.

And the most important thing: You are not doomed to a life of misery. There is hope. You can learn to transform your negative thoughts into positive thoughts that can strengthen your relationship. It will take sustained effort, but it’s worth it.

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DISCLAIMER:The contents of this post are for informational purposes only and in no way are intended as a substitute for treatment by a mental health care professional. While every effort has been made to verify assertions and statements by the sources footnoted in this post, the author is not a mental health professional and does not accept responsibility for the veracity of any source.

Last updated: September 30, 2012

[[1]]Manicavasagar, Vijaya; Silove, Derrick. (1997, April). Is there an adult form of separation anxiety disorder? A brief clinical report. Retrieved September 30, 2012 from http://www.ncbi.nlm.nih.gov/pubmed/9140640 [[1]]

[[2]]American Psychiatric Association. DSM-IV: Diagnostic criteria for 309.21 Separation Anxiety Disorder. Retrieved September 30, 2012 from http://behavenet.com/separation-anxiety-disorder [[2]]

[[3]]American Psychiatric Association. “E 00 Separation Anxiety Disorder.” DSM-5 Development: Proposed Revisions, Anxiety Disorders. Retrieved September 30, 2012 from http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=118 [[3]]

[[4]]Shorey, Hal S. The Interactions of Hope and Attachment Styles in a Social-cognitive-motivational Model of Depressive Vulnerability. Page 7ff. Retrieved September 30, 2012 from http://books.google.com/books?id=-pf7CVI2v50C&pg=PA7&lpg=PA5&dq=Hal+Shorey+attachment+styles&source=bl&ots=8buC1O8UGe&sig=22vtJb9amGmIuHHwmXK43uqtcmI&hl=en&sa=X&ei=ZLNoUK7FEIec8gTwxIGABQ&ved=0CE8Q6AEwCA#v=onepage&q=Hal%20Shorey%20attachment%20styles&f=false [[4]]

[[5]]Bernstein, Elizabeth. “When It Never Gets Easier to Say Goodbye”. Wall Street Journal. September 18, 2012. Retrieved September 30, 2012 from http://online.wsj.com/article/SB10000872396390443995604578002352537833908.html?mod=WSJ_LifeStyle_Lifestyle_5#articleTabs%3Darticle. This interesting and informative article discusses the causes of Adult Separation Disorder, its relationship to attachment styles, helpful tips, and has both video and audio supplements. [[5]]

[[6]]Donahue, Wendy. “Beyond chemistry: Science of relationships”. Chicago Tribune. March 27, 2012. Retrieved September 30, 2012 from http://www.chicagotribune.com/features/tribu/sc-fam-0327-relationship-science-20120327,0,3245786.story [[6]]

[[7]]Bernstein, 2012. [[7]]

[[8]]Donahue, 2012. [[8]]

[[9]]Bernstein, 2012. [[9]]
[[10]]Bernstein, 2012. [[10]]
[[11]]Bernstein, 2012. [[11]]
[[12]]Bernstein, 2012. [[12]]