Addiction as an Attachment Disorder

Addictions2 comments

In the world of addiction treatment, some therapists are focused on stopping a particular behavior yet neglect to get to an addict’s core issues which I believe are related to themes of attachment, emotional intimacy, bonding, and relationships.

In my work in the sex addiction field, while time must be spent to educate clients on what they need to do to quit sexually “acting out”, another vital component is helping them understand and experience a healthy emotional relationship where they develop the skills necessary to be comfortable sharing their inner worlds with others-starting first with the therapist.

I believe more clinicians need to move clients past the goal of “individuation” or “independence” towards that of interdependency.  In other words, we need to give clients the opportunity to learn how to trust and depend on others while also giving of themselves to those around them.  Addicts want to stay emotionally autonomous, isolated, or independent from their partners and those around them.

In Attachment theory, attachment is measured on two-axis, one tmeasures anxiety while the other measures avoidance (emotional).  The diagram below best illustrates the general patterns of how one attaches in relationships to those close to them.

As you can see, those who are in the secure quadrant are individuals who score low on anxiety and the avoidance scale.  They are comfortable being emotionally intimate with others and feeling secure in having others depend on them and also in depending on others.

The other three quadrants can pose attachment problems as they run the range of obsessively worrying about a partner’s love for them (Pre-Occupied attachment) or on the other end, dismissing the need for emotional comfort or intimacy (Dismissing-Avoidant attachment).  The Fearful-Avoidant is one who struggles with ambivalent feelings of wanting intimacy yet has extremely high anxiety and high avoidant tendencies when it comes to intimate relationships (i.e. intimate meaning emotionally close with either gender).

In the book, Addiction as an Attachment Disorder, Dr. Philip Flores expands the theory and its impact on addiction:

“Talking intimately with another about themselves is a developmental function that not all adults achieve.  Communication about one’s feelings in relation to another person             is also a skill that many alcoholics and addicts do not possess.  Knowing oneself and sharing that knowledge with another requires the capacity of putting one’s feelings into words, a developmental task that requires the acquisition of inner speech or what is referred to as self-narrative”.

In what’s known as the Experiences in Close Relationships (ECR) Inventory, the questionnaire sheds light on one’s comfort or discomfort with a romantic partner.  Below is a sample of statements that can guide your own understanding of emotional intimacy (Keep in mind clients are asked to rate themselves on a scale of 1 to 7 in terms of how strongly they agree with the following statements).

If you would to see where you score on this, please go to the following link:

___ 1. I prefer not to show a partner how I feel deep down.

___ 2. I worry about being abandoned.

___ 3. I am very comfortable being close to romantic partners.

___ 4. I worry a lot about my relationships.

___ 5. Just when my partner starts to get close to me I find myself pulling away.

___ 6. I worry that romantic partners won’t care about me as much as I care about them.

___ 7. I get uncomfortable when a romantic partner wants to be very close.

___ 8. I worry a fair amount about losing my partner.

___ 9. I don’t feel comfortable opening up to romantic partners.

___ 10. I often wish that my partner’s feelings for me were as strong as my feelings for him/her.

___ 11. I want to get close to my partner, but I keep pulling back.

___ 12. I often want to merge completely with romantic partners, and this sometimes scares them away.

___ 13. I am nervous when partners get too close to me.

___ 14. I worry about being alone.

___ 15. I feel comfortable sharing my private thoughts and feelings with my partner.

___ 16. My desire to be very close sometimes scares people away.

___ 17. I try to avoid getting too close to my partner.

___ 18. I need a lot of reassurance that I am loved by my partner.

___ 19. I find it relatively easy to get close to my partner.

___ 20. Sometimes I feel that I force my partners to show more feeling, more commitment.

___ 21. I find it difficult to allow myself to depend on romantic partners.

___ 22. I do not often worry about being abandoned.

___ 23. I prefer not to be too close to romantic partners.

___ 24. If I can’t get my partner to show interest in me, I get upset or angry.

___ 25. I tell my partner just about everything.

___ 26. I find that my partner(s) don’t want to get as close as I would like.

___ 27. I usually discuss my problems and concerns with my partner.

___ 28. When I’m not involved in a relationship, I feel somewhat anxious and insecure.

___ 29. I feel comfortable depending on romantic partners.

___ 30. I get frustrated when my partner is not around as much as I would like.

___ 31. I don’t mind asking romantic partners for comfort, advice, or help.

___ 32. I get frustrated if romantic partners are not available when I need them.

___ 33. It helps to turn to my romantic partner in times of need.

___ 34. When romantic partners disapprove of me, I feel really bad about myself.

___ 35. I turn to my partner for many things, including comfort and reassurance.

___ 36. I resent it when my partner spends time away from me.

When it comes to addiction, many addicts worry about abandonment and fear the loss of a loved one and have difficulty sharing, not only their addictive behaviors but also their everyday concerns, thoughts, and feelings.  Some are on the other extreme, having lost any sense of attachment, they have no concern with losing their partners but have high anxiety when it comes to being close and interdependent with their spouses.

Part of the hard work of therapy is to restore the rupture in healthy attachment whereby they can then transition back to the “real world” with their spouses and friends and learn to develop a richer, fuller, and more intimate relationship with the ones they most dearly love.

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