Mental Health



Mandy Kloppers

Reactive attachment disorder

Reactive Attachment Disorder is the result of a child not forming a secure attachment to a primary parent or caregiver before the age of five. The lack of an early relationship where the child’s basic needs of food, shelter, warmth, and nurturing aren’t being met causes the child not to be able to form caring, loving relationships with others.

Reactive Attachment Disorder interferes with an adult’s ability to form close intimate relationships. trust issues and barriers up despite wanting closeness and love.

According to the American Psychiatric Association’s (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), reactive attachment disorder must be diagnosed between the developmental ages of nine months and five years, its effects are long-lasting, often extending into adulthood.

Reactive Attachment Disorder causes low self esteem a low sense of self efficacy.


Certain behaviors as well as inner emotional experiences indicate reactive attachment disorder in adults. These signs and symptoms include:

  • Detachment
  • Withdrawal from connections
  • Inability to develop and maintain significant relationships, romantic or otherwise
  • Inability to show affection
  • Resistance to giving and receiving love despite craving it
  • Control issues
  • Anger problems
  • Impulsivity
  • Sense of distrust
  • Inability to fully grasp emotions
  • Feelings of loneliness and emptiness
  • Lack of a sense of belonging


What does adult attachment look like?

Every day, you experience threats. Some are so small you barely notice them, like a glare from someone passing you on the highway or your sister angrily taking back the shirt you borrowed without asking. Other threats are more obvious, like parents getting divorced or a close friend moving away. The threat could even be a thought, a dream, or a memory that evokes certain feelings.

Threats are anything that ignites your need to be relational. It’s a momentary and subconscious need to gain safety by seeking the proximity of someone you care about. A small child will run to parents when they hear a loud, unexpected noise. As an adult, you might call a friend when you get bad news, or even when you get good news!

These threats instinctively drive us to connect, or attach, with others in our life.


Developmental Model-02

What you do with this urge to connect depends on your “internal working model”. Internal working models consist of:

  • How you see yourself (Am I worthy? Am I loved?)
  • How you see others (Are they available? Are they responsive?)
  • How you see the world around you (Is it safe? Is it fair?)

Believe it or not, you began developing your internal working model before you were even born. After birth, your early experience with your caregivers further shaped your internal working model. Did someone hold you when you cried? Were you fed when you were hungry? Were you soothed when you were distressed? Perhaps your caregivers did respond to you and did everything they could, but were still unable to soothe you. How your caregivers responded to you as an infant made a lifelong impact on how you view the world.

As you got older, you had other experiences that impacted your internal working model. You might have been bullied at school, experienced abuse, had frequent discord in your home, lived with an emotionally unstable parent, or lost a family member due to death or divorce. We have all had traumatic experiences. How you and those around you handle these experiences continues to shape your beliefs about the world around you.


When you experience a threat, your emotions are heightened. If Plan A works and you’re able to “seek and find”, you can usually work through the emotions with your attachment figure. However, if you “seek and don’t find” or “don’t seek”, prepare for an increase in emotional distress. Your body has a Plan B to neutralize the threat, crisis, or emotion in whatever way it has to.

When a baby cries and gets no response, she will start screaming, grabbing for someone, doing anything in her power to get her need met. Adults missing an attachment will also have a reaction. You might be able to keep yourself from crying and screaming, but instead, you might find yourself:

  • Self-harming
  • Making suicidal threats and attempts
  • Feeling depressed
  • Feeling anxious
  • Having angry confrontations
  • Misusing substances
  • Engaging in eating disorder behaviors
  • Or isolating, to name a few

If you’ve been in therapy before, you’ve probably learned that you need to learn better coping skills and emotion regulation to get through these symptoms. These can be helpful, especially in tough moments that just need to be survived. But to really heal, your true focus needs to be on internal working models.


In order to treat Reactive Attachment Disorder, it is necessary to ‘unlearn’ or deprogramme some of the early lessons you learned in life. In a way, it’s like learning to parent yourself again, to understand your triggers and learn new ways of relating to others and to threat.

Cognitive Behavioural Therapy is a form of talking therapy that can help. Dialectical Behavioural Therapy is useful too as it can help an individual learn how to deal with emotional distress and regulate their intense emotions.

Mandy X


Scroll to Top