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Addiction as a Disease of Isolation

Attachment anxiety as a vulnerability factor to addiction

Attachment anxiety (anxiety over possible abandonment) may develop when attachment figures are inconsistent or unpredictable. Children with insecure attachments are significantly more likely to develop separation anxiety. They suffer frequently from persistent fears, stemming from childhood experiences of neglect or abuse. Insecurely attached people are susceptible to rejection, criticism, and disapproval. The effect works through dysfunctional attitudes about the self, such as “I am nothing if a person I love does not love me.” These distorted thinking patterns leave insecure people vulnerable to distress and a risk factor for self-destructive behaviors (for example, addiction and eating disorders).

Attachment is an inborn system that motivates an infant to seek proximity to a caregiver, especially in dangerous and uncertain situations. Early attachment difficulty and the experience of child neglect and abuse interfere with the maturation of the cognitive system. A sense of vulnerability keeps a person’s mind preoccupied with threats and the need for protection, and interferes with emotion regulation.

Over time, interactions with one’s caregivers are thought to shape people’s attachment styles: Anxious (for example, excessive demands for attention and care) or avoidant (for example, denial of attachment needs and independence). Anxious persons are attentive with respect to signs of attachment figure availability or unavailability. In contrast, avoidant style involves denying attachment needs, suppressing attachment-related thoughts and emotions. Avoidant individuals rely on distancing (emotional detachment) as a strategy for emotion regulation. These behaviors are natural reactions to the loss or unavailability of an attachment figure, but once established as habitual coping strategies, they contribute to psychological and social difficulties.

The mental habits acquired in childhood are later played out in adult relations. As adults, they tend to treat new partners the way they related to past attachment figures. Through the power of projection, individuals’ interpersonal interactions begin to conform to their internal expectations and experiences. Research shows that to the extent that individuals experience rejection during their formative years, they develop the anxious expectation that other will reject them. This reaction is known as rejection sensitivity (RS): a tendency to perceive even ambiguous events in interpersonal situations (for example, partner momentarily seems inattentive) as indicators of rejection that quickly trigger automatic defensive reactions (for example, anger, withdrawal). The negative reactions to rejection often produce the very rejection they most want to avoid (an unfortunate version of the self-fulfilling prophesy).

Since insecurely attached individuals doubt the availability and supports of others, they use other tactics to mitigate and control negative affect. One compensatory strategy is attachment to non-human targets (for example, objects, blankets in the case of children, intense religiosity, and materialism). In other words, they substitute relationships with objects for relationships with people. For example, teenagers who highly value materials success report having less nurturing mothers. They adopt materialistic values in order to cope with loneliness. Hoarding behavior has been linked to anxious attachment, in which people acquire a great deal of material possessions that overcrowd their lives and cause significant distress. However, such pursuit of extrinsic goals may further amplify their loneliness.

Anxious attachment is related to substance abuse. For example, insecure attachment among college students was associated both with alcohol consumption in order to cope with stress. Avoidant individuals, who attempt to detach themselves from psychological distress, can use alcohol and drugs as a means of avoiding painful emotions and self-awareness. Attachment anxiety also contributes to eating disorder and impulsive food intake. Eating and weight related concerns are defensive methods of directing attention to external problems and goals and to compensate for feelings of helplessness, insignificance, and vulnerability.

The anxiously attached person chooses the chemical shortcut to avoid pain and frustration, and becomes trapped there. The behavior becomes habitual because it can only relieve feelings of inadequacy temporarily because the deficit in the self remains and so the addict returns to feelings of emptiness. The addict lacks the internal resources to sustain feelings of self-approval and self-esteem.

In contrast, secure attachment liberates. According to the “broaden-and-build” theory, attachment security expands a person’s resilience resources for maintaining emotional stability in times of stress (Attachment security frees up cognitive resources, enabling people to focus on explorations and other important goals. This secure attachment makes it easier to commit to a chosen task (for example, academic or career), practice self-control, rather than being impulsive, jumping from one goal to another, and never completing a course of action.

In sum, we are driven innately from birth for close human contact. To the degree that we are deprived of this and do not possess the ability to accomplish this task, we are emotionally deficient and vulnerable to addiction. Anxiously attached individuals harbor doubts about the availability and responsiveness of others and they are particularly sensitive to the social pain of rejection. In contrast, secure attachment provides psychological resources for dealing with problems and adversity.

Attachment theory suggests that addicted and eating disorders individuals with attachment anxiety may benefit from a treatment approach that focuses on managing impulse control and increasing reflective thinking capacity and interpersonal connectedness.

More from Shahram Heshmat Ph.D.
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