Attachment Theory and Grief

Co-authored with Dr. Phyllis Kosminsky.

What do we lose when we lose someone we love?

The answer is as varied as love itself. When someone we love and whose presence we relied upon dies, our world is significantly altered. Grief has been described as the loss of the assumptive world, a violation of the conscious and unconscious assumptions, cognitions, and beliefs that guide our everyday life. The discrepancy between the reality we once knew and the present reality where our person is gone is disorienting, painful, and anxiety-provoking.

Grief not only challenges our foundational ideas of reality, but blows a hole in our sense of identity, our feeling of belonging, and our sense of safety. Taken together, these profound emotional, physiological, and psycho-spiritual losses can, and often do, become the ingredients of a gnawing fear:

• Fear of the pain.
• Fear of the future.
• Fear of our ability and capacity to face the uncertain without the person we have lost.

Source: Photo by Jordan Whitt on Unsplash

Attachment, Separation Distress, and Grief

John Bowlby and Mary Ainsworth proposed that our need to remain connected to caregivers is a survival-oriented instinct regulated by the attachment system. Loss of connection with the caregiver (i.e., the attachment figure), can prompt separation and attachment-related distress. Expressions of distress are meant to signal, and restore contact with, the caregiver.

Children who are anxiously attached may respond to separation with excessive distress, weeping, and hyperactivation. Avoidantly attached children may show disinterest, down regulation of emotion and avoidance of the caregiver.

In contrast, securely attached children have internalized the assumption that an absent primary caregiver will return and not be absent forever. Children with secure attachments can move flexibly between wanting to be close with primary caregivers while also wanting to play and explore the world.

When someone in our life dies, we lose not only a person but an important attachment figure. In childhood, the possibility of reunion from a state of separation is possible, whereas in adult bereavement, physical reunion is not possible. Thus, early attachment instincts may come to the surface in the experience of grief as we experience profound deprivation and separation from the person we loved.

What is healthy grief?

Healthy grief essentially means being able to effectively swing back and forth between different psychological experiences. We may go from crying, yearning, and deep diving into a loss, while at other times being able to tend to new responsibilities, develop new identities, and find some momentary relief from our grief. In healthy expressions of grief, people can navigate the pain of loss while staying meaningfully connected to self and others.

How do anxious, avoidant, and disorganized patterns of attachment in early childhood contribute to issues with grief later in life?

Insecure attachment patterns contribute to specific types of disturbances in one’s ability to oscillate in grief. Difficulty around recognizing, acknowledging, and managing or sharing emotions in grief is indicative of early attachment wounding. What brings many people to grief therapy is the underdeveloped ability to re-regulate in an unfamiliar world, and a lack of flexibility in grief.

Anxiously attached individuals report higher levels of emotional, depressive, and grief symptoms due to their struggles with independence. In contrast, avoidantly attached individuals may be dismissive, downplay grief experiences, and be avoidant towards emotion or vulnerability in a time of loss. Individuals with a disorganized attachment may employ the previously mentioned strategies chaotically, while also struggling with conflicting thoughts towards the person who died and may frequently dissociate or experience profound shame.

In all cases, insecurely attached people have difficulty tolerating emotions and often find themselves stuck in a specific patterned response. No one is spared the heartbreaking nature of grief, but these individuals must go through bereavement while navigating the additional pain of having a mind in conflict with an additional layer of relational disconnection. These people are wonderful candidates for attachment-informed grief therapy.

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What is grief therapy from an attachment perspective?

Grief therapy is a concentrated form of empathically attuned and skillfully applied social support in which the therapist helps the bereaved person reregulate after a significant loss by serving as a transitional attachment figure. Successful grief therapy encourages a state of flexibility in grief, where individuals can authentically re-engage in life without relinquishing their attachment to the deceased.

What does attachment theory teach us about grief?

We know that our relationships with others form a kind of hierarchy, or pyramid, metaphorically speaking. At the top of the hierarchy are the people on whom we most depend, and whose loss is most impactful. This principle – that the severity and persistence of a person’s grief is influenced, and to some extent mirrors, their style of relating to others, particularly their inclination, or disinclination, to form close relationships, is a cornerstone of attachment theory.

Given this association between attachment and loss it is not surprising to find that clinicians who encounter bereaved clients have come to regard attachment theory as a source of valuable insight and direction in this work, a guide to developing interventions that are specifically designed to be most acceptable, and most helpful, to people based on their having a secure, or insecure orientation to attachment. In Attachment Informed Grief Therapy: The Clinician’s Guide to Foundations and Applications (Kosminsky & Jordan, 2024, 2^nd edition) the authors elaborate on this, and provide specific clinical guidelines for implementing an attachment-informed approach.

Kosminsky and Jordan emphasize that regardless of one’s past childhood experiences, developing secure relationships with self and others is possible later in life, even in a time of devastating grief. Secure attachment in grief allows us to experience psychological flexibility, emotional regulation, and helps us better navigate the natural ups or downs that come with grief. The attachment-informed clinician develops a secure bond with the griever, and in so doing provides the relational scaffolding that can help a person move through painful loss and reinvest in life.

This article was co-authored by Mark Shelvock and Dr. Phyllis Kosminsky. Dr. Kosminsky is a clinical social worker who has been practicing for over 30 years and has numerous publications in the clinical literature. Both Mark and Phyllis specialize in providing attachment-informed grief and trauma-responsive psychotherapy.