Attachment difficulties

From birth, we develop a close bond with our main caregivers (usually our parents). The attachment a child forms to its carers helps them to learn and develop in a trusting environment, and even at such a young age, to know their parents will be there for them.

For some children, however, a safe and secure attachment bond is not formed. There are a multitude of reasons for this, but typically there is a situation where the caregiver is unable to provide the care and attention required to form a close attachment. Whatever the cause, the effect of not forming this secure bond can lead to attachment difficulties which can vary in severity and the way they present. A child may have been abused, neglected or separated from their parents for other reasons such as being born prematurely or parent/child ill health in infancy.

There may be other reasons why parents were unable to provide the security the baby needed to develop their attachment such as:

  • Postnatal depression
  • Not feeling secure (money/ housing worries)
  • One or both parents in a violent or frightening relationship
  • Feeling alone and unsupported
  • Unhappy memories about their own childhood.

Find out more about attachment difficulties in the dropdown boxes below.

Usually babies develop close bonds to their caregivers by the age of nine months. They have learnt to rely on their parents to provide food, shelter and protection. This gives children the confidence to try new things, learn and cope with new situations. The baby learns that the world is a safe place where they will be looked after. While this is happening the baby’s brain is making connections between nerve cells which can influence how the brain will work though childhood and beyond.

Babies at this age (between six and nine months) tend to go through a ‘clingy’ stage and don’t like being separated from their parents. This is because of the close bond they’ve formed and because they associate their parents with safety.

These strong and ‘secure’ attachments are not always made, however. In these cases, the security and safety element associated with parents is lost. This can make it difficult for the child to deal with new experiences and form relationships.

Not forming this bond can lead to a set of behavioural and emotional difficulties which can affect development and result in less desirable outcomes within relationships and educational settings. Attachment difficulties work on a spectrum. For some the effects are minimal, for others, the effects are emotionally traumatic.

Like many mental health concerns, attachment problems fall on a spectrum. Some are mild cases that can be more easily addressed, while others may become an attachment disorder.

Recognising the signs and symptoms of insecure attachment can help you take action quicker. Although it’s never too late to seek help, the earlier difficulties are addressed, the less likely it is to develop into attachment disorder.

Some of the signs your child may have an attachment problem include:

Problems expressing anger - Children with attachment problems may struggle to control and express their anger. They may express it through tantrums and acting out, or use passive aggressive behaviour. They can also hide anger under socially acceptable behaviours, like hugging too tightly or being over friendly with strangers.

Poor eye contact - Difficulty holding eye contact can signify a number of things with children. If seen along with other associated symptoms, it could be a sign that the child is struggling with attachment.

A need for control - Often those with attachment difficulties feel a strong desire to be in control. They may go to great lengths to feel in control of situations and can become disobedient and argumentative.

Problems with self-monitoring - Self-monitoring is when we observe our own behaviour (either consciously or subconsciously) and recognise if behaviours need to change. For those with attachment disorder, this can become difficult.

Difficulty showing affection - When the attachment bond to parents is insecure (or not there at all) children often show little to no affection towards their parents, or fluctuate between being very demanding of attention and affection to rejecting it completely.

Seeks affection from strangers - If a child with attachment problem is/was unable to get ‘enough’ affection from their parents, they may seek it elsewhere. They may, therefore, act inappropriately affectionate towards strangers.

An underdeveloped conscience - Those with attachment problems can act as if they don’t have a conscience, failing to show remorse or regret after behaving badly.

If the child is very young, you may want to keep an eye out for the following behaviours:

  • Not turning towards their parent/caregiver when scared or upset
  • Is uncomfortable being comforted or touched
  • Shows little to no affection towards their parents/caregivers
  • Doesn’t respond or smile when interacting with adults
  • Doesn’t get upset in situations where you would expect a child to be upset
  • Seems withdrawn and avoids interacting with adults and other children
  • Appears anxious and fearful
  • Shows aggressive behaviour towards others.

Parenting a child with attachment disorder is a challenging experience. Of course, providing safety for the child and the rest of the family will be a priority. Families will need ongoing support and education to help overcome challenges with attachment.

Before seeking further support and advice, it can be useful to do some preparation. Noting down a list of the following can help:

  • Behavioural problems and/or emotional issues you’ve seen
  • Personal history, for example, details relating to the pregnancy, birth and early stages of the child’s life
  • Medical history, any medication, or significant injuries/illnesses
  • Any major life changes/stresses your family has gone through.

Attachment difficulties typically develop by the age of five. Those at high risk of developing difficulties include:

  • Children who have suffered abuse
  • Children who have been neglected
  • Children in the care system
  • Children who have been separated from caregivers
  • Children who have been exposed to domestic violence
  • Children who have exercised a chaotic and unstable early home environment.

These are examples and generally, any situation where caregiver and child are unable to form a bond can lead to attachment difficulties.

If you think your child might have attachment difficulties, there are professionals who can help.

  • Health Visitors
  • CAMHS (Child and Adolescent Mental Health Services)
  • Community Paediatricians
  • Family Support Workers

If attachment issues are left untreated, they can become more entrenched and cause further behavioural problems as the child grows older. For this reason, the earlier attachment concerns are addressed, the better. Having said this, help can be sought at any stage.

If you're worried about attachment issues in your child, contact your GP, who can help to refer you to the right service.

Within CAMHS, attachment based therapies often used include Theraplay; Video Interaction Guidance (VIG); Dyadic Developmental Psychotherapy (DDP); Family Therapy; and Attachment-Focused Parent Groups.

Depending on the situation, therapy aims to strengthen the bond between the child and caregiver while helping the child develop ways to cope with symptoms of attachment difficulties.

Parents play a significant role in the input provided and are a crucial aspect of helping a child with their attachment difficulties.