Signs You Have an Anxious-Preoccupied Attachment Style

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Anxious preoccupied attachment, also sometimes known simply as preoccupied attachment or anxious attachment, manifests as high anxiety about the relationships and connections in our lives.

Attachment styles refer to the emotions and behaviors an individual has around the significant relationships in their lives. We form an attachment style as young children, though these styles can change over time in response to life experiences, trauma, and treatment.

Research surrounding attachment styles is largely contributed to the work of Dr. Mary Ainsworth, a developmental psychologist who studied how children’s attachment impacts their response to an unfamiliar situation.

If your attachment style is anxious-preoccupied, you might have significant difficulty trusting people and have a strong fear of being rejected. Although you may desire close, intimate relationships, your anxiety about being abandoned can interfere with your ability to form these connections.

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Signs of Anxious Preoccupied Attachment

Individuals with an anxious preoccupied attachment style tend to have low self-esteem and a negative view of themselves. They tend to see others as superior to them, and as such, they may tend to be reliant and dependent in relationships.

It is important to remember that, if you have a preoccupied attachment style, this does not mean that you are inferior to others. Instead, it means that you feel that you are inferior.

If you have an anxious preoccupied attachment style, you might have a strong need for close relationships, fear of abandonment and rejection, and difficulty trusting others. You might be overly in tune with others’ emotions and behaviors, and you may tend to jump to conclusions about your partner’s mood due to these fears.

If a child has an anxious preoccupied attachment style, they will likely cling to their parent or caregiver and can exhibit symptoms of separation anxiety. They may become very upset when the parent leaves them with another caretaker and might express fear that the parent will not return. Upon the parent’s return, they may immediately run to the parent for comfort.

Identifying Anxious Preoccupied Attachment

Although anxious preoccupied attachment is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it can manifest as a symptom of some diagnoses, including:

  • Borderline personality disorder (BPD): Individuals with BPD experience “frantic efforts to avoid real or imagined abandonment,“ which is a component of the anxious preoccupied attachment style.
  • Social anxiety disorder (social phobia): People diagnosed with social anxiety disorder have intense anxiety that others are judging them or think negatively of them and may experience preoccupied attachment.
  • Substance use disorders (SUDs): Research has shown that some individuals with SUDs can display a preoccupied attachment style.

Although attachment style does not definitively predict that an individual will develop a specific diagnosis, identifying your attachment style can help inform how you approach relationships and can aid in developing an appropriate treatment plan.

Causes of Anxious Preoccupied Attachment

Anxious preoccupied attachment is often influenced by a number of different factors. Some causes that can play a role include:


As with most aspects of our mental health, attachment styles can be influenced by genetics. However, early childhood experiences and interactions with caregivers play a major role in how attachment styles develop.

Stress and Trauma

Stressful or traumatic events can cause a child to develop an anxious preoccupied attachment style. If an infant experiences inconsistent responses from the caregiver, they will develop uncertainty and anxiety about whether their needs will be met.

If a parent is available and nurturing at times but unavailable at other times, this can bring about feelings of insecurity in the child because the child cannot understand or predict the parent’s behavior.

Parenting Behaviors

A child can also develop a preoccupied attachment style if parents are overprotective. The child can pick up on the parent’s anxiety and can become fearful that they are unsafe and need strong protection to avoid being harmed.

If an infant experiences inconsistent responses from the caregiver, they will develop uncertainty and anxiety about whether their needs will be met. If a parent is available and nurturing at times but unavailable at other times, this can bring about feelings of insecurity in the child because the child cannot understand or predict the parent’s behavior.

Adult Relationships

In adulthood, a person can develop traits of this attachment style if they experience this inconsistency from a romantic partner or friend. Partners who display inconsistent affection or emotionally abusive behaviors can cause insecurity and anxiety around attachment.

For instance, if you are consistently told that you are unintelligent, incompetent, and incapable by your partner, you may start to believe these things about yourself. These beliefs can cause you to cling to your partner and rely on them for protection and care that you do not feel you can provide yourself.

Treatment for Preoccupied Attachment Style

People with an anxious preoccupied attachment style might struggle with relationships, emotions, and mental health as a result of their attachment style. However, research has shown that our attachment style can change throughout our lives in response to experiences and treatment.

If an individual with this attachment style has a diagnosable mental health condition, they can benefit from therapy services and other evidence-based treatments for that diagnosis. Attachment therapies can specifically address maladaptive attachment styles.

Since attachment styles impact relationships, someone with a preoccupied attachment style who is in a long-term relationship can benefit from couples therapy to work on identifying their emotions and communicating with their partner in healthy ways.

Children and teens can benefit from family therapy to create a healthier attachment to caregivers and other family members. Parent-child interaction therapy is a specific type of family therapy that promotes healthy attachment.


Research has shown that our attachment style can change throughout our lives in response to experiences and treatment.

Coping With a Anxious Preoccupied Attachment

Identifying that you have a preoccupied attachment style is an important step in understanding your behaviors and emotions in your relationships. You can then use this knowledge to seek appropriate treatment and make changes.

  • Learn healthy communication skills and share your needs with your loved ones in a healthy way, and practice using your voice when you are struggling.
  • Develop friendships and connections with multiple people so that you have a strong support system and have multiple people you can turn to when you are having difficulties.
  • Engage in self-esteem building to become more confident and competent in your abilities.
  • Maintain healthy self-care techniques that you can rely on when you are having trouble.

Frequently Asked Questions

  • What does an anxious preoccupied attachment look like?

    Characteristics of an anxious preoccupied attachment include poor self-worth, a constant need for reassurance, excessive dependence on relationships, fear of rejection and abandonment, problems trusting partners, and hypersensitivity to the moods of others.

  • How do you fix an anxious preoccupied attachment?

    While anxious preoccupied attachment can create problems, it is possible to heal and develop a more secure attachment style. Working to build health attachments, including with friends, family, and romantic partners can help people heal. Psychotherapy can be an important part of this process, so talk to a mental health professional about your treatment options.

  • How do you love someone with an anxious preoccupied attachment?

    If someone you love has an anxious preoccupied attachment style, there are strategies you can use that may help. Focus on being consistent and dependable. Communicate your feelings clearly and be careful to avoid invalidating your partner's emotions.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hashworth T, Reis S, Grenyer BFS. Personal agency in borderline personality disorder: the impact of adult attachment style. Front Psychol. 2021;12:669512.

  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

  3. Conrad, R., Forstner, A.J., Chung, ML. et al. Significance of anger suppression and preoccupied attachment in social anxiety disorder: a cross-sectional study. BMC Psychiatry 21, 116 (2021).

  4. Vismara L, Presaghi F, Bocchia M, Ricci RV, Ammaniti M. Attachment patterns in subjects diagnosed with a substance use disorder: a comparison of patients in outpatient treatment and patients in therapeutic communities. Front Psychiatry. 2019;10:807.

  5. Fraley RC, Roisman GI. The development of adult attachment styles: four lessons. Current Opinion in Psychology. 2019;25:26-30.

By Amy Marschall, PsyD
Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.