Attachment-based therapy

Attachment-based psychotherapy is a form of talk therapy that looks at how early experiences, especially with primary caregivers, shape your emotional and relational patterns as an adult. This therapy focuses on how different attachment styles—secure, anxious, avoidant, and disorganized—developed from your early childhood experiences. By understanding these patterns, you can build healthier ways of relating to others by improving emotional regulation, boosting self-esteem, and strengthening communication. Attachment-based therapy can even help someone shift their attachment style over time.

What are the origins of attachment-based therapy?

Attachment-based psychotherapy is grounded in the work of John Bowlby and Mary Ainsworth, two pioneers in the field of clinical psychology who studied how early relationships shape emotional and social development. John Bowlby’s attachment theory emphasizes that secure childhood attachments lay the foundation for emotional growth, while disruptions — such as neglect or inconsistent caregiving — can lead to attachment struggles and difficulties with trust and self-regulation.

What are the different attachment styles?

It’s important to remember that attachment styles are general patterns, and you might find that you don’t fit neatly into one category. Let’s take a closer look at each attachment style and how each may be formed from childhood experiences.

Secure attachment develops when a caregiver is consistently responsive to a child’s emotional and physical needs. This fosters trust and balance in relationships. People with a secure attachment style tend to feel comfortable with both independence and closeness, express their emotions freely, and manage conflict well. They have a strong sense of self-worth and tend to form long-lasting, healthy relationships.

Anxious attachment often forms when a caregiver is inconsistent or unpredictable. This can lead to feelings of insecurity and a fear or rejection. Adults with an anxious attachment style may worry a lot about their relationships, seek constant reassurance, and sometimes become overly dependent on their partner for emotional support. They may misread small signs of distance—like a delayed text—as abandonment, and become preoccupied with overanalyzing situations or seeking validation.

Avoidant attachment forms when a caregiver is emotionally distant or unresponsive, teaching the child to suppress their emotional needs and prioritize independence. Adults with an avoidant attachment style can appear distant or aloof. They may resist vulnerability, prefer to solve problems on their own, or pull away when their partner gets too close. Emotional intimacy can feel uncomfortable, and they might downplay the importance of connection.

Disorganized attachment arises from inconsistent or frightening caregiving, which creates confusion about how to seek comfort. Adults with a disorganized attachment style may act unpredictably, alternating between seeking closeness and pushing others away. Their relationships can feel chaotic because they struggle with trust, fear abandonment, and long for intimacy—but also fear it. When feeling overwhelmed, they might withdraw when they most need connection or become anxious during conflict.

When is attachment-based therapy used?

Attachment-based therapy can be used in many different ways depending on what you need — whether you’re attending therapy individually, with a partner, as a family, or even in a group setting. For example, in individual therapy, people often explore how early attachment patterns are affecting their emotions and relationships today, especially if they’re dealing with anxiety, depression, or past trauma.

Attachment-based family therapy can be helpful in mending strained relationships between family members, improving communication, and healing broken bonds — particularly when there are histories of disrupted connections. In group therapy, clients can connect with others facing similar challenges, which helps create a sense of community and shared healing.

Attachment-based therapy is especially helpful for people who’ve experienced trauma or have post-traumatic stress disorder (PTSD) from childhood experiences, since early attachment ruptures often play a big role in the development of trauma-related symptoms. It’s also commonly used for treating mental health conditions like anxiety, depression, and relationship struggles.

For children and adolescents who’ve faced neglect, abuse, or disruptions in attachment relationships (such as those in foster care or adoption), attachment-based therapy can be a key part of healing. Plus, this form of therapy is great for those dealing with complex emotional challenges, like chronic loneliness, low self-esteem, or trouble trusting others.

How does attachment-based therapy work?

When early attachment experiences are disrupted — whether due to neglect, abuse, or inconsistent caregiving — it can lead to struggles with trust, self-esteem, and emotional regulation. For example, if a caregiver dismisses a child’s distress by saying, “You’re fine, stop crying,” the child might start to believe that their emotional needs won’t be met, which leads them to suppress their feelings and rely only on themselves. When this occurs over a long period of time, it can lead to an avoidant attachment style.

In attachment-based therapy sessions, the therapist works with clients to identify patterns from childhood that may still be affecting their thoughts, behaviors, and relationships. By recognizing these patterns, clients can start to heal past emotional wounds and build healthier, more secure ways of connecting with others.

In attachment-based therapy, the therapist creates a safe, supportive space to explore these early attachment ruptures, acting as a secure attachment figure. This helps clients learn healthier ways of relating to others and rewires their emotional responses. Over time, this process can ease symptoms of anxiety, depression, trauma, and relationship struggles, building a strong foundation of emotional resilience and security.

What is attachment-based therapy like?

In attachment-based therapy, clients usually have consistent therapy sessions — often once a week — and the therapy can last anywhere from a few months to over a year, depending on what the client is working on and their specific needs.

In the early sessions, the therapist will explore the client’s childhood experiences and family dynamics to understand how attachment patterns might be influencing their current relationships. The therapist might ask questions like, “How did your primary caregivers respond when you needed comfort?” or “How do you experience attachment in your relationships?”

As therapy continues, the therapist may use different interventions like reflection, role-playing, or other activities to help clients see how those early experiences impact their current behavior. The therapist may also share tools and strategies for building healthier, more secure attachments, like practicing emotional openness, building trust, and setting clear boundaries. This process helps clients move past old patterns and create more stable, trusting connections with others.

Is attachment-based therapy effective?

What makes this therapy so effective is its focus on early emotional bonds and the relationship between the client and the therapist. When children receive consistent care, love, and support from caregivers, they develop a sense of security that helps them feel confident navigating the world and forming healthy adult relationships. Mary Ainsworth’s Strange Situation study showed that children who have a secure base — a trusting, reliable relationship with their caregiver — are more confident and able to explore the world, knowing their needs will be met when they return.

How to find an attachment-based therapist

If you think attachment-based therapy might be right for you, it’s important to speak with a licensed and experienced clinician who uses this approach in their practice. Because the memories and feelings in attachment-based therapy can be sensitive and uncomfortable, it’s important to find someone who makes you feel safe, respected, and understood.

There are many types of mental health care providers who practice attachment-based therapy, including licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs), psychologists, psychiatrists, psychiatric nurses, licensed professional counselors (LPCs), licensed mental health counselors (LMHCs) and more. Look for a therapist who’s trained in attachment theory and understands how it impacts emotional and relational challenges.

On top of finding someone specializing in attachment-based therapy, you want to make sure they meet your other needs. For example, if you struggle with an anxiety disorder, you’ll want to find an attachment-based therapist who also specializes in treating anxiety. In addition, finding a therapist who accepts your insurance can make therapy much more affordable.

You can find a therapist who accepts your insurance and specializes in attachment-based therapy by using Grow Therapy. After filtering for your location, insurance, and needs, you can then select “Attachment-based” from the “Treatment methods” drop-down.