Anxious Attachment: Signs, Causes and How Therapy Can Help
An anxious attachment style is a pattern of relating to others in which you worry about being rejected or abandoned, and need a lot of reassurance to feel safe in a relationship. It usually begins with early experiences of care. It is not a diagnosis, and research shows it can shift towards greater security, including through psychological therapy.
If you have ever reread a message five times looking for hidden meaning, or felt your stomach drop when a partner went quiet, you will know how exhausting this can be. The good news is that attachment patterns are learned, and what is learned can be gently relearned.
What is an anxious attachment style?
An anxious attachment style (sometimes called anxious-preoccupied attachment) describes adults who tend to see themselves less positively than they see the people they love. That combination often shows up as constant worry about abandonment, close watchfulness for signs that love and support are slipping away, and a strong pull towards closeness.
Attachment theory, first developed by the British psychiatrist John Bowlby, rests on a simple idea: when we feel threatened, we seek out someone who helps us feel safe.
Researchers usually measure adult attachment on two dimensions. Attachment anxiety reflects how insecure you feel about whether a partner will be available and responsive. Attachment avoidance reflects how uncomfortable you feel being close to, or depending on, others. Most people sit somewhere on both scales rather than fitting neatly into one box.
Insecure attachment is also common. NICE's guideline developers note that around 30 to 35% of representative populations have an insecure attachment, and suggest it is arguably unhelpful to treat this as an "attachment problem".
Signs of anxious attachment in relationships
The signs of anxious attachment centre on fear of losing connection and a strong need for reassurance. They tend to show up most in romantic relationships, though close friendships and family ties can be affected too. You might notice that you:
Worry a lot about being left. A delayed reply or a change in tone can feel like evidence that something is wrong.
Stay on high alert. You scan for small shifts in a partner's mood or attention, and find it hard to switch this off.
Read ambiguity negatively. People with higher attachment anxiety are more likely to interpret others' behaviour in a negative light, a link UK researchers found across 18 studies.
Feel emotions intensely. Attachment-anxious adults tend to regulate emotion by turning it up rather than down.
Put your own needs last. Keeping the peace can feel safer than saying what you want, which overlaps with patterns we explore in our article on toxic relationship traits.
Everyone experiences these differently, and having a few of them now and then is part of being human. It is when they shape most of your relationships and leave you feeling drained that it may be worth talking to someone.
What causes anxious attachment?
Anxious attachment is most often linked to early care that felt unpredictable. NICE notes that children whose caregiving is erratic or intrusive typically develop an anxious-ambivalent attachment, staying close to their caregiver by turning their distress up: becoming clingy and hard to settle, even when comfort is offered.
In other words, the anxiety made sense. If comfort sometimes came and sometimes did not, staying alert and asking loudly for it was a clever way to get your needs met.
It is rarely about a single cause, and it is not about blame. NICE describes how patterns pass between generations through a parent's own sensitivity and attunement, and notes some children may be more sensitive to their early environment than others. Understanding where the pattern came from is about making sense of it, not finding fault.
Is anxious attachment a mental health condition?
No. Anxious attachment is a relational style, not a diagnosis. NICE is clear that attachment classifications do not represent a disorder, and that they should not be confused with attachment disorder, a recognised but much rarer condition seen mainly in children.
That said, it can make life harder. A meta-analysis of adult studies found attachment anxiety was moderately linked with both depression and generalised anxiety. A large German trial also found people with social anxiety disorder scored notably higher on attachment anxiety than the general population. If that rings true, our article on why we fear being judged may also help.
These are associations, not causes, but attachment can be one thread worth understanding if you are already struggling with anxiety or low mood.
How to heal an anxious attachment style
An anxious attachment style can heal and shift towards security over time. NICE notes that early attachment patterns stay stable when caregiving stays the same, which also means new, consistent relationships matter. Psychologists sometimes call the result "earned security".
Therapy is one of the best-studied routes. A University of Manchester systematic review found that attachment security tends to increase, and attachment anxiety tends to decrease, over the course of psychological therapy. In the German SOPHO-Net trial of 495 adults, attachment anxiety fell after CBT while it stayed flat for people on a waiting list, and it kept falling for a year after both CBT and psychodynamic therapy ended.
There is no NICE guideline specifically for anxious attachment in adults, so the evidence is still developing. In practice, therapy might help you:
Make sense of your story, linking today's fears to what you learned about closeness early on.
Notice the pattern in the moment, so a quiet phone becomes a feeling to understand rather than a fact to act on.
Experience a steady relationship. UK clinicians describe the therapy relationship itself as a "secure base" from which to explore change.
Ask for what you need directly and kindly, rather than through protest or withdrawal.
Approaches such as CBT, compassion focused therapy and ACT can all be shaped around these goals. Where the pattern is playing out with a partner, couples therapy may also help.
Support for anxious attachment at Regal Private Therapy Practice
At Regal, our doctoral-level, HCPC-registered Clinical Psychologists support adults who want to feel steadier in their relationships.
Therapy starts with an initial assessment, where we listen to your story and agree on goals together. From there, your Clinical Psychologist draws on evidence-based approaches such as CBT, compassion focused therapy and ACT, shaped around what you need. Sessions are available in person in Marylebone and online across the UK.
Regal was named Best Evidence-Based Mental Healthcare Service, London at the GHP Mental Health Awards 2026. To find out more, visit our adult therapy service or get in touch with our team.
If you need urgent support
If you are struggling to cope or worried about your safety, help is available now. Call 111 and select the mental health option, or contact your GP. Samaritans are available 24 hours a day on 116 123. In an emergency, call 999 or go to your nearest A&E.
Frequently asked questions about anxious attachment
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Anxious attachment involves worrying about closeness being lost, so you tend to seek more reassurance and contact. Avoidant attachment involves discomfort with closeness, so you tend to pull back and rely on yourself. Researchers measure these as two separate dimensions, so some people score high on both, and most people sit somewhere in between.
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Yes. Attachment styles are not fixed. A University of Manchester review found attachment security tends to increase and attachment anxiety tends to decrease during psychological therapy. Steady, responsive relationships outside therapy can also help over time. Psychologists sometimes call this "earned security", meaning a sense of safety in relationships that develops later in life.
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There is no set timescale, and it varies from person to person. In one large German trial, adults had up to 25 therapy sessions over roughly nine months, and their attachment anxiety continued to fall for a year after therapy ended. Change tends to be gradual, with small shifts in how you react adding up over time.
References
Berry, K. and Danquah, A. (2016). Attachment-informed therapy for adults: Towards a unifying perspective on practice. Psychology and Psychotherapy: Theory, Research and Practice, 89(1), 15–32. https://doi.org/10.1111/papt.12063
Li, D., Carnelley, K. B. and Rowe, A. C. (2022). Insecure attachment orientation in adults and children and negative attribution bias: A meta-analysis. Personality and Social Psychology Bulletin, 49(12), 1679–1694. https://doi.org/10.1177/01461672221117690
National Institute for Health and Care Excellence (2015). Children's attachment: attachment in children and young people who are adopted from care, in care or at high risk of going into care (NICE guideline NG26), including final scope and full guideline. nice.org.uk/guidance/ng26
Strauß, B. et al. (2018). Changes of attachment characteristics during psychotherapy of patients with social anxiety disorder: Results from the SOPHO-Net trial. PLOS ONE, 13(3), e0192802. https://doi.org/10.1371/journal.pone.0192802
Taylor, P., Rietzschel, J., Danquah, A. and Berry, K. (2015). Changes in attachment representations during psychological therapy. Psychotherapy Research, 25(2), 222–238. https://doi.org/10.1080/10503307.2014.886791
Woodhouse, S., Ayers, S. and Field, A. P. (2015). The relationship between adult attachment style and post-traumatic stress symptoms: A meta-analysis. Journal of Anxiety Disorders, 35, 103–117. ResearchGate
Zhang, X., Li, J., Xie, F., Chen, X., Xu, W. and Hudson, N. W. (2022). The relationship between adult attachment and mental health: A meta-analysis. Journal of Personality and Social Psychology, 123(5), 1089–1137. PDF
