The link between social anxiety disorder and attachment theory

Social anxiety gets precipitated by an excessive fear of social situations, which frequently gets characterized as a person having exaggerated perceptions of the potential for catastrophic outcomes, e.g., humiliation, loss of self-worth, and negative judgments from others (Clark & Wells, 1995).

Social anxiety

Typically, people who report having feelings of social anxiety have also reported that their early caregivers or parents often displayed harsh or unsympathetic parenting styles and were often:

  • Controlling or intrusive
  • Emotionally distant and cold
  • Critical and tended to shame them when being disciplined as children

Social anxious symptoms

Socially anxious patients frequently display several acute symptoms as a result of their social anxiety, which includes:

  • Intense fear of interacting with or talking to strangers
  • Fear that others will notice how anxious they are
  • Fearing the physical symptoms that may cause embarrassment such as going red, sweating, shaking, or having a trembling voice
  • Avoidance of speaking to people or taking part in activities for fear of embarrassment
  • Avoiding scenarios where they are at risk of being the center of attention
  • Overly worrying about humiliating or embarrassing oneself.
  • Fearing scenarios where there is the potential to get judged
  • Experiencing intense fear or anxiety during social functions
  • Analyzing behavior and performance and scrutinizing ones’ flaws after a social event
  • Anticipating the worst possible outcomes from any negative experiences during social situations

Attachment style

Social anxiety could be conceptualized from an attachment viewpoint, especially since adult and interpersonal relationships are critical to both.

Researchers believe that social anxiety sufferers’ experiences of being parented may predispose them to develop an insecure attachment style.

Attachment anxiety

Several studies have demonstrated the link between social anxiety and adult attachment using interview-style measures of Attachment.

One particular study by Bifulco, Lillie, Ball, and Moran (1998), recruited thirty adults from a university and social anxiety support groups where both got screened for social anxiety symptoms.

The interviewees completed questionnaires for anxiety, locus of control, and self-esteem. They also got interviewed.

Attachment relationship

The study concluded that those in the socially anxious group chiefly displayed insecure attachment styles. They also exhibited fearful behavioural types and anxious classifications.

Researchers noted that people with insecure attachment styles did not display signs of significant social anxiety. 

However, those with a fearful type and an anxious classification reported significantly higher social anxiety scores.

Attachment theory

Attachment theory focuses on the relationships and bonds between one person and another – particularly long-term relationships such as the dynamics between caregiver and child and between romantic partnerships.

John Bowlby: Stages of Attachment

According to a British child psychiatrist and psychoanalyst, John Bowlby

“Attachment is the long-lasting psychological connection with a meaningful person that creates pleasure while interacting and offers a soothing balm in times of stress.

The quality of Attachment has a detrimental impact on development and gets linked to various aspects of positive functioning, such as emotional wellness.”

Attachment system (maternal deprivation)

Bowlby began studying Attachment and thus developed his attachment theory through the research he conducted on hospitalized children and child delinquents.

These studies led him to explore the negative impact of maternal deprivation. In this scenario, the mother was either absent or non-responsiveness for long periods during a child’s first two years of life.

Direct effect

Bowlby hypothesized that children have an instinctive need to develop a close relationship with attachment figures, ideally the mother.

In the unfortunate instance where a secure bond between child and mother does not occur, the child is at increased risk of other negative consequences such as:

  • A decline in intelligence
  • Aggression
  • Depression
  • Delinquency
  • Affectionless psychopathy (a condition where an individual severely lacks empathy and compassion for others)

Study

Following his work on maternal deprivation, Bowlby developed a theory that would support his results where he based his studies on an influential attachment theory developed by Harlow and Zimmerman (1959).

Harlow and Zimmerman’s infamous study was conducted on monkeys and separated young monkeys from their mothers and put them into cages with ”surrogate mothers”.

Study on the relationship between Attachment

One of the ”mothers” got made out of wire with a bottle attached, and the other got covered in cloth.

The results concluded that the monkeys chose to be comforted by the clothed mother over the wired mother, even though she did not offer them any food.

All this goes against previous attachment studies where the goal of Attachment was to have one’s needs satiated, such as being fed.

Later on, Bowlby developed his theory based on these results, hypothesizing that Attachment gets formed by the inherent need to establish an emotional bond with one’s mother. This need goes way beyond the urge to be fed.

Stages

Social anxiety

Bowlby concluded that infants go through four main stages of Attachment. 

They include:

  • Pre-attachment (newborn to 8 weeks): Newborn babies instinctively understand how to get attention from adults, whether it be through crying, cooing, making eye contact, or smiling. Babies in this stage are not yet attached to their mothers but can get soothed by other people’s presence.
  • Attachment in making (6 weeks up to 6-8 months): During this stage, infants begin developing a sense of trust towards primary caregivers (mother). They are soothed a lot quicker by the mother than any other figure and often smile in her presence.
  • Clear cut Attachment (6 to 8 months – 18 months to 2 years): The Attachment between infant and caregiver gets established. Babies in this stage prefer their mother’s over anyone else. They also experience separation anxiety when she is not present. The way the mother soothes the baby and the infant’s temperament during times of separation will influence the intensity of separation anxiety.
  • Formation of reciprocal relationships ( 18 months + years): As an infant’s language develops, separation anxiety decreases. The child has a clear understanding of when the mother is leaving and when she will return. Essentially, a deep sense of security has gotten established, and the child is secure in the knowledge that even though the mother is not always present, she will always return. This sense of security and rapport often gets referred to as ”internal working models”.

Attachment styles

Bowlby tested his attachment theory through the ”strange situation” study, where children’s responses to their mother’s presence and absence got recorded.

The results that got concluded from the study became the premise in which Bowlby’s attachment styles got formulated. 

Bowlby’s attachment styles include:

  1. Secure Attachment: Young children who have developed a secure attachment style feel happy and secure and exhibit an eagerness to explore their surroundings. Children with secure attachments get reassured that no matter how far they go, the mother will always be there for them – they may experience distress when the mother is absent, but they can get reassured that she will return. The behavior of the mother is sensitive and consistent with the child’s needs.
  2. Anxious-avoidant-insecure-attachment: Children who have developed an anxious-avoidant – insecure – attachment style don’t trust their mother to meet their needs. They exhibit indifference towards the mother whether she is absent or present but are anxious internally. Children with this attachment style are emotionally distant and not very explorative. The mother shows no interest in the child and shows emotional disengagement towards the child.
  3. Anxious-resistant (ambivalent) Attachment: Young children with anxious-resistant attachments demonstrate a combination of helplessness and anger towards their mother. Experience has taught these children that they cannot rely on their mother, and as a result, they act passively and feel insecure. The mother behaves inconsistently and is often unresponsive and neglectful towards the child.
  4. Disorganized/disoriented Attachment: Children who fit into this attachment style can act angry, depressed, apathetic, or passive. The mother’s behavior tends to come in extremes, such as flitting between aggression and passivity.

Attachment and social anxiety disorder

Despite the profound implications of social functioning, minimal research has attempted to explore the link between attachment styles and social anxiety disorder.

Attachment anxiety

N.L Collins (1996) conducted a cluster analysis and separated 118 patients with social anxiety disorder into ”anxious” and ”secure attachment” style clusters.

The cluster revealed that patients belonging to the ”anxious attachment” group displayed more severe social anxiety, more profound impairment, more significant depression, and lower life satisfaction than patients belonging to the ”secure attachment” cluster.

It concluded that social anxiety mediated the link between attachment insecurity and mental health conditions such as depression.

Behavioral models

Cognitive-behavioural models of social anxiety illustrate the dysfunctional thought processes and perceptions that a social anxiety sufferer holds regarding him or herself and the world around them. All this involves:

  • The adoption of maladaptive emotion regulation strategies (such as substance abuse)
  • Irrational underlying assumptions and beliefs
  • interpretative bias

Adult attachment style

Research into social anxiety illustrates the strong correlation between dysfunctional attachment styles and social anxiety disorder.

When attachment figures are consistent and responsive to a child’s needs and any displayed signals of distress, they form a secure attachment where they internalize their perceptions of others as caring, loving, consistent, and reliable, and the self as worthy, valued, and competent.

Socially anxious individuals

Socially anxious individuals

However, this process also works in reverse. 

Suppose attachment figures demonstrate unresponsiveness, are rejecting, and display inconsistent responses to distress. 

In that case, the person develops insecure attachments, internalizes the belief that others are untrustworthy and unreliable, and views the self as ineffective and unworthy.

A research article titled Adult Attachment and Social Anxietyexplored the mediating role of emotion regulation strategies and explained that:

“Insecure attachment encourages the development of insecurities regarding the effectiveness of the use of support seeking as a distress regulation strategy, all of which disrupts the development of critical social competencies.

All this suggests the vital link between social anxiety disorder and insecure attachment styles.

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Ameet Braich - Camino Recovery Spain

Ameet Singh Braich, a distinguished Clinical Director at Camino Recovery, is renowned for expertise in addiction and trauma resolution. With 15+ years of experience, he transforms lives through a holistic therapeutic approach. His research focuses on childhood maltreatment's impact on cognitive, emotional, and social functioning.

A dynamic speaker and trainer, Ameet empowers clients to achieve lasting recovery, prioritizing trauma resolution and relapse prevention. His diverse training includes EAP, crisis intervention, and EMDR. Committed to positive transformation, Ameet equips individuals across fields to address challenges of addiction.

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