What Is an Anxious Preoccupied Attachment Style? We Asked an Expert

If you watch This Is Us, you probably feel sympathetic (albeit frustrated) at how Kate Pearson (Chrissy Metz) is constantly second-guessing herself and has a hard time advocating for herself. Given the context of the show, if we had to guess, we’d say she is the poster child for anxious preoccupied attachment style. She is a classic overthinker who often needs approval from her loved ones, and despite being a badass, she has a hard time accepting her worth. Now, before we go diagnosing Kate—or the rest of the Pearson gang for that matter—let’s turn to the experts for the legit breakdown of how this attachment style presents itself.  

“Preoccupied attachment style (aka anxious preoccupied attachment style) manifests as high anxiety about the relationships and connections in our lives,” explains Dr. Susan Zinn, LPCC, LMHC, NCC and certified trauma specialist. “Although preoccupied attachment style is not officially diagnosed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it can manifest as a symptom of some diagnoses, including borderline personality disorder, social anxiety disorder and substance use disorders.”

Because people who have the anxious preoccupied attachment style are insecure, they often are approval junkies who heavily rely on the input of the people around them. When it comes to relationships, for example, they easily fall for the idea of being with someone but when it comes to the gritty work of managing and sustaining the relationship—communicating their needs, conflict resolution, finding a balance, etc.— things tend to falter. 

“Those with an anxious preoccupied attachment style usually have low self-esteem with a more positive view of others and [they] feel inferior to others,” says Dr. Zinn. “They fear abandonment and rejection and have difficulty trusting others. A person with an anxious preoccupied attachment style can often become overly dependent on relationships. They may become excessively attuned to others' emotions and behaviors, leading to jumping to conclusions about their partner's mood, being fearful, panicking and worrying about their partner's behaviors and intentions.”

As with many of the coping mechanisms that present themselves in adulthood, an anxious preoccupied attachment style can stem from the way you were reared. If you grew up in an environment where caregivers—whether that was your parents or other primary guardians—couldn’t provide stable or consistent support, it’s more likely that you develop uncertainty and anxiety about whether or not your needs will be met. Conversely, if you grew up with an overly-protective parent who catastrophized each minor inconvenience, you might also develop a preoccupied attachment style because you automatically become fearful and feel unsafe even under even mildly inconvenient circumstances.  

But it doesn’t all come down to the traumas from our childhood. Toxic relationships in adulthood can also be catalysts to the preoccupied attachment style. “Partners who display emotionally abusive behaviors can cause insecurity and anxiety around attachment,” Dr. Zinn tells us. “If you are consistently told that you are unintelligent and incompetent by your partner, you may start to believe these things about yourself. Unfortunately, these beliefs can cause you to cling to your partner—even though they are being emotionally abusive—for protection and security that you can no longer provide yourself.” So, yeah, be careful of the company you keep and don’t ignore any red flags.

In the same way that the anxious preoccupied attachment style can develop later in life, it can also be worked on in adulthood (only if you’re aware it’s happening, of course). Here are six ways to cope: 

1. Seek help. It cannot be stressed enough: Therapy is your best friend. Find a therapist or counsellor you can fully trust and be open with. They can help you manage expectations, air out grievances and maybe even make appropriate decisions. Dr. Zinn tells us, “Various therapy forms can help create healthier attachments, since attachment styles impact relationships. For instance, someone with a preoccupied attachment style in a long-term relationship can benefit from couples therapy to work on identifying their emotions and communicating with their partner in healthy ways.”

2. Keep a journal. Even if you’re one of those people who doesn’t necessarily feel as though journaling is therapeutic, you can still try it to help streamline your thoughts. For the moments when you’re feeling a little on edge, simply putting your thoughts to paper may alleviate your anxiety. “[Journaling can be a] helpful exercise for getting out your emotions and it may help you recognize some patterns in your thoughts and behaviors,” Dr. Zinn points out. “It may also be worthwhile to bring your journal to therapy sessions where you can unpack its contents with your mental health professional.”

3. Practice coherence techniques. Coherence techniques—which are methods that can help bring your brain and your heart into physiological alignment­­­—can help you manage your emotions and your anxiety. Dr. Zinn recommends heart-focused breathing and heart-centered techniques from the Heart Math Institute.

4. Be a better communicator. This is relationships 101. If you feel like something your partner (or friend or sibling or boss) did is triggering some angst and uneasiness in you, communicate. If they love and care for you, they’ll adjust. If they don’t, then you can work on reevaluating their place in your life. Either way you slice it, finding a healthy way to verbalize your needs is paramount.

5. Engage in self-esteem-building experiences. You’ve probably heard this ad nauseum, but finding things you’re good at and enjoy doing is a major key. Not only are you able to handle any obstacles better, but your performance is almost always better simply because you like what you’re doing.

6. Choose a partner who has a secure attachment. “Research shows that success in a relationship for someone who experiences preoccupied anxious attachment is higher if they are partnered with someone who has a secure attachment style,” Dr. Zinn states. That way, instead of having two people overthinking and being heavily dependent on each other, there’s at least one partner adept at fortifying healthy boundaries and establishing balance within the relationship.