Attachment security and trauma in sex addiction recovery therapy

Since John Bowlby and Mary Ainsworth’s work in the 1970’s, attachment has been an increasing focus in therapy and healing from addiction.

Averaging various studies on this, we understand roughly half of Americans are securely attached as adults and about half insecure. Attachment Theory informs us that if we are not securely attached, we are more likely to have difficulty in relationships and develop addictions, depression, anxiety, and other mental health challenges. Patrick Carnes found that 92% of sex addicts he tested scored insecure.

Common symptoms of insecure attachment:

  • Not trusting ourselves or others
  • Impulsive Behavior
  • Poor emotion regulation
  • Feeling lonely even when with group of people or in a relationship
  • Anxiety and excessive fearfulness
  • Anger, quick temper
  • Frustration, depression, feeling of discontent
  • Internalized, Toxic Shame and Guilt
  • Addictive behavior

According to many addiction experts, notably Gabor Mate, trauma is at the root of addiction. Trauma and attachment are related. According to the late Harvard Psychologist and Attachment Researcher Daniel Brown, the most effective way to heal from trauma is to treat insecure attachment. Though therapy and recovery, we can heal from our attachment wounds and move from insecure attachment to secure attachment.

There are four types of attachment styles. Knowing our attachment style can help us manage in our relationships and also give us insight into healing.

Secure Attachment:

Stan Tatkin calls these “anchors” because they can be a steadying influence in a relationship. If a person is secure in a relationship, it means they can give and receive love. They are good at things like honoring boundaries, keeping agreements, keeping secrets. They want the best for their partner but don’t sacrifice themselves. They want to be close to their partner but are OK when separated. When they experience negative emotion or challenges, they can soothe themselves, calm their nervous system, and figure out the best plan. Secure Attachment represents about 50% of U.S. adults.

Avoidant Attachment:

Stan Tatkin calls these “islands”, because they tend to isolate. If one is extreme avoidant, they often feel suffocated by their partner. They need space. Avoidants want a relationship and they want closeness, but their defense mechanisms might cause them to shut it down if it gets too close or if it’s not the right time for closeness. Avoidants value independence and my mistrust others. Secure Attachment represents about Avoidant Attachment (also called “Dismissive”) represents about 22% of U.S. adults.

Preoccupied Attachment:

Stan Tatkin calls these “waves”, because when they come for their partners, they can overwhelm them like a tidal wave.  An extreme preoccupied always feels like they love their partner more than their partner loves them. They can become consumed with fears of rejection and abandonment. They might appear needy. They sometimes create conflict as a way to draw the partner in to create a form of perceived intimacy. Preoccupied Attachment (also called Anxious or Ambivalent) represents about 20% of U.S. adults.

Fearful Avoidant Attachment:

This category is sometimes ignored when discussing attachment styles. It comes into play in two ways. 1) When the person is insecurely attached on both the avoidant and preoccupied scales and uses both patterns as attachment strategies. 2) When significant trauma effects like lack of safety and disassociation are present. Often this is a result of abuse. Fearful Avoidant Attachment (sometimes called Disorganized Attachment) represents about 8% of U.S. adults.


Earned Secure Attachment, Neuroplasticity, and Healing:

The great thing about attachment, is that even if we currently suffer from symptoms related to insecure attachment, we can grow and heal and move towards secure attachment. This is called “earned secure attachment.” We can move from very insecure to slightly insecure. We can move from slightly insecure to secure. We can move from secure to very secure. With each step in progress, we will suffer from less of the symptoms of insecure attachment and enjoy more benefits of secure.


Ways to work towards Secure Attachment:


Five Conditions for Secure Attachment:

Five conditions need to be present for a child to gain secure attachment. As we attempt to model these conditions to our relationship partner or child or close friends, we can heal our relationships and our own selves.

  1. Felt Safety. The child feels safe in the parent’s presence and feels safe enough to explore outside the parent’s presence, knowing she can return at any moment for safety.
  2. A sense of being seen and known. A parent is attuned to the child and understands his emotional states perfectly. Any change in emotion is quickly recognized. All emotions are accepted unconditionally. When a child has a need, the parent meets the need.
  3. Felt Comfort. The parent can soothe the child when she is upset and bring the child back to feeling comfort. The enables the child learn to soothe himself as he grows older.
  4. Sense of being valued. The parent is delighted in everything the child does and expresses that delight so she feels totally valued in exactly who she is.
  5. Felt support for fostering self-development. The child feels supported to explore the world, become independent, and develop into her best self. The child feels unconditional support and encouragement from the parent in this.


Why treat attachment security in sex addiction recovery?

We believe that addiction stems from attachment insecurity, and that successful treatment of attachment insecurity will lead to freedom from addiction. When the client moves to secure attachment, even without ever working on sexual sobriety or even talking about sexual behavior, we believe the client will eventually walk away from unwanted sexual behavior along with any other unhealthy coping strategy.

When you combine attachment repair work with behavioral change programs like 12 Steps, or therapeutic guidance of the CSAT or OCSB treatment programs, progress in aligning sexual behavior with values is optimized and freedom from addiction is expedited.


Take the test and discover your attachment style

This article is a summary of a 15 page ebook you can get by taking our attachment assessment here.




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Bartholomew, K., & Moretti, M. (2002). The dynamics of measuring attachment. Attachment & Human Development, 4(2), 162–165.

Brown, D. P., Elliott, D. S., & Morgan-Johnson, P. (2016). Attachment disturbances in adults: Treatment for comprehensive repair. W.W. Norton & Company.

Carnes, P. (1983). Out of The shadows: Understanding sexual addiction. CompCare Pub.

Flores, P. J. (2004). Addiction as an attachment disorder. Jason Aronson.

Maté, G. (2021). In the realm of hungry ghosts: Close encounters with addiction. Vintage Canada.

Morgan, O. J. (2019). Addiction, attachment, trauma, and recovery: The Power of Connection. W.W. Norton & Company.

Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W.W. Norton & Company.

Tatkin, S. (2012). Wired for love: How understanding your partner’s brain can help you defuse conflicts and Spark Intimacy. New Harbinger.

Zapf, J. L., Greiner, J., & Carroll, J. (2008). Attachment styles and male sex addiction. Sexual Addiction & Compulsivity, 15(2), 158–175.

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