What is the Anxious/Preoccupied Attachment Style?

Painting of an Old Couple, Artist Unknown, 19th Century

From a psychodynamic psychotherapy perspective, anxious-preoccupied attachment develops from early experiences with inconsistent or emotionally unavailable parents and caregivers, leading to deep-seated fears of abandonment and an excessive need for reassurance in relationships. Relational patterns are then internalized, where love and security feel unpredictable, leading to hypervigilance toward perceived rejection. Their internal working models, shaped by early experiences, reinforce a belief that they must cling to others to maintain closeness, often leading to emotional dependency and anxiety in relationships. Therapy would explore these unconscious relationship dynamics, helping individuals recognize how past experiences shape their present fears and behaviours.

A core concept in psychodynamic theory is transference, where individuals unconsciously project unresolved feelings from their caregivers onto current relationships. Someone with an anxious-preoccupied attachment style may react intensely to subtle changes in a partner’s behaviour, reliving past fears of neglect. They may experience overwhelming anxiety when a partner seems emotionally distant, interpreting this as a sign of impending abandonment. This heightened sensitivity to relational cues can lead to behaviours such as excessive reassurance-seeking, emotional over-dependence, or even conflict initiation as a way to maintain engagement. In therapy, recognizing these patterns helps individuals differentiate past experiences from present reality.

Defense mechanisms also play a role in managing the anxiety, such as clinging, hypervigilance, and excessive self-sacrifice to maintain relationships. Although these behaviours can provide temporary relief, they can reinforce underlying insecurities, creating a cycle of dependency and distress. In therapy, exploring these defenses allows individuals to understand how they unconsciously attempt to protect themselves from perceived rejection while also deepening their fears of abandonment at the same time.

Returning Home, Painting by Edgar Barclay, 1910

The therapeutic relationship itself can serve as a corrective emotional experience, allowing patients to explore their fears of abandonment in a safe and consistent environment. A psychodynamic therapist helps clients uncover and process unconscious fears, address unmet childhood needs, and reconstruct their models of relationships, leading to a sense of security and gradually reducing their dependency on external validation. This process involves recognizing and tolerating ambivalence in relationships rather than fearing emotional fluctuations as signs of rejection.

Ultimately, psychodynamic psychotherapy works through early relationship wounds in order to reintegrate fragmented aspects of the self, allowing individuals with anxious-preoccupied attachment to develop a more cohesive and stable sense of identity. As a result, an individual would be able to cultivate internal security rather than relying solely on others for affirmation. This shift enables them to engage in healthier relationships, where intimacy is based on mutual connection rather than attachments driven by fear, and helps individuals develop the capacity to maintain closeness without excessive anxiety.