Anxious and Avoidant Attachment Responses to Chronic Pain

Secure attachments and insecure attachments influence relationships in various ways. Individuals with secure attachments may have more confidence in their relationships with others than individuals with insecure attachment styles. It is well documented that insecure attachment styles can negatively impact many areas of social functioning. Anxious insecure individuals may be overly cautious of their relationships and may need constant reassurance of loyalty and commitment. Avoidant insecure people may not need the relationship maintenance of anxious individuals, and may choose to pull away from those close to them due to their fears of abandonment. Regardless of whether an individual exhibits anxious or avoidant behaviors to those closest to them, in times of extreme stress, these relationships can become very strained.

Chronic pain is a condition that can cause stress in people and those around them. Understanding how attachment style affects pain response can help clinicians design tools to address this issue. Anna L. Kratz of the Department of Physical Medicine and Rehabilitation at the University of Michigan recently led a study that evaluated how anxious and avoidant insecure attachment styles influenced catastrophizing of pain symptoms in a sample of 210 adult women. The women had been diagnosed with either fibromyalgia or osteoarthritis and were instructed to keep a daily diary detailing the severity of their pain, the level of catastrophizing, and how much social support they received.

After 30 days, Katz reviewed the diaries and found that the women with the highest levels of anxious insecure attachment also had the highest levels of catastrophizing. These women reported the most severe levels of pain and the least amount of positive social support. The insecure avoidant women had high levels of pain catastrophizing as well but minimal social support, positive or negative. In contrast, the participants with secure attachments reported the lowest levels of pain and better support responses than the insecure attachment women. These findings suggest that insecure attachment styles motivate individuals to solicit help for fear of not receiving any while secure attachment styles provide self-reliance that allows individuals to cope with pain and stress in a more adaptive and regulated manner. Katz added, “Findings suggest that a social development perspective can inform our understanding of adjustment to chronic pain and the creation and use of more effective prevention and treatment strategies.”

Kratz, A. L., Davis, M. C., Zautra, A. J. (2012). Attachment predicts daily catastrophizing and social coping in women with pain. Health Psychology 31.3, 278-285.

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  • Josephine

    July 2nd, 2012 at 3:33 PM

    Ok so the people who are screwed up all the way around are the ones who hurt the most too. Great. Just what they need. More anxiety and stress in their lives, and now we see that they also feel pain even more profoundly even more than the rest of us do.

  • Blakely

    July 3rd, 2012 at 4:08 AM

    You don’t think about how one thing like this could add up to something like this, but I think that we can see form these conclusions that the way we attached to significant others throughout our lives has a big impact on how we live our lives in general. That more secure attachment gives us more a sense of well being, and although I don’t think that those who have chronic pain that it’s all just in their head, I do think that being secure in life and with others offers you better coping skills and perhaps an overall better ability to live life pain free.

  • jasmine freeman

    July 3rd, 2012 at 11:09 AM

    Having support from others in your life if this is an issue that you live with is key to progressing and finding different forms of relief.
    Sometimes htose of us who live daily with constant and chronic pain need someone to take our minds off of what we are feeling.
    It does not make the pain go away, but just having a friend or a partner who you can share your thoughts with and who can make you smile can go a very long way toward easing much of what you feel when you have this in your life.
    If you know someone who is living with this, I urge you to give them a call or stop by just to check in on them and see how they are doing. Just having a kind word to say is often enough to make me smile and make me feel like living another day.

  • susan

    July 3rd, 2012 at 4:29 PM

    having loving and fulfilling relationships definitely does wonders to your other problems.a stable relationship like having a support and stability program in times of crises and can really help you to overcome things mentally.been there experienced that :)

  • Shepherd

    July 5th, 2012 at 1:17 PM

    “Company” matters more than “support”, much more.

  • Auntie Hosebag

    October 14th, 2012 at 7:10 PM

    Pretty simplistic. Having suffered from chronic pain for over 30 years, and spent most of that time with the same partner, I would caution putting too much faith in these findings.

    Lots of factors go into chronic pain, including where it comes from, what makes it better or worse, how good or bad one’s treatment is, type(s) and amount(s) of pharmaceuticals employed, number and reliability of partners and the like–as well as their knowledge and understanding of the underlying condition(s)–sleep patterns, diet, even weather. The practice of inventing new labels and words to paint complex physical/mental/emotional/spiritual states with a broad brush so that people with tiny attention spans can grasp one speck of the phenomenon should be regarded with skepticism, at least.

    I find my own chronic pain is much more affected by physical action(s) than by something I’m thinking. Of course, everyone’s chronic condition is different. One thing is for sure, though: “relationships”–for want of a more useful word–really take a beating under the cloud of chronic pain. As a charter member of a chronic pain support group about a decade ago–a rarity then as much as now–I noticed, in fact, the whole group did, how universal the complaints about the stresses imposed on “relationships” by the introduction of chronic pain. Far too often, the still-physically-healthy person in said “relationship” would abandon the chronic pain sufferer in pretty short order–within months of the onset of pain–the most common excuse being that the damaged person had “changed”. Duh.

    No shortage of assholes in this or any other world.

  • Kimberly S

    October 25th, 2012 at 11:23 PM

    Your research has affirmed what I had a strong sense may have been my greatest barrier to forming loving relationships and that my physical illness was somehow connected to my early childhood experiences. I was diagnosed with juvenile rheumatoid arthritis at age 13, but as early as six, had allergies and joint pain (but still and adventurous & determined little girl). At the age of 34, while working in sales, I developed fibromyalgia and what was diagnosed as an unspecified mixed connective tissue disease. I traveled to asia in 2010 and could not carry my humira, methotroxate, and ran out of lyrica, but after 3 months, came to realize that my physical pain had subsided. Most recently, I am working with a Gestalt therapist who has written a book “What is Love”. All the connections are falling into place. How the brain works, feelings of love, inner child work, discovering self love and worth, cranial sacral therapy, reike, it has been 2 years (but the most significant being in the last two months) of peeling back the layers to the core of where pain comes from. This has been my path to healing. I also believe that this healing does not require years of therapy, but can be done quickly by a team of highly qualified professionals with a mixture of treatments specific to the individual. Unfortunately, in America, people are reliant on doctors to tell them what they need- and many physicians don’t know either. There is much work to be done…. Thank you for your work!

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