The Anxious-Preoccupied Attachment Style And Its Impact On Mental Health

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated July 30th, 2025 by BetterHelp Editorial Team

Learning about the anxious-preoccupied attachment style can be worthwhile, especially for individuals who struggle with rejection or fear of abandonment. Attachment styles typically highlight how individuals relate to one another, and they’re often shaped by childhood experiences. A person’s attachment style can determine how they act in relationships with peers, friends, and family. This article explores the anxious-preoccupied attachment style, its impact on mental health and adult relationships, and ways to build a more secure attachment style. 

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A look at the anxious-preoccupied attachment style

The anxious-preoccupied attachment style (typically referred to as “anxious attachment”) is one of the four primary attachment styles. People who crave emotional intimacy and connection but also fear rejection and abandonment can be said to have an anxious-preoccupied attachment style. As outlined in John Bowlby’s attachment theory, this attachment style normally stems from relationships with caregivers during childhood. When caregivers are emotionally distant or inconsistent, children may grow to have an anxious-preoccupied attachment style as adults.

Traits of an anxious attachment style

When referring to the anxious-preoccupied attachment style, the term “anxious-preoccupied” can describe the way in which individuals with this attachment style tend to be highly anxious and preoccupied with monitoring their relationships. This may lead individuals to seek constant reassurance, become hyper-fixated on potential signs of rejection, act clingy or controlling, ruminate on negative experiences, or experience jealousy over seemingly small things. 

The mental health impact of anxious attachment

The anxious-preoccupied attachment style is one of three insecure attachment styles: anxious, avoidant, and disorganized. During the COVID-19 pandemic, anxious-preoccupied attachment was thought to be a risk factor for poor mental health. People with an anxious attachment style may be at risk for various mental health symptoms, especially when relationships aren’t going perfectly.

Common mental health symptoms related to anxious attachment

Below are several mental health concerns often experienced by those with anxious attachment styles.

The relationship between fear and anxious attachment

Fear is one of the core features of anxious-preoccupied attachment. It may be the fear of rejection, fear of disconnection, fear of being alone, or fear of negative outcomes, among other potential fears. It can be common for those with an anxious attachment style to assume the worst in relationships. For example, individuals may ruminate and fear that their partner is cheating on them when they go out to dinner with friends. A fearful perspective can lead even stable relationships to seem unsafe and insecure.

How to address fear

A combination of strategies can be used to build a more balanced perspective and address fear in relationships. Once individuals understand how fear shows up in their lives – whether through overthinking, difficulty concentrating, or stomach upset, for instance – they can begin taking meaningful action. From there, therapeutic techniques like cognitive reframing, which can change a person’s perceptions of a given situation, can help individuals build self-awareness and a healthier perspective. Often, seeking the guidance of a licensed therapist is helpful during this process.

The impact of anxious-preoccupied attachment on relationships

Those with an anxious attachment style tend to have a strong desire for emotional intimacy, often coupled with a fear of rejection. These traits can have a negative impact on relationships. Some studies suggest that anxious attachment is associated with relationship dissatisfaction. For partners of anxiously attached individuals, the constant need for reassurance may be emotionally taxing, and controlling behavior stemming from anxiety may become overbearing. 

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Building healthier relationships

A supportive relationship may rewire the brain's understanding of love, trust, and compassion. A partner who is emotionally available and consistent can help someone with anxious attachment become more secure. Exposure to healthy relationship patterns can be transformative for anxious-preoccupied individuals. To build a secure attachment, couples can practice active listening and communication, provide emotional support during difficult times, define and respect healthy boundaries, be emotionally responsive to each other, and show dependability through action. Spending quality time together, free from distractions like cell phones and laptops, can help couples build stronger relationships.

The four attachment styles

As highlighted earlier, anxious-preoccupied attachment, avoidant-dismissive attachment, and disorganized-fearful attachment are three types of insecure attachment. The fourth attachment style, secure attachment, is typically characterized by the ability to form healthy, secure, and balanced relationships. The three insecure attachment styles are similar in that individuals may lack trust in the security of their relationships.

Anxious vs. avoidant attachment

Anxious and avoidant attachment styles are, in some ways, at opposite ends of the spectrum when it comes to insecure attachment patterns. Anxious-preoccupied individuals usually value emotional intimacy and fear rejection. Meanwhile, avoidant-dismissive individuals tend to value independence and often appear emotionally distant or unavailable. Research suggests that childhood adversity is a risk factor for both anxious and avoidant adult attachment styles

Moving from anxious, avoidant, and disorganized to secure attachment

The mental health symptoms associated with an insecure attachment style, including depression, anxiety, and jealousy, may seem taxing, but with intentional effort, people can make positive changes. Research suggests that a variety of life events can change an adult's attachment style. Whether it’s experiencing a healthy relationship, attending therapy, or practicing meditation, there are many ways to build a more secure attachment style. 

Online therapy for anxious-preoccupied attachment

Therapy can give individuals a better understanding of their attachment style and its impacts on their mental health and relationships. Interventions like attachment-based therapy are now offered online, eliminating the need to commute to and from sessions and allowing individuals to choose from a wide range of therapists. Platforms like BetterHelp can connect clients with therapists based on their individual preferences. Users can change therapists at any time for no additional cost to find the right fit.

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Can online therapy foster a more secure attachment style?

While current research hasn’t yet examined the efficacy of online therapy specifically for anxious-preoccupied attachment, existing studies suggest that online therapy can effectively address a range of related concerns, such as depression and anxiety disorders. Research supports the use of online therapy as a valid alternative to in-person mental health treatment.

Takeaway

Attachment style, which is often shaped by childhood experiences, can inform the way individuals behave in relationships. Individuals with anxious-preoccupied attachment tend to crave emotional intimacy and fear rejection and abandonment. These fears can impact both individual mental health and relationship satisfaction. However, there are ways to build healthier relationships and foster qualities of secure attachment, such as comfort with intimacy, positive self-image, and open communication. Therapy, whether online or in person, is a tool individuals can utilize to build self-awareness, foster mental health, and improve relationship satisfaction.
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