It’s Not Just Anxiety: When Attachment Is the Real Driver

Amanda Dounis

Anxiety is one of the most common reasons clients walk into therapy. Well, at least that’s what I have noticed in 10 years as a counsellor. They describe overthinking, replaying conversations, checking their phone repeatedly, struggling to sleep, feeling tense in their chest, and being unable to settle their mind. So many individuals are saying the same thing that it often feels like an epidemic. Many will say, “I’ve always been anxious”, and they genuinely believe that is the core issue. But anxiety comes in so many forms, and has so many definitions, and each individual’s experience is different. This is where we need to investigate, and where I believe attachment activation plays a role.

Quite often, when I slow the story down and look at the pattern carefully with them, something else becomes clear. The anxiety is not everywhere. It is not across all areas of their life – not necessarily present when they think about work, finances, health or social situations. My training taught me to look for “patterns” that individuals run again and again. Once we notice the pattern, we find a way to “interrupt” it.

Let’s look at some scenarios that I find are familiar. People are calm during the day, then unsettled at night after a message goes unanswered and the day is coming to an end. They function well professionally, but feel completely destabilised if their partner seems pre-occupied or distant. A slight change in tone can trigger spiralling thoughts. Now we all know that communication is a whole bunch of things. In my opinion, we should all have the opportunity to learn all the different styles of communication. For instance, a delayed reply can feel intolerable and create symptoms within the body. Even ambiguity about commitment can create a level of distress that looks, on the surface, like severe anxiety.

Notice the patterns and how it contaminates relationships? Outside the relationship, they are steady. Inside it, everything feels amplified. Interesting how they practice to disguise it and soldier on.

We are wired for connection. From early childhood, our nervous system learns what closeness feels like. Was it consistent? Was it unpredictable? Did we have to perform to receive approval? Was love steady, or did it feel conditional? Plus, what about the rest of the family –what did we learn from them?

Those early experiences form our future templates. They shape how safe a connection feels in adulthood. Intimate relationships, especially romantic ones, tend to activate those templates more than any other context. This is evident in the young clients who come in with relationship concerns.

When someone has grown up with emotional inconsistency, unpredictability or conditional affection, their nervous system may become highly alert to signs of distance. It does not take much, and sometimes it is subtle.

The reaction can feel immediate and intense.

Clients often say to me, “I know I’m overreacting”, or “Logically I know he cares about me”, or “I don’t know why I’m like this”, but how they feel is another story.

That sentence tells me something important. The thinking part of the brain is online. They can see that their reaction might be disproportionate, but their nervous system is activated. So now we know what we need to work on: relaxing the nervous system and then continuing the counselling session really helps the thinking brain look at different pathways and options.

I always remind myself, when the nervous system is activated, logic alone does not calm it.

In session, attachment activation can look almost identical to anxiety. There are racing thoughts, tightness in the chest, reports of trouble sleeping and constant rumination. There may be an urge to analyse every word of a conversation, replay conversations, or to even seek reassurance. Some clients report they double text because they lack the patience to wait. Others withdraw to see if the partner will pursue them and prove they care.

These behaviours are not random or dramatic. They are attempts to restore the feeling of safety. The nervous system is trying to reduce what it sees as a threat and re-establish connection, and the mind isn’t always equipped to manage that.

One pattern I see regularly is what I describe as the reassurance cycle. The client feels insecure and reaches out. The partner reassures them. Relief follows. But it does not last. The doubt creeps back in. Then the need for reassurance increases. And the cycle continues. I’m sure we have all experienced something similar at some stage of our lives.

Over time, emotional stability can become dependent on someone else’s response. The more reassurance they receive, the less confident they feel in holding themselves steady without it. As therapists, we have to be mindful here. Validation is important. Clients need to feel understood. But if we repeatedly reassure them without helping them build internal regulation, we risk reinforcing the same external dependency. It is important that counselling therapists maintain their own training and stay up to date with current literature. Understanding attachment changes the direction of therapy toward a pathway of healing.

When I explain attachment activation to clients, I often see them express visible relief. It shifts from “There’s something wrong with me” to “My nervous system learned to respond this way”. That reframing reduces shame, a crucial component we should all talk more about. Personalising each session by discussing someone’s values and beliefs is also incredibly important.

In session, we can explore gently where patterns might have started. Many clients describe early environments where emotional availability was inconsistent. Love may have been present, but unpredictable. Approval may have felt earned rather than freely given. Needs may not have been responded to reliably. This shapes how they behave as they grow up and develop. I know this is true for myself too. But this does not mean we cannot change.

The nervous system adapts to environments by staying alert. It learns to scan for subtle changes. That adaptation makes sense at the time, and helps us stay connected. But in adulthood, it can create unnecessary distress in otherwise healthy relationships.

Once clients understand the pattern, we slow it down.

After exploration, I often ask them to walk me through a recent trigger using the following questions:

• What happened?
• What did you immediately tell yourself?
• What did you feel in your body?
• What did you feel compelled to do next?

Mapping the sequence builds awareness. It moves the experience from automatic to observable. Then we work on internal regulation. Instead of immediately sending another message for instance, can they pause? Can they take five slow breaths? Can they put the phone down for 10 minutes? Can they remind themselves of evidence that the relationship has been stable overall?

Even small delays interrupt the automatic reassurance loop. The nervous system learns that activation does not require instant action. This is not about suppressing needs or pretending not to care. It is about building tolerance for uncertainty, and not just in these circumstances alone – life itself is uncertain!

Cognitive work remains important. Many clients carry long-standing beliefs such as “I am too much”, “I am not enough”, or “People always leave”. These beliefs fuel attachment activation, and when patterns recur, they are used to confirm the old narratives. But as I say to clients all the time, these stories can be rewritten. After we discuss beliefs and narrow in on when it was created (usually at a much younger age), I explain to clients that beliefs can always be updated. You will be surprised at how many individuals did not realise this.

Challenging these beliefs takes time. It requires careful, steady work. But attempting to challenge them while someone is emotionally flooded rarely works. Regulation must come first. Once the nervous system settles, the thinking brain can engage more effectively as I mentioned earlier.

Differentiating attachment activation from generalised anxiety allows us to tailor treatment more accurately. If anxiety is present across multiple domains, the formulation may look different. But when distress is strongly tied to relationship triggers, reassurance-seeking and fears of abandonment, an attachment-informed lens often provides clarity.

This does not mean abandoning anxiety interventions. Grounding techniques, cognitive restructuring and behavioural experiments are still useful. They simply sit within a broader understanding of what is being activated.

Ultimately, the goal is not emotional independence in the sense of detachment. Healthy attachment involves closeness, reassurance and interdependence, and being able to move forward when things go wrong, without getting stuck in them. The goal is internal steadiness. We want clients to be able to experience relational uncertainty without feeling as though their entire sense of self is collapsing.

There is a noticeable shift when a client says, “I felt triggered, but I didn’t react immediately”, or “I was anxious, but I calmed myself”, or “I didn’t need reassurance this time”. That is significant growth. The relationship may not have changed dramatically, but their sense of self has strengthened. They are no longer relying solely on external cues to feel safe.

Not all anxiety is the same. When distress is closely linked to relational triggers, repetitive reassurance cycles and fears of abandonment, it is worth considering whether attachment is the deeper driver. When we address that layer, therapy becomes less about symptom management and more about building internal security. And when clients begin to feel secure within themselves, their relationships often become calmer too – especially their relationship with themselves. I value this so I always include it in my sessions.

It’s not that I want their world suddenly to become predictable, but I aim for them to be steadier inside it.

Author Biography

Amanda Dounis is a Counsellor, NLP Master Practitioner, Strategic Psychotherapist and Clinical Hypnotherapist, Founder of The Positive Thinking Clinic and Director of the Dounis Group. She is also the founder of four established early learning centres in Sydney and an Author and Course Creator dedicated to emotional wellbeing and personal development.

Amanda works across the lifespan, supporting children, adolescents and adults to strengthen resilience, regulate emotions, shift limiting beliefs and move confidently toward meaningful goals. Her approach integrates evidence-based practice with practical tools that create lasting change.

With three Bachelor degrees, additional qualifications and ongoing professional development, Amanda maintains a strong commitment to excellence, innovation and high standards of care. Her work is grounded in the belief that growth begins within — and that with the right support, every individual has the capacity to evolve, adapt and thrive.

For more information or to connect:
www.positivethinkingclinic.com.au
amanda@positivethinkingclinic.com.au