Understanding Attachment Styles and Chronic Illness: Insights from Miranda Campbell LCSW

 

I recently interviewed Miranda Campbell, LCSW on The Chronic Illness Therapists Podcast. Miranda, co-author of The Attachment Style Makeover, shared invaluable insights on healing attachment wounds and building healthier relationships with others as well as with ourselves and our health challenges.

Attachment Styles Aren't Fixed

One of the most hopeful messages from Miranda is that attachment styles aren't set in stone. There's such a thing as "earned secure attachment,” which means that we can shift from insecure patterns toward more secure ones through intentional work and practice.

“Our attachment styles are not set in stone and there's things that we can do to kind of shift to more secure patterns, at least more secure patterns more often," Campbell explains.

How Attachment Styles Affect Chronic Illness Management

Different attachment styles profoundly influence how we experience and manage chronic illness:

  • Anxious Attachment: People with anxious attachment may struggle to ask for help without feeling guilty or like a burden. Miranda, who experiences migraines herself, admits: "I [often] feel like it needs to be debilitating before I ask for help."

  • Avoidant Attachment: Those with avoidant tendencies may isolate themselves and resist seeking needed support in an effort to maintain autonomy and independence.

  • Disorganized Attachment: This style creates an unpredictable push-pull dynamic - desperately wanting help at times while rejecting it at others, which can confuse caregivers.

Destiny offers a simple yet important framework for understanding attachment styles: 

Anxious attachment means moving toward conflict, while avoidant attachment means moving away from it. 

This movement metaphor perfectly captures how these patterns play out in relationships. The anxiously attached person leans in during times of stress - seeking reassurance and connection, sometimes with intensity that can feel overwhelming to others. They might ask multiple questions, seek excessive reassurance, or even create conflict as a way to engage. 

person behind laptop screen

The avoidantly attached person does the opposite - retreating into themselves, creating emotional or physical distance, and focusing on self-sufficiency when relationship tensions arise. 

The disorganized attached person oscillates between the two in a pattern that often feels predictable to them, but unpredictable to the people around them. This can make it really hard to explain and to understand, and this unpredictability can strain relationships and medical care, as providers and loved ones struggle to establish consistent support patterns that work.

With chronic illness, these patterns become even more pronounced: the anxious person might frantically seek medical answers and support, while the avoidant might minimize symptoms or delay care even when care is very needed.

The Caregiver's Attachment Style Matters Too

Miranda addresses how a caregiver's attachment style affects the support they provide:

  • Anxiously attached caregivers may feel threatened when not appreciated enough

  • Avoidant caregivers might struggle to express their own needs

  • Disorganized caregivers might oscillate between being overly present and burning out

Recognizing a caregiver's attachment style isn't about assigning blame or inducing shame - it's about understanding the complex dance between two people navigating chronic illness together. These patterns developed for valid reasons, often as a way to protect themselves in the early years of their lives. 

When caregivers and those with chronic illness can compassionately identify how their attachment styles interact, they gain valuable insight into recurring conflicts and misunderstandings.

For example: 

  • how an anxiously attached caregiver might overwhelm an avoidantly attached patient

  • how an avoidantly attached caregiver might trigger abandonment fears in an anxiously attached patient

  • how an anxiously attached patient might need more emotional support 

  • how a disorganized attached person might need consistent routines and clear boundaries to feel safe, along with patience and understanding during their push-pull cycles.

Many of us have immense shame surrounding our needs, which means that you might feel negatively even now as you read these words. I encourage you to try to go back through this article and read these words as objective and without judgment towards yourself or others.

This is arguably the most important part of this work.

This awareness creates a pathway to more intentional interactions, where both parties can recognize their patterns in real-time and make conscious choices toward secure relating, even when their instincts pull them elsewhere. The chronic illness itself becomes less of a battleground and more of a shared challenge that can actually strengthen connection when approached with this understanding.

Moving Toward Secure Attachment

Securely attached caregivers bring valuable balance to the caregiving relationship. They can set healthy boundaries while remaining emotionally available, communicate needs clearly without guilt or defensiveness, and maintain their own wellbeing without feeling selfish. Their consistency creates a foundation of trust for the person with chronic illness, allowing both parties to navigate health challenges with greater resilience. 

This secure foundation helps the relationship withstand the unpredictable nature of chronic illness, as securely attached caregivers can adapt to changing needs without taking setbacks personally or becoming overwhelmed by them.

Miranda offers practical advice for building more secure attachment patterns:

  1. Get curious about acting secure even when you don't feel secure: "Even if I don't feel secure, I still may feel anxious... However, I can choose to act secure."

  2. Be proactive: Ask for help before reaching a crisis point. "I can choose to act secure by asking proactively."

  3. Run mini-experiments: Practice new behaviors with the safest people first to "stack the deck" for success.

  4. Grieve what wasn't: Accept that some relationships may never look like a "Hallmark movie" and forge new paths based on everyone's capabilities.

  5. Adjust expectations: "Closeness may not be wearing the same pajamas... Closeness may be distant, or small doses, or speaking about surface level topics."

Back View of Person Comforting Her Friend

Cultural Context Matters

Miranda emphasizes how cultural and generational context shapes attachment:

“For many of us in a BIPOC (Black, Indigenous, & People of Color) community, our parents and their parents may not have had the privilege of really tending to their own emotional needs. They were burdened with survival."

She explains how our current generation has more opportunity to address emotional needs and heal generational trauma, even though this work comes with its own challenges. This perspective acknowledges the significant impact of historical and societal factors on attachment patterns across generations.

father and child laughing

For communities that have faced systemic oppression, economic hardship, or displacement, survival often took precedence over emotional processing or relationship-building. 

Parents and grandparents may have developed attachment styles focused on protection and resilience rather than emotional vulnerability.

When addressing attachment wounds in these contexts, Miranda suggests we must honor these survival mechanisms while recognizing the opportunity we now have to evolve beyond them.

This intergenerational lens helps us understand attachment patterns with greater compassion, seeing them not just as individual psychological traits but as adaptations shaped by collective experiences across time, culture, and community.  

The Power of Communication

Communication is essential for both people with chronic illness and their caregivers. Understanding each other's attachment styles can help create supportive dynamics that work for everyone.

Miranda suggests tailoring support to attachment needs, such as giving space to those who value independence, creating consistent routines for those with disorganized attachment, and providing reassurance for anxiously attached people.

These insights remind us that while chronic illness presents unique challenges, understanding our attachment patterns can help us navigate these challenges with more compassion for ourselves and for others. The journey toward secure attachment isn't about perfection but it’s definitely about consistently taking small steps that gradually reshape our relationships with ourselves, our bodies, and those who care for us. 

As Miranda Campbell, LCSW reminds us, we can choose to "act secure" even when we don't feel secure, gradually building new neural pathways that make security our default setting. In doing so, chronic illness becomes not just a challenge to overcome but an opportunity to deepen our understanding of ourselves and cultivate more authentic connections with those around us. 

The path may not be linear, and there will be setbacks along the way, but with awareness, intention, and compassion, we can transform our attachment wounds into sources of wisdom and strength.

 

 

Therapist Miranda Campbell

Miranda Campbell LCSW brings 15 years of experience in trauma-informed therapy, specializing in attachment wounds, boundaries, and relationship healing. She combines her professional expertise with a deep understanding of how cultural identity, family dynamics, and past experiences shape relationships today.


Meet Destiny - The host of The Chronic Illness Therapist Podcast and a licensed mental health therapist in the states of Georgia and Florida. Destiny offers traditional 50-minute therapy sessions as well as therapy intensives and monthly online workshops for the chronic illness community.

Destiny Davis, LPC CRC, is solely responsible for the content of this document. The views expressed herein may or may not necessarily reflect the opinions of Miranda Campbell, LCSW.

Destiny Davis (formerly Winters)

Destiny is a Licensed Professional Counselor and chronic illness educator.

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