Adult separation anxiety disorder: fear of letting go

Adult separation anxiety disorder affects roughly 7 per cent of adults.

  • The Australian 
    I was chatting to a psychiatrist recently about one of her cases, “Jenny”, who’s in a destructive relationship but is unable to leave. Or, rather, she leaves and gets ill with symptoms ranging from mental anguish to physical symptoms of compromised immunity: the flu, an ulcer playing up, recently a skin disorder. Then in her helpless, panicky or ill state she calls and he comes around. It’s all chicken soup and sympathy until he starts pulling away again.

“I’m not saying his behaviour is wrong or bad, just that it upsets her,” says the psychiatrist, who cannot be named. “It’s toxic for her given her childhood wounds. But she keeps going back.”

I said I knew a lot of people, mainly female (but I know one man) in relationships such as this. In fact, I’ve been in a couple myself. There is something attractive about the unavailable, the slap-stroke of pain-pleasure that comes from being in love with the unpredictable. But one usually grows out of it. Or thank god I did.

The doctor says she had diagnosed her patient with adult separation anxiety disorder, which affects roughly 7 per cent of adults. ASAD often begins in early childhood and continues.

“It’s a very real and prevalent phenomenon. It arises in kids who don’t have a comfortable or trusting relationship with their parents or authority, or come from too close-knit a family. The child goes on to develop anxiety where they are scared to leave the parent’s side or even the home. Or they find a substitute, an aunt, grandpar­ent, sibling, teacher or sometimes friend, and never leave them alone. They can get very jealous and possessive of friends at school. When they get older, they often find a partner to play out the same pattern. It’s a form of co-dependency.” She says they project all their neediness on to this other person and feel quite sick or furious at the thought of them going home for the night or not calling.

As a result of their clinging behaviour they often cause friends or family to be overwhelmed and begin pulling away, especially romantic partners. This reinforces the patterns of insecurity and gives them cause to be even more controlling, demanding or intrusive.

“Once Jenny retreats or initiates a breakup, her then ex-partner is often happy to come back, having been given space,” the doctor says. “Adults who team up with ASAD sufferers are often from damaged childhoods themselves and, while they crave the adora­tion of a person who acts beholden to them, they are often intimacy avoidant and can feel smothered and pull away unexpectedly.

“It’s a co-dependent dance that leads to both parties remaining mentally childlike and unable to grow beyond pain. The pattern of push-pull feels familiar to both parties and becomes a self-fulfilling prophesy, triggering the very abandonment they fear.”

According to the American Psychology Association, the severity of the symptoms in separation anxiety disorder sufferers ranges from anticipatory uneasiness to full-blown anxiety. They may recurrently exhibit social withdrawal, apathy, sadness or difficulty concentrating on work or play. Although once thought of as a childhood/adolescent disorder, it has now been listed in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders as an adult disorder too, contingent on being present in the adult for six months or more.

To have ASAD or SAD one must have three (or more) of the following symptoms:

Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated.

Persistent and excessive worry about losing, or possible harm befalling, major attachment figures.

Irrational fear that an untoward event will lead to separation (for example, getting lost, being kidnapped, an accident, flying).

Persistent reluctance or refusal to go to school or elsewhere because of fear of separation.

Distress at the thought of being alone or without major attachment figure/s.

Persistent reluctance to go to sleep without being near a major attachment figure or to sleep away from home.

Repeated nightmares involving the theme of separation.

Repeated complaints of physical symptoms (such as headaches, stomach aches, nausea or vomiting) when separation from major attachment figures occurs or is anticipated.

One also may add the belief that the person cannot live without another person, or that their joy of life will be completely diminished by not being with the other in situations such as seeing a film. They also may avoid going out in public and need to be chaperoned. They pretend they’re just being social: “I like to chat with people when I walk or travel. I’m just a very intimate, connected person.” Which is true and natural for most humans as we are a social species, but in excess it can indicate a subliminal terror.

Separation anxiety also can be around pets, or may involve social media, at a time when emotional attachments are often developed via electronic means.

The website Calm Clinic says telltale signs include mooching; grown kids who won’t leave home (and parents who let them stay). Or a friend who visits for lunch but never leaves. Jealousy also can be a sign. “The individual becomes far less trusting because they’re subconsciously worried that someone will leave them … the jealousy is accompanied by irrational concerns about infidelity.”

The negative emotions present in those with ASAD may include anger and feelings of neglect. Stress-related physical symptoms can develop, and those with ASAD are likelier to have other anxiety disorders, including avoidant, dependent and obsessive-compulsive disorder, panic attacks and depression. But psychologists warn not to confuse SAD with other disorders it may mimic such as agoraphobia — a fear of going outside — which may be triggered by SAD but not exclusively.

The solution: meditation, sometimes medication, but most certainly some form of therapy that allows a person to observe their often compulsive self-defeating thoughts such as: “I am nothing without him/her; I won’t cope alone. I will be abandoned and die of starvation,” which is true of an infant but not an adult where the starvation is more about fear of emotional deprivation or withdrawal. Cognitive-based therapies fostering self-awareness can help.

The psychiatrist quoted earlier says one way to cope is by leaving to go “to” something better rather than seeing oneself as being “separated from”; in other words, moving towards an object, place, hobby or passion. The trick is to stop the pattern, so that any new relationship will not end up like the last.

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Separation anxiety can be a form of codependence. Pop-pscychologists have long been saying that narcissists and codependents are attracted like the opposite poles of a magnet.

LIke DonQuixote and Sancho, each meets the other’s needs: the narcissist’s insecurity is lessened by the codependent’s faith in their grandiose claims about themselves, and the codependent derives an identity and sense of worth by being the sidekick of the most important person in the(ir) universe.

When the narcissistic partner in the relationship departs (be they parent, child or partner) the codependent’s life suddenly has no compass and they become anxious.

Sancho was desperate for DonQuixote to maintain his role as narcissistic leader in their relationship, but Quixote had moved on: “Don’t look in last year’s nests for this year’s birds” was his advice to his old mate.



Many of the symptoms of this condition with the experience of childhood trauma, seem to be similar to an other, often serious mental health condition, Borderline Personality Disorder (BPD).

Both conditions create serious problems for the sufferer and can badly affect relationships. If not recognised and treated correctly (marrage counselling by itself is not adequate) relationships will become toxic and fail.

Botswana O'Hooligan

Botswana O’Hooligan

With all due respect this is all part of life so we have to get on with it one way or the other. An ideal relationship should be a fifty fifty affair but they rarely are as this old bloke has found out to his cost when he has given a couple of ex wives the lot and walked away sadder and not much wiser. Certainly the ex wives haven’t learned their lessons either despite becoming extremely well off, so the point is proven as one gazes out the window of a house called “Penury” and reflects on the journey thru life.



@Botswana O’Hooligan  A friend owned a house in an expensive part of Sydney. He got married fairly late in life and they were together for about 20 years. They divorced, and he later told me that his wife “bought my half of the house.” Marriage had turned a whole house into half a house. Sounds like vandalism to me…



@John @Botswana O’Hooligan  Was it Ms Z.Z. Gabor who said: I marry for love and divorce for money? Heard a Hungarian tale. was it the Fortuna Hotel in Budapest or such. Get spun around in the revolving entry exit door and emerge without your trousers or wallet? I recall the song. “And I am walking on Memphis.”



The solution for this – as with everything else – is ethanol, that wonderful little scamp of an organic molecule.

More enjoyable and ultimately cheaper than therapy.

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