Fear of Abandonment in Adults: Causes, Symptoms, and Help
The worry about being left behind is something most people can relate to. While it can be difficult to source the exact roots of these worries, many say that abandonment confirms an innate fear that they’re unlovable or it’s proof of low worth.
For a lot of people, the fear of being left behind is a small part of being human and can be handled well. However, for others, it begins to influence big parts of their relationships. For these people, a fear of abandonment often reflects an early-learned lesson: that love and attention can disappear.
If a fear of abandonment is affecting your relationships, self-esteem, and overall quality of life, professional support can be a valuable stabilizing force. This page can also help by explaining the ins and outs of fear of abandonment, including:
- How to understand the fear of abandonment
- Exploring the causes of fear of abandonment
- The overlap between fear of abandonment causes
- Treating the fear of abandonment
- Knowing when it’s time to reach out for help
- Mission Connection support for fear of abandonment
What Is Fear of Abandonment?
Fear of abandonment describes a strong worry that people you care about might leave or stop caring about you in return. It can appear in romantic relationships, friendships, families, or even work settings where emotional connection feels uncertain.
It’s worth noting, though, that the fear of abandonment isn’t a standalone diagnosis. In fact, it’s an emotional pattern that can appear in several mental health conditions, including separation anxiety disorder,1 borderline personality disorder, and other adult attachment-related difficulties.2
As a singular example, research estimates that SAD affects around 4.1% of children and 6.6% of adults,1 showing just how widespread attachment issues in adults may be. These numbers highlight that worries about being left behind or unloved aren’t rare and exist on a broad spectrum of human experience.
This makes recognizing the signs of fear of abandonment especially important, as they may be part of a deeper emotional or psychological issue that deserves attention and care.
If you or someone you care about shows signs of fear of abandonment, you may:2
- Attach quickly to others: Connection can feel urgent, as if closeness now might stop someone from leaving later
- Stay in unhealthy relationships: Walking away might feel harder than holding on, even when it hurts
- People-please: Saying “yes” to things you don’t want because rejection feels unbearable
- Feel unworthy of love: Struggling to believe that someone could stay without needing a reason
- Experience intense separation anxiety: Feeling uneasy or restless when distance appears in the relationship
- Be hypersensitive to criticism: Hearing concern or feedback as a sign that love might be fading
As is the case with many psychological issues, these worries don’t appear out of thin air, and it’s usually our experiences with others that can shape the fear of abandonment.
What Causes Fear of Abandonment?
Fear of abandonment can take root early in life or form through later experiences that disrupt a person’s sense of safety. Research shows that when childhood care feels uncertain or unstable, it can shape how we connect with others well into adulthood.2 Likewise, betrayal, loss, or unstable relationships can make it difficult to believe that love will last.
Below are some of the main factors linked to the causes of abandonment issues in psychological research.
Childhood Neglect or Inconsistent Caregiving
When a child grows up with caregivers who are inconsistent in their attention, it can plant the belief that people, in general, can’t be relied on to be present for them.3 Attachment theory suggests that this can lead to what’s known as an “anxious attachment style,” where reassurance can feel like a constant need.2 Without consistent care, the child may grow into an adult who intensely desires closeness and worries that affection always comes with an expiry date.
Trauma
Losing someone significant through life events like death or divorce can disrupt a child’s developing sense of stability.4 The idea that loved ones could suddenly disappear may continue into adult relationships, creating anxiety around being left alone.
Object relations theory points out that trauma can interfere with “object constancy,” the sense that people continue to exist and care even when they’re not present.5 For those who’ve experienced this kind of loss, every goodbye can feel uncertain.
Additionally, growing evidence shows that insecure attachment, and by extension, fear of abandonment, can increase the risk of PTSD. A large meta-analysis involving around 9,000 participants found that people with secure attachment showed fewer PTSD symptoms, while those with insecure attachment were more likely to experience them.6
The strongest connection appeared in attachment styles marked by high anxiety about being abandoned, such as fearful-avoidant or previously mentioned anxious types. People with these styles showed the highest levels of PTSD severity,6 suggesting that PTSD and abandonment fears can make traumatic experiences even harder to process.
Abusive or Unstable Relationships
Experiencing betrayal or emotional abuse in relationships can make it difficult to trust that love is safe. Those who’ve experienced infidelity, for example, may become suspicious about future partners, causing “snooping” behaviors.7 Repeated instability or rejection can reinforce this belief, deepening the idea that abandonment is inevitable.8 Even when someone new enters their life with kindness, the fear can remain close beneath the surface.
Underlying Mental Health Conditions
Certain mental health conditions include abandonment anxiety as a core feature. Borderline personality disorder, for example, lists an “intense fear of abandonment” among its diagnostic criteria.9
Separation anxiety disorder and dependent personality disorder may also involve distress around being left.2 In these cases, fear of abandonment isn’t always linked to a single event and could very well be part of how the condition manifests and shapes relationships.
The Overlap Between Fear of Abandonment Causes
The causes of fear of abandonment rarely exist in isolation, and it can be difficult at first to understand why this isn’t the case. The best thing we can do is to start by picturing a person raised by caregivers whose moods and affection shifted without warning. Growing up in this uncertainty can create an anxious attachment style, in which closeness feels both comforting and unpredictable.10 Alternatively, in the disorganized/fearful avoidant style, it may create a conflicting sense of safety and fear.
Later, in adult relationships, betrayal or emotional withdrawal might reopen that same wound. Because their sense of security is already fragile, such moments can feel devastating, especially as it might feel like “proof” that “people always leave.”11
In this way, fear of abandonment becomes the thread linking past and present experiences. It colours new relationships with the shadow of older ones, turning normal conflict into confirmation of deeper insecurity. When this fear drives clinginess or jealousy, partners may pull away, unintentionally repeating the cycle.
As this fear is allowed to develop over time, these repeated patterns can shape a worldview where safety and love feel conditional, and loss feels inevitable.
If this description is ringing true for you or a loved one, it’s key to remember that it doesn’t have to stay like this forever, and there are treatments out there for you.
How Is a Fear of Abandonment Treated?
As stated earlier, the fear of abandonment that you’re feeling could be linked to different types of mental health conditions. Therefore, determining the root cause is key to what kind of treatment is used.
Below, we explore some of these associated conditions and their lines of treatment.
Borderline Personality Disorder
In people with BPD, fear of abandonment is a core feature12, which means psychological treatments focus on ways to reduce this fear. The main aim here is to improve emotional regulation and interpersonal functioning, which in turn could reduce the abandonment-related distress.12 One of the recommended therapies is dialectical behavior therapy,12 which teaches skills in distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness.
Other effective therapies include:
- Mentalization-Based Therapy,12 which helps people better understand their own and others’ mental states
- Schema therapy,12 which targets deeply held patterns (or “schemas”) related to trust and abandonment.
These therapies help reframe the belief that others will inevitably leave and build a more stable self-concept.
Post-Traumatic Stress Disorder
For those whose fear of abandonment is rooted in trauma, especially early relational trauma, trauma-focused therapies are often most effective.13 These may include:
- Cognitive processing therapy, which focuses on modifying maladaptive beliefs related to trauma and trust.
- Prolonged exposure, which involves safely confronting trauma memories to reduce avoidance and emotional reactivity.
- Eye Movement Desensitization and Reprocessing, which helps reprocess distressing memories that may underpin attachment-related fears.
These treatments don’t target abandonment fears directly, but by helping people process and resolve PTSD symptoms, they have the potential to reduce the negative thought processes tied to fear of being left.
Separation Anxiety Disorder
As is the case with BPD, for those with SAD, anxiety and abandonment often go hand in hand. The most effective anxiety treatment option is cognitive behavioral therapy tailored to separation fears.1 This typically includes:1
- Psychoeducation about anxiety and its triggers
- Cognitive restructuring to challenge catastrophic thoughts about separation
- Exposure therapy to gradually increase time apart from attachment figures in a controlled, supportive way
CBT for SAD is highly structured and skills-based, helping those with abandonment fears build coping mechanisms and gradually reduce the intensity of their worries.
When Is the Time to Reach Out for Help?
Everyone experiences the fear of abandonment at some point, and in many ways, it’s what helps us value connection. But when this fear begins to shape your relationships or interrupt your daily life, it may be time to reach out for support from professionals who understand how deep this feeling can run.
Sometimes the hardest part is recognizing when the fear applies to you. If it’s been there for years, it can blend into your personality so well that you forget what life felt like without it. The line between what’s “normal” and what’s consuming can become blurry.
If you’re unsure, take a moment to reflect with the self-assessment questions below. They don’t aim to diagnose anything, but they can help you open the door to a conversation that matters.
- Do you find yourself needing frequent reassurance that people won’t leave you?
- Do you feel intense worry when a loved one becomes distant or doesn’t respond?
- Do you stay in relationships that hurt you because being alone feels worse?
- Do you overthink small changes in someone’s tone or behavior, fearing rejection?
- Do you struggle to trust that affection and care are genuine?
- Do you feel anxious or “empty” when you’re not in close contact with others?
If you found yourself answering “yes” to one or more of these questions, it could be a sign that fears of abandonment are present. Speaking with a mental health professional may help you explore what’s behind those feelings and how to ease them.
Mission Connection: Effective Support for Fear of Abandonment
If you’ve been living with a fear of being left behind, know that there’s help out there for you. This fear can be deeply rooted and may leave you feeling uncertain about who to turn to, especially when relationships begin to feel fragile or overwhelming.
At Mission Connection, we recognize how persistent and painful abandonment anxiety can be. That’s why our licensed clinicians provide tailored therapy for those struggling with fears of rejection and offer mental health support for relationships. Our treatment focuses on understanding where these fears come from, helping you rebuild trust and confidence in your connections.
We treat clients whose fear of abandonment connects to:
- Borderline personality disorder
- Separation anxiety disorder
- Depression
- Anxiety
- Trauma-related conditions
- Attachment difficulties
Our facilities across the US offer both intensive outpatient (IOP) and partial hospitalisation (PHP) programs, depending on your level of need. But if attending in person feels difficult, our telehealth services allow you to take part in sessions from home using your preferred device.
Reach out to Mission Connection today and take the first step toward understanding your fears and discovering the sense of stability that real connection can bring.
References
- Feriante, J., Bernstein, B., & Torrico, T. (2023, February 26). Separation anxiety disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560793/
- Fritscher, L. (2019). Why Some People Experience a Fear of Abandonment. Verywell Mind. https://www.verywellmind.com/fear-of-abandonment-2671741
- Litner, J. (2023, November 30). Abandonment issues: Signs, symptoms, treatment, and more. Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/abandonment-issues#causes
- Szeifert, N. M., Oláh, B., & Gonda, X. (2025). The mediating role of adult attachment styles between early traumas and suicidal behaviour. Scientific Reports, 15(1), 15855. https://doi.org/10.1038/s41598-025-00831-8
- Matejko, S. (2022, May 12). Object Constancy in Borderline Personality Disorder and Narcissism. Psych Central. https://psychcentral.com/disorders/borderline-personality-disorder/object-constancy-understanding-the-fear-of-abandonment-and-borderline-personality-disorder
- Woodhouse, S., Ayers, S., & Field, A. P. (2015). The relationship between adult attachment style and post-traumatic stress symptoms: A meta-analysis. Journal of Anxiety Disorders, 35(1), 103–117. https://doi.org/10.1016/j.janxdis.2015.07.002
- Rodriguez, L. M., DiBello, A. M., Øverup, C. S., & Neighbors, C. (2015). The Price of Distrust: Trust, Anxious Attachment, Jealousy, and Partner Abuse. Partner Abuse, 6(3), 298–319. https://doi.org/10.1891/1946-6560.6.3.298
- Palihawadana, V., Broadbear, J. H., & Rao, S. (2019). Reviewing the clinical significance of “fear of abandonment” in borderline personality disorder. Australasian Psychiatry, 27(1), 60–63. https://doi.org/10.1177/1039856218810154
- Cruz, D., Lichten, M., Berg, K., & George, P. (2022). Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Frontiers in Psychiatry, 13(1), 1–14. https://doi.org/10.3389/fpsyt.2022.800687
- Simpson, J. A., & Rholes, W. S. (2017). Adult attachment, stress, and romantic relationships. Current Opinion in Psychology, 13, 19–24. https://doi.org/10.1016/j.copsyc.2016.04.006
- Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024). Borderline personality disorder: A comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23(1), 4–25. https://doi.org/10.1002/wps.21156
- Schrader, C., & Ross, A. (2021). A Review of PTSD and Current Treatment Strategies. Missouri Medicine, 118(6), 546–551. https://pmc.ncbi.nlm.nih.gov/articles/PMC8672952/
- Mansour, M., Joseph, G. R., Joy, G. K., Khanal, S., Dasireddy, R. R., Menon, A., Mason, I. B., Kataria, J., Patel, T., Modi, S., Mansour, M., Joseph, G. R., Joy, G. K., Khanal, S., Dasireddy, R. R., Menon, A., Mason, I. B., Kataria, J., Patel, T., & Modi, S. (2023). Post-traumatic stress disorder: A narrative review of pharmacological and psychotherapeutic interventions. Cureus, 15(9), 1–8. https://doi.org/10.7759/cureus.44905