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AbstractAttachment styles may influence interpersonal strategies used to cope with stress. We examined links between attachment style, communicative behaviors, and physical well‐being among 166 couples coping with cancer. Results of actor–partner interdependence mediation models indicated that insecure attachment styles were associated with greater self‐report of two different and seemingly contradictory communicative behaviors (disclosure and holding back), which in turn were associated with poorer physical well‐being. These effects were intrapersonal for both patients and spouses, with the exception of anxious attachment and holding back for spouses. They were also interpersonal in that spouse insecure attachment was associated with poorer patient physical well‐being through spouse communication (greater holding back and disclosure). Couple‐based communication interventions to support adjustment should consider attachment style.