ATTACHMENT: FROM EARLY CHILDHOOD THROUGH THE LIFESPAN

 

Attachment is a fascinating “idea.” All of us are at this conference because we are interested in the concept, and seem to feel it is somehow important to the work we do. But it is important to stop for a moment and reflect on what we mean by attachment. I was recently at a multidisciplinary conference where a female professor of anthropology was talking to me about the baby boomers’ relationship with their parents. Over lunch she told me she deeply loved and admired her father who was an immigrant who came to the United States with nothing, and fought his way to a good life in this country. She posed the question: “but why was he such a difficult man?” In so doing she immediately became sad and a bit tearful. The conversation went on to explore the why, but for the purpose of this introduction, I use this as one small example of the pervasiveness of attachment in our lives. Clearly the anthropologist had a mental representation of her relationship with her father (which involved emotion), and over lunch in her 50’s she was pondering her father’s unresolved traumas and grappling with the effect they had on her life. The mismatch between the loving secure base aspect of her father and the other aspects of his personality created conflict and sadness. I could give you countless other examples of how attachment phenomenon presents in art, religion, entertainment and relationships. Thus, attachment is woven into the very experiential fabric of our daily lives.

Attachment theory was first conceptualized in the 1950’s by John Bowlby. It was first a clinical theory based upon the observation that the delinquent boys he was working with all suffered severe traumatic losses (Bowlby, 1944). His inquiry led him to explore the effects of early separation, evolutionary biology, ethology, cognitive neuroscience and information processing theory. Even though these ideas seem second nature to us today, at the time they were controversial, and led to his eventual expulsion from the British Psychoanalytic Society (Holmes, 1993). Bowlby’s dedication and research into attachment was stalwart, and he eventually collaborated with Mary Ainsworth. It was Ainsworth’s work that shifted the focus from clinical inquiry to empirical research and the study of normal development. She developed and refined the strange situation study in which children were observed with mother, separated from mother, and on reunion to mother. Her student Mary Main (1990, 2000) has expanded this empirical research and deepened our understanding of attachment.

Intuitively, we all know what attachment means, because we all have it within us and between us, and this conference will explore how much influence the quality of attachment actually has on our lives and the lives of our patients. In thinking about what attachment is, and why it is so important of a topic, I’ve created four interfaces to view attachment: biology, development, psychopathology, and psychotherapy.

Attachment is first and foremost an innate (instinctual) biologic system in all primates. It evolved because of its survival value to the species. In behavioral terms attachment is defined as proximity-seeking and proximity maintaining behavior focused upon specific figures. From an evolutionary perspective, this behavioral system increases the likelihood of infant and childhood survival to a reproductive age. Secondly, attachment is defined by a sequence of responses (each one more seriously harming to the infant than the last) to violation of the demand for proximity: protest, despair, and finally detachment.

Beyond the basic biologic nature of attachment there is a psychologic element. Children approach the attachment figure for comfort when they are distressed. The nature of the emotional response of the attachment figure to the child defines successful soothing or failure at delivering comfort. Attunement, empathy, caring and support are psychologically soothing to the child. The interface between the emotions of the child and the emotional response of the mother to the child create the inter-subjective field [minds knowing minds] by which the quality of attachment is defined. This experience is given representation form in the mind, and has the capacity to regulate affect. Given satisfactory respect for the integrity of the attachment system, secure attachment results, and exploratory behavior is easy and stress-less. Separation is endured and relationship harmony is easily restored at reunion. With secure attachment there is a fertile environment for the capacity for five kinds of love: maternal love, paternal love, peer love, sexual love, and parental love (Harlow, 1974). Furthermore, the quality of attachment defines the successful capacity to regulate, maintain, and modulate the individual’s affective experience.

Subsequent to the discovery of attachment a series of behavioral observations led to the description of insecure or anxious attachments. These attachments were later subdivided into ambivalent and avoidant. Later, Mary Main added a third attachment style, the disorganized type. The discovery of the insecure attachment led Bowlby to discuss “developmental pathways.” In this model, he sees development as a continuum within which successive tasks had to be mastered. He conceived of the insecure attachment and the unconscious representation of the parents who created them as vulnerabilities that could be reactivated by adverse life events. Then the individual could become symptomatic and deviate from the norms established by the securely attached population. In addition, Dr. Main has demonstrated the relationship between unresolved parental trauma as measured by the Adult Attachment Interview (AAI), and the subsequent development of insecure attachment in the children of those parents.

As mentioned earlier, Bowlby’s observations were not accepted by some sections of the psychoanalytic community. His observation and theory challenged the tenets of dual drive theory and this was seen by some as heresy. His theory seemed to threaten the centrality of dual drive theory to the development of neurosis. He also stressed the importance of actual life events and quality of relationship as important factors in the development of psychopathology. In his view, patient’s brought with them to therapy the unconscious attachment style that they brought from their childhood, and these characteristics were transferred to the therapist. He saw therapy as a forum to inquire and explore the nature of the unconscious attachment despite the resistance that the patient may demonstrate to that process. He saw the therapeutic relationship as an alternate attachment system by which the discomfort from the original attachment could be faced and hopefully repaired. Bowlby (1984) was enthusiastic about the capability of therapy to alter attachment patterns. Even today we are re-designing therapies to accomplish these goals. Instead of seeing the patient as a helpless victim of powerful unconscious drives which created unbearable conflict and defense, he saw the need for safety, security, and comfort as a cornerstone of mental health. Once those needs were satisfied, the patient had the capacity to expand, explore and create, free of symptoms.

Today attachment and attachment theory is expanding its frontiers into the areas of treatment of patients with borderline and narcissistic pathology. For one of the first times in the history of psychotherapy, empirical developmental research (as opposed to clinical inquiry) is dictating changes in clinical technique. The potential applications of attachment theory to individual therapy, couples therapy and family therapy are just beginning to be established. Another frontier application of attachment theory is to community intervention at the mother/child interface, and last, but not least, to society at large, with an emphasis on appropriate resource allocation to the needs of mothers and children.

Lifespan Learning Institute has worked long and hard to bring together what we believe to be the world’s leading thinkers and innovators in the area of attachment. The co-coordinators of this conference hope that each of you will enjoy this festival of knowledge, and will leave here as stimulated and excited by this topic as we are.

Robert J. Neborsky, MD

Conference Co-coordinator