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Attachment as a Context for Development: Challenges and Issues
Quality Contexts for Children's Development
What is Attachment?
Attachment is a process which takes place between the primary caregiver and an infant:
An attachment may be defined as an affectional tie that one person or animal forms between himself and another specific one - a tie that binds them together in space and endures over time. (Ainsworth et al in Woodhead et al, 1992, p 31)
Attachment is usually talked about in relation to mothers and their infants. John Bowlby first brought this concept to the fore. His work was considered to place an undue emphasis on the role of the mother and fell into disfavour. This was largely due to the fact that his work was used in the post World War II era to pressure women into remaining at home to care for their children rather than seeking employment. The major thrust of Bowlby's work was the impact of traumatic separation on infants. His work represented a significant move away from the psychoanalytic focus on the inner world as he developed a theory to explain behaviour which took account of external events. Later research has expanded on Bowlby's ground breaking research and has reinstated attachment as an important concept.
The emphasis on attachment to the mother has shifted to an emphasis on the primary caregiver (which may not be the mother) and it is now recognised that children can form multiple attachments. An important development in challenging the assumption that mothers needed to be at home full-time was the discovery that quality was more important than quantity in forming secure attachments between caregivers and their children.
There has been confusion over the terms bonding and attachment. Bonding has at times been portrayed as an almost mystical experience for mothers following the birth of their child. While some mothers do have this experience many do not. Attachment is a two way process which develops over time. Both the primary caregiver and the infant are active participants in this process. The key factor for the caregiver is sensitive responsiveness - the ability to attune to the child and respond to their signals. The child's responsiveness is also an important contributor to the process. Attachment problems are more likely to arise with "difficult" babies.
Before moving on to a discussion of some of the difficulties which may arise it is important to note that research has established a clear link between secure attachment and other developmental processes, in particular language development and exploratory behaviour. (Sroufe in Belsky & Nezworski, 1988; Caruso, 1989) An enormous amount of learning takes place during the pre-school years. Growth and change take place on a daily basis. Children learn from the world around them. Attachment provides a frame of reference and the security necessary for the child to undertake this learning. It also provides a major incentive in the acquisition of socially appropriate behaviour. The desire to gain the approval of significant adults is a powerful motivation in learning to control equally powerful but less desirable urges.
Attachment during infancy also lays the foundation for future relationships. We are social beings and dependency during infancy is not just physical. During the 1950s Spitz made a film entitled Grief; A Peril in Infancy which graphically portrayed babies in a serious state of decline even though their physical needs were attended to. (Bowlby, 1982) Bowlby identified attachment behaviours such as approaching, following, clinging, smiling, calling and crying. These are behaviours designed to promote proximity to, or contact with the caregiver. As the two-way relationship develops these behaviours become more sophisticated and develop into patterns of interaction. More recent research, especially the work of Selma Fraiberg (1980) and Mary Main (1984) has demonstrated the ways in which attachment patterns can be transmitted across generations. Fahlberg (1988) provides a succinct summary of the function of attachment for the child.
"Attachment helps the child:
- attain full intellectual
What problems can occur?
The attachment process is based on fine-tuning the relationship between caregiver and child. Therefore multiple difficulties may arise in any situation. For example separation due to illness, depression, stress and tension within the family may make it difficult for the primary caregiver and/or child to respond to each other. Major difficulties are likely to occur where the caregiver has unresolved issues in relation to their own attachment to their caregiver(s). This is not an inevitable outcome of attachment difficulties in childhood, but is likely to be a problem where these difficulties are not recognised.
Consistency in the response of the caregiver is an important factor in building secure attachments. Where the environment is chaotic and the primary caregiver is not available to the child secure attachment will not be possible.
Different patterns of attachment have been identified by Ainsworth using the 'Strange Situation'. This was a laboratory experiment in which the interaction between mothers and infants was observed prior to, during and after a brief separation. Three categories have been identified by Ainsworth:
This research involved white middle-class American families. Others have since developed and expanded this ground-breaking work. Crittenden (in Belsky & Nezworski, 1988) has undertaken research with at-risk relationships, further exploring the applicability of these patterns. She identified a group of children who became compulsively compliant in response to controlling, abusive mothers. These children were often classified as securely attached as their behaviour most closely approximated that group. She identified a fourth category - avoidant/ambivalent. The children in this group became compulsively compliant. They also inhibited signals of displeasure even in situations which warranted protest.
Crittenden describes the way in which children respond to their mother's style of caregiving as adaptation and raises the question of whether children who are forced to adapt to unfavourable circumstances are able to remain flexible enough to change when conditions improve.
Follow-up research has demonstrated a connection between secure attachment and later development. Bretherton and Waters study of six year olds indicated that securely attached children were more able to cope with parental absence and related to unfamiliar adults more readily. Insecurely attached children were anxious, tongue-tied and rejecting of their parents. Other researchers have identified a link between insecure attachment and conduct problems and long term consequences of avoidance. (Belsky & Nezworski, 1988)
The role of the mother Attachment theory highlights the role of the primary caregiver and in the process puts the spotlight on the person who is most likely to undertake this role in our society - the mother. This can lead to mother-blaming and be used to argue against mothers working. However a focus on attachment as the context within which development takes place alerts us to the need to provide appropriate support to those who carry the responsibility of caring for young children. This responsibility can, and I would argue should, be a shared one.
The role of the father Men have to a large extent been neglected, relegated to the role of provider. Attachment involves a relationship between a child and a primary caregiver. The process is not restricted to the female gender! Even where the primary relationship is with the mother this does not exclude the possibility of attachment relationships with others. (Rutter, 1979, pp 270 - 271) The opportunity for men to enjoy secure attachment relationships with their young children is available. Unfortunately social expectations about the roles of men and women and employment practices tend to limit the extent to which this opportunity is taken up. In discussing attachment it is important that we do not continue to neglect the role of men and perpetuate a pattern of non-involvement.
Day-care for pre-school children One of the ways in which the task of parenting can be shared is through the provision of day-care. A range of services are now available. In the past the child's need for secure attachment has been used as an argument against the provision of these services. However it is now clear that such services are not detrimental and that the issue is the quality of such services. In assessing quality, attachment is an important variable - in particular the opportunity for young children to form secure relationships with those providing alternate care. This has implications for both the service providers and for parents seeking such care. It is important that positive relationships are maintained and that there is respect for the contribution that each party makes to the child's care and development.
In a recent conversation with a person who provides family day-care the role of such services in supporting families in difficulty was highlighted. This role has much in common with families who provide alternate care for children on a full-time basis. Many of the issues and dilemmas which I will be outlining in relation to alternate care apply in these situations.
Parental separation Children are born into a diverse range of family structures and these structures may change during the course of childhood. Difficult decisions have to be made when parents separate. An understanding of attachment and its significance for children can provide guidelines for these decision-making processes. Priority must be given to the child's ability to form and maintain secure attachment to at least one primary caregiver. When deciding custody and access arrangements the needs of adults must be balanced by the child's need for security. While it is possible for a child to be securely attached to more than one adult this is not likely to be possible when those adults are in conflict. Given the importance of secure attachment for learning and development it is important that this is not compromised in an effort to appease adults.
Children at risk. When families are in serious difficulty social workers may become involved. An understanding of attachment is essential. Attachment is relevant to both the assessment of at-risk situations and in terms of children in care. Crittenden's research highlights the importance of assessing the quality of attachment as a critical variable in relation to risk. Many mothers can identify times when they may have been at risk of hurting their children. Secure attachment provides an element of protection during periods of high stress. An essential element of secure attachment is the ability to identify with the child and recognise that their distress or defiance is not an attack on oneself. Secure attachment provides a cycle of positive reinforcement for both child and adult. Each is able to appreciate and enjoy the other during periods of positive interaction. In the absence of a secure attachment a negative cycle may become established which places both the child and the adult at risk. (Schmidt & Eldridge, 1986)
Attention to the quality of parent-child interaction and the security of attachment are essential in assessing risk. Observation of the interaction combined with careful attention to the history of the relationship provide a means for assessing the security of attachment relationships. Fahlberg (1988) provides a useful checklist for assessing attachment for children of different ages.
Children in alternative care When children come into care the opportunity to experience secure attachment must be a top priority. Children cannot live with uncertainty for protracted periods. A focus on attachment may allow greater clarity in weighing the merits of different options. For example is it appropriate to work with the family to strengthen existing attachments or does the child need to be placed in a situation where they have the opportunity to develop secure attachment?
When considering alternative placement it is important not to underestimate the difficulties encountered when attempting to establish secure attachment for older children. The circumstances which led to their placement away from the family of origin are likely to have mitigated against the establishment of secure attachment. There may be some exceptions to this. Where a child has established a secure attachment and suffers disruption of this, they fare better than children who have never experienced secure attachment. There is evidence that once secure attachment has been established this can be transferred.
Where a child has never experienced secure attachment, their ability to trust is severely limited. Past experience is likely to mean that they are wary of adults and may expect the worst. At the very least they have been let down by adults, and at the worst they have suffered emotional, physical and/or sexual abuse. Most children coming into foster care have experienced the world as a chaotic and dangerous place. They may not have internalised any of the normal rules that govern daily existence. They are likely to rely on external guidelines but their co-operation with these is by no means guaranteed.
Secure attachment establishes a framework within which learning on all levels can take place. In the absence of secure attachment there may be no framework. The child's ability to learn, especially to learn about social relationships and expectations is severely impaired. Attachment is a necessary prerequisite to co-operation. While a child remains unattached there is no good reason to comply with requests or instructions. The child is likely to be experiencing a wide range of emotions which they are unable to sort out and may not even be able to label appropriately. These emotions will spill over in all sorts of situations. Adults providing care for these children require a great deal of support. Whether care is provided by extended family members or by strangers, considerable skill, patience and resilience is required. Those providing alternative care need to be prepared for the task they are taking on and an understanding of attachment is an important element in that preparation. It is not enough to provide a family environment for a child who is unable to live with their own family.
When a child is placed with another family they bring with them their connections to their family of origin. No matter how unsatisfactory their experiences may have been there are ties that bind them to the significant adults and to brothers and sisters. Crittenden has the following to say:
Attachment theory proposed that the maintenance of affectional bonds, particularly the bond between a mother and her young child, is essential to the survival of the human species and a compelling individual need.
The data from this study suggest that those people who are most at risk for destroying their love relationships altogether devote the most intense effort toward maintaining the semblance of bonds; inept mothers and their children scrap and feud; mildly abusing mothers and their infants are hostile and difficult, but many severely maltreating mothers and their children do not dare to challenge the durability of their relationships.
Rather they struggle to hide from themselves and from each other the tenuous nature of their bonds; it is as though they fear that a simple dispute could become an uncontrollable attack on the relationship. Such disasters cannot be risked often. This suggest that the pseudo-sensitive behaviour of maltreating mothers and the pseudo-cooperative behaviour of maltreated children are not false fronts offered to the prying observer, but rather reflect an armed peace protecting the interactants from themselves. 0nly those who have completely given up, who are totally depressed or angry beyond control, can withdraw from relationships entirely. These are the most tragic casualties a family can produce. (Crittenden in Blesky & Nezworski, 1988, pp 163-164)
Most of the children in care come from these types of situation. It is difficult for them to know what is real and who can be trusted. At the same time that foster parents are attempting to establish meaningful relationships with them they continue to grapple with the complexities of their families of origin. Social Workers have an important role in monitoring and mediating access arrangements. Foster parents need to feel heard, as do natural parents and the children. The priority has to be the needs of the child and security of attachment is an important variable in determining these.
What can be done when attachment has been disrupted?
The most important first step is to begin the process of building secure attachment. Early intervention has the greatest chance of success. Appropriate models of intervention with mother-infant dyads are available. (Muir 1992). The availability of support services to new mothers is essential.
Intervention with toddlers and older children is also possible. To understand how to do this we need to look at the way in which secure attachment develops between caregiver and infant. While we cannot recreate this situation it is important to remember that the basic needs of the baby are still unmet in the child who is not securely attached. These include:
Holding and eye contact are very important. Children with attachment difficulties often resist this. However, holding has been demonstrated to be effective in a wide range of situations. This technique is based on the physical holding of children, even while they protest. Clearly there are problems implementing this with older children and children have suffered abuse. However, holding can be achieved in other ways - sitting with children, tucking them into bed and staying with them etc. (Welch 1988)
For parents or alternate caregivers to provide secure holding they in turn need to be "held". This means they need to feel valued and respected in their role as caregivers. They need to understand the child's experience and the links between present behaviour and past experience. A significant part of holding is attention to the practical details of financial support, access arrangements, and future goals/plans. If the child is in care the social worker's role is very important in this process. Social work also has an important contribution to make in supporting intact families in the community. Attention to attachment difficulties may eliminate the need for the child to come into care. There are excellent models of intervention available. (Lieberman et al 1984 & 1991)
Secure attachment provides the foundation for positive growth. It is therefore essential that all children have the opportunity to enjoy such relationships. A wide range of people come into contact with children and families. Sometimes it is necessary to speak out on behalf of children to ensure that their voices are heard by those who have power in their lives. Sometimes we have the opportunity to do this in relation to specific children and on other occasions we may be able to influence social policy or agency practice to ensure that children's right to secure attachment relationships is given priority.
Ainsworth, Mary D.S., 'Object Relations, Dependency, and Attachment: A Theoretical Review of the Infant-Mother Relationship', Child Development, Vol. 40,1969, pp 969 -1025
Ainsworth, Mary D.S., 'Infant-Mother Attachment', American Psychologist, Vol.34, No.10, 1979, pp 932 - 937
Ainsworth, Mary D. S., Bell, S. M. & Stayton, D. J., 'Infant-mother attachment and social development: 'socialisation' as a product of reciprocal responsiveness to signals', in M. Woodhead, R. Carr & P. Light (eds), Becoming a Person, Routledge, London, 1991
Belsky, J. & Nezworski, T. (ed.) Clinical Implications of Attachment, Lawrence Erlbaum Assoc., Hillsdale, New Jersey, 1988
Bowlby,J., Attachment and Loss Volume 1: Attachment, Penguin Books, Harmondsworth, 1971
Bowlby, J., 'Attachment and Loss: Retrospect and Prospect', American Journal of Orthopsychiatry, 52(4), October 1982, pp 664 -678
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Lieberman, A. J. & Pawl, J. H., 'Searching for the Best Interests of the Child', Psychoanalytic Study of the Child, Vol. 39,1984, pp 527 - 548
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Main. M. & Goldwyn, R., 'Predicting Rejection of Her Infant From Mother's Representation of Her Own Experience: Implications for the Abused- Abusing Intergenerational Cycle', Child Abuse and Neglect, Vol. 8,1984, pp 203 -217
Muir, E., 'Watching, Waiting and Wondering: Applying Psychoanalytic Principals to Mother-Infant Intervention', Infant Mental Health Journal, Vol 13, No. 4, Winter 1992, pp 319 -328
Peterson, C., Looking Forward Through the Life Span (second edition), Prentice Hall, Australia, 1989 pp 129 -151
Russell, S., 'Attachment Disorders: Implications for Child Welfare Practice', Children Australia, Volume 17. No. 1,1992, pp 20 - 24
Rutter, M., 'Attachment and the Development of Social Relationships', in Scientific Foundations of Developmental Psychiatry, ed. M. Rutter, Heineman, London, 1979, pp 267 - 279
Schmidt, E. & Eldridge, A., 'The Attachment Relationship and Child Maltreatment', Infant Mental Health Journal, vol. 7. No. 4, Winter 1986, pp 264 - 273
Welch, M., Holding Time, Century, London, 1989
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