Attachment Theory is located in the Psychodynamic School, founded by Sigmund Freud. This school principally asks “Why?” as in “Why is he behaving like this when there is no current or visible reason for the behaviour? Unfortunately, Freud came to believe that mostly all children’s worrying behaviour was Oedipal by nature, a damaging consequence of the child unconsciously suppressing sexual thoughts and fantasies about their parents. This became the dominant orthodoxy that John Bowlby and his colleagues were up against when arguing for more provable causes of distressing behaviours, such as childhood environmental failure in general, and failure of attachment with parents in particular.
Jeffrey Masson (1992) claims that Freud originally believed the young people who spoke of childhood sexual abuse by family members and recovered from psychosomatic conditions in the ‘talking’ process. Freud shared his findings with the Society for Psychiatry and Neurology in April 1896 and later published his paper “The Aetiology of Hysteria”. But a year later Freud revised his findings, now stating that the young people had lied about their abuse and were sharing fantasies, so shameful that they had also been supressed ‘as if’ they were actual events. Masson argues, based on correspondence he discovered between Freud and his close colleague and friend Fleiss, that because Freud’s original thesis met with such critical disdain and hostility, he changed his findings in order to save his career.
Two years before his death John Bowlby (1988) looked back, somewhat angrily, I think, for such a usually reserved man, at how
… the concentration in analytic circles on fantasy and the reluctance to examine the impact of real- life events has much to answer for. Ever since Freud made his famous, and in my view, disastrous volte-face in 1897, when he decided that the childhood seductions he had believed to be aetiologically important were nothing more that the products of his patients’ imagination, it has been extremely unfashionable to attribute psychopathology to real life experiences (p87).
Bowlby’s own hero was Charles Darwin (1990), whose acclaimed psycho-biography Bowlby wrote in the last few years of his life. He much respected how Darwin meticulously researched his subject, spending nearly four demanding years voyaging on The Beagle and yet Darwin hesitated to publish his findings, and when he did so it was with great diffidence. Perhaps Bowlby compared Darwin unfavourably with Freud, who founded an empire of theory not based on anything he could scientifically prove but only assumed.
It has only recently ( I believe in Ireland in the early 1990s) become official policy to believe children when they disclose abuse. For example, the Irish Children First: National Guidance for the Protection and Welfare of Children (2017) now recommends that reasonable grounds for concern and informing Tusla is “A child saying or indicating by other means that he or she has been abused” (p 17). It is terrible to speculate how many children and young people who spoke up about their abuse were ignored or reviled as sexual fantasists. And how many of their abusers confidently assumed and told their victims that this would be the case.
Young health care professionals today may look back on those times with amazement at how gullible so many intelligent and professionally trained people were. But it is also profitable to ask if there are any such phenomena possible today. Is is reasonable to ask whether it makes sense today how the presenting psychopathology of children with clear evidence of early neglect, trauma and abuse can be instead diagnosed and treated as ADHD? This is a controversial condition for which there is yet no scientific cause or proof that ADHD is the cause of brain malfunction (see for example F.A Baughman (2006) and P.R. Breggin (2001). If we were following the science, however, there is overwhelming scientific evidence that neglect, trauma and abuse can affect how the brain is miss wired. The treatment for this is not pharmacology but psychotherapy (see A N Schore (2012).
John Bowlby was born into a very comfortable middle class family in London on February 26th 1907, the fourth child. His father was Major-General Sir Anthony Bowlby, a surgeon who operated on one of Queen Victoria’s children and subsequently became Royal Surgeon to Edward VII and George V. Bowlby’s childhood experiences were to influence his life’s work as a child psychoanalyst and lead to his part in developing Attachment Theory. His biographer, Jeremy Holmes (1993) paints a vivid picture of this joyless childhood, regulated by order and clocks, parents who rarely saw their children and who left their rearing to a nanny and her two nursemaids. Bowlby remembered one of them, Minnie, as his effective mother, and when she left the household to work elsewhere when he was four years of age he was emotionally devastated. He was sent to boarding school when he was seven, where he recalled that he was beaten for defining a cape as a form of cloak rather than a promontory, so perhaps not the most progressive of schools. These were some of the significant events of separation and loss which were to inspire him to join the staff at a progressive boarding school (Priory Gates, in Norfolk), an offshoot of A.S. Neill’s (1968) Summerhill, once his father, as Bowlby put it ‘fortunately’ died and he was free at last, at the age of 21, to make his own decisions.
There he encountered a seven year old boy who became known as Bowlby’s Shadow, as he attached himself to the newcomer and could not be separated from him. Bowlby found that he could relate to the young people there and put this down to being able to empathise from his own unhappy childhood experiences. Another boy caught his attention, a boy who patrolled the boundaries of the school but only came in at night to eat the food and milk left out for him. Bowlby asked himself: how can one boy not bear to be separated, while another dare not come close? His colleague and mentor there, John Alford, suggested, not altogether tongue in cheek, that Bowlby should train as a child psychoanalyst and bring them back the answers!
His first supervisor was Joan Reviere, an associate of Melanie Klein who had made the earliest mother/infant relationship all important and the fantasies of the infant key to everything. Freud was long dead but his daughter Anna strongly disagreed and followed her father’s more, according to Klein, paternalistic view, that neurosis developed round about the age of two with the Oedipus Complex, penis envy and fear of castration. Clifford (2017) claims that “Bowlby’s formal training as a psychoanalyst led him to an extraordinarily contentious training analysis with Joan Reviere , in which he demanded that she demonstrate the validity of her psychoanalytic beliefs.” This is hardly surprising given Bowlby’s respect for scientific rigour and his insistence that intuition is not enough.
Bowlby volunteered for service at the outset of World War 2 but was deployed instead to training officers for active duty. He also worked clinically as a psychotherapist with traumatised children and with delinquent children evacuated from London. Researching the former group he produced the paper Forty-four Juveniles Thieves, their characters and their home lives (1940) . Here he coined the phrase ‘affectionless psychopath’ and claimed that the absence of loving and continuous childhood care resulted in him (usually a ‘him’) not having a capacity for empathy and concern for anyone else.
After the war he and many of his former army colleagues regrouped at the Tavistock Clinic, in Hampstead, London where he was elected Deputy Director and founded the Department for Children. He was commissioned by the World Health Organisation to evaluate the condition of the children affected by the war throughout the world and his monograph (1951) and the subsequent abridged edition Child Care and the Growth of Love (1965) brought him international credit and distinction. But he remained a controversial and unpopular person in London psycho-analytic circles, opposed as he was to the orthodoxy of Freud’s sexual fantasy.
It is not surprising that Bowlby was drawn to ethology, the study of animals in their natural environments, pioneered by Darwin, for evidence of developmental process, as opposed to a mere instinctual drive to survive. He was delighted to form a close friendship with Konrad Lorenz, (link to uTube ) an Austrian ethologist who worked with greylag geese and established that their drive for proximity to their parents was stronger than their desire for lifegiving food and water. He also met Harry Harlow (link to uTube) who with his research students at MIT (Massachusetts Institute of Technology) had been working with rhesus monkeys, depriving them of sustenance and then releasing them in to a cage where they chose a padded mannequin for comfort, but starved, rather than going to the unpadded one that had the food and water they desperately needed. The findings of both pieces of research conflicted with Freud’s classic drive theory, proposing that comfort was a stronger motivational drive than hunger. This strengthened Bowlby’s hand when arguing that proximity was more an end in itself, rather than simply a way of avoiding predation.
Mary Ainsworth (1969) responded to an advertisement placed by Bowlby in the London Times seeking researchers in the area of the mother/child relationship. She had trained with fellow Canadian William Blatz (1966) who had developed security theory, later to be reframed by Bowlby as the Secure Base, the principle that the more secure the infant felt with his carer, the further he or she could make excursions from the base. The base in this context means a place where one lives for a while but must inevitably move on from. The paradox is that the more secure the base, the sooner it is left. Bowlby was impressed with and grateful for this theory but it is curious how Blatz subsequently disappeared from the attachment narrative and is never acknowledged. My hunch is that his earlier experiments with a chair that unexpectedly collapsed under the unsuspecting subject, measuring heartbeat and emotional responses, did not impress a more ethically scrupulous Bowlby.
Another recruit to this small research group was James Robertson (1952) a conscientious objector during the war who had been propitiously sent to maintain the boilers and clean the toilets at Anna Freud’s nursery in Hampstead.
She recognised a person with an acute ability to observe and record and encouraged him to train as a child psychoanalyst. He later became very concerned about the state of children in London hospitals who were separated from their parents. He produced a terrible to least terrible league of London hospitals, some that allowed no visiting whatever, to others at the less terrible end, that allowed perhaps an hour at weekends. He brought this thinking to Bowlby and his associates and argued that people would never get the importance of attachment until they understood loss and separation. Bowlby agreed and together they made a black and white film documenting a small girl, aged 2, separated from her parents when she went to hospital. They showed it to a meeting of the British Psychoanalytic Society and won the support of Anna Freud. However “the Kleinians in the audience were unimpressed, and felt that the girl’s distress was due more to her unconscious destructive phantasies towards her mother’s unborn baby than to the separation itself” (Holmes, 1993, p.4 ). It remains impossible not to be moved watching that film today and not be affected by the girl’s terrible distress and her gradual deterioration and withdrawal into despair. An extract of this film, John Robertson “A two year old goes to hospital” is available on uTube and is worth the personal effort of downloading it, rather than pressing a link. As she asks, “I want my mother”, ask yourself, is this all in her mind?
Mary Ainsworth went to Uganda in 1952 to undertake research into mother/child attachments. As an experienced scientist and researcher, she was somewhat sceptical about Bowlby’s enthusiasm for an ethological approach although very impressed with Robertson’s use of it, using film in an ethological respectful way similar to David Attenborough today. She also thought that Robertson undersold his own role in the development of attachment theory. She was expecting to observe children who had been separated from their mothers in order to ‘forget the breast’ a form of weaning that was now discontinued when she arrived.
What she studied instead was how children greeted their parents when they returned from the bush after gathering food and fuel. Parents took the older children to work and the babies they carried. Those left behind were the toddlers and those too young to be helpful. She observed the majority of these children running up to parents, happy to see them but also protesting their absence. She called this group Securely Attached.
A second much smaller group seemed to wait and see which mother came back, the one who had effusively loved them that morning, or the same mother who might ignore and reject them this evening. She called these children Insecure Ambivalently Attached, as the mothers seemed to be ambivalent about their children. She also noticed that these children seemed to anxiously hang around their mothers, too insecure to make excursions and play. This group can also be classified therefore as Insecure Ambivalent/Anxious.
The third group she identified were children who neither ran forward, nor hung back, but seemed to hide when their mothers returned. She put this down to their realistic fear of being beaten or punished for little or no reason. She termed this group Insecure Avoidant.
Mary Main (1990) later realised that many children previously categorised as Securely Attached, could be better termed Insecure Disorganised/Disoriented as these were children who when things were going well appeared to be or presented as Securely Attached but in stressful situations these children chronically and consistently lost the ability to self-regulate, as we call it now. These are the children who probably present the greatest challenge to carers. In the next chapter, I will explain the role Attachment Theory has in the provision of therapeutic care and treatment and the contribution of Donald Winnicott.
REFERENCES
Ainsworth, M. (1969) ‘Object relations, dependency and attachment: a theoretical review of the mother-infant relationship’. Child Development, 40:969-1025
Blatz, W. (1966) Human Security: Some Reflections Toronto: University of Toronto Press
Bowlby, J. (1944) ‘Forty-four juvenile thieves: their characters and home life’ International Journal of Psycho-Analysis, 21, 154-78
Bowlby, J. (1951) Maternal Care and Mental Health Geneva: World Health Organisation
Bowlby, J. (1988) A Secure Base Routledge: London
Bowlby, J (1990) Charles Darwin A New Biography Hutchinson: London
Baughman, F.A. (2006) The ADHD Fraud Trafford Publishing: Oxford, UK.
Breggin, P.R. (2001) Talking Back to Ritalin Perseus Publishing: Cambridge MA
Clifford, M.D. (2017) Attachment Volume 11, Number 1 May 2017, pp. 51-72 Phoenix Publishing House
Davies, J. (2014) Cracked – Why Psychiatry is Doing More Harm Than Good Icon Books Ltd: London
Holmes, J. (1993) John Bowlby & Attachment Theory Routledge: London
Neill, A.S. (1968) Summerhill Pelican: London
Main, M. and Solomon, J. (1990) ‘Procedure for identifying infants as disorganised/disoriented during the Ainsworth Strange Situation’ in M. Greenberg, D. Cicchetti, and M. Cummings (eds.) Attachment in the preschool years, Chicago: University of Chicago Press.
Masson, J. (1992) The Assault on Truth Fontana: London
Robertson, J. (1952) A two-year old goes to hospital (film) , Ipswich: Concord Films Council.
Schore, A.N. (2012) The Science of the Art of Psychotherapy Norton: New York and London