Attachment theory

  Attachment theory is a psychological, evolutionary and ethological theory that provides a descriptive and explanatory framework for discussion of interpersonal relationships between human beings. Attachment theory originated in the work of John Bowlby. In infants it is primarily a process of proximity seeking to an identified attachment figure in situations of perceived distress or alarm. Infants become attached to any individual who is physically available to them for a long period of time. They become securely attached to an individual who is emotionally available (i.e., sensitive and responsive) to them for a long period of time. Parental responses lead to the development of patterns of attachment which in turn lead to 'internal working models' which will guide the individuals feelings thoughts and expectations in later relationships.^[1]

In Bowlby's approach, the human infant has a need for a secure relationship with adult caregivers, without which normal social and emotional development will not occur. However, different relationship experiences can lead to different developmental outcomes. A number of attachment styles in infants with distinct characteristics have been identified known as secure attachment, avoidant attachment, anxious attachment and disorganized attachment. These can be measured in both infants and adults. In addition to care-seeking by children, attachment behaviours include peer relationships of all ages, romantic and sexual attraction, and responses to the care needs of infants or sick or elderly adults.

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Tenets of attachment theory

Attachment theory uses a set of assumptions to connect observable human social behaviors. These assumptions form a coherent whole that fits with available data. The following is a list of the assumptions that form the theory:^[2]

1.Adaptiveness: Common human attachment behaviors and emotions are adaptive. Evolution of human beings has involved selection for social behaviors that make individual or group survival more likely. For example, the commonly observed attachment behavior of toddlers includes staying near familiar people; this behavior would have had safety advantages in the environment of early adaptation, and still has such advantages today.

2. Brain functions: Specific structures and functions of the central nervous system underlie at least some of human attachment behavior. For example, the preference of infants for looking at faces and eyes is based on brain and sensory functioning as it exists in the early months. Such brain characteristics are genetically controlled and therefore can be shared by all, or almost all, human beings, thus establishing basic behavioral tendencies that need not be learned.

3. Developmental changes: Specific attachment behaviors begin with predictable, apparently innate, behavior in infancy, but change with age in ways that are partly determined by experiences and by situational factors. For example, a toddler is likely to cry when separated from his mother, but an 8-year-old is more likely to call out, "When are you coming back to pick me up?" and/or to turn away and begin the familiar school day.

4. Experience as essential factor in attachment: Infants in their first months have no preference for their biological parents over strangers and are equally friendly to anyone who treats them kindly. Preferences for particular people, and behaviors which solicit their attention and care, develop over a period of time.

5. Monotropy: Early steps in attachment take place most easily if the infant has one caregiver, or the occasional care of a small number of other people.

6. Social interactions as cause of attachment: Feeding and relief of an infant's pain do not cause an infant to become attached to a caregiver. Infants become attached to adults who are sensitive and responsive in social interactions with the infant, and who remain as consistent caregivers for some time.

7. Transactional processes: As attachment behaviors change with age, they do so in ways shaped by relationships, not by individual experiences. A child's behavior when reunited with a caregiver after a separation is determined not only by how the caregiver has treated the child before, but on the history of effects the child has had on the caregiver in the past.

8. Critical period: Certain changes in attachment, such as the infant's coming to prefer a familiar caregiver and avoid strangers, are most likely to occur within a fairly narrow age range. The period between about 6 months of age and 2 or 3 years is the time during which attachment to specific caregivers is most likely to occur.

9.Robustness of development: Attachment to and preferences for some familiar people are easily developed by most young humans, even under far less than ideal circumstances.

10. Internal working model: Early experiences with caregivers gradually give rise to a system of thoughts, memories, beliefs, expectations, emotions, and behaviors about the self and others. This system, called the internal working model of social relationships, continues to develop with time and experience, enables the child to handle new types of social interactions. For example, a child's internal working model helps him or her to know that an infant should be treated differently from an older child, or to understand that interactions with a teacher can share some of the characteristics of an interaction with a parent. An adult's internal working model continues to develop and to help cope with friendships, marriage, and parenthood, all of which involve different behaviors and feelings. The internal working model is likely to owe much to the individual's early experiences with caregivers, but it can and does change with both real and vicarious experiences.

Attachment is an affectional tie that one person or animal forms between him/herself and another specific one (usually the parent) — a tie that binds them together in space and endures over time.^[3]. Attachment theory states that attachment is a developmental process based on the evolved adaptive tendency for young children to maintain proximity to a familiar person, called the attachment figure.^[4] Attachment Theory has become the dominant theory used today in the study of infant and toddler behavior and in the fields of infant mental health, treatment of children, and related fields. Many evidence-based treatment approaches are based on applications of attachment theory.

History

The concept of infants' emotional attachment to caregivers has been known anecdotally for hundreds of years. Most early observers focused on the anxiety displayed by infants and toddlers when threatened with separation from a familiar caregiver. Freudian theory attempted a systematic consideration of infant attachment and attributed the infant's attempts to stay near the familiar person to motivation learned through feeding experiences. In the 1930s, the British developmentalist Ian Suttie put forward the suggestion that the child's need for affection was a primary one, not based on hunger or other physical gratifications ^[5]

The formal origin of attachment theory can be traced to the publication of two 1958 papers, one being John Bowlby's "the Nature of the Child's Tie to his Mother", in which the precursory concepts of "attachment" were introduced, and Harry Harlow's "the Nature of Love", based on the results of experiments which showed, approximately, that infant rhesus monkeys spent more time with soft mother-like dummies that offered no food than they did with dummies that provided a food source but were less pleasant to the touch.^[6][7]

As John Bowlby began to formulate his concept of attachment, he was influenced by case studies such as one by David Levy ^[8] that associated an adopted child's lack of social emotion to her early emotional deprivation. Bowlby himself was interested in the role played in delinquency by poor early relationships, and explored this in a study of young thieves. ^[9]

Other sources that influenced Bowlby's thought included ethological studies such as those discussed by Tinbergen ^[10]. Tinbergen and his colleague Konrad Lorenz had examined the phenomenon of "imprinting" and felt that it might have some parallels to human attachment. Imprinting, a behavior characteristic of some birds and a very few mammals, involves rapid learning of recognition by a young bird or animal exposed to a conspecific or an object or organism that behaves suitably. The learning is possible only within a limited age period, known as a critical period. This rapid learning and development of familiarity with an animate or inanimate object is accompanied by a tendency to stay close to the object and to follow when it moves; the young creature is said to have been imprinted on the object when this occurs. As the imprinted bird or animal reaches reproductive maturity, its courtship behavior is directed toward objects that resemble the imprinting object. Bowlby's attachment concepts later included the ideas that attachment involves learning from experience during a limited age period, and that the learning that occurs during that time influences adult behavior. However, he did not apply the imprinting concept in its entirety to human attachment, nor assume that human development was a simple as that of birds. He did, however, consider that attachment behavior was best explained as instinctive in nature.

Bowlby's view of attachment was also influenced by observations of young children separated from familiar caregivers, as provided during World War II by Anna Freud and her colleague Dorothy Burlingham ^[11] Observations of separated children's grief by Rene Spitz were another important factor in the development of attachment theory.^[12]

The important concept of the internal working model of social relationships was adopted by Bowlby from the work of Kenneth Craik, the philosopher ^[13]. The theory of control systems (cybernetics), developing during the '30s and '40s, influenced Bowlby's thinking about attachment ^[14]. The young child's need for proximity to the attachment figure was seen as balancing homeostatically with the need for exploration. The actual distance maintained would be greater or less as the balance of needs changed; for example, the approach of a stranger, or an injury, would cause the child to seek proximity when a moment before he had been exploring at a distance.

Mary Ainsworth conducted research based on Bowlby's theory and devised the Strange Situation protocol, still used today to assess attachment style in children, as the laboratory portion of a larger study that included extensive home visitations over the first year of the child's life. This study identified three attachment patterns that a child may have with his primary attachment figure: secure, anxious-avoidant, and anxious-ambivalent.

Further research by Dr. Mary Main and colleagues (University of California at Berkeley) identified a fourth attachment pattern, called disorganized attachment, which reflects these children's lack of a coherent coping strategy.

Other recent research has followed children into the school environment, where securely attached children generally relate well to peers, ambivalently attached children tend to victimize peers and avoidantly attached children may be victimized by peers and be coy.^{[4][15][16] [17]} These early studies focused on attachment between children and caregivers.

Although research on attachment behaviors continued after Bowlby's death, there was a period of time when attachment theory was considered to have run its course. Some authors argued that attachment should not be seen as a trait (lasting characteristic of the individual), but instead should be regarded as an organizing principle with varying behaviors resulting from contextual factors^[18]. Related later research looked at cross-cultural differences in attachment, and concluded that there should be re-evaluation of the assumption that attachment is expressed identically in all humans ^[19]

Interest in attachment theory continued, and the theory was later extended to adult romantic relationships by Cindy Hazen and Phillip Shaver.^{[20] [21] [22]}

Peter Fonagy and Mary Target have attempted to bring attachment theory and psychoanalysis into a closer relationship by way of such aspects of cognitive science as mentalization, the ability to estimate what the beliefs or intentions of another person may be. ^[14]

A "natural experiment" has permitted extensive study of attachment issues, as researchers have followed the thousands of Romanian orphans who were adopted into Western families after the end of the Ceasescu regime. The English and Romanian Adoptees Study Team, led by Sir Michael Rutter, has followed some of the children into their teens, attemtping to unravel the effects of poor attachment, adoption and new relationships, and the physical and medical problems associated with their early lives. Studies on the Romanian adoptees, whose initial conditions were shocking, have in fact yielded reason for optimism. many of the children have developed quite well, and the researchers have noted that separation from familiar people is only one of many factors that help to determine the quality of development. ^[23]

Basic attachment theory

Main article: Attachment in children

It has been suggested for many years that children develop different styles of attachment based on experiences and interactions with their primary caregivers. Researchers have developed various ways of assessing attachment in children, including the Strange Situation Protocol developed by Mary Ainsworth and story-based approaches such as Attachment Story Completion Test. Four different attachment styles have been identified in children: secure, anxious-ambivalent, anxious-avoidant, and disorganized. (For research purposes, Avoidant (insecure), Secure and Resistant/Ambivalent (insecure) are called A,B and C respectively. Group D, Disorganized/disoriented (insecure) attachment was added later when it became apparent some infants did not fit A,B or C. ^[24])

• Secure Attachment - The child protests the mother's departure and quiets promptly on the mother's return, accepting comfort from her and returning to exploration.

• Avoidant Attachment - The child shows little to no signs of distress at the mother's departure, a willingness to explore the toys, and little to no visible response to the mother's return.

• Ambivalent Attachment - The child shows sadness on the mother's departure, ability to be picked up by the stranger and even 'warm' to the stranger, and on the mother's return, some ambivalence, signs of anger, reluctance to 'warm' to her and return to play.

• Disorganized Attachment - The child presents stereotypes upon the mother's return after separation, such as freezing for several seconds or rocking. This appears to indicate the child's lack of coherent coping strategy. Children who are classified as disorganized are also given a classification as secure, ambivalent or avoidant based on their overall reunion behavior.

Additionally, the attachment patterns observed in children are correlated with certain behavior patterns and communication styles in the attachment figure:

• Secure Attachment - The attachment figure responds appropriately, promptly and consistently to the emotional as well as the physical needs of the child. She helps her child to transition and regulate stress, and as a result, the child uses her as a secure base in the home environment.

• Avoidant Attachment - The attachment figure shows little response to the child when distressed. She discourages her child from crying and encourages independence and exploration. The avoidantly attached child may have lower quality play than the securely attached child.

• Ambivalent Attachment - The attachment figure is inconsistent with her child; she may at some times be appropriate and at other times neglectful to the child. The child raised in an ambivalent relationship becomes preoccupied with the mother's availability and cannot explore his environment freely or use his mother as a secure base. The ambivalently attached child is vulnerable to difficulty coping with life stresses and may display role reversal with the mother.

• Disorganized Attachment - This can be associated with frightened/disoriented behaviour, intrusiveness/negativity and withdrawal, role/boundary confusion, affective communication errors and child maltreatment.

Changes in attachment after the infant-toddler period

According to Bowlby's theory, the child's early experience of social interactions with familiar people leads to the development of an internal working model of social relationships, a set of ideas and feelings that establish the individual's expectations about relationships, the behavior of others toward him or her, and the behaviors appropriate for him or her to show to others. The internal working model continues to develop and become more complex with age, cognitive growth, and continued social experience. As the internal working model of relationships advances, attachment-related behaviors lose some of the characteristics so typical of the infant-toddler period, and take on a series of age-related tendencies. Basically, Bowlby's Attachment theory states that the relationship a child has with his or her primary care-giver determines the pattern of relationships he or she will have in adulthood.

It should be noted that some authors have suggested continuous rather than categorical gradations between attachment patterns, and have discussed dimensions of underlying security rather than the classifications derived from Ainsworth's work ^[5]

Some commentators have provided a more extensive discussion of the development of attachment behavior and the internal working model after the toddler period ^[5] They suggest that the preschool period involves the use of negotiation, bargaining, and compromise as part of attachment behavior, and that these social skills ideally become incorporated into the internal working model of social relationships, to be used with other children and later with adult peers. As children move into the school years, most develop a goal-corrected partnership with parents, in which each partner is willing to give up some desires in order to maintain the relationship in a gratifying form. Incorporation of this type of partnership into the internal working model prepares the growing child for later mature friendships, marriage, and parenthood. The mature internal working model of social relationships thus advances far beyond the basic desire to maintain proximity to familiar people, although this type of behavior may continue to be present in times of threat or pain.

Attachment in adults

Main article: Attachment in adults

Attachment in adults is commonly measured using the Adult Attachment Interview and self-report questionnaires. Self-report questionnaires have identified two dimensions of attachment, one dealing with anxiety about the relationship, and the other dealing with avoidance in the relationship. These dimensions define four styles of adult attachment: secure, preoccupied, dismissive-avoidant, and fearful-avoidant.

There are a wide variety of attachment measures used in adult attachment research. The most popular measure in the social psychological research is the Experiences in Close Relationships-Revised scale. This scale treats attachment as two dimensions: anxiety and avoidance. The Adult Attachment interview is also commonly used to assess an individual's ability to discuss previous relationships with attachment figures. The interview consists of 36 questions, varying in detail from basic background information to instances of loss and trauma (if any). An independently trained coder determines the consistency of the individual's descriptions based on emotion regulation and content of information in the interview. Developmental psychologists use the Adult Attachment Interview (AAI; George,Kaplan, & Main) or the Adult Attachment Projective (AAP; George, West, & Pettem). The AAI is an interview about attachment experiences that gets recorded and analysed for attachment status. The AAP is a guided interview which uses vague drawings about which the individual can tell a story. The story responses are recorded and decoded for attachment status. Generally attachment style is used by social psychologists interested in romantic attachment, and attachment status by developmental psychologists interested in the individual's state of mind with respect to attachment. The latter is more stable, while the former fluctuates more.

Attachment in adult romantic relationships

Hazan and Shaver extended attachment theory to adult romantic relationships in 1987. It was originally characterized by three dimensions: secure, anxious/ambivalent and avoidant. Later research showed that attachment is best thought of as two different dimensions: anxiety and avoidance. These dimensions are often drawn as an X and Y axis. In this model secure individuals are low in both anxiety and avoidance. Thus, attachment can also be broken down into four categories: secure, anxious-ambivalent (preoccupied), avoidant (dismissive), and fearful-avoidant. However, people's attachment varies continuously so most researchers do not currently think in terms of categories.

Attachment research into romantic relationships has led to a wide variety of findings. Mario Mikulincer has shown through a wide variety of studies that attachment influences how well people are able to cope with stress in their life. Nancy Collins and colleagues have shown that attachment influences many kinds of care-giving behavior. Jeff Simpson and Steve Rholes have conducted a number of studies showing that attachment influences how people parent their newborn children and how well they are able to cope with the stress of having a newborn child.

Attachment theory in clinical practice

Attachment disorder

Main article: Attachment disorder

Attachment disorder is an ambiguous term used in many different ways. One use is to refer to an inability to form normal attachments with caregivers during childhood. This may have adverse effects throughout the lifespan. Results of a study showed a positive and strong correlation between the security of the child-mother attachment representation and positiveness of self. It also showed significant and positive correlations between positiveness of self to competence and social acceptance, to behavioral adjustment at school, and to behavioral manifestations of self-esteem.^[25] Attachment disorder is also sometimes used to refer to Reactive attachment disorder, the only 'official' clinical diagnosis, and on occasion to refer to the less desirable attachment styles.

Reactive attachment disorder

Main article: Reactive attachment disorder

Reactive Attachment Disorder — sometimes referred to by its initials, "RAD" — is a psychiatric diagnosis (DSM-IV-TR 313.89, ICD-10 F94.1/2). The essential feature of Reactive Attachment Disorder is markedly disturbed and developmentally inappropriate social relatedness in most contexts that begins before age 5 years and is associated with gross pathological care. There are two subtypes, one reflecting the disinhibited attachment pattern and the other reflecting the inhibited pattern.

Criticism

Criticism of Bowlby's view of attachment has been sporadic. One critic questioned the suggestion that early attachment history had a lifelong impact. ^[5] Another discussed how mother and child could provide each other with positive reinforcement experiences through their mutual attention and therefore learn to stay close together; this explanation would make it unnecessary to posit innate human characteristics fostering attachment. ^[5] A recent critic is J. R. Harris[1], who is generally concerned with the concept of infant determinism and stresses the effects of later experience on personality.

See also

References

Further reading

• Barrett, H. (2006) Attachment and the perils of parenting: a commentary and a critique. National Family and Parenting Institute, London, UK.
• Cassidy, J., & Shaver, P., (Eds). (1999) Handbook of Attachment: Theory, Research, and Clinical Applications. Guilford Press, NY.
• Greenberg, MT, Cicchetti, D., & Cummings, EM., (Eds) (1990) Attachment in the Preschool Years: Theory, Research and Intervention University of Chicago, Chicago.
• Greenspan, S. (1993) Infancy and Early Childhood. Madison, CT: International Universities Press. ISBN 0-8236-2633-4.
• Holmes J (1993). John Bowlby and attachment theory, Makers of modern psychotherapy. London; New York: Routledge. ISBN 0-415-07730-3 (pbk). ISBN 0-415-07729-X. OCLC 27266442. 
• Holmes, J. (2001) The Search for the Secure Base: Attachment Theory and Psychotherapy. London: Brunner-Routledge. ISBN 1-58391-152-9.
• Karen R (1998) Becoming Attached: First Relationships and How They Shape Our Capacity to Love. Oxford University Press. ISBN 0-19-511501-5.
• Parkes, CM, Stevenson-Hinde, J., Marris, P., (Eds.) (1991) Attachment Across The Life Cycle Routledge. NY. ISBN 0-415-05651-9
• Siegler R., DeLoache, J. & Eisenberg, N. (2003) How Children develop. New York: Worth. ISBN 1-57259-249-4.
• Attachment & Human Development. ISSN 1469-2988.
• Infant Mental Health Journal.