Tuesday, April 26, 2011

The Great Attachment Debate - How important is early experience?


The March/April issue of Psychotherapy Networker offered a series of articles on The Great Attachment Debate: How important is early experience? It looks as though the articles are freely available online, so I'm going to give a taste of each one - you can read the ones that interest you.

The image above is from one of the pioneering studies that led to attachment theory - Harry Harlow and Zimmerman (1959) found that infant rhesus monkeys raised in isolation would either die or exhibit severe mental illness. When raised with a choice between two surrogates, a cloth covered monkey shape or a wire monkey with a source of food, the infants would cling to the cloth mother, aside from brief trips to the wire mother for food. Some would not leave the cloth mother and starved to death.

Interestingly, these studies were inspired by work done by John Bowlby (Maternal Care and Mental Health published in 1951) that looked at maternal deprivation. This work was inspired by the Freudian Rene Spitz, who had observed infants in foundling homes at the end of WWII:
In 1945 he did research on hospitalism in children in a foundling home. He found that the developmental imbalance caused by the unfavourable environmental conditions during the children's first year produces a psychosomatic damage that cannot be repaired by normal measures.
Essentially, the neglect these children suffered in being left alone all day with only brief feedings prevented them from attaching to another human being (it doesn't have to be the mother) and the ones who did not die suffered severe psychopathology.

Harlow's experiments are now seen as cruel and unnecessary, but they influenced John Bowlby to further the line of inquiry, which led (with the profound assistance of Mary Ainsworth) to our modern attachment theory.


Among the authors in this collection of essays are Dan Siegel, Jerome Kagan, and Mary Sykes Wylie, all well know psychologists and authors. The final piece is actually a short story by Bruce Jay Friedman that I quite liked and certainly is relevant to the discussion represented in these articles.

The Verdict Is In

The case for attachment theory

By Alan Sroufe and Daniel Siegel

While many schools of psychotherapy have held that our early experiences with our caretakers have a powerful impact on our adult functioning, there have been plenty of hard-nosed academics and researchers who've remained unconvinced. Back in 1968, psychologist Walter Mischel created quite a stir when he challenged the concept that we even have a core personality that organizes our behavior, contending instead that situational factors are much better predictors of what we think and do. Some developmental psychologists, like Judith Rich Harris, author of The Nurture Assumption, have gone so far as to argue that the only important thing parents give their children is their genes, not their care. Others, like Jerome Kagan, have emphasized the ongoing influence of inborn temperament in shaping human experience, asserting that the effect of early experience, if any, is far more fleeting than is commonly assumed. In one memorable metaphor, Kagan likened the unfolding of life to a tape recorder with the record button always turned on and new experiences overwriting and erasing previous experiences. n At the same time, the last 50 years have seen the accumulation of studies supporting an alternative view: the idea that the emotional quality of our earliest attachment experience is perhaps the single most important influence on human development. The central figure in the birth of this school of research has been British psychiatrist and psychoanalyst John Bowlby, who challenged the Freudian view of development, claiming that it had focused too narrowly on the inner world of the child without taking into account the actual relational environment that shapes the earliest stages of human consciousness.

Bowlby's thinking was influenced by his study of how other mammals rear their young, and the distinctive core of his contribution to developmental psychology may be traced to a very simple observation: whereas young ground-dwelling animals run to a place of protection when frightened, primates like chimpanzees and gorillas run to a protective adult, who then carries them to safety. As he focused on the developmental significance of this survival pattern, Bowlby concluded that humans—the most dependent of mammal infants—are wired like their primate cousins to form attachments, because they couldn't survive without them.

But Bowlby went further. While agreeing with his psychoanalytic colleagues that early experiences with our caretakers are crucial to the people we become, he made an important distinction. Infants are attached to their caregivers not because caregivers feed them, but because caregivers trigger the unfolding of infants' inborn disposition to seek closeness with a protective other. By divorcing human attachment from the drive-reduction notions of Freudian theory, Bowlby laid the foundation for a shift from seeing people as individuals somehow standing apart from their social environment to a more fine-tuned grasp of just how deeply relational human nature is.

Read more.

* * * * * *

Bringing Up Baby

Are we too attached?

By Jerome Kagan

One of the strongest articles of faith among psychotherapists is the intuitively attractive proposition that the security of early attachments to parents has a profound influence on adult mental health. Thousands of articles, books, and conferences have probed this topic, and many therapists have made attachment theory a cornerstone of their clinical approach. Even clinicians who aren't particularly loyal to attachment theory accept the general proposition that the quality of infants' emotional experiences with their caretakers affects their vulnerability to psychological disorders as adults. However, when I examine the evidence for this belief as a research psychologist, rather than as a clinical practitioner, a different, less clear-cut picture emerges. Three major assumptions underlie attachment theory. First, variation in the caretaker's interactions with the infant creates variation in the infant's emotional bond to that person. This bond is called an attachment. Most psychologists, including this writer, regard this assumption as true and proven by evidence. Second, the consequences of the quality of the early attachment are preserved for many years and influence the older child and adult's personality and vulnerability to pathology. This assumption, as we shall see, is far from proven. The final premise involves the measurement of the infant's quality of attachment. As we shall see, many psychologists believe that an experimental procedure called the Strange Situation is a sensitive measure of the different types of infant attachments. This assumption, too, is a hypothesis still awaiting confirmation. A theory that rests on three assumptions, only one of which has consensual validity, should require closer examination before being embraced as indisputably true. But many clinicians believe that all three assumptions of attachment theory have been proven to be correct.

Attachment Theory in Perspective

Some influential ideas in the social sciences have their roots in the life experiences of the creator and his or her culture. This appears to be true of attachment theory. Let us consider the life experiences of the British psychiatrist John Bowlby, the father of attachment theory. As the fourth of six children growing up in an upper-middle-class London family, Bowlby, born in 1907, and his siblings were cared for by nurses on the top floor of the family's spacious home. He recalled seeing his mother for perhaps an hour each day after teatime, and his father, a prominent surgeon, once a week. His favorite nanny, with whom he had a close relationship, left the household when he was 4. By 7, he'd been sent to a boarding school. He later said of that experience, "I wouldn't send a dog away to boarding school at age 7."

Of course, we can't know whether the frequent separations from parents and the loss of the nanny contributed to Bowlby's strong ideas about attachment. We do know, however, that from the beginning of his career, he was unusually sensitive to the importance of a child's experience of parental love. He'd been trained in psychoanalytic theory and had a personal analyst. At age 21, he worked for a short time at a progressive school for emotionally disturbed children. Some of these children had experienced early separation from their parents or obvious neglect, and Bowlby interpreted their disturbed behavior patterns as support for his belief that a mother's love for a child was vital for healthy psychological development—as vital as good nutrition is for physical growth.

Read more.

* * * * * *

The Attuned Therapist

Does attachment theory really matter?

by Mary Sykes Wylie and Lynn Turner

Five hundred people sat in a packed workshop at the Networker Symposium last March, listening to eminent developmental psychologist and researcher Jerome Kagan draw on more than four decades of research he's conducted as he discussed the clinical relevance of inborn temperament. Midway through the session, responding to a question from the audience, he tried to clarify an earlier, seemingly disparaging, comment he'd made about attachment theory. But he soon removed any possible doubt about where he stood. "I'm glad that attachment theory is dead," he said. "I never thought it would go anywhere."

There was a moment of stunned silence, followed by a low hum as people shifted in their seats and murmured to each other. Whatever their imperfect understanding of the voluminous research literature of attachment theory, for most therapists in the room, the idea that the early emotional attunement of a mother/caregiver (or lack of it) profoundly affects the child's psychological development was as self-evident as the worthiness of therapy itself. Indeed, during the last 15 to 20 years, attachment theory has exerted more influence in the field of psychotherapy than just about any other model, approach, or movement. Though not a clinical methodology, it has justified a whole range of therapeutic perspectives and practices. Among them are a particular sensitivity to the role of traumatic or neglectful ties with early caregivers; the fundamental importance of affect regulation to successful therapy; the importance of establishing relationships with clients characterized by close, intense, emotional, and physical attunement; and the ultimate goal of recreating in therapy an attachment experience that makes up, at least to some degree, for what the client missed the first time around. That attachment theory itself has amassed a vast body of empirical evidence (see p.34) is often taken, by extension, to cast a glow of scientific credibility on attachment-based therapy. So when Kagan delivered his offhand rebuke, he was raising fundamental questions about the evidence supporting findings that most therapists there considered not just theory, but well-established fact.

Suddenly, in the wordless void that followed Kagan's bombshell, psychiatrist, brain researcher, and staunch attachment theory proponent Daniel Siegel popped out of his seat, looked for a floor microphone to respond, and, finding none, strode up the center aisle and bounded onto the stage. As a startled Kagan looked on and the entire ballroom audience sat dumbfounded, Siegel, the conference keynote speaker from that morning, asked for a microphone and announced: "I can't let this audience listen to your argument without hearing the other side. Have you actually read the attachment research?" he demanded of his colleague.

There followed a heated, impromptu debate between the two men that later became the talk of the conference. Part of the buzz was because it was a disagreement between two stars—Jerome Kagan, arguably the most revered developmental psychologist in the world, and Daniel Siegel, one of the most influential thinkers and teachers in the field of psychotherapy today. Each brought to bear both an impressive resume and passionately held convictions on the age-old question about human development: which counts more—nature or nurture? Beyond its sheer drama, two things stood out about this spontaneous encounter—the surprise that a discussion of research findings could generate such intellectual fervor at a psychotherapy conference and, for the majority of the audience, the shock that there was any debate at all about the role of early experience in human development. It was as if a leading biologist had gotten up at a professional conference to denounce germ theory.

In the world of psychotherapy, few models of human development have attracted more acceptance and respect in recent years than the centrality of early bonding experiences to adult psychological well-being. Nevertheless, the Kagan–Siegel encounter brought to the surface a barely visible fault line between true believers in attachment and its doubters, who not only question the idea that the quality of the mother-child attachment always and permanently affects a child's psychological development, but whether attachment theory itself has had a positive or negative influence on the practice of psychotherapy. It raised the question of whether the growing centrality of attachment theory has begun to blind the field to other vital influences on a person's development—inborn temperament, individuation needs, family dynamics, even class and culture—which all lie outside the mother–child dyad.

But what on earth could ever be wrong with emphasizing early bonding, connection, and relationship as the foundation of all good therapy? Are there ever times when too much "attunement" and "empathy" can constrict a therapist's clinical repertoire and obfuscate the issues with which clients should deal? For those for whom this debate focuses on a theory that wasn't even on their grad-school curriculum, what's all the fuss about, and what exactly does attachment theory tell us that we haven't known since the days of Freudian analysis?

Read more.

* * * * * *

The Nightgown

In search of the answerman

By Bruce Jay Friedman

Stranded in Manhattan on a holiday weekend, Nat Solomon, a visiting academic from Detroit, decided to treat himself to an off-Broadway play. The production had received tepid reviews, but he was intrigued by the theme: a Catholic priest had begun to doubt his faith. Rather than speak to his bishop—he'd been there before—the priest decided to reach beyond the church and consult a psychiatrist.

Solomon had lost three of them; that is to say, a trio of psychiatrists had died on him. They were old men; he'd sought them out for their wisdom. It had never occurred to him that, one by one, they'd expire, which they did just as he was getting somewhere. Undeterred, he tried again—this time a Jungian. She was clearly a compassionate woman. Still, when she learned of the three dead shrinks, she turned color and refused to take him on as a patient.

At the moment, Solomon had no one. When it came to his mental health, he was flying solo, barely holding his life together—a distant wife, a rudderless daughter, shrinking income, and crumbling knees. It was quite a package.

He lucked out and got an aisle seat in the tiny theater—the better to stretch out his left knee, the one that gave him the most trouble. Both performers in the two-character play were accomplished, but Solomon couldn't take his eyes off the actor who played the psychiatrist. Never before had he seen such compassion in a therapist's face. Each time the priest cried out in anguish, the therapist cried out with him, though silently (if such a thing was possible). The few times the therapist spoke, his words trembled with humility and quiet strength—a difficult combination to pull off. Solomon waited for him to stroke his chin, an unbearable cliche. Stroke it he did, although the stroke was closer to the ear than the chin, which made a world of difference. When the therapist drummed his fingers on his desk, Solomon did some drumming of his own—on the armrest. The priest had been waffling. The drumming was a gentle nudge: get to the heart of what's eating you.

There was a slight trace of cockney in the psychiatrist's voice, which was appealing. There was a puckish grin in the mix. All of it was irresistible.

Read more.

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