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 adults who are sensitive and responsive in social interactions with the infant, and who remain as consistent caregivers for some months during the period from about 6 months to two years of age. Parental responses lead to the development of patterns of attachment which in turn lead to 'internal working models' which will guide the individual's feelings, thoughts, and expectations in later relationships. Children subsequently learn to use attachment figures as a secure base to explore from and return to.

Attachment theory was developed by Bowlby as a consequence of his dissatisfaction with existing theories of early relationships. He explored a range of fields including evolution by natural selection, object relations theory (psychoanalysis), control systems theory, evolutionary biology and the fields of ethology and cognitive psychology, in order to formulate a comprehensive theory of the nature of early attachments. The result, after some preliminary papers from 1958 onward, was published in a trilogy called "Attachment and Loss" between 1969 and 1980. Mary Ainsworth's innovative methodology and comprehensive observational studies informed much of the theory, expanded its concepts and enabled its tenets to be empirically tested. Although in the early days he was criticised by academic psychologists and ostracized by the psychoanalytic community, attachment theory has become the dominant approach to understanding early social development and given rise to a great surge of empirical research into the formation of children's close relationships. There have been significant modifications as a result of empirical research but attachment concepts have become generally accepted. Many treatment approaches, some currently in the process of being evaluated, are based on applications of attachment theory.

Criticism of attachment theory has been sporadic, much of it relating to an early precursor theory called "maternal deprivation", published in 1951. There was considerable criticism from ethologists in the 1970s. More recent criticism relates to the complexity of social relationships within family settings, and the limitations of discrete styles for classifications.

In Bowlby's approach, the human infant is considered to have 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. Mary Ainsworth developed a theory of a number of attachment styles in infants in which distinct characteristics have been identified known as secure attachment, avoidant attachment, anxious attachment and, later, disorganized attachment. Subsequently other theorists extended attachment theory to adults. Attachment styles can be measured in both infants and adults, although measurement in middle childhood is problematic. 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.

Tenets of attachment theory

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. 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:

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. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. Consequences of disruption: In spite of the robustness of attachment, separation from a familiar caregiver, or frequent changes of caregiver that prevent development of attachment, may result in psychopathology at some point in later life.
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 has been described as 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.. However, it may be more accurately described as an attitude, or readiness for certain behaviors, that one person displays toward another. The attachment attitude involves the seeking of proximity to the other person and may include a variety of other attachment behaviors, but attachment behaviors are likely to occur only in threatening or uncomfortable circumstances. Thus, attachment may be present without necessarily being displayed behaviorally, and it may be impossible to measure the presence of this attitude without creating some apparently threatening circumstance such as the approach of an unfamiliar person.

Attachment theory accepts the customary primacy of the mother as the main care-giver, but there is nothing in the theory to suggest that fathers are not equally likely to become principal attachment figures if they happen to provide most of the childcare. Infants will form attachments to any consistent caregiver who is sensitive and responsive in social interactions with the infant. The quality of the social engagement appears to be more influential than amount of time spent.

Developments

Although the basic tenets of attachment theory have stood up to empirical research, some aspects of it have not and either no longer form part of current thinking on attachment or are the subject of ongoing dispute and research. Rutter (1995) set out the four main changes that have taken place over the years to 1995. First, it became apparent there were more differences than similarities with imprinting and the analogy was dropped (Bowlby 1988). Second, the sensitivity period has been modified to a less "all or nothing" approach so that although there is seen to be a sensitive period during which which it is highly desirable that selective attachments develop, the time frame is probably broader and the effects not so fixed and irreversible. Third, "monotropy" has effectively been abandoned insofar as it was understood to mean attachment with just one person, qualitatively different from others. Rather, there is seen to be a high degree of selectivity and very definite hierarchies within which it is usual for most children to develop selective attachments with a small number of people closely involved in child care. Finally it has come to be appreciated that social development is affected by later as well as earlier relationships (Bowlby 1988).

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 and gratification of libidinal drives. 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.

Early developments

Bowlby was influenced by the beginnings of the object relations school of psychoanalysis and in particular, Melanie Klein, although he profoundly disagreed with the psychoanalytic belief then prevalent that saw infants responses as relating to their internal fantasy life rather than to real life events. As John Bowlby began to formulate his concept of attachment, he was influenced by case studies such as one by David Levy 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. Bowlby's contemporary R.A. Spitz proposed that "psychotoxic" results were brought about by inappropriate experiences of early care.

In 1951, in Maternal Care and Mental Health, Bowlby propounded the theory that "the infant and young child should experience a warm, intimate, and continuous relationship with his mother (or permanent mother substitute) in which both find satisfaction and enjoyment" and that not to do so may have significant and irreversible mental health consequences. This proposition was both influential in terms of the effect on the institutional care of children, and highly controversial. There was limited empirical data at the time and no comprehensive theory to account for such a conclusion.

Attachment theory

Following the publication of Maternal Care and Mental Health Bowlby sought new understanding from such fields as evolutionary biology, ethology, developmental psychology, cognitive science and control systems theory and drew upon them to formulate the innovative proposition that the mechanisms underlying an infants tie emerged as a result of evolutionary pressure. Bowlby realised that he had to develop new theory of motivation and behaviour control, built on up-to-date science rather than the outdated psychic energy model espoused by Freud. Bowlby expressed himself as having made good the "deficiencies of the data and the lack of theory to link alleged cause and effect" in "Maternal Care and Mental Health" in his later work "Attachment and Loss" published in 1969.

Ethology

Bowlby's attention was first drawn to ethology when he read Lorenz's 1952 publication in draft form although Lorenz had published much earlier work. Soon after he encountered the work of Tinbergen, and began to collaborate with Robert Hinde. In 1953 he stated "the time is ripe for a unification of psychoanalytic concepts with those of ethology, and to pursue the rich vein of research which this union suggests". 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. Bowlby followed this up with two more papers, Separation Anxiety (1960a), and Grief and Mourning in Infancy and Early Childhood (1960b).

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, an approach that does not rule out the effect of experience, but that stresses the readiness the young child brings to social interactions. Some of Lorenz's work had been done years before Bowlby formulated his ideas, and indeed some ideas characteristic of ethology were already discussed among psychoanalysts some time before the presentation of attachment theory. For instance, one well-known author discussed emotional development,using the concept of the critical period in a way resembling the ethological view: "...the importance of factors of any kind which affect development depends to a large extent on the specific phase in which they occur. This... is also one general principle of developmental physiology or embryology. Here we find that there is a critical period for every experimental interference."

Psychoanalysis

Bowlby's view of attachment was also influenced psychoanalytical concepts and the earlier work of psychoanalysts. In particular he was influenced by observations of young children separated from familiar caregivers, as provided during World War II by Anna Freud and her colleague Dorothy Burlingham , although he apparently paid little attention to their reports on the Theresienstadt children, whose attachment was primarily to each other. Observations of separated children's grief by Rene Spitz were another important factor in the development of attachment theory. However, Bowlby rejected psychoanalytical explanations for early infant bonds. He rejected both Freudian "drive-theory", which he called the "cupboard-love" theory of relationships, and early object-relations theory as both in his view failed to see the attachment as a psychological bond in its own right rather than an instinct derived from feeding or sexuality. Thinking in terms of primary attachment and neo-darwinism, Bowlby identified as what he saw as fundamental flaws in psychoanalysis, namely the overemphasis of internal dangers at the expense of external threat, and the picture of the development of personaltiy via linear "phases" with "regression" to fixed points accounting for psychological illness. Instead he posited that several lines of development were possible, the outcome of which depended on the interaction between the organism and the environment. In attachment this would mean that although a developing child has a propensity to form attachments, the nature of those attachments depend on the environment to which the child is exposed.

Internal working model

The important concept of the internal working model of social relationships was adopted by Bowlby from the work of Kenneth Craik, the philosopher . The theory of control systems (cybernetics), developing during the '30s and '40s, influenced Bowlby's thinking about attachment . 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.

Attachment styles

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. These early studies focused on attachment between children and caregivers.

Developments

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. 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 In a recent study conducted in Sapporo, Behrens, et al., 2007. found attachment distributions consistent with global norms using the six-year Main & Cassidy scoring system for attachment classification.

Interest in attachment theory continued, and the theory was later extended to adult romantic relationships by Cindy Hazen and Phillip Shaver. 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. 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, attempting 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.

Attachment styles

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. )

• 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.

Mother and child

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

Some commentators have provided a more extensive discussion of the development of attachment behavior and the internal working model after the toddler period 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.

Behavioral development and attachment

Behavior analysts have constructed models of attachment. Such models are based on the importance of contingent relationships. Behavior analytic models have received support from research and meta-analytic reviews

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

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. RAD denotes a lack of age appropriate attachment behaviours that amount to a clinical disorder rather than a description of insecure of disorganised attachment styles however problematic those styles may be. Despite its popularisation on the Web within the field of an alternative therapy known as attachment therapy for a range of perceived behavioural difficulties in children, it is thought to be rare.

Attachment disorder

Main article: Attachment disorder

Attachment disorder is an ambiguous term. It may be used to refer to reactive attachment disorder, the only 'official' clinical diagnosis, or the more problematical attachment styles, or within the alternative medicine field of attachment therapy as a form of unvalidated diagnosis.

One use is to refer to a failure 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.

One study has reported a connection between a specific genetic marker and disorganized attachment (not RAD) associated with problems of parenting. Another author has compared atypical social behavior in genetic conditions such as Williams syndrome with behaviors symptomatic of RAD.

Typical attachment development begins with unlearned infant reactions to social signals from caregivers. The ability to send and receive social communications through facial expressions, gestures and voice develops with social experience by seven to nine months. This makes it possible for an infant to interpret messages of calm or alarm from face or voice. At about eight months, infants typically begin to respond with fear to unfamiliar or startling situations, and to look to the faces of familiar caregivers for information that either justifies or soothes their fear. This developmental combination of social skills and the emergence of fear reactions results in attachment behavior such as proximity-seeking, if a familiar, sensitive, responsive, and cooperative adult is available. Further developments in attachment, such as negotiation of separation in the toddler and preschool period, depend on factors such as the caregiver's interaction style and ability to understand the child's emotional communications.

With insensitive or unresponsive caregivers, or frequent changes, an infant may have few experiences that encourage proximity seeking to a familiar person. An infant who experiences fear but who cannot find comforting information in an adult's face and voice may develop atypical ways of coping with fearfulness such as the maintenance of distance from adults, or the seeking of proximity to all adults. These symptoms accord with the DSM criteria for reactive attachment disorder. Either of these behavior patterns may create a developmental trajectory leading ever farther from typical attachment processes such as the development of an internal working model of social relationships that facilitates both the giving and the receiving of care from others.

Atypical development of fearfulness, with a constitutional tendency either to excessive or inadequate fear reactions, might be necessary before an infant is vulnerable to the effects of poor attachment experiences.

Alternatively, the two variations of RAD may develop from the same inability to develop "stranger-wariness" due to inadequate care. Appropriate fear responses may only be able to develop after an infant has first begun to form a selective attachment. An infant who is not in a position do this cannot afford not to show interest in any person as they may be potential attachment figures. Faced with a swift succession of carers the child may have no opportunity to form a selective attachment until the possible biological-determined sensitive period for developing stranger-wariness has passed. It is thought this process may lead to the disinhibited form.

In the inhibited form infants behave as if their attachment system has been "switched off". However the innate capacity for attachment behavior cannot be lost. This may explain why children diagnosed with the inhibited form of RAD from institutions almost invariably go on to show formation of attachment behavior to good carers. However children who suffer the inhibited form as a consequence of neglect and frequent changes of caregiver continue to show the inhibited form for far longer when placed in families.

Additionally, the development of Theory of Mind may play a role in emotional development. Theory of Mind is the ability to know that the experience of knowledge and intention lies behind human actions such as facial expressions. Although it is reported that very young infants respond differently to humans and objects, Theory of Mind develops relatively gradually and possibly results from predictable interactions with adults. However, some ability of this kind must be in place before mutual communication through gaze or other gesture can occur, as it does by seven to nine months. Some early emotional disorders, such as autism, have been attributed to the absence of the mental functions that underlie Theory of Mind. It is possible that the congenital absence of this ability, or the lack of experiences with caregivers who communicate in a predictable fashion, could underlie the development of reactive attachment disorder.

Criticism and controversy

Criticism of Bowlby's view of attachment has been sporadic, but began even before the theory was completely formulated.

Early criticism

Bowlby's colleague M.D.S. Ainsworth listed nine concerns that she felt were chief points of controversy related to the attachment theory precursor referred to as "maternal deprivation", a system that includes some of the tenets that later made up attachment theory. 1) The vagueness of the term "maternal deprivation" used in the description of a child's history of attachment experiences. 2) The lack of clarity of the theory's implications for experiences with multiple caregivers. 3) The implications for the theory of the degree of variability following "deprivation." 4) The question of what specific effects result from "deprivation". 5) The question of individual differences in children's reactions to separation or loss. 6) The question of the degree of permanence of specific effects of "deprivation". 7) The question of delinquency as an infrequent outcome of separation and loss. 8) The question of specifics of deprivation and whether these have to do with the caregiver or the more general environment. 9) Controversies having to do with the effects of genetic defects or of brain damage on the developmental outcome.

As the formulation of attachment theory progressed, critics commented on empirical support for the theory and for the possible alternative explanations for results of empirical research. One critic questioned the suggestion that early attachment history (as it would now be called) had a lifelong impact. Another critic 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.

Later criticisms

A recent critic is J. R. Harris, who is generally concerned with the concept of infant determinism and stresses the effects of later experience on personality. Another recent concern about attachment theory has to do with the fact that infants often have multiple relationships, within the family as well as in child care settings, and that the dyadic model characteristic of attachment theory cannot address the complexity of real-life social experiences.

The criticisms mentioned so far have had to do with the possible incapacity of attachment theory (or its preliminary version) to encompass a variety of empirically-demonstrated data, or with loose terminology that makes it difficult to know how to fit some information into the attachment theory framework. Some past criticism stressed the gradual disappearance of some of the theory's constructs from frequent use. In the 1970s, problems with the emphasis on attachment as a trait (a stable characteristic of an individual) rather than as a type of behavior with important organizing functions and outcomes, led to a situation where some authors considered that "attachment (as implying anything but infant-adult interaction) [may be said to have] outlived its usefulness as a developmental construct."

The authors who quoted the crititicism noted in the last paragraph proposed that attachment behaviors were best understood in terms of their functions in the child's life. A given function, such as as achieving a sense of security, might be achieved in different ways by children of different ages and in different environments, and the different but functionally comparable behaviors should be categorized as related to each other. This way of thinking later developed into a discussion of the secure base concept as a central aspect of attachment theory, but one which had all too often been omitted from consideration. Commenting on secure base behavior, the organization of exploration of an unfamiliar situation around returns to a familiar person, it has been noted that the "secure base construct is central to the logic and coherence of attachment theory and to its status as an organizational construct." Similarly, it has been pointed out that "other features of early parent-child relationships that develop concurrently with attachment security, including negotiating conflict and establishing cooperation, also must be considered in understanding the legacy of early attachments." However, current discussion of attachment theory does not appear to have been influenced by these criticisms, and work on attachment, as well as popular understanding, continues to stress attachment as an emotional response or a set of specific behaviors.

Criticism from specific disciplines

It may be useful to discuss criticism of attachment theory from the viewpoint of the five lines of thought that influenced its formulation: psychoanalysis. evolution, ethology, control systems, and cognition. . The clinical and observational evidence on which the theory was based has also been criticized.

Psychoanalysis

From an early point in the development of attachment theory, there was criticism of the theory's lack of congruence with the various branches of psychoanalysis. Like other members of the British object-relations group, Bowlby rejected Melanie Klein's views that considered the infant to have certain mental capacities at birth and to continue to develop emotionally on the basis of fantasy rather than of real experiences. But Bowlby also withdrew from the object-relations approach (exemplified, for example, by Anna Freud), as he wished to abandon the "drive theory" assumptions in favor of a set of automatic, instinctual behavior systems that included attachment. Bowlby's decisions left him open to criticism from well-established thinkers working on problems similar to those he addressed.

Ethology

Ethologists, too, expressed concern about the adequacy of some of the research on which attachment theory was based, particularly the use of generalization to humans from animal studies, an important point in ethological work, where comparison of species was frequently done. Not all animals are suitable for generalization to human beings. The use of data from animals in the formulation of attachment theory drew serious criticisms such as the following: "...it must be emphasized that data derived from species other than man can be used only to suggest (italics) hypotheses that may be worth applying to man for testing by critical observations. In the absence of critical evidence derived from observing man such hypotheses are no more than intelligent guesses. There is a danger in human ethology... that interesting, but untested, hypotheses may gain the status of accepted theory. [One author] has coined the term 'ethologism' as a label for the present vogue [in 1970]... for uncritically invoking the findings from ethological studies of other species as necessary and sufficient explanations... Theory based on superficial analogies between species has always impeded biological understanding... We conclude that a valid ethology of man must be based primarily on data derived from man, and not on data obtained from fish, birds, or other primates."

Ethologists like Robert Hinde also expressed concern with some of the language commonly used in discussion of attachment issues. He noted that it was important to use the word "attachment" as a data term, not to imply that it was an intervening variable or a hypothesized internal mechanism. He suggested that confusion about the meaning of attachment theory terms "could lead to the 'instinct fallacy' of postulating a mechanism isopmorphous with the behavious, and then using that as an explanation for the behaviour". However, Hinde considered "attachment behaviour system" to be an appropriate term of theory language which did not offer the same problems "because it refers to postulated control systems that determine the relations between different kinds of behaviour."

Ethologists and others writing in the 1960s and 1970s questioned the types of behavior used as indications of attachment, and offered alternative approaches. For example, crying on separation from a familiar person was suggested as an index of attachment. Observational studies of young children in natural settings also provided behaviors that might be considered to indicate attachment; for example, in one study of toddlers in parks with their mothers, the children were observed to stay within a predcitable distance of the mother without effort on her part. The children walked when moving away from the mother, but ran when returning to her. When the child saw or heard something surprising, he or she related this to the mother, looking at her while pointing to the event if at a distance, pointing and tapping her with the other hand if near. The toddlers, unexpectedly, did not follow the mother if she moved away, but most "froze" in place. Another unanticipated indication of the relationship was that the toddler picked up small objects and brought them to the mother, a behavior that did not usually occur in behavior toward other adults who were present. Although ethological work tended to be in agreement with Bowlby, work like that just described led to the conclusion that "[w]e appear to disagree with Bowlby and Ainsworh on some of the details of the child's interactions with its mother and other people". Some ethologists pressed for further observational data, arguing that psychologists "are still writing as if there is a real entity which is 'attachment', existing over and above the observable measures."

One discussant of Bowlby's use of ethological concepts commented that these concepts as used in attachment theory had not kept up with changes in ethology itself. For example, this author said, Bowlby "assumes the fully innate, unlearned character of most complex behavior patterns" whereas recent animal studies showed "both the early impact of learning and the great intricacy of the interaction between mother and litter". Again, this author criticizes Bowlby for applying "to human behavior an instinct concept which neglects the factor of development and learning far beyond even the position taken by Lorenz [the ethological theorist] in his early propositions."

None of the criticisms or suggestions of ethologists appear to have influenced the current use of attachment theory or the designs of related research. Ethological concepts are currently used in related work on robotic systems

Cognitive development

Criticism from the viewpoint of cognition has been much less frequent. However, Bowlby's reliance on Piaget's theory of cognitive development gave rise to questions about object permanence (the ability to remember an object that is temporarily absent) and its connection to early attachment behaviors, and about the fact that the infant's ability to discriminate strangers and react to the mother's absence seems to occur some months earlier than Piaget suggested would be cognitively possible . More recently, it has been noted that the understanding of mental representation has advanced so much since Bowlby's day that present views can be far more specific than those of Bowlby's time. .

Criticism of methodology

In addition to criticism of the basic concepts and methods of attachment theory, there has been criticism of research techniques and conclusions drawn from data. For example,the idea of attachment styles, thought to be measured by techniques like the Strange Situation, has been questioned. Such techniques yield a taxonomy of categories considered to represent qualitative difference in attachment relationships (for example, secure attachment versus avoidant). However, a categorical model is not necessarily the best representation of individual difference in attachment. An examination of data from 1139 15-month-olds showed that variation was continuous rather than falling into natural groupings. This criticism introduces important questions for attachment typologies and the mechanisms behind apparent types, but in fact has relatively little relevance for attachment theory itself, which "neither requires nor predicts discrete patterns of attachment." As was noted above, ethologists have suggested other behavioral measures that may be of greater importance than Starnge Situation behavior.

There has been critical discussion of conclusions drawn from clinical and observational work, and whether or not they actually support tenets of attachment theory. For example, at least one author based criticism of a basic tenet of attachment theory on the work of Anna Freud with children from Theresienstadt, who apparently developed relatively normally in spite of serious deprivation during their early years. This discussion concluded from Freud's case and from some other studies of extreme deprivation that there is an excellent prognosis for children with this background, unless there are biological or genetic risk factors. The psychoanalyst Margaret Mahler interpreted ambivalent or aggressive behavior of toddlers toward their mothers as a normal part of development, not as evidence of poor attachment history. Most tellingly, however, Bowlby's interpretations of the data reported by James Robertson were eventually rejected by the researcher, who reported data from 13 young children who were cared for in ideal circumstances during separation from their mothers. Robertson noted," ...Bowlby acknowledges that he draws mainly upon James Robertson's institutional data. But in developing his grief and mourning theory, Bowlby, without adducing non–institutional data, has generalized Robertson's concept of protest, despair and denial beyond the context from which it was derived. He asserts that these are the usual responses of young children to separation from the mother regardless of circumstance..."; however, of the 13 separated children who received good care, none showed protest and despair, but "coped with separation from the mother when cared for in conditions from which the adverse factors which complicate institutional studies were absent".

Effects of changing times and approaches

Some authors have noted the connection of attachment theory with Western family and child care patterns characteristic of Bowlby's time. The implication of this connection is that attachment-related experiences (and perhaps attachment itself) may alter as young children's experience of care change historically. For example, changes in attitudes toward female sexuality have greatly increased the numbers of children living with their never-married mothers and being cared for outside the home while the mothers work. This social change has also made it more difficult for childless people to adopt infants in their own countries, and has increased the number of older-child adoptions and adoptions from third-world sources. Adoptions and births to same-sex couples have increased in number and even gained some legal protection, compared to their status in Bowlby's time. These historical differences may have made a difference to the development of attachment, but no reformulation of attachment theory has been considered.

One focus of attachment research has been on the difficulties of children whose attachment history was poor, including those with extensive non-parental child care experiences. Concern with the effects of child care was intense during the so-called "day care wars" of the late 20th century, during which the deleterious effects of day care were stressed. As a beneficial result of this controversy, training of child care professionals has come to stress attachment issues and the need for relationship-building through techniques such as assignment of a child to a specific care provider. Although only high-quality child care settings are likely to follow through on these considerations, nevertheless a larger number of infants in child care receive attachment-friendly care than was the case in the past, and emotional development of children in nonparental care may be different today than it was in the 1980s or in Bowlby's time. However, attachment theory itself has apparently not been influenced by this historical change.

Finally, any critique of attachment theory needs to consider how the theory has connected with changes in other psychological theories. Research on attachment issues has begun to include concepts related to behavior genetics and to the study of temperament (constitutional factors in personality), but it is unusual for popular presentations of attachment theory to include these. Importantly, some researchers and theorists have begun to connect attachment with the study of mentalization or Theory of Mind, the capacity that allows human beings to guess with some accuracy what thoughts, emotions, and intentions lie behind behaviors as subtle as facial expression or eye movement. The connection of theory of mind with the internal working model of social relationships may open a new area of study and lead to alterations in attachment theory.

See also

• Affectional bond
• Attachment in adults
• Attachment in children
• Attachment disorder
• Attachment measures
• Attachment parenting
• Attachment-based psychotherapy
• Attachment therapy

• Behavior analysis of child development
• Child psychotherapy
• Emotionally Focused Therapy
• Family therapy
• Human bonding
• Maternal deprivation
• Object relations theory
• Reactive attachment disorder

• Mary Ainsworth
• John Bowlby
• Harry Harlow
• Jerome Kagan
• Melanie Klein
• Jean Piaget
• Michael Rutter
• Rene Spitz

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 0-415-07729-X. OCLC 27266442. ISBN 0-415-07730-3 (pbk).
• 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.

External links

• International Attachment Conference 2007
• Relationship Advice: How Understanding Adult Attachment Can Help
• Attachment Questionnaire
• Attachment Diagnostics (German)
• Details of authors, publications, measures and books on attachment psychology
• A support forum for adults with attachment disorder or attachment related issues.. welcome!
• Rene Spitz's movie "Psychogenic Disease in Infancy" (1957)