The formation of attachment relationships with caregivers is a primary developmental task and the quality of those relationships is associated with subsequent competence in social and emotional functioning (Haskett et al., 2006). In this regard the quality of maternal and paternal behaviour, as well as the quality of both mother-child/father-child interactions, remain the most reliable correlation of individual differences in psychological, social and cognitive adjustment in infancy as well as in later childhood (Thompson, 1998 in Kelly and Lamb, 2001). Through their impact on parenting, some contextual influences create impact on the child either directly or indirectly as the child is seen as nested within a changing/transforming network of influences operating on many levels (Sroufe et al., 1999).
There is a growing body of evidence that forges the importance and influence of attachment quality on the success of a child’s developmental pathway toward a self-reliant adulthood (Carlson and Sroufe, 1995; Thompson, 1999 in Hoffman et al., 2006). Therefore, as Hodnett (2010) suggests, there is an equally important need to emphasise on parenting issues such as nurturing, attachment, empathy and parental insight, other than those relating to serious behaviour problems in children.
2.4 Patterns of Attachment
Attachment is referred to as a pattern of organised behaviour within a relationship (Sroufe and Fleeson, 1986 in Sroufe et al., 1999). There is nevertheless an attachment whenever the infant has spent a reasonable amount of time in the care of the mother (Kelly and Lamb, 2001). However the elements involving time and space vary from child to child and mother to mother. For example, when comparing between those exposed to natural (i.e. undisrupted, well treated) and unnatural (i.e. disrupted, maltreated) conditions individual differences in children coping with momentary stress could be observed (Field, 1996).
Furthermore when disruptions in care occur during the tender stages of cultivating attachment relationships (Dozier et al., 2009) or under extreme environmental circumstances such as maltreatment, complete lack of time with a caregiver and so on infants are likely fail to develop attachments (Kelly and Lamb, 2001).
Because attachment is not a trait infants have in varying quantity it is neither immutable nor independent of subsequent experiences (Sroufe et al., 1999). Instead the critical role early experience often plays is hoisted on a surrounding context of sustaining environmental supports (Sroufe et al., 1999) that are represented largely by the quality of mother-infant interaction forming an attachment pattern such as could be classifiable as secure, insecure/avoidant, insecure/ambivalent (Ainsworth, 1978 in Kelly and Lamb, 2001) and disorganised (Main and Solomon, 1984 in Kelly and Lamb, 2001).
According to Hecht and Hansen (2006), the behavioural system that evolves as a result of the affective tie between the infant/child and the caregiver can be categorised as secure if the caregiver is responsive and supportive of the child, or insecure if the caregiver does not adequately meet the child’s needs or rejects the child. A predominant rejection by the caregiver to a child’s call for attention will have a negative effect on the child’s sense of worth and belief in the availability of others (Bowlby, 1951 in McMillan et al., 2008).
Consequently, of the four patterns mentioned, the disorganised form of attachment has often been associated with many severe difficulties in the family, including parental psychopathology, child maltreatment or other forms of trauma (Kelly and Lamb, 2001). Research on abuse and neglect in infancy has demonstrated a strong association between maltreatment and subsequent disorganised behaviour (Lamanna, 2007). Furthermore, longitudinal studies suggest that it increases the risks of depression, self-harm, substance abuse and even suicide risk in adult life (McMillan et al. 2008). Longitudinal studies also offer a basis for checking the reliability of predictions based on attachment theory (Barth et al., 2005)
However research also shows that parents having attachment disorders (i.e. avoidant) are better suited to behavioural than representational models of psychotherapy due to their inability to introspect about the role of earlier experiences in current parenting (Bakermans - Kranenburg et al., 2003 in McMillan et al., 2008).
2.4 Disturbances in Attachment Relations with Maltreated Children
According to Higgins (1998), certain characteristic patterns of adult social life behaviour become established in early life and are replicas of how the child was treated thus explaining the intergenerational transmission of violence and abuse (Bowlby, 1988 in Higgins, 1998).
Examining the probable roots of personality, Bowlby gave focus on the influence of traumatic life events and circumstances because he saw these as amenable to modification (versus hereditary influence), which could not be changed, although people could be helped to develop their individual potential to the full and live more happily (Parkes, 1995).
Precisely because traumatic life events affect or interfere with child development in so much as emotional abuse has been linked with disorders of attachment, developmental and educational problems, socialisation, and behaviour problems (McMillan et al., 2008), interest in the clinical implications of attachment disorders has increased substantially in recent years to obtain greater understanding of the particular needs of children who experienced adverse early care (O’Connor and Zeanah, 2003).
As Haskett et al. (2006) have surmised it should not be unexpected that maltreated children show insecure attachment patterns and a confused, conflictual pattern of relatedness to parents because the context wherein maltreated children would strive to develop early relations with parents is one of conflict, social isolation and limited resources. As a result of the poor, inconsistent care, rejection and harshness of the interactions (Crittenden and Ainsworth, 1989 in Hecht and Hansen, 2006), maltreated children tend to develop insecure relationship with their caregivers which in later life could be linked to problems such as poor peer relations, low self-esteem, aggressive behaviour and depression (Hecht and Hansen, 2006). Moreover, the psychological unavailability of primary caregivers in early childhood and consistent rejection by a caregiver is associated with lower self-esteem, emotional instability and increased aggression (McMillan et al., 2008).
Amidst the value and volume of research O’Connor and Zeanah (2003) have observed the seeming paradox in the state of affairs concerning attachment disorders because on one hand there is sufficient evidence that the attachment disorder describes real and distinct clinical entities warranting clinical attention, but on the other there is no consensus or protocol available for assessing attachment disorder and related behaviours (O’Conner and Zeanah, 2003). An evaluator may therefore experience difficulties in reliably distinguishing alienation from a child’s valid, expectable reaction to traumatic experiences and other unobservable forms of abusive parenting (Kelly and Lamb, 2001).
Hecht and Hansen (2006) contend that child maltreatment is a multidimensional construct and is difficult to study. Limitations of the research include but are not limited to definitional problems and the identification of adequate control populations, sampling biases for both the maltreating and control groups, subject recruitment and retention, and biases in parental report of child behaviour.
In a particular instance, Main and Solomon (1986 in Byng-Hall, 1995) discovered in a group of insecure children (80% of which were in the maltreated group) some who could not be classified under any of the previous categories by Ainsworth (1978). This would seem to indicate that the researchers did not anticipate such an outcome nor had they thought of an organised strategy for handling the way in which the parent and child greet each other on reunion (Byng-Hall, 1995). Byng-Hall (1995) holds the opinion that perhaps the reunion may include a mixture of avoidance and ambivalence or an approach avoidance conflict created by fear of the attachment figure who may be maltreating the infant. Nonetheless, it has become clear that this group is an important one because it is likely to include children who may become part of the clinical population (Byng-Hall, 1995).
According to Cassidy (2001), studies have shown that parentally maltreated infants exhibit a disorganised attachment pattern more likely than others. Moreover, child victims of both sexual and physical abuse are very likely to display behaviour that resembles core features of disorganised attachment (Lyon-Ruth and Jacobvitz, 1999 in Cassidy, 2001).
2.5 Attachment Theory: As Theoretical Foundation for Intervention
In exploring new solutions on the prevention and treatment of psychological abuse of children by primary carers McMillan et al. (2008) have identified the theory of attachment as one of the four main theoretical approaches in the development of interventions for the treatment of emotional abuse and to prevent, halt or address negative parental effects and state that the use of attachment theory is performed ideally by focusing on ways the parent’s attachment status influences their own parenting behaviours and by determining the impact of such a status to the child’s attachment status.
Through this attachment-based approach the study of a parent’s attachment status can perhaps successfully lead to the reduction or prevention of an important aspect of emotionally harmful parent-child relations called maternal insensitivity (MacMillan et al., 2009).
According to Byng-Hall (1995), the process can be elucidated through the use of the Adult Attachment Interview (AAI) developed by Main and Goldwyn (1985, in Byng-Hall, 1995), whereby adults are interviewed about their experiences of attachment in childhood and asked to give adjectives that describe each parent. In general, the AAI or Parenting Bonding Instrument is used to identify the attachment status of parents. Knowing the attachment status of parents through the AAI enables the researcher to also identify parents that would benefit from interventions such as interaction guidance that have a more behavioural orientation (McMillan et al., 2008). However the caveat remains that the AAI measures are not based on the assumption that adults are able to remember childhood experiences accurately (Ijzendoorn, 1995).
Haskett et al. (2006) have noted that there has been recent success with attachment-centred interventions purposely designed to enhance the quality of the attachment relationship between depressed mothers and their toddlers. Outcomes show benefits for the child’s developmental status (Haskett et al., 2006), and therefore attachment-based interventions might improve insensitive parenting and infant attachment insecurity (MacMillan et al., 2009).
Although according to (MacMillan et al., 2009) there is no direct evidence that these interventions prevent the recurrence of psychological abuse attachment theory helps to inform the therapist of situations likely to affect security, and about what strategies are likely to be useful when dealing with the sense of insecurity (Byng-Hall, 1995). Interventions that help prevent or reduce the occurrence of certain risk factors are likely to promote positive emotional and behavioural development of children (Hecht and Hansen, 2006). Without it, behavioural problems in younger children can lead to more serious difficulties in adolescence (Oates, 2007) and when care is neglected, they could grow up to reproduce it themselves (Parkes, 1995).
However, developing intervention or prevention strategies for maltreated children could be more challenging. First, the extent of the problem can be measured in terms of lifetime prevalence normally expressed in statistical percentages; secondly, the accuracy of reports and different use of terms and definitions make comparison difficult. Therefore it is crucial to know the approximate frequency and distribution of child maltreatment within the population in order to understand the extent of the problem before devising a plan (Higgins, 1998), otherwise what could develop are intervention strategies that were developed and based more on intuition than on empirical findings (Rosenberg, 1987 in Higgins, 1998).
3. DISCUSSION:
Four main theoretical approaches have informed the development of interventions for the treatment of emotional abuse - psychodynamic theory (focusing on the way in which 16 parents re-enact with their own children, painful and unconscious experiences from their own childhood); attachment theory (focusing on the way in which the parent’s attachment status influences their parenting behaviours and the impact of this on the child’s attachment status); behavioural/cognitive perspectives (that focus on the ways in which aversive parenting behaviours are learned or how cognitive distortions lead to abusive parenting); and finally family systems theory (focusing on the way in which the boundaries between parents and children can become blurred resulting in abusive parenting behaviour). Each of these approaches has shaped the development of interventions to prevent, halt or address the impact of parental negative effect.
With the increasing attention that attachment theory has claimed, especially from psychoanalysts interested in empirical research (Gullestad, 2001), the theory is facing the challenge of revalidation and certain test-retest reliability criteria or interjudge reliability if claims of a scientific kind are involved (Hook 1990).
In order to provide comparison by subsequently examining the weaknesses of the original theory of attachment by Bowlby, the discussion in this section will be limited to (although further discussions are anchored on) the context of attachment and separation. There are a number of other argumentative issues but the length of this essay is not enough to cover them.
3.1 Attachment and Separation
Field (1996) has identified five problems associated with attachment theory that are hereby enumerated as follows:
(1) On the strange situation studies (Ainsworth, 1967), the model attachment is based on behaviours that occur during momentary yet stressful separations rather than during non-stressful situations when they can observe the mother and infant interact during natural situations. Moreover, the reaction related to the time both mother and infant were separated should warrant a different attachment behaviour. As Field and Reite (1984, in Field, 1996) have asserted, most young children following a more prolonged separation (three days instead of three minutes), reject their mothers rather than greet them and seek physical contact (Field, 1996).
(2) The attachment has been defined on the basis of behaviours directed to the person referred to as the attachment figure. Therefore, it was limited to behaviours that occur with the primary attachment figure during an impending separation and following reunion (Field 1996). According to Barth et al. (2005) Bowlby’s attachment theory recognises that substitute parents may not always have or develop close relationships with children who have experienced adversities before joining them, but its scientific bases are limited both in terms of its ability to predict future behaviours and its use as underpinning theory for therapeutic intervention with children suffering adverse experiences (Barth et al., 2005).
(3) The list of attachment behaviours is limited to those that occur with the primary attachment figure, typically the mother. However other attachments are not necessarily characterised by those same behaviours (Field, 1996).
Holmes (1995, in Gullestad, 2001) posits that part of the difficulty lies in the difference between attachment theory and classical psychoanalysis whereby the former implies an essentially harmonious rather than conflicting mother-infant interaction, unless the interaction is disturbed by external difficulty. Hence, conflict becomes the consequential outcome of an environmental failure, yet conflict is regarded as an inherent part of normal development in classical psychoanalysis (Gullestad, 2001).
After a review on attachment literature, Rutter (1996, in Barth et al., 2005) concludes with stressing a need to reject its psychoanalytic theories of development on which some proponents of the attachment theory rely, and to orient current emphasis on maternal bonding to infants and disorders of attachment. Gullestad (2001) has provided three levels that differentiate attachment theory from classical psychotherapy: (a) basic explanatory principles, (b) theory of motivation, and (c) understanding of psychopathology.
(4) The behaviour list only includes overt behaviours. There are physiological changes that also accompany separations and reunions which in turn suggest alternative explanations for the attachment/separation phenomena (Field, 1996). Observing overt behaviours parallels the paradigms for studying human infants and infant monkeys. Recent studies with the use of improved monitoring devices have shown subtle differences in biological mechanisms thus raising further enquiries with regards to the methodological validity with the former research by Ainsworth and Bowlby.
In relation to the above, Gullestad (2001) explains that in attachment theory the insecure child constantly seeks and monitors the whereabouts of the attachment figure while the secure child can devote himself to exploration. However exploration concerns not only the outer but also the inner space, where the secure child can examine his own mind and that of his caregiver (Gullestad, 2001).
Field (1996) further reiterates the need to study the multiple types of attachments at different life stages which may include both overt and physiological behaviours that occur when attached individuals are both together and apart. Attachment may therefore instead be viewed as a relationship that develops between two or more organisms as their behavioural and physiological systems become attuned to one another (Field, 1996).
(5) The mother is viewed as the primary attachment figure although multiple, simultaneous attachments may occur between the child and the mother, the father, and siblings who may also be considered primary attachments, particularly in families where fathers and siblings share in the care giving (Field, 1996).
According to Kelly and Lamb (2001), Bowlby’s notion of monotropy - the presumption that infants form a single relationship before all others - has retained credibility in popular mythology and has continued to mislead judges, clinicians and custody evaluators in the Family Court, although such a notion has never been supported empirically and is no way central to attachment theory (Rutter, 1995 in Kelly and Lamb, 2001) because infants show evidence of attachment to fathers despite the fact that the latter may spend less time interacting with them.
There have been some interesting attempts to rescue developmental psychology from a feminist perspective or to make attachment theory less exclusively focused on mothering (Scourfield, 2010). Walsh (in Scourfield, 2010) concludes that a narrow focus on maternal attachment would be less helpful than a more systemic approach which considers the role of all relevant family members.
3.2 Critiques
In parental custody issues Kelly and Lamb (2000) ascertain that there are unnecessarily restrictive and prescriptive guidelines (with no particular mention which ones) which were not subject to child development research and so reflected an outdated view of parent-child relationships. Whether they discreetly refer to attachment theory or not there still exists that shared characteristic readily pointing to Bowlby, for neither his work nor Ainsworth’s was readily accepted by developmental psychologists (Fleming, 2008).
Others critique the working model construct as vague and metaphorical (Dunn, 1993; Thompson and Raikes, 2003; in Vaughn et al., 2006) as well as overly extensive in its purported explanatory range (Rutter and O’Connor, 1999 in Vaughn et al., 2006).
In his critical review, Rutter (1997, in Fleming, 2008) raised that research confirms that there is a considerable span for later change in attachment style between a child and an adult, which is in contrast to the idea in attachment theory that infant experiences determine adult behaviour.
In the same vein as the argument by Kelly and Lamb (2000), Rutter (1997, in Fleming, 2008) asserts that the mother, viewed as the primary caregiver, can be blamed unduly or unwittingly for what she does and how she reproduces attachment styles is a crucial factor in child development. Clearly, Bowlby’s use of ethology to relate how mothers develop attachment with their young took much influence in highlighting the role of mothers providing individual care for children while fathers are rarely looked at and given no intrinsic value at all (Rutter, 1997 in Fleming, 2008).
From the above and from what Barth et al. (2005) assert, an overemphasis on the relationship of attachment paradigm to psychological disorders and behaviour problems is perilous. This is because the conceptualisations of attachment have become muddled or distorted to the extent that other psychological concepts like identity and self-esteem, as well as the uses of attachment theory, have strayed too far from their origins making its validity as bases for intervention difficult (Werner-Wilson and Davenport, 2003 in Barth et al., 2005).
4. CONCLUSION
From the above review and discussion a conclusion can be drawn that distortions causing possible maladaptations of attachment theory cause serious risks both in the assessment and treatment of attachment disorders particularly with maltreated children. For instance, the strange situation procedure was designed to classify infant attachment among groups of infants performed in a research setting rather than to diagnose an infant in a clinical setting (O’Connor and Zeanah, 2003).
Albeit by undue diligence, some unsuspecting researchers or evaluators might be tempted to use the same bases and rely on the conclusions drawn by Ainsworth (1978) and/or by Main and Solomon (1984). This could easily lead to unvalidated and faulty assessments to the extent of executing a partially effective or totally wrong therapeutic judgment. There is also the danger of mislabelling between pathologic and non-pathologic variations in attachment behaviour.
To clarify, Sroufe et al. (1999) asserted that early attachment variations do not automatically mean pathologic behaviour. Instead, the varying patterns of attachment often lay the groundwork for disturbances in the developmental processes that can lead to psychopathology but are by no means inevitable. Hence these ought to be viewed as the initiating conditions that play a dynamic role in pathological development whereby certain environmental engagements frame subsequent tendencies and expectations (Sroufe et al., 1999).
Concerning the applicability of original attachment theory to today, the essence of Bowlby’s theory of attachment still remains relevant as some findings can be taken from its metaphorical value. However, revalidation, if not reconstitution of the methodologies that were once used by Ainsworth (1978) or Main and Solomon (1984), is recommended.
Today’s research methodologies are undeniably more stringent and researchers would demand no less for consistency, reliability and reproducibility of results. Where literature suggests that longitudinal studies have contributed to the discovery of several flaws and criticisms, researchers would comment on the limitations and the weakness of Bowlby’s original theory of attachment. For instance Sroufe and colleagues (Roisman et al., 2002 in Barth et al., 2005) studied a sample of high-risk and maltreated children to adulthood and through the longitudinal method discovered discrepancies between predictions based on early childhood assessments of attachment and adult relationship outcomes.
In retrospect, the levy that attachment theory has put on the shoulders of mothers - they being the principal attachment figure in a child - is an indication that Bowlby centred on the values of mothering in the shadow of post WWII where huge amounts of separation were experienced by men and women (Rutter, 1997 in Fleming, 2008). He did not anticipate the time when modern mothers would have to do other important things rather than simply devoting their time to rearing a child. As dictated by today’s economics, many more women are in the workforce than were some 60 years ago.
Lastly, amidst all the criticism propounded against the works of Bowlby and Ainsworth, be it as a team or in their respective capacities, we should be grateful for their contributions for without them there might never have been a highly acclaimed, if not a controversial, theory that stood out as an inspiration and precedential base for other studies to be undertaken.
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Susan M Bailey
Atypical Development