The impact of early secure attachment on relationships

by Chick74 (student)

“Following the British psychiatrist John Bowlby’s claim that secure attachment to a parental figure is necessary for healthy psychological development, opinions about the impact of early relations have varied wildly.” (Bentall, 2003)

The theory of attachment was originally put forth by John Bowlby as an approach to understanding early development and the formation of relationships. The central theme of his theory is that babies/young children who have their mother readily available and responsive to their needs develop a strong sense of security and enable them to form emotional attachments. Young children show their attachment patterns by seeking proximity to primary attachment figures especially in times of fear or distress and use these attachment figures as a secure base from which to explore the world. Bowlby (1973) felt that these early emotional attachments and relationships form the basis for relationships and social interactions later in life. Certain events such as separation, death or neglect can have a detrimental impact by interfering with attachment patterns and this can have short and long term consequences. For the purpose of this essay I will focus on how accurate Bowlby’s claim regarding secure attachment to a parental figure actually is, and whether it can be used to explain onset of mood disorders such as depression and bipolar by looking at the key theoretical ideas and exploring some of the research findings.

Bowlby (1973) as cited in Gross (2001) argued that because new born babies are completely helpless, they are genetically programmed to behave towards their mothers in ways that ensure their survival. He felt also that the mother inherited a genetic blueprint which programmes her to respond to her baby. He felt that there was a critical period in which the attachment was to take place and that if this attachment was delayed until after 12 months that it would never come to fruition. The child’s attachment to its mother will regulate how far away from the mother the child will move and the amount of fear it will show towards strangers. In general, attachment behaviours become more obvious if the child is fearful, in unfamiliar surroundings or distressed (Gross, 2001). Research has found that disruptions such as neglect, death and separation may cause people to grow up fearing abandonment and have problems maintaining relationships (Stone, 1993 as cited in Durand & Barlow, 2010).

The mother has an automatic bond towards her child having carried him/her for 9 months but research suggests in line with Bowlby’s theory that it is imperative that early contact is available for bonding to occur (Kring, Johnson, Davison & Neale, 2010). Bowlby (1973) felt that it was vital that the infant/small child should experience a secure, warm and reliable relationship with its mother in order to avoid significant and irreversible mental health consequences later in life. Infants who are securely attached to their caregivers grow up to be psychologically healthy adults, whereas infants who are anxiously attached to their caregivers are more likely to experience psychological difficulties in life (Kring et al, 2010).

The idea that insecure attachments lead to problems in later life was possibly fuelled by the results of the Copenhagen high-risk study which found an association between positive symptoms and early separation from parents (Skovgaard, Houmann, Christiansen, Landorph & Jorgensen, 2007). Further evidence came from the Finland Birth Cohort Study in 1966 which found that unwanted pregnancies resulted in a four-fold increase in psychosis in later years implying that parents’ emotional ambivalence towards their children increase the risk that they will grow up to suffer positive symptoms (Bentall, 2003). Attachment theory has regularly been used to explain the development of psychopathology (Davila, Ramsey, Stroud & Steinberg, 2005) as cited in (Lee & Hankin, 2009). However, some research has suggested that insecure attachment itself does not cause psychopathology directly, but early childhood attachment, family context and other social experiences may shape a person in such a way that certain developmental pathways are more likely to be followed than others (Lee et al, 2009). Research has suggested that if a child is exposed to insecure attachments with their primary caregiver during formative years this can increase the risk of a host of problems later in life including mood disorders. Depression and anxiety are among the most common psychiatric disorders during adolescence and prevalence of major depressive disorder and anxiety disorders increase significantly during adolescence and into adulthood (Costello, Egger & Angold, 2005). Bowlby (1980) as cited in Lee et al (2009) stated that people form mental representations that include models of the self and others by interacting with their caregiver. These internal working models he hypothesized to be the framework guiding one’s thoughts, feelings and behaviours in the context of future relationships.

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Holmes (1993) also found that approximately one third of adults will have relationships characterised by anxious, secure attachment and it has been argued that this may provide vulnerability for mental health problems such as depression when people experience stressful or difficult life events. Bowlby (1973) suggested that loss of, or separation from the mother in childhood, or inadequate relationships with primary care givers can leave a person vulnerable to depression in later life. This has been confirmed by subsequent research (Lee & Hankin, 2009). Harris & Bifulco (1991) as cited in Goodwin (2003) found that women who had lost their mothers through bereavement at an early age had significantly higher rates of depression (one in three) compared with non-bereaved women (one in ten). This experience of early loss of the mother they argued led commonly to lack of adequate care in childhood accompanied by the development of a sense of helplessness and hopelessness. Harris et al (1991) felt that this subsequently led to teenage pregnancy which meant limited choice of partner, poor living conditions, few personal or social resources which in turn left the women more vulnerable to stress and continued sense of helplessness leaving them much more likely to develop depression. Rosenfarb, Becker & Khan (1994) also found that severely depressed women and women with bipolar disorder reported minimal attachment to their mother at all stages through childhood. Rosenfarb et al (1994) found that severely depressed women felt less attached than a non-depressed control group to their peers during development which is in concurrence with Bowlby’s theory that young children need a secure base from which to explore the world. However, Strahan (1995) argued that the quality of current peer attachment in adulthood can moderate the impact of early parental bonding on levels of depression indicating that present relationships are equally as significant as past relationships.

Attachment theory cannot be held to account for mood disorders on its own. Mood disorders must be investigated from a multifactorial perspective. Research suggests that parental psychopathology, parent-child relations and life events are all relevant factors in adolescent depression and should be considered in combination for assessment, prevention and intervention effort (Seguin et al, 2003). While children of depressed parents are at increased risk for the development of psychopathology and adjustment problems (Cummings & Davies, 1994) developmental factors, temperament, childhood loss, neglect and early adverse life experiences have all been shown to be contributors to the development of mood disorders (Seguin et al, 2003).

Much research has focused on the significance of insecure attachment patterns in adults. Bowlby (1942) as cited in Goodwin (2003) himself proposed a connection between adult mental health and early parental loss. Attachment theory suggests that mental illness may be influenced in three interrelated ways. Firstly, the breaking of bonds can cause a disturbance. Secondly, how disturbed early attachment patterns are internalised can have an impact on subsequent relationships in such a way that leaves a person more vulnerable to stress. Finally, a person’s current perception of their relationships may make them more or less vulnerable to break down in the face of future trials in their lives (Holmes, 1993).

There is also growing evidence to suggest that mood disorders are not exclusive to adulthood. Depression can be detected in children as young as 5 years and one reason for this has been suggested to be the development of insecure and/or disorganised attachment patterns (Luby, Belden & Spitznagel, 2006). Goodman & Gotlib (1999) found that a predictor of mood disorders including depression was the presence of depressive symptoms in the child’s mother and suggested that the depressed mother’s inability to cope and engage with her child and to provide a secure base and fail to provide the child with the effective coping strategies to deal with stressful or fearful situations. Martins & Gaffan (2000) found significantly lower levels of secure attachment among infants of mothers with depression. Klaus, Kennell & Klaus (1995) found that children whose mothers gave them an extra 5 hours contact per day for the first three days showed significantly higher IQ scores later in life and were more secure in their relationships.

The Attachment theory emphasis on maternal care above all others has been criticised for a number of reasons. The main criticism is that it excludes the important role of the father in the child’s development. It has also been criticised for confining women with children to the ‘mothering role’ and has failed to acknowledge the role of the child as an active agent in his/her social environment (Goodwin, 2003). Bowlby’s views of attachment and monotropy have been further criticised on a number of different levels. For example, infants and young children display a whole range of attachment behaviours to a wide variety of people in their lives as well as to their mother. While Bowlby did not deny the presence of multiple attachments he claimed the one to the mother was the most important. Kendler, Myers & Prescott (2000) however found no significant differences across any parenting dimensions for any disorder. Their findings suggested that parenting from fathers and mothers is equally important in influencing risk for psychiatric disorders and substance abuse. In a later research Heider, Matschinger, Bernert, Alonso & Angermeyer (2006) also found no significant difference between care of mother and care of father for the child.

While there is much evidence to suggest that attachment patterns in childhood are reflective of attachment and relationships in later life there is a strong research base to suggest that it is not as simplistic as that. Schaffer (1998) as cited in Gross (2001) believed that psychological development is much more flexible than previously thought and our personalities are not fixed once and for all by events that occur in our early years. He felt that given the right circumstances, the effects of even quite severe and prolonged deprivation could be reversed. Clarke and Clarke (2000) also felt that relationships are not merely predetermined by the experiences of the early years alone but result from the combination of genetic and environmental interactions and transactions. Whilst they don’t dismiss the importance of early years Clarke et al (2000) suggest that early experiences are merely the first step on an ongoing life path and that no exclusive point of development is any less important that another, they are all equally important.

Psychopathologists have identified biological, psychological, environmental and social factors which all contribute together to have an impact on mood disorders (Durand & Barlow, 2010). Whilst much research has been in agreement with Bowlby’s (1973) theory the repeated failure of twin and adoption studies to find significant evidence for family environment on the aetiology of psychiatric disorders has cast a cloud over the idea that attachment theory can be accountable alone for these issues and has led some researchers to suggest that parents do little to their children that influences risk for psychiatric illness beyond transmitting them their DNA (Kendler et al, 2000). Klein, Lewinsohn, Rohde, Seeley & Durbin (2002) however, found that genetics had a role to play and their findings suggested that an increasing severity and recurrence of major depressive episodes in the proband was associated with higher rates of depression in relatives. Some research on twin studies have shown that genetics is linked to mood disorders and their severity with identical twins being two to three times more likely to present with a mood disorder than a fraternal twin if the first twin has a mood disorder (McGuffin & Katz, 1989). Twin studies have shown that 37% of the variance in depression can be accounted for by genes (Sullivan, Neale & Kendler, 2000). Evidence from twin studies also indicates bipolar disorder to be among the most heritable of disorders. A Finnish community-based twin sample that used semi-structured interviews to obtain diagnoses resulted in a heritability estimate of 93% (Kieseppa, Partonen, Haukka, Kaprio, & Lonnqvist, 2004). These findings, however, seem to lean more towards a biological and genetic explanation that an attachment one.

Mood disorders have also been linked to serotonin levels. The function of serotonin is to regulate systems involving norepinephrine and dopamine and when levels of serotonin reduce other neurotransmitters become deregulated which contribute to mood irregularities including depression (Durand & Barlow, 2010). Other biological factors in the study of mood disorders include the endocrine system. The HPA axis (hypothalamic-pituitary-adrenocortical axis) which is the system that manages reactivity to stress has been shown to be overly active during episodes both of major depressive disorder and bipolar disorder. The HPA axis triggers the release of cortisol which is the main stress hormone and helps the body prepare for threats (Kring et al, 2010). Although cortisol helps mobilise beneficial short-term stress responses, prolonged high levels can cause harm to certain body systems e.g. the hippocampus – studies have found smaller than normal hippocampi among people who have experienced depression for years (Durand & Barlow, 2010).

Research also supports the idea that life events (e.g. unemployment, divorce, having a baby etc.) can pose a trigger for mood disorders such as major depressive disorder. Not all people become depressed after life events but some are more vulnerable than others. Current thinking is that stressful life events trigger the onset of depression by activating stress hormones which in turn interfere with neurotransmitters such as dopamine and serotonin and if this process lasts long term it may turn on certain genes which could produce long-term structural changes in the brain (Durand & Barlow, 2010). Research highlights the role of low social support, high expressed emotion, need for reassurance and poor social skills as risk factors for depression. Depression results in negativity and may lead to rejection from other people potentially prolonging the episodes (Kring et al, 2010).

While Bowlby’s theory is a strong framework for understanding human attachment and relationships it cannot account for mood disorders on its own and these mood disorders must be considered within a multifactorial framework. Research strongly suggests the role of life events as a trigger for depression but some people are more vulnerable to life events than others. Research also highlights the role of low social support, need for reassurance and poor social skills as risk factors for depression and once a person becomes depressed, increased in negativity and reassurance-seeking may lead to more negativity and rejection from other people which could potentially prolong the episode. Unfortunately, less research is available on bipolar disorder but many of the predictors for depression also appear to predict bipolar (Kring et al, 2010). It is clear therefore that the causes of mood disorders emanate from a complex interaction of psychological, biological and social factors and therefore must be considered from within this mixed framework.

In summation, although there is strong evidence to support the relationship between attachment theory and onset of mood disorders the findings are not wholly conclusive and some concerns have been expressed that it is essentially a child-based theory and therefore not readily adaptable to adult issues (Gross, 2001). Many findings, on the other hand, have found it to be a useful, rigorous model for the study of complex human behaviour throughout the life span. Bowlby (1973) proposed that disruptions in mother-child relationships lead to insecure attachment which leaves the person vulnerable to mood disorders such as depression later in life (Goodwin, 2003) and this has been confirmed by much research (Harris et al, 1991). Children who have secure relationships with their parents typically but not always grow up to form secure relationships with their own partners and go on to become parents of securely attached children. Insecurely attached children however, often have problems forming relationships in later life and sometimes fail to bond adequately with their own children (Bentall, 2003).

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The impact of early secure attachment on relationships

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