A New Look at Attachment Parenting......
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|Sun, 06-29-2003 - 11:04pm|
The controversial science of mother-infant bonding gets a new look
By Joshua Kendall, 6/29/2003
SINCE THE DEATH of Dr. Benjamin Spock in 1998, Dr. William Sears of San Clemente, Calif., has assumed the moniker of ''America's pediatrician.'' Sears, often in collaboration with his wife, Martha, a registered nurse, is the author of numerous parenting books, including the mega-selling encyclopedic tome ''The Baby Book: Everything You Need to Know About Your Baby from Birth to Age Two.'' In an approach known as ''attachment parenting,'' the books recommend building up the all-important attachment between you and your baby through long-term breastfeeding, bed sharing, and stay-at-home parenting.
For Sears, the concept of attachment is a literal one. To help ''immunize'' your child against ''the social and emotional diseases that plague our society,'' he suggests carrying the baby strapped to your body-perhaps with the help of the Dr. Sears Original Baby Sling, available at his online store for $39.95.
Unlike Dr. Spock's seat-of-the-pants approach to parenting, Sears's approach has its roots in a distinct, if controversial, body of theory. First fleshed out some 50 years ago by the British psychoanalyst John Bowlby, attachment theory holds that the early interactions between infant and caregiver have a profound impact on an infant's social, emotional, and intellectual growth. To most parents, the notion that the child is father to the man may seem self-evident. But not so for a legion of psychoanalysts, developmental psychologists, and feminists, whose intense campaign of ideological and personal vilification kept Bowlby's theories on the margins of American psychiatry for decades.
These days, however, attachment theory is undergoing a renaissance of sorts, in both the lab and the clinic. As a wealth of long-term studies now show, children who develop strong bonds with their parents are likely to form similar bonds with peers, partners, and eventually their own children. Earlier this month, a group of Canadian researchers announced results of a study showing that mother rats who groomed their infants more than usual triggered the expression of a gene that enabled the babies to grow into less anxious adults with lower levels of stress hormones. While the researchers warned against directly extrapolating the results to humans, the study highlights a causal mechanism that might explain how early maternal care directly contributes to future mental health.
Bowlby's work is getting a second look as well. In 2000, the Journal of the American Psychoanalytic Association devoted an entire issue to attachment theory, kicked off with a startling foreword apologizing for a half-century of ''outright rejection and denigration'' of attachment theory and ''disparagement'' of Bowlby. But support for attachment theory has spread beyond the insular and theory-driven world of psychoanalysis. As Allan Schore, a UCLA behavioral specialist, says, ''New findings in psychobiology and psychophysiology give attachment theory the foundation it lacked in 1969 when Bowlby published `Attachment','' the first volume of his magnum opus.
The prehistory of attachment theory dates back to the late 1920s, when Bowlby took a year off after completing his undergraduate studies at Cambridge University. While working at a progressive school for maladjusted boys, Bowlby noticed that symptoms like emotional numbness and theft were often associated with the lack of a stable mother figure. Bowlby became convinced that the early experiences in childhood shaped personality development-an idea that would get him into trouble after he completed his medical studies and began his psychoanalytic training.
Though the stuff of childhood has always been central to psychoanalysis, mainstream analytic thinking of the day held that emotional problems stemmed primarily from internally generated conflicts or fantasies. External reality (say, whether a parent was depressed at any point during the analysand's childhood) was typically considered irrelevant. The legendary British analyst Melanie Klein, who supervised Bowlby's training, considered actual events of such minimal importance that she forbade him to interview the mother of a 3-year-old he was treating.
In contrast to the orthodox Freudians who saw babies as obsessed with breasts, Bowlby stressed the importance of their emotional connection to the primary caregiver or attachment figure-typically, the mother. As Bowlby argued in a famous 1958 paper, ''The Nature of a Child's Tie to his Mother,'' drives like hunger or libido are secondary to the need for attachment and protection. In Bowlby's formulation, the child develops an ''internal working model'' of other people, based on the mother's availability and responsiveness. In other words, on some level we see our mothers in everyone. Bowlby kept a single-minded focus on this hypothesis until his death in 1990.
In the 1960s and `70s, the American developmental psychologist Mary Ainsworth, a protg of Bowlby, gave his theoretical speculations an empirical footing. Ainsworth's most celebrated contribution consisted of a laboratory procedure called the ''strange situation,'' which involved two brief separations between infants (aged 1-2 years) and their mothers. Based on the infant's response upon reunion with the mother, Ainsworth identified three distinction attachment styles: secure, avoidant, and ambivalent.
Secure infants protest their mother's departure and seek close contact upon her return. In contrast, avoidant infants, who tend not to express much emotion, show little interest in their mother's whereabouts. Ambivalent infants, though upset at the mother's departure, are not easily comforted upon her return. (In the 1980s, Mary Main, a psychologist at UC-Berkeley, added a fourth attachment style: disorganized. Typically, such children have a history of abuse or neglect and tend to act in chaotic ways-hiding, say, or staring into space when the mother returns.)
Ainsworth contended that these experiments provided accurate snapshots of everyday interactions at home. In her view, attachment style was a critical indicator of the child's overall personality structure.
But despite such empirical findings, attachment theory has generated a blistering barrage of criticism from the very start. Psychoanalysts went after Bowlby's ideas as well as the man himself. Although he aimed simply to fine-tune psychoanalytic theory, most analysts saw Bowlby as an antichrist hell-bent on destroying the faith. In 1960, Anna Freud and two other analytic heavyweights each wrote articles harshly dismissing Bowlby's ideas as worthless.
The attacks on Bowlby from feminists, beginning in the 1970s, have been less personal but just as vehement. In her influential book ''Mother-Infant Bonding: A Scientific Fiction'' (1992), Diane Eyer, an adjunct professor of psychology at the College of New Jersey, equated attachment theory with social Darwinism and other pseudoscientific notions used to oppress the disenfranchised. Bonding, Eyer charged, was ''part of an ideology in which mothers are seen as the prime architects of their children's lives and are blamed for whatever problems befall them.''
But the most rigorous challenge to Bowlby's ideas has come from a group of developmental psychologists, led by Harvard's Jerome Kagan. As Kagan said recently, ''Infant experience is very critical only if your mother goes after you with a frying pan. But extremely averse circumstances are rare.'' While Kagan concedes that severe neglect can have grave developmental consequences, as in the case of the Romanian orphans who have been the subject of numerous recent attachment studies, in his view the vast majority of children receive sufficient nurturing to grow into mentally healthy adults.
Furthermore, Kagan doubts that the ''strange situation'' measures anything useful. Although many studies show that the three attachment styles identified by Ainsworth remain consistent over time, others have shown very different results. For example, a 1996 study by the child-care scholar Jay Belsky found that only about 50 percent of the infants received the same category classification when retested after three months.
But whatever the lingering controversies over attachment theory, it's now charting new directions for both mental-health practice and policy. New research in the neurobiology of bonding has put the theory on ever-stronger empirical footing. The nation's number one research psychiatrist, Thomas Insel, who became director of the National Institute of Mental Health last year, has been a key contributor to the this effort. In a series of studies of rat pups and their mothers conducted over the last two decades, Insel has explored the role of brain chemicals called neuropeptides in pair-bonding. The discovery of these so-called ''attachment hormones,'' such as oxytocin and vasopressin, has highlighted the physiological basis of various attachment behaviors, such as the infant's desire to be soothed.
In two just-released books, Allan Schore synthesizes this voluminous body of neurobiological research and teases out its implications for psychotherapy. According to Schore, this research now shows that the mother-or whoever assumes the role of the child's primary caregiver-actually helps to determine the ultimate architecture of the child's brain.
Schore acknowledges that this may be a downer from the point of view of women, who are still responsible for the lion's share of child care. But the good news is that what works in the crib also works in the consulting room. In Schore's view, therapists can facilitate emotional growth, and even treat serious mental illness such as borderline personality disorder, by serving as protective attachment figures. Not just drugs but a strong therapeutic relationship itself, regardless of the specific style of therapy, can alter faulty brain chemistry for the better.
Attachment researchers have also begun to focus on early intervention programs. Harvard Medical School's Karlen Lyons-Ruth, for example, has designed a landmark study involving 72 families that tracks the long-term effects of home visits aimed at helping mothers improve their communication style-by expressing more positive emotion, for example. At age 5, children whose mothers received the added support were less hostile and aggressive toward peers than children in the control group. ''From a policy standpoint, it's clear that as a society, we need much more support for mothers. There's a big payoff,'' says Lyons-Ruth.
Daniel Siegel, a professor of psychiatry at UCLA and coauthor of the recently published ''Parenting From the Inside Out,'' likewise defends attachment theory against charges of guilt-mongering and misogyny. ''Attachment theory isn't about beating up on parents. It's about helping them do the best job they can,'' he says.
Dr. Sears's baby books say the same thing. With a whole generation of parents now following hisprescription, could the Prozac Nation era be drawing to a close-to be replaced by a warmer, fuzzier, and more securely attached America?
Joshua Kendall is writing a book on the evolution of treatment for depression for Other Press.
This story ran on page D1 of the Boston Globe on 6/29/2003.
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