Attachment Theory And Implications For Therapeutic Counselling Social Work Essay

Outline your understanding of attachment theory and describe the implications of this for therapeutic counselling? Illustrate your answer with reference to clinical work. Consider the implications of this theory in a modern society, which has many alternative family structures.

Introduction:

What is early attachment theory? John Bowlby originally proposed attachment theory and defined attachment as “any form of behavior that results in a person attaining or retaining proximity to some other differentiated and preferred individual, usually conceived as stronger and/or wiser” (Bowlby, 1973, p. 292).

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Attachment or bonding is the developing relationship to parents, a carer or carers and is necessary for ordinary development. Children’s attachments can have an impact on the rest of their lives. Attachment behaviours begin early in life. This trusting relationship which is developed in infancy forms the foundation for a child’s development. If children have a secure attachment, they will grow up to view the world as a safe place and they will be able to develop other emotions.

However, children who experience early separation and loss will express this through their behaviour. A secure attachment will lead to better general coping skills, and the cost of insecure attachment may lead to isolation (Bowlby, 1969).

In this essay I will present material about attachment theory. I will explore the different views and my aim is to relate it to clinical work. My illustrations will be drawn from theory and personal experience.

Theory:

According to Vera Fahlberg (1988) the most common causes of attachment problems, the highest risk being in the first two years of life, are sudden or traumatic separation from primary caretaker through death, illness, hospitalisaton of caretaker, or removal of child from the care of the established attachment figure/figures. Furthermore, she claims there are other causes for attachment problems which include physical, emotional or sexual abuse, neglect of physical or emotional needs, illness or pain that cannot be alleviated by caretaker, and frequent moves and/or placements i.e. foster care, adoptions and changes of caretaker within the family setting. John Bowlby (1988) believes if no bond or attachment is formed during early life the child is more likely to be unstable and anxious as an adult. The work of John Bowlby seems to have been the most influential in attachment theory and I feel Bowlby highlights the important implications for the counselling relationship.

Before Bowlby the behaviour of infants to seek attachment with adults was thought to be about an instinct to search for food (Bee, 1999). Bee (1999, p. 42) cites Freud (1856-1939) as saying “…love has its origin in attachment to the satisfied need for nourishment”. Freud suggested that the baby forms a bond with its mother by satisfying its hunger. He calls this stage of development the oral stage which begins soon after birth. Freud believes if the child satisfies this related need then it should promote a feeling of pleasure therefore, returning to a comfortable state (Bee, 1999).

However, according to Fahlberg there is some evidence that the social needs are more important to the attachment process than meeting the physical needs. Fahlberg refers to Ainsworth’s (1913-1999) 1952 findings, “social interactions, not routine care, are the most important part of mothering” (Fahlberg, 1988, p.27).

Erikson (1902-1994) however, shared most of Freud’s basic assumptions, but differed between inner instincts, and outer cultural and social demands. Unlike Freud who placed central emphasis on inner instincts. However, Erikson named his developmental stages as ‘psychosocial stages’ as he believes a person goes through different stages through their lives. To be able to reach self acceptance they must first fully develop each stage. If this does not happen then problems will arise (Bee, 1999).

According to Bee (1999) Erikson describes the first stage as ‘basic trust versus mistrust’. Bee went on to say “Erikson believed that the behaviour of the major caregiver (usually the mother) is critical to the child’s establishment of basic sense of trust.” (p.45). Therefore, if the caregiver responds to the child consistently, in a way the child has become accustomed, and responds in a loving and predictable way, then trust will develop. However, he believes if that doesn’t happen, and the child has had inconsistent care then mistrust may develop, which may lead to anxiety. Erikson believed that development went on through the entire life span, as the child, and then the adult developing a sense of ever-changing identity (Bee, 1999).

However, John Bowlby disregarded these theories of attachment, believing instead that the process was much more complicated. He put forward the idea that babies look for physical closeness, comfort, food and familiar interaction (Bowlby, 1988). “The young child’s hunger for his mother’s love and presence is as great as his hunger for food” (Bowlby, 1969, preface xiii) John Bowlby brought this concept to the fore and as Robert Karen states in his book, Becoming Attached, “Bowlby’s theory was bold, full of common sense, speculative but grounded in science, and threatening to the older views” (1998, p.101). However, all three theorists seem to agree that healthy secure attachments are very important for human development.

Attachment helps the child:

– attain full intellectual potential;

– sort out what he or she perceives;

– think logically

– develop a conscience;

– become self-reliant;

– cope with stress and frustration;

– handle fear and worry;

– develop future relationships;

– reduce jealousy.” (Fahlberg, 1988, p.13)

According to Ainsworth (1913-1999), attachment is an affectional bond that has been established by having a continuous loving and caring relationship with another human being. “…an affectional bond is a long enduring emotional tie to a specific individual” (Leather, 2004, pp.21-25). Studies of children raised in institutions have shown that adequate physical care is not enough. A primary person to whom the child can become attached, who responds to the child’s needs and who initiates positive activities with the child is indispensable.

Attachments are formed by the constant repetition of two very positive cycles of interaction: ‘The arousal – relaxation cycle’ and ‘The positive interaction cycle’ Fahlberg, V. (1988) Fitting the Pieces Together. (Practice Series: 17) British Agencies for Adoption & Fostering:

The following diagram illustrates a successful interaction between the caregiver and child. The child cries because of its need for food, caregiver feeds the child, the child becomes calm, therefore the child’s needs have been met which will then establish a secure and trusting attachment. This cycle must be completed to ensure a healthy development.

Fahlberg, V. (1988) Fitting the Pieces Together (p. 25)

The next diagram illustrates the positive interactions between caregiver and child. The caregiver interacts and plays with the child, meeting social needs, the child responds, therefore building a child’s confidence.

Fahlberg, V. (1988) Fitting the Pieces Together (p. 27)

If the baby’s needs are not met consistently then the baby doesn’t develop trust, becomes full of rage and perceives the world as a dangerous place. This is then carried through into adulthood, causing feelings of insecurity through to sociopathic behaviour depending on the degree of mistreatment or abandonment for the individual (Fahlberg, 1998).

The three patterns of attachment are:

Secure Attachment – exploration from secure base – active seeking of contact upon reunion.

Anxious/Avoidant Attachment – independent exploration – active avoidance upon reunion.

Anxious/Resistant Attachment – Poverty of Exploration – Difficulty separating on reunion.

Source: Mary Ainsworth (1979).Research.

Jeremy Holmes stated in his book John Bowlby & Attachment Theory, “Mary Ainsworth (1982) first used the phrase ‘secure base’ to describe the ambience created by the attachment figure for the attached person. The essence of the secure base is that it provides a springboard for curiosity and exploration.” (Holmes, 1993, p. 70) John Bowlby believed that a ‘secure base’ was the most important aspect of parenting “…a central feature of my concept of parenting, the provision by both parents of a secure base from which a child or an adolescent can make sorties into the outside world…” (Bowlby, 1988, p.11).

Cultural Implications:

Studies in other countries support Ainsworth’s belief that some form of ‘secure base’ is needed for all infants, however, there are indications that behaviour may have to be interpreted differently in other cultures. According to Helen Bee (1999, p.192) “German researchers, for example, have suggested that an insecure/avoidant classification in their culture may reflect not indifference by mothers, but explicit training towards greater independence in the baby” (Grossmann, Grossmann, Spangler, Suess, & Unzner, 1985).

Furthermore, “…in Japan a greater valuing of emotional interdependence is associated with limited separation experiences, therefore heightening the distress experienced by many Japanese infants…” (Harwood, Miller & Irizarry 1995. p.14) Therefore, it would appear that the infant behaves in a manner that responds to the maternal behavior that is both intuitive and reflective of the behaviour in its community.

It is stated in Helen Bee’s book ‘The Growing Child’ “…some form of “secure base behaviour” occurs in every child, in every culture….” (1999, p.192). Bee says, we have a long way to go to understand how cultural differences affect the development of children but they form a significant backdrop for all development and to understand nurture, we must first understand the part culture plays (1999).

Children are born into a diverse range of family structures and these structures may change during the course of childhood. Attachment theory highlights the role of the primary caregiver and in the process puts the spotlight on the person who is most likely to undertake this role in our society – the mother. This can lead to argue against mothers working. Wyse (2004) states, “Once the child has developed an attachment they will protest at separation from that preferred person and will show fear of strangers” (p. 23). However, Vera Fahlberg says the attachment figure does not have to be the child’s mother. The initial bonding can be the father or even an adoptive or foster mother, as long as the care is consistent during the early years of development.

Of course there are many alternative family structures and views have changed over the years. Many people feel marriage is outdated and prefer to just live together. There also is the difficulty that surrounds divorce and the impact this has on young children. According to Robert Banton Jack Straw, the home secretary, stated in a document called Supporting Families (1998) “…changes in

family organization we have mentioned are really linked to the social problems” (2004, p.33). With rising divorce rates, social acceptance of sexual relations outside marriage and single sex partnerships will all have an impact on the way in which children are raised and by whom.

I believe parenting practices have a greater effect on children than marital status. I divorced my husband when my children were still at school. I maintained a healthy relationship with my ex-husband because I felt it was important for the children to still see us as a family unit. I was determined that my children had constant access to their father and that he played a part in their upbringing. This has certainly had an impact on my children and they often said it was a better arrangement than two unhappy people living together.

Blakeslee & Wallerstein stated in their book Second chances: Men, women and children a decade after divorce when referring to children from divorced families, “They fear betrayal. They fear abandonment. They fear loss. They draw an inescapable conclusion: Relationships have a high likelihood of being untrustworthy; betrayal and infidelity are probable” (1989, p. 55). Although my children experienced the trauma of divorce, I feel I kept that disruption to a minimum.

Clinical references and Personal insight:

Following the birth of my first child, I chose to go back to work when she was six weeks old. Childcare was shared out between my husband, my cousin and my aunty and this situation continued for some time. I then made the decision to send my daughter to nursery when she was three, but she would not settle and screamed hysterically when I left her. When I picked her up she would cling to my legs and cry if I talked to anyone on the journey home. This seems to follow

the pattern of ‘insecure attachment’. In Dominic Wyse’s book, Childhood Studies an Introduction, Leather cites stages of separation behaviour as observed by Robertson and Robertson “…may be unwilling to trust parent if/when they return, or may become very ‘clingy’ and refuse to let parent leave them in any situation” (2004, p.23).

However, my daughter is now in her late twenties, she suffers from periodic bouts of depression and anxiety attacks. She doesn’t seem to be able to settle into long term relationships, but in spite of that, in her working environment she is a confident adult holding a managerial position. I feel however, my daughter has inherited traits from her father as he suffers with bouts of depression; furthermore, two of his siblings have had a mental breakdown. Leather says, children take traits from both the mother and father such as physical features, but they can also inherit illnesses (2004)

There is now a large body of evidence saying that children are capable of forming attachments to two or three caregivers and if the care arrangements are of good quality, and the quality of parenting has been established, then the child stands to benefit. Furthermore, Fahlberg says, it is not unusual to share the job of ‘mothering’ and that the child, providing the quality of care is good and that it is consistent, can do just as well as those attached to one caregiver (1994). My daughter’s carers were consistently part of her growing up therefore; I feel the hereditary factor does play its part in her development.

However, after my son was born I chose to give up my job and stay at home. My son didn’t experience separation from me as an infant until the age of four when he settled into nursery with no problems. As an adult he seems to cope much better with stress and frustration and he is extremely confident and self reliant. This seems to bear out the positive effects of attachment therefore, highlighting

that the relationship formed in early development seems to create a prototype for future relationships.

It is interesting to reflect on my own parenting. My mother died when I was twelve and I became ‘the little mother’ to my father and brother until my father died fifteen months later. This has left me with my own insecurities to deal with. According to Bowlby women who have lost their parent’s at an early age not only are they likely to have marital problems, after the birth of a child, they can also have difficulty interacting with their child (Bowlby, 1988).

Unfortunately, as I said earlier my marriage did breakdown, but I don’t believe I had difficulty interacting with my child. On the contrary, I feel I was over protective, because of loosing my parents, and I was anxious for my daughter. This may have contributed to my daughter’s dependency on me. Furthermore, I take into account that she was the first-born and therefore she had been the sole recipient of my attention. It would have been a different experience for her brother.

Through personal development I am aware I have carried through, into adulthood, a lot of unresolved issues. There have been moments where I have felt a great dependence on my therapist and I worked very hard being ‘the perfect client’ for my therapist to accept me. However, through exploration of my own attachment history I was able to recognise why I felt this dependency and need for acceptance. As my relationship with my therapist grows I feel I am able to be more honest about my feelings. I believe it is through establishing this warm trusting relationship I am able to work towards self acceptance, and as my confidence grows I feel more comfortable with who I am, therefore I no longer feel a need to please others to earn acceptance. This has highlighted how a client, with similar insecurities, may feel in the therapeutic relationship.

Like me, the client will bring his own history into the counselling relationship and I feel the therapist needs to be able to acknowledge, with a deep understanding

the insecurities the client may be feeling. I feel it is important to explore the client’s relational history to establish whether there may be an issue of dependency. It was not easy to explore negative feelings that have been buried for so many years, but my therapist was able to provide a safe space for this to happen. Therefore, although I had my secure base ripped from under me at an early age, I feel my therapy is now my ‘secure base’ where I can unravel my history and make some sense of it.

This intimate relationship I have established with my therapist has allowed me to challenge, explore and take risks with the confidence of feeling accepted. “…intimate attachments to other human beings are the hub around which a person’s life revolves, not only when he is an infant or a toddler or a school child but throughout his adolescence and his years of maturity as well, and into old age” (Bowlby, 1980, p. 422).

Conclusion:

There seems to be an agreement between all the theorists that a secure attachment between a mother and infant is the ideal first relationship, and that relationship is of primary importance.

Feeling secure and having your needs met by a consistent caregiver, within all cultures during the early years, is imperative to a healthy development. I feel attachment is the same across all societies, and that fundamentally all children need a secure base.

“Relationships are of fundamental importance in:

the development of personality and sense of self;

the difficulty clients bring to therapy (relations with the self and relations with other people);

the therapeutic process (the therapy relationship is the heart of the process)” Paul, S. and Pelham, G. (2000, pp. 110 -126).

Relationships are important for our wellbeing. Whilst attachment types have helped me to understand my history, they have also helped me to understand the important elements for development. Attachment is about a close relationship, and its impact last from cradle to grave. It is now accepted that this relationship can be with more than one person as long as the care is affectionate, consistent, and provides a secure base.

It is also agreed that separation from the caregiver during infancy will predict how an individual forms relationships as an adult. As a counsellor it is important to be aware of the different attachment behaviours to be able to provide that ‘secure base’ from which the client can explore his/her own relationship history. Therefore, the counsellor needs to be able to provide support with deep understanding, Bowlby says,”….it is the emotional communications between a patient and his therapist that play the crucial part” (Bowlby, 1988, p.156)