The One Thing That's Missing from Attachment Theory

Challenging a Therapeutic Cornerstone

Jerome Kagan

One of the strongest articles of faith among psychotherapists is the intuitively attractive proposition that the security of early attachments to parents has a profound influence on adult mental health. Thousands of articles, books, and conferences have probed this topic, and many therapists have made attachment theory a cornerstone of their clinical approach. Even clinicians who aren't particularly loyal to attachment theory accept the general proposition that the quality of infants' emotional experiences with their caretakers affects their vulnerability to psychological disorders as adults. However, when I examine the evidence for this belief as a research psychologist, rather than as a clinical practitioner, a different, less clear-cut picture emerges.

Attachment Theory in Perspective

Some influential ideas in the social sciences have their roots in the life experiences of the creator and his or her culture. This appears to be true of attachment theory. Let us consider the life experiences of the British psychiatrist John Bowlby, the father of attachment theory. As the fourth of six children growing up in an upper-middle-class London family, Bowlby, born in 1907, and his siblings were cared for by nurses on the top floor of the family's spacious home. He recalled seeing his mother for perhaps an hour each day after teatime, and his father, a prominent surgeon, once a week. His favorite nanny, with whom he had a close relationship, left the household when he was 4. By 7, he'd been sent to a boarding school. He later said of that experience, "I wouldn't send a dog away to boarding school at age 7."

At age 21, he worked for a short time at a progressive school for emotionally disturbed children. Some of these children had experienced early separation from their parents or obvious neglect, and Bowlby interpreted their disturbed behavior patterns as support for his belief that a mother's love for a child was vital for healthy psychological development—as vital as good nutrition is for physical growth.

In 1946, Bowlby joined the staff of the famous Tavistock Clinic in London, where he met a social worker named James Robertson, who was angry at the hospital's policy of not allowing mothers to visit young children who'd been admitted for surgery—a hospital policy intended to prevent infections from spreading through the ward. Robertson noticed that children in the second year, but not those who were younger or older, became unusually distressed when they were alone on the ward lying in a crib, and he told Bowlby about his observations. Bowlby interpreted these children's distress as further confirmation of his ideas on attachment. However, Robertson disagreed, arguing that the children's distress could be avoided by simply having any adult present on the ward. This fact meant that the crying didn't reflect the fact that the children missed their mothers, but rather that they were frightened because they were alone in an unfamiliar place.

Bowlby’s work first gained currency at a time when important changes in American society made their ideas particularly attractive. These changes include the public's brooding on the horrors of World War II and the new economic structures that were transforming the traditional family that had dominated Western culture during the prior 200 years. Young mothers were now entering the workforce in unprecedented numbers and needed to find surrogate care for their babies, often in day care centers. This disruption in the time-honored form of infant care by mothers provoked a contagion of worry among professionals and parents. Could infants be cared for adequately if they didn't have the full-time attention of their mothers? This worry had a long tradition in Europe as well as America. In the middle of the 18th century, Jean-Jacques Rousseau wrote that when women are good mothers, their sons will be good husbands and fathers. Sigmund Freud thought that mothers' nursing and toilet-training practices affected adult personality.

The evidence indicates clearly that serious neglect or abuse of infants during the first year or two can harm the child's future psychological development. No one quarrels with that statement. But there are no studies to date that have investigated the mother-infant interaction in the first year with a large group of infants from all social classes, followed these children to age 20, and demonstrated that insensitive mothers usually produced less happy adults than sensitive mothers, when social class and culture are controlled. Thus, this aspect of attachment theory remains a hunch.

The Course of Human Development

A serious limitation of attachment theory is its failure to recognize the profound influences of social class, gender, ethnicity, and culture on personality development. These factors, independent of a mother's sensitivity, can be as significant as the quality of the early attachment.

Research has demonstrated that social and economic factors have a powerful influence on development. The strongest predictor of adult depression or anxiety in many cultures is growing up in a disadvantaged social class. For example, Mississippi has a larger proportion of minority residents living in poverty than North Dakota, and the incidence of depression in Mississippi is three times that of North Dakota, according to the Centers for Disease Control.

Why does a disadvantaged social class position predict mood disorders, criminal careers, or addictions? One reason is that children identify with their class, which in the United States and Europe is defined by type of work, education, and income. Children belonging to less-advantaged class categories feel less potent, less virtuous, and possess a weaker sense of agency because of their identification. These traits are reflected during childhood—long before a depression or anxiety disorder develops—in lower school motivation, poorer grades, hostility to more advantaged peers, and less willingness to persist with difficult challenges.

The Researcher's Role

By remaining skeptical of oversimplified explanations of the human psyche and reductive answers to complex questions, psychological research forces clinicians to ask difficult questions and not pretend that they know more than they do. In that way, research serves as a corrective against the pervasive human temptation to construct a narrative that matches our preconceptions and unexamined biases, walled off from the messy reality in which all of us—clients, therapists, and researchers alike—have to live.

***

This blog is excerpted from "Bringing Up Baby" by Jerome Kagan. The full version is available in the March/April 2011 issue, The Great Attachment Debate: How Important is Early Experience?

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Topic: Anxiety/Depression | Attachment Theory | Children/Adolescents

Tags: addiction | addictions | anxiety disorder | attachment disorder | depression | mood disorders | psychotherapy | therapy | attached | John Bowlby | babies | mothers | infants | baby | mother | infant | social class

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12 Comments

Sunday, December 9, 2018 2:04:20 PM | posted by Jay Seiff-Haron
Agree with the main points of this article, but Bowlby actually wrote about internal working models of social groups and organizations and causes in (I believe) volume two of his treatise on the subject. That part of his theory never got much attention, and some expansion of it would be terrific, but it was very much part of attachment theory.

Friday, October 27, 2017 1:34:58 AM | posted by Kamagra
Some influential ideas in the social sciences have their roots in the life experiences of the creator and his or her culture. This appears to be true of attachment theory. Let us consider the life experiences of the British psychiatrist John Bowlby, the father of attachment theory.

Wednesday, October 5, 2016 2:55:37 AM | posted by Kamagra Bestellen
A genuine constraint of connection hypothesis is its inability to perceive the significant impacts of social class, sex, ethnicity, and society on identity advancement. These components, free of a mother's affect ability, can be as noteworthy as the nature of the early connection.

Sunday, May 8, 2016 9:15:00 PM | posted by Barb Perkins
Thank you for this important article and the viewpoint offered by the author. I wonder if his writings and research take into consideration Adverse Childhood Experiences and attachment? People who develop resilience often have supportive attachment figures. I'm concerned that Kagan's work fails to take this into account and I would love to read more. Clearly there are enough foster kids in the system to demonstrate that attachment is important to development as without it, kids are often struggling emotionally and developmentally. I believe all of these issues have been clearly demonstrated through research. We clearly don't need to demonstrate to parents that they do not need to provide secure attachment.

Sunday, May 8, 2016 4:21:34 PM | posted by Kevin
I wonder if the point has been missed here? Bruce Perry cites early experiences as building the architecture of the brain. It's. It so much attachment their and neuroscience and interpersonal neurobiology. Add Steven Porges Polyvagal theory and we see the importance of the earliest experiences. Attachment is no more than a set of neuro associations which set a template, or worked my model, in which to interpret future experience.

Sunday, May 8, 2016 3:28:12 PM | posted by
What a lot of hooey - in three easy steps: 1. "But there are no studies to date that have investigated the mother-infant interaction in the first year with a large group of infants from all social classes, followed these children to age 20, and demonstrated that insensitive mothers usually produced less happy adults than sensitive mothers, when social class and culture are controlled. Thus, this aspect of attachment theory remains a hunch." Well a good hunch for sure - it's called common sense. 2. "A serious limitation of attachment theory is its failure to recognize the profound influences of social class, gender, ethnicity, and culture on personality development. These factors, independent of a mother's sensitivity, can be as significant as the quality of the early attachment." Where/how do you think this "social influence " is absorbed from -- duh -- the caretaker (usually the mother)". It is the first relationship, (e.g.) mother, that passes along these very factors, which have formed her/his social-psycho karma. 3 "Why does a disadvantaged social class position predict mood disorders, criminal careers, or addictions? One reason is that children identify with their class, which in the United States and Europe is defined by type of work, education, and income..." Duh again! It seems obvious (again common sense) that the transmission of the effects of these social condition is transferred to the infant by the one person the infant identifies with early on, when brain/emotion neurological connections are being built. Yes as the child grows up and becomes a part of a social network/community - these factors continue to influence their bio/emotional self- systems. But to question whether their is any doubt that early attachment has an effect (i.e. just a "hunch" ) is beyond senseless.

Sunday, May 8, 2016 10:28:19 AM | posted by Paul
Great article and final paragraph. I would like to contact with you I am a therapist.

Sunday, May 8, 2016 10:06:32 AM | posted by Joelle Lazar
An interesting article, and a good point that other factors besides the temperament of ones mother contribute to psychological health. Certainly attachment theory research has expanded from focusing only on the quality of connection with the mother, to any consistent care giver in a child's life, a concept known as "earned security". Attachment theory has been confirmed across widely differing cultures, and had been validated by neurobiological research. The latter demonstrates that brain development is a direct outcome of the level of safety a child experiences with primary caregivers. Seeking safety is a biological process as is responding to a threat, and the two share neural circuitry. More to this attachment idea than discussed in this analysis by Kagan.

Tuesday, May 3, 2016 12:30:27 PM | posted by Gregory Popcak
Attachment theory is not above criticism, but critics should at least take time to learn what contemporary approaches to attachment theories look like before criticizing it. Kagan's looks at Bowlby's research, but completely ignores Allan Schore's more current work on attachment and the developing brain and, most interestingly, the power of maternal attachment to facilitate the full development of the baby's hypothalamic-pituitary-adrenocorital axis (HPA axis) and other structures of the social brain to regulate stress. Kagan's point that poverty and other social ills is well taken. No attachment theorist would argue that poverty or social injustice is a good thing. But healthy attachment facilitates the development of those brain structures that help children manage social stress more effectively, encouraging them to seek more pro-social outlets for stress. WIthout secure attachment to a mother (with whom attachment helps children down-regulate stress and increase joy) AND a father (whose presence physiologically "teaches" baby to down-regulate aggression) children respond to the social stressors Kagan mentions with such anti-social behaviors as bullying, drug and alcohol abuse, and high risk sexual behaviors. Social stressors are not insignificant, but Kagan's hypothesis effectively puts the social cart before the interpersonal/neurological horse.

Sunday, August 16, 2015 1:19:43 PM | posted by Lorrie
There are three deficits I observed in the population as a prison social worker: judgement, problem-solving, and self-soothing, all of which reflect a brain that could not develop optimally in abusive home environments. Certainly this included problematic attachment. As one who is unfamiliar with the literature on attachment and brain development in early childhood, it would seem that neuropsych testing of the differences in the brain capacities of people from backgrounds with adequate attachment opportunities and those without such opportunities would help move theory from intuition to skilled observation.

Saturday, August 15, 2015 7:28:31 PM | posted by Mark Baumann
Dr. Kagan,

Thank you for your critical thoughts. I wonder if you have seen Dr. Patricia Crittenden’s work enhancing attachment theory and have an opinion about how her theories address your concerns? She seems to consider the aspects you mention, and others in her Dynamic Maturational Model of Attachment and Adaptation. She has a number of free articles available at http://familyrelationsinstitute.org. Assessing adult attachment: A dynamic-maturational approach to discourse analysis, Crittenden, P. M., & Landini, A., (2011), New York: W. W. Norton & Company, describes the DMM in depth.

Warm regards.
Mark Baumann

Saturday, August 15, 2015 6:25:33 PM | posted by Matthew Ganda
My understanding and application of attachment theory does take account of what in the UK family therapy community has come to be referred to as social ggrraacceess (geography, gender, race, religion, age, ability, culture, class, education, employment, sexuality and spirituality). Isn't most social research self-reflexive?