Psychobiological Roots of Early Attachment

ABSTRACT— New laboratory research has revealed a network of simple behavioral, physiological, and neural processes that underlie the psychological constructs of attachment theory. It has become apparent that the unique features of early infant attachment reflect certain unique features of early infant sensory and motor integration, learning, communication, and motivation, as well as the regulation of biobehavioral systems by the mother–infant interaction. In this article, I will use this new knowledge to answer three major questions that have remained unsettled in our understanding of early human attachment: What creates an attachment bond? Why is early maternal separation stressful? How can early relationships have lasting effects? I will discuss the implications of these new answers for human infants and for the development of mental processes. Attachment remains useful as a concept that, like hunger, describes the operation of subprocesses that work together within the frame of a vital biological function.     

Introduction: A Systems View

Our goal in this series of four papers is a further refinement of a theory of interaction for psychoanalysis, with a specific focus on the concept of intersubjectivity. Psychoanalysis has addressed the concept of intersubjectivity primarily in the verbal/explicit mode. In contrast, infant research has addressed the concept of intersubjectivity in the nonverbal/implicit mode of action sequences, or procedural knowledge. We propose that an integration of explicit/linguistic with implicit/nonverbal theories of intersubjectivity is essential to a deeper understanding of therapeutic action in psychoanalysis today. To shed light on an implicit/nonverbal dimension of intersubjectivity in psychoanalysis, we include concepts from adult psychoanalysis, infant research, developmental systems theories, and nonverbal communication, particularly the distinction between implicit processing out of awareness and explicit processing at the declarative/verbal level. We conclude with an adult psychoanalytic case illustrating the integration of implicit/nonverbal forms of intersubjectivity into adult treatment.     

An Expanded View of Intersubjectivity in Infancy and its Application to Psychoanalysis

We consider the relevance of forms of intersubjectivity in infancy to the nonverbal and implicit dimension of intersubjectivity in psychoanalysis. The term forms of intersubjectivity, within the adult explicit and implicit modes and the infant presymbolic implicit mode, is offered to clarify the multiple meanings of intersubjectivity. The ideas of infant intersubjectivity of Meltzoff, Trevarthen, and Stern that have particular relevance for psychoanalysis are highlighted: the dialogic origin of mind, the role of correspondences, and the idea that symbolic forms of intersubjectivity are built on presymbolic forms. We build on their work to define a fourth position: that the full range of patterns of interactive regulation provides the broadest definition of the presymbolic origins of intersubjectivity, with correspondence being only one of many critical patterns. We additionally address the place of interactive regulation, problems with the concept of matching, the role of self-regulation, the role of difference, and the “balance model” of self- and interactive regulation. We take the position that all forms of interactive regulation are relevant to the possibility of perceiving and aligning oneself with the moment-by-moment process of the other. A broadened understanding of intersubjectivity in infancy sets the stage for a more fruitful exchange between infant researchers and psychoanalysts.     

On Traumatically Skewed Intersubjectivity

ABSTRACT

Beginning with his Interpersonal World of the Infant (1985), Daniel Stern suggested that the infant is driven from birth to connect intersubjectively with his caregivers. By the final three months of the first year of life, as the infant begins to use protodeclarative pointing and jointly attends to the outer world, he also begins to jointly attend with his caregiver to their respective intrapsychic worlds, the mental states of his caregiver and himself. Clinically, analysts observe at this crucial point of development of secondary intersubjectivity mothers who, more often than not, respond only selectively and often unpredictably to their infants. In many instances, this may be motivated out of a mother’s own need for regulation of emotion and arousal as we have shown in our empirical research. This article elaborates on clinical observations that, for the infant or young child to feel his traumatized mother’s affective presence, he must try to enter mother’s state of mind, while simultaneously, mother is seeking to self-regulate in the wake or the revival of trauma-associated memory traces, this at the expense of mutual regulation of emotion and arousal. We call this phenomenon traumatically skewed intersubjectivity. We find that children coconstruct with their traumatized mothers a new, shared traumatic experience by virtue of the toddler’s efforts to share an intersubjective experience with a mother who is acting in response to posttraumatic reexperiencing. The problem is that the infant or young child has no point of reference to decipher the traumatized mother’s social communication. And so, what is enacted leads to a new, shared traumatic event. Both the child’s anxiety and aggression can, in this setting, easily become dysregulated, further triggering mother’s anxiety and avoidance, leading thus to a vicious cycle that contributes to intergenerational transmission of trauma. Clinical examples and implications for psychoanalytically-oriented parent-infant psychotherapy will be discussed.     

Exploration of the links among fathers' unresolved states of mind with respect to attachment,atypical paternal behavior,and disorganized infant–father attachment

Atypical maternal behavior has consistently been identified as a precursor of disorganized infant–mother attachment, but to date, no research has examined the role of atypical paternal behavior in the development of disorganized infant–father attachment. This study aims to enhance our understanding and conceptualization of infant–father attachment by examining the role of fathers' unresolved states of mind and the display of atypical paternal behavior in the development of disorganized infant–father attachment. Thirty‐one middle‐class couples participated in this study. Maternal and paternal Adult Attachment Interviews (C. George, N. Kaplan, & M. Main, 1996 ) were completed prenatally and at infant age 6 months, respectively. Infant–mother and infant–father dyads participated in the Strange Situation paradigm (M. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978 ) when the infants were 12 and 18 months of age, respectively. The Atypical Maternal Behavior Instrument for Assessment and Classification (E. Bronfman, E. Parsons, & K. Lyons‐Ruth, 1999 ) was used to assess maternal and paternal behavior during the Strange Situation. Maternal states of mind regarding attachment predicted infant–mother attachment relationships, and paternal states of mind predicted infant–father attachment relationships. Atypical maternal behavior was associated with infant–mother disorganized attachment; however, atypical paternal behavior did not predict infant–father disorganized attachment. Thus, it is possible that other factors, yet to be uncovered, might contribute to the development of infant–father disorganized attachment.     

Infant–mother and infant–father synchrony: The coregulation of positive arousal

To examine the coregulation of positive affect during mother–infant and father–infant interactions, 100 couples and their first‐born child were videotaped in face‐to‐face interactions. Parents' and infant's affective states were coded in one‐second frames, and synchrony was measured with time‐series analysis. The orientation, intensity, and temporal pattern of infant positive arousal were assessed. Synchrony between same‐gender parent–infant dyads was more optimal in terms of stronger lagged associations between parent and infant affect, more frequent mutual synchrony, and shorter lags to responsiveness. Infants' arousal during mother–infant interaction cycled between medium and low levels, and high positive affect appeared gradually and was embedded within a social episode. During father–child play, positive arousal was high, sudden, and organized in multiple peaks that appeared more frequently as play progressed. Mother–infant synchrony was linked to the partners' social orientation and was inversely related to maternal depression and infant negative emotionality. Father–child synchrony was related to the intensity of positive arousal and to father attachment security. Results contribute to research on the regulation of positive emotions and describe the unique modes of affective sharing that infants coconstruct with mother and father. ©2003 Michigan Association for Infant Mental Health.     

Imagining Fear: Attachment,Threat, and Psychic Experience

Attachment theory is today considered an integral part of contemporary psychoanalytic theory and practice, and yet the theoretical and clinical implications of Bowlby’s emphasis on fear and the search for safety have been largely overlooked. From Bowlby’s perspective, the dynamic relationship between the experience of threat and attachment shapes the development and maintenance of essential relationships, the organization of psychic structure, and the nature of defenses and adaptation. This element of attachment theory—which alerts us to the ways in which the infant or child is compelled to seek safety when in a state of fearful arousal—is particularly relevant to the clinical situation. It helps us imagine moments of fearful arousal in our patients’ pasts, attend to their manifestations in the present, and understand current suffering in light of the long-term sequelae of adaptations that were crucial to survival. Finally, it helps us find language that brings alive or mentalizes these aspects of the patient’s early experience such that transformation is possible.     

The Present Moment in the Primary Triangle

ABSTRACT

Daniel Stern described the present moment as “what happens here, now, between us” (BCPSG, 2010, p. 41). Stern considered the present moment as the basic unit of intersubjective communication or the sharing of inner states for both mother-infant pairs and therapist-patient dyads. He emphasized the importance of implicit processes for fostering change in relationships. Evidence collected during the last three decades in the Lausanne Centre for Family Studies points to a parallel, but collective form of intersubjective communication in the family that originates in infancy, thanks to the previously unknown competence of the young infant for multipartite interaction and sharing inner states with others. Collective intersubjectivity opens up new avenues for the understanding of development and change in the family, as well as for family therapy. These results are illustrated in several case vignettes and discussed in reports of conversations with Daniel Stern.     

老年人的依恋特点

老年阶段进入依恋研究者的视野是上个世纪90年代之后才陆续开始的。十几年来,该领域积累了不少研究成果。一系列研究考查了不同依恋对象对老年人生活的影响,包括对兄弟姐妹、成年子女、配偶、父母的依恋以及一种特殊的依恋：符号化依恋;不少研究发现了依恋模式分布的年龄效应,冷漠型和安全型依恋是老年依恋的主要模式,这与年轻成人的分布有很大差异;当前关于老年依恋的心理功能研究主要集中于以下两大领域：（1）老年依恋与慢性疾病中的照料;（2）老年依恋与心理健康。对于老年人依恋的研究还远未达到成熟的地步,老年依恋的测量工具亟待改进,跨文化的研究也需要进一步推广     

Contributions of Attachment Research to Understanding Dissociative Attunement

This discussion elaborates the author’s use of attachment theory and research to understanding Susan’s clinical process (see Jacobs, this issue). I have delineated different patterns of attachment, its precursors in infancy, both in infant parent interactions and in parent’s state of mind with respect to attachment. I also link this to how dissociative process can be embedded in a combination of infant disorganization and trauma. I think that clinical applications of the ideas Jacobs and I subscribe to add a great deal to understanding how unformulated experiences with a frightened and frightening parent can lead to a person’s vulnerability to developing dissociative responses to later trauma. The dialogic nature of infant parent attachment experiences can further enrich an understanding of how certain transference–countertransference enactments are manifestations of certain kinds of procedural or relational knowing. In this way, clinicians can further understand the possibilities for psychic transformation as embedded in bearing that which was experienced but which cannot yet be known.     

Voice as Communication and Attachment in Therapy with Children

This paper suggests that both voice and face are factors in the development of attachment to important others in the environment from birth. Four vignettes are presented with differing psychological issues as support for the idea that voice communicates the nature of the attachment. It is further suggested that all the sense modalities are important for the development of attachment. However, it would seem that the voice is a powerful tool to gain and maintain the attention of the infant and older children.     

Group Therapy for Loss: Attachment,Intersubjectivity, and Healing

Loss is a fundamental human experience that can impact a person’s mental health in diverse ways. While this experience is potentially formative, harmful manifestations can fracture one’s sense of self and undermine relational health. In this article, we present a rationale for process-oriented group therapy focused on healing relational injuries associated with loss. We draw on attachment, self-psychology, intersubjectivity, and Yalom & Leszcz’s (2005) model of group psychotherapy to explore how group processes allow clients to work through losses and relational frustrations in the here-and-now. A case vignette and discussion offer practical insight on the ways in which loss manifests in the room and demonstrate the uniqueness of the group setting for reparative processing.     

Attachment and preschool children's understanding of maternal versus non‐maternal psychological states

There is growing evidence that insecurely attached children are less advanced in their social understanding than their secure counterparts. However, attachment may also predict how individual children use their social understanding across different relationships. For instance, the insecure child's social‐cognitive difficulties may be more pronounced when the psychological states of an attachment figure are being considered. In the current study, forty‐eight 4‐ to 5‐year‐old children were asked about their mothers' emotions and false beliefs, as well as those of non‐attachment figures. The Separation Anxiety Test (SAT) was administered to assess children's attachment representations. Children's SAT scores predicted their overall performance on the false belief and causes of emotion tasks, even after controlling for age and verbal ability. More interestingly, however, children with high scores on the Avoidance dimension of the SAT experienced greater difficulty understanding maternal false beliefs relative to those of an unfamiliar adult female. Thus, although attachment insecurity may hinder social‐cognitive development in general, the findings suggest that there are more specific effects as well. Attachment representations that are characterized by high levels of avoidance appear to interfere with children's ability to fully engage their social‐cognitive skills when reasoning about maternal mental states.     

Affect Attunement and Maternal Attachment: A Pilot Study

The notion that individual differences in mothers' representations of their own early childhood attachment relationships impede or facilitate the recognition of an infant's experiences and needs was investigated. Women were classified as secure, dismissing, of preoccupied in relation to attachment on the basis of the Adult Attachment Interview (George, Kaplan, & Main, 1985) and then videotaped in a laboratory setting with their 10- to 13-month-old babies. Maternal attunement behaviors and fantasies about the babies during the attunement moment were recorded and examined in light of individual differences in maternal attachment. The findings reveal that securely attached mothers are more attuned to their babies than are those mothers who are insecurely attached. Secure mothers attune to a range of infant affect, whereas insecure mothers attune to particular affects and not to others. Specifically, dismissing mothers tended not to attune to negative affect, whereas preoccupied mothers randomly attuned to both positive and negative affect states. Qualitative analyses suggest that insecure mothers misattune to infant affects that threaten their internalized attitudes toward attachment. The findings support the hypothesis that the nature of a mother's internal affective experience powerfully influences the affects she acknowledges and attunes to in her child.     

The Importance of Emotion Regulation in Understanding Attachment and Intersubjectivity: A Comment on Lyons-Ruth

This discussion provides a commentary on Lyons-Ruth's article examining the interface between attachment and intersubjectivity. First, this commentary posits that it may be useful to conceptualize proximity-seeking behaviors more broadly in order to encompass the types of communicative bids observed in the affective face-to-face interactions of parents and infants. Such a revision to this concept underscores the similarity between primitive proximity-seeking behaviors and the drive for intersubjectivity, which may fundamentally constitute part of the same motivational system. Finally, this article argues that both Lyons-Ruth and others have discussed the role of the attachment relationship as promoting the regulation of affects of all valences as opposed to just distress and that the augmentation and regulation of positive affect within the attachment relationship may be a promising direction for future research and theory.     

Dyadically expanded states of consciousness and the process of therapeutic change

This paper addresses an intersubjective issue that arises out of our model of therapeutic change: Why do humans so strongly seek states of emotional connectedness and intersubjectivity and why does the failure to achieve connectedness have such a damaging effect on the mental health of the infant? A hypothesis is offered—the Dyadic Expansion of Consciousness Hypothesis—as an attempt to explain these phenomena. This hypothesis is based on the Mutual Regulation Model (MRM) of infant–adult interaction. The MRM describes the microregulatory social-emotional process of communication that generates (or fails to generate) dyadic intersubjective states of shared consciousness. In particular, the Dyadic Consciousness hypothesis argues that each individual, in one case the infant and mother or in another the patient and the therapist, is a self-organizing system that creates his or her own states of consciousness (states of brain organization), which can be expanded into more coherent and complex states in collaboration with another self-organizing system. Critically understanding how the mutual regulation of affect functions to create dyadic states of consciousness also can help us understand what produces change in the therapeutic process. © 1998 Michigan Association for Infant Mental Health     

Adult Attachment in Children Raised by Parents with Schizophrenia

Maternal schizophrenia is known to have an adverse effect on the quality of mother–infant interaction; and children of parents with severe mental illness run a higher risk of poor mental health and social outcomes. Hence, children raised by a parent with schizophrenia may be less likely to attain secure attachment, although there is less evidence so far to support this. Moreover, there is a lack of research in this field that focusses on the needs and experiences, the strengths and vulnerabilities, of the children themselves. Qualitative methods are thus needed to generate new insights and hypotheses. The present study uses semi-structured interviews with 23 adults who, as children, were raised with a parent who experienced schizophrenia. This reveals a range of attachment problems, resulting in difficulties in forming secure adult relationships. Problems with trust and intimacy were found to be common.     

Attachment Theory,Psychoanalysis, Personality Development,and Psychopathology

Blatt and Levy place attachment theory and research in a broad theoretical matrix by considering the relationship of attachment patterns to personality development and to different types of psychopathology in adults. Thus Blatt and Levy construct conceptual bridges between the two configurations of personality development and psychopathology that Blatt and colleagues have developed over the past quarter century (e.g., Behrends and Blatt, 1985; Blatt, 1974, 1995; Blatt and Behrends, 1987; Blatt and Blass, 1990, 1996; Blatt and Shichman, 1983) and attachment theory and research. Blatt and Levy identify a polarity that is central to attachment theory and research, the polarity of attachment and separation, and they note that this polarity has also been central in much of classic psychoanalytic theory (e.g., Freud, 1930; Loewald, 1962). This polarity is expressed in attachment theory and research in the differences between avoidant and anxious-preoccupied insecure attachment patterns as well in the distinction between two types of disorganized attachment, helpless-withdrawn and negative intrusive, identified by Lyons-Ruth (1999, 2001).

This polarity of attachment and separation, or relatedness and self-definition is also fundamental to personality development that occurs in the hierarchical dialectic transaction of two basic developmental lines—interpersonal relatedness and self-definition (Blatt and Blass, 1990, 1996). This polarity is also inherent in the conception of two fundamental configurations of psychopathology—anaclitic psychopathology, the dependent (or infantile) and hysterical personality disorders—that are preoccupied with issues of interpersonal relatedness, and introjective psychopathology, the paranoid, obsessive-compulsive and depressive personality disorders, in which issues of self-definition and self-worth are dominant (Blatt, 1974, 1995; Blatt and Shichman, 1983). Thus, the identification of this fundamental polarity provides the basis for establishing links between attachment patterns, personality development, and adult psychopathology. Blatt and Levy also attempt to integrate psychoanalytic concepts of the representational world (e.g., Sandler and Rosenblatt, 1965)—the development of concepts of self and significant others—with the internal working models (IWMs) of attachment relationships. This integration enabled Blatt and Levy to bring a fuller developmental perspective to the IWMs of attachment theory and to note that, based on differences in the content and structural organization of the IWMs or mental representation of self and significant others, several developmental levels can be identified in both avoidant and anxious preoccupied attachment. These developmental levels within each attachment style also identifies less and more adaptive forms of both types of insecure attachment. Thus, the integration of the psychoanalytic concepts of mental representation with concepts of the IWM of attachment theory and research enables Blatt and Levy to create a fuller developmental perspective in the study of insecure attachment patterns.     

The move from categories to process: Attachment phenomena and clinical evaluation

Despite the degree to which attachment theory and research have been embraced by clinicians in recent years, many remain unsure as to what this perspective adds to clinical understanding and psychodynamic thinking about the clinical process. In this article, I outline some ways that developments in the study of attachment have the potential to enrich our clinical work with children and families, and may be particularly illuminating with respect to certain aspects of evaluation, formulation, and diagnosis. This added value comes not from formally assessing patients' attachment classification but from sensitizing clinicians to observing the functioning of the attachment system and to the internal and interpersonal functions of attachment processes. Such awareness on the part of the therapist makes it possible for these dynamic regulatory, defense, and motivational systems to be addressed within the context of evaluation and ongoing psychotherapeutic work. Thinking about attachment processes within the clinical situation does not supplant other aspects of dynamically oriented assessment and evaluation, but rather is theoretically consistent with psychoanalytic models of development and offers new levels of richness and understanding to formulations and treatment planning.     

On Attachment to Internal Objects

This paper considers some clinical implications of attachment theory from the perspective of the theory of internal object relationships and the unconscious phantasies that derive from such relationships. The paper focuses on the contributions of Bowlby and his followers, particularly Mary Main, who has developed a language-based methodology to study representational processes in adults and children, bridging the gap between the systematic study of human behavior and clinical psychoanalysis. The theory of inherent role responsiveness in the internal object world—mental representations of self and other in interaction and externalized in complementary role relationships through exchanges of unconscious and conscious messages—is presented as the psychoanalytic complement of Bowlby's theory of internal working models of attachment. Role responsiveness occurs internally as well as externally, so that one can speak of attachment to phantasy objects as well as external objects. Clinical examples illustrate how the therapist, through maintaining a free-floating responsiveness to the patient's enactments, may reconstruct the internal working models of attachment and their origins in the transference. The paperthus illustrates the way in which the origins of phantasy derive from the wished for and feared states related to early experiences of felt security, or lack of it, in relation to the attachment objects, thereby integrating the psychoanalytic theory of phantasy with attachment theory.