Читать книгу Attachment Theory and Research - Группа авторов - Страница 13

Since 1948 the Tavistock Child Development Research Unit has been concerned with recording the manifest responses which commonly occur when children between the ages of about 12 months and 4 years are removed from the mother figures ² to whom they are attached and remain with strangers. Preliminary papers and a scientific film have been published (Robertson & Bowlby, 1952; Robertson, 1953a, 1953b; Bowlby, 1953, 1954) and a comprehensive report by James Robertson and the writer is in preparation. In it we shall draw not only on Robertson’s own observations and those of other workers reported in the scientific literature, notably those of Burlingham and Freud (1942, 1944), and Heinicke (1956), but also on reports given us by mothers and nurses with first‐hand experience of the problem. Since there is a high consensus in these reports we regard it as firmly established empirically that all children of this age, except those who have already suffered considerable deprivation of maternal care or are seriously ill, react to the experience with shock and anxiety. Our confidence in the validity of these observations is something we wish to emphasize since it is not uncommon for those whose theories lead to expectations of a different kind to cast doubt on them. In our view it is the theories which are mistaken, not the observations, and it is with the theoretical issues raised by these data that this paper is concerned.

It is evident, however, that the nature and dynamics of the responses to the rupture of a social bond cannot be understood until there is some understanding of the nature and dynamics of the bond itself. It was because of this that in a recently published paper (Bowlby, 1958) I discussed how best the nature of the young child’s tie to his mother could be conceptualized. In it I advanced the view that instead of the tie being motivated by a secondary drive or one wholly based on orality, which are the most commonly held views today, it may be mediated by a number of instinctual response systems which are partially independent of one another and which wax and wane in activity at different periods of the infant’s and young child’s life. I suggested that much psycho‐analytic theory, by concentrating attention too narrowly either on the meeting of ‘physiological’ needs (e.g. for food and warmth) or on orality, may have led to the picture as a whole being seen out of perspective; and that other responses, particularly clinging and following which seem to reach their zenith in the second and third years, require far more attention than they have yet been given.

The reasons leading me to advance these views are clinical: traditional theory has seemed to me to account neither for the intense attachment of child to mother‐figure which is so conspicuous in the later months of the first year and throughout the second and third years of life, nor for the dramatic responses to separation from her which are the rule in these years. A formulation, based on a theoretical framework stemming from modern instinct theory, has seemed to me more promising. It is the line of thought begun in the previous paper that I shall pursue further in this one.

First let us consider the data.

Our observations³ concern healthy children of 15 to 30 months admitted to a hospital, perhaps for investigation or elective surgery, or to some other residential institution and there cared for in traditional ways. By traditional ways we mean that the child is handled by a succession of strange nurses, mainly students, who will variously bathe, feed, and change him. The nurses will be on shift duty, and often within a few weeks most will have moved to other departments. No matter how kind each may be in her fragment of care, there will be no nurse whom he can come to know or with whom he can enter into a stable relationship. He may see his mother for a short time each day, but it may be less often. In this context a child of 15 to 30 months who has had a normal relationship to his mother and has not previously been parted from her will commonly show a predictable sequence of behaviour. This sequence can usefully be broken into three phases according to what attitude to his mother is dominant. We describe these phases as those of protest, despair, and detachment.⁴ Though in presenting them it is convenient to differentiate them sharply, it is to be understood that in reality each merges into the next, so that the child may be for days or weeks in a state of transition from, or alternation between, one phase and another.

The initial phase, that of Protest, may last from a few hours to a week or more. During it the young child appears acutely distressed at having lost his mother and seeks to recapture her by the full exercise of his limited resources. He will often cry loudly, shake his cot, throw himself about, and look eagerly towards any sight or sound which might prove to be his missing mother. All his behaviour suggests strong expectation that she will return. Meantime he is apt to reject all alternative figures who offer to do things for him, though some children will cling desperately to a nurse.

During the phase of Despair, which succeeds protest, his preoccupation with his missing mother is still evident, though his behaviour suggests increasing hopelessness. The active physical movements diminish or come to an end, and he may cry monotonously or intermittently. He is withdrawn and inactive, makes no demands on the environment, and appears to be in a state of deep mourning. This is a quiet stage, and sometimes, clearly erroneously, is presumed to indicate a diminution of distress.

Because the child shows more interest in his surroundings, the phase of Detachment which sooner or later succeeds protest and despair is often welcomed as a sign of recovery. He no longer rejects the nurses, accepts their care and the food and toys they bring, and may even smile and be sociable. This seems satisfactory. When his mother visits, however, it can be seen that all is not well, for there is a striking absence of the behaviour characteristic of the strong attachment normal at this age. So far from greeting his mother he may seem hardly to know her; so far from clinging to her he may remain remote and apathetic; instead of tears there is a listless turning away. He seems to have lost all interest in her.

Should his stay in hospital or residential nursery be prolonged and should he, as is usual, have the experience of becoming transiently attached to a series of nurses each of whom leaves and so repeats for him the experience of the original loss of his mother, he will in time act as if neither mothering nor contact with humans had much significance for him. After a series of upsets at losing several mother‐figures to whom in turn he has given some trust and affection, he will gradually commit himself less and less to succeeding figures and in time will stop altogether taking the risk of attaching himself to anyone. Instead he will become increasingly self‐centred and, instead of directing his desires and feelings towards people, become preoccupied with material things such as sweets, toys, and food. A child living in an institution or hospital who has reached this state will no longer be upset when nurses change or leave. He will cease to show feelings when his parents come and go on visiting day; and it may cause them pain when they realize that, although he has an avid interest in the presents they bring, he has little interest in them as special people. He will appear cheerful and adapted to his unusual situation and apparently easy and unafraid of anyone. But this sociability is superficial: he appears no longer to care for anyone.

We have had some difficulty in finding the best term to denote this phase. In previous papers and in the early drafts of this one the term ‘denial’ was used. It gave rise to many difficulties, however, and is now abandoned in favour of the more purely descriptive term ‘detachment’. An alternative is ‘withdrawal’, but this has two disadvantages for my purpose. In the first place there is a danger that it might convey the picture of an inactive child withdrawn from the world, a picture that is the opposite of what often obtains. In the second, in psycho‐analytic writing it is commonly associated with libido theory and the idea of instinct as a quantity of energy which can be withdrawn, a model I am not using. Not only does the term ‘detachment’ have neither of these disadvantages, but it is a natural counterpart of ‘attachment’. The nature of the defence process, or processes, that give rise to it is of course a matter for detailed study. In an earlier publication (Bowlby, 1954) I have discussed briefly its relation to repression and I hope at a later date to give this further attention.

Returning now to the empirical data, I wish to emphasize that the behaviour seen in the phases of Protest and Despair is not, as is sometimes alleged, confined to children whose relations to their mothers are already impaired. Though we have no large series of well‐observed cases to quote, we are satisfied that there is clear evidence that it occurs in children whose previous relationships would be judged to have been anything between excellent and fairly unfavourable. It appears to be only in children whose relationships are already severely impaired, and who may therefore already be in a phase of Detachment, that such behaviour is absent.

In examining the theoretical problems raised by these observations it is convenient to consider them with reference to these three phases of behaviour. The phase of Protest raises the problem especially of separation anxiety; Despair that of grief and mourning; Detachment that of defence. Each of them is central to psychoanalytic theory and will therefore need detailed discussion – the first in this paper, the second and third in succeeding ones. The thesis to be advanced is that the three types of response – separation anxiety, grief and mourning, and defence – are phases of a single process and that when treated as such each illumines the other two.

Often in the literature they have been considered piecemeal. The reason for this appears to be the inverted order in which their psycho‐pathological significance was discovered: for it was the last phase which was recognized first, and the first last. Thus the significance of defence, particularly repression, was realized fully by Freud in the earliest days of his psycho‐analytic work and provides the basis of his classical theorizing: his first paper on the subject is dated 1894 (Freud 1894). His grasp of the roles of grief and separation anxiety on the other hand, although not wholly absent in his earlier work, was none the less fragmentary. Thus, although early alive to the place of mourning in hysteria and melancholia (Freud, [1897] 1954), twenty years were to elapse before, in Mourning and Melancholia (1917), he gave it systematic attention. Similarly in the case of separation anxiety: although in the Three Essays on Sexuality (1905) he gave it a paragraph (p. 224), and in the Introductory Lectures (1917) three pages (pp. 339–341), it is not until 1926 that in his important late work, Inhibitions, Symptoms and Anxiety (Freud, 1926), he gives it the central place in what was to be his final theory of anxiety. ‘Missing someone who is loved and longed for’ he affirms, ‘is the key to an understanding of anxiety’ (pp. 136–137), and it is on this datum that the whole argument of his book rests.

The reason for this inverse recognition of the three phases is clear: always in the history of medicine it is the end result of a pathological sequence which is first to be noted. Only gradually are the earlier phases identified, and it may be many years before the exact sequence of the whole process is understood. Indeed it was understanding the sequence which baffled Freud longest. Does defence precede anxiety, or anxiety defence? If the response to separation is pain and mourning, how can it also be anxiety? (Freud, 1926, pp. 108–109 and 130–131). It can now be seen that during the thirty years of his main psycho‐analytic explorations Freud traversed the sequence backwards, from end result to initial stage. Not until his seventieth year did he clearly perceive the source and course of the processes to which he had devoted half a lifetime of study. The effects on psychoanalytical theorizing have inevitably been confusing.

By 1926 a substantial corpus of psycho‐analytic theory was already being taught. As regards anxiety, castration anxiety and superego anxiety were cornerstones of thought and practice in Vienna and elsewhere, whilst Melanie Klein’s hypothesis relating anxiety to aggression had recently been formulated and, linked to the concept of the death instinct, was soon to become a key concept in a significant new system. The full weight of Freud’s ideas on separation anxiety and its relation to mourning came too late to influence the development of either of these two schools of thought.

Moreover, apart from the prophetic early reference by Hug‐Hellmuth ([1913] 1919) and a brief word by Bernfeld ([1925] 1929), some years were to pass before the clinical papers drawing attention to the pathogenic significance of separation experiences were published. Some of the earliest, by Levy (1937), Bowlby (1940, 1944), and Bender and Yarnell (1941), presented empirical evidence suggesting an aetiological relationship between certain forms of psychopathic personality and severely disrupted mother–child relationships. At about the same time, Fairbairn ([1941] 1952, [1943] 1952) was basing his revised psycho‐pathology on separation anxiety, having been preceded by some years by Suttie (1935) and to be followed a few years later by Odier ([1948] 1956); whilst Therese Benedek (1946) was describing responses to separation, reunion and bereavement which were to be observed in adults during the war. Meanwhile the firsthand observations of Dorothy Burlingham and Anna Freud (1942, 1944) of how young children respond to separation were being recorded, and Spitz (1946) was about to shock those who had eyes to see with his account of extremely deprived babies. Despite all this work by qualified analysts, however, and a number of important papers by Goldfarb (1943) and others, separation anxiety has never gained a central place in psycho‐analytic theorizing. Indeed Kris (1956), writing as a participant in the Viennese scene, remarked recently how, when in 1926 Freud advanced his views regarding separation anxiety, ‘there was no awareness amongst analysts … to what typical concrete situations this would apply. Nobody realized that the fear of losing the object and the object’s love were formulae to be implemented by material which now seems to us self‐evident beyond any discussion.’ He acknowledged that only in the past decade had he himself recognized its significance, and could have added that even today there are schools of analytic thought which deny its importance. The continuing neglect of separation anxiety is well illustrated by a recent and authoritative survey of ‘the concept of anxiety in relation to the development of psycho‐analysis’ (Zetzel, 1955) in which it is not once mentioned.

In the event, it is clear, some of the ideas Freud advanced in Inhibitions, Symptoms and Anxiety fell on stony ground. This was a pity, since in that book, written at the end of his professional life, he was struggling to free himself of the perspective of his travels – defence, mourning, separation anxiety – and instead to view the sequence from his new vantage point: the priority of separation anxiety. In his concluding pages he sketches out a new route: anxiety is a reaction to the danger of losing the object, the pain of mourning to the retreat from the lost object, defence a mode of dealing with anxiety and pain. This is the route we shall be following.