1979), Bowlby sees higher animals as needing a map or model of the world in the brain, if they are successfully to predict, control and
manipulate
their environment.
Bowlby - Attachment
For Freud, the basic goal of life was the search for happiness based on physical satisfaction - he saw this as inevitably doomed to disappointment.
Bowlby's emphasis on security provides a more realisable aim.
His vision of the harmonious reciprocity of the responsive mother and her infant offers a metaphor for a balanced relationship between man and his environment that is healthy and not based on splitting and idealisation.
A secure child can cope with temporary separation and sub-optimal conditions by healthy protest and non- defensive grief.
If a secure base can be achieved, exploration of possible ways out of our political and ecological crisis is possible.
In a prescient statement about the dangers of nuclear weapons, Bowlby wrote:
All our previous experience points inescapably to the conclusion that neither moral exhortation nor fear of punishment will succeed in controlling the use of this weapon. Persons bent on suicide and nations bent on war, even suicidal war, are deterred by neither. The hope for the future lies in a far more profound understanding of the nature of the emotional forces involved and the development of scientific social techniques for modifying them.
(Bowlby 1947a)
A small but significant example of the kind of 'understanding' and 'technique' which Bowlby advocates can be found in Middleton's (1991) description of Sherif's Boys Camp Experiment, in which thirty teenagers were taken for a month's camping in the wilderness by a group of psychologists working as camp attendants. The boys were divided into two groups who ate, slept
208 Imlications
and played separately. Rather like in Golding's Lord of the Flies, two distinct cultures of behaviour, slang and group identity developed. When members of the two groups met, scuffles broke out. The experimenters then arranged for the food lorry to break down some miles from the camp, which meant that the two groups had to collaborate in bringing essential supplies to their base. The results were as follows:
After some initial prevarication and quarrelling, the two groups coalesced into a larger and sufficiently coherent and cohesive group for this essential task. As this happened the stereotyping, antipathy and intense competition between the groups also dissolved as they worked together in pursuit of their mutual interest.
(Middleton 1991)
The discovery of a superordinate goal enabled the two groups to collaborate. The leadership provided them with a secure base from which they could explore ways collectively to solve their common problem.
The ecological vicious circle the world faces is one in which, confronted with a threat to the environment and therefore to the fundaments of security, nations, and where nations break down tribal groups, fight ever more desperately to extract what resources they can from it. This is rather like the children of abusive parents who, in their fear, cling to the very object that causes their distress. The common objective of global security needs to be made real if this vicious cycle is to be put into reverse, just as the skilled therapist will see that both abusive parent and child are in search of a safety that neither can provide for the other, and, as far as possible will try to remedy this herself, or mobilise others who can do so. If we feel locally secure, with a home base which we know will be respected and protected, there will be less need to project of insecurity onto others. Secure as inhabitants of our locality, we become free to explore our citizenship of the world. As the Sicilian writer Gesualdo Bufalino puts it:
Now I finally know this simple truth: that it is not only my right but my duty to declare myself a citizen of Everywhere as well as of a hamlet tucked away in the Far South between the Iblei Mountains and the sea; that it is my right and duty to
Attachment Theory and society 209
allow a place in my spirit for both the majestic music of the universe and that of the jet gushing from a fountain in the middle of a little village square, on the far southern bastions of the West.
(Bufalino 1992)
For Freud, our biological heritage was a shackle, creating an inevitable conflict between our selfish and drive-driven nature and the repressions of culture. In his vision of alienation we are prisoners of our paleocortex. Bowlby's more benign picture (the contrast between the two men is partly a reflection of the differing cultural heritage - one a European Jew, the other a member of the English upper middle classes) implies a need to re-establish connections with our evolutionary past. Humans survived and evolved on the basis of bonding and mutual support. Competition and the neglect of these basic ties threaten to destroy us. Nomads and agriculturalists, explorers and stay-at-homes, male and female, men and women of contemplation and of action, pursuers of the inner and outer worlds, psychologists and politicians, yogis and commissars - we all share a need for common security. We are all attached inescapably to an Earth in whose 'environment of evolutionary adaptedness' we originated, and which we now threaten with destruction as we are caught in the vortex of a negative spiral of insecurity.
Chapter 11 Epilogue
Sow a thought and you may reap an act; sow an act and you reap a habit; sow a habit and you reap a personality; sow a personality and you reap a destiny.
(Buddhist proverb; Jones 1985)
We ended the previous chapter with a rhetorical flourish which John Bowlby, however much he approved of its sentiment, would probably have considered overstated, insufficiently underpinned by close-grained scientific fact. This is perhaps excusable as we near the end of this book. As suggested in the Introduction, the biographer is both patient and therapist to his subject. At the end of therapy a patient will often yearn for a 'verdict' and ask, implicitly or explicitly, 'Well, what do you really think of me, what is your opinion? ' But the therapist has already done his work, said all he can say in the course of the therapy. What more can he add? In the CAT model of brief therapy (Ryle 1990), this dilemma is met by the introduction of the 'farewell letter' which the therapist presents to the patient in the penultimate session. This attempts to summarise the patient's strengths and weaknesses, the progress that has been made in therapy, and some predictions for the future. This heterodoxy is not, it should be noted, the exclusive preserve of eclectic therapists like Ryle: Clifford Scott records that the most moving moment of his analysis with Melanie Klein in the 1930s occurred when she read out to him a long interpretation she had written over the weekend. 'This was proof that I was in her as well as she was in me' (Grosskurth 1986).
Here, then, presumptuously perhaps (but is not any therapy - or biography - an act of presumption? ), is an attempt at a farewell
Epilogue 211
letter for John Bowlby, with which the reader, like the patient in CAT, is also invited to disagree, add to, reject, treasure or do what they will.
Dear John,
We are nearing the end of our time together. I would like to say how much I have enjoyed working with you and how much I have learned from our collaboration. I hope you feel that justice has been done to your work and that the boundaries of privacy which, from an early age, you placed around your feelings have been handled with sensitivity.
Like many outstanding psychologists you come from a background that was not entirely easy, although it offered you many opportunities. Perhaps one of them was the fact that your family was so delightfully unpsychological. As Gwen Raverat, granddaughter of your hero, Darwin, said of her father and his brothers (all of whom were distinguished scientists):
'They had [no] idea of the complications of psychology. They found it difficult to conceive of a mixture of motives; or of a man who says one thing and means another; or of a person who is sometimes honest and sometimes dishonest; because they were so completely single-hearted themselves.
(Raverat 1952)
Perhaps it was because you were so familiar with those to whom psychology is a mystery that you were such a good populariser. Some of your life's work at least can be understood in terms of the problems which presented themselves to you as a small child. You were the middle boy between a very bright and vigorous older brother and a younger brother who was considered backward. Your compassion for the weak and your undoubted ambition and competitiveness bear the impress of the mould you shared with them. Your father was a distant, awe-inspiring figure, whose voice you are said to have inherited and in whose footsteps you followed into the medical profession. In terms of public recognition your achievements were at least comparable with his, although as it happens, as a resilient and independent-minded person you did not appear to seek or need external approval. Your mother - or, should we say, mothers? - seems in her urban persona to have been rather neglectful and partial in her handling of the children, but was very different on those long
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holidays which were such an important influence on your life and work. From her you learned the importance of nature, that as creatures we are part civilised, part wild. In middle years you kept the wild side of yourself well hidden, but it was certainly there in your early independence and rebelliousness, and emerged again as you grew older.
I suspect, like many others of your generation, you were very excited when you started your training as a psychoanalyst at the prospect of being able to apply your scientific outlook not just to the external world but also to the inner landscape of feelings. Here, in your own words (Bowlby 1973a), was a continent to conquer. In those days your views were progressive and, while never a Marxist (or indeed an anything-ist), you saw an opportunity to ameliorate psychological as well as material suffering.
Your encounter with psychoanalysis did not really live up to your expectations. Your teachers did not seem particularly interested in trying to change society. They were certainly conservative in their outlook if not in their politics. They ran their society in an authoritarian way and, to succeed, you had to submit to this, even if, as I suspect, your heart was not really in it. Your analyst was Mrs Riviere, your supervisor Melanie Klein. As one of your obituarists put it, 'it is a tribute to [your] independence to point out that neither of these two formidable ladies appear to have had the slightest effect on [your] subsequent development' (Storr 1991). That is not of course quite true because you were, as you yourself later said, determined to prove them wrong. Perhaps you thought you would 'bag' them both, like a brace of pheasants (and you were never happier than after a good day's shooting), with your theory of attachment.
The way you did this was interesting. What you did, in effect, was to appeal over their heads to the higher authority of Freud, much as you might have done as a child when, with your father away at the war in France, you might have wanted some paternal authority with which to out-trump your didactic mother and dominant older brother. First, you emphasised your common scientific outlook with Freud's, in contrast to their lack of scientific understanding. Second, you insisted that they had not really grasped the importance in Freud's late work on attachment (as opposed to instinct), and the role of loss as a cause of neurosis.
You had the social and intellectual self-confidence to challenge psychoanalytic authority - and it certainly needed challenging. But
Epilogue 213
perhaps you missed out on something too. So important was it for you resist what you saw as the negative influence of these wrong- headed ideas - especially the neglect of real trauma in favour of phantasy - that you did not really allow yourself to feel the full emotional impact of psychoanalysis. The imaginative leaps, the heights and depths of emotion, the understanding of how intimate experience is engendered and gendered - you seem to have avoided these. Meanwhile, you built your case, painstakingly and slowly, that psychoanalysis - or the Kleinian version of it, at least - was on a wrong course. The effort of self-control and sustained concentration that this took may have contributed to the impression you gave to some of detachment and even arrogance.
Together with your intelligence and independence you were clearly an excellent organiser and highly efficient. These qualities brought you to the top - or nearly to the top - of your professions of psychoanalysis and child psychiatry. You were Deputy Chairman of the Tavistock and Deputy President of the Psycho-Analytical Society. But something kept you from the summit. Was it your reserve, your lack of overt warmth? Or did you value most strongly the rebellious part of you which wanted to strike out on your own rather than become too identified with an institution? You mistrusted authority, although in your own way you exercised a strong hand in your research group. Running a tight ship always was your style.
Maternal deprivation made your name. What a case you built up for the mother-love which you experienced so intermittently and unpredictably in your childhood. What a devastating criticism and idealisation of motherhood that was! And how the public loved - and hated - you for it. It is a pity that you weren't able to say more about fathers, especially as they are so much more important now in child care than they were when you began your theorising. But the principles of mothering which you put forward remain valid if we speak now instead of parenting, as long as this does not gloss over the fact that the bulk of child care is still done by mothers, who are as vulnerable and unsupported now, although in different ways, as they were when you surveyed the post-war scene in the 1940s.
And loss. What a keen eye for that you had. Your understanding of it may turn out in the end to be your greatest contribution to psychology. And yet how well
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hidden you kept the losses in your own life that made you so sensitive to others' grief and misery. Was it your father's absence during the war? Or the loss of your younger brother's vigour? Was it your sensitivity to your parents' grief, both of whom had lost parents in their youth - your paternal grandfather's death, your maternal grandmother's preoccupation with the younger children? Or was it Durbin - your Lycidas, a close friend cut down in his prime, trying, tragically, to save another man from drowning?
I wonder what you would have made of our contemporary emphasis on stories and narrative in psychotherapy? You were suspicious of hermeneutics and tried always to stay within the confines of evolutionary science. And yet from your work has come a line of understanding which shows how the capacity for narrative, to link the past with the present and the future in a coherent way, is a continuation of that responsive handling in infancy which you (and Winnicott) saw so clearly were the foundations of security. You made the first entries in the non-verbal grammar of mother-child interaction which is slowly being written. From this has come an understanding that it is the handling of patients by their therapists that matters, not the precision of their interpretations. There is no Bowlbian school of psychotherapy because your emphasis was on the non-verbal language of care-giving. The stories - Kleinian, Freudian or what you will - come later. You were a good story-teller yourself as your books, with their logical progressions and solid factual backing for your theories, attest. You would have agreed that the ability to tell a story is the mark of psychological health. You knew that to be able to talk about pain and loss is the best way to overcome it. You would have been fascinated by the evidence - springing mostly from your work - that securely attached babies become good story-tellers in their teens, and that they in turn have securely attached babies.
I suspect you were one of those people who grow happier as they get older. Towards the end you allowed the twinkle in your eye to show more often. You could finally start to play - your way. Perhaps you hadn't really been able to do this since the thirties. Your battle with psychoanalysis was over and you could be your own man. You returned in your last years to an authority that pre-dated Freud - Darwin, to a Victorian time when progress and order and the power of science were valued, where the battle lines were clear cut, far removed from the
Epilogue 215
chaos and confusion of our post-modernist world.
What of your legacy? Attachment Theory is, as you were, vigorous and independent. If anything, it is likely to come even more into prominence in the 1990s as psychoanalysis struggles with its own need for a secure base, theoretically and economically. The demand for psychological help grows ever stronger as we contemplate the emotional casualties of capitalism; the confusion of psychotherapeutic tongues grows ever louder as the different therapies compete in the marketplace. Your still - but not so small (that 'orotund' charge still rankles) - voice would have been helpful in bringing us back to earth, to the practical questions of who needs help most and with what therapy based on what theory. You would, I think, have taken much satisfaction from the cross- fertilisations stimulated by your work - by analysts like Fonagy and Hobson using the Adult Attachment Interview to study their borderline patients, developmental psychologists like Main and Bretherton beginning to look at object-relations
theory.
You were never an intrusive or dependence-creating
therapist, despite your insistence on the persistence of dependency needs throughout the life cycle. You have made it so that we can manage without you. You clearly saw the two poles of insecurity - avoidance and ambivalence - and, like the good navigator you once were, tried to steer a true course between them. You could see clearly the 'hardboiledness' (your word) of your affectionless psychopaths of the 1930s reminiscent of the narrow scientism of the behaviourists on the one side, and on the other the clinging adherence to unquestioned shibboleths of the psychoanalytic orthodoxy. You saw behind them to the vulnerability they were defending. You knew that the good therapist has to cultivate a state of 'non-attachment' in which people, ideas, things are neither avoided nor clung to but are seen squarely for what they are. This non-attachment can only grow in a culture of secure attachment to parents and a society that is worthy of trust. You were a good model for such trustworthiness (even if your reliability was a bit too much at times for us less organised types! ). On the basis of this secure attachment it is possible to face the inevitable losses and
216 John Bowlby and Attachment Theory
failures, the essential transience of things, and to recognise that, if circumstances allow for due grief and mourning, then out of difficulty can come a new beginning.
Yours, with affection and admiration . . .
Glossary of terms relevant to Attachment Theory
ADULT ATTACHMENT INTERVIEW (AAI) A semi-structured psychodynamic interview in which the subject is encouraged to talk about their early attachments, their feelings about their parents, and to describe any significant losses and childhood traumata. The transcripts are then rated, not so much for content as for style, picking up features like coherence of the narrative and capacity to recall painful events. Subjects are classified into one of four categories: 'Free to evaluate attachment', 'dismissing of attachment', 'enmeshed in attitudes towards attachment', and 'unresolved/disorganised/disorientated'. When given to pregnant mothers the AAI has been shown to predict the attachment status of the infants at one year with 70 per cent accuracy (Fonagy et al. 1992).
AMBIVALENT ATTACHMENT A category of attachment status as classified in the Strange Situation (q. v. ). The infant, after being separated and then re-united with its mother, reacts by clinging to her, protesting in a way that can't be pacified (for instance, by arching its back and batting away offered toys), and remains unable to return to exploratory play for the remainder of the test. Associated with mothers who are inconsistent or intrusive in their responses to their babies.
ASSUAGEMENT AND DISASSUAGEMENT Terms introduced by Heard and Lake (1986) to describe the state of satisfaction or dissatisfaction of attachment needs. The securely attached individual when re-united with an attachment figure clings to them for a few minutes and then, in a state of assuagement, can get on with exploratory activity. If the attachment figure is unable
218 John Bowlby and Attachment Theory
to tolerate attachment behaviour or unavailable, this produces a state of disassuagement of attachment needs associated with defensive manoeuvres such as avoidance or clinging, with consequent inhibition of exploration.
ATTACHMENT The condition in which an individual is linked emotionally with another person, usually, but not always, someone perceived to be older, stronger and wiser than themselves. Evidence for the existence of attachment comes from proximity seeking, secure base phenomenon (q. v. ) and separation protest. ATTACHMENT BEHAVIOURAL SYSTEM This is conceived to be the basis of attachment and attachment behaviour, and comprises a reciprocal set of behaviours shown by care-seeker and care-giver in which they are aware of and seek each other out whenever the care-seeker is in danger due to physical separation, illness or tiredness.
AVOIDANT ATTACHMENT Together with ambivalent attachment (q. v. ), the second main category of insecure attachment delineated in the Strange Situation (q. v. ). Here the child, when re-united with its mother after a brief separation, rather than going to her for assuagement (q. v. ), avoids too close contact, hovering near her in a watchful way, and is unable fully to resume exploratory play. Associated with mothers who reject or ignore their babies.
BORDERLINE PERSONALITY DISORDER (BPD) A term used rather differently by psychiatrists and psychotherapists to denote a group of difficult and disturbed patients characterised primarily by instability of mood and difficulty in sustaining close relationships. In addition, they often show self-injurious behaviour such as self-harm and drug abuse; have destructive angry outbursts; suffer from identity disturbance with uncertainty about life goals and sexual orientation; and experience chronic feelings of emptiness and boredom. Although a precise definition is difficult, the term captures the sense of an individual who often lives on the borderline of relationships, neither in nor out of them, and, psychologically, on the borderline between neurosis and psychosis.
COGNITIVE THERAPY A form of psychotherapy associated with the work of Aaron Beck (Beck et al. 1979) which focuses on the patient's cognitions (i. e. , thoughts) rather than emotions, based
Glossary 219
on the principle that cognitions determine feelings rather than vice versa. Thus, a depressed person may assume that everything they attempt is bound to fail, and this will lead to feelings of hopelessness and helplessness. In therapy, the patient is encouraged to monitor and challenge these automatic dysfunctional thoughts; for example, questioning whether everything they do really is hopeless, or only some things, and so begin to build up positive thoughts about themselves.
CONTROVERSIAL DISCUSSIONS (1941-44) Series of meetings held in the aftermath of Freud's death between two factions, led by Melanie Klein and Anna Freud, in the British PsychoAnalytical Society. The two sides disagreed about theory - especially about the existence or otherwise of the death instinct, and the age at which infantile phantasies could be said to exist. Each side felt that the other had an undue influence over Training Candidates and was trying to denigrate and dismiss each other's theories. Eventually a compromise was reached in which two, and later three, streams of training were created within the society: the Kleinian, the Freudian and a third, non-aligned ('middle') group.
DEPRESSIVE POSITION/PARANOID-SCHIZOID POSITION Melanie Klein's (1986) distinction between a state of mind characterised by splitting (hence the 'schizoid' aspect), in which good and bad are kept separate, and in which bad, persecutory feelings are projected onto the environment (hence the 'paranoid' aspect); and one in which good and bad are seen to be two aspects of the same thing, and which therefore leads to depressive feelings that are healthy and constructive because the sufferer is taking responsibility for their hatred and is appropriately guilty. Klein saw the infant as progressing from the paranoid-schizoid to the depressive position in the course of the early years of life. The move from one position to the other is also a feature of successful therapy. Bowlby differs from Klein in seeing splitting as a response to sub-optimal parenting, a manifestation of insecure attachment, rather than a normal phenomenon. He agrees with Klein about the importance of depression as an appropriate response to loss and separation.
EPIGENETIC A term coined by Waddington (1977) to describe the development of a differentiated organism from a fertilised ovum. The developing embryo proceeds along a number of
220 John Bowlby and Attachment Theory
possible developmental pathways depending on environmental conditions. Epigenesis may be contrasted with a 'homuncular' (from 'homunculus' or 'little man') model of development in which all the stages of development are already pre-formed. Bowlby applied this distinction to psychological development, and contrasted his own approach in which there are many possible pathways which an individual may take through infancy depending on their interaction with their care-givers, with the classical Freudian approach which sees development in terms of a number of fixed 'stages' through which a person must pass, irrespective of environmental influence. He felt that his approach was more consistent with modern biological thinking, and allowed for a more subtle view of the complexity of interaction between an individual and their environment. Thus 'anxious' attachment, rather than being a 'stage', like the so-called 'oral stage' of development, becomes a possible epigenetic compromise between a child's attachment needs and a parent who is unable fully to meet them. Like Klein's 'positions', but unlike Freud's 'stages', Bowlby's attachment patterns persist throughout life, unless modified by good experiences (which would include successful therapy).
ETHOLOGY Literally, the study of an individual's 'ethos' or character. Ethology is a biological science which studies animal behaviour in a particular way: the animal is considered as a whole; behaviour is usually studied in natural or wild conditions; there is great attention to the antecedents and consequences of behaviour patterns; the function of any behaviour is considered; and an evolutionary perspective is always taken. An attempt is made to see how the animal views the world from its own perspective and to visualise the internal 'maps' and rules which govern its activities. Ethology is contrasted with behaviourism, which usually concentrates on particular bits of behaviour and does not consider the organism as a whole and is unconcerned with evolutionary considerations. Bowlby saw the methods and theories of ethology as highly relevant to the study of human infants, and this led to a fruitful collaboration between him and the leading ethologist Robert Hinde (see Hinde 1982a and b; 1987).
Glossary 221
EXPRESSED EMOTION (EE) A rating scale initially developed for the relatives of patients suffering from schizophrenia (Left and Vaughn 1983), but applicable to other disorders including affective illness and Alzheimer's disease, measuring such dimensions as 'hostility', 'warmth' and 'overinvolvement'. Patients whose relatives score high on negative 'expressed emotions' are more likely to relapse from their illness. A link is suggested between anxious attachment and high expressed emotion (see Chapter 9).
INTERNAL WORKING MODELS On the basis of cognitive psychology (see Craik 1943; Beck et al.
1979), Bowlby sees higher animals as needing a map or model of the world in the brain, if they are successfully to predict, control and manipulate their environment. In Bowlby's version humans have two such models, an 'environmental' model, telling us about the world, and an 'organismal' model, telling us about ourselves in relation to the world. We carry a map of self, and others, and the relationship between the two. Although primarily 'cognitive' in conception, the idea of internal working models is applicable to affective life. The map is built up from experiences and is influenced by the need to defend against painful feelings. Thus an anxiously attached child may have a model of others in which they are potentially dangerous, and therefore must be approached with caution, while their self-representation may be of someone who is demanding and needy and unworthy to be offered security. The relationship with a person's primary care-givers is generalised in internal working models, which leads to a distorted and incoherent picture of the world, and one that is not subject to updating and revision in the light of later experience. This, in Bowlby's eyes, is the basis for transference, and the task of therapy is help the patient develop more realistic and less rigid internal working models.
MATERNAL DEPRIVATION A catch-phrase summarising Bowlby's early work on the effects of separating infants and young children from their mothers. He believed that maternally deprived children were likely to develop asocial or antisocial tendencies, and that juvenile delinquency was mainly a consequence of such separations. The corollary of this was his advocacy of continuous mother-child contact for at least the first five years of life, which
222 John Bowlby and Attachment Theory
earned him the opprobrium of feminists. Subsequent research has confirmed that lack of maternal care does lead to poor social adjustment and relationship difficulties, but suggests that disruption, conflict and poor maternal handling are more common causes of difficulties in late life than the loss of mother in itself.
METACOGNITIVE MONITORING Concept introduced by Main (1990) and Fonagy (1991) to denote the ability to 'think about thinking'. Securely attached children and adults are able to reflect freely on their thought processes (e. g. , 'I was really upset when my mum and dad split up and felt pretty hostile to all the children at school who seemed to have happy homes'), in contrast to insecure individuals, who tend either to dismiss their thought processes (e. g. , 'Oh, the split-up didn't affect me at all, I just concentrated on my football'), or to be bogged down in them ('I can't really talk about it . . . it makes me too upset'). Defects in metacognitive ability are common in pathological states, such as borderline personality disorder, and one of the aims of psychotherapy is to facilitate metacognition.
MONOTROPY An ethological (q. v. ) term introduced by Bowlby to denote the exclusive attachment of a child to its principal care- giver, usually the mother. He was impressed by Lorenz's (1952) studies of geese and their young which suggested that the goslings became imprinted onto a moving object at a sensitive period in the first day or two of life. Bowlby thought that a similar process occurred in humans. In fact, imprinting seems not to be a feature of primate development, where attachments develop gradually and over a wide range from the early months to adolescence. Also, attachment in humans is not so much monotropic as hierarchical, with a list of preferred care-givers, with parents at the top, but closely followed by grandparents, siblings, aunts and so on.
OBJECT-RELATIONS THEORY (ORT) Attachment Theory is a close relation of, and provides experimental evidence in support of, Object-Relations Theory (Greenberg and Mitchell 1983). This psychoanalytic school is particularly associated with a group of British theorists who include Klein (1986), Fairbairn (1952), Balint (1968) and Winnicott (1965), as well as Bion (1978). In contrast to Freud's early view of the organism as primarily driven by instinct and the need to discharge accumulated psychic energy ('libido'), Object-Relations Theorists see people as primarily seeking a
Glossary 223
relationship to their 'objects'. There is thus a progression in psychoanalytic thinking, starting with Freud's drive discharge theory, through Object Relations, in which a whole individual is seeking a relationship with an 'object' (i. e. , not quite a person), to the reciprocity of care-giver and care-seeker implicit in Attachment Theory and recent developmental psychology.
PARENTAL BONDING INSTRUMENT (PBI) A questionnaire test, devised by Parker (1983) to try to elicit in a systematic way an individual's perception of their parental relationships in childhood. It gives two main dimensions: 'care' and 'protection'. 'Care' ranges from warmth and empathy at one extreme to coldness and indifference at the other. 'Protection' similarly ranges from over-protection and infantilisation to promotion of autonomy. People with borderline personality disorder and depressive disorders regularly report the constellation of low care and high intrusiveness ('affectionless control'). There is some evidence that such reports of parental behaviour are an accurate reflection of their actual behaviour (Parker et al. 1992).
PERCEPTUAL DEFENCE This, and the related concept of unconscious perception (Dixon and Henley 1991), refer to the apparently paradoxical phenomenon by which an individual can be shown to respond in behaviour to a stimulus without it reaching conscious awareness. Thus, for example, a subject presented with a neutral face and asked to judge whether it is 'happy' or 'sad', will be influenced by the simultaneous presentation of a subliminal word with positive or negative connotations. This provides experimental confirmation of the existence of unconscious thinking. Bowlby (1981c) uses this idea in his discussion of ungrieved loss to suggest that painful feelings are kept out of awareness but may nevertheless influence a person's state of mind and behaviour. By bringing these feelings into awareness - that is, by reducing the extent of perceptual defence - they are then available for processing (cf. 'working through'), leading to a more coherent and better adapted relationship to the world and the self.
SECURE BASE A term introduced by Ainsworth (1982) to describe the feeling of safety provided by an attachment figure. Children will seek out their secure base at times of threat - danger, illness, exhaustion or following a separation. When the danger
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has passed, attachment behaviour will cease, but only if it is there to be mobilised if needed will the child feel secure. The secure base phenomenon applies equally to adults. We all feel 'at home' with those whom we know and trust, and within such a home environment are able to relax, and pursue our projects, whether they be play, pleasure-seeking or work.
STRANGE SITUATION An experimental method devised by Ainsworth (Ainsworth et al. 1978) to study the ways in which one-year-old children can cope with brief separations from their care-givers. The child is left first with the experimenter and then alone while the mother goes out of the room for 3 minutes. The child's response to the separation, and more importantly to the re-union, is observed and rated from videotapes. On the basis of this rating children can be classified as secure (usually characterised by brief protest followed by return to relaxed play and interaction) or insecure, the latter being subdivided into avoidant (q. v. ) and ambivalent (q. v. ) patterns of insecurity. See Chapter 6, page 104, for a more detailed description.
SYSTEMIC Adjective derived from Systems Theory, a conceptual model used by family therapists (originating with information theory), in which the family as a whole is seen as a quasi-organism, or 'system', with its own rules and ways of behaving. Certain general principles apply to systems whatever their nature, whether they are cells of the body, whole organisms, families or social groups. These include the property of having a boundary, of the need for information flow between different parts of the system, of a hierarchy of decision-making elements, and of 'homeostasis', the tendency towards inertia. Attachment Theory is systemic in that it sees care-seeker and care-giver as a mutually interacting system regulated by positive and negative feedback. Pathological states can result from the operation of such feedback - for example, when a child clings ever more tightly to an abusing parent, because the source of the attack is also the object to which the child is programmed to turn in case of danger.
Chronology
1907 Born, Edward John Mostyn Bowlby, fourth child and second son of Sir Anthony and Lady May Bowlby. Lived at Manchester Square, London.
1914-25 Preparatory school and then Royal Naval College, Dartmouth.
1925-28 Trinity College, Cambridge.
1928-29 Teacher in progressive school for maladjusted children.
1929 Started clinical medical studies at University College Hospital, London, and psychoanalytic training at the Institute of Psycho-Analysis, London. Training analyst, Mrs Joan Riviere.
1933 Medical qualification. Psychiatric training at Maudsley Hospital, London, under Aubrey Lewis.
1937 Qualified as an analyst. Starts training in child analysis, supervisor, Melanie Klein.
1938 Married Ursula Longstaff, by whom two sons and two daughters.
1940 Publication: Personality and Mental Illness (with F. Durbin).
1937-40 Psychiatrist, London Child Guidance Clinic.
1940-45 Specialist Psychiatrist, Royal Army Medical Corps, mainly concerned with Officer Selection Boards.
1946 Publication, 'Forty-four juvenile thieves: their characters and home life'.
1946-72 Consultant Child Psychiatrist and Deputy Director, Tavistock Clinic, London, and Director, Department for Children and Parents.
226 John Bowlby and Attachment Theory
1950-72 Consultant in Mental Health, World Health Organisation.
1951 Publication of Maternal Care and Mental Health. 1957-58 Fellow, Centre for Advanced Study in the Behavioural
Sciences, Stanford, California.
1956-61 Deputy President, British Psycho-Analytical Society.
1958-63 Consultant, US National Institute of Mental Health.
1969 Publication of Attachment, first volume of the Attachment and Loss trilogy.
---- Visiting Professor in Psychiatry, Stanford University, California.
1963-72 Member, External Scientific Staff, Medical Research Council.
1972 Commander of the British Empire.
1973 Publication of Separation, second volume of the Attachment
and Loss trilogy.
1973 Travelling Professor, Australian and New Zealand College
of Psychiatrists.
1977 Honorary Doctor of Science, University of Cambridge.
1979 Publication of The Making and Breaking of Affectional Bonds.
1980 Publication of Loss, third volume of the Attachment and Loss trilogy.
1981 Freud Memorial Professor of Psychoanalysis, University College, London.
---- Foreign Honorary Member, American Academy of Arts and Sciences.
1987 Celebration of Bowlby's 80th birthday with a conference at the Tavistock Clinic, bringing together researchers and clinicians, entitled 'The Effect of Relationships on Relationships'.
1988 Publication of A Secure Base.
Chronology 227
1989 Fellow of the British Academy.
1990 Publication of Charles Darwin, A New Biography.
---- Dies while in Skye, at his holiday home where much of his writing had been done.
Bibliography
PUBLICATIONS OF JOHN BOWLBY
Personal Aggressiveness and War, (1938) (with E. P. M. Durbin) London: Kegan Paul.
'The abnormally aggressive child', (1938) The New Era (Sept. -Oct. ). 'Hysteria in children', (1939a) in A Survey of Child Psychiatry, pp. 80-94,
Humphrey Milford (ed. ), London: Oxford University Press.
'Substitute homes', (1939) Mother and Child (official organ of the National
Council for Maternity and Child Welfare) X (1) (April): 3-7.
'Jealous and spiteful children', (1939) Home and School (Home and School
Council of Great Britain), IV(5): 83-5.
Bowlby, J. , Miller, E. and Winnicott, D. W. (1939) 'Evacuation of small children'
(letter), British Medical Journal (16 Dec. ): 1202-3.
'The influence of early environment in the development of neurosis and neurotic
character', (1940) International Journal of Psycho-Analysis, 21: 154-78. 'Psychological aspects', (1940) ch. 16, pp. 186-96, in Evacuation Survey: A Report to the Fabian Society, Richard Padley and Margaret Cole (eds),
London: George Routledge & Sons Ltd.
'The problem of the young child', (1940c) Children in War-time, 21 (3): 19-30,
London: New Education Fellowships.
'Forty-four juvenile thieves: their characters and home life', (1944) International
Journal of Psychoanalysis, 25: 1-57 and 207-228; republished as a
monograph by Baillie`re, Tindall & Cox, London, 1946.
'Childhood origins of recidivism', (1945-46) The Howard Journal, VII (1): 30-
3, The Howard League for Penal Reform.
'The future role of the child guidance clinic in education and other services',
(1946a) Report of the Proceedings of a Conference on Mental Health,
(14-15 Nov. ), pp. 80-89, National Association for Mental Health. 'Psychology and democracy', (1946b) The Political Quarterly, XVII (1):
61-76.
'The therapeutic approach in sociology', (1947a) The Sociological
Review, 39: 39-49.
'The study of human relations in the child guidance clinic', (1947b)
Journal of Social Issues, III (2) (Spring): 35-41.
'The study and reduction of group tensions in the family, (1949a) Human
Relations, 2 (2) (April): 123-8.
'The relation between the therapeutic approach and the legal approach
Bibliography 229
to juvenile delinquency', (1949b) The Magistrate, VIII (Nov. ):
260-4.
Why Delinquency? The Case for Operational Research, (1949c) Report
of a conference on the scientific study of juvenile delinquency held at the Royal Institution, London 1 Oct. , and published by the National Association for Mental Health.
'Research into the origins of delinquent behaviour', (1950) British Medical Journal 1 March 11: 570).
Maternal Care and Mental Health, (1951) World Health Organisation, Monograph Series No. 2.
'Responses of young children to separation from their mothers', (with J. Robertson) (1952a) Courier, Centre International de l'Enfance, II (2): 66-78, and II (3): 131-42, Paris.
A two-year-old goes to hospital: a scientific film, (with J. Robertson) (1952b) Proceedings of the Royal Society of Medicine, 46: 425-7. 'A two-year-old goes to hospital', Bowlby, J. , Robertson, J. and
Rosenbluth, D. (1952) The Psychoanalytic Study of the Child, VII:
82-94.
'A two-year-old goes to hospital: a scientific film', (with J. Robertson)
(1952b) Proceedings of the Royal Society of Medicine, 46: 425-7. 'The roots of parenthood', (1953) Convocation Lecture of the National
Children's Home (July).
Child Care and the Growth of Maternal Love, (1953b) (abridged version
of Maternal Care and Mental Health, 1951), London: Penguin Books;
new and enlarged edition, 1965.
'Critical phases in the development of social responses in man and other
animals', (1953c) New Biology, London: Penguin Books, pp. 25-
32.
'Some pathological processes set in train by early mother-child
separation', (1953d) Journal of Mental Science, 99: 265-72. 'Research strategy in the study of mother-child separation', (with M. G. Ainsworth) (1954) Courier, Centre International de l'Enfance, IV:
105-13.
'Family approach to child guidance: therapeutic techniques', (1955)
Transactions of the 11th Interclinic Conference for the Staffs of Child Guidance Clinics, National Association for Mental Health (26 March).
'The growth of independence in the young child', (1956) Royal Society of Health Journal, 76: 587-91.
'Psychoanalytic instinct theory', (1956) in Discussions on Child Development, vol. 1 , J. M. Tanner and B. Inhelder (eds), pp. 182- 87, London: Tavistock Publications.
'The effects of mother-child separation: a follow-up study', (with M. Ainsworth, M. Boston and D. Rosenbluth) (1956) British Journal of Medical Psychology, XXIX, parts 3 and 4 : 211-47.
'An ethological approach to research in child development', (1957) British Journal of Medical Psychology, XXX, part 4 : 230-40.
Can I Leave my Baby? , (1958a) The National Association for Mental Health.
230 John Bowlby and Attachment Theory
'A note on mother-child separation as a mental health hazard', (1958b) British Journal of Medical Psychology, XXXI, parts 3 and 4 :247-8. Foreword to Widows and their Families by Peter Marris, (1958c) London:
Routledge & Kegan Paul.
'The nature of the child's tie to his mother', (1958d) International Journal
of Psycho-Analysis, 39, part V : 350-73.
'Psychoanalysis and child care', (1958e) in Psychoanalysis and
Contemporary Thought, J. Sutherland (ed. ), London: Hogarth Press. 'Ethology and the development of object relations', (1960a) International
Journal of Psycho-Analysis, 41, parts IV - V : 313-17. 'Separation anxiety', (1960b) International Journal of Psycho-Analysis,
41, parts II - III : 89-113.
Comment on Piaget's paper: 'The general problems of the psychobiological
development on the child', (1960c) in Discussions on Child Development, vol. 4 , J. M. Tanner and B. Inhelder (eds), London: Tavistock Publications.
'Grief and mourning in infancy and early childhood', (1960d) The Psychoanalytic Study of the Child, XV: 9-52.
'Separation anxiety: a critical review of the literature', (1961a) Journal of Child Psychology and Psychiatry, 1 (16): 251-69.
Note on Dr Max Schur's comments on grief and mourning in infancy and early childhood, (1961b) The Psychoanalytic Study of the Child, XVI: 206-8.
'Childhood mourning and its implications for psychiatry', The Adolf Meyer Lecture, (1961c) American Journal of Psychiatry, 118 (6): 481-97.
'Processes of mourning', (1961d) International Journal of Psycho- Analysis, 42, parts IV - V : 317-40.
'Defences that follow loss: causation and function', (1962a) unpublished. 'Loss, detachment and defence', (1962b) unpublished.
'Pathological mourning and childhood mourning', (1963) Journal of the
American Psychoanalytic Association, XI (3) (July): 500-41.
All our previous experience points inescapably to the conclusion that neither moral exhortation nor fear of punishment will succeed in controlling the use of this weapon. Persons bent on suicide and nations bent on war, even suicidal war, are deterred by neither. The hope for the future lies in a far more profound understanding of the nature of the emotional forces involved and the development of scientific social techniques for modifying them.
(Bowlby 1947a)
A small but significant example of the kind of 'understanding' and 'technique' which Bowlby advocates can be found in Middleton's (1991) description of Sherif's Boys Camp Experiment, in which thirty teenagers were taken for a month's camping in the wilderness by a group of psychologists working as camp attendants. The boys were divided into two groups who ate, slept
208 Imlications
and played separately. Rather like in Golding's Lord of the Flies, two distinct cultures of behaviour, slang and group identity developed. When members of the two groups met, scuffles broke out. The experimenters then arranged for the food lorry to break down some miles from the camp, which meant that the two groups had to collaborate in bringing essential supplies to their base. The results were as follows:
After some initial prevarication and quarrelling, the two groups coalesced into a larger and sufficiently coherent and cohesive group for this essential task. As this happened the stereotyping, antipathy and intense competition between the groups also dissolved as they worked together in pursuit of their mutual interest.
(Middleton 1991)
The discovery of a superordinate goal enabled the two groups to collaborate. The leadership provided them with a secure base from which they could explore ways collectively to solve their common problem.
The ecological vicious circle the world faces is one in which, confronted with a threat to the environment and therefore to the fundaments of security, nations, and where nations break down tribal groups, fight ever more desperately to extract what resources they can from it. This is rather like the children of abusive parents who, in their fear, cling to the very object that causes their distress. The common objective of global security needs to be made real if this vicious cycle is to be put into reverse, just as the skilled therapist will see that both abusive parent and child are in search of a safety that neither can provide for the other, and, as far as possible will try to remedy this herself, or mobilise others who can do so. If we feel locally secure, with a home base which we know will be respected and protected, there will be less need to project of insecurity onto others. Secure as inhabitants of our locality, we become free to explore our citizenship of the world. As the Sicilian writer Gesualdo Bufalino puts it:
Now I finally know this simple truth: that it is not only my right but my duty to declare myself a citizen of Everywhere as well as of a hamlet tucked away in the Far South between the Iblei Mountains and the sea; that it is my right and duty to
Attachment Theory and society 209
allow a place in my spirit for both the majestic music of the universe and that of the jet gushing from a fountain in the middle of a little village square, on the far southern bastions of the West.
(Bufalino 1992)
For Freud, our biological heritage was a shackle, creating an inevitable conflict between our selfish and drive-driven nature and the repressions of culture. In his vision of alienation we are prisoners of our paleocortex. Bowlby's more benign picture (the contrast between the two men is partly a reflection of the differing cultural heritage - one a European Jew, the other a member of the English upper middle classes) implies a need to re-establish connections with our evolutionary past. Humans survived and evolved on the basis of bonding and mutual support. Competition and the neglect of these basic ties threaten to destroy us. Nomads and agriculturalists, explorers and stay-at-homes, male and female, men and women of contemplation and of action, pursuers of the inner and outer worlds, psychologists and politicians, yogis and commissars - we all share a need for common security. We are all attached inescapably to an Earth in whose 'environment of evolutionary adaptedness' we originated, and which we now threaten with destruction as we are caught in the vortex of a negative spiral of insecurity.
Chapter 11 Epilogue
Sow a thought and you may reap an act; sow an act and you reap a habit; sow a habit and you reap a personality; sow a personality and you reap a destiny.
(Buddhist proverb; Jones 1985)
We ended the previous chapter with a rhetorical flourish which John Bowlby, however much he approved of its sentiment, would probably have considered overstated, insufficiently underpinned by close-grained scientific fact. This is perhaps excusable as we near the end of this book. As suggested in the Introduction, the biographer is both patient and therapist to his subject. At the end of therapy a patient will often yearn for a 'verdict' and ask, implicitly or explicitly, 'Well, what do you really think of me, what is your opinion? ' But the therapist has already done his work, said all he can say in the course of the therapy. What more can he add? In the CAT model of brief therapy (Ryle 1990), this dilemma is met by the introduction of the 'farewell letter' which the therapist presents to the patient in the penultimate session. This attempts to summarise the patient's strengths and weaknesses, the progress that has been made in therapy, and some predictions for the future. This heterodoxy is not, it should be noted, the exclusive preserve of eclectic therapists like Ryle: Clifford Scott records that the most moving moment of his analysis with Melanie Klein in the 1930s occurred when she read out to him a long interpretation she had written over the weekend. 'This was proof that I was in her as well as she was in me' (Grosskurth 1986).
Here, then, presumptuously perhaps (but is not any therapy - or biography - an act of presumption? ), is an attempt at a farewell
Epilogue 211
letter for John Bowlby, with which the reader, like the patient in CAT, is also invited to disagree, add to, reject, treasure or do what they will.
Dear John,
We are nearing the end of our time together. I would like to say how much I have enjoyed working with you and how much I have learned from our collaboration. I hope you feel that justice has been done to your work and that the boundaries of privacy which, from an early age, you placed around your feelings have been handled with sensitivity.
Like many outstanding psychologists you come from a background that was not entirely easy, although it offered you many opportunities. Perhaps one of them was the fact that your family was so delightfully unpsychological. As Gwen Raverat, granddaughter of your hero, Darwin, said of her father and his brothers (all of whom were distinguished scientists):
'They had [no] idea of the complications of psychology. They found it difficult to conceive of a mixture of motives; or of a man who says one thing and means another; or of a person who is sometimes honest and sometimes dishonest; because they were so completely single-hearted themselves.
(Raverat 1952)
Perhaps it was because you were so familiar with those to whom psychology is a mystery that you were such a good populariser. Some of your life's work at least can be understood in terms of the problems which presented themselves to you as a small child. You were the middle boy between a very bright and vigorous older brother and a younger brother who was considered backward. Your compassion for the weak and your undoubted ambition and competitiveness bear the impress of the mould you shared with them. Your father was a distant, awe-inspiring figure, whose voice you are said to have inherited and in whose footsteps you followed into the medical profession. In terms of public recognition your achievements were at least comparable with his, although as it happens, as a resilient and independent-minded person you did not appear to seek or need external approval. Your mother - or, should we say, mothers? - seems in her urban persona to have been rather neglectful and partial in her handling of the children, but was very different on those long
212 John Bowlby and Attachment Theory
holidays which were such an important influence on your life and work. From her you learned the importance of nature, that as creatures we are part civilised, part wild. In middle years you kept the wild side of yourself well hidden, but it was certainly there in your early independence and rebelliousness, and emerged again as you grew older.
I suspect, like many others of your generation, you were very excited when you started your training as a psychoanalyst at the prospect of being able to apply your scientific outlook not just to the external world but also to the inner landscape of feelings. Here, in your own words (Bowlby 1973a), was a continent to conquer. In those days your views were progressive and, while never a Marxist (or indeed an anything-ist), you saw an opportunity to ameliorate psychological as well as material suffering.
Your encounter with psychoanalysis did not really live up to your expectations. Your teachers did not seem particularly interested in trying to change society. They were certainly conservative in their outlook if not in their politics. They ran their society in an authoritarian way and, to succeed, you had to submit to this, even if, as I suspect, your heart was not really in it. Your analyst was Mrs Riviere, your supervisor Melanie Klein. As one of your obituarists put it, 'it is a tribute to [your] independence to point out that neither of these two formidable ladies appear to have had the slightest effect on [your] subsequent development' (Storr 1991). That is not of course quite true because you were, as you yourself later said, determined to prove them wrong. Perhaps you thought you would 'bag' them both, like a brace of pheasants (and you were never happier than after a good day's shooting), with your theory of attachment.
The way you did this was interesting. What you did, in effect, was to appeal over their heads to the higher authority of Freud, much as you might have done as a child when, with your father away at the war in France, you might have wanted some paternal authority with which to out-trump your didactic mother and dominant older brother. First, you emphasised your common scientific outlook with Freud's, in contrast to their lack of scientific understanding. Second, you insisted that they had not really grasped the importance in Freud's late work on attachment (as opposed to instinct), and the role of loss as a cause of neurosis.
You had the social and intellectual self-confidence to challenge psychoanalytic authority - and it certainly needed challenging. But
Epilogue 213
perhaps you missed out on something too. So important was it for you resist what you saw as the negative influence of these wrong- headed ideas - especially the neglect of real trauma in favour of phantasy - that you did not really allow yourself to feel the full emotional impact of psychoanalysis. The imaginative leaps, the heights and depths of emotion, the understanding of how intimate experience is engendered and gendered - you seem to have avoided these. Meanwhile, you built your case, painstakingly and slowly, that psychoanalysis - or the Kleinian version of it, at least - was on a wrong course. The effort of self-control and sustained concentration that this took may have contributed to the impression you gave to some of detachment and even arrogance.
Together with your intelligence and independence you were clearly an excellent organiser and highly efficient. These qualities brought you to the top - or nearly to the top - of your professions of psychoanalysis and child psychiatry. You were Deputy Chairman of the Tavistock and Deputy President of the Psycho-Analytical Society. But something kept you from the summit. Was it your reserve, your lack of overt warmth? Or did you value most strongly the rebellious part of you which wanted to strike out on your own rather than become too identified with an institution? You mistrusted authority, although in your own way you exercised a strong hand in your research group. Running a tight ship always was your style.
Maternal deprivation made your name. What a case you built up for the mother-love which you experienced so intermittently and unpredictably in your childhood. What a devastating criticism and idealisation of motherhood that was! And how the public loved - and hated - you for it. It is a pity that you weren't able to say more about fathers, especially as they are so much more important now in child care than they were when you began your theorising. But the principles of mothering which you put forward remain valid if we speak now instead of parenting, as long as this does not gloss over the fact that the bulk of child care is still done by mothers, who are as vulnerable and unsupported now, although in different ways, as they were when you surveyed the post-war scene in the 1940s.
And loss. What a keen eye for that you had. Your understanding of it may turn out in the end to be your greatest contribution to psychology. And yet how well
214 John Bowlby and Attachment Theory
hidden you kept the losses in your own life that made you so sensitive to others' grief and misery. Was it your father's absence during the war? Or the loss of your younger brother's vigour? Was it your sensitivity to your parents' grief, both of whom had lost parents in their youth - your paternal grandfather's death, your maternal grandmother's preoccupation with the younger children? Or was it Durbin - your Lycidas, a close friend cut down in his prime, trying, tragically, to save another man from drowning?
I wonder what you would have made of our contemporary emphasis on stories and narrative in psychotherapy? You were suspicious of hermeneutics and tried always to stay within the confines of evolutionary science. And yet from your work has come a line of understanding which shows how the capacity for narrative, to link the past with the present and the future in a coherent way, is a continuation of that responsive handling in infancy which you (and Winnicott) saw so clearly were the foundations of security. You made the first entries in the non-verbal grammar of mother-child interaction which is slowly being written. From this has come an understanding that it is the handling of patients by their therapists that matters, not the precision of their interpretations. There is no Bowlbian school of psychotherapy because your emphasis was on the non-verbal language of care-giving. The stories - Kleinian, Freudian or what you will - come later. You were a good story-teller yourself as your books, with their logical progressions and solid factual backing for your theories, attest. You would have agreed that the ability to tell a story is the mark of psychological health. You knew that to be able to talk about pain and loss is the best way to overcome it. You would have been fascinated by the evidence - springing mostly from your work - that securely attached babies become good story-tellers in their teens, and that they in turn have securely attached babies.
I suspect you were one of those people who grow happier as they get older. Towards the end you allowed the twinkle in your eye to show more often. You could finally start to play - your way. Perhaps you hadn't really been able to do this since the thirties. Your battle with psychoanalysis was over and you could be your own man. You returned in your last years to an authority that pre-dated Freud - Darwin, to a Victorian time when progress and order and the power of science were valued, where the battle lines were clear cut, far removed from the
Epilogue 215
chaos and confusion of our post-modernist world.
What of your legacy? Attachment Theory is, as you were, vigorous and independent. If anything, it is likely to come even more into prominence in the 1990s as psychoanalysis struggles with its own need for a secure base, theoretically and economically. The demand for psychological help grows ever stronger as we contemplate the emotional casualties of capitalism; the confusion of psychotherapeutic tongues grows ever louder as the different therapies compete in the marketplace. Your still - but not so small (that 'orotund' charge still rankles) - voice would have been helpful in bringing us back to earth, to the practical questions of who needs help most and with what therapy based on what theory. You would, I think, have taken much satisfaction from the cross- fertilisations stimulated by your work - by analysts like Fonagy and Hobson using the Adult Attachment Interview to study their borderline patients, developmental psychologists like Main and Bretherton beginning to look at object-relations
theory.
You were never an intrusive or dependence-creating
therapist, despite your insistence on the persistence of dependency needs throughout the life cycle. You have made it so that we can manage without you. You clearly saw the two poles of insecurity - avoidance and ambivalence - and, like the good navigator you once were, tried to steer a true course between them. You could see clearly the 'hardboiledness' (your word) of your affectionless psychopaths of the 1930s reminiscent of the narrow scientism of the behaviourists on the one side, and on the other the clinging adherence to unquestioned shibboleths of the psychoanalytic orthodoxy. You saw behind them to the vulnerability they were defending. You knew that the good therapist has to cultivate a state of 'non-attachment' in which people, ideas, things are neither avoided nor clung to but are seen squarely for what they are. This non-attachment can only grow in a culture of secure attachment to parents and a society that is worthy of trust. You were a good model for such trustworthiness (even if your reliability was a bit too much at times for us less organised types! ). On the basis of this secure attachment it is possible to face the inevitable losses and
216 John Bowlby and Attachment Theory
failures, the essential transience of things, and to recognise that, if circumstances allow for due grief and mourning, then out of difficulty can come a new beginning.
Yours, with affection and admiration . . .
Glossary of terms relevant to Attachment Theory
ADULT ATTACHMENT INTERVIEW (AAI) A semi-structured psychodynamic interview in which the subject is encouraged to talk about their early attachments, their feelings about their parents, and to describe any significant losses and childhood traumata. The transcripts are then rated, not so much for content as for style, picking up features like coherence of the narrative and capacity to recall painful events. Subjects are classified into one of four categories: 'Free to evaluate attachment', 'dismissing of attachment', 'enmeshed in attitudes towards attachment', and 'unresolved/disorganised/disorientated'. When given to pregnant mothers the AAI has been shown to predict the attachment status of the infants at one year with 70 per cent accuracy (Fonagy et al. 1992).
AMBIVALENT ATTACHMENT A category of attachment status as classified in the Strange Situation (q. v. ). The infant, after being separated and then re-united with its mother, reacts by clinging to her, protesting in a way that can't be pacified (for instance, by arching its back and batting away offered toys), and remains unable to return to exploratory play for the remainder of the test. Associated with mothers who are inconsistent or intrusive in their responses to their babies.
ASSUAGEMENT AND DISASSUAGEMENT Terms introduced by Heard and Lake (1986) to describe the state of satisfaction or dissatisfaction of attachment needs. The securely attached individual when re-united with an attachment figure clings to them for a few minutes and then, in a state of assuagement, can get on with exploratory activity. If the attachment figure is unable
218 John Bowlby and Attachment Theory
to tolerate attachment behaviour or unavailable, this produces a state of disassuagement of attachment needs associated with defensive manoeuvres such as avoidance or clinging, with consequent inhibition of exploration.
ATTACHMENT The condition in which an individual is linked emotionally with another person, usually, but not always, someone perceived to be older, stronger and wiser than themselves. Evidence for the existence of attachment comes from proximity seeking, secure base phenomenon (q. v. ) and separation protest. ATTACHMENT BEHAVIOURAL SYSTEM This is conceived to be the basis of attachment and attachment behaviour, and comprises a reciprocal set of behaviours shown by care-seeker and care-giver in which they are aware of and seek each other out whenever the care-seeker is in danger due to physical separation, illness or tiredness.
AVOIDANT ATTACHMENT Together with ambivalent attachment (q. v. ), the second main category of insecure attachment delineated in the Strange Situation (q. v. ). Here the child, when re-united with its mother after a brief separation, rather than going to her for assuagement (q. v. ), avoids too close contact, hovering near her in a watchful way, and is unable fully to resume exploratory play. Associated with mothers who reject or ignore their babies.
BORDERLINE PERSONALITY DISORDER (BPD) A term used rather differently by psychiatrists and psychotherapists to denote a group of difficult and disturbed patients characterised primarily by instability of mood and difficulty in sustaining close relationships. In addition, they often show self-injurious behaviour such as self-harm and drug abuse; have destructive angry outbursts; suffer from identity disturbance with uncertainty about life goals and sexual orientation; and experience chronic feelings of emptiness and boredom. Although a precise definition is difficult, the term captures the sense of an individual who often lives on the borderline of relationships, neither in nor out of them, and, psychologically, on the borderline between neurosis and psychosis.
COGNITIVE THERAPY A form of psychotherapy associated with the work of Aaron Beck (Beck et al. 1979) which focuses on the patient's cognitions (i. e. , thoughts) rather than emotions, based
Glossary 219
on the principle that cognitions determine feelings rather than vice versa. Thus, a depressed person may assume that everything they attempt is bound to fail, and this will lead to feelings of hopelessness and helplessness. In therapy, the patient is encouraged to monitor and challenge these automatic dysfunctional thoughts; for example, questioning whether everything they do really is hopeless, or only some things, and so begin to build up positive thoughts about themselves.
CONTROVERSIAL DISCUSSIONS (1941-44) Series of meetings held in the aftermath of Freud's death between two factions, led by Melanie Klein and Anna Freud, in the British PsychoAnalytical Society. The two sides disagreed about theory - especially about the existence or otherwise of the death instinct, and the age at which infantile phantasies could be said to exist. Each side felt that the other had an undue influence over Training Candidates and was trying to denigrate and dismiss each other's theories. Eventually a compromise was reached in which two, and later three, streams of training were created within the society: the Kleinian, the Freudian and a third, non-aligned ('middle') group.
DEPRESSIVE POSITION/PARANOID-SCHIZOID POSITION Melanie Klein's (1986) distinction between a state of mind characterised by splitting (hence the 'schizoid' aspect), in which good and bad are kept separate, and in which bad, persecutory feelings are projected onto the environment (hence the 'paranoid' aspect); and one in which good and bad are seen to be two aspects of the same thing, and which therefore leads to depressive feelings that are healthy and constructive because the sufferer is taking responsibility for their hatred and is appropriately guilty. Klein saw the infant as progressing from the paranoid-schizoid to the depressive position in the course of the early years of life. The move from one position to the other is also a feature of successful therapy. Bowlby differs from Klein in seeing splitting as a response to sub-optimal parenting, a manifestation of insecure attachment, rather than a normal phenomenon. He agrees with Klein about the importance of depression as an appropriate response to loss and separation.
EPIGENETIC A term coined by Waddington (1977) to describe the development of a differentiated organism from a fertilised ovum. The developing embryo proceeds along a number of
220 John Bowlby and Attachment Theory
possible developmental pathways depending on environmental conditions. Epigenesis may be contrasted with a 'homuncular' (from 'homunculus' or 'little man') model of development in which all the stages of development are already pre-formed. Bowlby applied this distinction to psychological development, and contrasted his own approach in which there are many possible pathways which an individual may take through infancy depending on their interaction with their care-givers, with the classical Freudian approach which sees development in terms of a number of fixed 'stages' through which a person must pass, irrespective of environmental influence. He felt that his approach was more consistent with modern biological thinking, and allowed for a more subtle view of the complexity of interaction between an individual and their environment. Thus 'anxious' attachment, rather than being a 'stage', like the so-called 'oral stage' of development, becomes a possible epigenetic compromise between a child's attachment needs and a parent who is unable fully to meet them. Like Klein's 'positions', but unlike Freud's 'stages', Bowlby's attachment patterns persist throughout life, unless modified by good experiences (which would include successful therapy).
ETHOLOGY Literally, the study of an individual's 'ethos' or character. Ethology is a biological science which studies animal behaviour in a particular way: the animal is considered as a whole; behaviour is usually studied in natural or wild conditions; there is great attention to the antecedents and consequences of behaviour patterns; the function of any behaviour is considered; and an evolutionary perspective is always taken. An attempt is made to see how the animal views the world from its own perspective and to visualise the internal 'maps' and rules which govern its activities. Ethology is contrasted with behaviourism, which usually concentrates on particular bits of behaviour and does not consider the organism as a whole and is unconcerned with evolutionary considerations. Bowlby saw the methods and theories of ethology as highly relevant to the study of human infants, and this led to a fruitful collaboration between him and the leading ethologist Robert Hinde (see Hinde 1982a and b; 1987).
Glossary 221
EXPRESSED EMOTION (EE) A rating scale initially developed for the relatives of patients suffering from schizophrenia (Left and Vaughn 1983), but applicable to other disorders including affective illness and Alzheimer's disease, measuring such dimensions as 'hostility', 'warmth' and 'overinvolvement'. Patients whose relatives score high on negative 'expressed emotions' are more likely to relapse from their illness. A link is suggested between anxious attachment and high expressed emotion (see Chapter 9).
INTERNAL WORKING MODELS On the basis of cognitive psychology (see Craik 1943; Beck et al.
1979), Bowlby sees higher animals as needing a map or model of the world in the brain, if they are successfully to predict, control and manipulate their environment. In Bowlby's version humans have two such models, an 'environmental' model, telling us about the world, and an 'organismal' model, telling us about ourselves in relation to the world. We carry a map of self, and others, and the relationship between the two. Although primarily 'cognitive' in conception, the idea of internal working models is applicable to affective life. The map is built up from experiences and is influenced by the need to defend against painful feelings. Thus an anxiously attached child may have a model of others in which they are potentially dangerous, and therefore must be approached with caution, while their self-representation may be of someone who is demanding and needy and unworthy to be offered security. The relationship with a person's primary care-givers is generalised in internal working models, which leads to a distorted and incoherent picture of the world, and one that is not subject to updating and revision in the light of later experience. This, in Bowlby's eyes, is the basis for transference, and the task of therapy is help the patient develop more realistic and less rigid internal working models.
MATERNAL DEPRIVATION A catch-phrase summarising Bowlby's early work on the effects of separating infants and young children from their mothers. He believed that maternally deprived children were likely to develop asocial or antisocial tendencies, and that juvenile delinquency was mainly a consequence of such separations. The corollary of this was his advocacy of continuous mother-child contact for at least the first five years of life, which
222 John Bowlby and Attachment Theory
earned him the opprobrium of feminists. Subsequent research has confirmed that lack of maternal care does lead to poor social adjustment and relationship difficulties, but suggests that disruption, conflict and poor maternal handling are more common causes of difficulties in late life than the loss of mother in itself.
METACOGNITIVE MONITORING Concept introduced by Main (1990) and Fonagy (1991) to denote the ability to 'think about thinking'. Securely attached children and adults are able to reflect freely on their thought processes (e. g. , 'I was really upset when my mum and dad split up and felt pretty hostile to all the children at school who seemed to have happy homes'), in contrast to insecure individuals, who tend either to dismiss their thought processes (e. g. , 'Oh, the split-up didn't affect me at all, I just concentrated on my football'), or to be bogged down in them ('I can't really talk about it . . . it makes me too upset'). Defects in metacognitive ability are common in pathological states, such as borderline personality disorder, and one of the aims of psychotherapy is to facilitate metacognition.
MONOTROPY An ethological (q. v. ) term introduced by Bowlby to denote the exclusive attachment of a child to its principal care- giver, usually the mother. He was impressed by Lorenz's (1952) studies of geese and their young which suggested that the goslings became imprinted onto a moving object at a sensitive period in the first day or two of life. Bowlby thought that a similar process occurred in humans. In fact, imprinting seems not to be a feature of primate development, where attachments develop gradually and over a wide range from the early months to adolescence. Also, attachment in humans is not so much monotropic as hierarchical, with a list of preferred care-givers, with parents at the top, but closely followed by grandparents, siblings, aunts and so on.
OBJECT-RELATIONS THEORY (ORT) Attachment Theory is a close relation of, and provides experimental evidence in support of, Object-Relations Theory (Greenberg and Mitchell 1983). This psychoanalytic school is particularly associated with a group of British theorists who include Klein (1986), Fairbairn (1952), Balint (1968) and Winnicott (1965), as well as Bion (1978). In contrast to Freud's early view of the organism as primarily driven by instinct and the need to discharge accumulated psychic energy ('libido'), Object-Relations Theorists see people as primarily seeking a
Glossary 223
relationship to their 'objects'. There is thus a progression in psychoanalytic thinking, starting with Freud's drive discharge theory, through Object Relations, in which a whole individual is seeking a relationship with an 'object' (i. e. , not quite a person), to the reciprocity of care-giver and care-seeker implicit in Attachment Theory and recent developmental psychology.
PARENTAL BONDING INSTRUMENT (PBI) A questionnaire test, devised by Parker (1983) to try to elicit in a systematic way an individual's perception of their parental relationships in childhood. It gives two main dimensions: 'care' and 'protection'. 'Care' ranges from warmth and empathy at one extreme to coldness and indifference at the other. 'Protection' similarly ranges from over-protection and infantilisation to promotion of autonomy. People with borderline personality disorder and depressive disorders regularly report the constellation of low care and high intrusiveness ('affectionless control'). There is some evidence that such reports of parental behaviour are an accurate reflection of their actual behaviour (Parker et al. 1992).
PERCEPTUAL DEFENCE This, and the related concept of unconscious perception (Dixon and Henley 1991), refer to the apparently paradoxical phenomenon by which an individual can be shown to respond in behaviour to a stimulus without it reaching conscious awareness. Thus, for example, a subject presented with a neutral face and asked to judge whether it is 'happy' or 'sad', will be influenced by the simultaneous presentation of a subliminal word with positive or negative connotations. This provides experimental confirmation of the existence of unconscious thinking. Bowlby (1981c) uses this idea in his discussion of ungrieved loss to suggest that painful feelings are kept out of awareness but may nevertheless influence a person's state of mind and behaviour. By bringing these feelings into awareness - that is, by reducing the extent of perceptual defence - they are then available for processing (cf. 'working through'), leading to a more coherent and better adapted relationship to the world and the self.
SECURE BASE A term introduced by Ainsworth (1982) to describe the feeling of safety provided by an attachment figure. Children will seek out their secure base at times of threat - danger, illness, exhaustion or following a separation. When the danger
224 John Bowlby and Attachment Theory
has passed, attachment behaviour will cease, but only if it is there to be mobilised if needed will the child feel secure. The secure base phenomenon applies equally to adults. We all feel 'at home' with those whom we know and trust, and within such a home environment are able to relax, and pursue our projects, whether they be play, pleasure-seeking or work.
STRANGE SITUATION An experimental method devised by Ainsworth (Ainsworth et al. 1978) to study the ways in which one-year-old children can cope with brief separations from their care-givers. The child is left first with the experimenter and then alone while the mother goes out of the room for 3 minutes. The child's response to the separation, and more importantly to the re-union, is observed and rated from videotapes. On the basis of this rating children can be classified as secure (usually characterised by brief protest followed by return to relaxed play and interaction) or insecure, the latter being subdivided into avoidant (q. v. ) and ambivalent (q. v. ) patterns of insecurity. See Chapter 6, page 104, for a more detailed description.
SYSTEMIC Adjective derived from Systems Theory, a conceptual model used by family therapists (originating with information theory), in which the family as a whole is seen as a quasi-organism, or 'system', with its own rules and ways of behaving. Certain general principles apply to systems whatever their nature, whether they are cells of the body, whole organisms, families or social groups. These include the property of having a boundary, of the need for information flow between different parts of the system, of a hierarchy of decision-making elements, and of 'homeostasis', the tendency towards inertia. Attachment Theory is systemic in that it sees care-seeker and care-giver as a mutually interacting system regulated by positive and negative feedback. Pathological states can result from the operation of such feedback - for example, when a child clings ever more tightly to an abusing parent, because the source of the attack is also the object to which the child is programmed to turn in case of danger.
Chronology
1907 Born, Edward John Mostyn Bowlby, fourth child and second son of Sir Anthony and Lady May Bowlby. Lived at Manchester Square, London.
1914-25 Preparatory school and then Royal Naval College, Dartmouth.
1925-28 Trinity College, Cambridge.
1928-29 Teacher in progressive school for maladjusted children.
1929 Started clinical medical studies at University College Hospital, London, and psychoanalytic training at the Institute of Psycho-Analysis, London. Training analyst, Mrs Joan Riviere.
1933 Medical qualification. Psychiatric training at Maudsley Hospital, London, under Aubrey Lewis.
1937 Qualified as an analyst. Starts training in child analysis, supervisor, Melanie Klein.
1938 Married Ursula Longstaff, by whom two sons and two daughters.
1940 Publication: Personality and Mental Illness (with F. Durbin).
1937-40 Psychiatrist, London Child Guidance Clinic.
1940-45 Specialist Psychiatrist, Royal Army Medical Corps, mainly concerned with Officer Selection Boards.
1946 Publication, 'Forty-four juvenile thieves: their characters and home life'.
1946-72 Consultant Child Psychiatrist and Deputy Director, Tavistock Clinic, London, and Director, Department for Children and Parents.
226 John Bowlby and Attachment Theory
1950-72 Consultant in Mental Health, World Health Organisation.
1951 Publication of Maternal Care and Mental Health. 1957-58 Fellow, Centre for Advanced Study in the Behavioural
Sciences, Stanford, California.
1956-61 Deputy President, British Psycho-Analytical Society.
1958-63 Consultant, US National Institute of Mental Health.
1969 Publication of Attachment, first volume of the Attachment and Loss trilogy.
---- Visiting Professor in Psychiatry, Stanford University, California.
1963-72 Member, External Scientific Staff, Medical Research Council.
1972 Commander of the British Empire.
1973 Publication of Separation, second volume of the Attachment
and Loss trilogy.
1973 Travelling Professor, Australian and New Zealand College
of Psychiatrists.
1977 Honorary Doctor of Science, University of Cambridge.
1979 Publication of The Making and Breaking of Affectional Bonds.
1980 Publication of Loss, third volume of the Attachment and Loss trilogy.
1981 Freud Memorial Professor of Psychoanalysis, University College, London.
---- Foreign Honorary Member, American Academy of Arts and Sciences.
1987 Celebration of Bowlby's 80th birthday with a conference at the Tavistock Clinic, bringing together researchers and clinicians, entitled 'The Effect of Relationships on Relationships'.
1988 Publication of A Secure Base.
Chronology 227
1989 Fellow of the British Academy.
1990 Publication of Charles Darwin, A New Biography.
---- Dies while in Skye, at his holiday home where much of his writing had been done.
Bibliography
PUBLICATIONS OF JOHN BOWLBY
Personal Aggressiveness and War, (1938) (with E. P. M. Durbin) London: Kegan Paul.
'The abnormally aggressive child', (1938) The New Era (Sept. -Oct. ). 'Hysteria in children', (1939a) in A Survey of Child Psychiatry, pp. 80-94,
Humphrey Milford (ed. ), London: Oxford University Press.
'Substitute homes', (1939) Mother and Child (official organ of the National
Council for Maternity and Child Welfare) X (1) (April): 3-7.
'Jealous and spiteful children', (1939) Home and School (Home and School
Council of Great Britain), IV(5): 83-5.
Bowlby, J. , Miller, E. and Winnicott, D. W. (1939) 'Evacuation of small children'
(letter), British Medical Journal (16 Dec. ): 1202-3.
'The influence of early environment in the development of neurosis and neurotic
character', (1940) International Journal of Psycho-Analysis, 21: 154-78. 'Psychological aspects', (1940) ch. 16, pp. 186-96, in Evacuation Survey: A Report to the Fabian Society, Richard Padley and Margaret Cole (eds),
London: George Routledge & Sons Ltd.
'The problem of the young child', (1940c) Children in War-time, 21 (3): 19-30,
London: New Education Fellowships.
'Forty-four juvenile thieves: their characters and home life', (1944) International
Journal of Psychoanalysis, 25: 1-57 and 207-228; republished as a
monograph by Baillie`re, Tindall & Cox, London, 1946.
'Childhood origins of recidivism', (1945-46) The Howard Journal, VII (1): 30-
3, The Howard League for Penal Reform.
'The future role of the child guidance clinic in education and other services',
(1946a) Report of the Proceedings of a Conference on Mental Health,
(14-15 Nov. ), pp. 80-89, National Association for Mental Health. 'Psychology and democracy', (1946b) The Political Quarterly, XVII (1):
61-76.
'The therapeutic approach in sociology', (1947a) The Sociological
Review, 39: 39-49.
'The study of human relations in the child guidance clinic', (1947b)
Journal of Social Issues, III (2) (Spring): 35-41.
'The study and reduction of group tensions in the family, (1949a) Human
Relations, 2 (2) (April): 123-8.
'The relation between the therapeutic approach and the legal approach
Bibliography 229
to juvenile delinquency', (1949b) The Magistrate, VIII (Nov. ):
260-4.
Why Delinquency? The Case for Operational Research, (1949c) Report
of a conference on the scientific study of juvenile delinquency held at the Royal Institution, London 1 Oct. , and published by the National Association for Mental Health.
'Research into the origins of delinquent behaviour', (1950) British Medical Journal 1 March 11: 570).
Maternal Care and Mental Health, (1951) World Health Organisation, Monograph Series No. 2.
'Responses of young children to separation from their mothers', (with J. Robertson) (1952a) Courier, Centre International de l'Enfance, II (2): 66-78, and II (3): 131-42, Paris.
A two-year-old goes to hospital: a scientific film, (with J. Robertson) (1952b) Proceedings of the Royal Society of Medicine, 46: 425-7. 'A two-year-old goes to hospital', Bowlby, J. , Robertson, J. and
Rosenbluth, D. (1952) The Psychoanalytic Study of the Child, VII:
82-94.
'A two-year-old goes to hospital: a scientific film', (with J. Robertson)
(1952b) Proceedings of the Royal Society of Medicine, 46: 425-7. 'The roots of parenthood', (1953) Convocation Lecture of the National
Children's Home (July).
Child Care and the Growth of Maternal Love, (1953b) (abridged version
of Maternal Care and Mental Health, 1951), London: Penguin Books;
new and enlarged edition, 1965.
'Critical phases in the development of social responses in man and other
animals', (1953c) New Biology, London: Penguin Books, pp. 25-
32.
'Some pathological processes set in train by early mother-child
separation', (1953d) Journal of Mental Science, 99: 265-72. 'Research strategy in the study of mother-child separation', (with M. G. Ainsworth) (1954) Courier, Centre International de l'Enfance, IV:
105-13.
'Family approach to child guidance: therapeutic techniques', (1955)
Transactions of the 11th Interclinic Conference for the Staffs of Child Guidance Clinics, National Association for Mental Health (26 March).
'The growth of independence in the young child', (1956) Royal Society of Health Journal, 76: 587-91.
'Psychoanalytic instinct theory', (1956) in Discussions on Child Development, vol. 1 , J. M. Tanner and B. Inhelder (eds), pp. 182- 87, London: Tavistock Publications.
'The effects of mother-child separation: a follow-up study', (with M. Ainsworth, M. Boston and D. Rosenbluth) (1956) British Journal of Medical Psychology, XXIX, parts 3 and 4 : 211-47.
'An ethological approach to research in child development', (1957) British Journal of Medical Psychology, XXX, part 4 : 230-40.
Can I Leave my Baby? , (1958a) The National Association for Mental Health.
230 John Bowlby and Attachment Theory
'A note on mother-child separation as a mental health hazard', (1958b) British Journal of Medical Psychology, XXXI, parts 3 and 4 :247-8. Foreword to Widows and their Families by Peter Marris, (1958c) London:
Routledge & Kegan Paul.
'The nature of the child's tie to his mother', (1958d) International Journal
of Psycho-Analysis, 39, part V : 350-73.
'Psychoanalysis and child care', (1958e) in Psychoanalysis and
Contemporary Thought, J. Sutherland (ed. ), London: Hogarth Press. 'Ethology and the development of object relations', (1960a) International
Journal of Psycho-Analysis, 41, parts IV - V : 313-17. 'Separation anxiety', (1960b) International Journal of Psycho-Analysis,
41, parts II - III : 89-113.
Comment on Piaget's paper: 'The general problems of the psychobiological
development on the child', (1960c) in Discussions on Child Development, vol. 4 , J. M. Tanner and B. Inhelder (eds), London: Tavistock Publications.
'Grief and mourning in infancy and early childhood', (1960d) The Psychoanalytic Study of the Child, XV: 9-52.
'Separation anxiety: a critical review of the literature', (1961a) Journal of Child Psychology and Psychiatry, 1 (16): 251-69.
Note on Dr Max Schur's comments on grief and mourning in infancy and early childhood, (1961b) The Psychoanalytic Study of the Child, XVI: 206-8.
'Childhood mourning and its implications for psychiatry', The Adolf Meyer Lecture, (1961c) American Journal of Psychiatry, 118 (6): 481-97.
'Processes of mourning', (1961d) International Journal of Psycho- Analysis, 42, parts IV - V : 317-40.
'Defences that follow loss: causation and function', (1962a) unpublished. 'Loss, detachment and defence', (1962b) unpublished.
'Pathological mourning and childhood mourning', (1963) Journal of the
American Psychoanalytic Association, XI (3) (July): 500-41.
