No More Learning

In Chapters 18 and 19, in which misattributions are discussed further, reasons are given for believing that many intense fears attributed to all sorts of common situations and termed phobias are best understood as being aroused in compound situations, a main component of which is the expectation of being separated from a principal attachment figure. The famous and theoretically influential case of 'Little Hans', who was afraid of being bitten by a horse, appears to be a good example ( Freud 1909, SE 10). Evidence is presented (Chapter 18) for believing that fear of separation played a much larger part in this case than Freud at the time realized.
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Misattribution and the role of projection
In some psychoanalytic traditions the concept of projection has been used very extensively in an attempt to explain any fear that is not readily intelligible as a response to a real danger. Since the term is itself used in several ways the resulting theory is often confused.
One usage of projection is to denote our propensity to perceive an object in terms of some preconceived notion, in other words to 'project onto' the object characteristics we suppose it to have, even though they are not apparent to the sense organs and may in fact be absent. In so far as this process is integral to all perception, it is normal. Although as a rule the resulting percept is reasonably valid, on some occasions seriously false percepts result.
A second usage is to denote the process whereby a person (male of female) attributes to another (male or female) some features of his own self, especially some aspect of himself that he dislikes or is afraid of. This process must, almost inevitably, lead to false and unfavourable attributions being made about the other person and his motives.
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There are two reasons for confining the term projection to the second usage. One reason is that another term, 'assimilation', introduced many years ago by Piaget, is already in wide currency to denote our propensity to perceive any object in terms of some model we already have, even though that model may fit the object imperfectly: the new object of perception is said to be assimilated to the existing model. The second reason is that in the various psychoanalytic traditions the most frequent usage of the term projection is to denote our propensity to attribute our failings to others and to be blind to them in ourselves, to see motes in the eyes of others and to be blind to beams in our own.
Using the term in its second sense, we find that the process of projection is invoked extremely frequently by psychoanalysts to explain how it comes about that children and adults should be so afraid, as we know they are, of the wide array of situations that are not intrinsically dangerous. This trend in theorizing has been carried furthest by Melanie Klein who has postulated that the process of attributing to others undesired and frightening features of the self occurs on a major scale during the earliest phases of normal development, with far- reaching effects on later personality. During his first year of life, in the Kleinian
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view, an infant regularly attributes to parent figures impulses that are in fact his own and then introjects (namely creates working models of) parent figures already distorted by these misattributions. In this view, then, the reason a child develops working models of hostile, rejecting, or unresponsive parents ('bad introjected objects') is not so much because of any actual experience he may have had of being unsympathetically or adversely treated by them as principally because, almost from the first, his perception of his parents is gravely distorted by his own prior projections. Since the death instinct is a special aspect of the self that Klein believes is always projected during the earliest months, she is led to a theory of anxiety she sums up in the following sentence: 'I hold that anxiety arises from the operation of the death instinct within the organism, is felt as fear of annihilation (death) and takes the form of fear of persecution' ( Klein 1946). It will be clear that this blanket application of the concept of projection is alien to the present approach. Not only is the Kleinian system of thought rooted in a non-evolutionary paradigm that bears no relation to modern biology, but in clinical work it has the effect, inimical to good practice, of directing attention away from a person's real experiences, past or present, and treating him almost as though he were a closed system little influenced by his environment. Another unfortunate effect of applying the concept of projection in this uncritical way is the danger of bringing a useful concept into disrepute. Let us therefore consider the problem afresh. Not infrequently a person is afraid that someone else intends him harm, but to another's eye this expectation seems misplaced. In such circumstances, as we have seen, psychoanalysts are very apt to postulate that the person who is afraid is projecting onto the other hostile intentions that are in himself but that he denies exist. Though there can be no doubt that this can happen it probably happens much less often than is supposed. In fact a situation of the kind described is explicable in at least four ways; and it is necessary to examine the evidence in each case before deciding which explanation, of which two or more together, is most likely to apply:
1. The subject has rightly detected harmful intent in the other person and in so doing has been more sensitive to the situation than the onlooker.
2. The subject during childhood has learnt that significant
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people are often hostile when they claim to be friendly, and is therefore apt, through a process of assimilation, to suppose that figures met with in later life are hostile also when they are not. 3. The subject, aware that he is no friend of the other person and even that he is disposed to do him harm, not unnaturally expects his ill intent to be reciprocated.
4. The subject, unaware of his own ill intent, maintains that, whereas he is friendly to the other, the other is hostile to him.
Of these four possible explanations only the process postulated in the fourth can properly be called projection when the term is used in the restricted sense of attributing to others unwelcome features of the self. That the process can be a source of misattributions is not in doubt. How large a proportion of misattributions have this sort of origin is a matter for inquiry.
The case of Schreber: a re-examination
The urgent need for fresh thinking in this area of psychopathology is shown by the findings of a re-examination by Niederland ( 1959a and b) of the case from which all psychoanalytic theorizing about paranoia and paranoid symptoms derives. Freud's original study of the Schreber case, based solely on the patient's published memoirs, appeared in 1911 ( SE 12: 9- 82). Although he later published other papers on paranoia, according to Strachey ( 1958) Freud never modified his earlier views in any material way.
Daniel Paul Schreber was born in 1842, the second son of an eminent physician and pedagogue. By 1884 he was serving as a judge. He then developed a psychiatric illness from which he recovered after some months. He resumed his legal post but after eight years fell ill again. This time he remained in an asylum for nine years ( 1893-1902) towards the end of which he wrote his memoirs. In 1903, shortly after his discharge, they were published, and soon became a subject of psychiatric interest. A principal theme concerns a number of bodily experiences that were extremely painful and humiliating to him. These experiences he construed as 'miracles' performed by God by means of 'rays':
From the first beginnings of my contact with God up to the present day my body has continuously been the object of divine miracles. . . . Hardly a single limb or organ in my body escaped being temporarily damaged by miracles, nor a
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single muscle being pulled by miracles, Even now the miracles which I experience hourly are still of a nature to frighten every other human being to death. 1
Freud's analysis of Schreber's delusions of persecution takes account of no material except that of the memoirs. Freud notes that Schreber's feelings towards God are intensely ambivalent, being on the one hand critical and rebellious and on the other reverential towards someone of whom he stands in awe. Freud calls attention also to the frankly homosexual attitude Schreber sometimes adopts towards God, including Schreber's belief that he had a duty to play the part of a woman for God's enjoyment. From material of this kind Freud postulates that delusions of persecution are attempts to contradict the proposition 'I (a man) love him (a man)', and to replace it by 'I do not love him -- I hate him', and, finally, by 'I hate him, because he persecutes me'.
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An internal perception is suppressed, and, instead, its content, after undergoing a certain kind of distortion, enters consciousness in the form of an external perception. In delusions of persecution the distortion consists in a transformation of affect; what should have been felt internally as love is perceived externally as hate.
To this process Freud gives the name projection SE 12: 63-6).
In his re-examination of the case Niederland ( "1959"a and b) draws attention to the fact that Schreber's father held extraordinary views about the physical and moral education of children and published a number of books describing his methods. In them he asserts the vital importance of starting the prescribed re? gimes during infancy and states repeatedly that he has applied his methods to his own children. It is safe, therefore to conclude that Schreber the son had been subjected to his father's educational methods from his earliest years.
The physical methods, recommended for application daily throughout childhood and adolescence, include a number of exercises and harnesses whereby posture is to be controlled. An
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1 In addition to Freud's paper and Strachey's editor's note in the Standard Edition, an English
translation of the memoirs is now available and also a paper by Baumeyer ( 1956) in which he summarizes and quotes from the original case records of Schreber's illnesses. Niederland's bibliography gives references to the above and to the published works of Schreber's father.
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example of a harness, designed to prevent a child's head from falling forwards or sideways, consisted of a strap clamped at one end to the child's hair and at the other to his underwear so that it pulled his hair if he did not hold his head straight. Because the device was apt to produce a stiffening effect it was recommended that its use be restricted to one or two hours a day. An example of an exercise is to place two chairs facing each other with a gap between of a few feet. A child is instructed to put his head on the seat of one chair and his feet on that of the other and to stiffen his back to make a bridge, in which position he must remain. The dire results that Schreber senior ascribed to bad posture included impeded circulation and, later, paralysis of arm and foot. Of one of his devices, an iron crossbar designed to ensure that a child sits straight, he comments that, besides its physical benefits, it provides an effective moral corrective.
Schreber senior held the sternest of views regarding moral discipline. Bad elements of the mind he regarded as 'weeds' to be 'exterminated', and he describes the threats and punishments by which, starting at five or six months, a parent should make certain that he becomes 'master of the child for ever'. The strong impression given that Schreber senior was a psychotic character is supported by a note made by a hospital psychiatrist and based, it is thought, on information from a member or close acquaintance of the family. It states that the patient's father 'suffered from obsessional ideas with murderous impulses'.
Niederland compares the son's descriptions of the fearful 'miracles' he had to suffer at God's hands with the father's prescriptions of how children should be treated for their physical and moral welfare. Point by point the resemblances are traced. The son complains of miracles of
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heat and cold. The father prescribes that, in order to toughen an infant, he should be washed in cold water from the age of three months and also subjected to various local cold applications. The son complains that his eyes and eyelids are the target of uninterrupted miracles. The father prescribes repeated visual exercises and advises spraying the eyes with cold water should there be irritation and fatigue following over-stimulation. The son describes a miracle in which his whole chest wall is compressed. Father prescribes a harness consisting of an iron bar that presses against the collar bones should a child not sit straight and upright.
In view of these remarkable resemblances, Niederland's hypothesis, in keeping with the second of the four possible explanations listed above (pp. 173 -4), is that Schreber's delusory
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beliefs regarding the way God was treating him were derived from memories of how his father actually treated him when he was a child. The delusory character of the beliefs is then regarded as due to (a) the patient's attributing the origin of his sufferings to the activities of God in the present instead of to his father in the past, and (b) his attributing the mechanism of his sufferings to 'rays' and miracles instead of to actual manipulations of himself by parent figures. As Niederland ( 1959a) himself remarks, the hypothesis is in keeping with ideas that Freud was entertaining towards the end of his life (but which still have been little exploited). In hallucinations, Freud ( 1937) suggests, 'something that has been experienced in infancy and then forgotten returns. . . . ' .
If this approach to understanding paranoid delusions is adopted, many problems remain still to be solved. How comes it that the patient has no recollection of how his parents treated him as a child? Why is it that, instead, childhood experiences are misplaced in time and the agent responsible for them is misidentified? Possible answers to these questions invoke hypotheses regarding the kinds of injunction, explicit or implicit, a parent may issue to a child; for example, an injunction on a child to construe whatever happens to him as beneficial, an injunction to see his parent as above criticism, an injunction neither to perceive nor to remember certain acts that he none the less witnesses or experiences. These hypotheses, with much evidence to show that they apply to the case of Schreber, are advanced in a recent paper by Schatzman ( 1971). Yet a further hypothesis, not discussed by Schatzman, is that children wish to see their parents in a favourable light and often distort their perceptions accordingly.
In Chapter 20 these matters are pursued further. Meanwhile, enough has been said to show that, when the actual experiences they have had during childhood are known and can be taken into account, the pathological fears of adult patients can often be seen in a radically new light. Paranoid symptoms that had been regarded as autogenous and imaginary are seen to be intelligible, albeit distorted, responses to historical events.
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Chapter 12
Fear of Separation
Hypotheses regarding its development
It is now time to draw together ideas regarding fear of separation and how it develops. At the end of Chapter I it is pointed out that 'presence' and 'absence' are relative terms that can give rise to misunderstanding. By presence is meant 'ready accessibility', by absence 'inaccessibility'. The words 'separation' and 'loss' as used in this work imply always that the subject's attachment figure is inaccessible, either temporarily (separation) or permanently (loss). Thus in what follows we are concerned with the developmental processes that lead a young child to respond with fear when he finds, or believes, his attachment figure to be inaccessible. Among the many questions raised and not yet answered are the following:
1. Is inaccessibility of mother in itself a situation that arouses fear in human children without its being necessary for any learning to have taken place?
2. Or is such fear elicited in an individual only after he has come to associate her inaccessibility with a distressing or frightening experience?
3. If the latter, what is the nature of such distressing or frightening experience, and by what type of learning does it become linked with separation?
Whatever the answers to these questions may be, because being alone carries an increased risk of danger, especially for young individuals and others who are weak, the fear response to inaccessibility of mother can usefully be regarded as a basic adaptive response, namely a response that during the course of evolution has become an intrinsic part of man's behavioural repertoire because of its contribution to species survival.
If that is so, there is no a priori reason to assume that fear elicited by mother's inaccessibility can be explained only in terms of an individual's having experienced something dis-
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tressing or frightening while separated from her, an assumption that has commonly been made. On the contrary, it is entirely possible that the response to mother's inaccessibility develops during ontogeny without learning of any sort having to take place. Let us call this hypothesis A.
Whether or not hypothesis A applies in the human case remains an open question. For, as was emphasized repeatedly in the first volume, there are many forms of behaviour that, like this one, can usefully be classed as instinctive but that develop functionally only when the environment provides opportunity for learning of some specific kind to occur. In other words, to hold the hypothesis that fear behaviour in a situation of maternal inaccessibility is instinctive in no way rules out the possibility that learning of some kind is necessary for its development. All that such a view requires is that, when an individual is reared in the species's environment of evolutionary adaptedness, opportunity for the necessary learning is always present.
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Reflection suggests that there are at least three hypotheses that are consistent with that proviso and merit attention. Let us call them hypotheses B1, B2, and B3.
The first, B1, is Freud's hypothesis of 1926 which postulates that fear of mother's absence results from an infant's learning that, when she is absent, his physiological needs go unmet, and learning, further, that this results in the accumulation within him of dangerous 'amounts of stimulation' which, unless 'disposed of', bring about a 'traumatic situation'. Since, moreover, the infant finds that, left to himself, he is unable to dispose of such accumulations, the danger situation that he comes intrinsically to fear is 'a recognized, remembered, expected situation of helplessness'. 1
Reasons for not adopting Freud's hypothesis will already be apparent. One is that it is embedded in a paradigm very different from the one adopted here (see Chapter 5). Another is that it seems to postulate a degree of insight into cause and effect that not only is improbable in an infant of a year or so of age but that we now know to be unnecessary to account for the findings. For the fact that so many of the responses shown by a human infant when separated from his mother are to be seen also in infants of non-human primate species demonstrates that
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1 Quotations are from Inhibitions, Symptoms and Anxiety ( SE 20: 137-8 and 166). Freud's
theory is described more fully in Appendix I. -179-
it is quite possible for such responses to be mediated at a primitive and presumably infra- symbolic level.
Objections of a similar sort apply to the theories advanced by Klein, which presuppose even more sophisticated cognitive functioning (see Appendix I).
A second hypothesis, B2, not very different from Freud's but simpler and implying no insight learning, is compatible with the theory of attachment behaviour proposed in the first volume. In Chapter 14 of that volume an account is given of the conditions that terminate crying during the early months of life:
. . . when a baby is not hungry, cold, or in pain, the most effective terminators of crying are, in ascending order, sound of voice, non-nutritive sucking, and rocking. These findings readily explain why babies are said to cry from loneliness and to have a desire to be picked up. Although to attribute such sentiments to babies in the early months of life is almost certainly not warranted, the statements none the less contain more than a grain of truth. When they are not rocked and not spoken to infants are apt to cry; when they are rocked and spoken to they cease crying and are content. And by far the most probable agent to rock and talk to a baby is his mother figure.
In view of this, it could be argued, an infant comes to learn that presence of mother is associated with comfort while absence of mother is associated with distress. Thus, through a fairly simple process of associative learning, an infant comes to associate mother's absence with distress, and so to fear her being inaccessible. This hypothesis is close to one advanced by Kessen & Mandler ( 1961).
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A third hypothesis, B3, derives from the fact that an infant is much more intensely afraid of fear-arousing situations, such as strangeness, or sudden approach, or loud noise, when his mother is absent than when she is present. After a few such experiences, it could be postulated, mother's absence might of itself come to elicit fear, again through a process of associative learning. This hypothesis is similar to one suggested by Rycroft ( 1968a) and referred to in Chapter 6 above.
On present evidence it is not possible to decide between hypotheses A, B2, and B3; each is plausible.
Hypothesis A, that an anxiety response to mother's inaccessibility develops during ontogeny without learning of any
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sort having to take place, is difficult to test. Furthermore, even if it were true, it would not make hypotheses B2 and B3 irrelevant, since learning of the kinds proposed by these two hypotheses could still occur and might be of much significance in accounting for degrees of separation anxiety above a minimum.
Whether hypothesis A is valid or not appears, at present, to be of no great clinical importance. This is because, were the forms of learning postulated by hypotheses B2 and B3 to occur at all, which they probably do, they would be taking place during the latter half of the first and during the second year of life and, except where a child had no mother figure, would be virtually unavoidable. As a situation that arouses fear, therefore, separation from an attachment figure would still be nearly universal, almost as much as it would were hypothesis A to apply.
Support for the view that associative learning of the kinds postulated by hypotheses B2 and B3 does take place comes from studies of individual differences in susceptibility to respond with fear, especially to separation. These show, as is discussed in detail in later chapters, that children who have been well mothered, and therefore, in all likelihood, have been protected from the experience both of intense distress and of intense fear, are those least susceptible to respond with fear to situations of all kinds, including separation; whereas children who have had intensely distressing and frightening experiences when away from mother are apt to show an increased susceptibility to fear, especially to fear of being separated again.
Should, as therefore seems likely, both these forms of associative learning occur during infancy and early childhood, their effects on personality development might possibly be rather different. For example, were a child, because of his particular experiences, to come to associate mother's absence with high degrees of discomfort and distress, he might perhaps grow up to respond to separation and loss, either actual or forecast, with psychosomatic troubles and general tension; whereas a child who, because of his particular experiences, came to associate mother's absence with being more or less intensely afraid might grow up prone to respond to any fear-arousing situation with more marked fear than would other individuals. Whether or not differences of these kinds occur in fact can be determined only by further research.
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Need for two terminologies
Throughout recent chapters a sharp distinction has been drawn between situations that arouse fear and situations that are intrinsically dangerous. Whereas situations that arouse fear can be regarded as constituting either natural or cultural clues to an increased risk of danger, they are certainly not infallible indicators of actual danger. How we feel in a situation bears therefore only an indirect relationship to the degree of risk present in that situation. Because the world as reflected in feeling is distinct from, though correlated with, the world as it is, two terminologies are necessary. At the end of Chapter 6 three terms, 'anxious', 'alarmed', and 'afraid' are introduced and the way in which they are used here is described. All three belong to the world as reflected in feeling. By contrast, 'dangerous' belongs to the world as it is. At this point it is necessary to settle on some analogously distinct terms suitable to refer, on the one hand, to a state of feeling antithetical to feeling afraid and, on the other, to a situation antithetical to one of danger. Etymology suggests 'feeling secure' for the one and a 'situation of safety' for the other. The original meaning of the English adjective 'secure' is 'free from care, apprehension, anxiety or alarm' ( Oxford English Dictionary). Historically, therefore, 'secure' applies to the world as reflected in feeling and not to the world as it is. By contrast, the original meaning of 'safe' is 'free from hurt or damage'. As such it applies to the world as it is and not to the world as reflected in feeling. The distinction is neatly illustrated by a seventeenth-century saying, quoted in the OED, 'The way to be safe is never to bee [sic] secure', namely feel secure. By using the terms in their original senses, it is possible accurately and without ambiguity to make statements such as:
--although the situation was safe enough he became very frightened, or
--I could see the situation was dangerous but somehow the captain's behaviour made us all feel secure.
The distinction drawn here between feeling secure and being safe is not always made so that a number of terms current in the literature do not conform to the usage proposed. This applies both to Harlow's 'haven of safety', termed here 'secure base',
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and to Sandler's 'feeling of safety' ( Sandler 1960), termed here 'feeling of security'.
Use of the word 'secure' in the sense proposed has, of course, for long been customary in clinical practice. For example, with reference to states of feeling, children and grown-ups are habitually described as being either secure or insecure. Moreover, because any person who is acting as an attachment figure for another is commonly referred to as providing that other with a sense of security, it is often convenient to describe an attachment figure also as a security figure or as providing a secure base. At the same time, it must be emphasized that a secure base, however much it may lead someone to feel secure, is no guarantee of safety, any more than a natural clue, however frightening we find it, is a certain indicator of danger. As a guide to what is safe and what is dangerous the kind of feeling a situation arouses in us is never more than rough and ready.
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Part III
INDIVIDUAL DIFFERENCES IN SUSCEPTIBILITY TO FEAR: ANXIOUS ATTACHMENT
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Chapter 13
Some Variables responsible for Individual Differences Constitutional variables
That individuals differ enormously in their susceptibility to respond to situations with fear is a commonplace. Why they should differ in such extreme ways remains a puzzle. In this chapter and those following an attempt is made to identify some of the many variables that are operating. The main focus, of course, is on the part played by a person's relationship to his attachment figure(s). This is held to be pervasive and still too little understood. Let us consider first some of the other variables. It must be assumed that genetic differences play some part in accounting for variance between individuals with regard to susceptibility to fear. Very little is yet known about their role in humans, but it is well documented in the case of other mammals, e. g. dogs ( Scott & Fuller 1965; Murphree, Dykman & Peters 1967). A difference in susceptibility in humans that is likely to be in part genetically determined is one between men and women.
Sex Differences
Feminist opinion notwithstanding, it is very commonly believed that there are some differences in susceptibility to fear as between men and women. This view is plausible and there is some evidence to support it. At the same time it is clear that in this regard there is much overlap between any population of women and a comparable population of men. Culture, moreover, can either magnify such potential differences as there may be, for example by sanctioning the expression of fear by members of one sex but not by those of the other, or else try to reduce them. Evidence from four sources supports the idea of a difference in susceptibility between the sexes:
In the experiments with nursery-school children, carried out by Jersild & Holmes ( 1935a) and described in Chapter 7,
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a higher percentage of the girls were afraid than of the boys. The situations in which the difference was most marked were going into the dark passage and approaching the two animals, snake and dog. In these three situations the percentages of boys who showed fear were respectively 36, 40, and 46. The comparable percentages for girls were 48, 50, and 59.
In interviews of mothers of children aged six to twelve years Lapouse & Monk ( 1959) found that the proportion of girls reported as being afraid of strangers and animals, notably snakes, was higher than that of boys. In two other studies in which children of about the same age were interviewed, girls reported more situations as feared than did boys ( Jersild, Markey & Jersild 1933; Croake 1969).
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In questionnaires given to students there is a consistent tendency for women to report more situations as feared than men (for references and comment see Marks 1969).
In epidemiological studies of psychiatric casualties women are reported to suffer from anxiety states about twice as frequently as men ( Leightonet al. 1963; Hare & Shaw 1965). Two-thirds of agoraphobic patients seen by psychiatrists are women ( Marks 1969).
A difference in the opposite direction -- that females tend to show less fear than do males -- seems not to have been reported.
Viewed in an evolutionary perspective these findings are not surprising. In most races of man, as in other species of groundliving primates, males are larger and stronger than females ( Cole 1963). While males bear the brunt of defence against predators, as well as attacking them when necessary, females protect young and, unless prevented from doing so, are more likely to retire from dangerous situations than to grapple with them. It would be strange were such long-standing differences between the sexes in respect of body structure and social role not to be reflected in complementary differences in behavioural bias.
Minimal Brain Damage
In Chapter 16 of the first volume an account is given of a longitudinal study of twenty-nine pairs of boys ( Ucko 1965), which shows that children who at birth are noted to be suffering from asphyxia are much more sensitive to environmental change than are matched controls. When the family went on holiday
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or changed house, boys who had suffered from asphyxia were more likely to be upset than were the controls. The same was true when a member of the family -- father, mother, or sibling -- was absent for a time. These differences were apparent during each of the first three years of life (though not significantly so during the third). A comparable difference was seen when some of the children started nursery school.
Soon after his fifth birthday every child started infant school, making this the only event that was common to them all (though of course they went to many different schools). Here again the difference between the two groups was striking and significant. On a three-point scale (reduced from five points), the children distribute as shown below:
Enjoyed start accepted it
Mild
protest
within one week
Mild
school from the
or
at least
apprehension and disappearing
8 10 apprehension or 13 2
Asphyxiated at birth
Controls
8 17
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marked
more than a week
Totals
Childhood Autism
disturbance
lasting
The behaviour of an autistic child shows a complete absence of attachment together with many indications of chronic fear. Tinbergen & Tinbergen ( 1972), adopting an ethological approach, suggest that the underlying condition may be one of chronic and pervasive fear, which cannot be allayed by contact with an attachment figure because the child also fears humans. If this is so, the syndrome could be conceived as resulting from a persistently lowered threshold to fear-arousing stimuli combined with delayed development of and/or inhibition of attachment. Causal factors might then include any of
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the following: (a) genetic factors, (b) brain damage, (c) inappropriate mothering. A combination of two or more factors seems likely. Clancy & McBride ( 1969) describe a treatment programme based on this type of theory.
Blindness
Nagera & Colonna ( 1965) report that blind children are apt to be more than usually afraid of such common fear-arousing situations as animals, mechanical noises, thunder and wind, and to live in a state of permanent alertness. A principal reason for this is probably that, being blind, they are likely to be out of contact with their attachment figure far more often than are sighted children, and thus often to be effectively alone when something frightening occurs. Their tendencies on some occasions to remain rigidly immobile and, on others, to seek very close bodily contact with an adult are in keeping with this explanation.
Great difficulties arise for such children after a brief separation because a blind child cannot track his mother visually and keep close to her as a sighted child commonly does on such occasions. Fraiberg ( 1971) describes the very acute reaction of a blind boy of fourteen months after his mother had been absent for three days, during which he had been cared for by various friends and relations. During the first fortnight after mother's return he screamed for hours at the highest pitch, 'something between terror and rage', or else shouted and chanted perpetually. Only when his mother held him was there any respite; and then he would crawl relentlessly all over her. Because the screaming was so distressing to mother it was suggested she give him pots and pans to bang together instead. This the child did with great gusto and the screaming ceased.
Fraiberg describes also another blind child, a little older, who was cared for by familiar grandparents while mother had a new baby. When reunited with his mother he was markedly ambivalent at first but responded quickly when she, an affectionate mother, gave him plenty of cuddling. The main reason for the far more acute reaction in the younger child is likely to have been that his mother was a disturbed woman whose mothering was erratic both before
Asphyxiated at birth
Controls
29 29
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and after her absence; another factor may have been that he was cared for by several different people while she was away.
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Changes during Development in a Child's Susceptibility to Fear
While every infant comes into the world with biases to respond in some ways more than in others, how he develops turns on a process of interaction between himself and his environment. In regard to a susceptibility to respond fearfully, there are certain developmental trends sufficiently buffered to environmental variation to be seen in a huge majority of individuals. For example, as related in Chapter 7, all descriptive studies agree that, whereas during the first two years of life a child is broadening the range of situations he fears -- to include especially strangeness, animals, darkness, and separation -- from his fifth birthday onwards, and often before, he is likely to become steadily more discriminating in what he fears and more confident and competent in dealing with situations that would formerly have frightened him. Because change towards greater discrimination and confidence represents the norm, we start by considering the nature of the experiences and processes likely to be responsible for it. Subsequently we consider experiences and processes that have an opposite effect, for example, those that interfere with the usual tendency for susceptibility to diminish, or even enhance the susceptibility, and others that have the effect of increasing the range of situations feared.
Experiences and processes that reduce susceptibility to fear
The experiences that occur and the processes at work during the ordinary course of a person's life that tend to reduce his susceptibility to fear are of many kinds. A principal process, increasing confidence in the availability of his attachment figure(s), is the subject of the next chapter. Of the others the main ones can be described, in everyday language, as getting used to situations that are initially alarming, discovering that in many such situations other people are not afraid, and learning to tackle a situation actively and thereby discovering that nothing ill befalls. In the language of learning theory they are termed:
-- habituation
-- observational learning leading to vicarious extinction
-- observational learning combined with guided participation.
Other processes are likely to be at work as well, though it is not clear how large a part they play during the ordinary course
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of development. For example, it may well be that there is some naturally occurring version of the procedure developed by behaviour therapists, and known variously as 'reciprocal inhibition', 'counter-conditioning', and 'desensitization', in which an association is gradually built up between a stimulus situation that is feared and something that the subject finds pleasant. 1
Yet another process, and one that it is easy to forget, is that as an individual grows up he becomes stronger and more skilful so that situations that might once have been, or at least seemed, dangerous to him cease to be so.
Knowledge of some of these processes has been greatly extended in recent years by the work of learning theorists and behaviour therapists. As Marks ( 1969) is at pains to stress, a large
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majority of these studies have been conducted with healthy individuals who happen to be intensely afraid of some delimited object or situation, such as a snake or a dog, and not with psychiatric patients who commonly suffer not only more generalized anxiety but usually difficulties in personal relationships and a tendency to depression as well. It is for this reason that many clinicians suspect that the findings of the learning theorists may prove to be of only limited value in psychiatric practice. Yet it is for this same reason that their findings are in all likelihood of much relevance in understanding how it happens that the tendency to respond fearfully recedes during the ordinary course of healthy development.
Let us consider further the three processes already listed.
Habituation
This is a process of learning not to respond to a situation when it is followed by nothing of consequence. It presumably plays a major part in restricting an infant's initial tendency to respond with fear to all and any strong or sudden stimulation. Later, habituation, perhaps in more sophisticated forms, also restricts the range of situations that are responded to with fear because they are strange; for much of what is strange today will not only have become familiar tomorrow but also have been found to lead to no untoward consequence. Thus habituation greatly limits the range of situations responded to with fear. It should none the less be noted that habituation in no way affects
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1 A full description of desensitization and related techniques is given in Marks ( 1969).
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the basic and persistent tendency to respond with fear, as well as with curiosity, to anything perceived as strange.
Observational Learning leading to Vicarious Extinction
It has already been remarked that observational learning can work in either of two directions: either the observer learns to fear situations that formerly he did not fear or else he learns not to fear situations that formerly he did fear. The most important component in learning not to fear situations formerly feared, Bandura ( 1968) finds, is that the observer should see that the feared situation can be approached and dealt with without there being any bad consequences. The identity of the person observed (model) and the degree to which the observer can identify with him are found to be of much less significance. Even watching a sequence on film can have a reassuring effect, provided always that the consequences of the model's actions are clearly depicted.
The process of learning that something is harmless from direct observation of the experience of others is very different, it should be noted, from merely being informed by another person that a situation is harmless. All those who have made a systematic study of the problem report that simple explanation and reassurance have only very limited effect, a finding that will come as no surprise to clinicians.
Fortunately, in the ordinary course of events, a child growing up in a family has endless opportunities to learn from observation that many of the situations that make him afraid are in
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fact harmless. Parents, older brothers and sisters, neighbours and schoolfellows are continually and without knowing it providing a child with this indispensable information.
Observational Learning combined with Guided Participation
This method requires much more from the model than giving the subject opportunity for simple observational learning. It is evident none the less that every sensible parent is constantly providing it. The method consists in the model's first demonstrating in action that the feared situation holds no danger and then encouraging the other person -- child or adult -- to tackle the situation himself. Once again it appears that the crucial part of the process is that the learner should discover, this time for himself, that approaching and tackling the situation can be done without untoward consequences. The efficacy of the method was commented on by several of the early students of
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children's fear behaviour (e. g. Jones 1924a; Jersild & Holmes 1935a), and their findings have been amply confirmed by Bandura and his colleagues in a number of recent experiments. In one experiment, reported by Bandura ( 1968), a study was made of a group of adolescents and adults who suffered acute fear of snakes. The subjects were divided into four subgroups and given four different sorts of treatment:
the now standard desensitization procedure of imagining increasingly alarming situations with snakes and at the same time engaging in deep relaxation exercises;
observing a graduated film depicting young children, adolescents, and adults engaging in progressively more fearprovoking interactions with a large harmless snake;
observing the therapist engage in a carefully graduated series of such procedures and at each step being aided by the therapist to engage in the same procedures, so that gradually the subject is himself led first to touch and stroke the snake, then to grasp the snake round the middle while the therapist holds its head and tail, and so on step by step until the subject is able to allow the snake in the room with him, to retrieve it, and finally to let it crawl freely over him; only when a subject has accomplished one step without fear is he encouraged to go on to the next;
receiving no treatment but, like subjects in the other subgroups, being tested for fear of snakes both at the start of the experiment and at the end of it, thus providing a control group.
When subjects in the four subgroups were tested at the end of their treatment by being required to engage in increasingly daring activities with snakes, those who had both observed the therapist interact with the snake and themselves taken part in the graduated exercises with it showed much the least fear. Subjects in subgroups (a) and (b) were less fearful than before but had not benefited as much as had those in subgroup (c). Finally, those in the control group showed as much fear of snakes at the end of the proceedings as they had done at the beginning.
In commenting on his results Bandura suggests that the striking efficacy (for these subjects) of observational learning combined with guided participation rests on two features of the method: first, the subject's fear is reduced sufficiently to enable
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him to start a process of interaction with the feared object; and second, after he begins to interact, he discovers for himself that it has no disagreeable consequences. Bandura lays emphasis on the point that to be successful the method has to be carefully graduated so that at no stage is fear of more than modest intensity aroused.
In the context of this work, perhaps the most important aspect of Bandura's findings is the key role played in his technique by a trusted and encouraging companion. Not only does the therapist perform the fear-arousing acts, but he stands by while the subject tries the same measures himself, encouraging him at every success and reassuring him after any failure. Only in the presence of such a companion is a subject likely to feel confident enough to tackle the problem in active fashion and so to discover for himself what the consequences really are.
A second valuable lesson from the work of behaviour therapists is that it is essential to work forward in small steps so that the fear aroused is never beyond low intensity. Once fear at high intensity is aroused, it is found, the subject may well be back where he began. It is of interest that the careers of men who later become astronauts appear to be built in a similar way, moving steadily from one modest success to another in unbroken series ( Korchin & Ruff 1964). These findings are referred to again in Chapter 21.
It is fortunate that most parents seem to know intuitively that no good comes from allowing a child to become acutely frightened. They also know that what allays fear more certainly than anything else is their own presence. As the Newsons write of their sample of four-year-olds and their mothers:
Two out of three of all our children have definite and recurrent fears of which the mother is aware. Once she realizes that the child is frightened, she will go through a series of remedies until she finds one that works: and that a remedy is effective is the main consideration to most mothers, even if it does upset the household, for few are unsympathetic to fear. There are no certain methods, and some fears are immune to endless ingenious expedients: the parents can only hope that the child will eventually 'grow out of it'. In general, mothers tend to favour a mixture of explanation and simple cuddling; and these usually at least have a soothing effect, even if they do not always drive the fear away ( Newson & Newson 1968).
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Experiences and processes that increase susceptibility to fear
It is argued in Chapter 6 that 'it is no less natural to feel afraid when lines of communication with base are in jeopardy than when something occurs in front of us that alarms us and leads us to retreat'. As a consequence, an individual's increased tendency to respond to situations with fear can be a result of either (or both) of two distinct types of experience. One is an experience in a particular situation that has led the person henceforward to become especially prone to avoid or withdraw from that situation. The other is uncertainty about the availability of his attachment figure (s). As a rule a specially alarming experience is likely to lead to an increased susceptibility to respond with fear in that specific situation only; whereas uncertainty about the availability of attachment figures results in increased susceptibility to respond with fear to such a wide range of situations that the person concerned is often referred to as suffering from 'free-floating anxiety'.
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Since the remaining chapters of this volume are concerned with susceptibility to anxiety about the availability of attachment figures, here we deal mainly with experiences that increase a person's susceptibility to be afraid of specific situations.
Frightening Experiences
Jersild and his colleagues and also the Newsons present evidence that in very many cases when an individual exhibits unusually intense fear of a particular situation the origin can be traced to a specific experience connected with that situation.
In describing their four-year-olds the Newsons remark that, when a child's previous experiences are known, his fear is often seen to be 'reasonable', even though it may now seem exaggerated. As examples, they describe: a child who had intense horror of mud which dated from a summer holiday during which her feet were trapped in wet sand so that, when the other children ran off, she was unable to follow; a child who would not go near water after she had fallen into a river; and a child terrified of anyone in a white coat after he had been shouted at and held down while being x-rayed ( Newson & Newson 1968).
Evidence of a similar sort and from two separate sources is reported by Jersild & Holmes: (a) from parents about factors that may have contributed to a child's having developed
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unusually intense fear of some particular situation ( Jersild & Holmes 1935b), and (b) from young adults about what factors they believe have been responsible for their having themselves developed intense and/or persistent fear of some situation ( Jersild & Holmes 1935a). For obvious reasons neither source is adequate and a great deal of further research is required.
Like the Newsons, Jersild & Holmes describe a number of cases in which a child's fear of a specific situation is reported by a parent to have developed in a thoroughly intelligible way. Examples are a child frightened of all objects resembling a balloon, whether on earth or in the air, following an operation during which a gas balloon had been used for an anaesthetic; and another child afraid of a familiar pet canary after having been frightened by the sudden hooting of an owl in the zoo. All such cases can be understood as due to a child's generalizing from too small a sample.
Similarly, the group of young adults report that in many instances fear of a particular situation had followed an alarming experience they had had as children. Examples include witnessing an accident, returning home to find the house had been burgled, witnessing an explosion, and mother being ill.
Since not all children become persistently afraid after a particularly alarming experience, specific conditions are presumably responsible. Of possible candidates, compound situations of which one component is being alone seem especially likely. It is perhaps noteworthy that in none of the examples quoted above is it stated whether the child was alone or with a trusted companion. In future studies of what appear retrospectively to have been traumatic situations, therefore, exact details of all the conditions obtaining are necessary.
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There is, of course, a large literature regarding experiences that have led individual animals to become persistently afraid of specific situations ( Hebb 1949). Animals, however, cannot be made afraid by stories heard or by threats uttered, as humans can.
Stories Heard
A major cause of persistent and/or intense fear was said by the young adults questioned by Jersild & Holmes ( 1935a) to have been hearing lurid tales, some true and some fictional. Other evidence suggests that this may be a more frequent cause of certain individuals coming to fear certain situations than is
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often supposed. An example given by Jersild & Holmes ( 1935b) is of an unprecedented number of young children reported to be afraid of wolves during the period when the song 'Who's afraid of the big bad wolf? ' was popular. In view of the difficulties a child has in distinguishing fact from fiction and in making realistic assessment of potential danger, already touched upon in Chapter 10, this finding should not surprise us. It seems likely that fear arising from such misunderstandings, though intense enough at the time, usually becomes modified once the individual's grasp of the world improves.
Situations of several sorts that are feared by some children and adults and not by others can be understood as culturally determined. For example, several studies report a difference of incidence in regard to fear of certain situations dependent on socio-economic class. In interviews of 400 children aged between five and twelve years in the vicinity of New York City a higher proportion of children from public schools than from private schools reported fear of robbers and kidnappers and also of supernatural happenings ( Jersild & Holmes 1935a). In their study of 482 children aged from six to twelve years in Buffalo, New York, based on interview data from mothers, Lapouse & Monk ( 1959) report a higher incidence of fear of wars, floods, hurricanes and murders, of fire and of being kidnapped among whites of lower socio-economic class than among upper-class whites. A difference in the same direction is reported by Croake ( 1969) who interviewed 213 children between the ages of eight and twelve years in South Dakota and Nebraska.
Many other differences in incidence between groups reported in the literature seem likely to be due to cultural influences.
Threats
In answering the questionnaire administered by Jersild & Holmes ( 1935a) many of the young adults were unable to give any clear account of how or why they had developed intense and/or persistent fear of some situation. Nevertheless, in examining the reasons that were given, the researchers were struck by how large a part deliberate threats of horrifying consequences seemed to have played in a number of cases. Some of those threats had been made by older children, sometimes perhaps to tease but at other times with serious intent. Other threats had been made by parents, or occasionally a schoolteacher, as a means of discipline. Some of these threats were of physical punishment. More often they were an exploitation of a
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child's tendency to fear one of the natural clues, notably darkness, isolation, or abandonment.
Unfortunately Jersild & Holmes found that it was not possible to make an exact count of 'apparently deliberate attempts to frighten' but they record some of the more extreme instances. It is a disturbing list. For example, if the answers to the questionnaire are to be believed, a child's fear of the dark had been exploited either by his having been punished by being locked in a dark room or cellar, or by his having been threatened that that would be done. In a few cases a child's fear of the dark had been amplified by its being alleged that the dark room was filled by such things as vicious rats or dreadful monsters.
Another type of threat used for disciplinary purposes, reported both by Jersild & Holmes ( 1935a) and by the Newsons ( 1968), is one entailing separation from parents. The threat can take one of several forms. A child can be threatened that he will be sent away, or that some alarming figure will come to take him away, or that his mother will go away and leave him. There is reason to believe that many children are exposed to threats of this kind, and also that such threats play a far larger part in increasing a person's susceptibility to separation anxiety than has yet been realized by psychiatrists. Evidence for these statements is given in later chapters (15, 18, 19), and some of the reasons why the role of these threats has been so seriously underestimated are discussed in Chapter 20.
The Key Role of Experience
In clinical circles great emphasis is often placed on the existence of cases in which a much raised susceptibility to respond with fear in a situation cannot be accounted for, apparently, by any experience of the kind so far discussed. Resort is then had to more complex explanations, often turning on fear of 'internal dangers'. The position taken here is that such explanations are invoked far too readily. In some cases highly relevant experiences are unknown to the patient or his relatives; in others they are known about but for one of many reasons are deliberately not reported. In yet other cases, experiences are known about but go unreported because they are thought not to be relevant or because the clinician appears uninterested or unsympathetic. In other cases again experiences are mentioned by the clinician hardly registers them because he is guided by theories that give them no place. Finally, it is not uncommon for fear that is
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aroused by one situation to be attributed erroneously either by patient or by clinician to another.
A major theme of this volume is that no fear-arousing situation is missed or camouflaged as often as is fear that an attachment figure will be inaccessible or unresponsive.
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Chapter 14
Susceptibility to Fear and the Availability of Attachment Figures
Throughout all this ordeal his root horror had been isolation, and there are no words to express the abyss between isolation and having one ally.
G. K. CHESTERTON, The Man who was Thursday
Forecasting the availability of an attachment figure
Enough has been said about the conditions that arouse fear to make plain how crucial a variable it is to be with or without a trusted companion. In the presence of a trusted companion fear of situations of every kind diminishes; when, by contrast, one is alone, fear of situations of every kind is magnified. Since in the lives of all of us our most trusted companions are our attachment figures, it follows that the degree to which each of us is susceptible to fear turns in great part on whether our attachment figures are present or absent.
But man does not live entirely in the present. As a child's cognitive capacities increase he becomes capable of foreseeing the possible occurrence of many sorts of situation, including those that he knows would arouse fear. And, of the many feararousing situations that a child, or older person, can foresee, none is likely to be more frightening than the possibility that an attachment figure will be absent or, in more general terms, unavailable when wanted.
It has already been noted (Chapter 1) that, in reference to an attachment figure, presence is to be understood as implying ready accessibility rather than actual and immediate presence, and absence implies inaccessibility. Still further amplification is required, however, since accessibility in itself is not enough. Not only must an attachment figure be accessible but he, or she, must be willing to respond in an appropriate way; in regard to someone who is afraid this means willingness to act as comforter and protector. Only when an attachment figure is both accessible and potentially responsive can he, or she, be said to be truly
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available. In what follows, therefore, the word 'available' is to be understood as implying that an attachment figure is both accessible and responsive.
In this chapter three distinct propositions are introduced, each of which is basic to the thesis of this work. The first is that, when an individual is confident that an attachment figure will be available to him whenever he desires it, that person will be much less prone to either intense or chronic fear than will an individual who for any reason has no such confidence. The second proposition concerns the sensitive period during which such confidence develops. It postulates that confidence in the availability of attachment figures, or a lack of it, is built up slowly during the years of immaturity -- infancy, childhood, and adolescence -- and that whatever expectations are developed during those years tend to persist relatively unchanged throughout the rest of life. The third proposition concerns the role of actual experience. It
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postulates that the varied expectations of the accessibility and responsiveness of attachment figures that different individuals develop during the years of immaturity are tolerably accurate reflections of the experiences those individuals have actually had.
Each of these three propositions is controversial, though each is much more controversial in some quarters than in others.
To psychoanalysts who adopt an object-relations theory of personality the first proposition is familiar enough: in terms of that theory, a person's confidence, or lack of it, in the availability of an attachment figure is regarded as resulting from his having either introjected, or failed to introject, a good object. By contrast, to those unfamiliar with object-relations theory, or perhaps alternatively with ethology, the proposition may be novel and even surprising.
The second proposition lies somewhere between, on the one hand, a view that attributes a high degree of plasticity to personality structure even during mature years and, on the other, a view, stemming especially from the work of Melanie Klein, that regards plasticity of personality as diminishing rapidly after the earliest months of infancy and as falling to a low ebb as soon as the first year or two are past. The view adopted here contrasts with both. It holds that the period during which attachment behaviour is most readily activated, namely from about six months to about five years, is also the most sensitive in regard to the development of expectations of the availability of attachment figures; but that nevertheless sensitivity in this
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regard persists during the decade after the fifth birthday, albeit in steadily diminishing degree as the years of childhood pass.
The third proposition, which concerns the role of experience, may seem fairly self-evident to many but has nevertheless been extremely controversial in psychoanalytic circles. It is a crucial question, since on how it is answered turn not only preventive measures but also therapeutic techniques. The controversy is referred to repeatedly in this and later chapters.
These three propositions, each of which can in principle be tested, provide the scaffolding for the rest of the volume. It is claimed that each is inherently plausible, that none is contradicted by evidence of weight, and that together they enable the evidence available to be fitted together in a way that makes sense.
Working models of attachment figures and of self
The states of mind with which we are concerned can conveniently be described in terms of representational or working models. In the first volume it is suggested that it is plausible to suppose that each individual builds working models of the world and of himself in it, with the aid of which he perceives events, forecasts the future, and constructs his plans. In the working model of the world that anyone builds, a key feature is his notion of who his attachment figures are, where they may be found, and how they may be expected to respond. Similarly, in the working model of the self that anyone builds a key feature is his notion of how acceptable or unacceptable he himself is in the eyes of his attachment figures. On the structure of these complementary models are based that person's forecasts of how accessible and responsive his attachment figures are likely to be should he turn to them for support. And, in terms of the
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theory now advanced, it is on the structure of those models that depends, also, whether he feels confident that his attachment figures are in general readily available or whether he is more or less afraid that they will not be available -- occasionally, frequently, or most of the time.
Intimately linked to the type of forecast a person makes of the probable availability of his attachment figures, moreover, is his susceptibility to respond with fear whenever he meets any potentially alarming situation during the ordinary course of his life.
The theory proposed can be formulated in two steps: from the
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early months onwards and throughout life the actual presence or absence of an attachment figure is a major variable that determines whether a person is or is not alarmed by any potentially alarming situation; from about the same age, and again onwards throughout life, a second major variable is a person's confidence, or lack of confidence, that an attachment figure not actually present will none the less be available, namely accessible and responsive, should he for any reason desire this. The younger the individual the more influential is the first variable, actual presence or absence; up to about the third birthday it is the dominant variable. After the third birthday forecasts of availability or unavailability become of increasing importance, and after puberty are likely in their turn to become the dominant variable.
Although the concepts of working models and forecasts derived from working models may be unfamiliar, the formulation adopted is no more than a way of describing, in terms compatible with systems theory, ideas traditionally described in such terms as 'introjection of an object' (good or bad) and 'self-image'. The advantages claimed for the present concepts are that they allow for greater precision of description and provide a framework that lends itself more readily to the planning and execution of empirical research.
Reflection shows that working models of attachment figures and of self can vary along many dimensions. One is that of simplicity versus sophistication (see Volume I, Chapter 17). Another is that of validity, which is discussed briefly later in this volume (Chapter 20). Yet another is the extent to which the roles of attachment figures, on the one hand, and of self, on the other, are differentiated. Let us consider the last.
Confidence that an attachment figure is, apart from being accessible, likely to be responsive can be seen to turn on at least two variables: (a) whether or not the attachment figure is judged to be the sort of person who in general responds to calls for support and protection; (b) whether or not the self is judged to be the sort of person towards whom anyone, and the attachment figure in particular, is likely to respond in a helpful way. Logically these variables are independent. In practice they are apt to be confounded. As a result, the model of the attachment figure and the model of the self are likely to develop so as to be complementary and mutually confirming.