Finally, while the observer sat quietly in one place, Josephine crept close enough to cover him with a small blanket, whereupon she
exclaimed
'All gone'.
Bowlby - Separation
In particular they emphasize how impossible it is in a nursery setting to provide a child with a substitute figure who can mother him as well as his own mother can.
When the Hampstead Nurseries were reorganized so that each nurse could care for her own little group of children they tell how the children became strongly possessive of their nurse and acutely jealous whenever she gave attention to another child: 'Tony (3 1/2) .
.
.
would not allow Sister Mary to use "his" hand for handling other children.
Jim (2-3) would burst into tears whenever his "own" nurse left the room.
Shirley (4) would become intensely depressed and disturbed when "her" Marion was absent for some reason.
'
Why, it may be asked, should these children have become so strongly possessive of their nurse and so deeply distressed whenever she was missing? Was it, as some traditionalists might suppose, that they had been spoiled by having been given too much attention and allowed too much their own way? Or
____________________
1 Although throughout this book the text refers usually to 'mother' and not to 'mother figure',
it is to be understood that in every case reference is to the person who mothers a child and to whom he becomes attached. For most children, of course, this person is also his natural mother.
-3-
was it, by contrast, that since leaving home they had been subjected to too many changes of mother figure and/or had too limited access to whoever in the nursery was acting temporarily as their mother figure? On how we answer these questions turn all our practices of child- rearing.
14
Not only did children in these nurseries become intensely possessive and jealous of their 'own' nurse but they were also unusually prone to become hostile towards her or to reject her, or else to retreat into a state of emotional detachment, as the following records illustrate:
Jim was separated from a very nice and affectionate mother at 17 months and developed well in our nursery. During his stay he formed two strong attachments to two young nurses who successively took care of him. Though he was otherwise a well adjusted, active and companionable child, his behaviour became impossible where these attachments were concerned. He was clinging, over-possessive, unwilling to be left for a minute, and continually demanded something without being able to define in any way what it was he wanted. It was no unusual sight to see Jim lie on the floor sobbing and despairing. These reactions ceased when his favourite nurse was absent even for short periods. He was then quiet and impersonal.
Reggie, who had come to our house as a baby of 5 months, went home to his mother when he was 1 year 8 months, and has been with us ever since his return to the nursery 2 months later. While with us, he formed two passionate relationships to two young nurses who took care of him at different periods. The second attachment was suddenly broken at 2 years 8 months when his 'own' nurse married. He was completely lost and desperate after her departure, and refused to look at her when she visited him a fortnight later. He turned his head to the other side when she spoke to him, but stared at the door, which had closed behind her, after she had left the room. In the evening in bed he sat up and said: 'My very own Mary-Ann! But I don't like her. '
These observations, made in the pressure of wartime and recorded anecdotally with all too little detail, none the less cast a shaft of light on the nature of many forms of psychiatric disturbance. States of anxiety and depression that occur during
-4-
adult years, and also psychopathic conditions, can, it is held, be linked in a systematic way to the states of anxiety, despair, and detachment described by Burlingham & Freud, and subsequently by others, that are so readily engendered whenever a young child is separated for long from his mother figure, whenever he expects such a separation, and when, as sometimes happens, he loses her altogether. Whereas during later life it is often extremely difficult to trace how a person's disturbed emotional state is related to his experiences, whether they be those of his current life or those of his past, during the early years of childhood the relationship between emotional state and current or recent experience is often crystal clear. In these troubled states of early childhood, it is held, can be discerned the prototype of many a pathological condition of later years.
It is, of course, a commonplace that most children who have had experiences of these kinds recover and resume normal development, or at least they appear to do so. Not infrequently, therefore, doubts are expressed whether the psychological processes described are in reality related so intimately to personality disturbances of later life. Pending much further evidence, these are legitimate doubts. Nevertheless, reasons for holding to the thesis are strong. One is that data from many sources can be arranged and organized into a pattern that is internally consistent and consistent also with current biological theory. Another is that many clinicians and social workers find the resulting schema enables them to understand better the problems with which they are grappling and so to help their patients or clients more effectively.
15
Why some individuals should recover, largely or completely, from experiences of separation and loss while others seem not to is a central question, but one not easily answered. In living creatures variation of response is the rule and its explanation is often hard to fathom. Of all those who contract poliomyelitis less than 1 per cent develop paralysis, and only a fraction of 1 per cent remain crippled. Why one person should respond one way and another another remains obscure. To argue that, because 99 per cent recover, polio is a harmless infection would obviously be absurd. Similarly, in the field under consideration, to argue that because most individuals recover from the effects of a separation or loss these experiences are of no account would be equally absurd.
Nevertheless the problem of differential response remains
-5-
important. Conditions likely to be playing a part can be considered under two main heads: those intrinsic to or closely associated with the separation itself, notably the conditions in which a child is cared for while away from mother;
those present in the child's life over a longer period, notably his relations with parents during the months or years before and after the event.
Here we consider variables in category (a). Those in category (b) are discussed in the later chapters of Part III.
We start by reviewing observations of how children behave when cared for in one of two very different settings. The first is an ordinary residential nursery, in which a child finds himself in a strange place with strange people none of whom is sufficiently available to give him more than very limited mothering. The second is a foster home in which a child receives the fulltime and skilled care of a foster mother with whom he has become in some degree familiar beforehand.
Conditions leading to intense responses
In our early studies children were observed during stays in institutional settings and it was on the basis of these observations that the sequence of responses which we term protest, despair, and detachment came first to be delineated ( Robertson & Bowlby 1952). Since then two further studies have been conducted by colleagues in the Tavistock Child Development Research Unit, the first by Christoph Heinicke ( 1956) and the second by Heinicke & Ilse Westheimer ( 1966). Although in each of these investigations only a handful of children were observed (six in the first and ten in the second), the studies are unique for the care of their design and the amount of systematic observation. Moreover, for each sample of separated children a contrast group was selected and observed: in the first study it was a fairly well- matched group of children observed during their first weeks of attendance at a day nursery; in the second it was a similarly matched group of children observed while living in their own homes. Heinicke & Westheimer treat their data statistically and also describe in some detail the behaviour of individual children.
In the larger investigation ( 1966), work was conducted in three residential nurseries. Arrangements and facilities were fairly similar. In each, a child belonged to a defined group of
16
-6-
children and was cared for mainly by one or two nurses. Ample opportunities were available for free play either in large rooms or outdoors in a garden. Before a child entered the nursery, contact was made with the family by a psychiatric social worker ( Ilse Westheimer), who was also responsible either then or later for collecting full information about the family and the child. Arrival at the nursery was observed; and in the course of his stay a child was observed during free play on six occasions each week. Each of the two observers (one male, Christoph Heinicke, and one female, Elizabeth Wolpert) observed for a period of at least half an hour during each of the three sample periods into which the week was broken (Monday and Tuesday; Wednesday and Thursday; Friday, Saturday, and Sunday). The method used, of categorizing behavioural units in terms of agent, object, relation, mode, and intensity, had been used in the earlier study and had been shown to be reliable.
In addition to the categorized observations of free behaviour, similarly categorized observations were made of every child's behaviour in standardized doll-play sessions; and a number of other records of each child's stay in the nursery were kept.
It was originally intended to select the separated children in accordance with the five criteria used in the first study, namely: (i) that the child had had no previous separations of more than three days, (ii) that he fell within the age-limits of fifteen to thirty months, (iii) that he did not enter the nursery with a sibling, (iv) that he was living with both mother and father at the time the separation occurred, and (v) that there was no evidence that being placed in a nursery indicated a rejection by his parents. Because of the difficulty of obtaining cases, however, these criteria had to be modified to allow greater latitude.
Although most of the children had had either no separations or only very brief ones prior to the one being studied, in one case the length of previous separation was four weeks and in two it was three weeks. The age-range was slightly extended and ran from thirteen to thirty-two months, instead of from fifteen to thirty months. But the most marked departure from the previous criteria was that four of the children entered the residential nursery in the company of a sibling: in three cases this was a four-year-old sibling and in one case the sibling was younger. The remaining two criteria remained unmodified: each of the children was living with both mother and father at the time of separation, and there were no indications that he
-7-
was being rejected by the parents by being placed in the nursery.
The reason that the ten children studied were cared for in a residential nursery was that, in a family emergency, neither relatives nor friends were available to take temporary care of them. In the case of seven families, mother was to be away in hospital having a new baby. In two others mother was to be in hospital for some other form of medical attention. In the tenth case, the family became homeless.
Among much else in their book, Brief Separations ( 1966), Heinicke & Westheimer describe behaviour typical of the ten children during their time in the nursery, and, similarly, behaviour typical of the children after they had returned home. In the paragraphs that follow some of their principal findings are presented. Every one of the patterns reported had also been
17
observed and recorded by Robertson during his earlier, less systematic though more extensive, studies.
Behaviour during Separation
The children arrived at the nursery in the care of one or both parents. Four of them, brought by father, stayed close to him and seemed already subdued and anxious. Some of the others, who had come with mother or both parents, seemed more confident and were ready to explore the new environment. They ventured forth on short or long excursions and then returned.
When the moment came for the parent (s) to depart, crying or screaming was the rule. One child tried to follow her parents, demanding urgently where they were going, and finally had to be pushed back into the room by her mother. Another threw himself on the floor and refused to be comforted. Altogether eight of the children were crying loudly soon after their parents' departure. Bedtime was also an occasion for tears. The two who had not cried earlier screamed when put in a cot and could not be consoled. Some of the others whose initial crying had ceased broke into renewed sobs at bedtime. One little girl, who arrived in the evening and was put straight to bed, insisted on keeping her coat on, clung desperately to her doll, and cried 'at a frightening pitch'. Again and again, having nodded off from sheer fatigue, she awoke screaming for Mummy.
Crying for parents, mainly for mother, was a dominant response especially during the first three days away. Although it decreased thereafter, it was recorded sporadically for each of
-8-
the children for at least the first nine days. It was particularly common at bedtime and during the night. In the early hours of her second day of separation one child, Katie, aged eighteen months, awoke screaming and shouting for Mummy. She remained awake and continued to cry for mother until noon. During the early days away a visit from father led to renewed crying. Another little girl whose father visited her on the third day cried frantically and continuously for twenty minutes after he left.
Searching for mother occurred also and was particularly evident in Katie. After the first week, Katie stopped crying for mother and, instead, seemed content to sit on the nurse's lap watching television. From time to time, however, she demanded that they go upstairs. When asked what she hoped to find there her unhesitating reply was 'Mummy'.
Oriented as they were to their missing parents, these small children were in no mood either to cooperate with the nurses or to accept comfort from them. Initially the children refused to be dressed or undressed, refused to eat, refused the pot. During the first day all but one child, the youngest, refused to be approached, picked up, or comforted. After a day or two resistance abated, but even at the end of two weeks over onethird of the nurses' requests and demands were still being resisted.
Nevertheless, although resistance to the nurses continued to be frequent, the children also began occasionally to seek some sort of reassuring or affectionate response from them. At first these bids for affection were not discriminating but before the end of the second week a few children were beginning to exhibit preferences. For example, one little girl, Gillian, who had refused any dealings with the nurses during the early days, had by the sixth day singled
18
out one nurse and seemed happy sitting on her lap. When the nurse left the room, moreover, Gillian looked longingly at the door. Even so Gillian's feelings for her nurse were not unmixed: when the nurse returned Gillian walked away.
The children's relations with the two research observers were also not unmixed. During the first day most of the children seemed friendly to at least one of the observers. Subsequently they made a point of avoiding the observers by moving away, turning their back, leaving the room, shutting their eyes, or burying their head in a pillow. Especially dramatic were certain occasions when a child broke into a panic the moment
-9-
one of the observers entered the room. On seeing him, or her, a child might scream and run to cling to a nurse. Sometimes a child would show marked relief as soon as an observer had left.
Needless to say, the observers were as unobtrusive as possible. In general their role was not to initiate interaction but to respond in a friendly way whenever a child approached them. Nevertheless, part of the plan was that, fairly late during each of the observation periods, the observer 'actively though cautiously approached the child to see how he would react'. In later chapters of this volume (Chapters 7 and 8) it will be seen that, unwittingly, this plan resulted in conditions that, in combination, are likely to be especially frightening. In some degree, at least, the children's fear of the observers must be attributed to these circumstances.
All but one of the ten children brought with them to the nursery a favourite object from home. For the first three days or so they clung closely to their object and became extremely upset if a nurse, trying to be helpful, happened to take hold of it. Subsequently, however, the children's treatment of their favourite object changed: at one moment they would cling to it, at another throw it away. For instance, one little girl alternated between carrying her rag doll about in her mouth, like a mother cat with a kitten, and flinging it away shouting 'All gone'.
Hostile behaviour, though infrequent, tended to increase during the two weeks of observation. It often took the form of biting another child or ill-treating the favourite object brought from home.
A breakdown in sphincter control was usual. Of the eight children who had attained some degree of control before arriving in the nursery, all but one lost it. The exception, Elizabeth, aged two years eight months, was the oldest of the children.
Although certain kinds of behaviour were common to all or almost all the children, in other ways the children differed. For example, four were constantly active whereas two others preferred to stay in a single spot. A few rocked; others, who seemed constantly on the verge of tears, continually rubbed their eyes.
It will be recalled that four of the children entered the nursery with a sibling, in three cases a four-year-old child and in one case a younger one. As had been expected, the frequency and intensity of the responses typical of children staying in a
-10-
19
residential nursery were much diminished in these children. They cried less and showed fewer outbursts of marked hostility. During the early days especially, siblings constantly sought each other's company, talked and played together. To outsiders they presented a united front, with exclamations such as 'She's not your sister, she's my sister'.
Behaviour at and after Reunion
Inevitably in a situation of this kind the length of time children remain away from home varies. In this study six children were away from twelve to seventeen days; the other four were away for weeks, the periods being seven, ten, twelve, and twenty-one weeks respectively. The ways in which the individual children responded when they returned home differed in many respects; and part of the difference was related to the length of time they had been away, a finding confidently forecast from the results of Robertson's earlier observations.
In this phase of the study two principal lessons learnt from earlier Tavistock studies were applied. The first was to make continuous first-hand observations of how a child responded on first meeting his mother again and during the next few hours. The second was to pay especial attention to a child's response to the visit to his home of an observer he had seen regularly in the nursery. Accordingly, with three research workers available, the following dispositions were made.
One worker, Ilse Westheimer, who had made contact with each of the families before a child went to the nursery, continued contact while the child was away, e. g. by visiting mother in hospital, and was on the spot to make observations when the child was reunited with his parents. Except for one brief visit, she avoided the children while they were in the nursery. In a complementary role, the two observers, Christoph Heinicke and Elizabeth Wolpert, who were responsible for all the observations made on the children in the nursery, took no part in liaising with the families; and they avoided visiting a child at home after he had returned there until a planned visit was made exactly sixteen weeks after his return. 1 (The only exception to this arrangement occurred because Ilse Westheimer was unavailable on one occasion when a child was returning
____________________
1 During the intervening sixteen weeks contact with the home was maintained by Ilse
Westheimer, who also administered doll-play procedures during the sixth and the sixteenth weeks after reunion, and during the equivalent weeks for the control children.
-11-
home, and observation of the return was in this case made by Elizabeth Wolpert. )
In seven cases Ilse Westheimer met mother at the nursery, witnessed the meeting of child and mother, and then drove them home. In three others she met father at the nursery, witnessed the meeting of child and father, and drove the pair home to mother. (In one case they picked mother up on the way, at the hospital in which she had been a patient. )
On meeting mother for the first time after the days or weeks away every one of the ten children showed some degree of detachment. Two seemed not to recognize mother. The other eight turned away or even walked away from her. Most of them either cried or came close to tears; a number alternated between a tearful and an expressionless face.
20
In contrast to these blank, tearful retreats from mother, all but one of the children responded affectionately when they first met father again. Furthermore, five were friendly to Ilse Westheimer as well.
As regards detachment, two findings of earlier studies were clearly confirmed in this one. The first is that detachment is especially characteristic of the way in which a separated child behaves when he meets his mother again, and is much less evident with father; the second is that the duration of a child's detachment from mother correlates highly and significantly with the length of his time away.
In nine cases detachment from mother persisted in some degree throughout almost the first three days of reunion. In five children it was so marked that the mother of each complained, characteristically, that her child treated her as though she were a stranger; none of these children showed any tendency to cling to mother. In the other four, detachment was less pronounced: phases during which they turned away from mother alternated with phases during which they clung to her. Only one child, Elizabeth, who was the oldest and whose separation was among the shortest, was affectionate towards her mother by the end of the first day home. Both Elizabeth and the four who alternated soon showed that they were afraid to be left alone and became far more clinging than they had been before they had gone away.
There is reason to believe that after a very prolonged or repeated separation during the first three years of life detachment can persist indefinitely; the problems to which this gives rise will be discussed in Volume III. After briefer separations
-12-
detachment gives way after a period lasting usually hours or days. It is commonly succeeded by a phase during which a child is markedly ambivalent towards his parents. On the one hand, he is demanding of their presence and cries bitterly if left; on the other, he may become rejecting, hostile, or defiant towards them. Of the ten children studied eight showed a noticeable degree of ambivalence, and in five of them it persisted for not less than twelve weeks. Among determinants of the length of time ambivalence lasts one of the most influential is likely to be the way a mother responds to it.
It will be evident from the descriptions given that when a child returns home after a period away his behaviour presents his parents, especially his mother, with great problems. How a mother responds depends on many factors: for example, the kind of relationship she had with the child before separation and whether she believes that a disturbed and demanding child is better treated with comfort and reassurance or with discipline. A variable to which Westheimer ( 1970) has drawn attention is the way in which a mother's feelings for her child may change in the course of a long separation from him, lasting many weeks or months, during which she does not see him. Warm feelings are apt to cool and family life to become organized on lines that leave no place into which the returning child can fit.
There is abundant evidence that after a child has been away from home in a strange place and in the care of strangers he is liable to be very frightened lest he be taken away again. This was borne in on Robertson during some of his early studies. Children who had been in hospital tended to panic, he found, at the sight of anyone in a white coat or nurse's uniform, and they indicated clearly their fear of being returned to hospital. Several children were apprehensive
21
when Robertson himself visited them at home. They took care to avoid him and, provided they were not in a detached condition, clung close to mother.
In the Heinicke-- Westheimer study one of the two observers who had been present in the nursery visited each child sixteen weeks after his return home. All the children seemed clearly to remember the observer and reacted with strong feeling; all but one made 'a desperate attempt' to avoid the observer. The mothers were much surprised that their child should be so afraid, and affirmed that other strangers who visited the house did not arouse such reactions.
-13-
The case of Josephine, who had been aged two years when she was in the nursery for thirteen days and was now aged two years and four months, illustrates the anxious hostile behaviour seen typically on the occasion of these visits. 1
When CH approached the door of the suburban home, he could hear Josephine making all kinds of excited, joyous noises. As her mother opened the door, however, Josephine at once exclaimed 'No', ran over to the staircase, sat down, ejaculated another 'No', and then picked up the gollywog she had had in the nursery and threw it at the visitor. Mother, observer, and child then went to sit in the garden. Josephine could not sit still, however, and remained excited throughout. She pulled clothes off the line and began to throw them on the grass. Though this seemed deliberately provocative, her mother at first did nothing.
Josephine became more excited, ran about vigorously and repeatedly threw herself in the air and landed on her bottom, but she seemed to ignore any pain she may have inflicted on herself. Later she became aggressive towards her mother, threw herself at her and began to bite, first her mother's arm and then her necklace. Mother was surprised by this behaviour since nothing like it had occurred for some time, and she now restricted it.
Throughout this time Josephine had been afraid of the observer and had assiduously avoided him. When he walked towards her a very worried look came over her face, she cried 'Mummy' and went over to her. Although Josephine continued to react to any approach of the observer by running away, she would try to sneak up to him and to hit him on his back as long as he remained still. Sometimes she ran away and then turned towards him and hit him suddenly.
Finally, while the observer sat quietly in one place, Josephine crept close enough to cover him with a small blanket, whereupon she exclaimed 'All gone'. She then uncovered him again.
Mother remarked that the way Josephine had treated the observer was quite different from the way she had treated other strangers, and she expressed surprise that Josephine should so anxiously avoid someone she had not seen for sixteen weeks.
Support for the view that the children were responding in a specially fearful way to the visitor they had known in the nursery comes from a comparison of their reactions with those
____________________
1 The case report is adapted and abridged from that given in Heinicke & Westheimer (
1966). -14-
22
of the matched group of children who had not been away. For the control group, a period of weeks was designated that was treated as the equivalent of the separated children's period of separation, and a succeeding period of weeks was treated as the equivalent of the separated children's period of reunion. During the period equivalent to separation, the control children were visited in their homes by either Christoph Heinicke or Elizabeth Wolpert who administered the same doll-play procedures as they had administered to the children in the nursery. In both samples each child was given either two or three such sessions. In the case of the separated children these were on the third and eleventh days of separation, and, when separation lasted more than three weeks, again a few days before return home. (In the case of all the control children sessions were given on the third, eleventh, and twenty-first days. ) At the end of the sixteenth week of the period equivalent to reunion each of the control children was visited by one of the two workers who had administered the doll-play procedures, just as the separated children were. The response of the control children was quite different from that of the separated children. In every case the control children seemed to recognize the visitor and then approached. 1
At one time it was supposed by critics of our thesis concerning separation that distress seen in a child during a period away from mother, and increased ambivalence and anxiety seen after it, must betoken an unfavourable relationship between child and mother before the event, or reflect perhaps a child's anxiety about his mother's pregnancy or illness. Yet observations of healthy children from thoroughly satisfactory homes,
____________________
1 It was not only at the sixteenth-week visit that the control children behaved differently
towards the observer when compared with the separated children. When the control children were visited in their homes during the period equivalent to separation they treated CH and EW in a far more friendly way than the separated children had done, and nothing resembling panic was seen. It must be remembered, however, that, compared with the separated children, the control children had a very different experience of the observers during the period equivalent to separation. Whereas the separated children were observed six times each week during play in the nursery as well as given two (or three) doll-play sessions, the control children had only the three dollplay sessions. It is possible, therefore, that some part of the difference in the ways in which the two groups of children treated the observers was due to their different experiences of them.
-15-
who are separated from mother for one of many different reasons, show that, whatever contribution other variables may make, when a young child is in a strange place with strange people and with mother absent, protest, despair, and detachment still occur. The only children so far observed in such conditions who appear undisturbed have been those who have never had any figure to whom they can become attached, or who have experienced repeated and prolonged separations and have already become more or less permanently detached. There can be no doubt that a number of variables when combined with absence of mother figure increase the degree of disturbance seen. For example, the more strange the surroundings and the people, or the more painful any medical procedures, the more frightened a child is likely to be and the greater will be his disturbance, both during and after the separation. Again, however, observations of how very differently young children respond to any or all of these conditions when mother is with them make it clear that these conditions of themselves are not sufficient
23
to cause more than transient distress and that, in determining the sequence of protest, despair, and detachment, a key variable is mother's presence or absence.
Conditions mitigating the intensity of responses
Among conditions known to mitigate the intensity of responses of young children separated from mother the two most effective appear to be:
--a familiar companion and/or familiar possessions --mothering care from a substitute mother.
As would be expected, when these two conditions are combined, as commonly happens at home when a child is cared for by a grandmother, disturbance is at a minimum.
Heinicke & Westheimer (see pp. 10 - 11 above) are among several observers who have noted that when a young child is in a residential nursery with a sibling his distress is alleviated, especially during the early days; and Robertson has noted that some comfort is obtained even when the sibling is only two years old and the younger of a pair. Thus the presence of a familiar companion, even when that companion provides a negligible degree of substitute mothering, is found to be a mitigating factor of some significance. Inanimate objects, such as favourite toys and personal clothes, are also known to provide some measure of comfort.
-16-
A second and important mitigating condition is the provision of substitute mothering. How effective this can be in reducing disturbance when given by a woman who is a stranger to the child is not systematically recorded. Much evidence of an unsystematic kind shows, however, that initially a young child is afraid of the stranger and rejects her attempts to mother him. Subsequently, he shows intense conflict behaviour: on the one hand he seeks to be comforted by her, on the other he rejects her as being strange. Only after a period of days or weeks may he become accustomed to the new relationship. In the meantime he continues to yearn for his missing mother figure and on occasion to express anger with her for being absent. (Examples of this sequence are given in Chapter 2 of the first volume. )
The period during which disturbance lasts turns partly on the skill of the foster mother in adapting her behaviour to that of a distressed and, at times, frightened and rejecting child, and partly on the age of the child. In one study (as yet reported only briefly) Yarrow ( 1963) found that every child aged between seven and twelve months was disturbed after being moved from a temporary foster home to a permanent adoptive home. Over this age-span, he found, the 'severity and pervasiveness of disturbance increases with increasing age'.
Thus, while distress is mitigated both by the presence of a familiar companion and by fostering from a motherly but strange woman, each arrangement has serious limitations.
An Experimental Project
In their study already referred to in the preface, James & Joyce Robertson ( 1971), combining the roles of observers and foster parents, took into their own home four young children who were in need of care while their mothers were in hospital. In doing so they were seeking to
24
discover how young children of previous good experience respond in a separation situation that offers as many ameliorating conditions as are at present known about and possible to arrange, in particular, responsive mothering from a foster mother with whom the child has already become familiar.
For these purposes Mrs Robertson undertook to give each child her full-time care and, in doing so, to adopt so far as she could his mother's own methods of care. Every attention was given to minimizing the strangeness of the situation and to maximizing familiarity. During the month or so prior to the
-17-
separation, the child was introduced to the foster home and to members of the foster family by means of a series of interchange visits between the families. Meanwhile, the foster mother did all she could to learn about the child's stage of development, his likes and dislikes, and his mother's methods of caring for him, in order to maintain during the fostering period as similar a re? gime as possible. On coming into care the child brought with him his own bed and blankets, his familiar toys and a photograph of his mother. Moreover, during the child's time away every effort was made to keep alive within him his image of his missing mother. The foster mother made a point of talking about her and showing the child her photograph. Father was encouraged to visit, daily if possible; and both father and foster mother did all they could to assure the child he would soon return home. In these ways everything possible was done to reduce the impact of change, to accept openly the child's concern over loss of his mother, and to assure him that it would not last longer than necessary.
In the event the Robertsons cared for four children, one at a time, in each case while mother was having a new baby. Ages and days in care are set out below:
Kate 2 years 5 months Thomas 2 years 4 months Lucy 1 year 9 months Jane 1 year 5 months
27 days 10 days 19 days 10 days
All four were first children, had been and were living with both parents, and had not previously been separated from mother, except for an occasional few hours in the care of a familiar person.
The degree of disturbance seen in these children was far less than is seen in less favourable circumstances. Nevertheless each child was perceptibly upset. The form of disturbance in the two older children differed from that seen in the two younger. Although for much of the time Kate and Thomas seemed content with the foster arrangements, both showed plainly that they missed their own mothers. In the brief accounts that follow, derived from Robertson & Robertson ( 1971), particular attention is given to the episodes when the children expressed discontent. There is therefore some danger of the accounts giving an unbalanced picture.
25
Thomas, an active and friendly boy who talked well, settled happily with his foster parents. For most of the time he was
-18-
good-humoured, in friendly contact with his caretakers, and able to enjoy play and activities offered. After two days, however, he began to express both sadness at his parents' absence and also anger about it. He talked much of his mother and sometimes cuddled her photograph. While he seemed to have some grasp of the temporary nature of the separation, as the days passed the situation clearly put increasing strain upon him. On occasion he rejected his foster mother's attentions and indicated that it was his mother's role to look after him: 'Don't cuddle me, my mummy cuddles me. ' At the end of a visit from father, Thomas did his best to prevent his leaving, cried bitterly if briefly after he had gone and insisted that no one else should sit on his father's chair. At the end of his visit on the ninth day father summed up the strain of the situation in four words: 'We've both had enough. '
Although in the Robertsons' opinion Thomas came through the experience better than the other three children, and disturbance after his return home was minimal, he seemed nevertheless to be more aggressive and defiant after it than he had been before. Moreover, when his foster mother visited his home, although he was friendly to her, he was also cautious and throughout made a point of staying close to his mother.
Kate, the other child of nearly two and a half, showed during her first ten days away many of the same features of behaviour as did Thomas. On the one side she ate and slept well, and was cheerful, active, and cooperative with her foster parents. On the other she expressed yearning for her absent parents and occasional anger with them for not taking her home. Owing to mother's obstetric complication, moreover, Kate was away nearly three times as long as Thomas. During the third and fourth weeks her relationship to the foster mother deepened and she seemed to be finding a niche for herself in the foster family. Nevertheless, her yearning for her own mother continued and was 'increasingly intermingled with anger'. Anger, directed at foster mother, was especially strong after Kate's two visits to see mother in hospital.
One other feature of Kate's behaviour during the separation is to be remarked. During the second week she became fearful of getting lost and began to cling. She also cried more easily and at times seemed preoccupied and dreamy. Her query 'What is Kate looking for? ', made on one of these occasions, seems to indicate that her yearning and searching for mother, though continuing active in her, were beginning to undergo repression.
-19-
When eventually Kate returned home she at once greeted her mother and began to rebuild their relationship. By contrast, she completely ignored her foster mother who had looked after her for nearly four weeks, and who was sitting quietly by.
Although Kate settled back in her family with only slight upset, she was noticeably more demanding of her parents' attention. Moreover, her reaction to an episode that occurred two weeks after her return suggested strongly that she was intensely afraid of another separation. Mother was eager to ensure that, when Kate reached five, she would be able to go to a particular school; so mother took her there to be enrolled, over two years in advance. The following night Kate screamed as though with nightmares and in the morning was acutely
26
breathless. When the doctor, who diagnosed bronchial asthma, inquired about stress, mother realized that, during talk at the school the previous day, the head had agreed to 'take' Kate.
Neither of the two younger children had much language capacity and neither could be helped as much as the two older ones to keep the absent mother clearly in mind. Perhaps because of this, each child seemed to transfer attachment from mother to substitute comparatively easily and to find security in the new arrangement. Neither child showed acute upset. Both continued to function well, learnt new skills, and increased their vocabularies. Yet for both children it was evident that all was not well. By her fourth day away Jane had become restless and demanding of attention and gave the impression of 'a child who was under strain and at times bewildered'. Lucy, similarly, had her bad patches and by the nineteenth day away is described as being 'in a highly sensitive state'.
In these little girls explicit yearning for the missing mother and being angry with her occurred only sporadically, and then only in response to specific reminders of her. Jane, for example, on her sixth day of separation noticed the gate of her own garden, opened it and entered, and tried unsuccessfully to open the door of her parents' apartment. Returning, she spoke the word 'Mama' for the first time and also resisted entering the foster home. Jane's relations with her father deteriorated as the separation progressed. At first she played happily when he visited, then she got angry with him and, finally, she seemed pointedly to ignore him, only to cling and cry when he made to leave. Lucy's relations with her father went through much the same sequence. After one visit when he had taken her to a park near their home, she became very
-20-
distressed after his departure; at first she refused to be comforted by her foster mother and subsequently clung tearfully to her and refused to be put down.
On reunion each of these younger children recognized mother immediately and responded pleasurably to her. Unlike the two older children, however, they seemed reluctant to relinquish the foster mother. Lucy in particular had difficulty in weaning herself from her and later showed marked conflict in relation to her. For example, during foster mother's visit three days after returning home Lucy 'oscillated between affection and apprehension, smiling and frowning, clinging to her mother yet crying bitterly when foster mother left'. Like Thomas and Kate, both these younger children were more hostile to mother after the separation than they had been before it (though presumably in each case this could have been due in some degree to the presence of a new baby).
Interpretation of Findings
All these children, then, showed far less distress than occurs when young children are separated from mother in less favourable conditions, yet all four showed unmistakable signs of strain and from time to time that they were aware of missing mother. In the interpretation of these responses there is some difference of opinion. The Robertsons, impressed by the fact that care by a responsive substitute mother in a benign environment holds anxiety at a 'manageable level' and permits 'positive development' to continue, believe that the onset of the deteriorative sequence of protest, despair, and detachment can be prevented. This leads them to the view that the responses shown by children fostered in this way are qualitatively different from those of institutionalized children, and cannot be understood as representing a difference of intensity only. An alternative view, however, is that the sequence of protest,
27
despair, and detachment, although greatly reduced in intensity and curtailed, cannot be regarded as absent. In the two older children, for example, the pattern of response, though at low intensity, showed very plainly most of the elements now known to be typical of how young children respond during and after a brief separation in less cushioned conditions -- yearning and searching for the missing mother, sadness, increasing protest at her absence and growing anger with her for staying away, increased ambivalence on return home, and evident fear of being separated again. Thanks to the precautions taken despair
-21-
was admittedly held at bay and with it detachment, though signs suggestive of the latter were seen in Kate. In the two younger children the pattern of response was less clear, but several typical elements were none the less present. This leads to the conclusion that the differences in response between the fostered children and children removed to an institution are properly regarded as differences of intensity. There are other ways in which the Robertsons contrast their theoretical position with the one I adopt, notably as regards the role of grief and mourning in early childhood. These issues will be discussed in the third volume. Meanwhile it is important to note that, whatever differences there may be between the Robertsons and myself in regard to theory, there are none in practice. For, when the Robertsons come to consider the practical lessons to be derived from their project, they warn that, because these carefully fostered children came through so well, it must not be assumed that the hazards of separation during the early years can be eliminated entirely. On the contrary, they state, their experience has served to reinforce them in the view, which we have long shared, that 'separation is dangerous and whenever possible should be avoided'.
Presence or absence of mother figure: a key variable
From the Robertsons' recent study and the many others now on record two main conclusions can be drawn:
The sequence of intense protest, followed by despair and detachment, which first caught our attention, is due to a combination of factors, of which the kernel is the conjunction strange people, strange events, and an absence of mothering either from mother herself or from a capable substitute.
Because separation from mother figure even in the absence of these other factors still leads to sadness, anger, and subsequent anxiety in children aged two years and over, and to comparable though less differentiated stress responses in younger ones, separation from mother figure is in itself a key variable in determining a child's emotional state and behaviour.
By 'mother figure' is meant that person to whom a child directs his attachment behaviour by preference; and by 'substitute mother' is meant any other person to whom a child is willing temporarily to direct attachment behaviour. Since, however, an individual as he grows older directs attachment behaviour to others besides mother or someone acting as a
-22-
substitute mother, it is convenient to have available terms that are less specifically tied to the child-parent relationship. Among terms used here in a generic way to cover anyone towards whom attachment behaviour is directed are 'attachment figure' and 'support figure'.
'Presence' and 'absence' are relative terms and, unless defined, can give rise to misunderstanding. By presence is meant 'ready accessibility', by absence 'inaccessibility'. The
28
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). 1
Not only here but elsewhere also, finding suitable language is a problem. For example, how long is a temporary separation? Plainly the answer turns on the subject's age. Thus what might seem interminable to a one-year-old might seem insignificant to a schoolchild. What might seem interminable to a schoolchild might seem of no great significance to an adult. Another problem, and one that is more difficult, is to know at what point a separation that started as temporary becomes permanent -- or at least becomes conceived by the victim and by others as being so.
Yet a further difficulty turns on the fact that a mother can be physically present but 'emotionally' absent. What this means, of course, is that, although present in body, a mother may be unresponsive to her child's desire for mothering. Such unresponsiveness can be due to many conditions -- depression, rejection, preoccupation with other matters -- but, whatever its cause, so far as her child is concerned she is no better than half-present. Then again a mother can use threats to abandon a child as a means of disciplining him, a tactic that probably has an immeasurably greater pathogenic effect than is yet recognized.
These and other problems are discussed in later chapters. Meanwhile, the thesis can be phrased more precisely. Whether a child or adult is in a state of security, anxiety, or distress is determined in large part by the accessibility and responsiveness of his principal attachment figure.
____________________
1 The present usage of the word separation should be distinguished from the very different
usage of Mahler ( 1968) who employs it to describe an intrapsychic process which results in 'differentiation of the self from the symbiotic object'. Prior to this development a psychological 'state of undifferentiation, of fusion with mother', termed symbiosis, is postulated.
-23-
There have been, and still are, clinicians and others interested in children who have found it difficult to believe that accessibility or inaccessibility of attachment figure can of itself be a crucial variable in determining whether a child (or an adult for that matter) is happy or distressed. One reason for disbelief is the supposition that, when there is nothing 'objective', namely intrinsically painful or dangerous, for a child or adult to be distressed about or afraid of, any distress or anxiety must be irrational and, if irrational, is to be deemed neurotic. Other reasons derive from a faulty theory of the nature of instinctive behaviour, and especially from failure to distinguish causation from function (see Volume I, Chapters 6 and 8). Others again derive from the many confusions and false value judgements to which the concept of dependency gives rise (see Volume I, Chapter 12). Yet another and different sort of reason may be the sheer inconvenience in practical life of the facts of the case as they seem actually to be in comparison with what things would be like were every normal child to be happy and content with any caretaker whatever -- provided she were kind. If children were only 'reasonable' in this regard, how much easier would life be!
In order to understand how some of the difficulties have arisen it is useful to consider how separation and loss have been treated in the psychoanalytic literature as situations of relevance
29
to personality development and psychopathology. In particular, it is useful to examine the place given to separation in theories of anxiety, and the kinds of explanation that have been proposed to account for its influence. Some of these ideas are traced in the following chapter, and opportunity is taken to compare the standpoint adopted in these volumes with that adopted in more traditional psychoanalytic works.
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30
Chapter 2
The Place of Separation and Loss in Psychopathology
A new pamphlet of mine, Inhibitions, Symptoms and Anxiety, is now being published. It shakes up much that was established and puts things which seemed fixed into a state of flux again. Analysts who above all want peace and certainty will be discontented at having to revise their ideas. But it would be rash to believe that I have now succeeded in finally solving the problem with which the association of anxiety with neurosis confronts us.
SIGMUND FREUD 1
Problem and perspective
From Freud's earliest studies of the aetiology of the neuroses, until the end of his life the twin problems of neurotic anxiety and defence were never far from his mind. Again and again he grappled with them, and on the various tentative solutions he offered rest his successive theoretical formulations. Since Freud's death, moreover, theories of anxiety and defence have continued to be the foundation-stones of psychoanalytic psychopathology; and it is through their espousing differing views on the nature and origins of these conditions that the several distinctive schools of psychoanalysis have come into being.
In Freud's earliest formulations there is no hint that anxiety arises from loss or threat of loss, or that defensive processes are evoked in conditions of intense anxiety. Only little by little, and mainly towards the end of his life, did Freud advance such views and, in so doing, bring his ideas on anxiety and defence into relation with his ideas on mourning which, until then, had been a significant but quite distinct strand in his thinking. A principal result of his new formulation was, as he rightly foresaw, to bring everything 'into a state of flux again'.
Although Freud himself at different periods of his life adopted ____________________
1 Letter to Oskar Pfister, 3 January 1926 (see H. Meng & E. L. Freud 1963).
-25-
a number of radically different theories in regard to anxiety, mourning, and defence, as have the various schools of thought that have grown up subsequently, each theory is based on data obtained by but a single method of inquiry. Data are derived from studying, in the analytic setting, a personality more or less developed and already functioning more or less well; and from these data an attempt is made to reconstruct the phases of personality that have preceded what is now seen. To many the resulting literature is as frustrating as it is stimulating. On the one hand, it is plainly dealing with problems that every sensitive clinician recognizes to be of central consequence for understanding and helping his patients; on the other, it presents a complex web of competing and often inconsistent theorizing without providing methods by which to sort grain from chaff.
What is attempted in these volumes is to approach the classic problems of psychoanalysis prospectively. The primary data are observations of how young children behave in defined situations; in the light of these data an attempt is made to describe certain early phases of
31
personality functioning and, from them, to extrapolate forwards. In particular the aim is to describe certain patterns of response that occur regularly in early childhood and, thence, to trace out how similar patterns of response are to be discerned in the later functioning of the personality. 1
Some of the essential data, as described in the previous chapter, can be summarized as follows. Whenever a young child who has had an opportunity to develop an attachment to a mother figure is separated from her unwillingly he shows distress; and should he also be placed in a strange environment and cared for by a succession of strange people such distress is likely to be intense. The way he behaves follows a typical sequence. At first he protests vigorously and tries by all the means available to him to recover his mother. Later he seems to despair of recovering her but none the less remains preoccupied with her and vigilant for her return. Later still he seems to lose his interest in his mother and to become emotionally detached from her. Nevertheless, provided the period of separation is not too prolonged, a child does not remain detached indefinitely. Sooner or later after being reunited with his mother his attachment to her emerges afresh. Thenceforward, for days or weeks, and sometimes for much longer, he insists on staying
____________________
1 The point of view adopted is described at greater length in the first chapter of Volume I.
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close to her. Furthermore, whenever he suspects he will lose her again he exhibits acute anxiety.
When I came to examine the theoretical problems raised by these observations it was evident that the first step must be to gain a clearer understanding of the bond that ties child to mother. Next, it gradually became apparent that each of the three main phases of the response of a young child to separation is related to one or another of the central issues of psychoanalytic theory. Thus the phase of protest is found to raise the problem of separation anxiety; despair that of grief and mourning; detachment that of defence. The thesis that was then advanced ( Bowlby 1960a) was that the three types of response -separation anxiety, grief and mourning, and defence -- are phases of a single process and that only when they are treated as such is their true significance grasped.
A reading of the psychoanalytic literature shows that, as a rule, separation anxiety, mourning, and defence have been considered piecemeal. The reason for this is the inverted order in which their psychopathological significance was discovered: for it was the last phase that was recognized first, and the first last. Thus the significance of defence, particularly repression, was realized by Freud in the earliest days of his psychoanalytic work and provides the basis of his original theorizing: his first paper on the subject is dated 1894 ( "'The Neuro-psychoses of Defence'", SE 3). 1 His grasp of the roles of grief and of separation anxiety, on the other hand, was at that time still fragmentary. Although he was early alive to the place of mourning in hysteria and melancholia (see note of 1897 to Fliess, SE 14: 240), twenty years were to elapse before, in "'Mourning and Melancholia'" ( 1917a, SE 14), he gave it systematic attention. Similarly in the case of separation anxiety: although in the Three Essays on the Theory of sexuality ( 1905b) he gave it a paragraph ( SE 7: 224 ) and in the Introductory Lectures ( 1917b) three pages ( SE 16: 405 408 ), it is not until 1926 that in his revolutionary late work Inhibitions, Symptoms and Anxiety he accorded it the central place in what was to be his final
32
theory of anxiety. 'Missing someone who is loved and longed for', he there affirms, is 'the key to an understanding of anxiety' ( SE 20: 136 -7). 2
____________________
1 The abbreviation SE denotes the Standard Edition of The Complete Psychological Works of
Sigmund Freud, published in 24 volumes by the Hogarth Press Ltd, London. All quotations
from Freud in the present work are taken from this edition.
2 For an account of the development of Freud's theories of anxiety, see
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The reason for this inverse recognition of the three phases is clear: always in the history of medicine it is the end-result of a pathological sequence that is noted first.
Why, it may be asked, should these children have become so strongly possessive of their nurse and so deeply distressed whenever she was missing? Was it, as some traditionalists might suppose, that they had been spoiled by having been given too much attention and allowed too much their own way? Or
____________________
1 Although throughout this book the text refers usually to 'mother' and not to 'mother figure',
it is to be understood that in every case reference is to the person who mothers a child and to whom he becomes attached. For most children, of course, this person is also his natural mother.
-3-
was it, by contrast, that since leaving home they had been subjected to too many changes of mother figure and/or had too limited access to whoever in the nursery was acting temporarily as their mother figure? On how we answer these questions turn all our practices of child- rearing.
14
Not only did children in these nurseries become intensely possessive and jealous of their 'own' nurse but they were also unusually prone to become hostile towards her or to reject her, or else to retreat into a state of emotional detachment, as the following records illustrate:
Jim was separated from a very nice and affectionate mother at 17 months and developed well in our nursery. During his stay he formed two strong attachments to two young nurses who successively took care of him. Though he was otherwise a well adjusted, active and companionable child, his behaviour became impossible where these attachments were concerned. He was clinging, over-possessive, unwilling to be left for a minute, and continually demanded something without being able to define in any way what it was he wanted. It was no unusual sight to see Jim lie on the floor sobbing and despairing. These reactions ceased when his favourite nurse was absent even for short periods. He was then quiet and impersonal.
Reggie, who had come to our house as a baby of 5 months, went home to his mother when he was 1 year 8 months, and has been with us ever since his return to the nursery 2 months later. While with us, he formed two passionate relationships to two young nurses who took care of him at different periods. The second attachment was suddenly broken at 2 years 8 months when his 'own' nurse married. He was completely lost and desperate after her departure, and refused to look at her when she visited him a fortnight later. He turned his head to the other side when she spoke to him, but stared at the door, which had closed behind her, after she had left the room. In the evening in bed he sat up and said: 'My very own Mary-Ann! But I don't like her. '
These observations, made in the pressure of wartime and recorded anecdotally with all too little detail, none the less cast a shaft of light on the nature of many forms of psychiatric disturbance. States of anxiety and depression that occur during
-4-
adult years, and also psychopathic conditions, can, it is held, be linked in a systematic way to the states of anxiety, despair, and detachment described by Burlingham & Freud, and subsequently by others, that are so readily engendered whenever a young child is separated for long from his mother figure, whenever he expects such a separation, and when, as sometimes happens, he loses her altogether. Whereas during later life it is often extremely difficult to trace how a person's disturbed emotional state is related to his experiences, whether they be those of his current life or those of his past, during the early years of childhood the relationship between emotional state and current or recent experience is often crystal clear. In these troubled states of early childhood, it is held, can be discerned the prototype of many a pathological condition of later years.
It is, of course, a commonplace that most children who have had experiences of these kinds recover and resume normal development, or at least they appear to do so. Not infrequently, therefore, doubts are expressed whether the psychological processes described are in reality related so intimately to personality disturbances of later life. Pending much further evidence, these are legitimate doubts. Nevertheless, reasons for holding to the thesis are strong. One is that data from many sources can be arranged and organized into a pattern that is internally consistent and consistent also with current biological theory. Another is that many clinicians and social workers find the resulting schema enables them to understand better the problems with which they are grappling and so to help their patients or clients more effectively.
15
Why some individuals should recover, largely or completely, from experiences of separation and loss while others seem not to is a central question, but one not easily answered. In living creatures variation of response is the rule and its explanation is often hard to fathom. Of all those who contract poliomyelitis less than 1 per cent develop paralysis, and only a fraction of 1 per cent remain crippled. Why one person should respond one way and another another remains obscure. To argue that, because 99 per cent recover, polio is a harmless infection would obviously be absurd. Similarly, in the field under consideration, to argue that because most individuals recover from the effects of a separation or loss these experiences are of no account would be equally absurd.
Nevertheless the problem of differential response remains
-5-
important. Conditions likely to be playing a part can be considered under two main heads: those intrinsic to or closely associated with the separation itself, notably the conditions in which a child is cared for while away from mother;
those present in the child's life over a longer period, notably his relations with parents during the months or years before and after the event.
Here we consider variables in category (a). Those in category (b) are discussed in the later chapters of Part III.
We start by reviewing observations of how children behave when cared for in one of two very different settings. The first is an ordinary residential nursery, in which a child finds himself in a strange place with strange people none of whom is sufficiently available to give him more than very limited mothering. The second is a foster home in which a child receives the fulltime and skilled care of a foster mother with whom he has become in some degree familiar beforehand.
Conditions leading to intense responses
In our early studies children were observed during stays in institutional settings and it was on the basis of these observations that the sequence of responses which we term protest, despair, and detachment came first to be delineated ( Robertson & Bowlby 1952). Since then two further studies have been conducted by colleagues in the Tavistock Child Development Research Unit, the first by Christoph Heinicke ( 1956) and the second by Heinicke & Ilse Westheimer ( 1966). Although in each of these investigations only a handful of children were observed (six in the first and ten in the second), the studies are unique for the care of their design and the amount of systematic observation. Moreover, for each sample of separated children a contrast group was selected and observed: in the first study it was a fairly well- matched group of children observed during their first weeks of attendance at a day nursery; in the second it was a similarly matched group of children observed while living in their own homes. Heinicke & Westheimer treat their data statistically and also describe in some detail the behaviour of individual children.
In the larger investigation ( 1966), work was conducted in three residential nurseries. Arrangements and facilities were fairly similar. In each, a child belonged to a defined group of
16
-6-
children and was cared for mainly by one or two nurses. Ample opportunities were available for free play either in large rooms or outdoors in a garden. Before a child entered the nursery, contact was made with the family by a psychiatric social worker ( Ilse Westheimer), who was also responsible either then or later for collecting full information about the family and the child. Arrival at the nursery was observed; and in the course of his stay a child was observed during free play on six occasions each week. Each of the two observers (one male, Christoph Heinicke, and one female, Elizabeth Wolpert) observed for a period of at least half an hour during each of the three sample periods into which the week was broken (Monday and Tuesday; Wednesday and Thursday; Friday, Saturday, and Sunday). The method used, of categorizing behavioural units in terms of agent, object, relation, mode, and intensity, had been used in the earlier study and had been shown to be reliable.
In addition to the categorized observations of free behaviour, similarly categorized observations were made of every child's behaviour in standardized doll-play sessions; and a number of other records of each child's stay in the nursery were kept.
It was originally intended to select the separated children in accordance with the five criteria used in the first study, namely: (i) that the child had had no previous separations of more than three days, (ii) that he fell within the age-limits of fifteen to thirty months, (iii) that he did not enter the nursery with a sibling, (iv) that he was living with both mother and father at the time the separation occurred, and (v) that there was no evidence that being placed in a nursery indicated a rejection by his parents. Because of the difficulty of obtaining cases, however, these criteria had to be modified to allow greater latitude.
Although most of the children had had either no separations or only very brief ones prior to the one being studied, in one case the length of previous separation was four weeks and in two it was three weeks. The age-range was slightly extended and ran from thirteen to thirty-two months, instead of from fifteen to thirty months. But the most marked departure from the previous criteria was that four of the children entered the residential nursery in the company of a sibling: in three cases this was a four-year-old sibling and in one case the sibling was younger. The remaining two criteria remained unmodified: each of the children was living with both mother and father at the time of separation, and there were no indications that he
-7-
was being rejected by the parents by being placed in the nursery.
The reason that the ten children studied were cared for in a residential nursery was that, in a family emergency, neither relatives nor friends were available to take temporary care of them. In the case of seven families, mother was to be away in hospital having a new baby. In two others mother was to be in hospital for some other form of medical attention. In the tenth case, the family became homeless.
Among much else in their book, Brief Separations ( 1966), Heinicke & Westheimer describe behaviour typical of the ten children during their time in the nursery, and, similarly, behaviour typical of the children after they had returned home. In the paragraphs that follow some of their principal findings are presented. Every one of the patterns reported had also been
17
observed and recorded by Robertson during his earlier, less systematic though more extensive, studies.
Behaviour during Separation
The children arrived at the nursery in the care of one or both parents. Four of them, brought by father, stayed close to him and seemed already subdued and anxious. Some of the others, who had come with mother or both parents, seemed more confident and were ready to explore the new environment. They ventured forth on short or long excursions and then returned.
When the moment came for the parent (s) to depart, crying or screaming was the rule. One child tried to follow her parents, demanding urgently where they were going, and finally had to be pushed back into the room by her mother. Another threw himself on the floor and refused to be comforted. Altogether eight of the children were crying loudly soon after their parents' departure. Bedtime was also an occasion for tears. The two who had not cried earlier screamed when put in a cot and could not be consoled. Some of the others whose initial crying had ceased broke into renewed sobs at bedtime. One little girl, who arrived in the evening and was put straight to bed, insisted on keeping her coat on, clung desperately to her doll, and cried 'at a frightening pitch'. Again and again, having nodded off from sheer fatigue, she awoke screaming for Mummy.
Crying for parents, mainly for mother, was a dominant response especially during the first three days away. Although it decreased thereafter, it was recorded sporadically for each of
-8-
the children for at least the first nine days. It was particularly common at bedtime and during the night. In the early hours of her second day of separation one child, Katie, aged eighteen months, awoke screaming and shouting for Mummy. She remained awake and continued to cry for mother until noon. During the early days away a visit from father led to renewed crying. Another little girl whose father visited her on the third day cried frantically and continuously for twenty minutes after he left.
Searching for mother occurred also and was particularly evident in Katie. After the first week, Katie stopped crying for mother and, instead, seemed content to sit on the nurse's lap watching television. From time to time, however, she demanded that they go upstairs. When asked what she hoped to find there her unhesitating reply was 'Mummy'.
Oriented as they were to their missing parents, these small children were in no mood either to cooperate with the nurses or to accept comfort from them. Initially the children refused to be dressed or undressed, refused to eat, refused the pot. During the first day all but one child, the youngest, refused to be approached, picked up, or comforted. After a day or two resistance abated, but even at the end of two weeks over onethird of the nurses' requests and demands were still being resisted.
Nevertheless, although resistance to the nurses continued to be frequent, the children also began occasionally to seek some sort of reassuring or affectionate response from them. At first these bids for affection were not discriminating but before the end of the second week a few children were beginning to exhibit preferences. For example, one little girl, Gillian, who had refused any dealings with the nurses during the early days, had by the sixth day singled
18
out one nurse and seemed happy sitting on her lap. When the nurse left the room, moreover, Gillian looked longingly at the door. Even so Gillian's feelings for her nurse were not unmixed: when the nurse returned Gillian walked away.
The children's relations with the two research observers were also not unmixed. During the first day most of the children seemed friendly to at least one of the observers. Subsequently they made a point of avoiding the observers by moving away, turning their back, leaving the room, shutting their eyes, or burying their head in a pillow. Especially dramatic were certain occasions when a child broke into a panic the moment
-9-
one of the observers entered the room. On seeing him, or her, a child might scream and run to cling to a nurse. Sometimes a child would show marked relief as soon as an observer had left.
Needless to say, the observers were as unobtrusive as possible. In general their role was not to initiate interaction but to respond in a friendly way whenever a child approached them. Nevertheless, part of the plan was that, fairly late during each of the observation periods, the observer 'actively though cautiously approached the child to see how he would react'. In later chapters of this volume (Chapters 7 and 8) it will be seen that, unwittingly, this plan resulted in conditions that, in combination, are likely to be especially frightening. In some degree, at least, the children's fear of the observers must be attributed to these circumstances.
All but one of the ten children brought with them to the nursery a favourite object from home. For the first three days or so they clung closely to their object and became extremely upset if a nurse, trying to be helpful, happened to take hold of it. Subsequently, however, the children's treatment of their favourite object changed: at one moment they would cling to it, at another throw it away. For instance, one little girl alternated between carrying her rag doll about in her mouth, like a mother cat with a kitten, and flinging it away shouting 'All gone'.
Hostile behaviour, though infrequent, tended to increase during the two weeks of observation. It often took the form of biting another child or ill-treating the favourite object brought from home.
A breakdown in sphincter control was usual. Of the eight children who had attained some degree of control before arriving in the nursery, all but one lost it. The exception, Elizabeth, aged two years eight months, was the oldest of the children.
Although certain kinds of behaviour were common to all or almost all the children, in other ways the children differed. For example, four were constantly active whereas two others preferred to stay in a single spot. A few rocked; others, who seemed constantly on the verge of tears, continually rubbed their eyes.
It will be recalled that four of the children entered the nursery with a sibling, in three cases a four-year-old child and in one case a younger one. As had been expected, the frequency and intensity of the responses typical of children staying in a
-10-
19
residential nursery were much diminished in these children. They cried less and showed fewer outbursts of marked hostility. During the early days especially, siblings constantly sought each other's company, talked and played together. To outsiders they presented a united front, with exclamations such as 'She's not your sister, she's my sister'.
Behaviour at and after Reunion
Inevitably in a situation of this kind the length of time children remain away from home varies. In this study six children were away from twelve to seventeen days; the other four were away for weeks, the periods being seven, ten, twelve, and twenty-one weeks respectively. The ways in which the individual children responded when they returned home differed in many respects; and part of the difference was related to the length of time they had been away, a finding confidently forecast from the results of Robertson's earlier observations.
In this phase of the study two principal lessons learnt from earlier Tavistock studies were applied. The first was to make continuous first-hand observations of how a child responded on first meeting his mother again and during the next few hours. The second was to pay especial attention to a child's response to the visit to his home of an observer he had seen regularly in the nursery. Accordingly, with three research workers available, the following dispositions were made.
One worker, Ilse Westheimer, who had made contact with each of the families before a child went to the nursery, continued contact while the child was away, e. g. by visiting mother in hospital, and was on the spot to make observations when the child was reunited with his parents. Except for one brief visit, she avoided the children while they were in the nursery. In a complementary role, the two observers, Christoph Heinicke and Elizabeth Wolpert, who were responsible for all the observations made on the children in the nursery, took no part in liaising with the families; and they avoided visiting a child at home after he had returned there until a planned visit was made exactly sixteen weeks after his return. 1 (The only exception to this arrangement occurred because Ilse Westheimer was unavailable on one occasion when a child was returning
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1 During the intervening sixteen weeks contact with the home was maintained by Ilse
Westheimer, who also administered doll-play procedures during the sixth and the sixteenth weeks after reunion, and during the equivalent weeks for the control children.
-11-
home, and observation of the return was in this case made by Elizabeth Wolpert. )
In seven cases Ilse Westheimer met mother at the nursery, witnessed the meeting of child and mother, and then drove them home. In three others she met father at the nursery, witnessed the meeting of child and father, and drove the pair home to mother. (In one case they picked mother up on the way, at the hospital in which she had been a patient. )
On meeting mother for the first time after the days or weeks away every one of the ten children showed some degree of detachment. Two seemed not to recognize mother. The other eight turned away or even walked away from her. Most of them either cried or came close to tears; a number alternated between a tearful and an expressionless face.
20
In contrast to these blank, tearful retreats from mother, all but one of the children responded affectionately when they first met father again. Furthermore, five were friendly to Ilse Westheimer as well.
As regards detachment, two findings of earlier studies were clearly confirmed in this one. The first is that detachment is especially characteristic of the way in which a separated child behaves when he meets his mother again, and is much less evident with father; the second is that the duration of a child's detachment from mother correlates highly and significantly with the length of his time away.
In nine cases detachment from mother persisted in some degree throughout almost the first three days of reunion. In five children it was so marked that the mother of each complained, characteristically, that her child treated her as though she were a stranger; none of these children showed any tendency to cling to mother. In the other four, detachment was less pronounced: phases during which they turned away from mother alternated with phases during which they clung to her. Only one child, Elizabeth, who was the oldest and whose separation was among the shortest, was affectionate towards her mother by the end of the first day home. Both Elizabeth and the four who alternated soon showed that they were afraid to be left alone and became far more clinging than they had been before they had gone away.
There is reason to believe that after a very prolonged or repeated separation during the first three years of life detachment can persist indefinitely; the problems to which this gives rise will be discussed in Volume III. After briefer separations
-12-
detachment gives way after a period lasting usually hours or days. It is commonly succeeded by a phase during which a child is markedly ambivalent towards his parents. On the one hand, he is demanding of their presence and cries bitterly if left; on the other, he may become rejecting, hostile, or defiant towards them. Of the ten children studied eight showed a noticeable degree of ambivalence, and in five of them it persisted for not less than twelve weeks. Among determinants of the length of time ambivalence lasts one of the most influential is likely to be the way a mother responds to it.
It will be evident from the descriptions given that when a child returns home after a period away his behaviour presents his parents, especially his mother, with great problems. How a mother responds depends on many factors: for example, the kind of relationship she had with the child before separation and whether she believes that a disturbed and demanding child is better treated with comfort and reassurance or with discipline. A variable to which Westheimer ( 1970) has drawn attention is the way in which a mother's feelings for her child may change in the course of a long separation from him, lasting many weeks or months, during which she does not see him. Warm feelings are apt to cool and family life to become organized on lines that leave no place into which the returning child can fit.
There is abundant evidence that after a child has been away from home in a strange place and in the care of strangers he is liable to be very frightened lest he be taken away again. This was borne in on Robertson during some of his early studies. Children who had been in hospital tended to panic, he found, at the sight of anyone in a white coat or nurse's uniform, and they indicated clearly their fear of being returned to hospital. Several children were apprehensive
21
when Robertson himself visited them at home. They took care to avoid him and, provided they were not in a detached condition, clung close to mother.
In the Heinicke-- Westheimer study one of the two observers who had been present in the nursery visited each child sixteen weeks after his return home. All the children seemed clearly to remember the observer and reacted with strong feeling; all but one made 'a desperate attempt' to avoid the observer. The mothers were much surprised that their child should be so afraid, and affirmed that other strangers who visited the house did not arouse such reactions.
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The case of Josephine, who had been aged two years when she was in the nursery for thirteen days and was now aged two years and four months, illustrates the anxious hostile behaviour seen typically on the occasion of these visits. 1
When CH approached the door of the suburban home, he could hear Josephine making all kinds of excited, joyous noises. As her mother opened the door, however, Josephine at once exclaimed 'No', ran over to the staircase, sat down, ejaculated another 'No', and then picked up the gollywog she had had in the nursery and threw it at the visitor. Mother, observer, and child then went to sit in the garden. Josephine could not sit still, however, and remained excited throughout. She pulled clothes off the line and began to throw them on the grass. Though this seemed deliberately provocative, her mother at first did nothing.
Josephine became more excited, ran about vigorously and repeatedly threw herself in the air and landed on her bottom, but she seemed to ignore any pain she may have inflicted on herself. Later she became aggressive towards her mother, threw herself at her and began to bite, first her mother's arm and then her necklace. Mother was surprised by this behaviour since nothing like it had occurred for some time, and she now restricted it.
Throughout this time Josephine had been afraid of the observer and had assiduously avoided him. When he walked towards her a very worried look came over her face, she cried 'Mummy' and went over to her. Although Josephine continued to react to any approach of the observer by running away, she would try to sneak up to him and to hit him on his back as long as he remained still. Sometimes she ran away and then turned towards him and hit him suddenly.
Finally, while the observer sat quietly in one place, Josephine crept close enough to cover him with a small blanket, whereupon she exclaimed 'All gone'. She then uncovered him again.
Mother remarked that the way Josephine had treated the observer was quite different from the way she had treated other strangers, and she expressed surprise that Josephine should so anxiously avoid someone she had not seen for sixteen weeks.
Support for the view that the children were responding in a specially fearful way to the visitor they had known in the nursery comes from a comparison of their reactions with those
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1 The case report is adapted and abridged from that given in Heinicke & Westheimer (
1966). -14-
22
of the matched group of children who had not been away. For the control group, a period of weeks was designated that was treated as the equivalent of the separated children's period of separation, and a succeeding period of weeks was treated as the equivalent of the separated children's period of reunion. During the period equivalent to separation, the control children were visited in their homes by either Christoph Heinicke or Elizabeth Wolpert who administered the same doll-play procedures as they had administered to the children in the nursery. In both samples each child was given either two or three such sessions. In the case of the separated children these were on the third and eleventh days of separation, and, when separation lasted more than three weeks, again a few days before return home. (In the case of all the control children sessions were given on the third, eleventh, and twenty-first days. ) At the end of the sixteenth week of the period equivalent to reunion each of the control children was visited by one of the two workers who had administered the doll-play procedures, just as the separated children were. The response of the control children was quite different from that of the separated children. In every case the control children seemed to recognize the visitor and then approached. 1
At one time it was supposed by critics of our thesis concerning separation that distress seen in a child during a period away from mother, and increased ambivalence and anxiety seen after it, must betoken an unfavourable relationship between child and mother before the event, or reflect perhaps a child's anxiety about his mother's pregnancy or illness. Yet observations of healthy children from thoroughly satisfactory homes,
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1 It was not only at the sixteenth-week visit that the control children behaved differently
towards the observer when compared with the separated children. When the control children were visited in their homes during the period equivalent to separation they treated CH and EW in a far more friendly way than the separated children had done, and nothing resembling panic was seen. It must be remembered, however, that, compared with the separated children, the control children had a very different experience of the observers during the period equivalent to separation. Whereas the separated children were observed six times each week during play in the nursery as well as given two (or three) doll-play sessions, the control children had only the three dollplay sessions. It is possible, therefore, that some part of the difference in the ways in which the two groups of children treated the observers was due to their different experiences of them.
-15-
who are separated from mother for one of many different reasons, show that, whatever contribution other variables may make, when a young child is in a strange place with strange people and with mother absent, protest, despair, and detachment still occur. The only children so far observed in such conditions who appear undisturbed have been those who have never had any figure to whom they can become attached, or who have experienced repeated and prolonged separations and have already become more or less permanently detached. There can be no doubt that a number of variables when combined with absence of mother figure increase the degree of disturbance seen. For example, the more strange the surroundings and the people, or the more painful any medical procedures, the more frightened a child is likely to be and the greater will be his disturbance, both during and after the separation. Again, however, observations of how very differently young children respond to any or all of these conditions when mother is with them make it clear that these conditions of themselves are not sufficient
23
to cause more than transient distress and that, in determining the sequence of protest, despair, and detachment, a key variable is mother's presence or absence.
Conditions mitigating the intensity of responses
Among conditions known to mitigate the intensity of responses of young children separated from mother the two most effective appear to be:
--a familiar companion and/or familiar possessions --mothering care from a substitute mother.
As would be expected, when these two conditions are combined, as commonly happens at home when a child is cared for by a grandmother, disturbance is at a minimum.
Heinicke & Westheimer (see pp. 10 - 11 above) are among several observers who have noted that when a young child is in a residential nursery with a sibling his distress is alleviated, especially during the early days; and Robertson has noted that some comfort is obtained even when the sibling is only two years old and the younger of a pair. Thus the presence of a familiar companion, even when that companion provides a negligible degree of substitute mothering, is found to be a mitigating factor of some significance. Inanimate objects, such as favourite toys and personal clothes, are also known to provide some measure of comfort.
-16-
A second and important mitigating condition is the provision of substitute mothering. How effective this can be in reducing disturbance when given by a woman who is a stranger to the child is not systematically recorded. Much evidence of an unsystematic kind shows, however, that initially a young child is afraid of the stranger and rejects her attempts to mother him. Subsequently, he shows intense conflict behaviour: on the one hand he seeks to be comforted by her, on the other he rejects her as being strange. Only after a period of days or weeks may he become accustomed to the new relationship. In the meantime he continues to yearn for his missing mother figure and on occasion to express anger with her for being absent. (Examples of this sequence are given in Chapter 2 of the first volume. )
The period during which disturbance lasts turns partly on the skill of the foster mother in adapting her behaviour to that of a distressed and, at times, frightened and rejecting child, and partly on the age of the child. In one study (as yet reported only briefly) Yarrow ( 1963) found that every child aged between seven and twelve months was disturbed after being moved from a temporary foster home to a permanent adoptive home. Over this age-span, he found, the 'severity and pervasiveness of disturbance increases with increasing age'.
Thus, while distress is mitigated both by the presence of a familiar companion and by fostering from a motherly but strange woman, each arrangement has serious limitations.
An Experimental Project
In their study already referred to in the preface, James & Joyce Robertson ( 1971), combining the roles of observers and foster parents, took into their own home four young children who were in need of care while their mothers were in hospital. In doing so they were seeking to
24
discover how young children of previous good experience respond in a separation situation that offers as many ameliorating conditions as are at present known about and possible to arrange, in particular, responsive mothering from a foster mother with whom the child has already become familiar.
For these purposes Mrs Robertson undertook to give each child her full-time care and, in doing so, to adopt so far as she could his mother's own methods of care. Every attention was given to minimizing the strangeness of the situation and to maximizing familiarity. During the month or so prior to the
-17-
separation, the child was introduced to the foster home and to members of the foster family by means of a series of interchange visits between the families. Meanwhile, the foster mother did all she could to learn about the child's stage of development, his likes and dislikes, and his mother's methods of caring for him, in order to maintain during the fostering period as similar a re? gime as possible. On coming into care the child brought with him his own bed and blankets, his familiar toys and a photograph of his mother. Moreover, during the child's time away every effort was made to keep alive within him his image of his missing mother. The foster mother made a point of talking about her and showing the child her photograph. Father was encouraged to visit, daily if possible; and both father and foster mother did all they could to assure the child he would soon return home. In these ways everything possible was done to reduce the impact of change, to accept openly the child's concern over loss of his mother, and to assure him that it would not last longer than necessary.
In the event the Robertsons cared for four children, one at a time, in each case while mother was having a new baby. Ages and days in care are set out below:
Kate 2 years 5 months Thomas 2 years 4 months Lucy 1 year 9 months Jane 1 year 5 months
27 days 10 days 19 days 10 days
All four were first children, had been and were living with both parents, and had not previously been separated from mother, except for an occasional few hours in the care of a familiar person.
The degree of disturbance seen in these children was far less than is seen in less favourable circumstances. Nevertheless each child was perceptibly upset. The form of disturbance in the two older children differed from that seen in the two younger. Although for much of the time Kate and Thomas seemed content with the foster arrangements, both showed plainly that they missed their own mothers. In the brief accounts that follow, derived from Robertson & Robertson ( 1971), particular attention is given to the episodes when the children expressed discontent. There is therefore some danger of the accounts giving an unbalanced picture.
25
Thomas, an active and friendly boy who talked well, settled happily with his foster parents. For most of the time he was
-18-
good-humoured, in friendly contact with his caretakers, and able to enjoy play and activities offered. After two days, however, he began to express both sadness at his parents' absence and also anger about it. He talked much of his mother and sometimes cuddled her photograph. While he seemed to have some grasp of the temporary nature of the separation, as the days passed the situation clearly put increasing strain upon him. On occasion he rejected his foster mother's attentions and indicated that it was his mother's role to look after him: 'Don't cuddle me, my mummy cuddles me. ' At the end of a visit from father, Thomas did his best to prevent his leaving, cried bitterly if briefly after he had gone and insisted that no one else should sit on his father's chair. At the end of his visit on the ninth day father summed up the strain of the situation in four words: 'We've both had enough. '
Although in the Robertsons' opinion Thomas came through the experience better than the other three children, and disturbance after his return home was minimal, he seemed nevertheless to be more aggressive and defiant after it than he had been before. Moreover, when his foster mother visited his home, although he was friendly to her, he was also cautious and throughout made a point of staying close to his mother.
Kate, the other child of nearly two and a half, showed during her first ten days away many of the same features of behaviour as did Thomas. On the one side she ate and slept well, and was cheerful, active, and cooperative with her foster parents. On the other she expressed yearning for her absent parents and occasional anger with them for not taking her home. Owing to mother's obstetric complication, moreover, Kate was away nearly three times as long as Thomas. During the third and fourth weeks her relationship to the foster mother deepened and she seemed to be finding a niche for herself in the foster family. Nevertheless, her yearning for her own mother continued and was 'increasingly intermingled with anger'. Anger, directed at foster mother, was especially strong after Kate's two visits to see mother in hospital.
One other feature of Kate's behaviour during the separation is to be remarked. During the second week she became fearful of getting lost and began to cling. She also cried more easily and at times seemed preoccupied and dreamy. Her query 'What is Kate looking for? ', made on one of these occasions, seems to indicate that her yearning and searching for mother, though continuing active in her, were beginning to undergo repression.
-19-
When eventually Kate returned home she at once greeted her mother and began to rebuild their relationship. By contrast, she completely ignored her foster mother who had looked after her for nearly four weeks, and who was sitting quietly by.
Although Kate settled back in her family with only slight upset, she was noticeably more demanding of her parents' attention. Moreover, her reaction to an episode that occurred two weeks after her return suggested strongly that she was intensely afraid of another separation. Mother was eager to ensure that, when Kate reached five, she would be able to go to a particular school; so mother took her there to be enrolled, over two years in advance. The following night Kate screamed as though with nightmares and in the morning was acutely
26
breathless. When the doctor, who diagnosed bronchial asthma, inquired about stress, mother realized that, during talk at the school the previous day, the head had agreed to 'take' Kate.
Neither of the two younger children had much language capacity and neither could be helped as much as the two older ones to keep the absent mother clearly in mind. Perhaps because of this, each child seemed to transfer attachment from mother to substitute comparatively easily and to find security in the new arrangement. Neither child showed acute upset. Both continued to function well, learnt new skills, and increased their vocabularies. Yet for both children it was evident that all was not well. By her fourth day away Jane had become restless and demanding of attention and gave the impression of 'a child who was under strain and at times bewildered'. Lucy, similarly, had her bad patches and by the nineteenth day away is described as being 'in a highly sensitive state'.
In these little girls explicit yearning for the missing mother and being angry with her occurred only sporadically, and then only in response to specific reminders of her. Jane, for example, on her sixth day of separation noticed the gate of her own garden, opened it and entered, and tried unsuccessfully to open the door of her parents' apartment. Returning, she spoke the word 'Mama' for the first time and also resisted entering the foster home. Jane's relations with her father deteriorated as the separation progressed. At first she played happily when he visited, then she got angry with him and, finally, she seemed pointedly to ignore him, only to cling and cry when he made to leave. Lucy's relations with her father went through much the same sequence. After one visit when he had taken her to a park near their home, she became very
-20-
distressed after his departure; at first she refused to be comforted by her foster mother and subsequently clung tearfully to her and refused to be put down.
On reunion each of these younger children recognized mother immediately and responded pleasurably to her. Unlike the two older children, however, they seemed reluctant to relinquish the foster mother. Lucy in particular had difficulty in weaning herself from her and later showed marked conflict in relation to her. For example, during foster mother's visit three days after returning home Lucy 'oscillated between affection and apprehension, smiling and frowning, clinging to her mother yet crying bitterly when foster mother left'. Like Thomas and Kate, both these younger children were more hostile to mother after the separation than they had been before it (though presumably in each case this could have been due in some degree to the presence of a new baby).
Interpretation of Findings
All these children, then, showed far less distress than occurs when young children are separated from mother in less favourable conditions, yet all four showed unmistakable signs of strain and from time to time that they were aware of missing mother. In the interpretation of these responses there is some difference of opinion. The Robertsons, impressed by the fact that care by a responsive substitute mother in a benign environment holds anxiety at a 'manageable level' and permits 'positive development' to continue, believe that the onset of the deteriorative sequence of protest, despair, and detachment can be prevented. This leads them to the view that the responses shown by children fostered in this way are qualitatively different from those of institutionalized children, and cannot be understood as representing a difference of intensity only. An alternative view, however, is that the sequence of protest,
27
despair, and detachment, although greatly reduced in intensity and curtailed, cannot be regarded as absent. In the two older children, for example, the pattern of response, though at low intensity, showed very plainly most of the elements now known to be typical of how young children respond during and after a brief separation in less cushioned conditions -- yearning and searching for the missing mother, sadness, increasing protest at her absence and growing anger with her for staying away, increased ambivalence on return home, and evident fear of being separated again. Thanks to the precautions taken despair
-21-
was admittedly held at bay and with it detachment, though signs suggestive of the latter were seen in Kate. In the two younger children the pattern of response was less clear, but several typical elements were none the less present. This leads to the conclusion that the differences in response between the fostered children and children removed to an institution are properly regarded as differences of intensity. There are other ways in which the Robertsons contrast their theoretical position with the one I adopt, notably as regards the role of grief and mourning in early childhood. These issues will be discussed in the third volume. Meanwhile it is important to note that, whatever differences there may be between the Robertsons and myself in regard to theory, there are none in practice. For, when the Robertsons come to consider the practical lessons to be derived from their project, they warn that, because these carefully fostered children came through so well, it must not be assumed that the hazards of separation during the early years can be eliminated entirely. On the contrary, they state, their experience has served to reinforce them in the view, which we have long shared, that 'separation is dangerous and whenever possible should be avoided'.
Presence or absence of mother figure: a key variable
From the Robertsons' recent study and the many others now on record two main conclusions can be drawn:
The sequence of intense protest, followed by despair and detachment, which first caught our attention, is due to a combination of factors, of which the kernel is the conjunction strange people, strange events, and an absence of mothering either from mother herself or from a capable substitute.
Because separation from mother figure even in the absence of these other factors still leads to sadness, anger, and subsequent anxiety in children aged two years and over, and to comparable though less differentiated stress responses in younger ones, separation from mother figure is in itself a key variable in determining a child's emotional state and behaviour.
By 'mother figure' is meant that person to whom a child directs his attachment behaviour by preference; and by 'substitute mother' is meant any other person to whom a child is willing temporarily to direct attachment behaviour. Since, however, an individual as he grows older directs attachment behaviour to others besides mother or someone acting as a
-22-
substitute mother, it is convenient to have available terms that are less specifically tied to the child-parent relationship. Among terms used here in a generic way to cover anyone towards whom attachment behaviour is directed are 'attachment figure' and 'support figure'.
'Presence' and 'absence' are relative terms and, unless defined, can give rise to misunderstanding. By presence is meant 'ready accessibility', by absence 'inaccessibility'. The
28
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). 1
Not only here but elsewhere also, finding suitable language is a problem. For example, how long is a temporary separation? Plainly the answer turns on the subject's age. Thus what might seem interminable to a one-year-old might seem insignificant to a schoolchild. What might seem interminable to a schoolchild might seem of no great significance to an adult. Another problem, and one that is more difficult, is to know at what point a separation that started as temporary becomes permanent -- or at least becomes conceived by the victim and by others as being so.
Yet a further difficulty turns on the fact that a mother can be physically present but 'emotionally' absent. What this means, of course, is that, although present in body, a mother may be unresponsive to her child's desire for mothering. Such unresponsiveness can be due to many conditions -- depression, rejection, preoccupation with other matters -- but, whatever its cause, so far as her child is concerned she is no better than half-present. Then again a mother can use threats to abandon a child as a means of disciplining him, a tactic that probably has an immeasurably greater pathogenic effect than is yet recognized.
These and other problems are discussed in later chapters. Meanwhile, the thesis can be phrased more precisely. Whether a child or adult is in a state of security, anxiety, or distress is determined in large part by the accessibility and responsiveness of his principal attachment figure.
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1 The present usage of the word separation should be distinguished from the very different
usage of Mahler ( 1968) who employs it to describe an intrapsychic process which results in 'differentiation of the self from the symbiotic object'. Prior to this development a psychological 'state of undifferentiation, of fusion with mother', termed symbiosis, is postulated.
-23-
There have been, and still are, clinicians and others interested in children who have found it difficult to believe that accessibility or inaccessibility of attachment figure can of itself be a crucial variable in determining whether a child (or an adult for that matter) is happy or distressed. One reason for disbelief is the supposition that, when there is nothing 'objective', namely intrinsically painful or dangerous, for a child or adult to be distressed about or afraid of, any distress or anxiety must be irrational and, if irrational, is to be deemed neurotic. Other reasons derive from a faulty theory of the nature of instinctive behaviour, and especially from failure to distinguish causation from function (see Volume I, Chapters 6 and 8). Others again derive from the many confusions and false value judgements to which the concept of dependency gives rise (see Volume I, Chapter 12). Yet another and different sort of reason may be the sheer inconvenience in practical life of the facts of the case as they seem actually to be in comparison with what things would be like were every normal child to be happy and content with any caretaker whatever -- provided she were kind. If children were only 'reasonable' in this regard, how much easier would life be!
In order to understand how some of the difficulties have arisen it is useful to consider how separation and loss have been treated in the psychoanalytic literature as situations of relevance
29
to personality development and psychopathology. In particular, it is useful to examine the place given to separation in theories of anxiety, and the kinds of explanation that have been proposed to account for its influence. Some of these ideas are traced in the following chapter, and opportunity is taken to compare the standpoint adopted in these volumes with that adopted in more traditional psychoanalytic works.
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30
Chapter 2
The Place of Separation and Loss in Psychopathology
A new pamphlet of mine, Inhibitions, Symptoms and Anxiety, is now being published. It shakes up much that was established and puts things which seemed fixed into a state of flux again. Analysts who above all want peace and certainty will be discontented at having to revise their ideas. But it would be rash to believe that I have now succeeded in finally solving the problem with which the association of anxiety with neurosis confronts us.
SIGMUND FREUD 1
Problem and perspective
From Freud's earliest studies of the aetiology of the neuroses, until the end of his life the twin problems of neurotic anxiety and defence were never far from his mind. Again and again he grappled with them, and on the various tentative solutions he offered rest his successive theoretical formulations. Since Freud's death, moreover, theories of anxiety and defence have continued to be the foundation-stones of psychoanalytic psychopathology; and it is through their espousing differing views on the nature and origins of these conditions that the several distinctive schools of psychoanalysis have come into being.
In Freud's earliest formulations there is no hint that anxiety arises from loss or threat of loss, or that defensive processes are evoked in conditions of intense anxiety. Only little by little, and mainly towards the end of his life, did Freud advance such views and, in so doing, bring his ideas on anxiety and defence into relation with his ideas on mourning which, until then, had been a significant but quite distinct strand in his thinking. A principal result of his new formulation was, as he rightly foresaw, to bring everything 'into a state of flux again'.
Although Freud himself at different periods of his life adopted ____________________
1 Letter to Oskar Pfister, 3 January 1926 (see H. Meng & E. L. Freud 1963).
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a number of radically different theories in regard to anxiety, mourning, and defence, as have the various schools of thought that have grown up subsequently, each theory is based on data obtained by but a single method of inquiry. Data are derived from studying, in the analytic setting, a personality more or less developed and already functioning more or less well; and from these data an attempt is made to reconstruct the phases of personality that have preceded what is now seen. To many the resulting literature is as frustrating as it is stimulating. On the one hand, it is plainly dealing with problems that every sensitive clinician recognizes to be of central consequence for understanding and helping his patients; on the other, it presents a complex web of competing and often inconsistent theorizing without providing methods by which to sort grain from chaff.
What is attempted in these volumes is to approach the classic problems of psychoanalysis prospectively. The primary data are observations of how young children behave in defined situations; in the light of these data an attempt is made to describe certain early phases of
31
personality functioning and, from them, to extrapolate forwards. In particular the aim is to describe certain patterns of response that occur regularly in early childhood and, thence, to trace out how similar patterns of response are to be discerned in the later functioning of the personality. 1
Some of the essential data, as described in the previous chapter, can be summarized as follows. Whenever a young child who has had an opportunity to develop an attachment to a mother figure is separated from her unwillingly he shows distress; and should he also be placed in a strange environment and cared for by a succession of strange people such distress is likely to be intense. The way he behaves follows a typical sequence. At first he protests vigorously and tries by all the means available to him to recover his mother. Later he seems to despair of recovering her but none the less remains preoccupied with her and vigilant for her return. Later still he seems to lose his interest in his mother and to become emotionally detached from her. Nevertheless, provided the period of separation is not too prolonged, a child does not remain detached indefinitely. Sooner or later after being reunited with his mother his attachment to her emerges afresh. Thenceforward, for days or weeks, and sometimes for much longer, he insists on staying
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1 The point of view adopted is described at greater length in the first chapter of Volume I.
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close to her. Furthermore, whenever he suspects he will lose her again he exhibits acute anxiety.
When I came to examine the theoretical problems raised by these observations it was evident that the first step must be to gain a clearer understanding of the bond that ties child to mother. Next, it gradually became apparent that each of the three main phases of the response of a young child to separation is related to one or another of the central issues of psychoanalytic theory. Thus the phase of protest is found to raise the problem of separation anxiety; despair that of grief and mourning; detachment that of defence. The thesis that was then advanced ( Bowlby 1960a) was that the three types of response -separation anxiety, grief and mourning, and defence -- are phases of a single process and that only when they are treated as such is their true significance grasped.
A reading of the psychoanalytic literature shows that, as a rule, separation anxiety, mourning, and defence have been considered piecemeal. The reason for this is the inverted order in which their psychopathological significance was discovered: for it was the last phase that was recognized first, and the first last. Thus the significance of defence, particularly repression, was realized by Freud in the earliest days of his psychoanalytic work and provides the basis of his original theorizing: his first paper on the subject is dated 1894 ( "'The Neuro-psychoses of Defence'", SE 3). 1 His grasp of the roles of grief and of separation anxiety, on the other hand, was at that time still fragmentary. Although he was early alive to the place of mourning in hysteria and melancholia (see note of 1897 to Fliess, SE 14: 240), twenty years were to elapse before, in "'Mourning and Melancholia'" ( 1917a, SE 14), he gave it systematic attention. Similarly in the case of separation anxiety: although in the Three Essays on the Theory of sexuality ( 1905b) he gave it a paragraph ( SE 7: 224 ) and in the Introductory Lectures ( 1917b) three pages ( SE 16: 405 408 ), it is not until 1926 that in his revolutionary late work Inhibitions, Symptoms and Anxiety he accorded it the central place in what was to be his final
32
theory of anxiety. 'Missing someone who is loved and longed for', he there affirms, is 'the key to an understanding of anxiety' ( SE 20: 136 -7). 2
____________________
1 The abbreviation SE denotes the Standard Edition of The Complete Psychological Works of
Sigmund Freud, published in 24 volumes by the Hogarth Press Ltd, London. All quotations
from Freud in the present work are taken from this edition.
2 For an account of the development of Freud's theories of anxiety, see
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The reason for this inverse recognition of the three phases is clear: always in the history of medicine it is the end-result of a pathological sequence that is noted first.
