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Attachment theory: the influence of early development

Maria Robinson
PhD
Independent Adviser in Early Development

How do children learn? This is the question posed by Ed Tronick at the beginning of the video presentation of his classic “still face” experiment.1 This was a procedure he and his colleagues devised back in the 1970s (that has been replicated many times since) to illustrate the exquisite sensitivity to facial expression and interaction that babies and very young children demonstrate when their parent(s)/carers briefly disengage from face-to-face play.

The reactions of these children demonstrated very clearly the powerful need to feel that their parent is noticing them, and Tronick surmises that such interactions are crucial to all forms of learning. Being the focus of attention, and feeling that the adult with you is involved and alert to your expressions and behaviour seems to be a fundamental need for the healthy development of babies and very young children. This is supported not only by attachment theory, but also by ongoing neuroscientific research into the early development of the human brain.

I would also suggest that it is crucial to the wellbeing of all of us - we all need to feel that we are “seen” by others. I am sure many of you have had the experience of being ignored when trying to purchase something and how irritating and frustrating this can be. Imagine how this must feel to the baby or young child if they feel that their parent does not engage with them; or how the older child feels when they seem not to be noticed by the teacher or left out of the current friendship crowd. It is how any of us feel when we experience loneliness, or when we feel we are not being understood or heard.

Early relationships
It would seem that humans need attention in the most fundamental way. Reddy describes the powerful intimacy of the relationship between mother and baby in the first eight to 12 weeks of life.2 This is a time when both appear to be fixated on one another, supported by ongoing hormonal and neurochemical responses to loving gaze and by nature's own cleverness. This latter is the existence of “sticky fixation” in the visual system of the baby, which means that babies find it rather difficult to look at something in their peripheral vision as it is easier simply to look ahead. Babies are fascinated by faces - the attraction to the human face is a brain stem reflex because human face (especially the mother's) is so interesting.

Mothers talk to their babies in a unique tone and universally use “motherese” - that lovely sing-song way of speaking that babies find so attractive and are so familiar with, having already heard it in the womb. Put all this together - along with feeding, holding and care - and there is a myriad of opportunities for two-way communication.

Reddy feels that this particular phase may be necessary for us, as new humans, to experience being noticed. Perhaps it is no coincidence that, following this phase, babies suddenly become more interested in toys and mobiles, and generally become more widely social. They are able to notice what is around them. This subtle shift can be difficult for some mothers who feel a sense of loss that their baby is no longer quite so fixated on them. It makes me wonder how often it might be that children diagnosed with attention deficit disorder may have had some disruption of close communication in those early weeks.

The power of emotions
The importance of communication is perhaps best exemplified by John Bowlby's attachment theory and the volumes of research that have been carried out since then.3-5 What Bowlby hypothesised about human babies was that we, like other mammals, have a biological and evolutionary need to be close to our parent to survive and to alleviate danger. We need to learn that we are safe both physically and psychologically.

Professor of Psychology at Harvard, Jeremy Kagan, is a powerful proponent for the role of temperament and can appear to be quite dismissive of attachment theory - although he is not dismissive of the power of emotions.6 The notion that we each have an innate temperament is an important one as, individually, we can have a propensity for general approach or withdrawal, or to be more bold or more cautious which, in turn, can influence our individual responses to the type and quality of our parenting. In other words, how we develop is not simply cause and effect - many threads in our developmental tapestry influence how our experiences ultimately combine to produce how we feel about the particular world we inhabit.

There is also widely accepted recognition that the human brain develops at its greatest rate in the first four years of life, continuing to mature and grow until our early 20s. It then appears to consolidate and reinforce existing pathways, integrating the connections between all the structures in the brain - which generations have instinctively understood to indicate the wisdom and reflection that can come with increasing age. This is a perspective that Aric Sigman in his angry, funny and very direct book, feels that is now being lost in our society.7

However, the implications of this fast early growth, and of the powerful nature of the oldest (in evolutionary terms) structures in the brain that deal with our basic human functions, our emotions and the time it takes for the parts of the brain that help to inhibit behaviour, are that young children need positive, loving interactions to help form those connections which lead to a healthy heart and mind, in physiological and psychological terms.8-11

If we do acknowledge the power of emotions in the earliest years in helping to form the way in which a child views the world, then we also have to acknowledge that, as adults, we do not suddenly become immune to what we feel about our lives, work and relationships. In fact, what we feel is the most important - even if we think we are highly logical, rational beings. Haidt points out that from ancient times, philosophers have noted that we seem to have a powerful emotional side to our humanity which sometimes needs to be held in check by how we are able to think about our actions.12 However, we also have to accept that how we feel about something impacts on our ability to think about it.

This leads me to how our emotional worldview influences how we work and potentially the quality of our interventions. As long ago as 1989, a study by Brody et al noted how the relationship between patients and their doctors influenced their perceptions of the treatment received.13 What this brings to the fore is the power and influence of the relationship between the professional and their patient whatever the circumstance - the personal within the professional.

When we meet a patient, a child, or a family we will have an emotional response to them and them to us. Our interpretation of their behaviour is obviously influenced by our professional lens, ie, the focus of our particular intervention; but it is also filtered by our emotional response. This is influenced by some very ancient neural pathways that involve our own experiences of how our distress was comforted, how we were encouraged and our own attitudes to authority.

We have to remember that the children and adults we meet will have, to a greater or lesser degree, a whole range of experiences that affect how they perceive you, the professional.

We are all the product of our early experiences, and the very growth and function of our brains makes it so. We need relationships, and to feel connected with others. The growth of perceived loneliness and unhappiness in current UK society, as well as the high rates of mental health problems in the young, should give us cause to reflect on what truly makes human beings lead generally contented lives.14

Health professionals meet people when they are vulnerable; but how you behave towards them, your capacity for compassion, empathy, and thinking about things from their perspective, have been built on your own early experiences, and tempered or reinforced by your later life. Therefore, such capacities rest not just on your professional training but also on your ability to know yourself.
 
References
1. Tronick E. The Neurobehavioral and Social-Emotional Development of Infants and Children.
New York: Norton; 2007.
2. Reddy V. How Infants Know Minds. London: Harvard University Press; 2008.
3. Bowlby J. Attachment and Loss, Vol 1: Attachment. London: Penguin; 1969.
4. Bowlby J. Attachment and Loss, Vol 2: Separation. London: Penguin; 1973.
5. Bowlby J. Attachment and Loss, Vol 3: Loss. London, Penguin; 1980.
6. Kagan J. The Temperamental Thread: How Genes, Culture, Time and Luck Make Us Who We Are. New York: Dana Press; 2010.
7. Sigman A. The Spoilt Generation: Why Restoring Authority Will Make Our Children and Society Happier. London: Piatkus Books; 2009.
8. Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Prev Med 2003;37(3):268-77.
9. Felitti VJ, Anda RF, Nordenberg D et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998;14:245-58.
10. Fries AB, Ziegler TE, Kurian JR, Jacoris S, Pollak SD. Early experience in humans is associated with changes in neuropeptides critical for regulating social behaviour. Proc Natl Acad Sci USA 2005;102(47):17237-40.
11. Hosking G, Walsh I. WAVE Report 2005: Violence and What to Do About It. Croydon: WAVE Trust; 2005.
12. Haidt J. The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom London: Heinemann (Arrow Books); 2006.
13. Brody DS, Miller SM, Lerman CE, Smith DG, Lazaro CG, Blum MJ. The relationship between patients' satisfaction with their physicians and perceptions about interventions they desired and received. Med Care 1989;27(11):1027-35.
14. Green H, McGinity A, Meltzer H, Ford T, Goodman R. Mental Health of Children and Young People in Great Britain. London: Department of Health; 2004.