- Hi, I'm Sally Popper, and I'm going to be talking today
about attachment and the clinical implications
of attachment theory in research.
I'll spend a lot of our time today
talking about what attachment is and how it develops.
Some of what I'm saying may not seem
relevant to you as a clinician.
But I think you'll find if you stick it out
that understanding how attachment really works
in human development will give you insights
into clients who didn't receive sensitive
and responsive caregiving as young children.
If you know enough about attachment,
it is often possible to identify
where a client is stuck developmentally.
And if you understand how attachment develops,
you can tailor therapy to fill in some of those deficits.
So we'll start with what is attachment?
Attachment is established in the first year of life,
primarily in the second six months.
Attachment is the exclusive relationship
between a child and a caregiver.
Once it's established, no one can replace
an attachment figure without very hard work.
Attachment evolved evolutionarily, we believe,
as a way for the child to maintain safety.
John Bowlby read a lot of evolutionary information.
He was studying Charles Darwin
when he came up with his theories about attachment.
And he believed that attachment evolved
to ensure the survival of the species.
Human babies, unlike most other animals,
have almost no skills to care for themselves.
And it's critical that they have a strong instinct
to seek their caregivers when they're in danger.
It's also critical that the caregivers
have a strong instinct to provide that safety.
So the fundamental quality of attachment
is that it is safety-seeking, it's activated
by threat, by hunger, by tiredness, by sickness.
And the child seeks closeness to the caregiver.
It's important to focus on this safety-seeking aspect
of attachment because when you see clients
who have not had a safe and secure attachment
when they were young, it becomes very relevant clinically.
And we will be discussing that later.
Another fundamental building block of attachment
is that it is and provides affect and arousal regulation.
The caregiver in the attachment relationship
is able to regulate the child's emotions
and the child's level of arousal.
If you think about it, a baby is very disorganized
and doesn't have good regulation
of body states or of feelings.
And different states and feelings
will come and go in the newborn.
That gradually changes over time, and it's the result,
the direct result of caregiving.
We'll be talking a lot more about this important
function of attachment relationships later.
Attachment begins in utero, although you can't say
that a baby is attached before they are born, certainly,
and across the first days and months of life,
as the baby learns the rhythm,
the sounds, and the smell of mother.
After birth, the baby learns how promptly
his parents respond to his or her needs
and how well they provide comfort.
The baby learns how it feels to be
calmed and regulated by parents.
And the baby learns to experience joy with parents.
And although experiencing joy may seem like a
sort of a side effect or a small aspect of attachment,
it actually is a very important piece
of the child's early development.
Over a lifetime, an infant's security of attachment
is one of the strongest predictors of psychological
and social outcomes in later childhood.
That doesn't mean that there can't be other impacts
of other events that are equally predictive.
But it is, it provides a basic direction
which can be changed or it can go on.
And if there is continuing similar caregiving, the original
attachment patterns become stronger and stronger.
That said, I want to tell you the story
I heard this summer from Alan Sroufe.
He wrote a wonderful book on attachment over a lifetime.
He's been doing a study of children, high-risk children
in Minnesota now for about 40 years.
And he's beginning to see the third generation of children
and studying throughout what attachment patterns he finds.
He told the story of one of the young boys in his study
who was very securely attached as an infant, looked great.
At around five or six, his parents had a bitter divorce.
And his father took his brother, he stayed with his mother.
He was not looking quite as good
at this point but was still fairly strong.
When he was around 12, he began to push away
from his mother, as many early teens do.
And he began to experiment with some--
hanging out with kids who might not have been the best kids.
And he began to get into behaviors that weren't so positive.
Just at that moment, his mother died quite suddenly.
And that plunged him into some
very negative behavior during his teenage years.
And if you'd seen him during his teenage years,
you wouldn't have thought that this was
a securely attached, well-developing child.
He was involved in a fair amount of deviant behavior.
But later in his 20s he found a partner
with whom he had a child, and at the last point in the study
Alan Sroufe said, his child was showing
a secure attachment to him, and he was showing
a secure model of attachment as an adult.
So this was an example of the ways
in which a child's development can change over time
still having the base of attachment.
And Sroufe's point was that the secure base
he had to start with reemerged when he found
a strong partner as an adult and had a child himself
and that that secure base that he had
did serve him well in the long run, although you might not
have thought that when he was a teenager.
Attachment is primarily a right brain process.
In the first three years of life the right hemisphere
of the brain is developing rapidly, and the left hemisphere
is coming along a little more slowly.
The right brain includes more emotional learning,
contextual learning, it's more the forest
whereas the left hemisphere is more the trees.
It's got more social learning, and it has what is called
implicit memory which is memory that is not stored verbally.
The left brain is more rational, logical,
has to do more with what we think of
as learning in school and so forth.
In the first three years prior to real language use
by a child the right hemisphere is dominant.
And it is, as I said, developing rapidly.
Attachment is primarily a right brain process.
And I mentioned implicit memories.
Memories in the first two or three years are implicit.
And that's one reason that we don't usually remember things
that have happened to us in the first years of life
because those memories are stored in our brains
on the right hemisphere, and there aren't words for them.
But I think if you think of an experience you've had,
and one of the ways I like to remember
what an implicit memory is, is to think
of entering a house where you catch a smell.
And smell is one of the most
direct routes to our right brain.
You catch a smell that reminds
you of your grandmother's house,
that suddenly you are surrounded
by the memory of your grandmother's house.
This isn't something that you remember,
oh, in my grandmother's house the couch was on the left
and the curtains were on the right
and the chair here was red, those aren't
the memories you have of your grandmother's house.
The memories are more holistic.
That's a right brain implicit memory.
The whole scene will come back to you,
the feelings, the smells, the look, the temperature,
all of those sensory aspects of the experience
will pop right into your mind.
And those are implicit memories.
So we all have lots of them.
But for most of the memories of things
we've done we have more explicit memory,
which is stored in our left hemisphere.
And that can be talked about in words,
and you can remember this happened first,
that happened next and so forth.
But the other place you find implicit memories
when you're doing therapy, which is an important
one to know, is when a person's been severely traumatized.
When you're traumatized, your brain begins to work
very efficiently to help you fight, flee, or freeze.
And suddenly your left hemisphere is offline.
So the memories of trauma are often implicit memories.
They're not verbally encoded, they don't go
through the hippocampus, which is the way
in which memories get sort of filed away
in the filing cabinets of our brain.
They actually just get stored
directly into the right hemisphere.
So that's why if you've had a trauma,
you may experience flashbacks in which suddenly
the entire traumatic scene is there in front of you.
And it feels as if you're reliving it.
That's an implicit memory coming to the surface.
So there are many ways in which implicit
memories are important clinically.
But one way is that in this first two to three years
lots of information is encoded in the right brain,
but we don't have access to it verbally.
And that's an important feature for therapy
because working with preverbal memories is difficult
since we tend to work verbally.
So we'll talk a little bit more about that later.
Right brain skills are many, and these are all skills
that are learned in the attachment relationship.
Children don't learn these without an attachment
relationship, these include reading social cues,
regulating affect so that you don't blow up suddenly
out of context, you don't shut down inappropriately.
You can manage your feelings in a fairly smooth manner.
Communicating nonverbally which as we know
is a really important aspect of communication.
Inhibiting impulses, which if you think about it
is one of our more critical skills.
The fact that I'm sitting here right now
and not jumping up and moving around
or thinking of something I want to call someone about
or that kind of thing is a function
of my ability to inhibit my impulses.
And for a child to succeed in school, certainly,
but even with friends or in a home
it requires that they're able to inhibit impulses.
Another right brain skill is focusing attention,
certainly critical for most things we do in life.
Understanding cause and effect is a critical right brain
skill, and it's one that caregivers teach babies.
Learning to plan, which includes understanding
cause and effect because if you're learning to plan,
you think if I do this, that's likely to happen,
maybe I don't want to have that happen,
so maybe I should do something else instead.
Let's think about what would happen if I did that.
These are all taught in the attachment relationship.
Often we call these executive function
skills, and they are critical skills.
If you haven't learned them in an attachment
relationship in the first years of life,
it's much harder to teach them later.
But it's critical that therapists, teachers,
and parents do that at a later time.
And actually, that's one of the problems I have with therapy
for children who've had attachment losses and trauma
where the therapy focuses only on the trauma
because if you don't take into account the skills
that the child lost or never developed early on,
you're not going to give the child
all the tools he needs to succeed.
Simply processing the trauma is not adequate.
Allan Schore is one of the most
important authors on early development,
on attachment, on regulation and so forth.
And his writings tend to be quite
ponderous and tough to get through,
although critically important in our field.
But one of the simpler things he said
is that a mother's primary job
in the first year of life is to increase positive emotion.
This is done through right brain play and social connection.
It happens through touch, voice tone, eye contact,
facial expression, rhythm, motion, and play.
And if you think of parents and children together,
those are the ways that they interact.
We just naturally begin to sing songs,
to play touching games, to do rhyming,
to do sing-song talking, and those things
are very important for a child
whose developing right brain is just soaking it up.
Another important piece of the early caregiver relationship
is that the parent and the infant--
and I'm talking about mothers, but it can be
any parent caregiver, their communication
and their feelings are contingent,
that means one follows the other in very close succession
and they're collaborative increasingly.
When a baby's tiny, there's not as much collaboration.
But as you watch development over months,
you begin to see more of the baby
leading the interaction and the mother responding,
then the mother responding and the baby leading--
I mean, the mother leading and the baby responding.
Berry Brazelton has called this the dance
between the mother and the baby.
And I spent some years doing research on this
where we did coding of mother and infant
interaction on a second by second basis.
So each second we had a split screen.
Mothers were on one side, babies were on the other side.
One person was coding what was the baby's feeling
or behavior in each second, and another person was coding
what was the mother's behavior and feeling in each second.
And it is astounding how closely related they are
in time so that one of them will lead,
the other will immediately follow with a response
that is contingent and collaborative.
Then it will go back and forth.
The baby may take a break, then they'll come back together.
But it is really a dance, and it's lovely to see.
Face to face interactions with a baby excite the baby.
So a good caregiver will regulate that level of energy
so that the baby doesn't become overexcited
and is able to stay with the interaction.
When you see children who've had profound neglect,
like the children we've seen coming out
of eastern European orphanages,
often they'll look almost autistic, and there's actually
a phenomenon called institutional autism.
And sometimes it's hard to know whether a child
who's fairly recently out of a situation like that
is actually autistic or if they have experienced
enough deprivation that they just look autistic.
I remember a period of time in my life
when I was working with a testing
specialist who could diagnose autism.
And some of the kids I would see would be
diagnosed as autistic by her at one time,
maybe a year or two later no longer autistic,
maybe a year later autistic again.
This really confused me, as you can imagine.
And I talked to her, and she said it really is
almost impossible to tell when a child has
some of the features of autism
that come from very profound neglect
whether that really is autism.
On the other hand, I think I've seen children
who look that way early on change significantly.
And so anyway, these behaviors that you tend to see
are self-stimulation, so children may flap,
they may clap, they may bang their heads,
they may masturbate excessively.
They may seem in their own world.
They really don't know how to have a relationship.
They don't know how to have eye contact.
They haven't learned that from experience.
And we just don't know how much this
can be moderated by intervention.
On the other hand, I have, for instance,
an example from my own work with clients
of a young girl who was adopted from Romania at 18 months,
looked at that time like about a six month old
and couldn't hold her head up.
She, when I last saw her, was about 14.
And she had moved out of looking quite autistic
in probably kindergarten and first grade,
to being able to interact, being able to understand a joke,
being able to understand sarcasm,
even though she was still quite concrete
in many ways and somewhat obsessive,
she was interacting well with people.
She had good eye contact, she was beginning to learn
to read nonverbal cues much better.
And when I last heard about her, she's going to college
and is able to function on her own quite well.
So I think you do see changes like that
in children who look institutionally autistic.
So thinking about resilience, because obviously
that's really critical when somebody's had
negative experiences early on,
infant resilience comes from a pattern of cycling
from positive to negative and back to positive again.
And it's important that the negative happens
because the child has to learn how to move back to positive.
So we don't want to protect
children from everything negative.
But the way that this occurs is
in well-regulated interactions
with a predictable caregiver that create a sense of safety
as well as a sense of excitement
and curiosity about the world.
All of these factors are critical to later mental health,
as you can imagine, I think.
So now let's talk about the processes
through which these right brain capabilities are created.
Mother's and infant's arousal, as I talked about earlier,
are synchronized within a split second of each other.
This synchronization creates a psycho physiological state
in the infant that matches the mother.
Allan Schore has talked about the mother
downloading her right brain into the infant's right brain.
And what we do know is that if you look
at the right brain patterns of
a caregiving mother and a baby, they will match.
Dan Siegel has called this interpersonal neurobiology,
that there actually is a neurobiology
that goes between people, usually in a dyadic situation.
So the way we tend to think of this
process happening is through an attuned caregiver.
And attunement is an important concept.
It's different from empathy, it means
feeling with rather than feeling for.
So I'm not feeling your pain, as Bill Clinton might say.
I am feeling with you
and really experiencing your experience.
Dan Siegel has called it feeling felt by.
And when a parent is attuned, they read the baby's cues,
and they communicate back that
the feeling is known and shared.
This is critical to later social development
because we need to understand that other people
can get us, can understand who we are.
And this leads to an intersubjectivity
of back and forth sharing that's about reading cues
and knowing that you are known by another.
So mother's attunement enables her
to organize the baby's states and promote
the development of the baby's right brain.
And gradually the infant learns to attune to the mother,
which is clearly an important skill
in all social situations, and certainly
as that infant becomes a parent him or herself.
And then there's reciprocal interaction and organization.
And the regulation that has been the mother's
becomes a collaborative process.
I'm going to read a couple of quotes
from Allan Schore, which are a little bit dense.
But I think they really add some important information here.
So one of the things he said is
"The moment to moment expressions
"of the mother's regulatory functions
"occur at levels beneath awareness.
"Even so, the attuned mother can self-correct
"by accessing her own reflective function
"whereby she monitors not only
"her infant's, but her own internal signals
"and differentiates her own affective state.
"She also regulates the type and intensity
"of socioaffective information
"within the dyads communication system."
Another quote from Schore, "Psycho biological attunement
"and the interactive mutual entrainment
"of physiological rhythms are fundamental processes
"that mediate attachment bond formation.
"And attachment can be defined as the regulation
"of biological synchronicity between organisms."
Now I want to give you a concrete example of how this works.
And I'm going to show you a film
of what is called a Still Face procedure
being run in Ed Tronick's labs in Boston.
Still Face procedure has proven to be
a really important step on our understanding
of this mother-infant dance that occurs and the way
in which parents provide regulation to their children.
In a Still Face, as you will see,
the mother and the child are face to face.
Baby's in a little seat, mother's right in front of him.
For a few minutes they play back and forth, talk,
tickle, sing, whatever is usual for them.
At a signal, the mother is told
to make her face still with no feeling.
And for a minute she does that.
She keeps her face completely expressionless.
And what you'll see is how the baby disorganizes
during that time, how important it is
that there's this back and forth engagement.
Often when you see this happen, babies begin to look
more young than they have been in the interaction.
They begin to look less organized,
less able to manage their own state.
And some babies, as they get a little older,
will try all kinds of tricks to get mom.
And I think in this film you'll see
a couple of the tricks that the baby uses
to try to get mom involved again.
They'll flirt, they'll reach out, they'll point,
they'll yell, they'll do anything to get mom back with them.
And then you'll see as soon as mom
does start showing expression again,
how quickly this baby re-regulates with her.
Some babies who really haven't had as adequate parenting
take much longer or don't re-regulate.
And they really can't come back from a loss like that.
But this has been one of the important steps
in our learning about how babies require this
responsive interaction at all times.
And if you think about children you may have seen
who had parents who were addicted,
who were severely depressed, other things that would cause
parents to neglect a child or to not just be responsive,
you can see why development is so compromised.
One of the things Schore mentioned in one
of those quotes I gave you was reflective function.
And reflective function, if you haven't read about it,
it's a great thing to understand
a little bit more about as a therapist.
Peter Fonagy and Mary Target have written about this.
And they've talked about the way a secure caregiver
can use attunement to the infant or the child
as a way to communicate her understanding
of the child's experience so that the child
begins to understand that there are others
who can not only understand him, but also help him
become the person that the caregiver is seeing.
And we all do this as parents, we see our kids,
when they're babies, as far more than they are.
And if we can reflect that back to the child,
the child can begin to grow into that conception.
Okay, I'm going to talk some more now
about affect regulation and its
importance in the child's life.
We've talked about that as a right brain skill
that's learned in the first few years.
What we know about babies' brains is that
they are experience dependent.
There's very little of development
that can occur without information going on,
without the baby receiving stimuli
from the outside and especially from people.
One scientist has said that the infant's brain
is designed to be molded by the environment it encounters.
As I said, the newborn is poorly regulated,
both physiologically and emotionally
and learns that regulation from caregivers.
Over time the baby internalizes
the caregiver's affective regulation.
And as a result, the baby sharing the mother's state,
which we've called interpersonal neurobiology.
And this means that the child is fairly well regulated
and then can devote his or her energy
to learning, enjoying things, and growing.
A lack of affect regulation underlies all psychopathology
and makes ordinary life very difficult.
And this is not something you can develop
on your own, really, this is something that has
to be developed within a dyadic relationship.
All right, so if we think about the way regulation
precedes in attachment development,
we see external regulation by the caregiver early in life
to coregulation where there's back and forth regulation
and finally to the ability to self-regulate by the infant.
This is when the child has internalized
the regulation that's been provided by the caregiver.
A development of competency comes out of this.
A sense of agency is also the result of a regulated brain.
And that's one of the things we find people missing
when they've had serious early trauma, is that sense
of agency and a belief that they can do things.
These are such fundamental skills
that you can only really teach in a dyadic relationship.
Finally, after developing internal regulation,
the child also develops collaborative problem solving.
They're able to work in partnership with another.
So that usually happens after the end
of the first year of life, the child begins to be able
to recruit the caregiver to help them solve a problem.
As a child's attachment is developing
toward the end of the first year,
there begins to be for the first time in the kid's life,
when he starts crawling around and getting into things,
he'll for the very first time hear no.
When you think about it, a little baby receives
in the hands of good caregivers,
receives such adoration and love,
and you can imagine what a shock it is
when they suddenly start hearing no.
And sometimes that no is very loud and decisive
and accompanied by mom picking up the baby
and grabbing him away from the electric outlet
or the street that he's about to crawl into
or the dirt that he's about to eat.
When this happens, if you remember yourself
as a parent or seeing families, a toddler just melts like
a puddle on the floor crying, he's devastated by this no.
And of course noes are essential for the child.
But it can be hard for parents to see
what happens when they say no.
But in fact, this is an important part
of a building block of attachment called interactive repair.
So a sensitive parent at this point
where the child is on the floor in misery
will pick him up and repair the broken feelings
by explaining that, you know, I love you
very much and you're a wonderful baby.
But if you crawl in the street, you're going to get hurt.
If you eat the dirt, it might make you sick.
If you touch the electric outlet, it will hurt you.
The caregiver explains it, and of course, you know,
a nine month old, ten month old can't understand this.
But the point of the repair is I love you,
you can't do this, let's find something else to do together.
So if you think about the number of times a baby
does something they can't do, it's thousands.
So there's no again and again and again
and again in this toddler's life.
But there's also repair again and again and again and again.
So over thousands of times the child learns
that he or she is lovable even
when he does things that are wrong.
And the child develops the confidence
to learn to repair breaks with others
and to try new and challenging tasks
where there may be mistakes made,
there may be hurts, there may be
other things that need to be repaired.
So it provides a profoundly important building block
for life because we've got lots of times
when we're going to make mistakes
and when we're going to hurt people.
And if we can repair, we have an important skill.
So two pieces of what I call brain wisdom,
Bruce Perry who runs a wonderful child trauma institute
in Texas and writes beautifully,
certainly I would track down his writings
if you're interested, he says, "States," internal states,
"become traits which become a lifetime pattern."
So the feelings you have that are predominant feelings
begin to become more embedded as traits.
And what Dan Siegel has said, which is
a paraphrase of the old Hebbian hypothesis,
he says, "What fires together wires together."
So what we're learning, this is all part of the fact
that the child's brain is molded by experience.
If the neurons are firing together again and again
and again and again in similar ways, eventually
that will become a pathway that's easily traveled.
And that's one of the things, the things we face
as therapists, is helping people change
those firing patterns so that the pathways begin to shift.
And fortunately, what we've learned
is that that's possible, even as adults.
All right, I'm going to talk a little bit about what we call
patterns of attachment or styles of attachment.
These describe, when you're talking about a baby
and their style of attachment,
whether they're secure or insecure, for instance,
we're talking about describing
the relationship, not the child.
So the child isn't a secure child.
The child has a secure relationship
with a mother, maybe with a father.
They may have different attachment relationships
with the mother and the father.
They can be secure with one and insecure with the other.
But as development goes on, these secure
and insecure patterns become internalized
into what we call an internal working model.
And the internal working model includes
the child's conception about themselves,
about the caregiving environment,
and about the world more generally.
And the way these patterns are established
is by sensitive and responsive caregiving
or the lack of sensitive and responsive caregiving.
So here's very grossly overstated but general sense
of how internal working models might be seen.
A baby who's secure or an adult
who has a secure working model
sees the self as lovable, worthy, and good,
sees others as helpful, trustworthy, and basically good,
and sees the world as safe and predictable, in large part.
Insecure attachments, more generally,
and they're sort of like Tolstoy said,
all happy families are the same.
Unhappy families each has its own story.
There's one form of secure attachment.
There are many ways in which you can be insecure.
So generally in an insecure attachment
you see yourself as unlovable, unworthy, and bad.
You see others as hurtful, untrustworthy
and maybe even coercive, and you see the world
as dangerous and chaotic or a place not to be explored.
So why does this matter?
Well, we carry our working model with us
into new relationships that we have.
And our working model actually shapes
these relationships by our expectations.
And if you think of meeting people,
you know, if you meet someone who approaches you
without good eye contact, who sort of, you know, says,
hi, you know, who cares is the feeling you get from them,
they may answer your questions briefly
or scornfully or dismissively,
you don't feel like being a friend with that person.
And that person who may have what we call
a dismissing attachment has reinforced his attachment
by causing you to not want to be close to them.
So they go into the interaction
feeling like people don't like me,
I don't want to get to know people
because they're not that great anyway.
And the way they approach the interaction actually causes
their expectation to happen, and so people avoid them.
If you meet someone who comes on with a smile,
who looks at you directly, who seems
genuinely interested to meet you,
who wants to hear what you have to say,
you're much more likely to want to befriend that person.
And that person has brought their secure model of attachment
with them and has given you the sense
that you're worthy and important
as well as they're being worthy and important.
So their own secure model will tend to evoke
similar responses in others and in
that way we tend to shape our world.
And when we search for a partner in life,
we tend to choose based on models
from our previous caregiving relationships.
One of the things, the most exciting aspects
of attachment research in recent years has been the work
on intergenerational transmission of attachment.
We developed ways of measuring adult attachment
that seem to be parallel to the ways
in which measure infant and child attachment.
And a group of people had the idea of doing
adult attachment interviews with mothers
who were pregnant and a year later doing
an attachment assessment of a baby and that same mother.
They found a 75 percent predictive concordance
of the mother's model of attachment
with the baby's relationship with the mother.
And in another study where foster babies and mothers
were tested, they found a 72 percent correlation
between the baby's attachment and the foster
mother's attachment prior to being with the baby.
These are astonishing figures, and they really indicate
how important it is that the attachment relationship
in the first year of life, how much it shapes
a baby's whole sense of how they're going
to interact with others throughout their life.
So when we talk about patterns of attachment,
we generally talk about secure relationships or insecure.
These aren't diagnoses, they're not psychological diagnoses.
But they are ways which we've learned to measure
in research settings, primarily.
And we think of insecure and secure.
But I think a more important way
to divide attachment relationships
is by organized and disorganized.
So an organized attachment means that a child
has a way to get their attachment needs met.
About 60 to 65 percent of babies
in middle class groups are securely attached.
They meet their needs by seeking the caregiver
when they're feeling sad, when they're hurt,
when they're tired, or when they just want to share.
And they take joy in seeing their parent when they return
to their parent after a period of separation.
Insecure babies tend to be split into--
insecure and organized babies tend to be split
into avoidant babies who are about
20 to 25 percent in the middle class groups.
Avoidant babies tend to act as if they don't have much
in the way of attachment relationships.
They tend to, if mom has been away
and comes back into the room, they tend to sort of act like,
well, so who cares that you're back.
In fact, if you measure these babies' physiological aspects,
you'll find that they're very aroused if mother's away.
And when mother comes back, they get
much calmer, but they don't act that way.
And the theory is that they've learned
the best way to get whatever they can get
from mom is not to act too needy.
So they tend to be involved with toys
or busy with something else, and that is their way
of making sure that they get whatever they can get from mom.
The other group of insecure organized babies
are called ambivalent or resistant.
These babies get very upset if mom leaves the room,
and they don't really get comforted when she comes back.
They either are very angry, they may kick her
and hit her and push on her, or they just may be
dissolved in a puddle of tears
and not be consolable when she comes back.
A secure baby, when mom comes back to the room
after a period of being a way, may be crying,
may reach for her, may want to be hugged and held,
but after a few minutes is ready to get going again
and doing the business of a baby,
which is exploring the world and enjoying toys.
So simply being insecure doesn't mean being pathological.
It doesn't mean psycho pathology.
And I would say most of us, if you came into the field
of social work, you're probably coming
from some situation which was less than ideal as a child.
My theory is that people who grew up very happy
don't need to become therapists.
We become therapists for reasons,
for solving our own problems.
And so many of us might have been avoidant
or ambivalent as young children.
And maybe we've worked our way out of that by now.
But it's important to recognize
that being avoidant or ambivalent
doesn't mean having a diagnosis.
I'm going to show you now an example
of the Strange Situation from Everett Water's lab
at Stony Brook in Long Island.
And we're going to show you both secure
and avoidant and ambivalent babies
to give you an idea of how these babies look
and how we measure their security.
We do this in what's called a Strange Situation
which was developed by Mary Ainsworth.
And in the Strange Situation the mother and the baby
come into a strange lab where there's video cameras,
toys on the floor, chairs on the side of the room.
And part of the point is that it's strange so that the child
is not in a secure setting where they feel comfortable,
but mom's there so they're okay for a while.
Mom sits for a while, maybe plays with the baby,
talks to the baby, then a stranger comes in the room.
The stranger talks to mom for a while
then sits down and plays with the baby
and then mom leaves the room.
The baby may be upset, the baby may be not seeming upset,
maybe the baby plays with the stranger,
different babies will do different things.
But what we're looking for is what happens
when mom comes back in the room.
Does the baby greet mom, does the baby get its needs
met by mom, and then does the baby return to play?
So you'll see different reactions of a secure
and insecure ambivalent and an insecure avoidant baby.
And the way in which these are rated
is really almost entirely looking
at how the reunion of the mother and the baby
in each of the two reunions that occur
in the Strange Situation, how those reunions take place.
So now I'm going to show you the Strange Situation.
And you'll have a chance to see for yourself
how we measure attachment in infants.
So one of the things you didn't see
in the Strange Situation is a disorganized baby.
I think because disorganized babies really are
more pathological and disorganization as an infant
is associated with later pathological development,
people tend not to maintain film banks of them.
And they don't make them publicly available.
So when a baby is disorganized
in their attachment to a parent, the experience
of that child is they have no way to get their needs met
because the source of safety, which is the caregiver,
and babies know that, is also the source of fear.
And this is either because the parent is abusive
or because the parent is frightening, scares the child
in some way without being physically abusive.
If the parent is the source of safety,
the child knows they have to go
to the source of safety when they feel fear,
but the parent is also the source of fear.
This puts the child in an irresolvable dilemma.
They can't both seek safety and get away from fear.
So in a Strange Situation when these children
are seen in reunion with their mother,
they show all kinds of anomalous patterns.
Some of them may freeze, some of them may walk
toward mom with their head covered like this.
They may approach mom and then turn around and walk away.
They may look just totally dazed, and we think
this is probably a precursor of later dissociation.
So they show one of these ways
of really looking like this is way over my head.
I don't know what to do in this situation.
And we see this pattern commonly
in children who've been maltreated.
We also see it to some degree for instance
in children where their parents have had a significant loss,
for instance, maybe one of the parents' own parents
in the short time before the baby was born.
So we see it not just in abusive parents, but parents
who maybe aren't psychologically available to their babies.
This is the only pattern of attachment
that really is seen as a risk for later
psycho pathology and behavior problems.
And it's a risk for both internalizing
and externalizing problems in children.
So other types of attachment reflect
an organized system, as I said.
And they help to organize later development,
whereas disorganization means that
later development is more chaotic.
And the baby tends not to develop
these wonderful right brain skills
which are the foundation for most of the rest of life.
So in a disorganized baby, the baby sees the mother
as a source of safety, without her, the baby won't survive.
And babies are aware of this on a very visceral level.
But the mother is simultaneously the source of fear.
And the baby is unable to approach when fearful
or to flee since there is no other safety.
And that's what causes the freezing
or the contradictory behaviors.
The internal working model of a disorganized baby
is of the self as not lovable,
not likely to have its needs met,
the caregiving environment is unpredictable or threatening,
and the world as a dangerous place
where you can't count on others.
And this working model, obviously,
has profound impact on later development.
What are the results of this kind of disorganization?
So we have not only a parent who's the source of fear.
We have a parent who hasn't taught the child
these wonderful skills that they need
to take on all the problems of life.
We may see extremes of emotional expression
that occur and stop unpredictably.
I've worked with parents who say, well, obviously,
when my child is having tantrums,
they're not really feeling this
because they can stop on a dime.
That doesn't mean they're not really feeling it.
It means the way they've learned to regulate
is to go from highly overaroused to shut down in one second.
That's not an adaptive pattern.
They're very hard to soothe, they often have
poor regulation of sleep, appetite,
bladder and bowels and other body states.
If you work with children who've had
significant disorganization early in life,
you spend an awful lot of time talking
about their poop and their pee
because they don't know how to regulate
even something as basic as that.
The lack of trust in a secure caregiver
means that the baby or the young child
tries to meet their own needs.
And often they will do anything to be in control.
And you can understand this because
a baby expects a grownup to be in control.
When they're not, the baby decides,
I'd better handle this for myself.
So when grownups later in their lives try to be in control,
these babies will resist, these children will resist
control by others very potently.
And when you have a child whose goal is
to be in control at all times,
it's hard to be as strong as they are
to assert control and safety so that they can begin
to learn that they can be safe and secure.
Their lack of trust also means
they don't know how to be intimate with others.
They're often very impulsive, they haven't learned
to control impulses, to inhibit impulses.
They may have an undeveloped conscience
or a warped conscience, and they tend to make
other people angry at themselves.
And even in working with an adult client,
if you've worked with an adult client
who just makes you angry all the time,
it's good to think back on whether
this may be the source of that.
So after there'd been a number of years
of research on infant attachment,
Mary Main and the other researchers in this field
began to look at whether you could measure
adult attachment in a similar way.
And they found by interviewing parents
of the infants with whom they had done Strange Situations,
they began to develop, to understand patterns in the adults
that are parallel to the infant patterns.
So some adults, many adults have
organized internal working models.
That's what we call the way we measure an adult attachment.
So organized adults may be secure or balanced.
And these people are able to explain clearly
what's going on in their lives
or to talk with you using both affect and rationality.
Insecure adults who are organized may be dismissing.
This is equivalent to the infant attachment of avoidant.
They tend, dismissing adults tend to defensively
exclude the importance of affective information.
They've learned not to put much emphasis
on feelings or affect because they're--
as a baby, of course, they learned
that the best way to get their needs met
by their mother was to appear not to have many needs.
As an adult, they've continued that pattern
by just trying to convince themselves
that they don't have many needs, and they tend
to leave out affective information when they talk.
Preoccupied adults are also organized attachment.
They tend to defensively exclude some emotional
information and some rational explanations.
And they tend to not get their needs met well by others.
Just as the baby couldn't be comforted by the mother,
these adults are always looking for more.
The adults who are not organized in their attachment styles
are called unresolved in relation to trauma or loss.
And they tend to show lapses in the monitoring
of their discourse and a lack of coherence.
I'll try to explain this a little better.
And in a couple of minutes I'll read
from some adult attachment interviews
to give you a better picture of how this works.
So when you're assessing an adult's attachment style
or a pattern, you interview them using something called
the Adult Attachment Interview,
which is a semi-structured interview which Mary Main
has said is designed to surprise the unconscious.
And it's interesting how well this works
because I think most of us who have been trained
to use the Adult Attachment Interview
of course at some point have someone else
give us the Adult Attachment Interview.
And I know in my case and in the case
of many of the people I worked with
our unconsciouses, our unconsciousnesses,
I guess that's the word, were truly surprised.
And I found myself in tears talking
to my colleague about my early experiences
because the way these questions are structured
brings up reexperiencing of early feelings.
So questions focus on the experience
of having been parented, how one's parents responded
to sicknesses or other difficult situations,
whether parents were ever threatening,
and how the adults feel their experience
of being parented affects them today,
and how they currently parent their children.
It takes about an hour, a little over an hour
sometimes to do an Adult Attachment Interview.
And when you've done this interview,
you record it, and it is then transcribed
word for word and pause for pause.
And it is rated in a very elaborate rating system
which where the focus of the rating is
on the coherence of the person's narrative.
And coherence has very specific meanings.
But the coherence means telling the story
with appropriate feeling and without defensiveness,
using enough examples and words
to make the story clear, but not running on
with irrelevant aspects of the story or other such things.
A coherent narrative makes sense
of their life, of one's life experiences.
And it challenges early on egocentric beliefs.
A coherent narrative tends to integrate
positive and negative feelings
and integrate across hemispheres of the brain.
And coherence moves a person toward
greater security of attachment.
This may be sort of confusing.
But I'm going to read to you from a few interviews
and see if this doesn't give you a better
sense of what we mean by coherent.
Okay, one of the first questions
on the Adult Attachment Interview
is that the person is asked to describe
for each parent to give five adjectives
that would describe their relationship with that parent
as far back as they can remember.
So here are three examples of adults who used
the word loving in relationship to their mother.
So the interviewer has just said,
"All right, the first word you gave to describe your
"relationship with your mother during childhood was loving.
"Can you think of a memory or incident
"that would illustrate for me why you chose that word?"
All right, here's a secure person
talking about a mother who is loving.
He says, "Loving, I don't know if this is
"the sort of thing you're looking for.
"But one thing that comes to mind
"is the way she stuck up for me
"when I got in trouble at school.
"Boy, if I told her about some problem at school
"and she thought I was in the right,
"or if I told her some kid or some teacher
"had treated me bad, she'd go out and investigate.
"And she'd stick up for me to the teacher
"or to the kid's parents or anybody, really.
"I could put it another way, too.
"I just knew where I stood with her
"and that she'd be comforting if I was
"upset or crying or something."
The interviewer says, "Thank you."
And the participant interrupts and continues,
"Oh, you wanted a specific example.
"That time I set fire to the garage
"using my brother's chemistry set.
"I absolutely, positively wasn't supposed to use that.
"She came running when the neighbors
"phoned the fire department about the smoke.
"I expected to get the life lectured out of me.
"But she just ran straight for me
"and picked me up and hugged me real hard.
"I guess she was so scared and so glad
"to see me, she just forgot the lecture.
"Later there were little hints
"at the dinner table about the incident.
"But I'd say basically what she did
"at the time, that was very loving."
So there's a person who's able to describe well
what that relationship felt like when he was young.
And you really do get a sense of what it was like
to be that child with that mother.