Attachment and Psychopathology

Bowlby showed that after the initial positive bond is formed between mother and infant at about 6 months, the infant reacts to loss of the mother in three characteristic stages. First, there is protest—crying and anger that serve to bring mother back. If this is unsuccessful, a period of despair follows, characterized by withdrawal, depression, and decrease in activity. Finally, a stage of detachment appears in which the infant is relatively unresponsive to people. The child's anger toward the mother figure is a central feature of this pattern. The anger is expressed openly in the protest phase and indirectly in the detachment phase. Bowlby stated that the separation experience elicits intense and violent hatred of the mother figure.

Bowlby's observations on separation and loss are supported by the infant studies of Ainsworth and a number of infrahuman primate studies. René Spitz described anaclitic depression as a condition in which the infant, when separated from the mother, dies because of hospitalization. Zas-low and Breger made an attachment analysis of early infantile autism that is followed by separation and loss. They derived several theoretical conclusions applicable to normal human attachment and the psychopathology of attachment. The first was that holding a child in a state of protest behavior, characteristic of infant-child crying, forms a stress-to-relaxation cycle that is a fundamental unit of positive attachment. The greater the intensity of protest, the greater the relaxation and the stronger the bond between child and parent. The second conclusion was that social-affective human attachment is to the face and not to the breast. The human species-specific behaviors important for the maintenance of face-to-face interactions, such as smiling, crying with tears, talking, and listening, are not found in the autistic child, who strongly resists eye-face contact. These provide an alternative behavioral network to the fight-flight response that results from the stress of prolonged eye-face contact found in lower species.

Bowlby reached a general conclusion about attachment theory and its relationship to psychopathology with the view that attachment theory is a scientifically valid system that incorporates concepts derived from psychoanalysis, ethology, cognitive theory, and control theory.

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