Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Thursday, January 17, 2013

Focus on the Family Buys Into Attachment Myths



Attachment theory, as formulated decades ago by John Bowlby, is a framework for understanding how human social interactions and relationships develop from infancy onward. Any theory works to pull together observations or other data on a topic and to suggest how they are connected with each other. Attachment theory deals with observable aspects of social relationships such as the apparent indifference of infants in the first months to contact with strangers, the quickly-developing preference for familiar people and fear of separation or strangers as infants  reach the end of the first year, the use of contacts with familiar people to help toddlers explore and learn, and the associations between early social experiences and adult attitudes toward other people.

Attachment theory, as it is conventionally understood, has been tested and revised as thousands of empirical studies have examined it. This is not the case, however, for an “alternative” view of emotional development that also uses the term attachment, but is in fact a matter of attachment myths.

The organization “Focus on the Family” appears to have bought into prevalent attachment myths. Although materials on its web site reference John Bowlby and attachment theory, it is in fact the myths that are repeated. Advice to parents  given by “Focus on the Family” is based on attachment myths, not on attachment theory.

Here is one example, taken from http://www.focusonthefamily.com/parenting/adoptive_families/attachment_and_bonding/new_definition_of_attachment-regulation.aspx. . The FoF author, Debi Grebenik, says this: “Children (biological or adopted) who do not get their needs met as babies and small children typically do not form a strong attachment with their parents. Even when adopting a baby, it is important to consider that the removal of a child from his or her biological mother creates a traumatic event in the life of the child.” Grebenik provides a diagram of the so-called “attachment cycle” that is solely a part of the attachment myths system and in no way a part of attachment theory.

Grebenik’s statements vary between the deceptive and the false. Certainly, young children are helpless to feed and care for themselves, and for good development must have caregivers who will do these jobs and do them well. However, it is a mistake to conflate good caregiving with the social interactions that are the actual cause of emotional attachment to caregivers. This aspect of attachment mythology adopts Sigmund Freud’s belief that children become attached to familiar people because those people provide food, an idea that was contradicted by Bowlby’s report, and the position of attachment theory, that pleasant social interactions with an adult are the actual cause of a child’s attachment to that adult.

Ordinarily, of course, caregivers who are neglectful or abusive are also likely to fail in providing pleasurable social interactions, and those who are attentive, sensitive, and responsive are also likely to create pleasant social interactions with their babies. It is easy to confuse these issues and to jump from care experiences to the social events that create attachment. If Grebenik is going to write about these issues, however, she should realize that it is deceptive to focus on satisfaction of needs as a cause of attachment, when in fact social interactions are the important factor here. Although events depicted in the “attachment cycle” diagram are usually accompanied by the important social interactions (which go unmentioned), the two are not the same things. This may seem like nitpicking--  except for the fact that attachment mythologists often recommend treatment of older children by attempts to re-enact the notional attachment cycle, such as spoon- or bottle-feeding. Buying into attachment myths in this way encourages parents and practitioners to choose forms of treatment that are neither plausible nor demonstrably effective.

In referring to the removal of a child from the biological mother as traumatic, Grebenik is again deceptive in her omission of important details. Of course, separation from a familiar caregiver (biological relative or not) is likely to be traumatic when two circumstances are present. The first is that the child has already formed an attachment to a familiar person, an event that does not occur before 6 months of age at the earliest. The second is that the new caregiver is unavailable, insensitive, and unresponsive. (I should note, by the way, that Bowlby did not consider, the second factor to be important, but his colleague John Robertson demonstrated that it was.) If the child is under 6 months old and is moved to a situation where a small number of attentive adults give good care and are socially responsive, this does not appear to be traumatic. Even an older child who is given sensitive, comforting care will adjust well over time. However, a child old enough to have formed an attachment, but too young to have developed good cognitive and language skills, is likely to be traumatized if placed in the care of a busy, unavailable, insensitive, and unresponsive caregiver. Children between 6 months and two years of age are most likely to have the reaction that Grebenik appears to ascribe to all children.

Let’s look at another FoF statement, at http://www.focusonthefamily.com/parenting/adoptive_families/wait-no-more/attachment-problems-up-close-and-personal.aspx. Here, in a piece by Kelly and John Rosati, we see the advice that emerges (logically but incorrectly) from the attachment myths described by Grebenik. Here’s what they say about the advice given to adoptive parents of a baby, whose age is not stated, but who was at the crawling stage. The adviser (an adoptive parent, not a professional ) inquired whether the baby held his own bottle, and whether when crawling toward an interesting object he looked back “to show it to you”. When the parents replied Yes and No, respectively to these questions, their adviser looked grave and announced that they were “in for trouble” if they did not work to overcome these attachment deficits.

[Let me take a moment here to point out two things. The first is that because there is no evidence that the “attachment cycle” described earlier actually exists, there is no reason to think that holding or not holding a bottle has any relevance to attachment. As for the second, the adviser appears to be confusing two developmental steps. At about 10-12 months, well-developed babies display “joint attention” by looking back and forth from an interesting object to a caregiver, until they get the caregiver to look at the object “with them”.  This is not usually considered a measure of attachment. The step this seems to have been confused with is secure base behavior, in which a child exploring a strange place or situation will occasionally make contact with a familiar person, by coming back to the adult, by “checking back” with a look, or by calling to the adult.  Unless an interesting object was also frightening, no one would expect a baby in a familiar setting to do much secure base behavior as he or she explored. ]

What did the adviser then suggest? “…only John and I should hold Daniel, and only I should feed him (not even John!). She told us that we should never let him hold his own bottle; he needed to depend on me to provide him with what he needed. … And then came the kicker: I needed to hold him and be face-to-face with him for almost eight hours a day!”

This mother recognized the implausibility of the advice--  although she apparently did not think of the interference with Daniel’s normal mastery motivation and with the eight hours of normal activity he would be missing, or of the training in passivity that was being given here. Scared of the dire predictions of the adviser, she did as she was told. “After several months of this therapeutic parenting…Daniel began to make good eye contact… and was more engaged and more emotionally connected with us”. The mother attributed the change she perceived to the treatment given--  although in fact one might well expect several more months in an adoptive family to be accompanied by increasing maturity and attachment to the new caregivers. (Indeed, I would ask whether those changes were actually slowed by the “therapeutic parenting”!)

There you have it. “Focus on the Family”, an outfit that draws many readers because of its religious and social positions, has bought into a mythology of attachment that contradicts  conventional attachment theory and that culminates in diagnoses and treatment that are inaccurate and inappropriate. How about it, FoF? Isn’t it time to replace the attachment myths with evidence-based material about attachment---  and help rather than hinder parents?

  

2 comments:

  1. Have you ever adopted a child who was severely neglected in the first several years of life? Have you ever cared for a child--not so called treated, actually cared for--with attachment issues? Have you ever experienced what numerous adoptive and foster parents deal with on a daily basis? I know that a handful of attachment practices are crocks but those bad eggs give the rest a bad wrap. A myriad of attachment issues that go untreated so when something works, a parent desperate to make these child's life better and give them better coping skills you go with it. What exactly was your "scientific" approach to determining that the attachment created between the baby and mother you reference was not because of the therapeutic parenting? I think maybe you were not held enough as an infant!

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    1. I'm publishing this as a wonderful example of the ad hominem arguments so typical of supporters of attachment therapy.

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