Concerned About Unconventional Mental Health Interventions?

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

Monday, March 25, 2013

Attachment, Empathy, Conscience: What Are the Connections?



A reader recently commented on this blog and referred to the belief that unless a child develops a secure attachment, he or she will be unable to feel empathy for other people and also will have no conscience. This statement is often made by proponents of attachment therapy as well as by many others. Is it just one more example of the current tendency in some circles to reduce everything in personality development to some aspect of attachment? I think it may be useful to go through some of the relevant facts and logical connections between facts, and to try to see what causal associations there actually are between attachment and other developmental milestones.

Let’s begin by looking at the assumption that attachment must be secure in order for empathy to develop. This seems most unlikely simply from a statistical perspective. About 35% of normally-developing toddlers are evaluated as insecurely attached on the basis of their behavior in the Ainsworth Strange Situation. Can it be that 35% of the older population is entirely without the capacity for empathy? Recognizing the frequency of selfish, egocentric, even narcissistic behavior, nevertheless it seems impossible that empathy is totally absent in that large a group, or that a society could function if a third of the population could not recognize or respond to other people’s emotions. In addition, insecure attachments, although not seen as ideal in terms of attachment theory, are within the normal range of personality developments, and it seems implausible that an important aspect of human behavior like empathy would be non-functioning while related aspects are normal. These things raise questions about whether secure attachment could be a necessary cause of empathy.

Thinking about empathy itself is an important step in examining these issues. Empathy can be thought of as responsiveness to other people’s feelings, but there is more than one way that responsiveness can occur. There is cognitive empathy, or accurate identification of facial expressions or other emotional messages like voice tone or posture and gestures. Even newborn babies show some of this ability by imitating facial movements like mouth opening, and it’s posited that they have “primary intersubjectivity” or the awareness that the face they see belongs to another person. Emotional empathy, the next step, involves a sharing of the emotions another person displays, but this does not happen all at once. After a couple of months, babies respond to smiles with smiles, and are disturbed if a person who usually responds to them stares blankly. By 7 or 8 months (yes, the time when attachment is first evident), babies recognize expressions of fear and respond to them with anxiety. They use social referencing--  looking at the faces of familiar people--  to see what those people feel about new events and people. If the familiar caregiver looks scared, the baby avoids the new thing; if the familiar adult looks happy, the baby explores it. So, that kind of empathy is certainly well underway by the end of the first year, at about the same time that attachment is really perking for family-reared children.

What about what we might call “functional empathy”--  not only identifying and feeling with another’s feelings, but also behaving in a kind and helpful way when someone is in distress? This is a much trickier development. Unfortunately, we human beings of all ages have complex responses to others’ distress, and our responses are not all helpful by any means. Sometimes we laugh when someone gets hurt---the basis of the Three Stooges’ popularity, but also of the embarrassing impulse to laugh at a funeral. Sometimes we get angry when someone displays distress and we can’t or don’t want to be of help; we tell them the problem was their own fault and maybe they’ll know better next time, or accuse them of manipulating people by pretending to be hurt. We may even attack a person who displays distress. Physical abuse of infants is often in response to the infant’s crying. Even normally kind parents under stress may threaten or actually smack a child who is whining or complaining (classically saying, ‘I’ll give you something to cry about”).  And toddlers and preschoolers too show all these kinds of responses to others’ distress.

So, how does it come about that a lot of people, both children and adults, respond helpfully a lot of the time, when they get other people’s messages of pain or fear?  Almost all will have had mixed experiences of responses to their own distress. Very few, if any, will have survived without ever having anyone respond to their needs and related emotions. Very few, if any, will have had caregivers who were always willing and able to respond to a child’s distress. Most will occasionally have had a parent unable to respond (for example, I remember having an allergic reaction and not being able to speak to my two-year-old for perhaps 15 minutes while the medicine went to work). Many will have had a caregiver laugh at a fall or other accident that later proved to be more serious than it looked. And probably most will at least once have had a stressed-out parent respond with an angry look to one-too-many complaints. Children who become nurturing and helpful as they get older seem to be the ones who have most often had sensitive and responsive care from adults who identified the child’s emotions correctly and acted as well as they could to comfort and soothe. Their experience with good role models tells them the ideal way to act, and like adults they do this as well as they can in given circumstances. (This does not mean, of course, that as children they can understand or deal with some of the powerful emotional issues of adulthood, nor should they be expected to empathize with many adult emotions.)

Given all of this--   does attachment (secure or insecure) serve as a necessary foundation for empathy? There seems to be no reason why the first should be the basis of the second. However, it is reasonable that this might appear to be the case. Secure attachment grows through experiences of pleasant social interactions with caregivers who are interested, engaged and engaging, sensitive and responsive to child messages. Although most parents and caregivers are better at dealing with certain child ages than with others, it’s generally true that those who have been sensitive and responsive (and fostered attachment) early on will continue to behave in the same way with an older child--  and thus will foster positive, helping behavior toward others’ distress. If the child who has become attached stays with the same caregivers, their continuing modeling of empathy and nurturing will help shape the same kind of behavior in him or her. Although the responses the child gets to his or her own distress are probably most important, such caregivers will probably also model empathy by direct instruction (“we pat the kitten very gently”) and by observable nurturing behavior to other people (“let’s get Grandma a cup of tea, she’s tired”).

But as usual, it’s not as simple as one experience, one child outcome. The researcher Grazyna Kochanska has looked at conscience development as an outcome not only of parenting methods, but of the child’s basic temperament. For children who were not very fearful, secure attachment in infancy was a good predictor of later conscience. For temperamentally fearful children, a better predictor was the mother’s use of gentle discipline. Kochanska referred to attachment as an “alternate pathway” to conscience.

Rather than secure attachment causing empathy, it may well be that “good things go together”, as so often seems to be the case in child development.
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