Concerned About Unconventional Mental Health Interventions?

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

Friday, July 26, 2013

What We Talk About When We Talk About Bonding

If you try to google bonding, you’ll get over five million results--  even if you’ve specified emotional bonding rather than a process for improving your teeth or a kind of insurance policy for people who handle others’ money. Wikipedia says bonding is the process of developing a close interpersonal relationship that is mutual and says that any two people who spend time together form a bond. However, the Wikipedia article then goes on to describe specialized, intense relationships like that between mother and child.

What are people talking about when they talk about bonding? Well, they’re all talking about pleasant and affectionate relationships and actions, but beyond that, what someone means seems to depend on what work he or she does.

Maternity nurses tend to use bonding to describe the actions of mothers toward babies that are encouraged in modern hospital care. They would describe mothers as “bonding” when they are holding their newborns, examining their fingers and toes, and gazing into their faces. Mothers who don’t get to do these things--  perhaps because the baby is premature or sick--  are considered to be at risk for problems in the later relationship with the baby.

In a Linked-in discussion, I recently encountered a person who stated that parents and babies, even very young ones, are bonding when the parent reads to the baby. Another discussant suggested that reading to the unborn baby has the same outcome. When I asked the first contributor what he meant when he said bonding, he replied: “Bonding is the child and parent connecting on a spiritual level, and this happens in so many ways.”

I was and am flummoxed by the introduction of spiritual references into this discussion. Like most other serious students of child development, I am committed to studying measurable events and using them to understand the complexities of  human developmental change. While of course the development of children’s beliefs about spiritual life is a reasonable topic of study, to try to explain other aspects of development by adding a spiritual factor is unparsimonious, to say the least. It also brings in a component that is impossible to measure and that therefore cannot be communicated to another person or validated by anyone else.

For the last 40 years or so, psychologists studying infant development have used bonding in a specific way (when they have used the term at all). That specific way was drawn from the work of Marshall Klaus and John Kennell, who posited, partly on the basis of biological information, that human mothers went through a process that altered their emotional responses when they were able to interact with their newborn infants. They called that process bonding and considered it to be essentially “falling in love” with the baby. At the time of Klaus and Kennell’s work, it was customary in American hospitals to separate newborns from their mothers until they were examined on the pediatrician’s rounds, which might occur almost 24 hours after the birth. Parents were asking for changes in this routine, and Klaus and Kennell were able to carry out research comparing the last babies born in a hospital that had not allowed extended early contact of mother and baby, with the first ones born in the same hospital after it had instituted a new extended early contact policy. Klaus and Kennell reported some significant advantages for the early contact babies over the other group, including better language development at age five years. According to their definitions, the early contact group had had an opportunity for bonding during a posited sensitive period shortly after birth, and the other group had not.

These findings were naturally of great interest to families and to professionals working with mothers and children. It was quickly decided that bonding was, as Klaus and Kennell suggested, a basic change in the mother that depended both on biological factors and on contact with her baby, and that it was essential that parents have the opportunity to bond--  which, if lost, might not be replaceable later, and which had a powerful effect on their ability to care for their child..

However, as so often happens, it soon became clear that Klaus and Kennell’s results might not be generalizable to many mothers who had different characteristics from the study group. The results were not readily replicated, and it began to appear that they were specific to the group Klaus and Kennell had studied--   very young, poor, ill-educated girls without much social support. They seemed to have benefited from a program that supported them and their babies, but it was doubtful that older, middle-class, educated women needed or would benefit from such a program (although they would probably enjoy it, especially if they had been reading about how important bonding was!). By the time ten years had passed from their first publications, Klaus and Kennell were saying that they regretted ever having made the strong statements they had begun with, in which they had claimed a sensitive period for maternal bonding in human beings (see www.nytimes.com/1983/03/29/science/influential-theory-on-bondng-at-birth-is-now-questioned.html).

In spite of some of the exaggeration about their findings, there was one highly significant point made by Klaus and Kennell which has unfortunately been lost in the fray. This was clarification of the fact that the two sides of the mother-infant relationship are reciprocal but not mutual. In other words, the changes in the mother called bonding are shown by different behaviors and emotions and follow a different schedule than the changes in the child called attachment. To say “bonding-and-attachment”, as if the two events are the same, is like saying “apples-and-oranges”.  Klaus and Kennell made it clear that when they said bonding, they were focusing on the mother’s “falling in love” and preoccupation with her baby, and not with the baby’s months-later primitive “falling in love” with adults.

I don’t think it would be necessary or even useful to insist on one or another definition among those I’ve just discussed. However, if you get into a conversation about bonding, it would be a good idea to try to discover what your opposite number thinks he or she means when this word is used.







    

2 comments:

  1. I find this topic interesting. I remember when I gave birth to my oldest almost 11 years ago I insisted on holding her for the first hour after birth. My hospital agreed and put off the bath, eyedrops, heel prick, etc, until after an hour. With my second almost 4 years ago I had to have a c-section because she was breech. I saw her for 2 minutes and then not again for over an hour and a half. I don't feel any more attached now, nor did I feel more bonded then, to either of my children (I even breastfed my youngest briefly). I'm now 36 weeks pregnant and am hoping to have another vaginal birth. And again, even with my understanding of attachment and bonding, I will hold my baby and hopefully breastfeed during that first hour. Everything else can wait. However, I'm not fooling myself into believing that it will cause me to become any more in love with this baby than I am with my other 2.

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    1. The thing is, it's a lot of fun and a terrifically good feeling to spend that time with your new baby. I think we should all thank Klaus and Kennell for working to make this possible for many more parents than used to be the case, even though it's no miraculous cure for any relationship problems.

      The same goes for breastfeeding. It's excellent for health and very gratifying for most mothers who do it. It doesn't have to accomplish any more than that.

      Congrats on the coming baby (as well as the others)! Best wishes for an easy delivery and plenty of milk coming in quickly!

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