Sunday, August 16, 2015
Follow the Child's Lead to Create Attachment
A recent e-mail from Jessica Pegis called my attention to a set of “rules for bonding” as put out by the magazine Adoption Today (www.adoptiontoday.com/bondingarticle2.html). An on line article on this topic, “Jump-starting attachment with babies and toddlers”, by Mary Ostyn, contains a range of misunderstandings about attachment and young children’s needs, as well as some good advice – e.g., that nurturing does not “spoil” a child.
My first concern about Ostyn’s remarks is that they suggest that attachment (not bonding) is something an adult can do TO a child, and that it is accomplished by ritually re-enacting with toddlers the behaviors that are normal parts of caring for infants. The term attachment refers primarily to attitudes and behaviors of young children toward adults, although some authors have tried to bring all later relationships under the attachment umbrella. As far as we presently know, attachment of a child to a caregiver occurs when the caregiver is sensitive and responsive to the messages the child sends about needs and wishes—that is, when the caregiver pays close attention to the child’s communications about both affectionate interactions and autonomy. (This kind of attention and response is just one detail of what is sometimes called “following the child’s lead”).
Ostyn seems to assume that the caregiving behaviors that typically precede an infant’s attachment to a parent are identical with the behaviors that will encourage attachment in a toddler or preschooler. My guess is that she takes this position because she shares with advocates of attachment therapy the belief that a child who has experienced separation has in some way been blocked from and stopped further development, and therefore experiences characteristic of early life must be recapitulated in order to “jump-start” typical development. However, the fact is that no living child stops developing in any way. Development may be distorted by events, but it continues to occur. This means that a toddler who has undergone separation cannot be considered to be stuck at the stage of development where she was at the time of separation. It’s more accurate by far to consider that aspects of development have been derailed and need to be guided back onto a desirable track.
Re-enacting baby care with an older child is thus not a plausible approach to helping kids who have experienced rough histories. What’s more, this kind of re-enactment of events ignores the important role played in attachment by the caregiver’s responsiveness to the child’s signals. Just doing what a caregiver thinks ought to be done may well involve being unresponsive to child communications, especially if a child is hard to “read”.
As Mary Dozier has pointed out, improving the parent’s ability to understand subtle child cues is the way to improve the child’s attachment to that parent; caregivers who proceed to follow “rules” without considering the child’s signals are working against attachment, not toward it. Ostyn suggests actually ignoring child cues to insist upon physical contact. She also ignores the fact of the typical extreme ambivalence of the toddler toward being held and being let go – the behavior that Margaret Mahler called a “rapprochement crisis”, where a normally-developing child wants to be held and then put down, wants help and then has a tantrum when receiving it, etc. Rather than recognizing age-appropriate behavior, Ostyn is confused by her assumptions about “stuck” development into thinking that this is an expression of genuine reluctance to develop a relationship. Instead, it’s an opportunity for a caregiver to show responsiveness to the confused and confusing signals the child is giving. The child’s desire for autonomy needs to be honored as much as the child’s desire for attachment—and I am at a loss as to how hours of carrying a big child can accomplish this, especially when the child resists. Once again, following the child’s lead as much as is practical is the way to go; carrying out a ritual re-enactment of some idea of infant care is not.
This leads me to the whole feeding issue. According to Ostyn, “bottlefeeding is great for bonding”—but there’s certainly no evidence that it makes any difference to attachment, any more than breastfeeding does. Does she mean that bottlefeeding makes a caregiver feel good? That would make sense if she’s really talking about bonding, which is the increased positive feeling of the adult for the child. Not so much if she means attachment, the feeling and behavior of the child toward the adult, however. A toddler or preschool child is likely to resist being given a bottle and will probably want to hold it herself and even take the nipple off to drink better, but caregivers who are convinced by Ostyn will not follow this lead as they should. (Some will even interpret these actions as a refusal to attach to them and a personal dislike.)
As a further comment on feeding, Ostyn advises that only the mother should feed the child, and all treats should come from the mother. Here we have a clear commitment to the Freudian concept of attachment as “cupboard love” created by associating a caregiver with food or other gratification. This outmoded view has long ago been replaced by the idea of attachment as a robust development that occurs in response to pleasurable social interactions and adult sensitivity to child communications. Certainly mealtime offers many opportunities for happy social engagement and responsiveness to the child’s cues, but these are not based on satisfaction of hunger or experience of “treats”. I might point out also that the idea of monotropy, the attachment of the child to a single individual, as initially argued by John Bowlby in an analogy to the imprinting of ducklings, is long gone from professional discussions of attachment. Most children experience attachment to several caregivers, including fathers and grandparents, and benefit from learning that there are a variety of ways of having pleasurable social play.
Ostyn should be given credit for a couple of good suggestions. One is about responsiveness to children’s night-time concerns, and in her comments about this she does encourage sensitivity and responsiveness to child communications. Her comments about playing on the floor every day are also excellent. “Floortime” (as it was dubbed by Stanley Greenspan) offers many opportunities for pleasurable, sensitive, and responsive communication and for following the child’s lead in play.
You can’t “jump-start” attachment by making the child go through ritual re-enactments of infancy. But you can gradually encourage a child’s attachment by becoming sensitive to subtle communications and being willing to follow the leads he gives you. If this seems difficult, sometimes it can be helpful to make videos of your interactions with the child and to look at them later to see whether there are cues that you are missing and leads you are not following. Keep in mind, too, that a toddler is developing attachment relationships that include negotiation and compromise, not just dependence, and that autonomy is an essential goal for development. That toddler or preschooler is not literally “stuck” at a baby’s emotional level—he or she needs experiences that resonate with current needs, not to what some adults imagine as past needs.