Mental health articles

The basis of emotional health for infants lies in the attachment relationship they develop with their main caregiver(s). John Bowlby developed his theory during the middle of the 20th century (Bowlby, 1979). Mary Ainsworth further developed this theory, recognising not only that there were secure and insecure modes of attachment, but that they could be reliably measured (Ainsworth, Blehar, Waters, & Wall, 1978). Karen’s book (1998) provides an easy reading guide to these theories.

In brief, infants are ‘hardwired’ to ensure that their physical needs are met, withtheir cries and endearing mannerisms attractingthe  attention and care of those around them. They learn in the repetitive day-by-day and minute-byminute interactions how each carer will respond, and whether the signals will be met sensitively by a personwho is emotionally  available (Biringen, 2004). The relationship that results with each frequent caregiver is the  attachment relationship. The infant whose needs are met by the parent who is ‘goodenough’ (Winnicott, 1953) is more likely to develop a secure attachment. They will resonate with a profound knowledge that their physical and emotional needs will be met when needed so they can explore and master the world in a confident fashion. The Circle of Security program (Marvin et al., 2002) is a deceptively simple representation of this theory and many of the authors in this book use elements from their program. Ainsworth originally described secure (depending on the sample, perhaps 65% of all infants) and anxious attachment, subdividing the latter into avoidant and ambivalent (sometimes known as resistant) attachment.

Mainand  colleagues (1985) later described disorganised attachment, generally associated with parenting that is frightening but at times loving or comforting as well, a highly confusing state for an infant. Borderline personality disorders may both produce and result from this form of parenting and are further discussed.

The style of relating to our principal caregivers in the early years of life tends to become the template for all other relationships throughout life, and remains as a measurable status within us.Hesse(1999) provides a clear account of the Adult Attachment Interview developed by Mary Main to measure adult attachment patterns which correspond, in part, to those developed in infancy. van Ijzendoorn (1992) showed that there is an intergenerational transfer of attachment relationships in nonclinical populations: secure parents will form secure attachment relationships with their offspring.Berlin, Ziv, Amaya- Jackson and Greenberg (2005) have compiled a state-of-the-art text regarding attachment theory and its ramifications, including ways of intervening to  optimise outcomes.

In the last 2 decades, Allan Schore (1994, 2001) has assembled work across many disciplines, including neurobiology, developmental neuro chemistry, developmental psychology and psychiatry, and evolutionary biology, to propound mechanisms whereby securely attached infants have more optimal brain growth, particularly of the right cerebral hemisphere with its connections to the limbic system and autonomic nervous system.

The concept of hardwiring is used here too: the nerve cells are in place at birth but their rate of growth  depends on the experiences encountered in the early years. Those parents who can sensitively tune into their infants and better provide them with relief from stress will help those infants’ brain growth and the associated external signs: more exploration, enhanced learning, calmer behaviour and better coping  mechanisms when anxious. This brilliant work has helped us to understand how more optimal parenting is associated with better outcomes for children.  Shonkoff and Phillips (2000) have also collated a book that brings together the work of many scientists to give an understanding across disciplines regarding early childhood development. In addition, they move from scientific understanding to recommendations about policies and practices that may make a  positive difference to small children’s development. Gerhardt (2004) has  provided an easy-to-read  account of scientific findings on attachment and brain development. Many other contributions are important in understanding good development. Fonagy and colleagues (1991) introduced the concept of reflective  functioning — a person’s ability to understand behaviour by relating it to  underlying mental functioning. When a parent can reflect on the infant’s  experience, and understand the state of mind of the other, a rich interconnection  develops, which allows the infant to learn over time how to interpret the actions of others as meaningful.

Authors such as Slade (2005) describe the central importance of maternal reflective functioning in attachment  relationships. Thus infants raised in homes by parents who reflect on their infants and use this knowledge to meet their physical and emotional needs well enough, are likely to move into childhood with security of attachment, an ability to explore the world well and an understanding of their relationships with others and how to work with them. Flory (2005), Siegel and Hartzell (2003), and Schmidt Neven (1996), among others, have written clear and easy-to-read accounts of parenting that focus on an understanding of how best to meet children’s emotional needs and enhance their attachment  relationships.

Tags: emotionally, healthy, infants