Assessment of Attachment Relationships

What is attachment?

The word attachment is used frequently by mental health, child development and child protection workers but it has slightly different meanings in these different contexts.

The first thing to know is that we humans create many kinds of “bonds.” A bond is a connection between one person and another. In the field of infant development, attachment refers to a special bond characterized by the unique qualities of the special bond that forms in maternal-infant or primary caregiver-infant relationships. The attachment bond has several key elements: (1) an attachment bond is an enduring emotional relationship with a specific person; (2) the relationship brings safety, comfort, soothing and pleasure; (3) loss or threat of loss of the person evokes intense distress. This special form of relationship is best characterized by the maternal-Student relationship.

These special relationships are vitally important for the current and future development of the IP. A solid and healthy attachment with a primary caregiver appears to be associated with a high probability of healthy relationships with others while poor attachment with primary caregivers appears to be associated with a host of emotional and behavioral problems later in life.

In the mental health field, attachment is used loosely has come to reflect the global capacity to form relationships. For the purposes of Functional Assessment of Behavior, attachment capabilities refer to the capacity to form and maintain an emotional relationship while attachment refers to process of forming a relationship bond. An IP may have an “insecure” attachment or “secure” attachment, for example.

Attachment Theory

Attachment theory is central to our philosophy of functional analysis because we look at how relationships, co-regulation, biological development and the environment interact to influence behavior.

Attachment theory emanated from the fields of psychodynamic psychology and ethology (the study of animal behavior, as well as the study of human behavior as a zoological species). Much of the original ideas came from observations of children who had experienced forced and abrupt separations from the mothers, and who subsequently suffered from emotionally disturbed symptoms.

The following introduction to Attachment Theory is adapted from Karen:[11]

In the 1950s, when an epic struggle between Skinnerian behaviorism and Freudian psychodynamicism was at a peak, John Bowlby (generally regarded as a founding father of attachment theory), who was influenced by recent studies by Konrad Lorenz (a founding father of the field of ethology) on species-specific, postnatal imprinting, began to study mother-infant relationships across mammal species. He speculated that the interplay between instinctual behavior patterns and events in the environment was found to exist throughout the animal world, with the young of each species prepared to react to significant symbols and events. He noted that behavior involving mating and parenthood could in many species be modified by learning, turned off when no longer needed, or strung together in long sequences to produce complex social interactions.

Bowlby maintained that the discoveries of the ethologists must apply in some form to human beings, that people, too, must have bonding behaviors and intergenerational cues, that they, too, must be prewired for some sort of relational experience, and that with them, too, nature’s intentions could go awry if the environment failed them. Bowlby would soon declare that sucking, clinging, following, crying, and smiling are all part of the IP’s instinctual repertoire, whose goal is to keep the “Attachment Figure” close by.

Bowlby introduced the formal term “attachment” to describe the infant-Caregiver bond. Unlike “bonding,” which suggested an instantaneous event (but critical to a healthy Caregiver-infant relationship), attachment suggested a complex, developing process. Indeed, to Bowlby attachment was much closer to the idea of love, if not identical with it. He now proceeded to define a new series of developmental stages based on the maternal bond. During the first year the infant is gradually able to display a complete range of “attachment behaviors,” protesting Caregiver’s departure, greeting her returns, clinging when frightened, following when able. Such actions are instinctual and rooted in the biological fact that proximity to Teacher, because it is essential to survival, is satisfying. The formation, maintenance, and renewal of that proximity begin feelings of love, security, and joy.

Evolutionary, Phylogenetic History/Evolutionary Psychology and Ethological Influences

It helps to have a little bit of evolutionary history here. B.F. Skinner thought of our inherited capacities for responding to the environment as phylogenetic antecedents. We use the fields of evolutionary psychology, ethology and anthropology to inform us about typical pathways of development, and more importantly, what elements of care and responding from the mother-infant dyad (and all subsequent relations the IP engages in) are necessary to form the basis for neurotypical and atypical emotional development?

Attachment Patterns in Humans – Attachment as our Innate Emotional/Behavioral Development System

Humans are typical of other ground-dwelling primates in their attachment behavior. When not under threat, the young typically run around and play (exploration) – which has its own fundamental role in development. But when a threat is sensed, they run quickly towards the protection of their mothers (attachment figures), and/or the rest of their social group.

Modern human beings emerged from earlier versions of humans who had long established this pattern of attachment behavior. For the vast majority of human history, human species were nomadic hunter gathers – as much potential prey as they were predators. Throughout the world – there were really big and bad predators out there, and to this day, there are societies where children are still vulnerable to animal predation (e.g., lions, hyenas, crocodiles, etc. in Africa; tigers and Komodo dragons in Asia; snakes all over the world…). Even in the absence of predation – life in the wild is difficult. Aside from the natural challenges of providing sufficient calories for survival in competition with other animals, there are natural hazards and disasters. And as always – the biggest threat to humans – is other humans.

Human children are particularly vulnerable. As a species, humans are not the fastest, strongest animals out there, nor are we poisonous, armor plated, camouflaged or deadly biters. The social culture – usually the tribe in most primitive societies – is essential for the survival of adults. Seeking of protection from the attachment figure is the only real survival strategy available to young children. This is why feelings of exclusion, unfairness, and rejection are among the most painful in the human emotional spectrum.

Intelligence is of course a fundamental element of our survival. The human species developed a large and integrated brain that allowed this to happen. That is our environmental niche. But humans do not survive on their individual wits and ingenuity alone. Because of our inherent physical disadvantage, we can only survive in groups. The theoretical hermit[12] living on his own in the middle of the wilderness is still vulnerable to any large predacious animal or human being, and if he gets sick, his chances of survival are decidedly less without nurturing care.

A central element in human survival is the social nature of the human brain. Evolutionary psychologists point to the need for social intelligence as a main driver of the expansion of the brain from earlier human species and primates.

The development of the mind (remembering that it is primarily a social regulator in humans) is predicated on the attachment system. One cannot occur without the other, and they cannot be thought of separately. Attachment relationships permit the development of the mind, shaping it, and providing the prerequisite conditions in order for it to develop.

Here’s what you need to know:

We ultimately view behavior as means of regulation of the body/mind, which can only be done in the context and under the global protection of attachment relationships. Even self-directed (self-stimulatory) behavior or behavior done when alone is not possible unless there is some comfort and security.[13]

Behavior is Functionally Analyzed along its main Axis of Attachment and Exploration:

All human behavior is rooted in a species-specific attachment system. The primary driver of human brain evolution and brain development throughout the lifespan is socio-cultural relationships.

Humans need other humans to survive – especially in infancy and childhood. All currently observed behavior, whether attachment motivated or not, evolved from earlier experiences involving instinctual interactions with a caregiver. The environment shapes these original behaviors into what is observed today – the tip of the iceberg.

Even exploration is viewed as a means of insuring one’s attachment to others. We learn to do well not only to insure our own survival – but to be needed by others. Our adult skills provide sustenance, protection, and pleasure not only for ourselves, but for the benefit of others. We use these skills all the time to regulate and co-regulate our relationships.

Our functional analyses reflect the attachment vs. exploration axis. We look first at the emotional structure of the individual and his or her relationships. These emotional structures predispose all behavior (see Setting Conditions, below). Emotional structures are essentially internal biological entities, but the forms they take always emanate in context with relationships and the rest of the environment.

We then look at the means (skills) in which the individual uses to regulate the body/mind and relationships. We analyze behavior according to how far it has evolved from the most instinctual, reflexive, and primitive forms to the more sophisticated and nuanced forms of behavior that have resulted from a lifetime of exploration.

While we look at behavior through the “lens” of the attachment behavior/exploratory behavior axis, proximity control, signaling, co-regulation axes, etc., we also must look equally at how environmental influences and experiences, as well as how the current profile of the IP’s developmental capacities shaped the behavior we see in the present.

Attachment vs. Exploration

In the overall attachment behavior system, a dynamic relationship exists between “attachment behavior” and “exploration.” Exploration is a part of the overall attachment behavior system. Exploration behavior only exists under conditions of relative comfort. It represents the individual’s efforts to go out into the world and learn from it (see Means of Exploration, below), which can only occur in a healthy way if the individual feels safe and secure. While learning from the world is an important means of ongoing survival – especially in humans, exploratory behavior only occurs when [the individual perceives that] immediate survival is not at stake.

Attachment behavior on the other hand is about immediate survival and protection. It represents a strong desire on the part of the individual to reconnect with the “attachment figure” – the primary person to whom the person receives most protective care – usually the Mother.[14]  Attachment behavior is strongest when survival is threatened – or when there is a perception that harm might occur if not protected.   Humans certainly stretch the notion of what is “threatening to survival” to many situations where their perception is not reality (their survival is not actually threatened, but the situation symbolizes to them some impending harm).  Individuals use different “means of attachment” (see Means of Attachment); developmental tools or strategies to increase proximity to the caregiver, depending upon their age and development, and we analyze how the IP’s current means predispose behavior.

Maternal Attunement is Necessary for Psychological Development

“Attunement” refers to the ability to read and respond to the communicated needs of another. This involves synchronous and responsive attention to the verbal and non-verbal cues of another.

The concept of attunement is vital for you to understand.

An attuned person resonates (feels) intuitively what their infant or significant other is feeling and acts accordingly. This communicates to the IP that her feelings are understood. From early bonding/attuned experiences stems a lifelong feeling of trust, belonging, and affiliation with other people.

The capacity and desire to form emotional relationships is related to the organization and functioning of specific parts of the human brain. Just as the brain allows us to see, smell, taste, think, talk and move, it is the organ that allows us to love — or not. The systems in the human brain that allow us to form and maintain emotional relationships develop during infancy and the first years of life. Experiences during this early vulnerable period of life are critical to shaping the capacity to form intimate and emotionally healthy relationships. Empathy, caring, sharing, inhibition of aggression, capacity to love and a host of other characteristics of a healthy, happy and productive person are related to the core attachment capabilities which are formed in infancy and early childhood.

Experiences of empathy and of being cared for, contribute significantly in the growing person’s capacities to understand the intentions and meanings of others’ behavior, which is an important control for anxiety.  In other words, not being able to understand the basic intentions and perceptions of others, as noticed by observing patterns in their behavior over a lifetime, can make the behavior of others spooky and difficult to anticipate.  Individuals without this normal ability to read the minds of others will find other reference points to measure their current safety.  They will tend to avoid others, avoid any normal level of uncertainty or change, and cling to static routines and highly controlled interactions.

The biological capacity to bond and form attachments is most certainly genetically determined. The drive to survive is basic in all species. Infants are defenseless and must depend upon a caregiving adult for survival. It is in the context of this primary dependence, and the maternal response to this dependence, that a relationship develops.   This attachment bond is crucial for survival.

Attachment becomes genetically hard-wired into a species through natural selection.  Basically, the mother that does not respond effectively to the off-spring’s signals of need for care and protection, would not be able to pass her genes through the infant to a third generation.  The infant that did not or could not develop means of effectively signaling and providing feedback for the attachment figure’s caregiving behaviors, did not survive to reproduce.

An emotionally and physically healthy [human] Mother will be drawn to her infant – she will feel a physical longing to smell, cuddle, rock, coo and gaze at her infant. In turn the infant will respond with snuggling, babbling, smiling, sucking and clinging. In most cases, the Mother’s behaviors bring pleasure, soothing and nourishment to the infant and the infant’s behaviors bring pleasure and satisfaction to the Mother. This reciprocal positive feedback loop, this maternal-infant dance, is where attachment develops.

Therefore, despite the genetic potential for bonding and attachment, it is the nature, quantity, pattern and intensity of early life experiences that express that genetic potential.  This reflects the reinforcement properties of the environment.  But this is a two-way street.

THIS IS SO CRITICAL: Our phylogenetic inheritence, the human attachment system, determines in large part what is reinforcing – or at least what should be reinforcing.  If human bonds and social experience-sharing are not part of the individual’s attachment means or do not function as reinforcement for behavior, there is a huge problem that should become a foremost target for developmental intervention.  A child’s over-reliance on independently controlled and static environments, and corresponding under-reliance on interdependent means of maintaining well-being is a definite sign of pathological development.  Intervention should prioritize attachment means, experiences and skills that promote the return to social-relating as a primary source of reinforcement.

Without predictable, responsive, nurturing and sensory-enriched caregiving, the infant’s potential for normal bonding and attachments will be unrealized. The brain systems responsible for healthy emotional relationships will not develop in an optimal way without the right kinds of experiences at the right times in life.

Timing is everything. Bonding experiences lead to healthy attachments and healthy attachment capabilities when they are provided in the earliest years of life. During the first three years of life, the human brain develops to 90% of adult size and puts in place the majority of systems and structures that will be responsible for all future emotional, behavioral, social and physiological functioning during the rest of life. There are critical periods during which bonding experiences must be present for the brain systems responsible for attachment to develop normally. These critical periods appear to be in the first year of life and are related to the capacity of the infant and caregiver to develop a positive interactive relationship.

The impact of impaired bonding in early childhood varies. With severe emotional neglect in early childhood the impact can be devastating. Children without touch, stimulation and nurturing can literally lose the capacity to form any meaningful relationships for the rest of their lives. Fortunately most children do not suffer this degree of severe neglect. There are, however, many millions of children who have some degree of impaired bonding and attachment during early childhood. The problems that result from this can range from mild interpersonal discomfort to profound social and emotional problems. In general, the severity of problems is related to how early in life, how prolonged and how severe the emotional neglect has been.

This does not mean that children with these experiences have no hope to develop normal relationships. Very little is known about the ability of replacement experiences later in life to “replace” or repair the undeveloped or poorly organized bonding and attachment capabilities. Clinical experiences and a number of studies suggest that improvement can take place, but it is a long, difficult and frustrating process for families and children. It may take many years of hard work to help repair the damage from only a few months of neglect in infancy.

Attachment and Autism

An important concept to understand is that of emotional “contingency.” From very early on in infancy, emotional contingency is readily observed in infant-caregiver pairs. The baby smiles or makes a face, and the Mother/Caregiver “mirrors” the face back at the infant. In this case, the Mother/Caregiver’s reaction was contingent upon the face of the infant. In a typical interaction, the flow goes the other way as well. Mom makes a face, and the baby copies or shows a complementary reaction. Videotaped episodes reveal that this mirroring process goes on every few seconds, and the reaction time between signal and contingent signal is less than 2 seconds.

The process of attachment that starts from before birth and continues throughout the lifespan is therefore a two-way street. In the first 3 years, the emotional experiences are very intense and provide the comfort and security necessary to spark exploration. Mirroring shows the infant that he can trust his caregiver to love, protect, and understand him, and safe in that knowledge, he will go out into the world and explore. He knows that if there’s a problem – he can always return, and she will have an attuned response.

The first 3 years represents the most intensified and critical period for the emotional teaching and learning that the child requires. To accomplish a normal course of development, the caregiver not only needs to be able to “read” their child’s emotional signals, the child has to be able to communicate readable signals.

Being able to read and learn from the caregiver’s face and non-verbal emotional cues begins and continues the process of social development – a process that continues throughout the lifespan. Sensory perceptual and motor output distortions skew the infant developing autism’s ability to take part in the emotional teaching that is so intense in infancy and early childhood. Early on, the infant or toddler developing autism experiences the sensory perceptual, and/or motor coordination experiences of a poorly integrated brain – and tends to generate idiosyncratic (and often unreadable) signals. The biological/genetic and cultural experiences the Caregiver brings to the bond are often not adequate to understand the peculiar experiences and signals their child is sending. And to add to the distortion and difficulty – the child might not have learned to recognize the emotional cause/effect of the signals they send and the typical reactions of the Caregiver– and this affects the child’s ability to send intentional and readable emotional cues to her.

Austin experienced a great deal of discomfort and irritability in his first two years. There were bouts of inconsolable crying that confounded his Teacher. Picking him up and trying to rock or hold him only made him cry louder and become more upset. Then, all of the sudden – he would stop crying for no apparent reason. Whatever made him stop had nothing to do with Teacher’s efforts.

Mother reported that it took an entire year for her to discover the connection between Austin’s crying and irritability and the refrigerator motor. When it came on – Austin started crying. To make matters worse, picking him up agitated his already hypersensitive reactions to touch, and the cooing and supposedly reassuring sounds Teacher made in her efforts to soothe him had the effect of totally overwhelming his brain’s ability to integrate the separate inputs. At first, Austin would meltdown only after being picked up or talked to, but over time – he began to meltdown immediately. He no longer whimpered and cried before melting down – he simply exploded.

Austin never sent any clear signal that would have helped his Mother figure out what was wrong or to do something to help him. Instead – both had a feeling of profound helplessness and anxiety that lasted an entire year. Of course, the constant anxiety and prolonged feelings of inadequacy Teacher experienced accumulated and led to her being depressed.

For Austin, these experiences were the first in his life. His brain was calibrating the most basic thermostatic emotional settings of mood, anxiety state, calming, and attention. His brain was literally being “wired for anxiety,” which has lasted throughout childhood. Austin later developed normal levels of cognitive and linguistic competence, although he had relatively profound deficits in social-cognitive, social-linguistic competence and emotional flexibility.

At 11-years-old, Austin was referred for explosive tantrums, sleeping in his Mother’s bed and clinginess around his Mother.

Essay of the relationship between early sensory integration dysfunction and later emotionally disturbed behavior: Why Does My Child Act This Way?”