Bowlby’s classical attachment theory (1969/ 1982, 1973) is an ethological theory emphasising the regulatory functions of an infant’s innate proximity-seeking behaviours directed towards their primary caregiver. Fundamentally, it classifies the infant-caregiver relationship as the foundation of an infant’s future social development and further ability to form relationships. Bowlby believed that a child’s attachment with its caregiver governs the development of internal working models (or mental representations) which the child subsequently applies to relationships with other people and in general, the social world. In turn he proposed that by determining the nature of an infant’s attachment with their caregiver (considered primarily to be the mother in this case), an infant’s future social behaviour patterns could be predicted i.e. certain attachment types would lead to certain behaviour types as a result of these internal working models (1973). Attachment types were formally assessed via the “Strange Situation” experiment (Ainsworth et al. 1978), out of which three basic types were discerned: the “secure” and the “insecure: anxious/ambivalent” and “insecure: avoidant”. A fourth attachment style – “insecure: disorganised” was later included, encompassing an insecure attachment style which couldn’t reliably be characterised as either anxious or avoidant (Van Ijzendoorn et al.; 1999).
Attachment theory is intrinsically relevant to psychoanalysis; being characterised as an attempt to update classical psychoanalysis (otherwise lacking empirical evidence; Kihlstrom, 1999), in light of advancements in evolutionary biology and cognition (Ainsworth et al. 1978, Schore & Schore, 2008). Fonagy (***) has extensively outlined the commonalties of both; fundamentally, both theoretical perspectives class anxiety as engendered by loss and postulate a non-isomorphic relationship to exist between (mental) representations and their external referents – whereby the former moreso reflect the psychic reality from which the latter are perceived. Related to this, Fonagy has likened the “internal working models” (IWM) of attachment theory to the “mental representations” (MR) of psychoanalysis, further distinguishing them by highlighting that the IWM are processed implicitly as opposed to explicitly (MR) and are stored in procedural as opposed to episodic memory (MR).
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Additionally, in both, personality development is conceived as most primarily a function of early social context, where infancy is a potent period of intense growth and the importance of the maternal figure is emphasised. The development of mentalisation (in Fonagy’s terms) which is akin to a theory of mind, or set of empathic-based processes is also key for growth in both. Finally, both Freud (1895) and Bowlby (1963) emphasised the role of early trauma in later vulnerability to psychopathology.
While many are reticent in accepting the implications of attachment theory and the possible anti-therapeutic effects of the labelling ethos it subscribes to (***), its cogency is difficult to deny considering its wide base of empirical support and its enduring legacy. The latter point is fortified by the well-documented recent resurgence of classical attachment theory initiated by the rise of neuroscience (“the decade of the brain”) and its transformation into “modern attachment theory” (Slater, 2007) . Specifically, it can be said to underscore the advent of neuropsychoanalysis (a branch of “interpersonal neurobiology”; Siegal, 2001; Schore & Schore, 2008); an assimilation of neuroscientific and psychoanalytic principles.
With such links and terms thus established, the ensuing aim of this essay is to outline the modern re-conceptualisation of attachment theory, which draws on neuroscience and forges a link between psychoanalysis and mainstream science. The neurobiological components underlying attachment will be outlined and discussed in relation to affect regulation. The subtext of the essay will be the implicit relevance of psychoanalysis and its use for modern practice which contrapose condemnations of it as being theoretically “dead” (i.e. Kihlstrom, 1999).
According to Whitehead (2006), psychoanalysis has undergone three major revolutions (currently in its third) since its inception, namely the Classical-Freudian, Post-Freudian and the third, currently wheeling, revolution characterised by a return to the project of mind-body integration which Freud abandoned. Indeed, while the likes of Freud eschewed neurological findings from theories of self and personality (vowing to ‘stick’ with the psychological realm) a number of psychoanalytically minded researchers are reconciling the two to form a field of research coined “neuropsychoanalysis” (Schore, 2002), which implicitly underlines mind-body integration in accordance with psychoanalytic principles via appeal to attachment theory and neuroscience; undergoing periods of resurgence and dominance, respectively, as of late (Slater, 2007). The advent of neuropsychoanalysis has also coincided with a new appraisal of the problem regarding the interface between outer reality and the inner fantasy worlds of the individual which Freud found problematic (Whitehead, 2006) reflected in the shift from one-person to two-person psychology (Pulver, 2001) arguably based on the advent and predominance of object relations theory propounded most evidently by Klein and Winnicott. The fundamental point of object relations was an emphasis on the role of interpersonal interactions in the development of personality and mind. The self psychology of Kohut (1957*) is in some ways an offshoot of object relations theory and engenders the most fertile and evident link between psychoanalysis and attachment theory; specifically considering that it has been taken as the basis for many explications of the neurophysiological underpinnings of the attachment process (i.e. Schore & Schore, 2002; Shore, 2008; 1994).
As explicated by Schore & Schore (2002), Kohut’s self-psychology concerns itself with four fundamental issues: 1) the emergence of self 2) the structuring of self 3) the genesis of psychopathology as a function of deficits in the structure of self and 4) the manifold manner in which psychotherapy may instigate change in the self. All of such issues have been addressed explicitly via modern attachment theory and its neurobiological underpinnings, the first three of which will be focussed on here.
Most significantly, the “other” is required for the emergence of self (i.e. intersubjectivity engenders subjectivity). For Kohut coupling with the “self-object” (i.e. the primary caregiver) facilitates affect regulation and the establishment of “internal homeostatic equilibrium” which precedes (structuring of) burgeoning selfhood. This reflects the aforementioned two-person psychology which characterises the current revolution of psychoanalysis; most apparent in (modern) attachment theory which will subsequently be discussed in greater detail.
The main aim of the first year of life is to form an attachment with the primary care-giver which will facilitate subsequent emergence of self and the optimal psychobiological development. To accommodate this is an innate, ‘attachment behavioural system’ which manifests in a number of instinctual behaviours (or attachment strategies) undertaken by the infant in an attempt to form such an attachment (Siegal, 2001). The primary attachment strategy engaged in by the infant is proximity-seeking; in moments of distress or threat the infants seeks out the primary caregiver as a source of security and comfort (Mikulincer, Sahver and Pereg, 2003). Attachment is achieved, whilst proximate to the caregiver, via inter-subjective interactions (engagement) with the self-object (attachment figure) through affect-laden face to face interactions – not strictly limited to visual stimulation (i.e. gaze episodes) but multi-modal (i.e. all senses implicated) emotional transactions. Evidencing the innate capacity to engage in such interactions are studies demonstrating infants as young as 12 days old imitating facial expressions (Eltzoff & Moore, 1977) and making facial movements in response to communications from the mother – expressions which, coupled with those of the mother, assist interpersonal contact and affect regulation (Trevarther, 1985).
The sensitivity and responsiveness of the self-object are pivotal for optimal attachment – sensitivity inheres that the self-object will recognise when engagement and affect regulation are required (i.e. in times of distress) while responsiveness entails a successful interpretation of social cues, regarding affect, as provided by the infant. The self-object, if sensitive and responsive, may facilitate the minimisation of negative affect and the increase of positive affect, that is, regulation of the infant’s affect-states – a process which gradually become internalised by the infant (Schore & Schore, 2008).
This occurs as a function of appropriate, consistent responses to such social cues (“affect synchrony”) permitting the development of mechanisms of anticipation – the infant learns of a correspondence between their own actions and the responses of others (and will begin to gauge just how their affects/experiences may be regulated). This in turn facilitates a self-other distinction to be made in which internal working models of the self and the self-object are constructed, engendering processes through which the infant may begin to modify their own behaviour in light of their ‘dyadic’ interactions with the self-object. As I see it, these processes effectively pre-empt the emergence of subjective consciousness. Particularly, Lipton et al (1999) has associated the development of orbito-frontal systems at this time of development with the infant’s integration of past, present and future experiences; which permits anticipation of future states of self and reflection on past states. In phenomenological terms, this manifests as the emergence of temporality; one of the fundamental tenets and characterisations of intentionality (i.e. consciousness; Husserl, 1952). This may be considered the foundation of the self, corroborating with self-reflexivity (i.e. the establishment of an internal working model of the temporal self) which emerges at this time in line with the above assertions of Lipton’s.
Indeed Slater (2007) has suggested that this marks the beginning of an internalisation of the attachment figure – i.e. the accessing of IWM/ MR of the self-object facilitates anticipation of future events and their instantiation of affect regulation. More specifically, as will be discussed, the process of internalising the schematics produced via the dyadic relationship with the self-object become to be gradually subsumed under the rubric of ‘self’. That is, the constellation of beliefs structured around representations of self and other bear ‘affect regulation strategies’ which are elicited in future times of distress. Should such beliefs reflect an unavailability or insufficiency of response from the self-object, secondary attachment strategies are cultivated which manifest attempts at affect regulation other than aforementioned proximity-seeking (Mikulincer et al. 2003).
To explicate this point further, comprising the in-born attachment behavioural system (Mikulincer, Sahver and Pereg, 2003) are a number of dynamic processes which govern which set of attachment strategies will be engaged in. These processes comprise of the infant’s monitoring and appraisal of: a) events (deeming whether or not they’re threatening), b) the availability of the attachment figure and c) the viability of proximity seeking as a means of dealing with a possibly threatening situation. Should an event be appraised as threatening, the infant considers whether or not the attachment figure is available. If the attachment figure is deemed unavailable, secondary attachment strategies classed as ‘deactivating’ are implemented (characterising the “avoidant” attachment style). If the attachment figure is deemed available but non-responsive or insufficient in their engagement (i.e. inefficient in their affect regulation), secondary strategies classed as ‘hyper-activating’ are employed (constituting the “anxious” attachment style). Finally if they are appraised as available and responsive, proximity seeking behaviour is undertaken – as already outlined – and engagement takes place (“secure” attachment).
According to Dozier and Lee (1995) corresponding to each specific attachment style is a schema for appraisal of one’s own self-concept, whereby insecure attachments lead to distortions in such appraisals whilst secure attachments manifest as appraisals of self as worthy and lovable (Schore, 1994) . Namely the avoidant strategies instigate a denial of feelings of distress when they arise while those of the anxious category amplify such feelings. In line with this characterisation it might be suggested that such appraisals lead to re-enforcement of such schemas which consequently persist into later life.
Indeed, the continuity of attachment styles, from infancy onwards, according to Mikulincer et al. (2003) is grounded in the inhibitory/excitatory network which accompanies the activation of attachment strategies. Specifically, implementation of hyper-activating strategies acts to increase sensitivity to later threatening event appraisal and evaluation of the availability of the attachment figure, whereby innocuous events are more likely to be deemed threatening and greater attempts to elicit responses from the attachment figure are made. The resultant state of ‘hyperarousal’ (****) manifests in an over-zealous urgency to be close to the attachment figure. The deactivating strategies on the other hand desensitise the individual to appraising events as threatening and similarly decrease the likelihood of appraisals of the AF as being available. This manifests in a sort of dissociativeness (***); the individual disavows concern as to whether or not a figure is available from which they might garner support and comfort. Due to previous frustration with the stress-response system, arising from it not being adequately handled, the avoidant infant acts to deactivate it altogether (Cassidy & Kobak, 1988).
Consistent with the neuropsychoanalytic approach; the neurobiological underpinnings of such a system are evident through appeal to the intense synaptic growth (‘neuron overproduction’) experienced in the brain during early infancy (Siegal, 2001). Specifically during the earlier periods of infancy synaptic pruning occurs driven by environmental interaction. In a ‘use it or lose it’ fashion those connections which are not implemented are pruned away under the guise that they are not needed in the current environment; those that are, are fortified, fine-tuned and maintained. As such it is considered that “interpersonal experiences directly shape genetically driven unfolding of the human brain” (p72, Siegal, 2001). In this manner it is readily conceivable as to how early interpersonal experiences shape cognitive and affective processes which consequently persist into later periods of life.
Schore (1994) has localised processes underlying the attachment process further, namely implicating attachment in the development of the right-brain, “the neurobiological core of human consciousness”. According to Schore (2001), the right brain – dominant in infancy- houses the developing limbic system and remains the hemisphere most dominant for stress response throughout life due to its links to the autonomic nervous system, which regulates the somatic aspects of stressor responses i.e. fight or flight. To this extent, “engagement” between the infant and caregiver is characterised by a coupling of the AF’s right brain with the infant’s right brain – the consequent transactions are non-verbal, affect laden and intrinsically informative of the shaping of the unconscious (Schore & Schore, 2008).
Psychoanalytic principles are thus represented insomuch that components of the right brain operate at a free-associative, non-verbal and unconscious level (indeed Schore has emphasised that psychotherapy implicitly involves a connecting of client’s right brain to therapist’s right brain) and implicitly exerts influence, as will be outlined presently, on the processes of cognition (Schore & Schore, 2008). Indeed, the right hemisphere has been involved in the storage of information pertaining to the emotional ties we have to certain experiences and events (Shuren & Grafman, 2002). Accordingly, encountering familiar events leads to a recall of related non-verbal, non-conscious emotional content which further instigate specific reasoning processes which are implemented in the appraisal of such experiences. The link between affect and cognition is well documented and another field of research which modern attachment theory and neuropsychoanalysis forge a mutually-beneficial tie with (Robins & Zacks**). Specifically, research from the field of “affective cognitive neuroscience” has shown that the neural circuits involved in cognition overlap and intertwine with those involved in affect (emotion) (****); as suggested by modern attachment theory.
As such, taking this into consideration we can validly assert, through inference, the role attachment strategies/behaviours play on engendering particular patterns of cognition i.e. attachment effects (and affects) cognition (Mikulincer et al. 2003) . Studies by Mikulincer & Sheffi (2000) and Pereg (2001) demonstrate, for example, that inducement of negative affect leads to a greater recall of positive thoughts amongst securely attached than those who are anxiously attached, who conversely recall significantly less positive cognitions and significantly greater negative thoughts – indicating the amplification of negative affect input and its pervasive effects in the brain – suffusing regions of working memory and cognition. Meanwhile, in both studies, cite the authors, those who were avoidant in their attachment styles demonstrated no particular differences in cognitive functioning as a result of positive or negative affect inducement; supporting the hypothesis that those of the avoidant category tend to dismiss and dissociate themselves from sources of distress. To further propound these points, Gillath et al (2005) found that attachment-related anxiety positively correlated with the activation of emotion-implicated areas of the brain and inversely correlated with the activation of areas involved in affect regulation (i.e. the orbito-frontal cortex); paralleling ties between anxious attachment and “distress amplification”/”affect dysregulation” (Dozier and Lee, 1995).
Furthermore, coinciding with Schore’s (2002) emphasis on the right brain as centre of self and regulatory/ stress response systems, ‘affective disorders’ such as depression and dysthymic personality traits have links with the right hemisphere of the brain. Liotti & Tucker (1992) for example document that depression interferes with the functions of right hemisphere activity by influencing its arousal mechanisms. Related to this point, a plethora of studies support both Freud and Bowlby’s assertions that early insecure attachments increase vulnerability to later psychopathology; specifically whereas the internalisation of affect-regulation schematics conducive to minimisation and manageability of distress occurs in secure attachment, a later to resilience to stressors is observed. Insecure attachments, however, with their accompanying internalised distortion of self-concept and detrimental (under/over) appraisal of threatening events and the disproportioning of the availability of support, lead to a documented increased vulnerability to psychopathology (Schore, 2004*).
Indeed, if we consider attachment theory as a theory of affect regulation and affective disorders such as depression as forms of affect dysregulation (Sroufe & Waters, 1977) a link between both (attachment styles and psychopathological vulnerability) seems readily tenable. Forbes & Dahl (2005), for example, suggest that depression – instead of a disorder in which there is an abnormal increase in negative affect; rather is a disorder reflected in the diminished activation of positive affect systems and motivation. This aligns with definitions of its major syndromal-features i.e. anhedonia (diminished capacity for enjoyment), fatigue (diminished motivation) and social withdrawal (diminished enthusiasm). As such we might infer that strategies for minimising negative affect and increasing positive affect (established in infancy) are inefficient in some way. The authors cite many examples of studies which espouse this consideration; for example, adults with MDD have shown diminished response to positive stimuli; in some instances evincing similar responses as if it were aversive. Furthermore, depressive adults have demonstrated lower expectancy of positive events in their futures. Additionally, studies have shown how adults with anxious attachment (hyperactivation strategies); more readily access painful memories, while demonstrating exaggerated appraisal of negative events and are subsequently more vulnerable to depression (Mikulincer and Orbach, 1995).
While many may criticise attachment theory as being highly pessimistic – derogating the possibilities for a child who happens to present with an ‘insecure’ attachment style to have a positive future free from psychopathological vulnerability, it is fair to say that it wasn’t the intent of Bowlby to delineate such a deterministic perspective. Indeed, as Siegal (2001) points out, the brain is plastic throughout the lifespan and as such attachment capacities can change. Furthermore, positive social factors such as prevailing support of peers may act to alter and/or loosen implicit secondary attachment strategies. Wu (2010) for example has cited that self esteem mediates the relationship between self-concept appraisal and attachment style, therefore social factors which bolster self-esteem might be seen as re-adjusting self-appraisal thereby breaking the re-enforcing patterns of negative self-perception. In addition, while many have emphasised the maternal role in the development of such attachment patterns, others have advised that the infant can develop different attachment styles in accordance to their interactions with different people (Siegal, 2001); as such there are a number of mediating factors which imply that early “insecure” attachment status to one figure isn’t as condemning as oft considered.
To conclude: this essay has outlined how classical attachment theory, rooted in psychoanalysis, has been transformed into “modern attachment theory” coinciding with the recent advent of neuropsychoanalysis; that is, a branch of neuroscience dealing with the interpersonal facilitations of neurobiological development, as advocated by object relations theory and self psychology which are themselves rooted in psychoanalysis. This third revolution of psychoanalysis heralds a return to the problems once confronted by Freud namely the mind/body separation and the interface between inner and external realities, and with attempts to resolve them comes a greater alliance between psychoanalysis and mainstream science. ‘Modern attachment theory’ as framework for many studies in affect (dys-)regulation have furthermore supported earlier postulations of Bowlby’s and Freud’s that earlier abnormal development and trauma may predict later vulnerability to psychopathology.
