ATTACHMENT THEORY

Presentee:Dr.priyanka 1st year Post

Graduate
Mentor:Dr.Maithri Senior Resident
PLAN OF PRESENTATION
• INTRODUCTION
• John Bowlby a)Importance of early emotional bonds
b)Ethological theory
c)Components of attachment
d)4 STAGES OF ATTACHMENT DEVELOPMENT
• Mary Ainsworth -strange situation.
• Harry harlow
• Anne frued
• Psychiatric implications
• REFERENCES
ATTACHMENT THEORY
• DEFINITION
One specific and circumscribed aspect of
relationship between child and caregiver, involved with
making child safe, secure and protected.
Attachment security & the theory of the
internal working model (IWM) are two hallmark ideas that
comprise attachment theory and influence how the child
views himself and other relationships.
• John Bowlby, in full name Edward John Mostyn Bowlby,
(born February 26, 1907, London, England—died
September 2, 1990,) British developmental psychologist
and psychiatrist best known as the originator of
attachment theory, which posits an innate need in very
young children to develop a close emotional bond with a
caregiver.
• Bowlby explored the behavioral and psychological
consequences of both strong and weak emotional bonds
between mothers and their young children
He described attachment theory as an inherent biological
response & behavioral system in place to provide
satisfaction of basic human needs.
• Bowlby was interested in understanding the anxiety and
distress that children experience when separated from
their primary caregivers.
 The Importance of Early Emotional Bonds
Attachment theory is a psychological, evolutionary and ethological theoryconcerning
relationships between humans. The most important tenet is that youngchildren need to develop
a relationship with at least one primary caregiver for normal social and emotional development.

• Bowlby (1969, 1988) was very much influenced by ethological theory in general, but
especially by Lorenz’s (1935) study of imprinting. Imprinting in animals was explained by
ducklings (after 3 days of) hatching are biologically programed to imprint on some object in
the environment .It is due to trigger of specific releasers in the environment.
• Attachment theory is focused on the relationships and bonds between people,particularly
long-term relationships, including those between a parent and child and between romantic
partners.
• Bowlby described attachment as “lasting psychological connectedness between human
being
 BOWLBY’S ETHOLOGICAL THEORY
• Ethological Theory of Attachment recognizes infant’s emotional tie to the
caregiver as an evolved response that promotes survival.
• John Bowlby induced this idea for infant-caregiver bond.
• He retained the psychoanalyst idea that the quality of attachment with the
caregiver has profound implication for child’s security and capacity to form
trustworthy relationship.He said ‘FEEDING IS NOT THE BASIS FOR
ATTACHMENT’.
• The central theme of attachment theory is that primary caregivers who are
available and responsive to an infant's needs allow the child to develop a
sense of security. The infant knows that the caregiver is dependable, which
creates a secure base for the child to then explore the world
 Components of Attachment
1. Safe Haven
Ideally, the child can rely on his caregiver for comfort at times whenever he
feels threatened, frightened or in danger. For example, if a child is given a toy
that he doesn't like, he'd cry and his mother would remove the toy and hug the
child so he would stop crying.

2. Secure Base
Here, the caregiver gives a good and reliable foundation to the child as he
goes on learning and sorting out things by himself. For example, a child would
ask questions to his mother about why his dad got sick and can't play with him
at the moment.

3. Proximity Maintenance
This means that the child aims to explore the world but still tries to stay close to his care
giver. For example, a teenager discusses peer problems with his mother.

4. Separation Distress
This means that the child becomes unhappy and sorrowful when he becomes separated
from his caregiver. For example, an infant cries loudly when his mother leaves for work.
ATTACHMENT , BONDING and IMPRINTING

Attachment is not bonding.

• Bonding concept was developed by Klaus and Kennel.
Implied that parent – child bonding depended on skin –
skin contact during an early critical period.
• Bonding has not been shown to predict any aspect of
child outcome, whereas attachment is a powerful
predictor of child’s later social and emotional outcome.
• IMPRINTING by Konrad Lorenz
4 PHASES OF ATTACHMENT DEVELOPMENT
Babies are born with behaviors like crying, babbling and laughing to gain adult
attention & on the other side, adults are biologically programmed to respond to
their signals.

He viewed the first 3 years as the most sensitive period for the attachment.
According to Bowlby, following are the 4 phases of attachment:
▪ Pre attachment Phase (Birth – 6 Weeks)
▪ Inscriminate Phase ( 6 Weeks – 6 to 8 Months)
▪ Discriminate Attachment Phase ( 6-8 Months to 18 Months-2 Years)
▪ Multiple attachment phase (18 Months – 2 Years and on)
Pre-Attachment Stage(BIRTH -6 WEEKS) •
The infant's signals, such as crying and fussing, naturally attract the attention of
the caregiver and the baby's positive responses encourage the caregiver to
remain close.

• The innate signals attract the caregiver (grasping, gazing, crying, smiling while
looking into the adult’s eyes).
• When the baby responds in a positive manner ,the caregivers remain close by.
• The infants get encouraged by the adults to remain close as it comforts them.
• Babies recognize the mother’s fragrance, voice and face. • They are not yet
attached to the mother and don’t mind being left with unfamiliar adults as they
have no fear of strangers.
Indiscriminate Attachment(6 Weeks – 6 to 8 Months)
• Infants begin to show preferences for primary and secondary caregivers.
• Infants develop trust that the caregiver will respond to their needs. While they
still accept care from others, infants start distinguishing between familiar and
unfamiliar people.
• Infants responds differently to familiar caregivers than to strangers. The baby
would smile more to the mother and babble to her and will become quiet more
quickly, whenever picked by the mother.
• The infant learns that his/her actions affect the behavior of those around.
• They tend to develop a “Sense of Trust” where they expect the response
of caregiver, when signalled.
• They do not protest when they get separated from the caregiver
Discriminate Attachment (6-8 Months to 18 Months -2
Years)
• Infants show a strong attachment and preference for one specific individual.
• They will protest when separated from the primary attachment figure
(separation anxiety), and begin to display anxiety around strangers .
• The attachment to familiar caregiver becomes evident. • Babies show
“separation anxiety”, and get upset when an adult on whom they rely, leaves
them.
• This anxiety increases b/w 6 -18 months, and its occurrence depends on the
temperament and the context of the infant and the behavior of the adult.
• The child would show signs of distress, in case the mother leaves, but with the
supportive and sensitive nature of the caretaker, this anxiety could be reduced.
Multiple Attachments (18 Months – 2 Years and on)
• Children begin to form strong emotional bonds with other
caregivers beyond the primary attachment figure. This often
includes the father, older siblings, and grandparents
• With rapid growth in representation and language by 2 years, the
toddler is able to understand few factors that influence parent’s
coming and going, and can predict their return. Thus leading to a
decline in separation protests.
• The child can negotiate with the caregiver to alter his/her goals via
requests and persuasions.
• Child depends less on the caregiver along with the age.
STRENGTHS

• Dominant explanation of why the attachment develops and

how?
• Bowlby suggests that attachment evolved as an aid to the
survival.
• In case its true, then attachment and care giving behavior
must be universal in all cultures irrespective of the
differences in the practices of child rearing.
WEAKNESSES

• Evolutionary ideas are very difficult for testing and also

difficult to prove or disprove.
• Bowlby’s attachment theory focuses on the mother’s role.
There is evidence that in two parent families,father’s
quality of attachment can also have a big impact on the
child’s behavior and development .
LORENZ PRINCIPLE OF IMPRINTING
• Lorenz (1935) took a large clutch of goose eggs
and kept them until they were about to hatch
out.
• Half of the eggs were then placed under a
goose mother, while Lorenz kept the other half
beside himself for several hours.
• When the geese hatched Lorenz imitated a
mother duck's quacking sound, upon which the
young bird regarded him as their mother and
followed him accordingly.
• The other group followed the mother goose
• Lorenz found that geese follow the first moving object
they see, during a hour critical period after hatching. This
process is known as imprinting and suggests that
attachment is innate and programmed genetically.
• Imprinting has consequences, both for short term survival,
and in the longer term forming internal templates for later
relationships.
• Imprinting occurs without any feeding taking place.
• Hess (1958) showed that although the imprinting
process could occur as early as one hour after
hatching, the strongest responses occurred between 12
and 17 hours after hatching, and that after 32 hours the
response was unlikely to occur at all.
• Lorenz and Hess believe that once imprinting has
occurred it cannot be reversed, nor can a gosling
imprint on anything else.
• Ethologists pointed that animal infants become imprinted on a
mother figure-clinging following closely that attachment in human
infants.
• During certain sensitive periods,infant of species are biologically
programmed to imprint on some objects in enviroment.
• Imprinting is trigerred by specific releasers in the enviroment.
• Some ethologists argued that attachment in human operates like
imprinting on other animals.
• Researher harry harlow in 1958 has done some research to shed
some light on this issue.
Harry harlow

Harlow studied monkeys.

The rearing conditions designed by Harlow for his
baby monkeys involved surrogate mothers-artificial
stand-ins for the monkeys real mothers.
• "Mother" had a nursing bottle, placed at the center of
her chest
the cloth "mother" had the nursing bottle they spent
almost all the time with the cloth "mother," regardless of
which mother fed them. contact comfort
the adverse effects of parent deprivation are reversible.
• Each monkey was equipped with a surrogate mother.
• One group had cylinder made of wire mesh with a block of wood as its
head.
• The other group had block of wood covered with sponge rubber then
terry cloth.
• Behind each mother was a light bulb provided radiant heat for infants.
• For one group of babies ,wire “mother” had the nursing bottle.
• For second group of babies the cloth “mother "had nursing bottle.
 Reaction of monkey Reaction of monkey reared with cloth
reared with wire mother
mother

1. On frightened 1. Made little efforts to go 1. Clungs tightly to their mother.

their mother.
2. Threw themselves on
floor
3. cried
4. grimaced
5. Rocking back & forth
while covering their face
with their hands

2. Attachment level 1. developed no attachment 1. Developed strong attachment

3. Other observed 1. Strange behavior

behaviour 2. Self destructive behaviour
3. Paced their cages for hours.
4. Bit themselves
5. Pulled out their own hairs.
 Mary Ainsworth
• Mary Ainsworth (1913 – 1999), Canadian developmental psychologist who conducted research
in the field of attachment theory and developed the Strange Situation Test.
• She began to systematically study infant-parent separations that a formal understanding of these
individual differences was articulated.she worked with john bowlby as well.

STRANGE SITUATION

Study revealed the profound effects of attachment on behavior. In the study, researchers observed
children between the ages of 12 and 18 months as they responded to a situation in which they
were briefly left alone and then reunited with their mothers.
Based on the responses the researchers observed, Ainsworth described three major styles of
attachment: secure attachment, ambivalent-insecure attachment, and avoidant-insecure
attachment.
Later, researchers Main and Solomon (1986) added a fourth attachment style called disorganized-
insecure attachment based on their own research.
"Strange Situation"
Strange Situation Procedure
• The security of attachment in one- to two-year-olds were investigated using
the strange situation paradigm, in order to determine the nature of
attachment behaviors and styles of attachment.
• Ainsworth developed an experimental procedure in order to observe the
variety of attachment forms exhibited between mothers and infants.
• The experiment is set up in a small room with one way glass so the behavior
of the infant can be observed covertly. The sample comprised of 100 middle-
class American families.
The procedure, known as the ‘Strange Situation,’ was conducted by observing
the behavior of the infant in a series of eight episodes lasting approximately 3
minutes each:
• In this procedure of the Strange Situation, the child is observed
playing for 21 minutes while caregivers and strangers enter and
leave the room, recreating the flow of the familiar and unfamiliar
presence in most children's lives. The situation varies in
stressfulness and the child's responses are observed. The child
experiences the following situations:
1. Parent and infant are introduced to the experimental room.
2. Parent and infant are alone. The parent does not participate while the infant
explores.
3. Stranger enters, converses with the parent, then approaches infant. Parent
leaves conspicuously
4.First separation episode: Stranger's behavior is geared to that of the infant.
5. First reunion episode: Parent greets and comforts infant, then leaves again.
6. Second separation episode: Infant is alone.
7. Continuation of second separation episode: Stranger enters and gears
behavior to that of the infant.
8. Second reunion episode: Parent enters, greets infant, and picks up the infant;
stranger leaves conspicuously
Four aspects of the child's behavior are observed:
• The amount of exploration (e.g. playing with new toys) the child
engages in throughout.
• The child's reactions to the departure of its caregiver.
• The stranger anxiety (when the baby is alone with the stranger).
• The child's reunion behavior with its caregiver.

On the basis of their behaviors, the children were categorized into

three groups, with a fourth added later. Each of these groups
reflects a different kind of attachment relationship with the caregiver
Scoring
Strange Situation classifications (i.e., attachment styles) are based primarily on
four interaction behaviors directed toward the mother in the two reunion
episodes
• Proximity and contacting seeking
• Contact maintaining
• Avoidance of proximity and contact
• Resistance to contact and comforting

The observer notes down the behavior displayed during 15-second intervals
and scores the behavior for intensity on a scale of 1 to 7.
Other behaviors observed included:
• Exploratory behaviors e.g., moving around the room,
playing with toys, looking around the room.
• Search behaviors, e.g., following mother to the door,
banging on the door, orienting to the door, looking at the
door, going to mother’s empty chair, looking at mother’s
empty chair.
• Affect Displays negative, e.g., crying, smiling.
Results - Attachment Styles
Ainsworth (1970) identified three main attachment styles,
• Insecure avoidant (type A)
• Secure (type B)
• Insecure ambivalent/resistant (type C).
• She concluded that these attachment styles were the
result of early interactions with the mother.
A fourth attachment style known as disorganized was later
identified (Main, & Solomon, 1990).
Secure Attachment
Secure attachment is what you’re aiming for. It happens when
parents or other caregivers are: Available, sensitive, Responsive,
accepting In relationships with secure attachment, parents let their
children go out and about but are there for them when they come
back for security and comfort.
These parents pick up their child, play with them, and reassure them
when needed. So, the child learns they can express negative
emotions and someone will help them. Children who develop secure
attachment learn how to trust and have healthy self-esteem.
Sounds like bliss! As adults, these children are in touch with their
feelings, are competent, and generally have
Anxious-insecure attachment
• This type of attachment happens when parents respond to their child’s needs
sporadically. Care and protection are sometimes there — and sometimes not.
• In anxious-insecure attachment, the child can’t rely on their parents to be
there when needed. Because of this, the child fails to develop any feelings of
security from the attachment figure And since the child can’t rely on their
parent to be there if they feel threatened, they won’t easily move away from
the parent to explore.
• The child becomes more demanding and even clingy, hoping that their
exaggerated distress will force the parent to react.
• In anxious-insecure attachment, the lack of predictability means that the child
eventually becomes needy, angry, and distrustful.
Avoidant-insecure attachment
Sometimes, a parent has trouble accepting and responding sensitively to their
child’s needs. Instead of comforting the child, the parent:
 minimizes their feelings
 rejects their demands
 doesn’t help with difficult tasks

This leads to avoidant-insecure attachment.

• In addition, the child may be expected to help the parent with their own needs.
The child learns that it’s best to avoid bringing the parent into the picture. After
all, the parent doesn’t respond in a helpful manner.
• In avoidant-insecure attachment, the child learns that their best is to shut
down their feelings and become self-reliant.
Disorganized-insecure attachment
• About 15 percent of babies in groups with low psychosocial risk and as many
as 82 percent of those in high-risk situations — develop disorganized-
insecure attachment.
• In this case, parents show atypical behavior: They reject, ridicule, and
frighten their child.
• Parents who display these behaviors often have a past that includes
unresolved trauma. Tragically, when the child approaches the parent, they
feel fear and increased anxiety instead of care and protection.
• The first three attachment styles are sometimes referred to as “organized.”
That’s because the child learns how they have to behave and organizes their
strategy accordingly.
Criticisms

• Parental sensitivity plays a major role in determining

children’s attachment, its not the only condition affecting. •
Differences in attachment could result from the diverse
infant temperament and their reaction to unfamiliarity, rather
than to sensitive parenting.
• It is limited to primary caregiver i.e. mother.
• This model is based on behavious that occurs in
momentary separation (stressful situation) than in
nonstressful situation.
ANNE FRUED
• In world war II, six Jewish infants orphaned when their parents
were killed in gas chambers, formed a close attachment to one
another in the concentration camp where thev were kept. After the
war Anna Freud (Sigmund's daughter) and Sophie Dann brought
the children by then aged 3 to 4, to Bulldogs Bank, England for
care.
• final outcome.
• The children were reunited by the psychologist Sarah Moscowitz
when she wrote her book Love Despite Hate: Child Survivors of
the Holocaust and Their Adult Lives in 1987. They have remained
in touch ever since
Reactive Attachment Disorder and Disinhibited Social Engagement
Disorder
• History of RAD in the DSM
• DSM III introduced Reactive Attachment Disorder (RAD)
• Categorized under the category of “Disorders Usually First
Diagnosed in Infancy, Childhood, or Adolescence”
• DSM III-TR introduced two subtypes:
• Disinhibited (externalizing)
• Inhibited (internalizing)
• DSM IV and IV-TR - minimal to no changes
Changes in the DSM-V
• Attachment disorders are now classified as “Trauma and Stress Related Disorders”
• Instead of two subtypes, there are now two distinct disorders:
• Reactive Attachment Disorder (known as Inhibited Type in DSM-IV-TR)**
• Disinhibited Social Engagement Disorder (formerly known as Disinhibited Type in DSM-IV-
TR)

• Different comorbidities between the two subtypes

• Not viewed as a lack of attachment, rather an issue of unmodulated and indiscriminate
attachment and social behavior
Criteria for Reactive Attachment Disorder in the DSM-V (inhibited type)

• Pattern of extremes of insufficient care, attributed to at least one of the

following:
• Social neglect or deprivation - persistent lack of meeting a child’s emotional
need for comfort, stimulation, and affection by care-giving adults
• Repeated change of primary caregiver, limiting opportunities to form stable
attachments (i.e. frequent changes in foster care)
• Rearing in unusual setting that severely limits the opportunity to form selective
attachments (i.e. high institutions with high caregiver to child ratio)
• Removed criteria of “disregard for physical needs” due to the emphasis on the
fact that these are disorders of social relationships
• Characteristics of DSED (Disinhibited Social Engagement
Disorder)
• Consistent childish behavior, inappropriate for
developmental age
• Inappropriate affectionate or familiar behavior with relative
strangers
• Seeks comfort from strangers
• Expresses distress for no apparent reason
• Chronically anxious
• Poor peer relationships
REFERENCES
• Kaplan and Sadock's Comprehensive Textbook of Psychiatry by Benjamin J.
Sadock (Author), Virginia A. Sadock (Author), Dr. Pedro Ruiz MD (Author)
• Introduction To Psychology, 7th Edition by Clifford Morgan (Author), Richard
King (Author), John Weisz (Author), John Schopler (Author)
• https://45aid.org/history/hostels/bulldogs-bank
• American Psychiatric Association. (2013). Diagnostic and Statistical Manual
of Mental Disorders (5th ed.) Washington, DC; Author
• Diagnostic and Statistical Manual of Mental Disorders (4th ed.) Washington.
Thank you