 Despite its considerable public health importance, childhood attachment is very much under-represented in medical training and practice.
According to attachment theory, pioneered by British psychiatrist John Bowlby and American psychologist Mary Ainsworth, the quality of the bonding we experience during our first relationship (infant-caregiver) often determines how well we relate to other people and respond to intimacy throughout life. This will impact not only our adult interpersonal connections and how we feel about them, but also it will affect our capacity to regulate our emotions in situations of distress and danger. We are all born with attachment-seeking behaviours such as crying, clinging, imitation & smiling. These behaviours are designed to keep caregivers close, and to ensure that the baby’s needs for survival, sensitive care and safety are met. Attachment is a process. Attachment is an evolutionary adaptation, is not a diagnosis. Attachment allows children the ‘secure base’ necessary to explore, learn and relate. It is important for safety, emotional regulation, adaptability and resilience. Attachment with the caregiver allows emotional regulation to develop. Through co-regulation the caregiver soothes the child's emotional distress. Attuned parenting provides meaning to the ‘inner world’ of the child. Through verbal and non-verbal communication the caregiver reflects back to their child what they believe is happening in the child's mind that is the basis for emotional regulation. Through this process, the child learns to self-regulate. We cannot do everything alone. We are not capable of healing in isolation, we are interdependent since we are born. The presence of those close to us makes a difference even in the most horrible circumstances. Our culture might encourage us to think of ourself as do-it-yourself projects, but we get more positive results when we adopt a we-can-do-it-together approach. The type of attachment we have experience in our early years and childhood creates a template that serves as a predictor of the types of attachment adaptations we expect to form in adulthood. It will create a blueprint and it will be re-enacted in every relationship we have based on our perceived level of safety / threat. Secure attachment Secure attachment is attunement. This adaptation is marked by emotional availability, ability to express one's needs, self-sufficiency and healthy boundaries. Diane Poole Heller says in her book that she believes that we all long for love and connection and that such longing comes directly from our secure attachment system, which is inherent in everyone, no matter our attachment style. Secure attachment reflects a positive-enough environment that creates and engenders basic trust. Main ingredients for an upbringing environment that promotes secure attachment:
Avoidant attachment This adaptation is marked by fear off intimacy and closeness, relational discomfort and difficulties recognizing and expressing one's needs. Adults with the avoidant adaptation are sometimes denigrated as “Detached,” “off in their own world,” “insensitive,” “cold,” “standoffish,” “lone wolf,” “workaholic”. People with an avoidant adaptation tend to regularly experience approach stress, even with people they love. However, we know that avoidant people actually do want connection, they just need more transition from alone to together time to take the pressure off and ease the way for a smoother path to connection. Diane Poole in her book recommends that those who align with the avoidance adaptation try to focus a little more on physical embodiment and emotional presence. Main ingredients for an upbringing environment that may result in avoidant attachment adaptation:
Anxious attachment This adaptation is marked by fear of rejection, hypersensitivity to perceived threat, need for reassurance and for intense interaction with others. Adults with the anxious attachment adaptation are sometimes denigrated as “needy,” “clingy,” “oversensitive,” “controlling,” “high-maintenance,” or “high-strung.” Diane Poole explains in her book that people with an anxious attachment adaptation tend to feel upset when are alone and not in close proximity to the important people in their life. They might be high-functioning and in contact with their secure attachment network when in the presence of their relationship partner, but as soon as their loved one leaves, they begin to mistrust the connection. People with anxious adaptation may find more difficulty to transition from together to alone time. This may be explained by the fact that they rely on "external regulation", constantly looking to use others to down regulate, or calm, their overactivated nervous systems. These individuals may benefit from learning to feel safe alone and use self-regulation and grounding techniques. Main ingredients for an upbringing environment that may result in anxious attachment adaptation:
Disorganized attachment This adaptation is marked by emotional dysregulation, confused sense of self, internal conflict, feelings of constant overwhelm, controlling behaviours, ongoing sense of failure and lack of impulse control. In some ways, disorganized attachment is a combination of the avoidant and ambivalent adaptations, but it is mixed with fear-induced survival defenses switched on to deal with ever-looming threat. The disorganized adaptation comes with a lot of confusion — cognitive, emotional, and somatic. This creates lack of confidence and sense of ongoing failure. Disorganized people with these feelings often don’t like to try new things because they’re convinced they’re going to fail at whatever they do. People with disorganized attachment adaptation struggle with emotional dysregulation, and they can move through life with too little control, especially when it comes to their emotions. It can be hard for them to manage their feelings, which leads to a lot of acting out. Disorganized attached people may dissociate a lot and nervous system may shut down into freeze response as a defense to a hostile perceived environment. The primary contributor to disorganized attachment—as first identified by Mary Ainsworth—is when parents are the source of fear, and the children's attachment system shut down. Main ingredients for an upbringing environment that may result in disorganized attachment adaptation:
Disclaimer: Attachment adaptations are not personality traits or clinical diagnoses. We can oscillate between different styles depending on the situation and the person we are interacting with in a given moment. Source: Book "The power of attachment" from Diane Poole Heller.
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