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Attachment
Book REVIEWS
455
rauonahze Its practices through systematic study so that e m p m c a l cnterm and guldehnes can be developed for evaluating the effectweness of praetmoner aetwmes relatave to the welfare of those being served It ~s readily apparent that collaboration by professional nurses was a necessary prerequisite for the preparaUon of the monograph, and reeogruuon of tlus reahty ~s reflected m numerous footnotes I f there ts any entacasm to be made, ~t is that the pracuUoner's perspeetwe on the complex Issues and problems of collaborataon is not included Perhaps the ormssion is s~mply another indicator that the "professtonahzataon" of nursing ~s not very far along To this reviewer, the book falls into the category of reqmred reading for professional nurses. Its usefulness as a resource is not imalted to nurses, however, and all professionals revolved m soeml praetace nught well profit from reading what Is a perceptwe and thoughtful analys~s of the relevance of pracuee theories both for behavioral science and for professional performance JEANNE C QUINT, D N S
School of Nursing, Umversity of Cahforma, San Francisco, Cahforma A T T A C H M E N T Volume 1 of Attactunent and Loss by JOHN BOWt.BY Hogarth Press and the Institute of Psychoanalysis 428 pp Price 63/0d Also pubhshed by Basle Books, N.Y Price $10 Tats book g~ves an explanation of the roots of love whaeh satisfies the canons of science and does justice to the complexaty of human interaction Bowlby's earher report to the World Health Orgamzatton* singled out "Maternal Deprivation" as an mmportant pathogen whose potentml effects on personahty development had previously been underestmaated Based largely on empirical studaes, the work revealed a correlation of obvious ~mportanee but ~t made no attempt to explain tt Since that ume. ehfld development research has flourished and m a n y of the questions arising out of the earher work can now be answered At what age Is the human infant most sensmve to separauon ~ Under what circumstances are substitute mothers acceptable ~ H o w does an unfamthar environment contribute to the effects of separation from mother 9 But the most important aspect of ttus book hes, not m the clartficauon of these issues. but m the well thought out theory wluch Bowlby expounds to account for "attaelament beha~1our" and its effects Bowlby sees "attachment behavlour" as "a product of the aclavlty of a number of behav~oural systems which have proxtmaty to mother as a predictable outcome" It ~s "a class of socml behav~our of an ~mportanee equwalent to that of mating behavlour and parental behavlour" He repudmtes the tradmonal psychoanalytic theory of oral object cathexas and the book includes a detaded critique of Freud's Libido Theory and Secondary Drive Theory Nevertheless. Bowlby remains a psychoanalyst at heart and extracts much that ~s worthwhde from the writings of psychoanalysts Theories of psychic e n e r ~ ' and Its discharge have become such an integral part of our thinking that it is hald, at first to see how theycan be replaced Bowlby devotes the first *J Bo~lby, Maternal Care and Mental Health World Health Orgamsatlon, Monogr 2, 1951
456
BOOK REVIEWS
174 pages of his book to the exposluon of the alternative, a view of instinctive behaxiour whmh owes much to recent work by ethologists and the apphcanon of control systems theory to human behavlour The account is lucid and well-documented but it m a y frustrate the reader who cannot be bothered with theories and fads to recogmze the fundamental significance of tlus section. It is rather like buying a book on surgery and finding that the first half is about anatomy It is not possible to do justice to the theory m the space of this review but a few points may give the reader a feel for the approach which is employed Bowlby does not see mstmctave behavlour as inherited, what is inherited is a potential to develop certain sorts of system which he terms "behavioural systems" These systems are environmentally stable or labile according to the extent to which their development is influenced by environmental factors "The patterns of human behavtour that result m mating, m the care o f babies and young children, and m the attachment of young to parents are found m almost all members of the human race and seem instances of mstmctlve behav~our" Hence their basic structure 'hs assumed to derive from some prototype or prototypes that are common to all animal species, that they have been augmented and greatly elaborated in certain directions is taken for granted" Attachment behaviour has, as its "predictable outcome" the maintenance of proxatmty between the child and its mother Its mare funcuon within the environment m which it evolved was protectaon from predators and it is elicited at tugh intensity in situations of alarm, sickness or isolation In other words whenever the young anmaal is particularly vulnerable to attack The components of attachment behaviour such as chngmg, smiling, babbhng, nonnutnlave suclong, following and, on occasion, crying and searching, are activated by one set of conditions and terminated by another--generally by proxirmty to mother but, as the cluld matures, by an increasing range of conditions Much of the book is concerned with the way m wluch attachment behavtour develops and the conditions which influence it Bowlby cites evidence which certainly seems to indicate that there is a sensitive period, m most human infants the 4th to 6th month, during which attachment is particularly hkely to develop After that age fear responses to strangers emerge and the development of fresh attachments m a y depend upon the security of the attachment to mother which has already arisen and the opportunities which exist for the child to use her as a secure base from which to explore It is "security of attachment" (akin to Enkson's "basic trust") which is thought to be the important factor for future development rather than "intensity of chngmg" Bowiby discusses the various factors which prevent the development of secure attachments and the factors which disrupt those stable attachments which have been made These are clearly of great importance to an understanding of personality de,,elopment and we look forward to the next stage of analysis which will follow in Volume 2 This will deal with the effects of child and adult separation and loss In sum, Bowlby has wntten a major treatise of great theoretical and practical importance which should be read by all who are not content to take human relationships for granted and who recognize the confusion which currently exists in our understanding of the nature of love C M PARKES, M D
Ta) tstock Institute of Human RelaHons, Belst:.e Lane, London, N H/ 3
455
rauonahze Its practices through systematic study so that e m p m c a l cnterm and guldehnes can be developed for evaluating the effectweness of praetmoner aetwmes relatave to the welfare of those being served It ~s readily apparent that collaboration by professional nurses was a necessary prerequisite for the preparaUon of the monograph, and reeogruuon of tlus reahty ~s reflected m numerous footnotes I f there ts any entacasm to be made, ~t is that the pracuUoner's perspeetwe on the complex Issues and problems of collaborataon is not included Perhaps the ormssion is s~mply another indicator that the "professtonahzataon" of nursing ~s not very far along To this reviewer, the book falls into the category of reqmred reading for professional nurses. Its usefulness as a resource is not imalted to nurses, however, and all professionals revolved m soeml praetace nught well profit from reading what Is a perceptwe and thoughtful analys~s of the relevance of pracuee theories both for behavioral science and for professional performance JEANNE C QUINT, D N S
School of Nursing, Umversity of Cahforma, San Francisco, Cahforma A T T A C H M E N T Volume 1 of Attactunent and Loss by JOHN BOWt.BY Hogarth Press and the Institute of Psychoanalysis 428 pp Price 63/0d Also pubhshed by Basle Books, N.Y Price $10 Tats book g~ves an explanation of the roots of love whaeh satisfies the canons of science and does justice to the complexaty of human interaction Bowlby's earher report to the World Health Orgamzatton* singled out "Maternal Deprivation" as an mmportant pathogen whose potentml effects on personahty development had previously been underestmaated Based largely on empirical studaes, the work revealed a correlation of obvious ~mportanee but ~t made no attempt to explain tt Since that ume. ehfld development research has flourished and m a n y of the questions arising out of the earher work can now be answered At what age Is the human infant most sensmve to separauon ~ Under what circumstances are substitute mothers acceptable ~ H o w does an unfamthar environment contribute to the effects of separation from mother 9 But the most important aspect of ttus book hes, not m the clartficauon of these issues. but m the well thought out theory wluch Bowlby expounds to account for "attaelament beha~1our" and its effects Bowlby sees "attachment behavlour" as "a product of the aclavlty of a number of behav~oural systems which have proxtmaty to mother as a predictable outcome" It ~s "a class of socml behav~our of an ~mportanee equwalent to that of mating behavlour and parental behavlour" He repudmtes the tradmonal psychoanalytic theory of oral object cathexas and the book includes a detaded critique of Freud's Libido Theory and Secondary Drive Theory Nevertheless. Bowlby remains a psychoanalyst at heart and extracts much that ~s worthwhde from the writings of psychoanalysts Theories of psychic e n e r ~ ' and Its discharge have become such an integral part of our thinking that it is hald, at first to see how theycan be replaced Bowlby devotes the first *J Bo~lby, Maternal Care and Mental Health World Health Orgamsatlon, Monogr 2, 1951
456
BOOK REVIEWS
174 pages of his book to the exposluon of the alternative, a view of instinctive behaxiour whmh owes much to recent work by ethologists and the apphcanon of control systems theory to human behavlour The account is lucid and well-documented but it m a y frustrate the reader who cannot be bothered with theories and fads to recogmze the fundamental significance of tlus section. It is rather like buying a book on surgery and finding that the first half is about anatomy It is not possible to do justice to the theory m the space of this review but a few points may give the reader a feel for the approach which is employed Bowlby does not see mstmctave behavlour as inherited, what is inherited is a potential to develop certain sorts of system which he terms "behavioural systems" These systems are environmentally stable or labile according to the extent to which their development is influenced by environmental factors "The patterns of human behavtour that result m mating, m the care o f babies and young children, and m the attachment of young to parents are found m almost all members of the human race and seem instances of mstmctlve behav~our" Hence their basic structure 'hs assumed to derive from some prototype or prototypes that are common to all animal species, that they have been augmented and greatly elaborated in certain directions is taken for granted" Attachment behaviour has, as its "predictable outcome" the maintenance of proxatmty between the child and its mother Its mare funcuon within the environment m which it evolved was protectaon from predators and it is elicited at tugh intensity in situations of alarm, sickness or isolation In other words whenever the young anmaal is particularly vulnerable to attack The components of attachment behaviour such as chngmg, smiling, babbhng, nonnutnlave suclong, following and, on occasion, crying and searching, are activated by one set of conditions and terminated by another--generally by proxirmty to mother but, as the cluld matures, by an increasing range of conditions Much of the book is concerned with the way m wluch attachment behavtour develops and the conditions which influence it Bowlby cites evidence which certainly seems to indicate that there is a sensitive period, m most human infants the 4th to 6th month, during which attachment is particularly hkely to develop After that age fear responses to strangers emerge and the development of fresh attachments m a y depend upon the security of the attachment to mother which has already arisen and the opportunities which exist for the child to use her as a secure base from which to explore It is "security of attachment" (akin to Enkson's "basic trust") which is thought to be the important factor for future development rather than "intensity of chngmg" Bowiby discusses the various factors which prevent the development of secure attachments and the factors which disrupt those stable attachments which have been made These are clearly of great importance to an understanding of personality de,,elopment and we look forward to the next stage of analysis which will follow in Volume 2 This will deal with the effects of child and adult separation and loss In sum, Bowlby has wntten a major treatise of great theoretical and practical importance which should be read by all who are not content to take human relationships for granted and who recognize the confusion which currently exists in our understanding of the nature of love C M PARKES, M D
Ta) tstock Institute of Human RelaHons, Belst:.e Lane, London, N H/ 3