Why Attachment? Whither Attachment?: John Bowlby’s Legacy, Past and Future

자료/Source: http://www.beyondthecouch.org/1207/reeves.htm

Christopher Reeves M.A. Ph.D.

The Online Journal of the American Association for Psychoanalysis in Clinical Social Work

Issue 2, December 2007

(This paper was originally presented at the Attachment and Social Work Practice Conference of the Greater Washington Society for Clinical Social Work, Washington, DC, May 12, 2007)

※ Note: This is a reading memo. Please refer to the link at the top to see the original article.

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I am honored to be invited to give this opening presentation on John Bowlby in his centenary year, and maybe a little surprised too, since though I knew him quite well. Indeed he was partly responsible for my selection on the Child Psychotherapy training course at the Tavistock Clinic after graduating from Oxford. Still I never reckoned myself one of his close associates. During my years of clinical training I became well acquainted with his ongoing research work on the effects of loss and maternal deprivation in conjunction with the Robertsons and Colin Parkes, but I never became as enthused as he would have liked with his vision of refashioning traditional psychoanalytic theory along more scientifically sustainable lines. Though like Bowlby I regarded the underlying instinct model of classical psychoanalysis as rather outmoded, my preference was for a reformulation that treats psychoanalysis as a form of communicative exchange and its theory as a branch of semiotics rather than as an offshoot of the biological sciences.

Anyway, it is from this standpoint, and primarily as a clinician that I propose to examine Bowlby’s legacy. I make no apology for the consequent emphasis on the therapeutic aspect. For all his desire to invest his findings with scientific rigor, it was ultimately their practical clinical benefits that interested him most. Whereas Freud aspired to be a scientist first and foremost, becoming a clinician almost in spite of himself, with Bowlby the opposite was true. Like his surgeon father, he possessed what Freud once dismissively characterized as a passion for caring, a “furor sanandi”.

Bowlby’s early letters home when a naval cadet at Dartmouth attest to his perennial desire ‘to spend his life doing something useful for his fellow men’. And at the end of his life he pointed out that though attachment theory has been mainly used to promote research in developmental psychology, it was originally formulated by a clinician for fellow clinicians, to diagnose and treat emotionally disturbed patients and their families. So he would not object, I am sure, to my here adopting what others might regard as a rather utilitarian stance, by concentrating on its usefulness as a clinical tool, and more particularly in regard to children and young people, even though he might demur at some of the things I'm going to be saying on this score.

It has been said, and truly, that while a man lives his life forwards, he revisits it backwards. The same applies to biographers – they tend to view the earlier in the light of the later. Go to a specialist bookshop in search of books by or about Bowlby: you will be offered works on attachment theory, models of attachment, attachment theory and neuroscience, attachment theory and cognitive behavior theory. But request, as I recently did, a copy of his most popular work, Child Care and the Growth of Love (Bowlby 1953), and you will find it is out of print. Yet had Bowlby died in the early 1960s instead of the 1990s, “maternal deprivation’, not “attachment” would have been the term most closely associated with his name. Now the disciplines of psychoanalysis as well as of hermeneutics encourage us to overcome our natural disposition to view the distant in terms of the more recent, and this is what I propose to do here. I am going to spend time looking at the historical context from which his ideas on attachment eventually took shape.

So I start with the well-established but neglected fact that Bowlby first came to the realization of the importance of attachment through a recognition of the importance and impact of loss, and he came to the recognition of loss, as in bereavement, through realizing the effects of absence or non-presence of a needful person in early childhood; in other words of maternal deprivation, since this was the factor marking out the first cohort of young individuals that caught his attention diagnostically and clinically.

Of course, by the end of his life his vision had broadened out immeasurably. By that stage, Bowlby wanted us to understand what separation and loss mean to human beings in terms of our overall human dependencies, our attachments, attachments moreover which in broad outline we share with the animal kingdom. And rightly so, because the nature and importance of attachment are the context in which we can best make sense of their pathological variants. Still, as clinicians, this approach only takes us so far. For all the importance of attachment, attachment theory, looked at in a certain way, as a self-standing system of ideas removed from its roots, can seem rather anodyne, a case almost of stating the obvious, namely that human beings need and aspire to stable relationships with other human beings, and that the capacity to achieve this is intimately affected by the relationship experiences of early childhood.

In fact, the very ‘obviousness’ of this basic premise is both fascinating and problematic. As his son Sir Richard Bowlby pointed out in an address he gave a few years ago in London (R. Bowlby, 2004), the real problem about attachment theory is to understand why it has been so overlooked, and for so long. From which arises a related question: why did it fall to John Bowlby to be the first to draw attention to the fundamental importance of human attachments, the one, if you like, to observe that in ignorance of this one parades like the Emperor without any clothes?

What then was it in terms of Bowlby’s own experience of life, and later of psychoanalysis, that led him from an early stage in his professional career to feel the need to strike out on his own, and in the process to cast aside the rigid orthodoxies in which both his parents and later his psychoanalytic mentors sought benignly to imprison him, by proclaiming the hitherto unspoken: namely that losing – or feeling you’re in danger of losing - someone important matters; that the fact or the fear constitutes not just a practical inconvenience but a psychological injury?

In terms of his personal life and upbringing his son Richard points to the significance of the sudden loss for young John of his nanny, called Minnie, when he was four. The Bowlby senior family was well-to-do and well connected. John’s father was a notable surgeon, who became Surgeon General in the British Army throughout the First World War. There were six children in all, of whom John was the fourth. His older brother was born only 13 months before him, and he had a younger brother who was handicapped from birth, and of whom John was very fond. Within the household two nannies and maid servants cared for the children. The boys usually only saw their mother for an hour or so at teatime each day. As a rule they enjoyed their father’s company only on Sundays. It was a family regime that however odd-seeming, even dysfunctional to our eyes, was accepted as fairly standard in those aristocratic and upper middle class British families able to afford it.

Later, as a young doctor and researcher Bowlby would encounter another type of British family constellation, very different from his own in terms of status and wealth, where children were similarly regarded, if not as appendages, as little more than functional units--and not very productive ones at that--within the domestic set-up. I am referring to the impoverished working class families of London’s East End between the wars where, as a child, you were a mouth to be fed and a body to be clothed and cared for until first school and then work could hopefully turn you into a productive and independent citizen.

If economic hardship, domestic strife, illness or death, rendered these modest targets unrealizable, then there was little general sense that family unity, a sense of belonging, kinship, were overriding imperatives. On the contrary, the belief seemed to be that if someone else, be it a person, an institution, or a colonial enterprise like the Child Migration Scheme, could better provide the wherewithal for a child’s future upbringing, then parents need feel little compunction in letting go of their child, either temporarily or permanently. I’m not saying that parents didn’t care for their children. I am saying that caring meant primarily caring for them – ensuring their physical wellbeing as far as possible – not caring about them in terms of placing their feelings or potential emotional states in the forefront of parental concerns.

I want just to pick out two factors relating to the fate of children, if I may call it that, in family constellations such as these for their bearing on Bowlby’s later work. The first is that loss (or absence) of a parent was accepted as fairly routine. And because it was routine it was not greatly averted to. This incidentally is a point well emphasized by Newcome and Lerner in their 1982 paper entitled Britain between the Wars: The Historical Context of Bowlby’s Theory of Attachment. So if a child like young John felt keenly the loss of his nanny when she suddenly left the family as he reached the age of four, the sense of loss, the accompanying grief, or mourning, would not have been accepted for what it was – I mean understood as a real predicament for the child, not just tolerated as an emotional reaction.

Bowlby doubtless had his own early experience of this in mind when years later he wrote:

A main reason why some find expressing grief extremely difficult is that the family in which they have been brought up and with which they still mix is one in which the attachment behaviour of the child is regarded unsympathetically as something to be grown out of as soon as possible. Crying and other protests are apt to be dubbed as babyish and anger and jealousy as reprehensible (Bowlby, 1979).

The other point to make here is that the reason for this widespread, culturally embedded non-recognition of loss was different in kind from the sort of repression of specific psychological traumata that Freud had encountered for the first time in his neurotic patients a couple of generations earlier. That other sort of disavowal of trauma arose from the effects of internal conflict and the repression of feelings. Bowlby always saw himself as drawing attention to the inconveniently obvious, hence overlooked, (which is why a few moments ago I said that attachment theory can appear almost anodyne), whereas for Freud it was a matter of unearthing the deeply hidden, the repressed unconscious, in the face of the patient’s internal resistance. One prided himself on “disturbing the sleep of the world”, the other was simply intent on drawing attention to a generalized indifference to a palpable fact of life.

I shall return to other differences between Freud and Bowlby and reflect on their implications later in this talk. But just now I want to turn attention away from the personal and social milieu both the one in which Bowlby grew up and the one he first encountered as a newly qualified doctor and look instead towards the professional climate and salient concerns that were around when he first became acquainted with psychoanalysis.

Biographers of Bowlby such as van Dijken(1998) and Holmes(1993) have made much of the ideological conflicts that raged in the British Psychoanalytic Society from the late 30s onwards between the followers of Melanie Klein and the Viennese analysts who had fled to England following the Anschluss and resulted in the so-called Controversial Discussions that took place from 1942 to 1945 in the effort to forge a compromise. But Bowlby’s differences with the prevailing psychoanalytic orthodoxy actually emerged at an even earlier stage than this, and although the immediate focus of difference was his analyst, Joan Riviere, and his supervisor, Melanie Klein, in fact his disagreements encompassed equally members of the Viennese school and the Kleinian party. They had to do with the relevance of what came to be referred to as ‘environment’ or ‘the outer world’ as compared with the ‘inner world’ in the proper understanding and management of early childhood disturbance. So basic and pronounced were these differences that Bowlby even had difficulty in becoming a fully-fledged member of the British Psychoanalytic Society on completion of his formal training.

What was this argument all about? What did 'environment' mean? Bowlby's analyst Riviere and - perhaps with more justification - Winnicott, insisted that they were not ignoring 'environmental factors' yet they disagreed profoundly with Bowlby (though the latter, it should be said, subsequently came nearer to Bowlby's view). It wasn't ultimately an issue about the importance of the causative effects of social and familial factors on how a child developed psychologically. It was about what as a therapist one did or didn't do in the face of such external factors.

I can perhaps best illustrate what Bowlby was confronted with ideologically at this early stage in his career by means of a personal anecdote. One of my first professional colleagues in the clinic where I began working as a Child Psychotherapist in the late 1960s was a very experienced and gifted Psychiatric Social Worker, who later became a Group Analyst. She was older than me and had been born and bought up as a child in Vienna. Her family moved in the analytic milieu of that city dominated, in addition to the Freuds, father and daughter by such figures as Erickson, Bernfield, the Burlinghams and Reich. Her parents sent her while still an infant to the experimental nursery school created by Anna Freud, Eva Rosenfeld and Dorothy Burlingham, where most of the children, even the very young ones, were undergoing analysis at the same time.

Among her vivid recollections from her days there was that whenever a small child appeared distressed at being without her mother, she would be told by way of consolation to “tell your analyst about it!” This was the stock in trade response to a child’s need for comforting. When I first heard this story I was both amused and shocked at the inappropriateness of this sort of reply. Since then, however, I have come to reflect more on what it really signified. After all the carers there were far from lacking in child-centeredness. In many ways the Heitzing School where my colleague was a child was a very model of its kind (Danto 2005). It was premised on the belief that the appropriate meeting of children’s needs was paramount. The question was of determining what exactly those needs were, and how they should best be met. Evidently not by a cuddle, or getting mother to come.

Underlying this Vienna paradigm was the premise that children, even very small children, were autonomous entities; not that they were independent, to be left to their own devices entirely, but that, apart from their immaturity they were essentially no different from adults insofar as they were endowed with instincts, sexual, aggressive, self-preservative, the control and moderating of which were, or should be, invested in the agencies inherent in that unity, that creature to whom those instincts belonged. In other words it was all about the cultivation of 'ego strength' in the child. The function of caregivers during the stage of the child's immaturity was to service her needs just insofar as she was physically too weak to minister to and modify them herself, and in the meantime to aid in the development of those structures and defenses that would not handicap her by reason of their severity and rigidity, but would in time enable her to manage them unaided.

I have called it the Vienna paradigm, but of course its basic assumptions were not confined to that particular group of analysts. Essentially they were shared by Melanie Klein and her school (albeit with less emphasis on defenses), and even in certain respects by the Hungarian followers of Ferenczi, though with them more importance was accorded to the infantile instinct to cling and be clung to. But--and this is the point I wish to stress--common to all of them was the picture of the infant as a unit, a single entity. Overarching and supporting this belief was not a system of observations so much as a basic paradigm of what the British analyst Rickman (1951) called a “one-body psychology”, as opposed to a two-body psychology on the one hand or a multiple body psychology on the other. With a one-body paradigm you regarded the child as an individual and you treated her as potentially autonomous in the matter of instinct and affect regulation. This was the common factor uniting the various psychoanalytic schools.

All of which, of course, suggests that child analysis was simply a by-product and response to a certain one-body way of looking at children’s real or imagined pathology, one that was derived from and applied unreflectingly from adult analysis. However, though true as far as it goes, this is only half the story. For there is another way of understanding the phenomenon of the burgeoning child analysis industry, if I may so call it, throughout the 1930sand 40s which sheds a different light on the matter.

In an interesting article, Claudia Frank (1999) put forward the thesis that what gave impetus to Klein's early analytic work with children was not so much a realization of the inherent severity of their disturbance (in fact many of them were not particularly disturbed at all) but rather the discovery of a technique derived from adult analysis that enabled the child to become what Frank rather cumbersomely calls “an object sui generis of cure and research”. Of course, children had already been objects of psychoanalytic research for somewhat longer - for instance Freud's Little Hans and Ferenczi's 'Little Chanticleer'. But these 'discoveries' (if they could be called that) were based on observation rather than on material derived from structured treatment sessions. What Klein was able to do, and Anna Freud and others somewhat similarly in Vienna, was to treat the child by adapting the verbal free association requirement of classical psychoanalysis and capitalizing on the child's innate propensity to enact, to play , and to fantasize.

All this of course is doubtless very familiar to you from your training as therapists and reading of the literature. What is novel about Frank's way of looking at these matters is her implied suggestion that it wasn't a case of the child analytic technique evolving in response to actual psychopathology, so much as a child patient's behavior becoming pathologized as an artifact and consequence of the evolution of the analytic technique.

It would be wrong to over-exaggerate this difference in ways of understandings the development of child analysis, and even more so to imply that its early practitioners were being disingenuous- as it were, inventing disturbance in order to treat it. But I do think that it helps throw light on why Bowlby became so ostracized as a child psychoanalyst virtually from the outset, even though he was one of the first to train as such with the British Institute of Psychoanalysis, and was for a long time the only male figure to be so designated apart from Winnicott. The reasons for this, I believe, are two-fold, and related: from the outset his paradigm for the proper understanding of the development of the child was a two-body paradigm, not a one-body one; and because of this, he did not unequivocally accept that the child was a potential object sui generis of treatment in the way that child analysts of the time chose to regard her. I want now to develop both these propositions in turn.

What I mean by a two-body psychology is that the behavior of the individual from infancy needs to be understood and addressed in terms of context, that is to say, not simply as a matter of dealing with the gamut of actions and reactions arising within the individual human organism in response to stimuli and their associated fantasy content, but rather as a pattern of meaningful and purposeful interactions with others with whom the child is in constant relationship.

The first thing that needs to be stressed is that this two-body paradigm underpins all Bowlby's subsequent work on maternal deprivation, attachment and loss. What is especially surprising is that in spite of being quite young and inexperienced Bowlby came to psychoanalysis with this already fixed orientation or frame of reference, namely that nurture was a more powerful factor than nature in determining the development of an individual's personality for good or ill, and that consequently the environment had to be taken into account as primary, rather than secondary, in assessing psychopathology. Not even the formidable figures of Riviere and Klein, his analyst and tutor respectively, nor the prevailing ideological outlook of the British Psychoanalytic Society at the time ever succeeded in altering this basic perspective of his.

Why was this conviction so deeply rooted? The answer lies in knowing how he came to psychoanalysis in the first place. Before embarking on his medical training we know that Bowlby spent six months working in a residential school for disturbed and delinquent adolescents. He later described this brief period as the most formative influence in shaping the direction of his later career. He realised that these young people were hungry for attachment and that this hunger was a direct result of their deprived childhood. His experiences there also taught him that meeting and responding to this hunger was not a straightforward matter. Deprived of affection he found these young people often angry, unpredictable and rejecting, and the more so as he attempted to meet their need for befriending. Bewildered by the complexity of their feelings, and keen to understand more, he began to reflect on the notion of ambivalence. In the process of doing so he became acquainted for the first time with the concepts of psychoanalysis through the powerful influence of a maverick but charismatic teacher colleague, John Alford. It was he who was responsible for directing the steps of the rather rudderless young adult Bowlby back towards medicine in spite of the disenchantment he had felt at such a prospect on completion of his first degree at Cambridge.

One of the many puzzles about John Bowlby is why he remained so surprisingly reticent about those months spent working in a residential special school considering they were so important for him. Even when later on in life he showed an active interest in my own career path away from conventional clinic-based work as a Child Psychotherapist when I took up the post of Principal of the Mulberry Bush School, he never once let on to me that he had himself once spent some time working in a similar establishment.

Even more surprising is the fact that though having been strongly influenced by this experience towards recognising the overriding effects of nurture on a child's later emotional and social development, he never became a strong advocate of such residential provision. At best he regarded these establishments as a necessary evil--a last possibility for emotional remediation when family ties between a young person and his parents had broken down. He always insisted that the emotional wellbeing of the child depended absolutely upon the mother remaining a constant presence in the home throughout his growing years, and the child not being sent away from home if at all possible.

This probably reflects Bowlby's lifelong conviction that prevention was better than cure, allied to another extremely optimistic belief of his, namely that delinquency and deprivation were social disorders on the pattern of disease entities. Hence his conviction, expressed at the time he gave evidence to a Government Commission of Inquiry on the future of Child Welfare services, that these conditions could be eliminated by proper measures on the model of

The contrast in this respect with his near contemporary Winnicott is particularly striking. Here was a child analyst initially quite comfortable with the one-body model of his mentors, who only became alive to the interpersonal dimension of disturbance and treatment and the consequent shortcomings of the classical analytic approach as a result of having to deal with the emotional and behavioral effects of childhood separation and deprivation in children caught up in the wartime evacuation programme. The effect of this experience on Winnicott, however, was not to cause him to proclaim the inviolability of the family at all costs, like Bowlby, but to make him realize that maternal (and paternal) nurturing could be provided vicariously, and that in a non-family setting; indeed, might even be better provided by such means if the need for nurturing had not been adequately met by 'good enough mothering' in the first place. It was this recognition that led Winnicott in the aftermath of the evacuation experience to advocate, along with his future wife Clare, the benefits of small residential establishments able to provide what they termed 'primary home experience' for such young people.

In short, for Bowlby the experience of milieu therapy as a young man pointed him firmly in the direction of the family as the optimal provider of even remedial nurturing, For Winnicott, on the other hand, exposure to the effects of family breakdown highlighted the potential benefits of milieu therapy removed from the family setting.

Returning to our main theme, we can now see why Bowlby became so ostracized as a child psychoanalyst. Not only did he reject the one-body psychology of his teachers, but he sought to alter the paradigm for the proper understanding of the development of the child from a one-body to a two-body psychology, and this both within psychoanalysis and in the realms of academic psychology as well. In the case of the former the shift of perspective he sought to bring about was fraught with opposition and was at best partial.

For much of his lifetime his fellow analysts seemed reluctant to acknowledge the relevance to their own work of Bowlby's and others' findings on the effects of maternal deprivation and mourning. Even when these became accepted as factors leading to childhood depression and delinquency, they were often seen as peripheral to their concerns as analysts, that is to say, as having no immediate bearing on their actual technique and frame of reference within sessions. One could go so far as to say that it was rather the realization of the prevalence of child abuse, both physical and sexual, and of its traumatic effect on its victims, that eventually hastened the change in child psychotherapy towards acknowledging the impact of 'real life events', rather than the effects of loss and deprivation that Bowlby had been at pains to flag up.

Why was there such resistance? Well, on a personal level Bowlby was not always his own best advocate. He admitted to being somewhat arrogant and opinionated, particularly as a young man. Marginalised by the psychoanalytic confraternity he sought and gained acceptance elsewhere, within the wider British scientific community where psychoanalysis itself had conventionally been shunned. When later in life he attempted to woo his colleagues from a position of some eminence within the scientific community, the exercise resembled a dialogue of the deaf. Bowlby came preaching the advantages of an empirically based approach to psychoanalytic research and therapy; they regarded him as continuing to ignore the play of the inner world in the shaping and understanding of an individual's psychopathology. Their attitude was, what has he got to teach us?

Of course, what he had to teach, fundamentally, is that a one-body psychology framework is not adequate for understanding and treating the psychological ills of children. But why was this not accepted? One of the most perceptive commentators on Bowlby's work has been his niece, Juliet Hopkins, herself, like me a British Child Psychotherapist and product of the Tavistock training. In an article entitled The Observed Infant of Attachment Theory (1990), Hopkins sums up her perception of the difference, and the difficulty as follows:

The infant of attachment theory has been created to explain the behaviour of infants rather than to explain the free associations of adults on the couch. Consequently few psychotherapists have become attached to it.

What this passage suggests are two things: firstly, that 'the infant' of theory and observation is a construct, not the actual baby. Secondly, the infant of classical theory is a derived construct, that is to say, its feelings, aspirations, instinctual propensities are attributed retrospectively, their content being inferred from the recollections of adulthood transmuted through the medium of psychoanalysis, rather than coming from direct observation. Hopkins' conclusion is that analysts remain wedded to their own (adult-based) perspective, hence are not truly child-centered even though they aspire to be. The further inference of course is that attachment theory in contrast is more focused on the child as he is, rather than he is imagined to be on the basis of a preconceived theory.

While I have sympathy with much of Hopkins' argument, I nevertheless think she overlooks one important feature of classical child analysis, a positive one in many respects, that relates back to Frank's idea of the child as an object sui generis of research and cure. All observations informed by a psychoanalytic perspective, even when they are not clinically based, seek to hold two aspects in view: firstly the external behavior or symptomatology manifested, and secondly the concomitant internal states of feeling or experiences of the person manifesting them (including here those of the infant).

Now it is this second dimension that appears less than adequately catered for in the eyes of most analysts by an empirically based observational approach such as that eventually favored by Bowlby, since in the interests of maintaining a scientifically objective approach this inevitably concentrates on identifiable, recordable and potentially replicable external data, leaving the accompanying 'felt experience' to be inferred. Such an approach feels, to its critics, if not impersonal, at least lacking an all-important subjective dimension, whatever the other gains to be had in terms of scientific objectivity and generality.

What both Klein and Anna Freud were trying do in their respective ways through establishing the practice of child psychoanalysis was to allow for and acknowledge the importance and impact on his behaviour of the child's subjective experience, namely the child's feelings for the child himself, not in terms of their meaning for the adult onlooker. This after all, is what Freud had earlier succeeded in doing for adults--attaching overriding importance to understanding the latent meaning of the symptom, a meaning, moreover, that could only ultimately be disclosed by and through the patient herself.

True as Hopkins says, the conceptualizations of Anna Freud and Klein, both about the nature of those childhood feelings and of the mental structures that encompassed them, were derived from work with adults to a much greater extent than they themselves realized; but at least their intended focus was on the phenomenology of the child's actual feelings and dispositions. And it was this search for the authentic child experience, I believe, that initially drew Bowlby from child care towards psychoanalysis--the wish to understand just why and over what the deprived child feels angry and hostile, or in fear of rejection, when often the expression of these feelings in action leads to further hurt and rejection; in short, the twin issues of anxiety and ambivalence. The root difficulty was in finding a way of reconciling his interactional, two-body model of understanding processes in and for the child with the quest for the lived experience of the child at all levels, conscious and unconscious, which Bowlby recognized as being the proper focus of therapy.

His biographer Jeremy Holmes (1993) points out that:

In all his vast output Bowlby only published one purely clinical - as opposed to theoretical or research- paper. This was “The Study and Reduction of Group Tensions in the Family”. (Bowlby 1949) (p.173)

What is interesting about this paper is that in it Bowlby admits to having got nowhere with a young adolescent boy he had been seeing in individual therapy for some time. He does not explain why, but the eventual sense of impasse prompted him to engage the whole family in a joint session, after 90 minutes of which he states that more progress was made towards alleviating the young person's difficulties than had occurred in all the previous two years of individual work. This hardly sounds like a ringing endorsement of individual child psychotherapy. What is surprising however is that following this paper Bowlby wrote nothing further on family therapy as such. I am not even sure whether he practised as a family therapist subsequently, and if so how much. None of his biographers throws light on this. Of course his formulations of attachment theory encouraged and inspired a whole generation of family and systemic therapists. In Britain one thinks of figures as diverse as Skynner, Byng-Hall and Dorothy Heard; in the United States you will doubtless have your own roll call.

Certainly therefore, Bowlby's espousal of a two-body psychology bore fruit in the subsequent introduction of new models of therapeutic intervention whose more distant origins lay in the basic concepts concerning unconscious mental processes and their impact on conscious feelings and attitudes, concepts deriving ultimately from the work of Freud. Viewed from this standpoint Bowlby's legacy is primarily as an innovator, researcher, a thinker and formulator of the theory of attachment, and secondarily, in the clinical field, as a facilitator of advances in therapeutic method across several different modalities. Not only does this represent an immense achievement in itself. It also, I imagine, reflects a fairly widespread summing up of the essence of his contribution to therapeutic endeavour.

But would Bowlby himself, I wonder, have been content with such a verdict on his life's work? I rather suspect not. My reason for saying so is that Bowlby's great aim was to reformulate psychoanalytic theory in a way that would be useful for psychoanalysts themselves, not just for those who were, or saw themselves, as working outside of its domain. Bowlby never abandoned psychoanalysis. He wanted to reform it. This much is clear from the preface and several other passages in the first volume of his major trilogy, Attachment (Bowlby 1969). Yet, it has to be said, such a conversion of psychoanalysis from within has not really taken place, certainly as regards child analysis. This much is evident if you read the writings of psychotherapist and philosopher Victoria Hamilton (1987, 1995) or the recently published reminiscences of child psychoanalyst Judith Issroff (2005), both of whom were close colleagues of Bowlby. While it is true, as I have said, that the concepts and findings of attachment theory have been assimilated into the thinking and formulations of many psychoanalysts, there nevertheless remains a resistance on the part of many others to recognizing the practical therapeutic relevance of the theory for the actual conduct of the encounter with the individual client, in particular the child. It is the source of this resistance I want to look at further in the final part of this paper.

The root of the difficulty, as I see it, lies in bringing together on the one hand the interactional two-body model for understanding projective and introjective processes and their impact on relationships, and on the other the desire to access and address the lived experience of the child, conscious and unconscious, which is, or should be, the proper focus of therapy. It was this latter quality, I believe, that Bowlby most prized about analysis (remember my earlier reference to his need to try to make sense of the ambivalent behaviour of the adolescents in his charge), a quality that he sought to carry over into his own interactional two-body based formulations. The problem is, one focuses on the 'in-between', the other on the internal.

How then to reconcile the two? Consider the term 'attachment' itself. Like the tango, it requires a twosome. Attachment doesn't in itself specify who is dominant in this pairing, but points rather to the mutuality or reciprocity of the relationship. Contrast this with that other relationship term ‘dependency’ which Bowlby was less in favor of. Unlike attachment, 'dependency' is a singleton term. That is to say, a person can be said to be dependent on another without it having to be supposed that the person so depended upon must be co-dependent on the other, or else on the dependency relationship itself. The fact, of course, that the term 'attachment' is open-ended in the way that dependency is not, suited some of Bowlby's explanatory purposes well. Although he initially had in mind primarily the child's attachment to the mother, a tie that is heavy with connotations of dependency, the reciprocity implicit in the term attachment highlights the fact that each party is to be viewed as being equally and mutually tied.

Attachment moreover is a term that doesn't just apply to the child in its standard form, but to adult relationships as well. Though such adult attachments are doubtless conditioned by earlier childhood relationships and their vicissitudes, and can in consequence be classified as insecure, ambivalent, avoidant or disorganized in character, still they are not seen as being defined by earlier dependent relationships in the way that for instance some of Klein's formulations about the putative mechanisms underlying adult relationships presupposed them to be (think, for instance, of her use of terms like envy, the paranoid schizoid position or the depressive position--all of them terms relating back in a very deterministic way to the earliest baby-breast relationship).

It can be seen then that the term attachment readily fits a two-body model in a way that dependency does not. The child is a co-respondent and this fact instates him as an object sui generis of research in terms of the theory. But what about the child as an object of cure in the context of Attachment Theory- the other element of Frank's designation? Well, in one respect, the two-body model may certainly be said to achieve this objective too. So, for example, in the case already referred to, when Bowlby decides to abandon his unproductive individual sessions, and opts for holding a family session instead, the child can indeed be said in a certain sense to have become an object of cure, since as a result of Bowlby's initiative he is no longer being treated as 'the problem' but as one party in a wider family problem.

Yet a crucial question remains, one that Bowlby himself doesn't address. It is this: in relieving the child of the label of 'the problem' is there a risk of depriving the child of an opportunity of having his own perspective--his personal sense of predicament or conflict--heard? Can one be sure that the 'family solution' accords with the child's own understanding of his predicament and his own problematic behavior? Put in more general terms, does the relationship not just of the therapist to the (so-called) child patient change in the move from individual to family therapy, but more crucially, the relationship of the child patient to the therapist as the conduit (through the transference) of the child's better contact with himself, more especially with his own unvoiced and unavowed feelings?

I want to leave this last question for you to mull over at leisure yourselves. I'm going to now briefly contrast Bowlby's concept of 'attachment' as applied to mother and child with Winnicott's alternative idea of the “nursing couple”. (Actually Winnicott was not the originator of the phrase, but no matter.) Contrary to appearances, the “nursing couple” is not a two-body concept, at least for Winnicott. There's no two to tango here. That's because the baby isn't regarded initially as an agent at all but rather as the 'patient': the baby is nursed and nurtured: the mother is the active party, the agent. (Think, if you like, of Winnicott's well-known phrase: there's no such thing as a baby.) Only as a result of this successful nurturing process does the infant acquire the first rudiments of agency, what Winnicott calls 'unit status' or 'integration'. So we see Winnicott generating the idea of a two-body psychology out of a one-body one, rather than starting out with a two-body paradigm as Bowlby had done. Only, in the case of Winnicott--and this is the crucial difference from the one-body formulations of Klein and Anna Freud--the initial one body in question isn't the child at all: it is the mother-and-child as a single unit.

One of the advantages of this Winnicott model is that it is inherently developmental. That is to say, it presupposes that this initial mother-child unity is unstable and posits the need for a transition from the one-body to the two-body stage. In conceptual terms it represents the bond as asymmetrical, thereby allowing for there being differences of attachment experience (and failures of attachment) as between the two parties, mother and baby. What I mean by this is that the baby doesn't experience its tie to the mother in the way that the mother experiences her tie to the baby.

Lastly, and most relevant to our present concerns, in terms of child psychotherapy, this perspective preserves the primary focus on the child as both the (eventual) agent and as object of cure. This point can perhaps best be illustrated by something the French child psychoanalyst, Maud Mannoni, says in her book The Child his Illness and the Other. (The author incidentally was strongly influenced both by Lacan and Winnicott.) Writing à propos the family dimension in the treatment of the child she asserts that it doesn't require the parents or siblings to be physically present in the consulting room in order for the therapist to learn what they have to say in regard to the child and how they perceive him. One has simply to be receptive to all the voices of the family as they register incidentally--for instance by means of phone calls, chance words uttered by a parent in the waiting room, explanations about missed appointments and so on--not just to what the child says in the session. This is because in child analysis the transference is not simply the child's, but the family unit's as a whole. All are present via the child in the consulting room.

Clearly Mannoni has a family perspective on the child's problems in the way that one imagines Bowlby would wholeheartedly approve of. Yet she also succeeds in situating the child at the center of the treatment situation, making his individual therapy the conduit of cure just as, in her view, his symptoms had been a conduit of the family pathology.

I mention this example near the close of my talk because I believe it suggests one possible way of marrying the one body and the two-body perspectives in a creative union. Bowlby's great achievement has been in what might be called 'enselving the child' that is to say, making of him or her an actual self conceptually, socially, politically, no longer to be seen as a mere appendage either of the parents or, in a symbolic sort of way, of psychoanalytic research and technique.

Alerting society to the reality of the child's feelings and needs in the way that Bowlby and his colleagues did was, and still is, shock-inducing; I remember the absolutely overwhelming effect the film about 17 month old John, placed in a short-stay residential hostel, had on the then British Minister of Health, Sir Keith Joseph, when he was due to present the Roberstons with a medal of achievement. So moved was he by what he saw on film of the child's reaction to separation that he could barely bring himself to perform the ceremonial presentation. Yet he was seeing what was there for everyone to see and realize, if only they were prepared to look. And yet this 'enselving' of the child, which I see as Bowlby's principal legacy, can come close to enslaving him too. Paradoxical though it may seem, recognizing children's selfhood does not guarantee that their needs will be appropriately met. This is evidenced--in Britain at least--by the continuing disavowal in political circles of the small child's need for the mother's continuing presence and availability, despite all Bowlby's powerful advocacy fifty years ago.

Part of the problem, I suspect, is that a two-body approach can end up creating the figment of the child as an adult writ small, someone just like us but not so powerful, thereby ignoring significant disparities in feelings and competencies. It would be a pity indeed if this became the eventual, unintended effect of Bowlby's legacy.

(... ...)

REFERENCES

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Bowlby, J. (1953). Child Care and the Growth of Love. Harmondsworth: Penguin Books.

Bowlby, J.(1969). Attachment and Loss Vol.1.: Attachment. London: Hogarth.

Bowlby, J. (1979). The Making and Breaking of Affectional Bonds. London: Tavistock.

Bowlby, Sir R. (2004). Fifty Years of Attachment Theory. London: Karnac.

Danto, E. (2005). Freud's Free Clinics. New York: Columbia University Press.

Fonagy, P. (2000). Attachment Theory and Psychoanalysis. New York: Other Press

Frank, C. (1999). The Discovery of the Child as an Object Sui generis of Cure and Research by Melanie Klein. Psychoanalysis and History 1(2).

Hamilton, V. (1987). Some problems in the clinical application of attachment theory. Psychoanalytic Psychotherapy 3(1).

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Rickman, J. (1951) . Methodology and Research in Psychopathology. British J. Med.Psychol. 24.

Van Dijken, S. (1998). John Bowlby: His Early Life. London: Free Association Books.