Attachment Theory

Introduction

• Originally developed by John Bowlby (1907 - 1990)
• He was a British psychoanalyst who tried to explain the intense distress experienced by infants who had been separated from their parent.
• Theory was further developed by Mary Ainsworth.
• The theory describes the dynamics of long-term relationships between humans especially as in families and life-long friends.
• The theory was published across three volumes
  • 1. Attachment (1969);
  • 2. Separation (1973); and
  • 3. Loss (1983.

Origins

Attachment theory derived its concepts from:

• ethology,
• cybernetics,
• information processing,
  
• developmental psychology,
• object relations theory
• and psychoanalysts,

Major Concepts

• Attachment: An enduring emotional tie to a special person, characterized by a tendency to seek and maintain closeness, especially during times of stress. 
• Attachment in the context of children: The enduring deep emotional bond between a child and a specific caregiver.
• Separation produces extreme distress in children.
• There are significant long-term adverse effects on the children as
  a result of even relatively brief separations.
• Theory emphasizes the role of mother in child's development, where father plays the second fiddle to mothering.

Stages

• Phase of limited discrimination (birth–2 months)
  • Baby’s innate signals attract caregiver.
  • Caregivers remain close by when the baby responds positively.
    
• Phase of limited preference (2–7 months)
  • Develops a sense of trust that caregiver will respond when signaled.
  • Infants respond more positively to familiar caregiver.
  • Babies don't protest when separated from parent
    
• Phase of focused attachment and secure base (7–24 months)
  • Babies display separation anxiety.
  • Babies protest when parent leaves.
• Phase of goal-corrected partnership (24–36 months)
  • Children ncrease their understanding of symbols and language improves.
  • Children understand that parents will return.

Conclusion

• Attachment theory has been widely applied to the nurse –patient relationship in those with chronic medical illness and also in the palliative care setting.

Refrences

1. Bretherton, I. (1992).The origins of Attachment theory John Bowlby and Mary Ainsworth. Developmental Psychology, 28, 759-775.
2. Bowlby, J. (1969). Attachment and loss: Vol. 1.Attachment. New York: Basic Books.
3. Bowlby, J. (1973). Attachment and loss: Vol. 2.Separation: Anxiety and anger. New York: Basic
4. Bowlby, J. (1980). Attachment and loss: Vol. 3 Loss: Sadness and depression. New York: Basic Books.