Monday, 21 September 2009

Laying the foundations for healthy relationships

Last week I wrote about one aspect of building healthy attachment in a new infant, the way in which parents respond to the individual needs of their children, at the earliest stage, when they cry.

This week I explore further how healthy adult relationships can depend upon the attachment built early on as a child with the parents. Relationship patterns that follow people throughout life are claimed by many psychologists to be established largely between the ages of 0 - 18 months. Of interest to this blog is how early attachment then defines our abilities to build relationships and assess "reality" when encountering differences with others (thus the amount of conflict one experiences in one's own emotional life), in later life. It is generally accepted that early experiences with caregivers gradually give rise to a system of thoughts, memories, beliefs, expectations, emotions, and behaviours about the self and about others, including what one should expect of love and intimacy from others. This system is called the "internal working model of social relationships", and continues to develop with time and experience. It enables the child to a greater or lesser extent handle new and different types of social interactions as it develops through adolescence and into adulthood. An adult's internal working model continues to develop and to help cope with friendships, marriage, and parenthood, all of which involve different behaviours and feelings. This is also the reason that different styles of relationships work for different people, rather than there simply being one blueprint for all. Some couples need and give more space than others; why one wife is happiest when her husband is around all the time, whereas another prefers to have time apart as well as time together, for example.

The main claim of Attachment Theory is that a young child needs a secure relationship to at least one primary adult caregiver for normal social and emotional development to take place. Indeed, significant separation from a familiar caregiver, or frequent changes of caregiver in a young infant, may result in psychopathology at some point in later life. Much has been written about attachment, including how an infant learns expectations and styles of attachment, from the earliest responses to its cries (at 0 - 2 months); to discriminating amongst various possible caregivers (from 6 months - 2 to 3 years, this being described by psychologists as the "critical period"). The theory originated from psychiatrist and psychoanalyst John Bowlby and has been developed further since. The key word for healthy attachment is secure. Feeling secure however is not a one-size-fits-all, with some infants appearing to be more temperamentally secure than others. The claim cannot be nature over nurture (that we are genetically predisposed, our temperaments are all set at birth and that is that), nor nurture over nature (that our environment, parents etc. will be totally responsible, disregarding individual temperament, more complex family systems, genetics, etc.), rather that the outcome for any individual is a more complicated blend of both.

There are however some parental givens in encouraging healthy attachment in one's infant, and these are defined quite clearly within Attachment Theory. Developmental Psychologist, Mary Ainsworth, introduced the concept of the "secure base" and developed a theory of how attachment patterns are developed in infants, through interaction between them and their primary caregiver (usually their mother), attachments defined as follows:

1. Secure attachment
2. Avoidant attachment
3. Anxious attachment
4. Disorganised attachment

She and her colleagues developed the "Strange Situation Procedure" in the 1960s, which is a widely used, well researched (tested in Scotland and Canada) and is a validated method of assessing an infant's pattern and style of attachment to a caregiver. This is administered as follows:

1. Parent and infant are introduced to the experimental room.
2. Parent and infant are alone. Parent does not participate while infant explores.
3. Stranger enters, converses with parent, then approaches infant. Parent leaves inconspicuously.
4. First separation episode: Stranger's behaviour is geared to that of 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 infant.
8. Second reunion episode: Parent enters, greets infant, and picks up infant; stranger leaves inconspicuously.

Two important aspects of the child's behaviour are observed:

1. The amount of exploration (e.g. playing with new toys) the child engages in throughout.
2. The child's reactions to the departure and return of its caregiver.

On the basis of their behaviours, the children are categorised into the four groups, listed above.

Our ability to hold mature, intimate and loving relationships depends largely upon our internal working model of social relationships, how evolved it is, and how capable we are of further evolution emotionally and cognitively. The optimistic view (and mine) is that we continue to evolve cognitively and emotionally as adults. There are some provisos of course, such as a need to be self-aware of some of the flaws in one's existing internal working model of social relationships. With someone experiencing a full-blown psychopathology, this self-awareness is extremely difficult to elicit, as perceptions have become fractured and dissociated. For most people however, learning to have even more fulfilling relationships includes having the ability to learn about one's own internal model. Here are some key questions to explore with yourself, keeping in mind the overall question "would someone else agree with my perceptions"?

1. What beliefs do I hold about my likelihood to be loved and to give love in return?
2. Are my expectations of others too low or too high (note: expectations could be high for some yet not others, e.g. high for work colleagues, yet too low for family members; etc.)?
3. How do I sense-check my perceptions, needs and expectations?
4. How do I recognise where I am being emotionally triggered by past events rather than the realities of the present e.g. my emotional reaction is likely to be considered by most others as inappropriate or out of proportion for the given situation (usually a triggering event, upsetting more to me than others)?

So what if there are some learned automatic responses such as insufficient reaction (lack of affect), distorted perceptions (misinterpretations) or over-reactions that need to change? If this is the case, cognitive behaviour therapy (CBT), cognitive behaviour analysis, dialectical behaviour therapy (DBT) and hypnotherapy are effective approaches to consider. They provide the pathways, or bridges to new, more adaptive internal models through providing opportunities for social learning, bringing more adaptive ways of responding and thinking. As with learning any new skill however, this involves being out of one's comfort zone, feeling uncomfortable, experiencing a higher level of uncertainty, accepting that with learning comes error and mistakes, and all of this can be incredibly hard for some who has developed disorganised, anxious or avoidant attachment styles. If you suspect you have or your partner has any of these attachment styles, my guidance is to find a therapist that you can trust, who can give you professional insight into your internal working model of relationships and also offer you the bridges to learning and experiencing new and more fulfilling intimate relationships. Many people can see in later life, years of wasted experiences that have repeated the same pattern time and time again, even with very different people. Changing or even avoiding partners will not change the patterns unfortunately.