There has not been enough effort made to identify what the basic requirements are of healthy development in childhood (Greenspan and Brazelton, 2009). When these needs are recognised, plans to fulfil these requirements can more easily be designed and evaluated. Under the increased stress of today, it is harder for parents to meet the needs of children – outside supports are needed. The above authors speak of ‘irreducible needs’ – experiences and types of nurturing which every child has a right to. This, the authors argue, will lead us to re-evaluate practices in child care, families, education, health care, social services and the legal system.
Human and animal studies point to needs every child has and there are long-term consequences for brain function if these are not met (Perry, 2002). All human behaviour can be traced to our mammalian predecessors and even earlier (Bloom, 2013). Security is the ‘first and foremost’ reason for social life. Human mothers and children are in a state of prolonged dependency so human groups have had to protect the mother-child bond for a long time compared to other species. Nature had to evolve a mechanism that would keep mother and child together for years and to protect human offspring within a wider circle of social relationships. This mechanism was attachment, present in all mammals, but very well developed in humans. Attachment behaviour is any behaviour that is designed to get children into close, protective relationships with their attachment figures whenever they experience anxiety. All mammals display a ‘separation cry’ when the baby becomes separated from its mother. This cry of distress brings forth predictable responses from the caregiver. There is a strong connection between separation, loss and depression in adults; separation and loss are also linked with medical disorders which is probably the result of dysregulation of the autonomic and immune systems (Bloom, 2013).
Attachment is a biological system designed to protect the infant from predators and as such is the primary force for development (Schore, 2012). Bowlby argued that infants are born with the ‘set goal’ of remaining in contact with the mother (Hrdy, 2005). Physical proximity symbolises the comforting availability of the caregiver (Wallin, 2007). The goal of attachment behaviour is not just protection from present danger but reassurance of the caregiver’s on-going availability. Availability is about accessibility but also, crucially, ‘emotional responsiveness’. In fact, it is the child’s appraisal of the caregiver’s availability that is critical; this appraisal depends largely on the caregiver’s availability in the past. The goal of the attachment system is ‘felt security’. The infant needs a ‘warm, intimate and continuous’ relationship in order for normal development to occur (Hrdy, 2005).
Human infants depend on their mothers to make sure proximity is maintained, that frequent feeding is provided and physiology is regulated (Ball and Russel, 2013). Attachment theory raises questions around childcare in the early years. If attachment is a survival system designed to keep mother and child in close proximity, what happens when mother and child are routinely separated for long periods of time each day that often starts when the attachment bond is forming in the first year?
In reciprocal interactions the child learns to modulate and control behaviour and impulses (Brazelton and Greenspan, 2009). Attachment theory has shifted to a regulation theory (Schore, 2019a), meaning that the purpose of attachment is the dyadic regulation of emotion (Sroufe et al., 2009). Schore (2012) describes how the ‘rhythmic developmental movement’ between survival-security and exploration ‘etches’ a template in the brain ‘for the rest of the lifespan’ (p.387). The rhythmic movement outward for exploration and inward for safety is the hallmark of emotional security. When this ‘life rhythm’ is supported by caregivers i.e. when it is synchronous, the child can attain more complex growth and development. ‘Optimal interactive regulation’ facilitates the development of more complex right brain functions of attachment security, affect regulation and a ‘burgeoning positive sense of self’ (Schore, 2012, p.387). Developmental neurobiology and psychobiology research shows that during ‘optimal’ moments of ‘bodily based affective communications’ the “primary caregiver’s exogenous sensory stimulation coincides with the infant’s endogenous organismic rhythms” (Schore, 2012, p.230).
Mary Ainsworth described how what distinguished insecure from secure attachments was the amount of caregiving provided for the baby and the mother’s ‘excellence’ as an informant about their infant (Mesman et al., 2016). These link to patterns of proximity and availability, interest in the child, perception of the needs of the baby and prompt responsiveness to a baby’s signals. Secure attachment is expected to be normative in contexts that are not threatening to health – in circumstances that don’t deviate too much from environments in which we evolved. Consistent, responsive care cultivates a secure attachment in both human and non-human primates. Parental sensitivity provides a secure base from which to explore, secure in the knowledge that the parent will be emotionally and physically available to alleviate distress.
The ‘sensitive’ mother creates synchronous and reciprocal interactions that are mutually satisfying and create secure attachment (Schore, 2012). However, the ability to read and recognise facial expressions under stress is lessened (Schore, 2017a). A classic study done by ‘Zero to three’ with traumatised mothers showed that educating parents to become good parents was not as important as helping them self-regulate (Shanker, 2015). When they learned how to self-regulate their ‘mind-reading’ abilities kicked in and they could read affective cues of their infants.
Babies shape their caregivers to be responsive to their needs; for this to occur, caregiver’s need to be present, available emotionally, and protected from too many demands (Brazelton, 2015). If not, the signals babies send go unheeded. The attuned mother responds promptly in appropriate ways to emotional expressions of the need for attachment repair (Schore, 2019b). These events scaffold and ‘invisibly support’ the development of the ‘right brain regulatory coping capacities’ of the child. The infant seeks proximity to the mother who in optimal contexts is perceived as predictable, ‘consistent and emotionally available’ (Schore, 2019a). The pre-reflective sensitivity of the caregiver’s right brain implicitly attends to, perceives, appraises and regulates the infant’s nonverbal expressions and states of positive and negative arousal. These implicit, spontaneous, rapid, intersubjective bodily-based emotional right brain nonverbal communications are operating outside of focal attention and verbalised experience.
The relational modulation of fearful arousal lies at the heart of attachment (Schore, 2012). Attachment is the regulation of interactive synchrony and so attachment stress is asynchrony in interactions. When the mother tunes her activity level to that of the infant during social engagement and then allowing recovery in disengagement, their interactions become synchronised (Schore, 2019a). This synchronisation of the mother’s responses to the signals of the infants is key to sensitive parenting and with it goes prompt responses and moment to moment adaptation to the child’s emotional state. To enter this communication the mother must resonate with the ‘dynamic crescendos and decrescendos’ of the infant’s bodily-based ANS and CNS arousal. ‘Regulated and synchronised affective interactions’ with a ‘familiar, predictable primary caregiver’ creates safety and “positively charged curiosity, wonder and surprise” that fuels exploration of novel environments. Responsive care with ‘co-regulated communication patterns’ is linked with good parasympathetic vagal tone which is essential for healthy functioning digestive, cardiac, respiratory, immune and emotional systems (Narvaez et al., 2013a).
There are five areas of developmental experience relevant to attachment security (Brown and Elliott, 2016). These are a what a child ideally experiences with ‘parent-figures’. These five primary conditions that promote secure attachment are: A sense of felt safety and protection; being seen and known through attunement; felt comfort through consistent and timely soothing and reassurance; being valued through expressions of delight in the child; support for being and becoming one’s unique best self, promoted by encouraging and supporting exploration. Parental presence, interest, consistency and reliability are features of all these categories.
It is clear from the above literature that both quantity and quality of caregiving increases the likelihood of developing secure attachments. It is hard to see how young children can perceive the parent as ‘predictable’, ‘consistent’ and ‘available’ when the attachment dyad are routinely separated for long periods each day. How do infants and toddlers cope with such separations? The child can begin to develop a secure relationship with care-givers in childcare, but this takes time and staff turnover creates problems here – note Schore’s (2019a) emphasis on a ‘familiar’ caregiver. Research supports the idea that these separations are problematic, as outlined below.
In modern caregiving systems children are often cared for by non-kin who are likely to be less attuned to the child than a family member would be (Narvaez et al., 2013a). Nonmaternal and nonparental care in the first year is a risk for insecure attachment and insecure-avoidant infants who have received such care express more negative affect and upon reunion engage less in object play with the mother (Schore, 2012). Even infants who use in home baby-sitters for more than twenty hours per week show more avoidance upon reunion and are more likely to be classified as displaying insecure attachment. There has also been a link reported between early day care and aggression and noncompliance. Elevated insecure patterns are consistently found in child care children. Schore writes that caregiving in the first two years of life is ‘an essential problem for the future of human societies’ (2012, p.362). Care initiated early in life and experienced for many hours, in particular in child care centres, is linked with higher levels of externalising behaviour problems which is not simply the result of low-quality care. There has also been shown to be a link between day care and elevated cortisol levels. The ‘stressful environment’ of day care is known to jeopardise children’s development (Schore, 2012).
One study demonstrating the effects of stress in the perinatal period shows that brief daily separations induced high stress for prolonged periods in the infant (Schore, 2012). This stress was linked with anxiety in adulthood despite the fact that the infants received increased maternal care afterwards. The authors conclude that exposure to stress in the postnatal period overrides the capacity of maternal care, programming anxiety behaviour through the inhibition of the normal growth spurt at this time. Research shows that maternal employment in the first year after birth is linked with developmental risks like insecure attachment and negatively impacting children’s cognitive abilities. The long-term impact of this is an increase in the number of people with a neurobiological predisposition for psychiatric disorders.
References
Ball H. and Russell C. (2013). Nighttime nurturing: an evolutionary perspective on breastfeeding and sleep. In Narváez, D. (2013). Evolution, early experience and human development: From research to practice and policy. Oxford University Press.
Bloom, S. L. (2013). Creating sanctuary: Toward the evolution of sane societies. Routledge.
Bowlby, J. (1969). Attachment and loss: Attachment.
Brazelton, T. B., & Greenspan, S. I. (2009). The irreducible needs of children: What every child must have to grow, learn, and flourish. Hachette UK.
Brown, D. P., Elliott, D. S., & Baltzer, C. R. (2016). Attachment disturbances in adults: Treatment for comprehensive repair. W. W. Norton.
Hrdy, S. (2005). Come the child before the man: How cooperative breeding and prolonged postweaning dependence shaped human potential. In Hewlett, B. S., & Lamb, M. E. (2005). Hunter-gatherer childhoods: Evolutionary, developmental, & cultural perspectives. Transaction Publishers.
Mesman, J., Van Ijzendoorn, M., Sagi-Schwartz, A. (2016). Cross-cultural patterns of attachment. In Cassidy, J., & Shaver, P. R. Handbook of attachment: Theory, research, and clinical applications (3rd ed.). Guilford Publications.
Perry, B.D. (2002). Childhood Experience and the Expression of Genetic Potential: What Childhood Neglect Tells Us About Nature and Nurture. Brain and Mind 3, 79–100 (2002). https://doi.org/10.1023/A:1016557824657
Schore, A. N. (2012). The science of the art of psychotherapy (Norton series on interpersonal neurobiology). W. W. Norton & Company.
Sroufe, L. A., Egeland, B., Carlson, E. A., & Collins, W. A. (2009). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. Guilford Press.