Is attachment the same as bonding?
Can I have a healthy attachment with my baby if I don’t breastfeed?
Do I have to babywear to develop an attachment to my baby?
Will being apart from my baby disrupt our attachment relationship?
Is co-sleeping critical to attachment?
These are just a few of the questions that listeners wrote to me after I sent out a call for questions on Attachment. This was such an enormous topic to cover that Dr. Arietta Slade and I did the best we could in the time we had, and we did indeed cover a lot of ground.
If you’ve ever been curious about the scientific evidence on how attachment forms, what are its benefits, and what it has NOT been shown to do, this is the episode for you. We also cover reflective functioning, one of the central ways that the attachment relationship develops, and discuss how to improve our skills in this arena.
Check this episode for more attachment research: Most of what you know about attachment is probably wrong
Dr. Arietta Slade’s Book
Attachment in therapeutic practice – Affiliate link
Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Erlbaum.
Benoit, D. (2004). Infant-parent attachment: Definition, types, antecedents, measurement and outcome. Pediatric Child Health 9(8), 541-545.
Bowlby, J. (1973/1991). Attachment and Loss: Volume 2. Separation: Anxiety and anger. London, U.K.: Penguin.
Bowlby, J. (1971/1991). Attachment and Loss: Volume 1. Attachment. London, U.K.: Penguin.
Cassidy, J. (2008). The nature of the child’s ties. In J. Cassidy & P.R. Shaver (Eds.) Handbook of Attachment (pp.3-22). New York, NY: Guilford.
Greenspan, S.H. & Salmon, J. (2002). The four-thirds solution: Solving the childcare crisis in America today. Boston, MA: Da Capo [Note that Dr. Slade mis-remembered the title of this book as “The Three Fourths Solution”]
Hudson, N.W., & Fraley, R.C. (2018). Moving toward greater security: The effects of repeatedly priming attachment security and anxiety. Journal of Research in Personality 74, 147-157.
Jones, J.D., Brett, B.E., Ehrlich, K.B., Lejuez, C.W., & Cassidy, J. (2014). Maternal attachment style and responses to adolescents’ negative emotions: The mediating role of maternal emotion regulation. Parenting: Science and Practice 14, 235-257.
Julian, T.W., McKenry, P.C., & McKelvey, M.W. (1994). Cultural variations in parenting: Perceptions of Caucasian, African-American, Hispanic, and Asian-American parents. Family Relations 43(1), 30-37.
LeVine, R.A., & Levine, S. (2016). Do parents matter? Why Japanese babies sleep soundly, Mexican siblings don’t fight, and American families should just relax. New York, NY: PublicAffairs.
Marvin, R.S., & Britner, P.A. (2008). Normative Development: The ontogeny of attachment. In J. Cassidy & P.R. Shaver (Eds.) Handbook of Attachment (pp.269-294). New York, NY: Guilford.
Nicholson, B., & Parker, L. (2013). How did attachment parenting originate? Attached at the heart. Retrieved from: www.attachedattheheart.attachmentparenting.org/faq/
Raby, K.L., Roisman, G.I., Labella, M.H., Martin, J., Fraley, R.C., & Simpson, J.A. (2018). The legacy of early abuse and neglect for social and academic competence from childhood to adulthood. Online first. Retrieved from https://socialinteractionlab.dl.umn.edu/sites/g/files/pua1356/f/2018/Raby%20et%20al%20%28CD%2C%202018%29.pdf
Sadler, L.S., Slade, A., & Mayes, L.C. (2006). Minding the Baby: A mentalization-based parenting Program. In J.G. Allen & P. Fonagy (Eds.), The handbook of mentalization-based treatment (pp.271-288). Chichester, U.K.: John Wiley & Sons.
Slade, A. (2014). Imagining fear: Attachment, threat, and psychic experience. Psychoanalytic Dialogues 24(3), 253-266.
Slade, A. (2005). Parental reflective functioning: An introduction. Attachment & Human Development 7(3), 269-281.
Slade, A., Sadler, L., Dios-Kenn, C.D., Webb, D., Currier-Ezepchick, J., & Mayes, L. (2005). Minding the Baby: A reflective parenting program. The Psychoanalytic Study of the Child 60, 74-100.
Slade, A. (2002). Keeping the baby in mind: A critical factor in perinatal mental health. Zero to Three. June/July, 10-16.
Jen: [00:37] Hello and welcome to the Your Parenting Mojo podcast. Today we have an absolutely gigantic topic together and we have a giant in the academic world to help us think through some vet as well. I’d like to welcome Dr Arietta Slade, clinical professor at the Yale Child Study Center and Professor Emeritus in the doctoral program in Clinical Psychology at the City University of New York, and she is here today to talk with us on the topic of attachment theory. She’s an internationally recognized theoretician clinician, researcher and teacher. She’s published widely on reflective parenting, the clinical implications of attachment theory, the development of parental mentalization and the relational context of early symbolization. For the last 13 years, she has co-directed Minding the Baby, which is an interdisciplinary reflective parenting home visiting program for high risk mothers, infants, and their families at the Yale Child Study Center and School of Nursing. This program is one of only 18 certified evidence based home visiting programs in the United States.
Jen: [01:37] Now, it does seem to be slightly ambitious to try and cover 60 plus years of research on attachment, which has been conducted by Dr Slade as well as other researchers in a single show, but we’re going to give it a shot. Welcome Dr Slade.
Dr. Slade: [01:58] Well, as you indicated in your introduction, it’s both a really huge topic and a very simple set of ideas. I mean, it’s a huge topic in that it’s been studied for, as you said, 60 years and it’s actually more like 80 years, but at the same time it comprises a set of really simple and accessible ideas and the central idea in attachment theory and has guided a tremendous amount of attachment research.
Dr. Slade: [02:24] There’s three or four, several key ideas. The first is that children, infants, in particular, human infants are born with a predisposition to become connected, to attach to, the people who take care of them, you know, and this is something that is present at birth and an infant is born with a number of ways to signal the people who are caring for him or her about their needs and their desires and their needs for safety and closeness. And these are signaled very, very early on. And this is essentially a biological given that individuals are born with. And there are plenty of other mammalian species that are born with the capacity to develop attachments.
Dr. Slade: [03:00] One of the main components of detachment system is to protect the child from danger so that the child is able from early on to signal alarmed, to reach out with his hands, to look at the parent, to call to the parent saying, I need help. I need comfort, I need to be protected. And that is a very strong component of the attachment system and that, as I said, is present from birth, and the second element of the attachment system is that when the child feels safe and protected, they are also biologically predisposed to explore their environment. You know, once they feel safe, they can go out and they can explore the world and they can even when they’re infants, they can explore the world with their eyes. They can explore the world with their hands. They can explore the world with their mouths and all of these efforts or efforts to learn about the world in which they are living, you know, in which they live from day one.
Dr. Slade: [03:53] So attachment brings them close to the caregiver. It makes them feel safe. At the same time, the safety that comes from attachment allows them to go out and explore the world and learn about the world and much of their learning about the world comes through exploration of the world and then another element of their learning about the world comes through the relationship with their parents who signal to them, this is important. This is something you should know. This is something I’m interested in. This is something you should be interested in, and much of this takes place non-verbally. Some of course takes place when the child, gets older verbally, but there are a variety of ways that the parent communicates to the child. This is a world in which you and I live and these are the things in our world that it’s important for you to know, so that’s another element of the attachment system.
Jen: [04:40] I wonder if you can tell us more about what are some of those ways that parents do that, particularly the nonverbal ways they communicate with children that this is the world that we live in and these are the parameters of it.
Dr. Slade: [04:50] Well, there are a number of ways that parents communicate with infants from the earliest days, and I’m sure you know this from your own interactions with your own children, with other people that when adult speak to children, they tend to exaggerate their facial expressions. They slow down the pace of their voice, they exaggerate the vowels and their speeches is notably different and it’s been called Motherese and Baby Speech and so on for many, many years. But they do a variety of things to signal, to really pace their information at a level that the child can grasp, to pace their, you know, like, “Oh wow, that’s big” [speaking slowly].
Dr. Slade: [05:32] You know, and that slows down the pace of information because the child obviously as an infant processes things more slowly. But there are a number of ways that parents communicate things nonverbally, you know, which is that when you moved toward that part of the room, I grimace. And when you reach for that toy, I tense and when I’m holding you in my arms and you cry, I get rigid. There are all these ways that a mother or father or parent caregiver communicates through their body. This is something I want you to attend to or this is something unacceptable and there you know so much of the research over the last, I don’t know, I want to say 40 years now, 30 years on mother-child interaction and parent child interactions has really documented that there’s a whole bunch of communication that takes place between parent and child that is completely out of our view. Only when you really slow down the videotape as it were and watch that baby initiate some other looks away, baby tries again.
Dr. Slade: [06:35] Mother looks away or baby initiates. Mother expands, baby expands, mother expands. All of those things happen again at a level that we might not see with the naked eye, but is one in which babies really received communication from the environment in a number of subtle ways. The simplest way to talk about it as of course nonverbal communication, but babies know when they’re being attuned to, they know when they’re not being attuned to. You know, when the caregiver has gone flat or when the caregiver turns away or when the is disinterested and all these are powerful messages that teach the baby about the parent, about themselves, about the world.
Jen: [07:13] Yeah. I guess I, I was not terribly insightful parent when my daughter was that old. I don’t think. And it’s almost mind boggling to wonder what she might have picked up from me when she was that age.
Dr. Slade: [07:28] Well, you know, that’s really the enormous responsibility of parenting and of course there are a million things we don’t want to communicate to our children and there are a million things we communicate to them anyway, and there are a lot of wonderful things that we communicate to children and you know, it’s always important to remember that infants are enormously robust. They’re very good at reading a diverse array of signals. It takes a lot of problematic communications to really disrupt them. And it’s not as if, if you think of him as little computers, they’re very good learners, but they’re also very robust learners so that it’s not that, you know, there’s a researcher who did so much important work in this area named Daniel Stern and he’s one of the people who pioneered these micro analytic studies back in the seventies.
Dr. Slade: [08:19] One of the things he really made clear is that, you know, essentially when in an anomalous thing happens between a parent and the child and the child sort of goes at first. So that wasn’t normal. That’s not mom, you know. And if it happens again, it’s like, oh, well. And then if it happens, you know, like 40 times it’s like, oh, well maybe I need to like develop a different kind of view of this situation because there’s been enough information to make me see it differently. But in general, I think it’s burdensome for parents to feel like every little thing they do is going to change the course of their child’s life because of the fact is it’s the buildup of things over time that really make for a relationship that make for an attachment a that make for a child’s sense of who they are.
Dr. Slade: [08:59] Sixty to 70 percent of children living in low risk environments feel safe in the world, feels secure in their attachments, feel loved and taken care of and supported. And it’s not hard to feel securely attached, you know, and that most environments, depending on the culture, have ways of making children feel secure, if you know what I mean. It’s not something that’s so delicate. It’s a very robust biological system because it’s best for children if they do feel safe and taken care of and understood. And therefore there are pretty able to extract from the environment “I’m safe, I feel, you know, I’m taking care of and I feel understood.” There’s a couple more points I wanted to make while I was defining attachments. So back to that for sec. A child is born with an active attachment system, which means that depending on their age, they have a variety of signals that are age appropriate to signal the caregiver.
Dr. Slade: [09:54] One of the functions of that is to protect them from danger. Another function of the attachment system, if you will, is to bring them into contact with their humanity. Children learn who they are, how they feel, what’s going on inside of them, what they like, what they don’t like, through interactions with their caregivers. You know, it’s the mom who says “you hate asparagus,” you know, well that’s hate and that’s asparagus. That kind of learning about my own internal, you know, the infant’s learning about his or her own internal experience takes place in the relationship. And so essentially I think about the attachment system is functioning first to facilitate protection, but also to develop the relationships that are key to a child’s feeling like a part of the world, like a part of their family, like they have an inner life and all that really derives from these relationships that grow from the looking, reaching, holding, sucking, you know, all the things that the child does to bring the caregiver or close to that.
Dr. Slade: [10:57] Well, yes. I guess the other thing I wanted to talk about, one of the primary functions of caregivers is that they regulate the child. And regulation is something that is so important because if you think about an infant crying, you know, and being distressed and wailing and you know, their whole body is sort of, if you will, their whole body is crying. You know, their arms are flailing, their feet are flailing. And the goal for a parent in that situation is to get them calmed down. So they pull their hands back to midline. They may hold their feet, they may swaddle them, and all of that is to get the child’s distress regulated. And what happens is when we regulate children over and over and over again, they begin to develop the capacity to self regulate. So they may not cry as long or if Mommy’s out of the room or Daddy’s out of the room and they start to get fussy, they may be able wait a little longer because they’re developing these capacities for regulation through the relationship with the parents and actually all attachment theorists do, but it’s not necessarily talked about that regulation is a key function of the attachment relationship and regulating emotions in particular and physical states and emotional states and that it’s a very important element of what happens between parents and children early on and you can easily imagine a parent who really is too like let’s say wrapped up in something going on in their own lives to really provide the child with that kind of regulation that that leaves the child somewhat at a disadvantage because being regulated feels good.
Dr. Slade: [12:38] Like I would have a lot harder time talking right now if I was starving or if I’d just gotten a terrible phone call, and all those things dysregulate you enough that you can’t keep yourself together. And that’s a parent’s job early on is to maintain a certain degree of regulation.
Jen: [12:54] Okay. So a follow up question on that that I’d like to dig into it a little bit deeper because I think for a new parent it often feels as though the baby spends a lot of time crying. My daughter did when she was very young and that the goal, which I thought when I was a young parent, you just have to stop the crying. Just make the crying stopped because it makes me feel terrible and she must be obviously unhappy if she is growing and so therefore the goal is to stuff it no matter what method you use. And so my thinking has shifted on this a little bit over time and of course I’m going to help her to address any needs that she has. If she’s hungry or if he’s wet or cold or whatever that is, if I can figure that out. But there are some times when you’re a parent that you just cannot figure out why your baby is crying. And in that circumstance, is it difficult for the child to have a parent who does not sort of swaddle and rock and “Happiest Baby on the Block” them? Or is it better to stop the crying or to acknowledge to the baby, I hear you crying. I wish I could figure out what it is that you need, but right now I just can’t, but I’m here with you and I support you.
Dr. Slade: [14:03] Well, they’re kind of two things that occurred to me as an answer to your question. The first thing that occurs to me is that the most important thing to happen in a situation where a child is very distressed is for the parent to be asking why rather than stop. Because if you’re asking why, then you’re actually much more likely to figure out what’s causing them to cry and either be able to get them to stop or say, okay, you know, she wants her binky and I don’t have her binky right now and I’m not going to have her binky for 20 minutes and she’s going to cry, you know, but at least you have somehow figured it out. And that process of being curious about what’s going on and why a child is behaving in a particular way is one of the most critical elements of parenting as far as I’m concerned.
Dr. Slade: [14:49] And I think many of us concerned, you know, to be attuned and curious and interested in what’s going on in your child now. Then the question, the second part of that question was what do you do when they just won’t stop crying? And the reality is that’s life. I mean there are situations where, you know, remember crying is a signal. Crying is a communication. Crying means something and sometimes it means my stomach is so upset or my tooth hurts so much, or I hate this environment so much that I’m just not going to stop crying until we’re out of this environment. Or I’ve got my binkie or whatever. And I don’t think it’s good for children to be relentlessly unhappy, of course. But every child and real life has times when they can’t be soothed. And that’s just, if you’re fortunate enough to have a baby who’s incredibly easily soothed, you know, God bless you.
Dr. Slade: [15:45] But the reality is that most children have really significant distress at some point or other, and you do the best you can and then what you said I think is exactly right. I’m here for you. I’m sorry I can’t fix it. We’ll just weather it out together. You know? Imagine for example, if a child is seasick when you’re on a boat, well there’s nothing you can do. And I think that’s a very common experience for all of us as parents and this people is there sometimes situations that you just have to weather it and for them to feel you’re right there with them, it’s the best thing you can do.
Jen: [16:18] Yeah. Okay. That makes a lot of sense. Thank you. So we’ve alluded to this a little bit in that things change over time. Your infant isn’t always going to be an infant and they gain cognitive skills like understanding how Mama exists even when she isn’t there. I remember that was a fun one for us to learn and you know, babies develop a better sense of time and they eventually become less fearful. So I’m curious about the kinds of milestones we should typically see and at what ages they often occur.
Dr. Slade: [16:46] Well what really happened is between probably a year and a half and two and a half and the timing of it depends on so many different factors. You know, the child’s biology children are different from one another and their biologies are different from one another and some kids are incredibly calm and some kids are incredibly what call “active” or you know, sort of temperamentally distressed. And so that is an ongoing factor sort of in how kids move through development. You know, some kids it’s sort of an easy shift from one developmental stage to another and some it’s a little bit more rugged but between 18 months and probably around 30 months. Children do develop the cognitive capacity to really have internalized the caregivers so that they can tolerate a lot longer time being separated from them. They can summon up, if you will, the caregiver to soothe themselves.
Dr. Slade: [17:41] You know, a lot of times you see two year olds when Mommy’s out of the room, they’ll go over to mom’s shoes or her bag or something that’s there that they’ll find comforting. And so I think that there are a variety of ways as kids are between one and a half and two and a half that they don’t actually need mommy mommy as desperately. Although certainly when they’re distressed they do, but they can begin to build up an internal sense of her so they can, you know, move away. They can tolerate longer times away from her. They can really start to be interested in the world away from mom, which of course kids actually are pretty early but they’re freer in a certain sense. And if you look at toddlers, you know what, about 10 or 11 months when they move away from mom or dad, that it’s almost as if there’s a kind of an invisible rubber band and they get to a certain point and they’re like, oh, okay, got to go back.
Dr. Slade: [18:27] I’ll go back to go back. But as they get more like two, two and a half, it’s like, well she’s or he is with me and I and I don’t need to kind of be as vigilant to where they literally are. And by the time, you know, obviously kids are three or four. They can tolerate much longer periods of separation, you know, develop other relationships, you know, really much more fully. And by the time a child is between one and a half and two and a half, they can start signaling their attachment needs through language and they do need you now. I want you come here, they’re much more able to initiate things within their relationship and in a sense they have more power, you know, you still feel pretty powerless at two and a half. Put more capacity to kind of let the world know what’s going on with you.
Dr. Slade: [19:12] And I just want to say something about fear. I guess I want to say a couple things about fear. One is that fear is a naturally occurring part of daily life and it’s a naturally occurring element of relationships. And ideally, you know, you stub your toe, you trip on a stair, there’s a loud noise in the street, any of those things will activate the child’s attachment system and they’ll be like, uh, you know, where are you? And the child’s experience should be. When I had that feeling of my stress hormones just got activated. I want to have that feeling that mom is there and when I’m a young child, I need her literally there and maybe when I’m a little bit older I can do it for myself, but you want to have the child not ever be in a chronic state of fear or a chronic state of stressful arousal and that is such an important component, both of secure attachment.
Dr. Slade: [20:02] It’s also a critical component of just feeling comfortable in your own skin and being able to sort of attend to your life tasks because you’re not in a state of fear. The other thing alongside that is I think that the most, from an attatchement perspective, the most problematic emotion, whether there are several but a really problematic emotion within the parent child relationship is fear. We all get angry at our kids. We all lose our tempers. We all at times frighten our children whether we mean to or not, but the critical thing is that not be chronic and it not be constant and when the child is frightened by the parent that it’s repaired. Sorry, I lost my temper. I’m sorry I blew up at you or I’m sorry I didn’t come right away because I was banging pots around in the kitchen, but just to be able to repair moments when the child has been afraid of something that’s gone on with the parents.
Jen: [20:50] Yeah, that makes a lot of sense. In the light of other episodes we’ve done on similar topics about modeling and emotion regulation and the idea that if you are really angry about something, if you just kind of grit your teeth and smile and say, “I’m not angry, darling, that you broke my precious, whatever it was,” then the child learns that you can’t really be trusted to accurately state what your emotions are and they need to be second guessing you. Whereas if you. Obviously it’s best not to scream at your kid. If you can help it, but if you can express that anger and take a breath and say, okay, I’m sorry that that happened. I’m sorry. If it scared you, then that actually is a much more powerful learning process for the child than if you just kind of hold it inside and don’t express your emotions. Is that right?
Dr. Slade: [21:36] Absolutely. And another component of that is you want the child to learn that whatever I feel is okay, if I’m angry, it’s frightened, it’s okay. But so many times you see in parent child relationships, all things get communicated subtly. Like it’s not okay when you get angry and I turned away from you and I’m not interested and I won’t, you know, but when a parent says “Oh no, my vase!” you know, and then, oh, it’s okay. It’s okay. I just was upset. Yeah. Of that Bob. Then at least the child learns that, okay, mom can be angry, mom can recover, mom can apologize, and it’s okay for me to get angry and recover and apologize.
Jen: [22:15] Yeah, for sure. Okay, so, so that’s the emotions from the parent’s side and I’m thinking about what suggestions you might have for those of us who sometimes find it hard to engage in. I think what is called reflective functioning to understand the emotions from the child’s side, so when a child is. I mean sometimes it seems like they’re deliberately being awkward or they’re having a tantrum about some tiny thing that you think really isn’t that important and there’s a woman named Kate Russell, whom whose work I really enjoy. She writes the blog, peaceful parents, confident kids and she says to herself, “my daughter isn’t giving me a hard time.” She’s having a hard time and so whenever we’re in Tantra mode over here, I try and repeat that to myself because it takes some of the focus off me and how frustrated I feel in that stressful moment and it reminds me to go back and look for that underlying source of the difficult behavior. Maybe isn’t the tiny thing that triggered it. Maybe there’s some bigger issue underneath that I need to deal with. Are there other tools like this that you think could be really helpful to parents?
Dr. Slade: [23:14] Well, I mean I think there are sort of two core elements of being, what we call it reflective functioning, which is a very user-unfriendly term. It’s an awareness first of yourself. I’m getting really upset here. I’m over the top. I’m really having a hard time. I don’t like it when she cries, you know, just to be aware of what’s going on in you. Reflective capacities are both and awareness of what’s going on in you and an effort to understand or make sense of what’s going on in the other person, which in this case we’re talking about a child and what happens – this is like sort of a mantra of the reflective functioning literature is that you can’t reflect when you’re upset and you know what happens most typically in interactions that are kind of falling apart, is the parent gets really upset and then that triggers the child who feels misunderstood and unheard and like you’re not even getting it.
Dr. Slade: [24:10] And then the child gets more controlling and more difficult than they start arching their back and throwing a tantrum and then the parent gets more upset in an interaction like that. I hate to say it, but parents are the grown ups to be able to, as you said, well maybe it’s not that she’s wearing her red sneakers today. Maybe it’s something that happened at school. And maybe this isn’t about my being a bad parent though. I’m feeling like a bad parent right now. It’s just so ironic that at a time when we need our reflective capacities, most namely when we’re upset is when they’re at least accessible to us. It’s like when you try to solve a problem, when you’re desperately anxious or desperately angry, It’s really hard. And so I think if you’re really having a hard time as a parent managing a situation with a child, like a Tantrum, you know, to sort of step back a little and say, okay, let me see if I can calm down. Let me see if I can get myself under control and understand why I’m so upset. And then maybe I’ll be able to be a little bit more open to her in that moment. And I think that quote you use is really great. She’s not giving me a hard time. She’s having a hard time. That means something most likely within her. Now of course there are times the children are trying to provoke you.
Dr. Slade: [25:43] Right, exactly. And there’s a great quote that I read probably 40 years ago now about an eight year old who says to his therapist, well, how would you feel if you were half the size of everybody else and you didn’t have a dime to your name. It’s a two year old or a four year old. You know, I, I can’t make anything happen. And all I can really do now is lie down on the floor. And again, it’s the hardest time to be calm and to slow things down and you know, you’re probably trying to get out the door, you’re trying to get to an appointment or get her shoes on or whatever. And that’s when she’s melting down. And so you don’t get her shoes on right away. I mean, I’m sure you know this intuitively.
Jen: [26:26] Take the shoes with you. Yeah, I’ve learned that for sure. So I want to get back to something you said earlier about fear and I think it’s important to acknowledge that families who are living in poverty and in difficult circumstances, the living conditions where fear might be a response that their children feel more often than we would like. And so I don’t want to necessarily spend a lot of time on that, but just kind of acknowledge that it’s out there. But a lot of us are relatively lucky enough that that is not such a dominant force in our world, but separation can be a really big source of fear among children. And it also really impacts parents, I think. And I was fascinated to read the John Bowlby, who’s really sort of the grandfather of attachment theory,
Jen: [27:16] Then I was giving him an extra generation of credit, but he basically wrote an entire book around separation and he based these observations on children who were separated from their parents during really long hospital stays around the time of the Second World War.
Dr. Slade: [27:32] And we’re sort of lucky that we don’t have parents who can’t see their kids for a couple of weeks at a time for, you know, by and large on a regular basis now. But one one time when parents really do experience this is at daycare drop off. And so I think parents can feel really bad when their kid is crying and desperately clinging to the parent. And the daycare workers always say, just rip off the BAND-AID and they’re going to be fine five minutes after you walk out the door because they always are. And so what do we do in these kinds of circumstances? We can be sort of reasonably sure that there is a fear response. There is a stress response involved in this process, but we have no maternity leave policies. We have to put our kids in daycare if we want to be able to work. What do you think about this?
Dr. Slade: [28:19] I’m going to reconstruct it a little bit. I’m going to start with your question about stressful environments. Okay. And just to briefly say that there are really two different overlapping perspectives on this that are incredibly important, which is the toxic stress hypotheses were literature and the trauma literature and they both make the point in different ways using different languages that when a child stress system is chronically elevated, it affects their metabolism. It affects their growth, it affects their cognitive development, it affects their emotional development, it affects their peer relationships, it affects their susceptibility to illness, it affects their inflammatory markers. It affects them profoundly. And the reason that this particular group of people at the Center for the Developing Child at Harvard led by Jack Shonkoff has called this toxic stress is because so many kids live in environments of stress that are literally toxic to every element of their development, their physical development, their health, et cetera.
Dr. Slade: [29:22] And the same is true, I mean toxic stress and encompasses, you know, community violence, racism, extreme poverty, food insufficiency, homelessness, all of these things that, if you can imagine suddenly your home was gone. And now the other perspective that I mentioned is the trauma perspective, which is kids who endure physical abuse or sexual abuse or major household dysfunction, parental mental illness, all of these things, those shoe have a powerful effect on the child’s biology, their psychology, their cognition, all of these things. And that’s just something to really acknowledge. And, and it’s something that really affects children. Living in poverty really affects children living in violent communities and with the government that fundamentally in many ways doesn’t attend to them. You know, they’re really neglected by society. So that’s one response. You know, the next response was about separation and I couldn’t help but think about all that we’re reading today about children separated at the border and the tremendous move on the part of developmentalists in the US, you know, really across the country to make the case that this is enormously destructive for children and for their development.
Dr. Slade: [30:37] There was a case just the other day in the newspaper about a child who had been separated at the border and he was reunited with his mother 50 days later or something and he’s showing massive signs of PTSD, you know, we won’t come out of the room. Any loud noises startle him and he’s not learning as well. He’s not eating as well. He’s not sleeping as well. Separation of that kind. And you think about Bowlby did so much work as did Anna Freud during the war and studying the impact of separation of children from their families. And you know, when you have, for instance, during the war, many children in England were sent off with siblings so that they had siblings with them to say, yes, your name is Nancy. Yes, we lived in London, we went to Priory Road Preschool together and I know who you are as opposed to kids who got sent away like at the border.
Dr. Slade: [31:26] Now they barely know their names. They don’t know how to reach their parents. I mean it’s just unthinkable. So that brings us to the, what do we call that, a high class problem, and there are really two questions in that and one is what to do when your child is distressed at separation from daycare. And the other question I think you were implicitly asking is does it have a long-term impact on children’s attachment to be in daycare? Very young. And the answer to the first one is I think it’s very important to evaluate when your child is having difficulty with separation. What the cause of that is. There are children for whom you really, really have to go slowly and titrate the separations over days and weeks to get them to really be able to tolerate the distress of your leaving. There are kids who have a big distress reaction and indeed they are fine after the parent leaves is important to say, well what’s happening with this child and what does it mean for this child and is my child really going to be okay?
Dr. Slade: [32:34] Or when I pick them up at daycare, are they still distressed or are they super clingy more than they scream and cry on Monday morning, you know, when it’s time to go back to daycare and that would indicate to me, really that there’s something more going on and it may be that the child is not quite ready for that level of daycare. It may mean that the child needs a place where there’s a little more one on one. It may need some may know they’re going to do better with a babysitter for awhile, but most kids over a period of a couple of weeks will transition into a new situation and do pretty well. But the thing from my perspective, and certainly this would be an attachment perspective, is it’s really the individual child and their adaptation obviously would also say that there are plenty of parents who are very gratified by their child’s being distressed at separation, but that they would say that or not is another question, but I”‘m going to leave now. Okay? Okay. You sure you’re okay? ”
Dr. Slade: [33:34] And that’s one reason the daycare workers say “Out” is because they want to interrupt that and sometimes that’s, you know, most times the right advice, but a parent also knows the child better than anybody else. Again, it goes back to this whole question of attachment. When the attachment system is activated and the attachment system being activated means I need you, I’m clinging to you, I’m crying for you, I’m holding you. I’m asking for you. When it’s activated, you need to ask yourself, is this a transient fear response that she separates every day and today she’s just having a hard time? Or is this really a fear response? In which case, let’s get to the bottom of it. Do you see what I’m saying?
Jen: [34:13] Yeah, I do. And I think you’ve offered some really practical information that parents can use in terms of understanding the difference between the two. Is this something that really does pass in five minutes or is it something that the daycare workers are potentially concerned or if they’re not going to tell you that it really concerned, are you still noticing it when you do pick up, do you notice it on your way to school or is it really just in that couple of minutes when it’s clear that you’re walking out the door?
Dr. Slade: [34:40] Right. And that’s again a normal biological reaction like, “oh, you’re leaving me? No!” But, if the child is actually really adapting really well to school, you would hope that most daycares would be honest with parents and saying he really is crying for half an hour, an hour after the where he’s just standing at the door begging for you. And then a parent really does need to think about, well why is he having so much trouble? And you know, in my experience, you know, my clinical experience over 40 years is that there are usually reasons when children really are having trouble separating that really needs to be addressed. Yeah.
Jen: [35:16] Okay. That’s super helpful. Thank you. And so there was another part of the question that we alluded to about whether it is harmful for children to be in daycare. I wonder if we could adjust to address that briefly.
Dr. Slade: [35:28] That is such a charged question and it has so many political and economic and class elements to it. As I said earlier, children are really resilient and adaptive. Otherwise our race would not have survived for so many millions of years. And the reality is that many mothers, particularly mothers who are poor or who are living in difficult circumstances and can’t get by without their salary and many mothers who choose to work and are ready to go back to work or who have zero maternity leave, as you said, three weeks, four weeks, which I would consider zero maternity leave, are in the position of putting their children in care. And there’s certainly evidence that the degree to which you can keep the hours of care less than the first year of life, the better. And I don’t mean like minimal, I just mean 40 or 50 hours of care is really a lot per child under one or two.
Dr. Slade: [36:29] That’s really a lot. But that’s what children, many children live with. In which case good care is really important. And that’s another thing that many mothers can’t control. And if you go to cultures that are so much more supportive of parents, like just one, I’m somewhat familiar with the Danish culture. They give parents both parents extended maternity and paternity leave and they have quality day care and there are plenty of countries that have much more high quality daycare than we do here in the United States. And it’s almost as if. And sometimes I think it’s almost a collusion between sort of a political structure that doesn’t want to acknowledge the needs of parents or children and they want to say, well this is fine and we don’t need to address this any further than we have. And then you have parents who need to work, who want to work, who in a sense, can’t bear to think that it could be in fact complicated.
Dr. Slade: [37:34] For some kids it’s fine. For some kids it’s too much. And for some kids being in daycare full time at six, well for any kids, being in daycare at six weeks is a big adaptation. You know, if they have the same person taking care of them all day, that’s better because they have attachment systems and they will get attached. None of the same level, but they will get attached to the people in the daycare or the creche or the home daycare that they’re in. But I think parents in the sense it’s very hard for parents to grapple with how hard this is for kids because they feel correctly that they don’t have any choice and they have no kind of societal support for other options
Dr. Slade: [38:17] There’s a wonderful book by a man named Stanley Greenspan, who was one of the giants of the infant mental health movement, who wrote a book called The Three Fourths Solution, and he suggested that if both parents worked three quarter time, the child would have one parent them all the time. Now, of course that’s a class solution, but it’s a very complex issue in one I think we don’t begin to give adequate attention to and I do think that children feel the wrench when they’re – I mean, we know from infant research that when you separate a parent, a child from his or her parents, that their heart rate changes, there are blood pressure changes. The body immediately goes, Whoa, this is different and that can be okay, but you don’t want them to go, whoa, this is different and who are you and I don’t like you multiple times.
Dr. Slade: [39:06] …and I’m stuck with you for the next eight hours for five days a week. Yeah, that makes a lot of sense. Well, we can’t solve this issue right now, I’m afraid, but thank you for being willing to give it a go. So the reason I wanted to leave some time is because we have a bit of an elephant in the room here and that is the attachment parenting elephant and I want to make sure to address this because I think a lot of parents may not realize that the Attachment Parenting that was developed and promoted by William and Martha Sears and others is actually a very different thing from the attachment theory that you’ve been talking about and Martha Sears actually acknowledged that Attachment Parenting is not based on attachment theory. I found a quote from her that said “we needed a positive name, so we came up with attachment parenting since the attachment theory literature was so well researched and documented by John Bowlby and others” and so I want to acknowledge but sort of set aside some of the more outlandish claims that these people have made about attachment parenting where they kind of say studies have shown that and then they say Attachment Parenting babies are smarter, healthier; they grow better, they behave better. And so I don’t necessarily want you to comment on attachment parenting itself because I know that scientists can be uncomfortable about talking about other scientists research, but I thought maybe we could look at some of the main ideas and just discuss the extent to which these are supported by the research. Is that okay?
Dr. Slade: [40:28] Yes, but I just want to pick up on a point that you made which is that I think actually that that attachment parenting, which as I understand it really makes the point that the mother and child should be separated as little as possible certainly for a fair amount of time, is actually really very, very different from attachment theory and one of the things that’s happened is the use of attachment and Attachment Parenting has given attachment theory a bad name because in fact attachment theory very much promotes closeness, but it also promotes exploration and autonomy and all of those things that are so incredibly important to development and the mother-child relationship is not the only place where the child is alive and feels safe and so on. It. It’s a very skewed use of the term attachment.
Dr. Slade: [41:17] Yeah, and I guess to pick up on that idea first then I think baby wearing is something that is commonly practiced by Attachment Parenting proponents and I think the series is a right, when they say, and I quote, carried babies first lesson, spend more time in a state of quiet alertness that behavioral state in which babies learn most about their environment and their nicest to be around, but that idea of carrying babies seems to have been really borrowed from other cultures where people use an almost continuous skin to skin contact, but they have a goal of raising a really compliant baby who will be a respectful, tolerant and an obedient child and there are also lots of other people around to help carry the babies now. Just the mother doing it all the time. So that seems to be because they’re taking an idea from another culture that has such different goals for rearing children than in North America. It just seems to me as though those can’t fit together with our goals for independent children who are, who go out and explore and come back to the safe space of the parents.
Dr. Slade: [42:17] Well, I mean, I think that when you look at it, when you look at it culturally, you know, as you say, in some cultures it’s absolutely completely appropriate and in our culture it’s not typical. I mean it’s really not typical in part for the reasons that you’re saying which is they’re not our cultural goals for our children. But there’s something implicit in attachment parenting that the baby needs to be worn a lot of the time in order to derive a sense of safety. And actually, as I said before, then the attachment system is quiet. That is when the baby feels safe. They don’t need to be on the mother. In fact, it’s restricting for them to be on the mother. You know, they’re, they’re supposed to be, you know, learning how to walk and how to crawl and how to move away and had to pick up objects and how to do all the things that they do in the world.
Dr. Slade: [43:04] And the presence of the mother is in fact somewhat inhibiting and unnecessary. And in fact, the whole idea is that if you feel safe and secure and understood, you feel ready to go out and you don’t need to be as it were, worn all the time. And I think baby wearing at certain points in development in early infancy is very appropriate and people have been doing it for a long time. You know, when you go to the, what do they call them, “snugglies,” but that’s very different from wearing the baby against your skin for a long, long time, which if you will, the job of the child is determined from the parent to the outside world to become observant in the outside world. And this is really interfering with that process.
Jen: [43:49] Interesting. And so another of the main principles is birth bonding. And this was one that was particularly important to me because I had. I was really worried about this. I didn’t have great role models and hadn’t been around children a lot. And so I was worried about this bonding process. And so I was fascinated to read a statement in a paper when I was researching this that said “attachment is not bonding. Bonding was a concept developed by two researchers named Klaus and Canal who implied that parent child bonding, dependent on skin to skin contact during an early critical period is concept of bonding, was proven to be erroneous and have nothing to do with attachment.” It’s really rare to find research is the will come out and just state something as non-circumspectly is that so is this bonding at birth still a concept that sort of separate from attachment that’s still important or is that period after birth really not unique and and mothers and child’s relationship?
New Speaker: [44:39] Well, I don’t have as much trouble with the concept of bonding, but maybe that’s because I’ve just incorporated that into my understanding of attachment. I do think that every time ever all of early infancy is quite important. I think in the formation of the child, but again, they’re enormously robust. I do think that something very important happens in the days and weeks after birth when the mother and child’s particularly, you know, because the child is most contact with the mother at that point and all the mothers hormones and everything or just sort of ready for their baby ready and the baby’s hormones or mommy ready and their brains are attuning to each other and getting in synchrony with each other and their hormones are getting in synchrony with each other and it’s not dependent only by any means on skin-to-skin contact and you know, obviously there are creative nurses have for generations figured out ways for a mother who has a C-Section or has had a really difficult labor to be in contact with her baby, but not necessarily holding the baby against her because it’s too painful for the mother.
Dr. Slade: [45:45] There are, again, to go back to this idea of attachment is a robust system. There are many ways that mothers and babies can feel close to each other and connected and the baby can start to feel “this is my person” and the mother can start to feel “this is my baby.” And that doesn’t, you know, that’s not, you have to do x, y, and nothing else will work. I mean, that is really not helpful at all. But you do want that to happen, you know, for instance, if a mother is really severely depressed, um, and develop some postpartum depression around the time of the baby’s birth, that’s going to complicate that process of early attaching. TNow does it scar the child for life. No, because presumably the mother’s going to get better. The child’s going to be nurtured and loved by other people in his environment until mom is there for him.
Dr. Slade: [46:35] But the idea that you have to have skin to skin contact and only that will work I think is not helpful. But to really appreciate that. I hate to sound corny about it, but the love covers a lot of biological processes, a lot of psychological processes that takes place. And there are plenty of parents who say, I didn’t feel anything at first. And that’s again, that parent is going to have to work a little harder to feel connected and they may be triggering some old issues for them. And again, we’re talking about a robust system, you know, the child can wait, mom will come around and the child is ready, and then there are some children certainly who are not responsive, they’re kind of flat, they’re kind of disinterested, you can’t engage them easily. And in that case mom has to work a little bit harder to engage the baby. But the point is that it’s not bonding per se, it’s all of the attachment processes that start from the very beginning. And that brings up the whole question of breastfeeding.
Dr. Slade: [47:52] And it is also an ideal, wonderful way to connect with the baby often face to face, you know, you’re often have skin to skin contact, you know, there’s a lot of warmth, there’s a lot of soothing, there’s a lot of exploration of the mom’s body that goes on by the baby. However, I don’t know what the percentage is, but as some percentage of mothers are unable to breastfeed and it can have skin to skin contact, they can have face to face contact that can have warm communication using formula. I mean in so many mothers, and I’m sure this is true of many of your listeners are so hard on themselves when they can’t nurse, you know, and there are all kinds of resources out there to help them, you know, La Leche and other breastfeeding advocates who work so hard to make it happen, but sometimes it just doesn’t. And that’s the way it is. I mean, and again, the baby is adaptive. They’ll find other ways. There’s a whole generations of people who were born in the forties and fifties who’s parents were discouraged from breastfeeding because it was thought to be less good than formula.
Jen: [48:52] Yeah. And, and listener emailed me and I think she said she had twins and was not able to produce enough milk and so is formula feeding and whereas worried that this might somehow have impacted the attachment that she has with her child. And of course you could never know for sure, but it seems as though the, what the evidence is saying that there are so many other ways to promote this attachment relationship that if she’s responding sensitively to her child’s needs, that is absolutely possible and of course has happened many, many times in the last 50 years since formula was invented that this attachment relationship has occurred in the absence of breastfeeding.
Dr. Slade: [49:29] Attachment isn’t remember as an emotional. I mean it’s also biological process, but it’s an emotional process now and it’s not dependent on breastfeeding or total skin to skin contact at birth. It’s a much larger set of processes than that. And a parent can provide a wonderful loving experience for a child without breastfeeding. Absolutely.
Jen: [49:53] Yeah. And so I guess just to take that one step further, is it right to say that things like skin to skin contact at birth and breastfeeding and some of the other Attachment Parenting ideas, each one by itself could potentially help to build that attachment relationship even though none of them are critical and you could even miss out on one, two, maybe three of them and still have a secure attachment with your child?
Dr. Slade: [50:15] Absolutely. And I think the other thing is that my understanding of Attachment Parenting is that in general, all these things go on for way, way, way longer. For instance, breastfeeding, babywearing, etc, go on for much, much longer than they would, let’s say otherwise in our culture, you know, usually a baby is, is weaned sometime between one and two. Some mothers wean much earlier, but it doesn’t typically go on past too. And my understanding is that an attachment parenting, both babywearing and breastfeeding are encouraged for a lot longer. So it’s taking the things that are in fact really good components of a good relationship, you know, being close and attentive and, and takes them to an extreme that disrupts other developmental processes that from an attachment perspective are equally important.
Dr. Slade: [51:11] Yeah. Exploration and I mean there’s a whole bunch of research that is very old now, but it really, it talks about, for instance, a child crawls toward a frightening stimulus and they and they don’t realize it’s going to be scary and then they get there, but they’re crawling and they look back at mom and they look at mom and they say, should I be scared or not? That’s a critical learning process, right? And the mother and they can manipulate this experimentally. Some others give a face like, oh no, don’t go there and the child will not go, but learning can’t take place unless the child is at a distance from the mother looking forward and then looking back and that whole process can be disrupted and even baby wearing doesn’t allow the child to have true reciprocal face to face contact where the baby is holding him or her self up upright and trying to stand and looking at the mom and all those things that you know, build their muscles and build reciprocity between two people. I’m saying that many of the techniques that are described that you’ve described like baby wearing and so on are taken to an extreme.
Jen: [52:16] Okay. Well thanks for being willing to help us think through that. So as we draw to a close here, I guess what I would like to leave listeners with, I think is an idea of confidence that if you do try to respond sensitively to your child’s needs, that chances are you’re going to develop a strong attachment relationship that really benefits your child and that it’s not something we should necessarily worry about: “Did I do this? Did I do that? Did I handle this situation exactly right?”
Dr. Slade: [52:45] Exactly. I mean, I think that you have to remember that it’s a very robust system that it works wonderfully, has worked wonderfully for millions of years and that the most important thing is love and comfort and connection and feeling close and being able to explore freely. And I think that from a parent’s perspective, if they feel like they’re having difficulty with any of this not feeling connected to the baby or they’re really noticing that the baby or the young child is anxious or having a hard time, you know, they can think about why that might be in and see if anybody else sees it that way. But in general, you know, you need to think that almost three quarters of babies within low risk cultures, you know, develop wonderful attachment relationships. And also the other thing is it doesn’t have to be perfect. There’s no such thing as a perfect attachment relationship. We all make mistakes and we all get ourselves in trouble as parents and we should just try to repair right? And on that positive note, thank you so much for taking the time to think through this with us. I’m so grateful. You’re so welcome. My pleasure. Thanks very much for the opportunity. I appreciate it. And so listeners can find all the references that we mentioned today and I drew on when researching this episode at YourParentingMojo.com/Attachment.
Also published on Medium.