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Fostering Healthy Attachment

Dr. Walant, tell us about your new book.

Creating the Capacity for Attachment looks at how we, as a society, have raised our children with the expectation that they become totally self-reliant and autonomous rather than with the hope that they have the capacity to form close, loving, intimate relationships with others. As a result of our social insistence upon self-reliance, we have witnessed an epidemic of addictions and what I call "the alienated self," meaning people who are disconnected from their internal thoughts and feelings - their inner selves - and are unable to form true intimacy with others. Addiction exemplifies how, by not allowing ourselves to deeply connect to other people, we have attached only to the other things. For example, a pacifier is often one of a child's first attachments. It is plastic - and not the same as having mother and her breast, to suck and to cuddle with. This unhealthy pattern of reliance on objects is encouraged in the detached parenting styles so common in Western society, and it's easy to see how, from this tendency, as adults we continue to seek comfort in other non-human objects, such as drugs, food, money, etc.

Very early on, children are generally taught not to disclose to others when feeling "weak" or scared, "needy" or alone. Many of the emotions we felt in childhood - what people call the "negative" emotions - we were taught not to share. So, we sought comfort from blankets, pacifiers, and teddy bears, and we learned not to seek comfort from our mothers, our fathers, our family. As we got too old for blankets and teddy bears, we turned instead to other comforts - food, alcohol, money, etc. As adults, we struggle with holding our emotions within because we fear that by sharing our inner souls with others, we will - as in childhood - be discounted, dismissed, or denied.

In your book, you discuss the importance of "immersive" moments. When do these moments occur and why are they important?

There are special moments that occur as part of the deepening of intimacy, which I have termed "moments of oneness" - moments when a person feels totally connected and understood by an other. The immersive moment is an intensely spiritual, holy one that occurs when two people can let down their barriers to intimacy and truly experience their inner feelings. This kind of feeling is a transcendent one - meaning that it moves someone, or shifts someone, to feeling more connected to another person.

The immersive moment occurs in feeling a sense of security in being held and comforted by an other - be that a spouse, friend, therapist, nature, or God. This kind of moment is first felt in baby-hood, when mother (we hope) picks up her child when he cries and holds him. She transcends his sense of pain and loneliness by holding and comforting him - something a pacifier just cannot do. It's similar to the feeling we get when we know that we can totally disintegrate into the arms of another person - just totally fall apart. Our baby falls apart in our arms, and we hold him, comfort him, quiet him. He knows that we are there, and that we - mothers, fathers, etc. - will put him back together again. We will find some way to reach into his being and contain what is distressing him so. We will take care of him. But if mothers and fathers do not pick up their crying baby, or hold their sleeping baby, then the experience is quite different. The child learns that he will not be comforted if (and when) he falls apart, and so he learns to hold in, dismiss, and cut-off from his fears and anxieties. If as children we do not get practice in "falling apart" into the arms of an other, then as adults we will also have difficulty achieving this level of intimacy.

It seems when babies fall apart in our arms, they have no concern whatsoever that we figure out what's wrong with them. They trust that we're going to comfort them. But as adults, we are insecure about why we fall apart.

Right. It is our cultural belief that we should be so self-reliant and so self-assured that we shouldn't need anybody else. It seems to me that one of the goals of Western parenting has been to raise children to need no one - to be totally self-sufficient. That is not, in my eyes, the point of parenting or of having children. In fact, I disagree with the widely-held notion that we are born alone, and we die alone, so therefore teach your kids to be alone. None of us are born alone - after all, our mothers are there! And nobody should have to die alone, either, because ideally there are loved ones surrounding us as we leave this world.

What happens when the parent reassigns a different motive to the child's cry and decides not to be responsive?

A child cries for a reason - not to manipulate his mother, not to be mean, or nasty, or to be a "pain in the neck." When, instead of trying to discern what her child needs, a mother simply says - "oh, he's just tired," or "he has to deal with sleeping by himself now" - she has given her baby the idea that expressing his inner self is wrong or bad. A baby is like someone who is quadriplegic. He can't do very much for himself - but that doesn't mean that he isn't thinking and feeling. When the baby cries and his mother responds, the child learns to have trust in the world around him and to have trust in himself. When the baby cries and his mother listens, the two join together in a moment of oneness that transcends the separateness, the aloneness, which the baby knows all too well.

Describe the process that happens from there.

If the child has not been responded to, if he has not been attuned to or empathized with, he begins to feel more and more powerless, alienated, and detached. You know, sometimes the best you can do is simply empathize with your baby - "I know, you are angry because . . ." or "You want to get out of this car seat right away!" Saying something like that is much better than ignoring your child. The less empathy that is developed between parent and child, the less understood the child feels, and from there, the disconnection between the two just grows and grows.

What happens when a child grows into adulthood with repeated patterns of relating like this with his parents?

Many people spend their lives feeling like nobody hears their cries - they feel alone, afraid, and powerless. When children are not responded to, in their earliest and most primary relationships, they learn that their thoughts and feelings are burdensome to others and that their needs are shameful. As adults, these same people often go underground with their feelings and seek comfort in substances. Or, alternately, these same people become so vocal in their neediness that, again, they are met with disdain from others and go on to find comfort, as well, in non-human substances.

This pattern of parenting that you are describing falls under what you call "normative abuse." Can you describe this concept for our readers and talk about what part it plays in the process of detachment?

Society (at least in the Western World) has encouraged a number of parenting practices that I call "normative abuse." "Normative," because these are approaches that are sanctioned by society, therefore enacted without any moral discomfort. By normative, I mean practices which appear normal for our culture. A hundred years ago, for example, severe physical abuse was routine to parenting. The abuse we see today stems from our insistence on separation, self-soothing and detachment at the expense of attachment, intimacy, and connectedness.

Describe these practices that you say fall under the "normative abuse" category.

First of all, normative abuse occurs when we avoid or ignore our parental instincts to be empathic and responsive to our children's needs. For example, parents are taught the best gift they can give their children is to encourage them to self-soothe at one, two, three months of age. Mothers frantically stick a pacifier in their babies' mouths or try to get their child to suck on his thumb, all in a well-meaning effort to wean their child from "needing" mom. In the psychoanalytic literature, for example, one writer even criticizes a mother who "allows" her baby to become "addicted" to her - can you imagine that? A baby should be "addicted" to his real mother, not to a substitute, plastic pacifier or even to his own thumb! Again, normative abuse occurs when the child's needs for attachment and closeness with his parents are sacrificed for the cultural norms that insist on autonomy and individuation. Babies need to be held - as much as possible, as often as possible. Therefore, I consider the over-use of strollers, playpens, and even cribs to be normative abuse.

Is this an all-inclusive statement - are you advocating that parents never use these items?

No, certainly not. As a mother of a 4 1/2-year-old and 17-month-old twins, I know that nothing can be back and white! Certainly, a stroller comes in handy if you must take two babies together, by yourself. But I think that parents automatically put their baby into a stroller, without giving any thought to what is truly best and most natural. As well, parents worry that holding their baby will spoil him, that he will never accept a stroller later if he is held now. That is an unfortunate supposition and one that is not at all true. What a toddler enjoys is not the same as what a newborn baby needs. I sometimes cringe when I look at a newborn baby, lying all by himself, in his expensive, state-of-the-art stroller that his parents bought with such love and devotion. Almost without exception, that baby would prefer to be held, I'm sure. When my twins were infants, we always used slings to carry them wherever we went, and I was able to make sure that I never went out without another adult to help me carry the boys.

We tend to treat babies like they want to be away from us - "Don't you want this toy?" or "Don't you want to be in this his neat bouncy seat?" - when what they really want is to be in our arms or on our lap.

That's right. Don't forget, we ourselves were parented in a detached manner, with normative abuse as well. So often, despite what we may intellectually know is best, we may still worry when our young children demand a closeness we never experienced in our own childhood. Despite what we know, we worry that he is "too clingy, too needy," and we become afraid that he will never want to become more independent. So, in spite of ourselves, we may push our children away, giving subtle messages that our children should learn to be independent of us. This is a Western worry - in other cultures, children are raised with the expectation that they will always remain near their parents, building a close-knit community rooted in the extended family.

It seems that we've lost the sense of family connectedness in our society that should sustain us throughout our lives.

Yes. In our world, a family that "still" has a 20-year-old living at home, for example, is considered suspect. "What went wrong?" people wonder. "Why is that young adult still at home?"

What are some other practices that fall under the term normative abuse?

The concept of normative abuse implies that intimacy and connectedness are devalued and replaced with social expectations of a self-sufficiency way beyond the baby and young child's ability. When we are not empathic to our children, we create a rift or a separation inside this loving relationship. For example, using nicknames that are in reality hurtful or mean, creates a barrier inside the relationship. Jokingly calling your child a "stinker," or "troublemaker," or "rebel," can have long-lasting effects on your child's self-perception. I knew a mother, who, for example, continually labeled her 3-year-old daughter's opposition behavior "ugly."

What challenges do parents face (in their own parenting) when they grew up in situations that were laden with "normative abuse" practices?

Well, the likelihood is that we will repeat, in some form or another, that which was done to us. Parenting is constant interaction, meaning we are always being challenged by our children in the moment. I like to hope that, at our best, we can parent in an introspective way. By that I mean, that we continue an ongoing conscious dialogue within ourselves, with our spouses, and with others so as to question and process how we are handling the everyday moments with our children. We need to "check in" with others who are also taking a more empathic approach to parenting, so as to make sure that our actions are intersecting with our intellect. For example, one mother I know needed ongoing reassurance after the birth of her young daughter, that her 4-year-old's wish to return to nursing was not "wrong" and that it did not indicate that her preschooler would always insist on being "babied" again. This is uncharted territory for most of us, and it helps to have others - like AA has sponsors - to guide us along the way. That's one of the wonderful aspects of magazines like The Nurturing Parent. People can feel reassured as they parent in a more attached way and can ask for help and guidance in navigating the waters of empathic parenting.

Another aspect of "doing unto our children what was done to us" is that we may, by attempting to become the opposite of our parents, still stimulate some of the same dynamics with our children. For example, some parents have the tendency to "overattach." By that I mean that they do not allow enough separateness inside the connectedness of their relationship with their children. In so doing, these parents are not attuning to the very important needs of their children to also have "separate time," or even "separate adventures" away from home. What causes this misattunement? In every relationship, we find characteristics in others which resemble our own parents and siblings. We essentially recreate, in our current relationships, the family scenario from which we came. In this, we then respond as we have always responded, feeling the same emotional dynamics that we have always felt, and therefore feeling a stability in our own core self. For example, a mother may have felt particularly traumatized by her own childhood experiences of abandonment. As an adult, she is exquisitely sensitive to feeling that others will leave her. With her own child, then, she may experience what is his healthy separateness, with dismay and fear. She experiences his natural growing independence and individuation as an abandonment of their relationship and then, as she did in her own childhood, she becomes anxious, insecure, and protests what is essentially his right to separateness.

How do we understand healthy attachment?

Healthy attachment allows for separateness as well as connectedness. Freud spoke of an "indissoluble bond," a bond in which we know that "we cannot fall out of this world." In a sense, we have an invisible, life-long umbilical cord which is attached to those we love most dear. And, as in the womb, we are free to move around, somersault, and rotate while still being fed and cared for through the umbilical cord.

Explain healthy separateness.

It varies from child to child, but generally speaking, we need to help our children develop what Winnicott, a British psychoanalyst, called the capacity to be alone. We need to be non-intrusive and respectful of times when our children want to play alone or color alone or to simply be alone. We don't need to force alone time on our children by shutting them away from us, but rather we can help them create the capacity for self-enjoyment by giving them time to entertain themselves while we are unobtrusively nearby. Even a baby has this experience, while being held on his mother's lap or snuggling inside a baby wrap. It's really a misnomer to think that a baby must be put down in order to experience his own separate body and mind. Even while being held, he is having his own thoughts, feelings, and sensations. Research has shown that, for example, a 3-month-old pair of conjoined twins already knew the difference between sucking their own thumb and sucking the thumb of their sibling.

Part of our job, as parents, is to help our baby feel comforted in negotiating the feelings that come from his sense of littleness and powerlessness. I often think of myself as a "human pacifier" because I can provide immersive moments through comfort, nurturance, and soothing to my children when they ask for, and need, my help.

After addressing the disease of detachment in the first half of Creating the Capacity for Attachment, you present breakthrough ideas concerning an approach to psychotherapy that facilitate the healing process for persons suffering it. Why did you choose to focus on this?

Psychotherapy is a wonderful place for people to discover the joy of intimacy through putting their thoughts and feelings into words. But all too often, psychotherapists have fallen short of encouraging the attachment process - of encouraging just what it takes to heal someone from their wounds of detachment. The 12-Step programs, such as Alcoholics Anonymous, have done a much better job of helping people re-attach to the loving bonds of humanity than, traditionally, has psychotherapy. These programs teach people how to redirect their very normal need for love and attachment to other members of the group, rather than to continue seeking comfort from substances. A therapist can, similarly, be someone who is willing to help create the kind of attachment, love and security that was missing in his or her patient's childhood. I believe this element has been left out of psychotherapy for too long. The level of intimacy that the therapist encourages inside the setting of the psychotherapy process can be very powerful and healing.

In your book, you discuss how you enable immersive moments to be part of the psychotherapy process in your practice. Can you describe this process?

I look at psychotherapy as a process of immersion, of always deepening my knowledge and understanding of the person I am sitting with. As he puts all his feelings and thoughts into words, he feels relief in being understood, in releasing himself from his inner demons, and he relaxes in our developing relationship. In this empathic process, there is usually a deepening of affection and trust. The development of a secure base, a secure attachment between us, is crucial to the process. Therefore, as with a baby or young child, I believe that as the therapist, I must be accessible, even between sessions. This is usually of great comfort to people, who are used to detachment and distance in most of their other relationships.

In your book, you comment that you've often been questioned about making yourself so accessible to your patients because it might create an unhealthy dependency, which might even mean that your clients would be calling you all of the time, not allowing you the space that you need.

It doesn't happen that way. Just knowing that I'm accessible is what seems to have been the most important part of my accessibility to my patients. I have provided the protective wall in which they can operate. This is such a direct parallel to the parent-child relationship. Attachment parents have been criticized for the same reasons. But, in truth, the children, like my patients, operate within the protective wall, and they do not form an unhealthy dependency. Instead, they do their own thing and grow to reach their own potential. Just like our children, my patients seem to thrive in the knowledge that I am present for them whenever they have a need.

John Bowlby has said that no matter how adult we are, as grownups we also do our best when we feel there's someone behind us or underneath us who is holding us up. It's as though we are all acrobats, walking on our own tightropes, feeling confident because there is a security net beneath us that we can see and believe in. This security net gives us the courage to continue walking along on our own highwire. This concept is as necessary to psychotherapy as it is in childrearing.

Dr. Karen Walant, author of Creating the Capacity for Attachment: Treating Addictions and the Alienated Self, is a psychotherapist in Connecticut. She has three children.