Personality disorders derive their form from stages that were normal at some earlier phase of life. In normal development, the individual is thought to progress through the oral, anal, phallic and genital stages. If fixations occur, the person “regresses” back down the ladder. Thus, the various disorders of later life repeat phases of a healthy childhood. The diagnostician considers the resolutions and fixations appropriate to each stage in order to decide whether the adult before him or her, suffers from a pregenital, anal-sadistic, narcissistic, borderline, oedipal or neurotic disturbance, opines Prof. Ashoka, in the sixth part of his erudite research, in the weekly column. A Different Truths exclusive.
The distinction between behavioural systems that are limited and those that are ongoing affects the conception of development. As one would expect, current views of human biology and control theory differ greatly from those of psychoanalysis. The traditional model implies that there is one developmental line. Personality disorders derive their form from stages that were normal at some earlier phase of life. In normal development, the individual is thought to progress through the oral, anal, phallic and genital stages. If fixations occur, the person “regresses” back down the ladder. Thus, the various disorders of later life repeat phases of a healthy childhood. The diagnostician considers the resolutions and fixations appropriate to each stage in order to decide whether the adult before him or her, suffers from a pregenital, anal-sadistic, narcissistic, borderline, oedipal or neurotic disturbance.
Bowlby’s model, drawn from control theory and ethology, proposes that at birth, there exists a large array of potential pathways. Development progressively diminishes these alternatives. We should look not for the cause of a fixation but at the restraints that lead an individual to choose one alternative over another. Returning to Tinbergen’s analogy, healthy development resembles the adjustments that a tightrope walker must make continuously in order to maintain his or her balance. Either excessive sensitivity or insensitivity to environmental changes will cause the tightrope walker’s downfall. In human development, sensitivity from birth allows for maximum adaptability to the social environment. This biological perspective, which stresses the cooperative nature of human behaviour, is opposite to and contradicts Freud’s view that avoidance and withdrawal precede approach behaviour. According to Attachment Theory, avoidance and withdrawal are most readily activated when the infant is able to discriminate the familiar from the strange.
Questions about the ontogenesis of mental disorder raise the problem of how to measure attachment. Initially, theorists sought to measure normal or abnormal behaviour by reference to the strength of the attachment between the individual and his or her childhood attachment figures. However, these researchers soon noted that intense attachment did not necessarily indicate a good or harmonious mother-child relationship. Paradoxically, attachment behaviour can be most intense when a mother discourages or threatens her child’s need for proximity. The traditional viewpoint might diagnose such a child as perverse or masochistic. But the child’s stubbornness makes systemic sense if his or her instinctual apparatus is geared toward proximity as the means of survival. The threat of withdrawal would redouble the child’s efforts. Fear stimulates attachment behaviour. A victim will often develop a strong attachment to the person who causes his or her suffering, especially if, as in the case of a young child, there is nowhere else to turn. Loss of an attachment figure is the child’s foremost fear.
Research on attachment shows that the two most important variables in the creation and maintenance of a secure attachment are the sensitivity of a mother’s responsiveness to her baby’s signals and the amount and nature of the interaction between the two. Degrees of security or insecurity provide the yardstick by which we measure a healthy attachment. Consequently, Bowlby (1973) has substituted the term “anxiously attached” for the traditional description of an insecure child as over-dependent. Clinging behaviour, illustrative of anxious attachment, has often been described as jealous, possessive, greedy, immature, over-dependent, or intensely attached. Bowlby’s concept of anxious attachment respects the natural
desire for a close relationship without pejorative connotations.
In addition to a child’s protest and upset over his mother’s departure, researchers now regard various other correlations as indicative of the security of an attachment. Foremost among these are the child’s behaviour upon reunion with the mother, and comparison of his behaviour at home with his or her behaviour in a strange (often experimental) setting. Anxiously attached children often fail to greet their mothers upon return. Furthermore, they are less exploratory than their secure counterparts, not only in a strange situation but also at home in their mothers’ presence. Ainsworth and Bell (1970a) have correlated children’s ambivalence in a strange situation with general ambivalence in the home environment. Ambivalent children tend to resist contact when picked up and to ask to be picked up when they are set down. They do this whether at home or in a strange environment. Logically, one might expect proximity-seeking behaviour to be incompatible with exploration. However, Ainsworth, together with other attachment researchers, have noted that most children do not explore constructively when avoiding contact. Avoidant children tend to move around hyperactively or to alternate uncomfortably between avoiding and seeking contact. In addition, children who resist contact, are often more angry, aggressive and disobedient than children for whom contact is pleasurable.
Bowlby correlates the development of “puzzling phobias” with anxious attachment. When a child is unable to communicate directly his fears about separation, he may try to redirect or displace onto animals or other puzzling objects the anxieties he feels in relation to his parents. He may be furious and terrified that the parent will desert him, but he dares not express such feelings lest by so doing he provokes that which he most fears. Instead, he complains about something else, or he may have temper tantrums that express both rage and fear. Bowlby reinterprets Freud’s case of Little Hans in this light.
(To be continued)
©Prof. Ashoka Jahnavi Prasad
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Ashoka Jahnavi Prasad is a physician /psychiatrist holding doctorates in pharmacology, history and philosophy plus a higher doctorate. He is also a qualified barrister and geneticist. He is a regular columnist in several newspapers, has published over 100 books and has been described by the Cambridge News as the ‘most educationally qualified in the world’.