Bonding/attachment
Sheena L Carter (scart01@emory.edu)
Sat, 23 Mar 1996 13:05:48 -0500 (EST)
The difficulty so many of you describe in "bonding" with your babies is a
well-known phenomena common with prematurely born infants. There has
been quite a bit of research on the topic. I will try to briefly summarize:
The process of attachment begins early in pregnancy and develops in a
fairly predictable pattern through many stages. The early "bonding" at
birth has been given a lot of attention in the nursing literature and is
considered an important step in the process of developing a secure
attachment relationship with a primary caregiver. Secure or insecure
attachment in most easily assessed around 1 year of age as the child's
separation anxiety is usually peaking and they can be observed to use
their parent(s) as a secure base for exploration. "Goal-corrected
attachment" at around 3 years of age is thought of as the point at which
a child is usually able to realize the security of the relationship and
can usually demonstrate this with comfortable separations. The
relationship with each parent, of course, continues to develop, but these
first (roughly) three years are widely believed to form the basis of all
further human relationships.
Initial "bonding" is an important event in the attachment process,
particularly for the mother. It is not, however, necessary nor
sufficient for development of a secure attachment. (Witness the many
successful adoptive relationships formed with parents and children who do
not meet until far beyond any critical period for bonding.) Premature
delivery, along with a number of other perinatal complications, can
greatly interfere with bonding and disrupt the usual process. There are
other routes to the same end, however, and many families work through the
missed bonding experience on their own.
This is only one of the many "risk factors" for problems with
socio-emotional development in the preterm infant. The issues are rather
complex, and unfortunately, not generally at the forefront during those
early months when so much concern must be directed toward dealing with
significant health issues. This has presented a serious challenge for me
in my work with families as I struggle with how and when to address
psychological issues which appear to be interfering with the development
of healthy relationships.
Bottom line: It is a very real issue. Most people eventually work
through it, but often with great difficulty. Additional risk factors
include your own mental and physical condition at the time of delivery,
post-partum depression, your family history, your child's neonatal and
current physical health, and even personality or temperament issues. No
no should feel guilty if they have more trouble with this (nor superior
if they had none!) as most of the risk factors are totally beyond your
control. You do have a lot of power to improve the relationship,
however, if you can gain a better understanding of what is causing you to
feel as you do. If you are worried that you and your child are not
developing the kind of relationship you had hoped for, do not hesitate to
seek a consultation, preferably from a mental health professional who
specializes in parent-infant interaction or infant mental health. A
little understanding can go a long way. (I would expect that just sharing
your experiences on-line will also be of great benefit.)
Sheena