Attachment
From early infancy, it appears that our ability to regulate emotional states depends upon the experience of feeling that a significant person in our life is simultaneously experiencing a similar state of mind.
—DANIEL J. SIEGEL, M.D.
THE AREAS OF THE CORTEX responsible for attention and self-regulation develop in response to the emotional interaction with the person whom we may call the mothering figure. Usually this is the birth mother, but it may be another person, male or female, depending on circumstances. Although, for the sake of convenience, I will at times refer to this person only as the mother, the word should always be understood to refer to whoever the primary nurturing figure may be—father, mother, or grandparent, foster parent or adoptive parent of either gender. Because the formation of the child’s brain circuits is influenced by the mother’s emotional states, I believe that ADD originates in stresses that affect the mothering parent’s emotional interactions with the infant. They cause the disrupted electrical and chemical circuitry of ADD. Attachment and attunement, two crucial aspects of the infant-parent relationship, are the determining factors. They are the subject of this chapter.
The right hemisphere of the mother’s brain, the side where our unconscious emotions reside, programs the infant’s right hemisphere. In the early months, the most important communications between mother and infant are unconscious ones. Incapable of deciphering the meaning of words, the infant receives messages that are purely emotional. They are conveyed by the mother’s gaze, her tone of voice and her body language, all of which reflect her unconscious internal emotional environment. Anything that threatens the mother’s emotional security may disrupt the developing electrical wiring and chemical supplies of the infant brain’s emotion-regulating and attention-allocating systems.*
Within minutes following birth, the mother’s odors stimulate the branching of millions of nerve cells in the newborn’s brain. A six-day-old infant can already distinguish the scent of his mother from that of other women. Later on, visual inputs associated with emotions gradually take over as the major influences.
By two to seven weeks, the infant will orient toward the mother’s face in preference to a stranger’s—and also in preference to the father’s, unless the father is the mothering adult. At seventeen weeks, the infant’s gaze follows the mother’s eyes more closely than her mouth movements, thus fixating on what has been called “the visible portion of the mother’s central nervous system.” The infant’s right brain reads the mother’s right brain during intense eye-to-eye mutual gaze interactions. As an article in Scientific American expressed it, “Embryologically and anatomically the eye is an extension of the brain; it is almost as if a portion of the brain were in plain sight.”1 The eyes communicate eloquently the mother’s unconscious emotional states:
[O]ne person uses another’s pupil size as a source of information about that person’s feelings or attitudes; this process usually occurs at unconscious levels. Dilated pupils occur in states of pleasure and are an indicator of “interest” … Experiments have shown that women’s eyes dilate in response to a picture of a baby. Most importantly … viewing enlarged dilated pupils elicits larger pupils in the observer. In a developmental study, infants smiled more when a female experimenter’s eyes were dilated rather than constricted …
Everyone has had the experience of suddenly feeling intense physiological and psychological shifts internally at trading glances with another person; such shifts can be exquisitely pleasurable or unpleasant. How one person gazes at another can alter the other’s electrical brain patterns, as registered by EEGS, and may also cause physiological changes in the body. The newborn is highly susceptible to such influences, with a direct effect on the maturation of brain structures.
The effects of maternal moods on the electrical circuitry of the infant’s brain were demonstrated by a study at the University of Washington, Seattle.2 Positive emotions are associated with increased electrical activity in the left hemisphere. It is known that depression in adults is associated with decreased electrical activity in the circuitry of the left hemisphere. With this in mind, the Seattle study compared the EEGS of two groups of infants: one group whose mothers had symptoms of postpartum depression, the other whose mothers did not. “During playful interactions with the mothers designed to elicit positive emotion,” the researchers reported, “infants of non-depressed mothers showed greater left than right frontal brain activation.” The infants of depressed mothers “failed to show differential hemispheric activation,” meaning that the left-side brain activity one would anticipate from positive, joyful infant-mother exchanges did not occur—despite the mothers’ best efforts. Significantly, these effects were noted only in the frontal areas of the brain, where the centers for the self-regulation of emotion are located. In addition to EEG changes, infants of depressed mothers exhibit decreased activity levels, gaze aversion, less positive emotion and greater irritability.
Maternal depression is associated with diminished infant attention spans. Summarizing a number of British studies, Dale F. Hay, a researcher at the University of Cambridge, suggests “that the experience of the mother’s depression in the first months of life may disrupt naturally occurring social processes that entrain and regulate the infant’s developing capacities for attention.”3
Just how important a close moment-to-moment connection between mother and infant can be was illustrated by a cleverly designed study, known as the “double TV experiment,” in which infants and mothers interacted via a closed-circuit television system. In separate rooms, infant and mother observed each other and, on “live feed,” communicated by means of the universal infant-mother language: gestures, sounds, smiles, facial expressions. The infants were happy during this phase of the experiment. “When the infants were unknowingly replayed the ‘happy responses’ from the mother recorded from the prior minute,” writes the UCLA child psychiatrist Daniel J. Siegel, “they still became as profoundly distressed as infants do in the classic ‘flat face’ experiments in which mothers-in-person gave no facial emotional response to their infant’s bid for attunement.”4
Why were the infants distressed despite the sight of their mothers’ happy and friendly faces? Because happy and friendly are not enough. What they needed were signals that the mother is aligned with, responsive to and participating in their mental states from moment to moment. All that was lacking in the instant video replay, during which infants saw their mother’s face unresponsive to the messages they, the infants, were sending out. This sharing of emotional spaces is called attunement.5 Emotional stress on the mother interferes with infant brain development because it tends to interfere with the attunement contact.
Attunement is necessary for the normal development of the brain pathways and neurochemical apparatus of attention and emotional self-regulation. It is a finely calibrated process requiring that the parent remain herself in a relatively nonstressed, non-anxious, nondepressed state of mind. Its clearest expression is the rapturous mutual gaze infant and mother direct at each other, locked in a private and special emotional realm, from which, at that moment, the rest of the world is as completely excluded as from the womb.
Attunement does not mean mechanically imitating the infant. It cannot be simulated, even with the best of goodwill. As we all know, there are differences between a real smile and a staged smile. The muscles of smiling are exactly the same in each case, but the signals that set the smile muscles to work do not come from the same centers in the brain. As a consequence, those muscles respond differently to the signals, depending on their origin. This is why only very good actors can mimic a genuine, heartfelt smile. The attunement process is far too subtle to be maintained by a simple act of will on the part of the parent. Infants, particularly sensitive infants, intuit the difference between a parent’s real psychological states and her attempts to soothe and protect the infant by means of feigned emotional expressions. A loving parent who is feeling depressed or anxious may try to hide that fact from the infant, but the effort is futile. In fact, it is much easier to fool an adult with forced emotion than a baby. The emotional sensory radar of the infant has not yet been scrambled. It reads feelings clearly. They cannot be hidden from the infant behind a screen of words, or camouflaged by well-meant but forced gestures. It is unfortunate but true that we grow far more stupid than that by the time we reach adulthood.
In attunement, it is the infant who leads and the mother who follows. “Where their roles differ is in the timing of their responses,” writes John Bowlby, one of the century’s great psychiatric researchers.6 The infant initiates the interaction or withdraws from it according to his own rhythms, Bowlby found, while the “mother regulates her behaviour so that it meshes with his … Thus she lets him call the tune and by a skillful interweaving of her own responses with his creates a dialogue.” The tense or depressed mothering adult will not be able to accompany the infant into relaxed, happy spaces. He may also not fully pick up signs of the infant’s emotional distress, or may not be able to respond to them as effectively as he would wish. The ADD child’s difficulty reading social cues likely originates from her relationship cues not being read by the nurturing adult, who was distracted by stress.
In the attunement interaction, not only does the mother follow the child, but she also permits the child to temporarily interrupt contact. When the interaction reaches a certain stage of intensity for the infant, he will look away to avoid an uncomfortably high level of arousal. Another interaction will then begin. A mother who is anxious may react with alarm when the infant breaks off contact, may try to stimulate him, to draw him back into the interaction. Then the infant’s nervous system is not allowed to “cool down,” and the attunement relationship is hampered.
Infants whose caregivers were too stressed, for whatever reason, to give them the necessary attunement contact will grow up with a chronic tendency to feel alone with their emotions, to have a sense—rightly or wrongly—that no one can share how they feel, that no one can “understand.”
Attunement is the quintessential component of a larger process, called attachment.7 Attachment is simply our need to be close to somebody. It represents the absolute need of the utterly and helplessly vulnerable human infant for secure closeness with at least one nourishing, protective and constantly available parenting figure. Essential for survival, the drive for attachment is part of the very nature of warm-blooded animals in infancy, especially of mammals.
In human beings, attachment is a driving force of behavior for longer than in any other animal. For most of us it is present throughout our lives, although we may transfer our attachment need from one person—our parent—to another—say, a spouse or even a child. We may also attempt to satisfy the lack of the human contact we crave by various other means, such as addictions, for example, or perhaps fanatical religiosity or the virtual reality of the Internet. Much of popular culture, from novels to movies to rock or country music, expresses nothing but the joys or the sorrows flowing from satisfactions or disappointments in our attachment relationships. Most parents extend to their children some mixture of loving and hurtful behavior, of wise parenting and unskillful, clumsy parenting. The proportions vary from family to family, from parent to parent. Those ADD children whose needs for warm parental contact are most frustrated grow up to be adults with the most severe cases of ADD.
Already at only a few months of age, an infant will register by facial expression his dejection at the mother’s unconscious emotional withdrawal, despite the mother’s continued physical presence. “(The infant) takes delight in Mommy’s attention,” writes Stanley Greenspan, “and knows when that source of delight is missing. If Mom becomes preoccupied or distracted while playing with the baby, sadness or dismay settles in on the little face.”8
*The circuitry and brain chemistry involved are described in the next chapter.