BOOK REVIEW---John Bowlby--- His Early Life

A Biographical Journey into the Roots of Attachment Theory, by Suzan Dijken, Free Association Books, Ltd., London, 1998, 214 pp. $55 hardcover.

"John Bowlby--- His Early Life, (A Biographical Journey into the Roots of Attachment Theory)," by Suzan Van Dijken.

This biography of the famous British psychoanalyst, John Bowlby, is both illuminating and frustrating. The beginning of the book recounts Bowlby's claim to fame, and it is considerable. I came to believe, after reading this book, that Bowlby's landmark discoveries have not been sufficiently recognized or taught in psychiatric residencies and psychoanalytic institutes.

According to this biography, Bowlby would have been the quintessential Academy member, not exactly the American (Psychoanalytic Association) type. I say this because Bowlby was described as more interested in behavior than words. In his early practice, he worked with delinquent boys and found a common denominator in the instability and inadequacy in the maternal (parental) bond. Delinquent boys had been invariably abandoned, rejected and abused, and their parental ties were frequently interrupted. We know that August Eichhorn worked psychoanalytically with these misfits, and can assume that Bowlby did as well. He was impressed with the connection between early maternal separation and loss and later delinquent behavior.

Important facts of his professional life and his achievements are nicely presented early in the book, to remind us of the pioneering work and importance of this great analyst. In the introduction, "Separation as a Theme in Bowlby's Life and Work," Van Dijken sets forth Bowlby's major contributions to the 20th century world.

She quotes Bowlby, which is worth repeating here:

"Evidence is accumulating that human beings of all ages are happiest and able to deploy their talents to best advantage when they are confident that, standing behind them, there are one or more trusted persons who will come to their aid should difficulties arise. The person trusted, also known as an attachment figure... can be considered as providing his (or her) companion with a secure base from which to operate. The requirement of an attachment figure, a secure personal base, is by no means confined to children though, because of its urgency during the early years, it is during those years that it is most evident and has been most studied."

This profound statement applies to many if not most of the patients we treat. Almost inevitably, we find childhood deficits attributable to poor or inconstant parenting, resulting in a poor self image, a lowered self-esteem, a lack of confidence and often considerable anxiety and depression. It might well be that Bowlby has been insufficiently appreciated because his theory competed with the primacy of the Freudian Oedipus complex in its adult ramifications.

Van Dijken is the consummate scholar in doing an exhaustive review of Bowlby's writings, as well as interviews of people who were close to him. The references, which are well indexed, would be a major source for anyone seeking to research or review them. She interviewed many of the people who knew him best, including close members of his family, his widow, his eldest son and his youngest sister. Dijken included many detailed reminiscences of parents and grandparents from a time before John was born, which to most readers would be considered fluff. Many such these details could have been edited out. I don't need to know that the paternal grandparent was in the military, or enjoyed walking in the park on a Sunday afternoon. Perhaps others would find such details charming, or maybe even illuminating.

The author makes an important discovery that Bowlby was interested in and writing about attachment and separation before WWII. It is commonly thought that he began his interest in the effects of early separation on children by observing those children removed from the London blitz for safekeeping in the country. His findings led us to wonder if this separation were really in the child's best interest. The children in the country were safe, but their development depended a lot on the quality of care they had before and after the displacement.

Van Dijken does a good job of informing the reader of the probable source of Bowlby's interest in the vicissitudes of the maternal bond. He had a typical upper-class English childhood, raised by parents who delegated most of the child-care to nannies, servants, cooks and housekeepers, the household staff. The children's quarters were removed from the rest of the house. It was a completely separate and self-contained habitat in the attic. The children were brought to the parents after dinner, which was also separate. They were customarily presented all scrubbed and combed and in their pajamas, after dinner, for maybe a story before bedtime.

So here is a basis for separation phenomena by itself. But in addition, the interesting fact emerges, that early in his life he was very attached to a loving and affectionate nanny. Then at the tender age of one and a half, she is replaced by a nanny who is cold, distant and unaffectionate. We can only imagine the effect on an otherwise pampered child, well nurtured and protected, of this change of scenery. It is not too much of a leap to think that deep down, it was catastrophic, and yet, Bowlby must have internalized his original mother and motherly nanny, which gave him the stability, trust and self-confidence he seemed to retain for the rest of his life. He probably had an internalized "good mother," more than just "good-enough!" Van Dijken gives significant data that encourages meaningful conjecture about the maturational development of this most significant psychoanalyst and scientific researcher.

His scientific work may well have been his means of dealing with his traumatic, but not pathogenic loss. His work gained worldwide recognition for its ultimate importance. For example, in December of 1949, Bowlby was asked by the World Health Organization (WHO) to write a report of the mental health of homeless children. This gave Bowlby the opportunity to discuss problems of mental health with colleagues in Europe and the USA who were also interested in the adverse effects of maternal separation. In addition to acquring personal contacts, Bowlby had the chance to read the available literature on the topic of separation and to put his ideas on paper. This study led him to formulate the following: '...what is believed to be essential for mental health is that the infant and young child should experience a warm, intimate and continuous relationship with his mother (or permanent mother-substitute) in which both find satisfaction and enjoyment.'

To support this conclusion, Bowlby presented in the WHO report evidence for believing that '...many forms of psychoneurosis and character disorder are to be attributed either to deprivation of maternal care or to discontinuties in a child's relationship with his mother figure.'

His main distinction in the world of psychoanalysis, I believe, was his interest in ethology, which came from his disagreement at the time with the 'cupboard love' theory, that children are attached to their mothers because they are the source of food. A friend drew his attention to this area of study by referring him to Lorenz'as work on imprinting and the following response of ducklings and goslings. Ethology showed Bowlby that in some animal species a strong bond to an individual mother figure could develop without the intermediary of food. This led him to Harlow's studies with monkeys, to understand their reaction to early and severe maternal separation.

Bowlby's far-ranging interests brought him out of the realm of merely listening to patients talking on a couch. He was interested in the evolutionary and biological basis for emotional problems and found them in developmentally adaptive behavior. His interests beyond the couch would have made him the perfect Academy member, as it seems to me the main difference between the analysts of the Academy and the American is the focus on the nonverbal, behaviorial and interpersonal methods of work, as opposed to the strictly verbal, intrapsychic and narrative accounts. Of course, analysts of both persuasions do both; with each analyst it is a matter of emphasis, but to me Bowlby's work reinforces a compelling idea that the Academy and the American should join forces rather than continue to maintain divisive and competing guilds.

Victor Bloom MD

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