Skip to main content

Advertisement

SpringerLink
Log in

Attachment, Mothering and Mental Illness: Mother–Infant Therapy in an Institutional Context

  • Original Paper
  • Published:
Culture, Medicine, and Psychiatry Aims and scope Submit manuscript

Abstract

This paper is an ethnographic exploration of how attachment theory underpins therapeutic practices in an Australian institutional context where mothers of infants have been diagnosed and are undergoing treatment for mental illness. We argue that attachment theory in this particular context rests on a series of principles or assumptions: that attachment theory is universally applicable; that attachment is dyadic and gendered; that there is an attachment template formed which can be transferred across generations and shapes future social interactions; that there is understood to be a mental health risk to the infant when attachment is characterised as problematic; and that this risk can be mitigated through the therapeutic practices advocated by the institution. Through an in-depth case study, this paper demonstrates how these assumptions cohere in practice and are used to assess mothering as deficient, to choose therapeutic options, to shape women’s behaviour, and to formulate decisions about child placement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Ethics consent for the project was granted by two committees: the University of Adelaide Human Research Ethics Committee Project Number H-092-2008, and Child Youth and Women’s Health Service in 2008, Research approval number: 2098.

  2. Although fathers were promoted as being welcome, throughout the time of fieldwork, only a handful of fathers slept in the unit with their partners and child.

  3. All participants have been given pseudonyms to protect anonymity.

  4. For an image of the Circle of Security diagram please visit: http://circleofsecurityinternational.com/userfiles/Downloadable%20Handouts/COS_chart-childsneeds.pdf.

  5. While family members were sometimes asked to participate in therapeutic sessions, ethics restrictions prevented observation of these sessions. Interviews revealed that others were invited in occasionally for mother-infant therapy sessions. However, the focus remained on the mother-infant dyad (as per the name of the therapy) and the issues in that relationship, rather than on broader family relationships and dynamics.

  6. Unfortunately, ethical restrictions at the time of research prevented firsthand observation of what happened in these therapy sessions, however from time to time patients would describe their experiences.

  7. With Helen’s permission, her mother-infant therapy videos were also used by Oliveto as an educational tool for mental health workers. It was chosen for clinical training because it was seen as an exemplar of the effects that poor attachment templates could create in mother-infant relationships across generations.

  8. This is a biomedical explanation about the sympathetic arousal of the autonomic nervous system, the ‘fight or flight response’.

References

  • Ainsworth, Mary D. S. 1967 Infancy in Uganda: Infant Care and the Growth of Love. Baltimore, MD: John Hopkins University Press.

    Google Scholar 

  • Ainsworth, Mary, Mary C. Blehar, Everett. Waters and Sally Wall 1978 Patterns of Attachment: A Psychological Study of the Strange Situation. Hillsdale, NJ: Lawrence Erlbaum Association.

    Google Scholar 

  • Ainsworth, Mary D. S. and Barbara A. Wittig 1969 Attachment and Exploratory Behavior of one-year-olds in a Strange Situation. In Determinants of Infant Behavior (Vol 4). B.M. Foss, ed. Pp. 111-136. London, England: Methuen.

    Google Scholar 

  • Barlow, Kathleen. 2013 Attachment and culture in Murik society: learning autonomy and interdependence through kinship, food and gender. In Attachment Reconsidered: Cultural Perspectives on a Western Theory. N. Quinn and J.M. Mageo, eds. Pp. 165-190. NY: Palgrave McMillan.

    Chapter  Google Scholar 

  • Barlow, Kathleen and Bambi L. Chapin 2010 The Practice of Mothering: An Introduction. Ethos 38(4):324-338.

    Article  Google Scholar 

  • Bowlby, John 1952 [1951] Maternal Care and Mental Health. World Health Organization.

  • Bowlby, John 1958 The nature of a child’s tie to his mother. International Journal of Psycho-Analysis 39: 350-373.

    Google Scholar 

  • Bowlby, John 1971 [1969] Attachment and Loss Volume I. Harmondsworth: Penguin Books.

  • Bowlby, John, and Colin M. Parkes 1970 Separation and loss within the family. The Child in his Family 1: 197-216.

    Google Scholar 

  • Bretherton, Inge. 1993 The roots and growing points of Attachment Theory. In Attachment Across the Life Cycle. Colin Parkes, Joan Stevenson-Hinde, and Peter Marris, eds. Pp. 9-32. Hoboken: Taylor and Francis.

    Google Scholar 

  • Cassidy, Jude and Phillip R. Shaver 2008 Handbook of Attachment: Theory, Research, and Clinical Applications. New York: Guilford Press.

    Google Scholar 

  • Chapin, Bambi L. 2010 “We have to give”: Sinhala mothers’ responses to children’s expression of desire. Ethos 38(4): 354-368.

    Article  Google Scholar 

  • Chapin, Bambi L. 2013 Attachment in rural Sri Lanka: the shape of caregiver sensitivity, communication, and autonomy. In Attachment Reconsidered: Cultural Perspectives on a Western Theory. N. Quinn and J.M. Mageo, eds. Pp. 143-162. NY: Palgrave McMillan.

    Chapter  Google Scholar 

  • Cooper, Glen, Kent Hoffman and Bert Powell 1998 The Circle of Security Project. Circle of Security Organisation: Early Intervention program for Parents and Children. United States of America.

    Google Scholar 

  • Crittenden, Alyssa N., and Frank W. Marlowe 2013 Cooperative childcare among the Hadza: situating multiple attachment in an evolutionary context. In Attachment Reconsidered: Cultural Perspectives on a Western Theory. N. Quinn and J.M. Mageo, eds. NY: Palgrave McMillan.

    Google Scholar 

  • David, Anthony S. 1990 Insight and psychosis. The British Journal of Psychiatry 156(6): 798-808.

    Article  Google Scholar 

  • Davila, Joanne and Deborah A. Kashy 2009 Secure base processes in couples: daily associations between support experiences and attachment security. Journal of Family Psychology 23(1): 76.

    Article  Google Scholar 

  • DeLoache, Judy S. and Alma Gottlieb 2000 A World of Babies: Imagined Childcare Guides for Seven Societies. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Diamond, Gary S, and Jay L. Lebow 2005 Attachment-based family therapy for depressed and anxious adolescents. In Handbook of Clinical Family Therapy. J. Lebow, ed. Pp. 17-41. Hoboken, New Jersey: Wiley.

    Google Scholar 

  • Eyer, Diane E. 1992 Mother-Infant Bonding: A Scientific Fiction. New Haven: Yale University Press.

    Google Scholar 

  • Fonagy, Peter and Mary Target 1997 Attachment and reflective function: their role in self-organization. Development and Psychopathology 9(4): 679-700.

    Article  Google Scholar 

  • Fraiberg, S, E. Adelson, and V. Shapiro 1975 Ghosts in the nursery A psychoanalytic approach to the problems of impaired infant-mother relationships. Journal of the American Academy of Child Psychiatry 14(3): 387-421.

    Article  Google Scholar 

  • Gaskins, Suzanne 2013 The puzzle of attachment: unscrambling maturational and cultural contributions to the development of early emotional bonds. In Attachment Reconsidered: Cultural Perspectives on a Western Theory. N. Quinn and J.M. Mageo, eds. Pp. 33-64. NY: Palgrave McMillan.

    Chapter  Google Scholar 

  • Goldfarb, William 1943 The effects of early institutional care on adolescent personality. Journal of Experimental Education 12: 106-129.

    Article  Google Scholar 

  • Goldfarb, William 1945 Psychological privation in infancy and subsequent adjustment. American Journal of Orthopsychiatry 15(2): 247.

    Article  Google Scholar 

  • Gottlieb, Alma 2004 The Afterlife is Where We Come From. Chicago, London: The University of Chicago Press.

    Google Scholar 

  • Hrdy, Sarah B. 2009 Mothers and Others: The Evolutionary Origins of Mutual Understanding. Cambridge Mass: The Belknap Press.

    Google Scholar 

  • Johnson, Susan M., and Valerie E. Whiffen 2003 Attachment Processes in Couple and Family Therapy: Guilford Press.

    Google Scholar 

  • Landers, Margo S., and Regina M. Sullivan 2012 The development and neurobiology of infant attachment and fear. Developmental Neuroscience 34(2-3): 101-114.

    Article  Google Scholar 

  • LeVine, Robert. 2014 Attachment Theory as Cultural Ideology. In Different Faces of Attachment: Cultural Variations on a Universal Human Need. H. Otto and H. Keller, eds. Pp 50-65. New York: Cambridge University Press.

    Chapter  Google Scholar 

  • LeVine, R and Patrice M. Miller 1990 Commentary Cross Cultural Validity of Attachment Theory. Human Development 33(1): 73-80.

    Article  Google Scholar 

  • LeVine, Robert and Karin Norman 2001 The Infant’s Acquisition of Culture: Early Attachment Reeaxmined in Anthropological Perspective. In The Psychology of Cultural Experience. C.C. Moore and H.F. Mathews, eds. Pp 83-104. New York: Cambridge University Press.

    Google Scholar 

  • Levy, Ruth J. 1947 Effects of institutional vs boarding home care on a group of infants. Journal of Personality 15(3): 233-241.

    Article  Google Scholar 

  • Liddle, Howard A. 1999 Theory Development in a Family-Based Therapy for Adolescent Drug Abuse. Journal of Clinical Child Psychology 28(4): 521-532.

    Article  Google Scholar 

  • Liddle, Howard A., and Seth J. Schwartz 2002 Attachment and family therapy: clinical utility of adolescent‐family attachment research. Family Process 41(3): 455-476.

    Article  Google Scholar 

  • Meehan, Courtney L. and Sean Hawks 2013 Cooperative breeding and attachment among the Aka foragers. In Attachment Reconsidered: Cultural Perspectives on a Western Theory. N. Quinn and J.M. Mageo, eds. Pp. 85-113. New York: Palgrave McMillan.

    Chapter  Google Scholar 

  • Meehan, Courtney L. and Sean Hawks 2013 2014 Maternal and Allomaternal Responsiveness: the Significance of Cooperative Caregiving in Attachment Theory. In Different Faces of Attachment: Cultural Variations on a Universal Human Need. H. Otto and H. Keller, eds. Pp 113-140. New York: Cambridge University Press.

    Chapter  Google Scholar 

  • Piaget, Jean 1964 Part I: Cognitive Development in children: Piaget development and learning. Journal of Research in Science Teaching 2(3): 176-186.

    Article  Google Scholar 

  • Porter, Louise, Burnip, Bernice, Soden, Zara, and Margaret Sullivan 2002 Typical developmental milestones. In Educating Young children with Additional Needs. L. Porter, ed. Pp. 241-259. Sydney: Allen & Unwin.

    Google Scholar 

  • Quinn, Naomi, and Jeanette M. Mageo 2013 Attachment and culture: an introduction. In Attachment Reconsidered: Cultural Perspectives on a Western theory. N. Quinn and J.M. Mageo, eds. New York: Palgrave McMillan.

    Chapter  Google Scholar 

  • Rheingold, Harriet L. 1943 Mental and social development of infants in relation to the number of other infants in the boarding home. American Journal of Orthopsychiatry 13(1): 41-44.

    Article  Google Scholar 

  • Rottger-Rossler, Birgit 2014 Bonding and Belonging Beyond Weird Worlds: Rethinking Attachment Theory on the Basis of Cross-Cultural Anthropological Data. In Different Faces of Attachment: Cultural Variations on a Universal Human Need. H. Otto and H. Keller, eds. Pp 141-168. New York: Cambridge University Press.

    Chapter  Google Scholar 

  • Scheper-Hughes, Nancy 1985 Culture, Scarcity, and Maternal Thinking: Maternal Detachment and Infant Survival in a Brazilian Shantytown. Ethos 13(4): 291-317.

    Article  Google Scholar 

  • Scheper-Hughes, Nancy 1993 Death Without Weeping: The Violence of Everyday Life in Brazil. Berkley and LA: University of California Press.

    Google Scholar 

  • Seymour, Susan C. 2004 Multiple caretaking of infants and young children: an area in critical need of a feminist psychological anthropology. Ethos 32(4): 538-556.

    Article  Google Scholar 

  • Seymour, Susan C. 2013 “It takes a village to raise a child”: attachment theory and multiple child care in Alor, Indonesia and North India. In Attachment Reconsidered: Cultural Perspectives on a Western theory. N. Quinn and J.M. Mageo, eds. Pp. 115-139. New York: Palgrave McMillan.

    Chapter  Google Scholar 

  • Stroebe, Margaret, Hank Schut, and Wolfgang Stroebe 2005 Attachment in coping with bereavement: a theoretical integration. Review of General Psychology 9(1): 48.

    Article  Google Scholar 

  • Sullivan, Regina M. 2012 The neurobiology of attachment to nurturing and abusive caregivers. Hastings Law J 63(6): 1553-1570.

    Google Scholar 

  • Super, Charles M., and Sara Harkness 1982 The infant’s niche in rural Kenya and metropolitan America. In Cross-cultural research at issue. L. L. Adler, ed. Pp. 47-56. NY: Academic Press.

    Google Scholar 

  • Tronik, Edward Z., Gilda A Morelli, and Steve Winn 1987 Multiple caretaking of Efe (Pygmy) infants. American Anthropologist 89(1): 169-206.

    Article  Google Scholar 

  • Weisner, Tom 2005 Attachment as a cultural and ecological problem with pluralistic solutions. Human Development 48(1-2): 89-94.

    Article  Google Scholar 

  • Weisner, Tom S., and Ronald Gallimore 1977 My brother’s keeper: child and sibling caretaking. Current Anthropology 18(2): 169-190.

    Article  Google Scholar 

  • Whiting, Beatrice B., and Caroline P. Edwards 1988 Children of Different Worlds: The Formation of Social Behavior. Cambridge: Harvard University Press.

    Google Scholar 

Download references

Acknowledgements

Research was funded by an Australian Postgraduate Award scholarship. The authors would like to acknowledge the Oliveto institution which allowed access for the research to be conducted. They would also like to thank the staff and patients who generously shared their knowledge and experiences with the researchers.

Funding

There was no grant money funding this study. Author Masciantonio had an Australian Postgraduate Award (Australian Federal Government) for the duration of her doctoral study.

Author information

Authors and Affiliations

  1. Department of Anthropology & Development Studies, University of Adelaide, Adelaide, SA, 5005, Australia

    Sonia Masciantonio & Susan R. Hemer

  2. School of Psychology, University of Adelaide, Adelaide, SA, 5005, Australia

    Sonia Masciantonio & Anna Chur-Hansen

Authors
  1. Sonia Masciantonio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan R. Hemer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Chur-Hansen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susan R. Hemer.

Ethics declarations

Conflict of interest

Masciantonio, Hemer, and Chur-Hansen declares that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the following institutions: University of Adelaide Human Research Ethics Committee Project number H-092-2008. Child Youth and Women’s Health Service in 2008, Research Approval Number: 2098, and with the 1964 Helsinki declaration and its later amendments. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Masciantonio, S., Hemer, S.R. & Chur-Hansen, A. Attachment, Mothering and Mental Illness: Mother–Infant Therapy in an Institutional Context. Cult Med Psychiatry 42, 112–130 (2018). https://doi.org/10.1007/s11013-017-9544-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11013-017-9544-9

Keywords

Search

Navigation