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Why should policy makers be more concerned with attachment?

 

There is a growing awareness of the prevalence of mental health problems in both the Republic of Ireland and Northern Ireland at present[i] [ii](O’Shea & Kennelly, 2008; Alwan, 2008). Allied to this is the significant need for mental health services that are delivered from an understanding of the origin of many mental health problems in interpersonal experience and early trauma.  In many instances violence stems from an inability within individuals and communities to cope effectively with distress. Failure to develop the capacity to regulate emotion, behaviour and thought can be closely associated with poor attachment experiences in early life. Healthy secure attachment relationships are therefore important protective factors that support people to cope with and prevent the occurrence of violence and other forms of abuse[iii].

There is also a related economic argument associated with related costs placed on public services due to the impact of mental health problems. The “Disability Adjusted Life Scales” which attempt to measure the impact of health and disability factors on individuals and society bear this out[iv]. Resourcing families and communities to relate to each other in more supportive ways begins with encouraging the development of positive attachment experiences early in life. Such positive experiences can lead to improved levels of mental health and wellbeing thus reducing the demands on services needed to cater for emotional and mental health difficulties. Aside therefore from the moral and social arguments for promoting an attachment perspective, this aspect presents a powerful economic case for investment in such an approach.

 

Optimal parent-infant interaction is more likely when both parent and infant are motivated towards, and capable of, achieving attunement and communication, and are living within an environment that supports their attuned relationship. A difficulty in any one of the following three areas can cause emotionally-supportive communication to become unavailable or blocked. When this occurs, there are frequently significant negative impacts on a child’s development[v].

  • Parental factors Some parents who have had mental health difficulties associated with their own attachment histories or who are using drugs or alcohol, can struggle to maintain adequate focus on children’s communications, while others manage despite these stresses. For example, a chaotic drug using parent would be unable to provide consistent interaction with a young child whereas the same parent, stable on a methadone maintenance programme, may be perfectly capable of providing the kind of attuned parenting that children need. Similarly, some women with postnatal depression are able to continue to communicate effectively with their baby, whereas others are overwhelmed. There is now a solid body of research evidence demonstrating that these differences can be reliably identified. Areas which we know less about include the effects of domestic violence, learning disabilities and poverty[vi].
  • Child factors 
Children are now believed to be genetically programmed, from before birth, to seek interaction with significant adults but some children, for example, premature babies, babies with chronic illness, children with autism, learning disabilities, fetal alcohol syndrome, or sensory impairments may struggle more than others with this. In addition, parenting a child who has experienced major trauma can be difficult because the effects of trauma can interfere with communication[vii].
  • Environmental factors 
Issues of poor housing, unemployment, discrimination and other forms of exclusion can all make communication with children more challenging for parents. Intervention in any one of these three areas, and/or intervention aimed at the interaction itself, may improve the functioning of the system.

As professionals working with children and families, the executive committee of IAIA have been aware of the high level of distress experienced by many children and young people. There is widespread consensus among professionals that problematic patterns of relating to others are often transmitted from one generation to another. Where this occurs, the associated distress often manifests as mental health problems and violence, which in turn influences the occurrence of such difficulties in future generations.

[i] O’Shea, E. and Kennelly, B. (2008) The Economics of Mental Health Care in Ireland, Irish Centre for Social Gerontology and Department of Economics, NUI Galway, Mental Health Commission. Available at:

http://www.mhcirl.ie/File/ecommhceire.pdf

Accessed 16th November 2016

 

[ii] Alwan, A. (2008) Mental Health Gap Action Programme : scaling up care for mental, neurological and substance use disorders, WHO,  IPH action areas in health inequalities – mental health and wellbeing.  Available at:

http://www.publichealth.ie/healthinequalities/mentalhealth

Accessed 16th November, 2016.

 

[iii] Collingshaw S, Maughan B, Goodman R and Pickles A Time trends in adolescent mental health. Journal of Child Psychology and Psychiatry.
Vol 45 pp 135-1362. Del Frate A & Van Kesteren J (2004) Criminal Victimisation in Urban Europe.

 

[iv] WHO Health Statistics and Information Systems 2000 – 2012 DALY scale (disability adjusted life years) Available at: http://www.who.int/healthinfo/global_burden_disease/estimates/en/index2.html

Accessed 24th October 2016

 

[v] Main M (1991) Metacognitive knowledge, metacognitive monitoring, and singular (coherent) vs. multiple (incoherent) model of attachment: Findings and directions for future research. In Parkes, C.M. Stevenson-Hinde, J. and Marris, P. (eds.) Attachment Across the Lifecycle London: Routledge

 

[vi] Surrey J (1991) The “self – in relation”: a theory of women’s development. In Jordan, J.V. Kaplan, A.G. Miller, J.B. (eds) Women’s Growth in Connection. New York: Guildford

 

[vii] Dixon L, Browne K and Hamilton-Giachristis C (2005) Risk factors of parents abused as children: a mediational analysis of the intergenerational continuity of child maltreatment. Journal of Child Psychology and Psychiatry. Vol 46 pp 47-57.