Handbook of Attachment.

Abstract

If handbook means “a small reference book providing specific information or instruction”, then this book does not fit the definition (1). Rather, it is a large, very complete review of the field of attachment. It also is a heartfelt tribute to Bowlby and Ainsworth. Early in Bowlby’s career, he became convinced that disruption in the mother/child relationship was seminal in the development of psychopathology, rather than the current psychoanalytic thinking that emphasized secondary drives and internal phantasy as causal. In 1944, he published his study of “44 Juvenile Thieves” that explicated his thesis about early life relationships and started an explosion of thought, study and publications (2). Meeting up with Mary Salter Ainsworth was fortuitous and led to an extremely fertile collaboration with her naturalistic studies in Uganda, continuing in Baltimore, providing a strong research base for the theory. The postulation of inherent motivation to establish a relationship or bond, continued to put him at odds with the psychoanalytic establishment. He stressed the importance of the affectional bonds and care-taking system and the uniqueness of the symmetrical relationship between child and mother, with the mother as solution to threat. His theorizing culminated in the publishing of the trilogy of Attachment and Loss, and the rest is history (3). As the theory is now so well accepted, it is hard to understand the strong early objections and how revolutionary his theory was at the time. The handbook is divided into six sections comprising thirty six chapters with an epilogue by Mary Main. Each chapter reviews theory from Bowlby, which can be repetitious, current research and theory, data available and then suggested directions for further work and development. The first section of five chapters gives an overview of Attachment Theory. Section II speaks to Biological Perspectives (six chapters). Section III and IV cover Attachment Theory in Infancy and Childhood (three chapters) and Adolescence and Adulthood (six chapters). These are followed by Clinical Applications of Attachment Theory and Research (seven chapters) and a final section on Emerging Topics and Perspectives (nine chapters) with the afore mentioned epilogue by Mary Main. This is an amazingly rich book with great depth of discussion. Although not a book which is read cover to cover, it is an incredibly thorough reference always bringing new knowledge and insight. As I went through the book, I was struck by the extensive development of the field and its many applications. The findings are complex and at times contradictory, giving much food for thought. I particularly liked the sections on Intergenerational Transmission explaining how psychopathology can travel through families. I liked also the chapters that show that attachment theory is not just a theory of infancy and has application to adolescents and adults and hence is a life span model. A weakness I found is that there was not much on the application of attachment theory to therapy. The model of the therapist providing a secure base from which the client/patient can explore and extend his or her world view is apt. Attachment theory gives a solid explanation of the predisposing factors leading to difficulties, but does not suggest how the therapist can facilitate the development of the therapeutic context as a secure base and inform what happens in and out of the therapeutic hour. In summary I would recommend this book highly, (even though it is costly) as an important book to have in one’s library and one that will not quicky go out of date, remaining a valuable resource to go back to again and again, each time gaining new insight.