Attachment: the Latest Dirty Word in Biological Psychiatry

The crowd that wants to substitute the “bio-bio-bio” model for the bio-psycho-social model in psychiatry apparently freaks out if anyone brings up the wealth of studies that look at the effects of attachment behavior and attachment trauma on human behavior.

Attachment phenomena are those interactional variables that are present in the relationship between babies or children with their primary caretakers. These patterns affect the child’s psychological development as well as his or her adult intimate relationships.

Attachment patterns are loosely classified as “secure” or “insecure.” Insecure attachments are further subcategorized as “avoidant/dismissive,” “ambivalent/preoccupied,” or “disorganized.”

Clear evidence ties parental behavior problems and parenting styles with subsequent behavioral and interpersonal relationship problems in their children. Those children with disorganized attachments, for example, become overcome with anxiety, confusion, and paralysis whenever they are involved in intimate relationships. The literature shows that the best predictor of how a mother will bond with her child is the nature of the attachment bond the mother had with her own mother.

At the recent meeting of the American Academy for Child and Adolescent Psychiatry in Hawaii, some of the so-called researchers who have been diagnosing bipolar disorder in young children were presenting their material. Peter Parry, an Australian academic psychiatrist who is, to say the least, highly skeptical about pediatric bipolar, relates the following:

“They had no answer to attachment and trauma. Melissa DelBello, when I asked her about her presentation on neuroimaging in Pediatric Bipolar Disorder (PBD) - which was incredibly detailed and actually quite well put together and I complimented her on that – I said that the findings presented seem to have considerable overlap (a phrase she'd kept using about findings with PBD and ADHD) to the neuroimaging findings presented by Alan Schore etc re attachment trauma.

She initially said she didn't understand my question; after repeating it she twice said that there are some differences with ADHD. I eventually had to again repeat that I wasn’t talking about ADHD - I was talking about the amygdala and right frontal changes she was showing with PBD which they also find in the attachment/developmental trauma literature - at which point she conceded they hadn't looked at that population.”

This interchange is typical of the way some researchers who are overly tied to a pet theory attempt to avoid looking at or talking about any data that would call their theories into question. Usually they just avoid answering any questions that would do this, and subtly change the subject. I admire Dr. Parry’s persistence in not letting her get away with that.