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February 13, 2015 by Kathy Brous

The Adult Attachment Interview (AAI) (Pt.1 of 2)

Mary Ainsworth’s Strange Situation

Mary Main & Dan Siegel December-2010-UCLA

Dr. Main with Dr. Daniel Siegel

Only 55% of us have “secure attachment”– a number which would worry us all if we knew what it meant — according to 1970-1996 research on over 2,000 infant-parent pairs. And the level of attachment we get as infants continues all our lives in our relationships.

The math says the other 45% of us suffer “insecure attachment.”  That means 45% can’t handle a committed, stable relationship with anyone, from childhood to the rest of our lives, as of 1996.  We also pass this emotional pain to our children, who turn out similarly.  A National Institute of Health article summarizes the secure rate:  “Infants with secure attachment greet and/or approach the caregiver and maintain contact but are able to return to play, which occurs in 55% of the general population.” 1

This is the blockbuster result of Dr. Mary Ainsworth’s 1970-1978 “Strange Situation” study of babies.  The work was completed by her student Mary Main, and Main’s research led to shocking conclusions.

Main discovered so many babies were peculiar, she got concerned about the parents. So in 1982, she created the Adult Attachment Interview (AAI) to study the adults, releasing results 1984-96.

Her journey was so “strange” and involved, that it got published in language hard to decipher (or even google) for most folks. The tale took me weeks to unravel (footnotes below).

This huge “insecure” figure is a predictor of broken homes and broken hearts for half the nation. It starts to explain why we’ve got a 50% divorce rate. If you’re like me and have tried “over 40” internet dating after a divorce, it won’t surprise you to hear that science shows 50% of adults out there can’t carry on a secure, committed, loving relationship. You’ve already experienced it.

And if 45% of us were “insecurely attached” in 1996, what’s the percent in 2014?  In 1996 most of us hadn’t heard of the Internet. In almost 20 years since, email, texting, and so on have further trashed our ability to relate in person. Several psychotherapists interviewed for this blog said that a round number of “about 50%” is a  conservative estimate for how many Americans lack secure attachment today. Many believe it’s much higher.

It gets worse; check out another “about 50%” shocker. The 1998 Adverse Childhood Experiences (ACE) Study showed that 58% of middle class U.S. adults suffered 2 or more types of traumas as kids. It lists physical and sexual abuse and 8 other types, including traumas that happen even to newborns like physical and emotional neglect.2  Such trauma by definition puts children into technical “fight-flight,” a chronic state biologically proven to shut down the organism’s capacity for feelings of attachment and love. Think soldier in a  battle ramped up in “fight-flight”– he can’t really feel much love for the other side.3

And it doesn’t go away. Continued fight-flight puts the nervous system into freeze: our vagus nerve starts shutting down bodily functions, Dr. Stephen Porges shows.4 So ACEs create the conditions underlying the top 10 medical causes of death in the U.S.

Major child trauma 58%?  The more statistics I see, the better that “about 50%” number looks for how many of us are not securely attached. Which means half of us are in serious emotional health and bio-medical trouble – and don’t even know it. Let’s get informed.

Then we can heal. If we didn’t get securely attached as kids, we can develop “earned secure attachment.” “It’s possible to change attachment patterns,” Dr. Main says in a 2010 video.5

 Strange Situation  Experiment

bowlby-johnAttachment Theory isn’t new, it just gets too little air time. British psychiatrist John Bowlby (left) developed it in the 1950s while dealing with the post-WWII crisis of dislocated orphans.6  Bowlby reasoned that all infants would seek to stay close to parents, since “proximity-seeking behavior” (attachment) is best for survival, so it’s bred into us by evolution. In 1952, he published a study of toddlers’ responses to major separations from parents. It showed that “when toddlers were placed in unfamiliar surroundings that provided no stable caregivers, they underwent three increasingly unfavorable stages of response to separation: protest, despair, and finally detachment.”7

Mary Ainsworth ca 1990Dr. Mary Ainsworth studied with Bowlby in London 1950-54, then studied this same “proximity-seeking behavior” (attachment) in infant-mother pairs in homes in Kampala, Uganda, published as “Infancy in Uganda” (1967).  Next, she “found astonishing similarities in homes in Baltimore, Maryland (Ainsworth et al. 1978).”7

So Ainsworth created the Strange Situation in the early 1970s, as a science experiment at Johns Hopkins in Baltimore to document this infant behavior. “Ainsworth deliberately structured the Strange Situation to include three of Bowlby’s ‘natural clues to danger’… to arouse babies to seek proximity” to the parent, Main says. Researchers watch and video-tape through one-way glass, as infant-mother pairs react to apparent danger.  First the babies respond to the strange lab room; then to two entrances of a stranger into the space; and separation from mother at two different times.8

In the Strange Situation, all or most babies were expected to stay close to parents as Bowlby thought.  Such babies, “that Ainsworth termed ‘secure,’ play and explore happily prior to separation; show signs of missing the parent during separation, such as crying and calling; seek proximity immediately upon the parent’s return; and then return to play and exploration, ‘secure’ once again in the parent’s presence,” said Main.8

But 30% of babies did not act secure — they avoided mom.  Given a choice, they show no preference between mom and the stranger.  “While a majority of infants behaved as expected and were termed secure, to Ainsworth’s amazement six showed little or no distress at being left alone in the unfamiliar environment, and then avoided and ignored the mother upon her return.”7

Ainsworth decided to categorize these babies separately, as “avoidant” of mother, so now she had two types: (A) Insecure Avoidant, and (B) Secure. She concluded that their mom didn’t respond to them, or respond with enough sensitivity to understand their actual need, so the infants felt “insecure.”8

Still later Ainsworth saw that of the insecure babies, some had yet a third reaction: actually, they were “ambivalent” about mom. They were very distressed when mom left, but on her return, they alternated between avoiding and frantic clinging–plus, they never calmed down. Research showed that ambivalent attachment results from moms who are sometimes available, sometimes not, so babies learn they can’t depend on mom to be there when they need her.

Thus it was that “surprisingly, Ainsworth found that infant responses to separation and reunion fell into three distinct, coherently organized patterns of attachment,” and added a third category: (C) Insecure Ambivalent, Main reports.8,9

By 1978, Ainsworth’s estimate for U.S. babies was (B) Securely Attached 69%; (A) Avoidant 23%, (C) Ambivalent 8%.  In the next 10 years, her Strange Situation study was done worldwide — always using her same three categories — with 2,000 infant-parent pairs in 32 different studies, in 8 countries.  Some countries varied, but the global results averaged out exactly the same as Ainsworth’s 1970s studies.  Amazing, yet since the U.S. is a cultural melting pot, it makes sense.1

But stay tuned for my next blog, when Ainsworth’s grad student Mary Main gets into the act big time.  Main found that Ainsworth’s concept of Securely Attached had flaws that made necessary a whole new fourth category of attachment failure.  And a whole lot fewer than 69% turned out to be “secure.”

If you can’t wait for Part 2, the whole article is here:http://attachmentdisorderhealing.com/adult-attachment-interview-aai-mary-main/.

———————————
Kathy’s news blogs expand on her book “DON’T TRY THIS AT HOME: The Silent Epidemic of Attachment Disorder—How I accidentally regressed myself back to infancy and healed it all.” Watch for the continuing series each Friday, as she explores her journey of recovery by learning the hard way about Attachment Disorder in adults, adult Attachment Theory, and the Adult Attachment Interview.

Footnotes

  1. NIH: Benoit, Diane , MD, FRCPC, “Infant-parent attachment: Definition, types, antecedents, measurement and outcome,” Paediatr Child Health, Oct 2004; 9(8) p. 541–545 at:www.ncbi.nlm.nih.gov/pmc/articles/PMC2724160/  4th subhead “Measurement” reports:
    “The three ‘organized’ strategies (secure, avoidant and resistant) are assessed in the Strange Situation (SS), a 20-minute laboratory procedure where patterns of infant behaviour toward the caregiver following two brief separations are categorized… “Infants with secure attachment greet and/or approach the caregiver and may maintain contact but are able to return to play, which occurs in 55% of the general population… Infants with insecure-avoidant attachment fail to greet and/or approach, appear oblivious to their caregiver’s return… avoiding the caregiver, which occurs in 23% of the general population. Infants with insecure-resistant [ambivalent] attachment are extremely distressed by separations and cannot be soothed at reunions,  displaying much distress and angry resistance to interactions with the caregiver, which occurs in 8% of the general population.” [This NIH article earlier reports that the remaining “approximately 15% suffer insecure ‘disorganized’ attachment,” citing their own footnote which states “In normal, middle class families, about 15% of  infants develop disorganized attachment.” [Note: 23%+8%+15%  = 46% not securely attached.]
  2. Felitti VJ, Anda RF, et. al, 1998, “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study,” American Journal of Preventive Medicine 1998;14:245–258.  Detailed article on the ACE Study:http://acestoohigh.com/2012/10/03/the-adverse-childhood-experiences-study-the-largest-most-important-public-health-study-you-never-heard-of-began-in-an-obesity-clinic/
  3. Karr-Morse, Robin, Wiley, Meredith,  “Scared Sick,”  Penguin Basic Books, 2012
  4. Porges, Stephen, PhD,Body, Brain, Behavior: How Polyvagal Theory Expands Our Healing Paradigm” 2013 Beyond the Brain: Vagal System Holds the Secret to Treating Trauma” 2013 –“The Polyvagal Theory for Treating Trauma” 2011 –“Polyvagal theory: phylogenetic substrates of a social nervous system” International Journal of Psycho-physiology 42, 2001,  Dept. of Psychiatry, Univ. Illinois Chicago
  5. Main, Mary; Hesse, Erik; Siegel, Daniel on the AAI:https://www.youtube.com/watch?v=YJTGbVc7EJY     “Earned secure” has been used to describe individuals who experience malevolent parenting (and therefore insecure attachment), but have risen above those experiences and who are assessed as securely attached. Quotes: “What’s even more important than the specifics of what happened to us is how we’ve made sense of our own childhood experiences.  When we come to make sense of our memories and how the past has influenced us in the present, we become free to construct a new future for ourselves and for how we parent our children. Research is clear:  If we make sense of our lives, we free ourselves from the prison of the past…Mindfulness has been shown to be effective in healing insecure attachment. Mindfulness can be described as “a deliberate, nonjudgmental attention to experience in the present moment.” (Siegel, 2007, Kabat-Zinn, 2005, Wallin, 2007). The purpose of both psychotherapy and mindfulness practice is to provide this internalized secure base. Attunement, whether it is internal in mindfulness, or interpersonal in attachment, is what leads to a sense of secure base,” (Siegel, 2010).
  6. Bowlby, John, “The Nature of a Child’s Tie to His Mother,” British Psychoanalytical Society, London, 1958; “Attachment and Loss,” New York, Basic Books, 1969
  7. Main, Mary,  2000,The Adult Attachment Interview: Fear, attention, safety and discourse processes;” also titled “The Organized Categories of Infant, Child, and Adult Attachment: Flexible vs. Inflexible Attention Under Attachment-Related Stress,” Journal of the American Psychoanalytic Association, 48:1055-1095.
  8. Main, Mary, 2005, with Hesse, Erik & Kaplan, Nancy, “Predictability of Attachment Behavior and Representational Processes at 1, 6, and 19 Years of Age – The Berkeley Longitudinal Study,” Chapter 10 of “Attachment from Infancy to Adulthood: The Major Longitudinal Studies,” edited by Klaus E. Grossmann, Karin Grossmann, and Everett Waters, pp. 245–304, New York: Guilford Press. Main refers to it as “Regensburg.”–Main’s summary of the Strange Situation: “Ainsworth structured the Strange Situation procedure to include three of Bowlby’s ‘natural clues to danger’ in eight episodes:  1. Introduction to the room.  2. Mother and infant are left alone in a toy-filled environment whose unfamiliarity supplies the first natural clue to danger.  However, the mother’s presence is expected to provide the infant with security sufficient for exploration and/or play.  3. Providing a second clue to danger, a stranger joins the mother and infant.  4. The mother leaves the infant with the stranger, providing two combined clues to increased danger. 5. The mother returns, and the stranger departs…. Many infants initially seek proximity but then, reassured of their mothers’ nearness, resume play. 6.  The mother leaves, and the infant remains entirely alone in the unfamiliar setting. Infant distress can be strong at this point, and this episode is often terminated rapidly. 7. The stranger, rather than the mother, enters the room. 8. The mother returns… By now, most infants are expected to be crying, and actively not only seeking proximity to mothers, but also… indicating a strong desire to be held… Nonetheless, they are expected to settle and renew interest in exploration and play by the end of this 3-minute period…“Somewhat surprisingly, Ainsworth found that infant responses to separation and reunion in this procedure fell into three distinct, coherently organized patterns of attachment (“secure,” “insecure-avoidant,” and “insecure-ambivalent” (Ainsworth, Blehar, Waters, & Wall, 1978). … Given the length and complexity of this chapter, we suggest individuals divide reading to its three central parts (secure attachment, pp. 261–273; avoidant attachment, pp. 273–279; and disorganized attachment pp. 279–288).”
  9. (1988 van Ijzendoorn: on global proof of Ainsworth’s 3 categories; written before Main’s 4 category put in use) van IJzendoorn, Marinus H.; Kroonenberg, Pieter M.  “Cross-Cultural Patterns of Attachment: A Meta-Analysis of the Strange Situation,” Child Development,Vol 59 No 1, Feb 1988, p.147–56 |  Abstract

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