Although babies can communicate many of their feelings right from the start, their social lives change rather dramatically as they become emotionally attached to their caregivers. John Bowlby (1969) uses the term to describe the strong affectional ties that we feel for the special people in our lives. According to Bowlby (1969), people who are securely attached take pleasure in their interactions and feel comforted by their partner’s presence in times of stress or uncertainty. Developmentalists have long debated the issue that people are especially responsive and affectionate to the person who feeds them. There are four influential theories of attachment: psychoanalytic theory, learning theory, cognitive-developmental theory and ethological theory.
According to Freud, young infants are “oral” creatures who derive satisfaction from sucking and mouthing objects and should be attracted to any person who provides oral pleasure. Since it is usually mothers who “pleasure” oral infants by feeding them, it seemed logical to Freud that the mother would become the baby’s primary object of security and affection, particularly if she was relaxed and generous in her feeding practices.
Erik Erikson also believed that a mother’s feeding practices influence the strength or security of her infant’s attachments. However, he claimed that a mother’s overall responsiveness to her child’s needs is more important than feeding itself. According to Erikson, a caregiver who consistently responds to all an infant’s needs fosters a sense of trust in other people, whereas unresponsive or inconsistent caregiving breeds mistrust. He adds that children who have learned not to trust caregivers during infancy may come to avoid close mutual-trust relationships throughout life.
Learning Theory: Rewardingness Leads to Love
For quite different reasons, some learning theorists have also assumed that infants become attached to persons who feed them and gratify their needs. Feeding was thought to be particularly important for two reasons (Sears, 1994). First, it should elicit positive responses from a contented infant such as smiles and coos, which are likely to increase a caregiver’s affection for the baby. Second, feeding is often an occasion when mothers can provide an infant with many comforts—food, warmth, tender touches, soft, reassuring vocalizations, changes in scenery, and even a dry diaper—all in one sitting. Over time, then, an infant should come to associate his mother with pleasure or pleasurable sensations, so that the mother herself becomes a valuable commodity. Once the mother (or any other caregiver) has attained this status as a secondary reinforcer, the infant is attached; he or she will now do whatever is necessary (smile, cry, coo, babble, or follow) in order to attract the caregiver’s attention or to remain near this valuable and rewarding individual.
Cognitive-developmental theory has little to say about which adults are most likely to appeal to infants, but it does remind us of the holistic character of development by suggesting that the ability to form attachment depends, in part, on the infant’s level of intellectual development. Before an attachment can occur, the infant must be able to discriminate familiar companions from strangers. He must also recognize that familiar companions have”permanence” about them (object permanence), for it would be difficult indeed to form a stable relationship with a person who ceases to exist whenever she passes from view (Schaffer, 1971). So perhaps, it is no accident that attachments first emerge at age 7 to 9 months—precisely the time when infants are entering Piaget’s fourth sensorimotor substage, the point at which they first begin to search for and find objects that they have seen someone hide from them.
Ethologists have proposed a most interesting and influential explanation for emotional attachments that has strong evolutionary overtone. A major assumption of the ethological approach is that all species, including human beings, are born with a number of innate behavioral tendencies that have in some way contributed to the survival of the species over the course of evolution. Indeed, John Bowlby (1969), who was originally a psychoanalyst, came to believe that many of these built-in behaviors are specifically designed to promote attachments between infants and their caregivers. Konrad Lorenz reported that very young goslings followed almost any moving object—their mothers, a duck, or even a human being, a behavior he labeled imprinting. Lorenz then concluded that imprinting was an adaptive response. Young birds generally survive if they follow their mothers so that they are led to food and afforded protection. Those that wander away may starve or be eaten by predators and thus fail to pass their genes to future generations.
Caregiving in Patients with Anxiety or Depression
Helping patients is not only about treating their immediate and pressing problems, caregivers and clinicians must also ensure that long-lasting effect will take place and that the client will not relapse into its past melancholy. Among the psychotherapy choices are cognitive behavioural therapy, interpersonal, psychodynamic, existentialist and personal approaches. Several researches illustrated that the best results can be obtained with the combination of medication and psychotherapy. Not only are indicators or symptoms of depression resolved, patients also learn how to manage their thoughts, feelings and behaviors that are causing their depression. Overall, a combination of these two keeps patient steadfast in their medication and prevents relapses.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy or CBT is a derivation from two earlier treatments, Cognitive Therapy and Behavioral Therapy. Beck et al. (1979) claimed that the rationale behind Cognitive Therapy is that “an individual’s affect and behavior are largely determined by the way in which he structures his world.” A person’s cognition of his world, therefore, determines his behavior and distress. Behavioral therapy on the other hand, was viewed as more suited to the severely depressed, “not only to hang behaviors, but also elicit cognitions associated with specific behaviors” (Beck et al. 1979). CBT was founded by Beck and Ellis in the 1960s.
What makes CBT effective is that it realigns skewed ways of thinking to reality and trains individuals to replace destructive behavioral patterns. Thus, both thoughts and actions are affected by the therapy and the patient feels relief because he can finally pursue the activities that his once negative thoughts are preventing him from doing. Support as Intervention
It is worth mentioning that depression or anxieties in children are triggered by hormonal changes during adolescence that can also trigger anxiety during this time (Cameron, J. 2005). Reproductive, adrenal, and growth hormones all change during puberty, Judy Cameron noted. Stress can cause hormone changes, too, by increasing cortisol levels. Moreover, hormone levels can fluctuate by the hour and differ among individuals.
In the light of analyzing this issue and relating it to the attachment theory, the intervention of support attempts to reassure the client of his or her ability to survive the threatening experience. Support may be communicated nonverbally by an understanding nodding of the head. It can be a verbal acknowledgment of the person’s distress, “This must be hard for you,” or reflecting the person’s own words, “You were really frightened.” Less preferably, one may even suggest, “You’ll get over this.”
Support is one of the most universally effective interventions. At its most fundamental level, it tells the client he or she is not alone, and that there is hope. When used to excess, there is risk that the client will shirk responsibility for coping with the problem and, instead, retire into a dependence upon the helper, Fantasies of a magical cure, or that the helper will solve the problem, may replace active striving to work it out. Excessive support may also seem patronizing, or suggest to the client that the counselor does not really understand the severity of the problem.
Secure and Insecure Attachments
Attachment theorists such as British psychiatrist John Bowlby (1089) and American developmental psychologist Mary Ainsworth (1979) argue that secure attachment in infancy is central to the development of social competence. In the last decade, developmentalists have begun to explore the role of secure attachment and related concepts, such as connectedness to parents, in adolescent development (Eberly & others, 1997). They believe that attachment to parents in adolescence may facilitate the adolescent’s social competence and well-being, as reflected in such characteristics as self-esteem, emotional adjustment, and physical health (Allen & Kuperminc, 1995). For example, adolescents who show more satisfaction with help received from parents report more emotional well-being (Burke & Weir, 1979), and adolescents with secure relationships with their parents have higher self-esteem and better emotional well-being (Armsden & Greenberg, 1987). In contrast, emotional detachment from parents is associated with greater feelings of parental rejection and a lower sense of one’s own social and romantic attractiveness (Ryan & Lynch, 1989). Thus, attachment to parents during adolescence may serve the adaptive function of providing a secure base from which adolescents can explore and master new environments and a widening social world in a psychologically healthy manner (Allen & Bell, 1995). Secure attachment to parents may buffer adolescents from the anxiety and potential feelings of depression or emotional distress associated with the transition from childhood to adulthood. In one study, when young adolescents had a secure attachment to their parents, they perceived their family as cohesive and reported little social anxiety or feelings of depression (Papini, Roggman & Anderson, 1990). The importance of both autonomy and relatedness in parent-adolescent relationships was recently documented in a longitudinal study (Allen & Hauser, 1994). Adolescents’ ability to establish their autonomy while maintaining a sense of relatedness when interacting with parents at 14 years of age was related to their success in intimate relationships and self-worth in early adulthood.
Helping the Depressed
There are more recent studies and materials that explain a variation in this. For example, the book by Ian Goodyer on The Depressed Child and Adolescent published by Cambridge University Press maintains his volume bears witness to the rapid advances taking place in our understanding of depression in children and adolescents, specifically, in the realms of psychopharmacology, psychotherapies, and genetics. Our understanding of the interplay between the bio-psycho-sexual-social factors is crystallizing: we are gaining better understanding of the way in which each component impacts on the other. Gone are the days of polarized camps of dynamic vs behaviorist vs biologic theorists. This is based on the most recent conceptual, clinical, theoretical, and research data in the field of child and adolescent depression. The editor is internationally well known in child and adolescent psychiatry for his scholarly book on the study of life experiences and their impact on the development of child psychopathology. He has collaborated with several contributors in this volume, choosing well-established and proven experts to contribute chapters on their particular area of clinical and academic research (Goodyer, I. (ed). 2001).
According to Erikson’s theory, the primary developmental task of adolescents is to achieve a positive role identity (Erikson, 1963; Gross, 1987; Rasmussen, 1964). One essential factor in achieving a positive role identity is the understanding by adolescents of their present self in terms of their past developmental achievements, and uniting it with their future aspirations and expectations of competence. This sense of continuity between present, historic, and future self is a hallmark of resolving one’s identity crisis. Another hallmark of an achieved identity is positive self-esteem. In order to resolve the identity crisis, adolescents need an opportunity to feel that they are persons of worth.
Once adolescents have a positive sense of worth and a basic sense of continuity of self, they are ready to move to succeeding psychosocial stages (Erikson, 1963). Adolescents then focus their psychosocial energy on intimacy formation – sharing themselves with another person while maintaining their own identity. Once basic identity and intimacy have been achieved, they enter the generativity stage of parenting (Erikson, 1963; Gross, 1987).
Following Erikson’s theory, it was assumed here that positive self-esteem should be a predictor of positive parenting; that is, competent parenting requires that the mother has achieved a mature sense of psychosocial identity. Thus, understanding how adolescent self-esteem relates to eventual parenting is necessary for delineating the predictors of positive parenting practices by adolescent mothers. It is important to underscore that this conclusion is based upon the assumption that developmental stages are more predictive of behavior than is age. However, it is recognized that age and developmental stages are correlated (Erikson, 1963; Gross, 1987).
According to the stage in Erikson on Identity vs. role confusion, adolescents explore different possibilities for career, interests, friends and family. . It is at this stage that adolescents are trying different behaviors and values from what they have learned at home. They may experiment with alcohol, drugs, sex, minor crimes, new religions, and new hobbies. They are trying to define themselves separate from their parents, although, in the end, most adolescents adopt many of their parents’ same values and behaviors as well as unique views of their own.
Indeed, in many other studies that have been conducted, researchers have suggested that family cohesion is related to several psychological outcomes, including depressive symptoms. Depressed adolescents seem to have a more negative thinking of their families than the other adolescents. The more depressed the young person, the more negative are his perceptions of the way in which his family functions. Specifically, depressed adolescents describe their parents as distant, unsupportive and emotionally unavailable (Eley, T., et.al. 2004).
In summation, effective parenting of the adolescents is vital to their emotional well-being than do the other factors such as heredity. The family is first of the social institutions in which the adolescent can find himself, be secure, and the one with the most profound influence on his emotional well-being. In the presence of a more cohesive and supportive family, depressed adolescents will decrease necessarily. Adolescents are particularly vulnerable to the effects of stress as this stage is in itself a complex developmental stage. From the information presented, we can conclude that the family provides a cushion for young people as they go through their adolescent stage. The family environment can mean a lot between a happy or a depressed adolescent. Resilience in adolescence can be built to create a positive mental health by the families to which they belong. In treating depression, it is important to note that the development of the more sophisticated investigative techniques need assessment and a closer examination whether they can really claim to do all of these things.
Secure attachment or connectedness to parents also promotes competent peer relations and positive, close relationships outside of the family. In sum, the old model of parent-adolescent relationships suggested that, as adolescents mature, they detach themselves from parents and move into a world of autonomy apart from parents. The old model also suggested that parent-adolescent conflict is intense and stressful throughout adolescence. The new model emphasizes that parents serve as important attachment figures, resources and support systems as adolescents explore a wider, more complex social world. The new model also emphasizes that, in the majority of families, parent-adolescent conflict is moderate rather than severe and that everyday negotiations and minor disputes are normal, serving the positive developmental function of promoting independence and identity.
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