Abstract
In a recent survey undertaken by the Department for Education (2018) in England, social workers were asked ‘What theories or research do you rely on to inform a plan of how to support a child?’ The most common answer was attachment theory, mentioned by 11 per cent of respondents. The next three most common responses were mental health (5 per cent), child development (4 per cent) and social learning theory (1 per cent).
These results might suggest that social workers in England are quite taken with attachment theory. No other formal theory was mentioned anywhere near as much. On the other hand, they could mean that social work is largely an a-theoretical profession. Only one in ten referred to attachment theory, and no other theory was mentioned by more than one in a hundred respondents (while mental health and child development are clearly important areas of practice, they are not theories or bodies of research). Even if we prefer the first interpretation, this leaves nearly ninety per cent of social workers who did not say they rely on attachment theory when making plans to support children. Perhaps the results would have been different if the question had asked about the use of theories and research, rather than reliance upon them. Nonetheless, it is common for social work academics either to rail against an over-reliance on attachment theory, or to argue that it should be used with a greater degree of nuance and understanding. The figures above suggest that those doing the railing might not need to be so concerned, or that those trying to promote it might need to up their game.
And yet how much do social workers really know about attachment theory, and how has it developed and changed over time? And what if the majority of the debates in social work are based on misunderstandings and misrepresentations? In Cornerstones of Attachment Research, Duschinsky argues that the most well-known accounts of attachment theory depend largely on early claims and arguments that have long since been discredited or substantially developed.
The first key argument in the book is about the use of language. For example, what does sensitive parenting mean? According to the Oxford English Dictionary (OED), sensitivity means displaying an appreciation of other people's feelings and responding appropriately. Sensitive parenting has been described as “the foundation for secure attachment relationships” (Barlow et al., 2014, p. 165). Given these definitions, one could be forgiven for thinking that a parent's ability to appreciate and respond to their child's feelings is very important. And in the Framework for the Assessment of Children in Need and Their Families (Department of Health, 2000), until recently the statutory basis for social work assessments in England, the importance of emotional warmth is indeed made clear. But what does sensitive parenting mean within attachment theory? Can we make claims about these everyday interpretations of sensitive parenting, and claim support from attachment theory? Almost certainly not. Sensitivity within attachment theory has a more technical meaning, that carers can “detect and successfully interpret behaviours that may convey their child's experience and offer a relevant response in a timely manner” (Duschinsky et al., 2019, p. 123). This definition is similar, yet subtly different from that given in the OED. It is perfectly possible for parents to be warm and tender, and yet lack sensitivity in this technical sense. Thinking back to my own practice career, could I have differentiated between a parent who was sensitive in a technical sense, and one who was ‘merely’ warm and tender? And would it have made any difference anyway? It is to attachment theory's detriment that it uses language that sounds so familiar to us, including sensitivity, caregiving, security and anxiety, yet with different technical meanings.
A second key argument made by Duschinsky is that attachment theory has largely been developed behind closed doors, with a reliance on unpublished manuscripts, and an oral tradition of debate. While John Bowlby was an effective publicist, most attachment researchers since have not since taken up his mantle. The most accessible portrayals of attachment theory are some thirty to fifty years out of date. Bowlby himself used language rather haphazardly, and frequently contradicted himself. Critics often attack Bowlby's original formulations and are unfamiliar with more recent developments. This has left many of us to propose or oppose quite different versions of it, while showing mutual incomprehension of the others’ position. “How can you follow a man who exhibited clear anti-feminist tendencies?” “How can we take your criticisms seriously when you obviously believe such a crude caricature of his work?” And so on.
Towards the end of the book, Duschinsky considers the use of attachment theory in practice. He notes the often-polemical nature of these debates and argues that we actually know very little about how professionals apply attachment theory in their work. While this is true, Duschinsky is surely correct when he claims that such applications are far more likely to be heterogenous than homogenous.
As a social worker, I believe we need two things from the attachment community. First, we need a dialogue (and not a one-way ‘broadcast’) about what attachment research means, and we need the focus to be on the kinds of problems that practitioners routinely encounter. There is nothing wrong with “pure” research about attachment relationships (or anything else), but the more attachment research can directly address questions of practice, the greater and more positive difference it will make for families. Second, social work's overwhelming aim is to help people, not to assess them. Much more could be done to translate the findings from attachment theory into supportive interventions to help parents (and children) who may be struggling, rather than simply to assess them. Beyond the scope of this book is a discussion of Patricia Crittenden or Peter Fonagy's work, both of whom have done more than most to engage with practice communities. Duschinsky has written about their work elsewhere (Duschinsky et al., 2019; Landa & Duschinsky, 2013).
Despite the detailed research upon which the book is based and its thoroughly expert nature (no ‘quick tips on attachment theory’ here), the author's style is highly accessible. There are extensive footnotes throughout, and a full index. In fact, the use of so many footnotes would be my main criticism of the book's style. While they provide fascinating details, they often distract from the main text. The majority would have worked better as endnotes, or even as the basis for a whole other book – they are that detailed.
In the introduction to the book, Duschinsky suggests that attachment theory: “Can be imagined as a maze of little streets and squares, with houses from various periods nonetheless situated by earlier structures. It is these structures, which continue to both constrain and enable what is built today, that come into view when science or a human personality is considered in historical terms” (p. xvii)
If so, the author is adept at finding the avenues and back-streets that link the main thoroughfares and leaves you with a greater understanding of how the city works and why it has developed in the way it has. While not aimed solely at social workers, there is every reason to suppose that child and family social workers will learn something new about attachment theory from reading the book (I know I did). It is highly commendable that the book is being made available as an open-access (free to download) eBook. If attachment theory is a maze of streets and squares, then Duschinsky is an accomplished tour guide.