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The most important thing about attachment theory, from my point of view as both a child psychiatrist and an attachment researcher, is that it presents an ideal, a depiction of what is adaptive and healthy, a description of a system that theoretically optimizes certain aspects of functioning. Some of the ideas that I will discuss have emerged from my own experience in integrating research and clinical work, but most have developed out of extensive discussions and collaborations with my close colleagues in attachment research, Everett Waters and Dominique Treboux.
To date, I think that the primary framework for understanding how attachment theory and research are related to issues of mental health has focused on risk, symptoms, deficits, and disorders, rather than on successful adaptation and health. Perhaps this is due, in part, to Bowlby's original focus in explaining how attachment experiences were related to the development of certain kinds of psychopathology. A lot of research has shown connections between attachment insecurity of different types and various forms of psychopathology. These studies have been valuable and thought-provoking. Some of the most interesting and important work, conducted by several of the participants in the conference, has examined mechanisms to explain the connection. I find this work intriguing and valuable, but as a clinician working with children and their parents, I cannot say it has been the most useful approach for me in applying attachment theory and research to my work in child psychiatry. I say this for the following reasons:
A lot of the research has said little more than that there is a connection between attachment security and psychopathology. This is an important first step, but doesn't tell you anything about how to assess the problem. It doesn't tell you where attachment fits within an etiological framework (that is, what other factors may be causing or
maintaining the problem, and their relative weight). And it certainl