Imaging Attachment

Bowlby's theory of attachment has been a productive source of empirically-testable psychoanalytic theories. For more than 30 years, attachment researchers, led by Mary Ainsworth and her successors have demonstrated that the descriptively unconscious strategies that a child uses to regulate emotional reactions to separation from a caregiver are related to (a) the ability of that child to adapt to his or her environment and (b) the strategies that his or her caregiver used in constructing his or her own narrative of early-life significant relationships. The empirical evidence overwhelmingly has supported the notion that these attributes of a child cannot be reduced to simpler traits of personality or temperament nor can their cross-generational transmission be attributed solely to genetic factors. Thus, the data from attachment research have supported a central tenet of psychoanalytic work, namely that early relationships have an important and irreducible role in shaping descriptively unconscious emotional strategies that in turn influence later behavior and symptomatology.

Research in attachment is keeping pace with the latest advances in how to study the brain and its development. In March 2010, Markus Quirin and colleagues in Germany, Montreal, and Kansas published in the journal Social Cognitive and Affective Neuroscience results of a study that used magnetic resonance imaging (MRI) to explore brain differences in individuals with different attachment styles. They measured the density of cells in the hippocampus of 22 healthy young adults without psychopathology and looked for an association between these observations and two measures of attachment security. Instead of using Mary Main's four-way adult attachment classification system (secure, dismissing, entangled-preoccupied, and unresolved with respect to trauma or loss), they used a newer system of measuring attachment based on the work of Phil Shaver. In this system, a 36-item questionnaire, completed by the study subject, is used to calculate two scores: attachment anxiety and attachment avoidance. Researchers have found that attachment anxiety, which is associated with continuous worries about rejection and abandonment, is related to emotional reactivity and psychopathology associated with the inability to down-regulate physiological arousal. Meanwhile, attachment avoidance, the reluctance to get close or intimate with a relationship partner, is associated with the overzealous use of suppression and repression to avoid emotionally dangerous situations. As psychoanalytic theory would predict, however, the strategies of attachment avoidant individuals frequently fail in difficult situations, resulting in the same level of physiological stress as individuals who show attachment anxiety, despite their superficially different appearance.

Attachment Anxiety, Attachment Avoidance and the Hippocampus

Quirin and colleagues found that both attachment avoidance and attachment anxiety were related to a reduced concentration of cells in the hippocampus. By also measuring “neuroticism” (a widely measured personality trait that reflects an overall negative perception of the world across relational and non-relational situations) in their subjects and then statistically removing the effect of neuroticism from the analysis of hippocampal density, they were able to say with some confidence that attachment security brings a unique and relevant perspective to understanding the relationship between structure and function of the brain. However, because the brain measurements were only taken at a single point in time, they were unable to conclude whether it was the reduced volume of the hippocampus that led individuals to be more susceptible to attachment insecurity (i.e., avoidance or anxiety) or whether attachment insecurity and the emotional stress it brings leads to changes in the hippocampus.

The findings of another recent study have been relevant to the question of the causal link between attachment and brain structure. In 2006, Marinus van IJzendoorn and Marian Bakermans-Kranenburg in Leiden, themselves early pioneers in attachment research, published the results of a study that looked for a genetic moderator between maternal unresolved loss and infant disorganized attachment style (a situation in which attachment patterns are so disrupted that the infant cannot settle on either a predominantly avoidant or anxious attachment and is predictive of the highest levels of psychopathology). They found that a change in the gene for the dopamine receptor (DRD4 7-repeat polymorphism) made an infant far more susceptible to the effect of an unresolved mother, than an infant without this genetic makeup and the same early childhood experience.

Taken together, these findings suggest that a combination of a genetic susceptibility (which is probably linked to differences in infant brain structure or function) and early experience may lead to a style of regulating relationships and emotion that is in turn linked to later distress and psychopathology. It is hardly surprising then that no single area of research—whether it be brain imaging, genetics, or attachment behavior—alone can tell a conclusive story about the way a child develops either an effective emotional style or one that results in symptoms at some point in their lives. What is becoming clear, though, is that the role of unconscious emotion and relationship patterns, so central to psychoanalytic theory and practice, in this transmission is crucial. Psychoanalytic theorists and practitioners have much to add to this discussion as they explore the interplay of these factors and perhaps someday apply the findings to their own work.