Developmental Stages and Attachment Parenting - Trust v. Mistrust

I teach Psychology classes at a university and I love that developmental theories support attachment parenting. One of my favorite theorists is Erik Erikson. He theorized 8 stages that go from birth to late adulthood. One of my favorite online articles about Erikson is on The Learning Place. The stages are opposing outcomes of the typical challenges during that age. The outcomes are on a continuum, so it’s not an “either/or” situation. The stages occur linearly, but people can return to the stages later on to address any issues that arose. Most people do that in adulthood while attending therapy.

The first stage is Trust v. Mistrust. It lasts from birth to 18 months. This is the stage that I feel is the most important and which Attachment Parenting addresses best (in my opinion). This is the stage that sets a person’s worldview: Is the world safe? Can I trust others? Since an infant is dependent completely on others, the learning is based only on interactions with the world.

At this point in life, the brain is growing tremendously fast. The brain is not completely done growing until a person is around 21 years old…yes, years. Over those 21 years, different areas of the brain “come online” and then need to be trained and fully developed. During this stage, an infant’s brain has a rudimentary form of memory. The infant’s memory is of patterns (the biographical, story-based memory we typically think of doesn’t develop until 18-24 months of age). The more something is repeated, the stronger the impression. This means that parents can slip up here and there and it will usually not make a big impression.

When it comes to Trust v. Mistrust, an infant is looking for patterns like, do people come when I cry, am I held and loved, am I clean, am I comfortable, is there interaction, do I get what I need when I ask for it (based on only a cry), am I left to relax when I’m over stimulated, am I allowed to sleep enough, am I safe or do I need to be afraid? Based on the patterns of care, the child will learn 1) that the world is safe, 2) that it is safe in some circumstances but not others, or 3) that the world is not a safe place. The same pattern recognition can be attributed to different caregivers. You can see this when the child has a preference for a caregiver or has a significant reaction when they see a person that has not developed a pattern of safety for the child. (This is not to be confused with separation anxiety.) An infant will also prefer their dominant caregiver, whether it’s a parent or a nanny (and that can cause some hurt feelings, especially when Mom stays home and baby isn’t excited to be passed over to Dad when he gets home – this also has to do with infants preferring the facial features of females over males from birth).

One practice that really scares me when we talk about trust v. mistrust is Cry It Out. Let’s apply the pattern recognition and what is learned to that practice. A child has gone through their nighttime rituals (bath, feeding, rocking to sleep or to a drowsy state) and is placed into the crib. If the child awakens due to hunger or loneliness or the need to be changed and begins to cry, the parents may let the child cry for an amount of time, then enter the room to verbally soothe the child. The child is generally not to be picked up because that would teach them that crying gets them out of the crib. The child may only get a short amount of comfort before being left alone again. The time between comforting is increase between each visit and each night the intervals get longer for each step until the child is “sleep trained” and doesn’t cry – usually within 7 days (at least according to the Ferber method). What does a child learn from this pattern?

This is my take on it: A child cries because there is a need. Infants and children work on immediate gratification. They don’t have the brain development to delay a need. So, when a child cries and there is a delay for a response, the child may think the caregiver is not coming and may not feel safe. This has the possibility of increasing the initial need that the cry originated for and adding an aspect of fear or increased need for comfort. Then the caregiver arrives but does not give comfort/address the need or gives only a short duration of verbal and/or physical comfort (again, they are not to pick the infant up). The caregiver is supposed to leave before the child is asleep, even if they are crying, and not return for another interval of crying time that is longer than the last. Perhaps the infant learns that their needs are not important to the caregiver. This might lead to the learned pattern of “I’m not important” or “I’m not worthy”. It might also lead to the learned pattern of “My needs are not important”. Each child would learn something different based on the combination of their innate personality and the actual practices of Cry It Out. Learning these patterns can lead to an anxious or depressed child because they feel the world is not safe or that they are not worthy. It can also lead to withdrawn behaviors – less eye contact, less willingness to snuggle with caregivers, more pushing away and alone time (some parents see this “independence” as a positive trait in the child but this pulling away is meant to happen later in development).

I think the reason that Cry It Out “works” is that the child learns that the caregiver will not respond as needed, so they give up trying to ask for what they need. Here is an article that goes deeper into that theory. This would also translate into Mistrust of the world and the caregiver. Sadly, it also translates into mistrust of their own sense of what they need. Later in life, people that fall on the Mistrust side of the continuum (stemming from abuse, neglect, or parenting practices done with the best intentions) are likely to have relationship issues (not trusting others, not asking for help, not letting people in, not having truly emotionally intimate relationships, feeling or acting “needy” or not trusting their intuition and becoming involved in abusive relationships) and emotional issue (depression, anxiety, suicidal thoughts, isolation, being withdrawn in social situations). In addition, children who are left to cry it out “suffer long-lasting damage to their nervous system. As a result, they are more susceptible to post traumatic stress and anxiety disorders, including panic attacks.” And while the child is crying it out “his blood pressure and heart rate have soared excessively and needlessly because no one has opted to comfort him.”

With Attachment Parenting, the child’s needs are attended to swiftly. A crying child is picked up, held, fed, burped, changed, or soothed for as long or as many times as it is needed throughout the day. A child who is co-sleeping may not cry for more than a moment before being offered the breast. The child is already close to the caregiver, so comfort is immediately available. If comfort and feeding are not meeting the need, a parent will move on to other actions to check for other needs to be addressed. And the need for comfort may be eased at night because they baby was worn or carried much of the day.

What does this teach the child? My take on it is that the child learns a pattern of “If I am in need, my caregiver will take care of me and keep me safe”, “The world is a safe place”, “My needs are valid”, and “I am worthy”. This usually leads to emotional health and the potential for loving and emotionally intimate relationships throughout life.
Though it is a little stretch to include this, I found a short article on the “discovery” by Americans of attachment parenting in Japan in 1946. The conclusion was “if a child is well-mothered and well-guided by both parents, then the child given the best of all possible starts in life and seems well on his way to emotional stability.”

You'd never know

I think there is a stereotype of the crunchy, hippie attachment parent. The kind of negative image that allows people to shun the practices of attachment parenting and "fit in" with the masses. I suspect that there is far more attachment parenting going on than people talk about in polite society. There are probably 1000 women whispering their "dirty secrets" about their parenting choices right this moment. "My son still sleeps in our bed." "I'm still breastfeeding." "I don't even own a stroller." "I carry my son in a Moby (or some other carrier) and he's 18 months old." "My son is not circumcised." I still whisper things to people and feel some unforeseen guilt about my attachment parenting decisions. I'm not sure why. My son is strong, independent, trusting, generous, funny, loving, and people love him deeply. I know that the parenting style that my husband and I have followed (as well as we're able) has enabled our son to be who he is...and not in that "wild child" way that people fear will happen if a child hasn't been put on a strict schedule from birth. We believe in setting firm limits. I'm a "freedom within limits" parent. I want to write about developmental stages in later posts (since I'm a child and family therapist and teach Human Development classes at a University level), so I'll leave it at that.

I think one things that keeps me from truly singing from the rooftops that I love attachment parenting is that you would never think I was doing all those wonderful techniques by looking at me. I appear to be one of a sea of Midwestern, German-descendant women. People rarely remember my name, even after I've met them a few times. They call me Lisa or Cynthia. Close, I guess, but it's Christina. I don't look like someone who embraces "alternative" lifestyles. Happily, I am very alternative in most things. I do my parenting, I stay home with my son (and work at home while I pay a nanny a few days a week, but I'm still in the same living room), I've been vegetarian/vegan for 16 years, I hug trees, I practice Buddhism, I believe strongly in the mind-body-spirit connection, yada yada. I'm a plain Jane on the outside but a crunchy hippie on the inside.

Since this is the first post, let me cover the main points of attachment parenting. I define attachment parenting as doing any or all of these techniques. I prefer not to be an "all or nothing" person. This information will be based loosely on what is covered on the Dr. Sears site: http://www.askdrsears.com/

• Bonding from birth and beyond - from the moment that a child is born, the parents will be close to the child. The mother will breastfeed on demand. (Hopefully, the child was taken directly to the mother's chest after birth for his/her first breastfeeding session.) A human child is not born fully developed, but it must be born because it would be too large to fit through the birth canal if it waited until it was fully developed to be born. The baby does not have the ability to regulate its system fully and relies on the parents (particularly the mother) to help it regulate its system for several months after birth. Being close to the parents, day and night, allows the baby's system to maintain effective breathing, heart rate, and body temperature. One of my favorite books is "A General Theory of Love" by Thomas Lewis, Fari Amini, and Richard Lannon. That is where I decided to go full force attachment parenting.
• Breastfeeding - I have been on enough discussion boards to know that this is a touchy topic. Seeing that this is my blog, I will lay out my thoughts, not to be disrespectful to those that see things differently, but to present a point a view. Nature did a great job when it designed us. We are set up to safely birth and feed a child. Formula is for the rare and unfortunate circumstances that would prevent a mother from breastfeeding her child. Breastmilk is perfect nutrition for the child and it changes to meet the needs of the child over time. The components of breastmilk (including stem cells, amazingly enough) set a child up for the best health throughout life. There are studies upon studies that state this. A child will be just fine if given formula, and most of my generation were raised on formula. It's just not optimal nutrition, as breastmilk is. Let's also mention that it's convenient! Food for the child, everywhere you go, without the extra baggage and fuss. Those are the nutritional benefits. Beyond that are the emotional benefits. The bonding (as above) and protection from SIDS (along with co-sleeping and babywearing) have also been demonstrated in scientific studies. There is comfort in breastfeeding a sick or injured child. They rally much quicker and trust more deeply that you are there for them. I also believe in child-lead weaning. Even the American Academy of Pediatrics says "at least 2 years" of breastfeeding, and the world average is 2-7 years. I think that children will naturally wean when they are ready. There are social aspects to our life that encourage weaning: school and busy lives will bring less opportunities to breastfeed as a child grows, so we don't have to fret about the 12 year old that still breastfeeds, it is unlikely to occur. Ask any mother who does "extended breastfeeding", it is not pleasant nor sexual in nature. It can be annoying and painful, but the benefits to the child and the relationship outweigh the down sides.
• Babywearing - whatever style that feels right for the parents, but keeps the child close. I would also hope it keeps the face-to-face contact, as well. It again touches on bonding and regulation of an undeveloped bodily system. The added bonus is that is efficient. I can place my baby in a Moby wrap and wear him while he sleeps and wakes, and I clean, rest, cook, walk, shop, etc. There is instant communication between parent and child, increasing the bonding and symbiosis. This leads to a less fussy child and a more relaxed parent.
• Co-sleeping - not just sharing the bed (bedsharing), but sleeping within arms' reach of the child. This is so important in protecting a baby from SIDS that it scares me how many children are given their own room at birth (See this article: http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.anthro.25.1.201?cookieSet=1&journalCode=anthro). Again, the baby's ability to regulate its own system is not developed enough at birth, so being close enough to hear parents breathe and attune to the rhythms of parents' systems is so important. Babies wake often because of this undeveloped regulatory system. If they hit deep sleep for too long, their systems may shut down. Read up on it, if you don't believe me (I attached some articles in the comments). Having a parent there can also mean that the parent awakens if the child is having difficulties and can act immediately. The universal benefit of co-sleeping is that parents get MORE sleep. A mother can roll over and begin breastfeeding, then both mother and baby can return to sleep within seconds. Revolutionary! Getting awoken by a screaming baby over a baby monitor means the child is so distressed that sleep is unlikely for some time, the parents have to fully awake and walk to a different room, and then the parent needs to remain awake to calm the child and feed the child before returning to bed and trying to get back to sleep.
• Responding to your child's cry - crying is a child's only way of communicating for the first 6-12 months (proponents of baby sign language are the exception - how I wish I'd followed through with that!) Not only are we talking about bonding again, but this is where psychological and physical health can be compromised. Allowing a baby to get so worked up that they cry for extended times will increase stress hormone levels that can change brain development. The Cry It Out method can also teach children that they are on their own and they cannot rely on others to take care of their needs. What a horrible lesson to teach an infant. I plan to have a whole post just on this, so I won't dive too deep. One thing I feel the need to add: When a parent is success in the Cry It Out method and their child is crying less or not at all, it means the child has learned that 1) the parent can't be trusted to take care of the child's needs, 2) the child's needs are not important, therefore the child does not feel worthy, or 3) both. This can lead to trust issues, anxiety, and relationship issues throughout life.
• Follow the lead of the child - let the child sleep when they are tired, eat when they are hungry, cry when they need something, and hold them when they need you. I extend this to breastfeeding,co-sleeping, and potty "learning". Allow the child to listen to their own needs and trust themselves, even as an infant.
• Some people also add Circumcision to this list, as in "Don't do it." I don't have anything to say about it other than, we didn't do it and we had our reasons.

As with anything, people need to research their options, discuss it as parents, and make an informed decision. It is their child who needs to live with the parenting style and the parents need to be able to be consistent with whatever style they decide on to give their child a solid base from the beginning.

In the spirit of my parenting choices, I need to go take care of my son since he just woke from a nap (on my lap, while he breastfed and I typed). Please for give any grammar or spelling errors (though I did a spell check, so I hope it's OK).

I'm looking forward to discussing more as time goes on.

(Please read the comments below. I added some research on co-sleeping and SIDS.)