The Effects of Child Family Interaction

Child and family interaction: the setting

The scene shows Eaton Kerr, a toddler, in a happy and playful family photo shoot
with other members of his family. These family members are his mother, Kerry; his
father, Jonathan; and his doting 8 year old brother, Jordan. The Kerr family lives in
Northern Ireland.

Kerry is clearly enamoured of her little boy. In her own words, she “can’t bear to be
away from him” and could just “gobble him up”. This is probably intensified by the
fact that Eaton had been an unproblematic infant, who slept well, ate well and rarely
cried. Kerry and Jonathan apparently had an easy time in the first few months after his
birth. This is evident in the casual and relaxed manner that can be seen with the entire
family.

However, one and a half years later, Kerry is yearning for a baby girl. Having
previously lost two female children, and currently raising two little boys, Kerry
hungers for a female child. A scene in which she strokes her dog’s head longingly
could perhaps be an indicator of how much she craves another child. Kerry has a
tendency for potential fatal blood clots, which is typically increased in pregnancy.
Despite past medical complications and a clear understanding of the associated risks,
Kerry is determined to pursue her dream. She is booked into the hospital for a medical
scan to assess potential risk of cerebrovascular or cardiovascular events during
pregnancy. The results are daunting and confirm that a pregnancy could be lifethreatening
for the young mother.

Understandably, Kerry is dejected by the prognosis, and four months later, she still
has not come to terms with the outcomes of the scan. Her severe levels of unhappiness
culminate in clinical depression: she is perpetually unhappy and tired; has lost all
motivation to carry out even mundane everyday tasks; and finds no pleasure in things
that normally make her happy (anhedonia). The loss of her two baby girls in the past
appears to be constantly on her mind and she keeps photo scans of the embryos which
would serve as a constant negative reminder. The fact that she has named these two
offspring (Jordana and Caitlin) shows the depth of the attachment she feels for them.
In addition, it seems she has recently lost her father – all these are textbook triggers
for clinical depression. Using the DSM-1 classification of mental health diseases,
Kerry’s depression would be classified as severe, as she confesses to having had
suicidal thoughts.

It is a well-known fact that depressed mothers find it difficult to respond to their
children’s needs. In a poor attempt to discipline her toddler, Kerry tries to implement
strict upbringing rules which are often not suitable to Eaton’s developmental phase.
This is clearly corroborated by the evidence of Eaton’s corresponding stunted
development. However, the little boy is shown as striving to obey his mother, only
becoming rebellious at the often-dreaded bedtime etc, thus showing signs of his first
battle for independence at eighteen months.

Poor sleep hygiene that is common among depressed patients is also proving to be
problematic in the mother-child relationship. In the video, classifying humans
according to their sleep patterns, Eaton is categorised as a lark – early to bed and early
to wake; while Kerry is a contradicting owl – who is up till late at night and,
consequently, stays in bed till late in the afternoon. This means that Eaton is often up,
for hours, sometimes for up to three and a half hours, crying for his mother before he
gets any attention. He is losing numerous battles for his independence in this ‘power
struggle and is learning that he has no control over his environment. Although it is not
voiced in the videotape, the constant absence of Eaton’s father, Jonathan, suggests
possible family problems. He has to leave for work early as he helps run the family
energy business, and appears to be blissfully unaware of the problems in his home.
Therefore, Kerry is probably going through these difficult times alone. Without the
vital family and social support, her depression is likely to worsen and would
essentially adversely impact on her little boy.

Child development

As Kerry is unable to motivate herself to do anything, she is also incapable of
stimulating the young Eaton. Her apparent insensitivity to his emotional needs is
clearly evident and would be detrimental to the child’s development. This is seen with
simple tests as outlined below:

• Progress testing: carried out by a child development specialist with picture books
  and block shapes. The results of this showed that Eaton could complete less than
  one third of his tasks and is behind other children of his chronological age.
• Empathy testing: using a scientifically based questionnaire, Kerry scored high on
  the empathy testing. However, she has been unable to pass this on to Eaton who
  scored very low on these tests, having a tendency towards blatant aggression
  towards not just his mother, but also to his eight-year old brother, Jordan. This
  sort of behaviour could lead to bullying traits in the future.
• Interaction experiment: this shows that Kerry is unwilling to allow Eaton grow
  and learn. By limiting his playtime to toys and games that don’t stimulate him, she
  is inadvertently limiting his development, probably in an unconscious and failing
  attempt to foster attachment to her. It seems she doesn’t want him to gain
  independence, but would rather he remain dependent on her.

Analysis of child-mother interaction: a literature review

Attachment theory

John Bowlby’s attachment theory is a psychological and ethological description that
helps to explain an infant’s attachment to a parent or caregiver. Infants become
attached to adults who are sensitive and responsive in their interactions with them.
The way a parent responds to their young infant in different situations is key to the
development of patterns of attachment in the child. These patterns are the skeletal
framework that guides the child’s feelings, thoughts and expectations in subsequent
relationships (Bretherton et al, 1999).

According to Bowlby’s theory, through physical and emotional closeness with a
parent or caregiver, the child develops an internal working model, reflecting the
parent’s own response to him/her. In Eaton’s case his thought process might mirror
the insensitivity that he has experienced from his depressed mother, and could
potentially cause problems in the future.

Family dynamics: a secure base

The point of attachment should ideally provide a secure base from which the child can
explore the environment and return when he/she feels fearful. If Eaton lacks that
secure haven, his mental health would be compromised.

In his book, A Secure Base, John Bowlby (1998) describes the initiation of the
mother-infant interaction. He highlights an initial elation and extreme possessiveness
immediately after delivery. This phase was probably evident in Kerry, in the first few
months when she stated her joy and reluctance to let Eaton out of her sight. However,
the well documented lively social interaction alternating with phases of
disengagement may have developed a pronounced effect of the latter phase, especially
after the disheartening results of her hospital scan.

Peri- and post-natal conditions that could affect (hinder or foster) positive attachment
and the effective formation of a secure base, as outlined by Bowlby (1998) are
outlined below:

• Adequate support for the mother with other aspects of household chores, etc.
• A secure base for the mother herself
• Length of separation from the baby in the hours and days following delivery
• Birth experience
• Attitudes and expectations expressed by the mother during her pregnancy

It is not clear from the brief clips of the videotape which, if any, of the above factors
are applicable to Kerry’s experience. However, interpreting non-verbal
communication and appearances, I think it is possible that Kerry receives little or no
support around the house, especially as Jonathan departs for work early and eight-year
old Jordan would be if limited help. This proposed lack of support could mean that
Kerry does not have her own personal security base and might have been in need of
assurances. While we are not privy to Kerry’s birth experience during the delivery of
little Eaton, her past medical history, in addition to that statement “I’ve cheated life
once already…”, suggest that she may have had a difficult pregnancy, which, in
addition, could have led to prolonged periods of separation from her newborn in the
periods immediately following the birth.

The Maternal Deprivation Theory

Revisiting the controversial ‘maternal deprivation’ theory, in the World Health
Organization report on Maternal Care and Mental Health, Bowlby (1951) explored the
effects of deprivation of maternal care. Maternal deprivation is not limited in
definition to mothers who are physically absent from their infant’s lives; it also
applies to mothers who are not sensitive or responsive to their child’s needs. In this
report, Bowlby concluded that a warm, intimate and continuous child-mother
relationship, in which both parties find satisfaction and enjoyment, is essential. Lack
of such a satisfactory relationship could lead to significant and irreversible mental
health malformations.

The case of Eaton and his mother, Kerry, could be seen as a classic example of the
maternal deprivation theory. While Kerry is present physically, her own self-admitted
lack of motivation and uninvolved attitude is not adequate to foster that close
relationship with her second son. As highlighted by Bowlby and later his close
colleague, Mary Ainsworth (1962), Eaton could be at risk of having some mental
problems in the future, if a timely and effective intervention is not implemented.

The long-term effects of poor child-family interactions

The consequences of the poor maternal and possibly paternal interaction which Eaton
is accustomed to cannot be overemphasised. In a recent study using a conceptual
model derived from the attachment theory, it was shown that attachment anxiety and
low empathy significantly increases the odds of child molester status (Woods and
Riggs, 2008). Furthermore, attachment insecurity in childhood is linked to
externalizing behaviour and higher and stable patterns of depressive behaviour at the
adolscence stage (Allen et al, 2007).

Also, conversely, avoidance of closeness in depressed mothers is implicated in the
development of internalizing symptoms in their children, because individuals who are
avoidant of closeness, logically, are poor care givers (Whiffen et al, 2005). Research
also shows that infants and toddlers of depressed mothers are at increased risk of
developing attachment insecurity and behavioural difficulties than offspring of nondisordered
mothers (Cicchetti et al, 1998).

Observing the effects of maternal depression on social cognition and behaviour in
parent-child interactions, Lovejoy (2007) depressed mothers, as a group, exhibited
more negative behaviour. Furthermore, maternal depression was found to be
associated with negative parent-child interactions and more negative, albeit fairly
accurate, perceptions of child behaviour. This factor could be a major implicating
factor in the apparent poor development that Eaton shows.

An older study by Seiner and Gelfand (1995) showed that enacted maternal
withdrawal and depression led to toddlers physically withdrawing from their mothers,
making more negative physical bids for attention and generally becoming unfocused
and negative, displaying their distress in a developmentally appropriate manner. In
addition, the children made no attempt to comfort their mothers; this can be related to
Eaton’s unsympathetic reaction to his mother’s apparent distress in the video.

There are numerous other studies in the literature that explore the negative impact of
poor interaction between child and mother (or care giver). There is a clear association
between attachment and maternal depression, and the development of the recipient
child.

Recently, Vieten and Astin (2008) evaluated the effectiveness of an eight-week
mindfulness-based intervention during pregnancy on prenatal stress and mood. Their
findings demonstrate that mothers who received this intervention showed significantly
reduced anxiety and negative effect during the third trimester in comparison to those
who did not receive the intervention. It is well-documented that stress and negative
mood during pregnancy increase the risk of poor childbirth outcomes and postnatal
mood problems and may interfere with mother-infant attachment and child
development. Accordingly, such interventions may be pivotal in supporting mothers
in preparation for child delivery.

Conclusion

In the course of research for this write-up, I have a gained a greater understanding of
the attachment theory and the role of the “secure base” in molding a child’s
development. More importantly, I am now aware of the need to provide as much
support to the mother as is expected for the newborn. This is especially the case for
at-risk mothers. Partners and family members need to be a part of the support
programme to ensure that mothers receive the care and security they need in order to
effectively carry out their newly acquired duties.