Can lack of affection in childhood lead to severe psychological consequences? Thanks to studies on attachment formation and the effects of separation between babies and mothers, we know it can.
Affection and attachment bonds are necessary for the proper development of a baby, and separation from attachment figures, depending on the timing and duration, can be devastating. René Spitz studied psychological alterations in institutionalized or hospitalized children separated from their mothers and found that in severe cases, death from wasting could occur.
John Bowlby studied how the bond between mother and baby forms, and Mary Ainsworth described different attachment patterns. In this article, we will review their work and Spitz's findings.
Attachment: Definition, Importance, and Attachment Patterns Attachment is a strong emotional bond established between the child and the attachment figure (usually the mother), which drives them to stay together. It is important for fostering environmental exploration, facilitating learning, and promoting proper physical and mental development. John Bowlby studied how attachment bonds form and the phases of their development. It is not until stage 3, starting around 7 months, that attachment proper forms, and separation anxiety and stranger anxiety begin to appear. In the preceding two stages, the child may show preference for one caregiver over another but does not protest separation.
Mary Ainsworth designed a laboratory situation called the Strange Situation, which allowed for the study of separations between children and their attachment figures in a controlled environment. By observing children's behavior during separation and reunion, she described three attachment patterns: Group A: Avoidant/insecure attachment. Group B: Secure attachment. Group C: Ambivalent/resistant insecure attachment. These attachment patterns are considered universal and appear across different cultures. Later, a fourth attachment type, disorganized/disoriented attachment (Group D), was identified.
Separation from Attachment Figures: Short-Term Effects Separation of a child from attachment figures before 6 months does not seem to cause many difficulties since attachment is not fully established yet. However, between 6 months and 2 years, children are especially vulnerable to separation anxiety. Bowlby studied the short-term effects of separation and the progression of anxious-depressive symptoms, describing three phases: Protest phase lasts between one hour and one week and begins when the child becomes aware of being alone. It is characterized by active attempts to regain the attachment figure, signaling for them (crying, screaming...), and rejecting help from others. If a reunion occurs, attachment behaviors intensify. Ambivalence or despair phase: The child shows increased anxiety and hopelessness and may exhibit regressive behaviors. Upon reunion, they may act indifferent or even hostile. Adaptation phase: The child adjusts to the new situation and may be able to form new bonds with new caregivers.
Long-Term Effects of Separation: Anaclitic depression, hospitalism, and wasting In cases where the child fails to adapt to the loss, serious consequences such as intellectual delay, socialization problems, and even mortality can occur. Spitz studied how early separation from the mother could lead to various psychogenic illnesses. His studies were based on direct observation of institutionalized or hospitalized children for extended periods. He also compared the development of children raised in institutions to those raised in women's prisons alongside their mothers.
Anaclitic depression is a type of depression caused by partial emotional deprivation, typically lasting between 3 and 5 months. Symptoms may disappear after re-establishing an emotional relationship with the mother, the attachment figure, or when they are adopted and form new bonds. It is also known as hospitalism syndrome because it was observed in children who had been abandoned at the doors of institutions that could take care of them (hospital, orphanage, convent...). The term hospitalism is used to describe profound physical and psychological alterations in abandoned children or those who have been hospitalized for a long period.
In this environment and under these conditions, it is common for the depressive condition to become chronic and for cognitive and social problems to develop. Among the most significant alterations described by Spitz in this condition are: Delayed bodily development. Delayed manual dexterity. Less language use. Lower resistance to diseases. In cases of total emotional deprivation, the condition can progress to wasting, potentially leading to the child's death. These children exhibit extreme thinness and nutritional and emotional deficits.
Why can wasting lead to death? Medically, wasting is a type of extreme malnutrition that occurs before 18 months because the mother stops feeding the baby. The nutritional deficit is so severe that it can lead to death if not treated promptly and complications are not resolved. However, it has been observed that it is not only caused by a nutritional deficit but also by total absence of affection in babies. Often, institutionalized children had no chance to form emotional bonds.
Crying, agitation, hopelessness, and other developmental delays are followed by cessation of crying, blank stares, lack of responsiveness to the environment, long periods of sleep, and total loss of appetite. It's as if the children gradually fade away. Thanks to Spitz's studies, reforms were made in the hospitalization and institutionalization conditions of children. His work demonstrated that even if institutionalized children had their nutritional needs met, there were other equally important needs that, if neglected or not addressed, became obstacles to their development.