Book Review: Encounters with John Bowlby. Tales of Attachment.
By Arturo Ezquerro (2017) Routledge.
This is a book that anyone interested in groups of any sort, group dynamics and group therapy (quite aside from anyone curious about how what drives us as human beings from our earliest years and throughout life) would do well to read. If you thought that Attachment Theory was solely confined to the relationship between mothers and babies, then think again. Arturo Ezquerro makes clear at the start that Bowlby was ‘a group person, a man who conceived the human mind as a social phenomenon’.
Ezquerro, a consultant psychiatrist and group analyst, has written a paeon to John Bowlby in an affectionate and touching book that weaves his own experience of supervision from Bowlby and career progression with part biography of Bowlby and part theoretical discussion of the development of his ideas that led to Attachment Theory. Biographical details are interspersed with some letters from Bowlby and later from his wife, Ursula, that bring the Bowlby couple vividly alive.
Make no mistake: Attachment Theory has been one of the most powerful ideas about human development in the twentieth century. It has stood the test of repeated empirical testing and has led to profound change certainly in the care of children. Bowlby was a towering figure of the last century – one of the most thoughtful, insightful and rigorous of its thinkers. That his name is not more popularly recognised is curious. Given that Bowlby died only in 1990, perhaps in time his name will have its rightful place. In addition to biographies by Van Dijken (1998) and Holmes (2014), Ezquerro makes a fine contribution to this endeavour, from both the perspective of a supervisee and a group analyst.
As Ezquerro readily acknowledges, he was fortunate to be supervised by Bowlby towards the end of his life when Bowlby, full of accumulated wisdom, was still active in teaching and supervision across the world. He had become confident both in the robustness of his ideas and that they had, finally, been widely accepted. In the mid 1980’s, newly arrived from Spain as a trainee in child psychiatry at the Tavistock Clinic, Ezquerro had boldly approached Bowlby to learn more about attachment theory. Six years of fortnightly individual supervision ensued, the thread that runs through this volume. It was, unsurprisingly, far more than supervision for Ezquerro. His encounters with Bowlby became a professional ‘secure base’ from which he could venture forth more confidently. Despite their distance, fathers – both Bowlby’s and Ezquerro’s – are never far from the pages of this book.
It is not straightforward to structure a book that attempts to weave such a tapestry but Ezquerro pulls it off. The first two thirds of the book chart Bowlby’s life and work from 1907 when John Bowlby was born the fourth child into an upper middle class Tory family in London. His childhood was however not without its difficulties: emotionally distant parents; the departure of a much loved nanny; his father’s leaving to fight in the first World War; and his later dispatch to boarding school, an uncongenial experience for the young Bowlby. Following a number of years in the navy, Bowlby read medicine at Cambridge, finally qualifying in 1933. He trained both as a psychiatrist at the Maudsley Hospital (where he was much influenced by Aubrey Lewis) and as a psychoanalyst, soon joining what came to be known as the Independent Group.
During the 1930’s at the London Child Guidance Clinic, Bowlby had become very curious about impact of maternal deprivation and the development of aggression in childhood. His 1940 dissertation for membership of the British Psychoanalytical Society, ‘The Influence of Early Environment in the Development of Neurosis and Neurotic Character’ presaged a lifetime’s painstaking work on the understanding the influence of childhood experiences and unravelling the complexities of personality development.
The Second World War had a profound impact on Bowlby’s life and his thinking. Bowlby played a prominent role in the War Office Selection Boards within the Royal Army Medical Corps where officers came to be selected – far more effectively than hitherto – on the basis of a programme that crucially included observation of how individuals worked within a group. Leadership, after all, is about relationships even though this had previously been little acknowledged. Bowlby repeatedly warned of the risks to the emotional health and healthy personality development of children separated from their parents as they were evacuated to physical safety during the war. Nor did he confine himself to medicine and psychology: with his great friend from Cambridge, the economist and politician Evan Durbin, Bowlby pondered long and hard about the social conditions in which humans flourish best, individually and collectively. Both were anxious about the rise of fascism in Europe during the 1930’s. Who knows where their partnership might have led had Durbin not tragically drowned in 1948?
All was not however plain sailing in Bowlby’s career. His recognition of the importance of external reality and of the relational experiences of individuals – and not just on internal phantasies – placed Bowlby increasingly at odds with the psychoanalytic establishment of the post war years. Ezquerro describes the dismissal of much of Bowlby’s work on this basis. Yet Bowlby had a sophisticated and subtle understanding of the delicate interplay between an experience in external reality and how it might be construed internally and go on reciprocally to influence how individuals relate with others and develop their personality. His notion of ‘internal working models’ – mental representations of relationships – brought the internal and external inextricably together. Bowlby’s emerging ideas, informed both by clinical practice, research and zoologists’ observations of animal behaviour, led to the development of Attachment Theory, rooted in the biological need for comfort, security and protection, just as strong as the need for food, water and sex. As is now recognised, when stressed or vulnerable, throughout life we seek care from those to whom we are attached.
As Director of the newly established Department for Children and Parents at the Tavistock Clinic where he then was to stay for the rest of his life, Bowlby put his developing ideas into practice. Influenced also by Bion’s group work, Bowlby started a weekly support group for mothers and babies and laid the foundations of family therapy by seeing all members of a family group together. Human development is, as Bowlby and Ezquerro do not let us forget, an intrinsically social phenomenon.
Ezquerro usefully debunks some enduring myths about Bowlby’s work: for example that Bowlby did not attend to the unconscious and the internal world; and, a feminist critique, that Bowlby was insistent that only mothers could attend to the attachment needs of their young child, precluding them from working outside the home. Attachment Theory suggests that it is about the quality of the relationships with and around the child that is so important, within the extended family and wider community, supporting both mother and father. Ezquerro nicely draws parallels with the Bowlbys’ own sharing of accommodation with friends (the Durbin family) when their children were young, creating in the words of Ursula, ‘a tribal area’ of family and friends.
The last third of the book explores themes that featured in Ezquerro’s supervision meetings with Bowlby including the increasing recognition of the of child sexual abuse and, a not dissimilar betrayal of trust, professional sexual abuse, as well as some personal reflections of Ezquerro’s experience of Bowlby, the man.
Overall, a warm and delightful book of tales that will enrich the reader.
Dr Jane Roberts
Consultant child and adolescent psychiatrist
Co-editor The Politics of Attachment: Towards a Secure Society