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Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
Fonagy and target 1997
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Fonagy and target 1997

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  • 1. Development and Psychopathology, 9 (1997), 679–700Copyright © 1997 Cambridge University PressPrinted in the United States of AmericaAttachment and reflective function:Their role in self-organizationPETER FONAGY AND MARY TARGETSub-Department of Clinical Health Psychology, University College LondonAbstractThe paper traces the relationship between attachment processes and the development of the capacity to envisionmental states in self and others. We suggest that the ability to mentalize, to represent behavior in terms of mentalstates, or to have “a theory of mind” is a key determinant of self-organization which is acquired in the context ofthe child’s early social relationships. Evidence for an association between the quality of attachment relationship andreflective function in the parent and the child is reviewed and interpreted in the context of current models of theoryof mind development. A model of the development of self-organization is proposed which has at its core thecaregiver’s ability to communicate understanding of the child’s intentional stance. The implications of the model forpathological self-development are explored, with specific reference to the consequences of maltreatment.The “self” and concepts allied to it are cur- continuity through time, creates a sense ofrently experiencing a considerable revival of freedom or initiative, and generates the expe-interest from social scientists and develop- riences leading to the distinctness of oneselfmentalists (e.g., Bracken, 1996; Cicchetti & as a person. Modern developmental psychol-Beeghly, 1990; Cicchetti & Toth, 1994). Psy- ogy has brought us closer to a full understand-chological interest in the self is usually traced ing of the mental processes which combine toto James’ (1890, 1892) distinction of two as- organize the representation of oneself.pects of the self, the “I” (self as sub-ject) and the “Me” (self as object). The I is Reflective Functionthe active agent responsible for construct-ing the self-concept of Me. To paraphrase in Developmentalists over the past 10 years havethe terms of current cognitive neuroscience, drawn attention to the remarkable capacity ofthe Me is the mental representation, while the young children to interpret their own andI embodies the mental processes or functions other people’s behavior in terms of mentalwhich underpin representations of the self states. Reflective function is the develop-(Mandler, 1985). The I organizes and inter- mental acquisition that permits the child to re-prets experience, ensures the experience of spond not only to other people’s behavior, but to his1 conception of their beliefs, feelings,We gratefully acknowledge the support of the Gatsby hopes, pretense, plans, and so on. ReflectiveFoundation and the Ludowyk Trust. We would also like function or mentalization enables children toto acknowledge the long-term collaboration with Miriam “read” people’s minds (e.g., Baron–Cohen,and Howard Steele and, more recently, Juliet Holder. We Tager–Flusberg, & Cohen, 1993; Morton &are particularly grateful for the creative suggestions of Frith, 1995). By attributing mental states toGyorgy Gergely. We benefited very much from the help- others, children make people’s behavior mean-ful editorial suggestions of Dante Cicchetti. Address correspondence and reprint requests to: PeterFonagy, Sub-Department of Clinical Health Psychology, 1. For economy of expression only, we will generally useUniversity College London, Gower Street, London “he” to refer to a child and “she” to refer to a parentWC1E 6BT, UK; E-mail: p.fonagy@ucl.ac.uk. or other caregiver. 679
  • 2. 680 P. Fonagy and M. Targetingful and predictable. As children learn to has great generalizability and explanatoryunderstand people’s behavior, they can flexi- value. Recent philosophers of mind (Hopkins,bly activate, from multiple sets of self–other 1992; Wollheim, 1995) have extended Den-representations organized on the basis of prior nett’s approach to unconscious processes.experience, the one(s) best suited to respond They illustrated that one of Freud’s most sub-adaptively to particular interpersonal transac- stantive contributions was to extend folk psy-tions. chology to unconscious mental states, a the- The interdependence of reflective function ory of unconscious mind, thus making thoseas it applies to others and to the self was high- aspects of behavior meaningful which—usinglighted by the second pioneer of psychologi- the ordinary constructs of intentionality—cal self theory, Cooley (1902/1964): “The make little sense (e.g., dreams, neurotic symp-thing that moves us to pride and shame is not toms, humor). These behaviors may be under-the mechanical reflection of ourselves, but an stood if we add unconscious beliefs, thoughts,imputed sentiment, the imagined effect of this and feelings to our everyday model of thereflection upon another’s mind” (p. 153). De- mind.velopmentally, this may be thought to imply Extending these ideas, we consider reflec-that a mental operation is required in early tive function to be the mental function whichchildhood, to derive the self-state from the ap- organizes the experience of one’s own andperception of the mental state of the other. others’ behavior in terms of mental state con-Exploring the meaning of others’ actions is structs. Reflective function concerns knowl-then a precursor of children’s ability to label edge of the nature of experiences which giveand find meaningful their own psychological rise to certain beliefs and emotions, of likelyexperiences. This ability arguably underlies behaviors given knowledge of beliefs and de-the capacities for affect regulation, impulse sires, of the expectable transactional relation-control, self monitoring, and the experience of ships between beliefs and emotions, and ofself-agency, the building blocks of the organi- feelings and beliefs characteristic of particularzation of the self. In previous papers (e.g., Fo- developmental phases or relationships. Its es-nagy, Steele, Moran, Steele, & Higgitt, 1991a) sence is not that the individual should be ablewe have labeled the predisposition to under- to articulate this theoretically, and this is clearstand behavior in mental state terms reflective in our operationalization (Fonagy, Steele,self-function, or more simply reflective func- Steele, & Target, 1997). Individuals differ intion. the extent to which they go beyond observ- The notion of reflective function is rooted able phenomena to explain their own or oth-in Dennett’s (1978, 1987) proposal that three ers’ actions in terms of beliefs, desires, plans,stances are available in the prediction of be- and so on. This undoubtedly high level cogni-havior: the physical stance, the design stance, tive capacity is, we believe, an important de-and the intentional stance. Dennett’s thesis is terminant of individual differences in self-or-that explanation in terms of beliefs and de- ganization, intimately involved with manysires, so-called intentional states, provides defining features of selfhood such as self-con-good grounds for predicting human behav- sciousness, autonomy, freedom, and responsi-ior—the only grounds accessible to all of us; bility (Bolton & Hill, 1996; Cassam, 1994).this knowledge is embodied in the theory of Intentional stance, in the broad sense consid-mind of folk psychology (see Churchland, ered here (i.e., including apparently irrational1986; Mele, 1992).2 unconscious motives), explains one’s own be- Theory of mind is an interconnected set of havior and therefore creates the continuity ofbeliefs and desires, attributed to explain a per- self-experience which is the underpinning ofson’s behavior. The theory of mind concept a coherent self-structure. It is important that reflective function is2. Dennett’s formulation is unnecessarily restrictive (Bol- not conflated with introspection. Bolton and ton & Hill, 1996). It does not address predicting the Hill (1996) note that the weakness of intro- behavior of systems which do not function rationally. spection is to define mental states in terms of
  • 3. Attachment and reflective function 681conscious motivation rather than, as here, in do not ask what the child feels about the men-terms of their capacity to regulate behavior. tal states he encounters in others. Yet, in thisIntrospection or self-reflection is quite differ- context at least, the question of knowledgeent from reflective function as the latter is an and that of emotional investment are evi-automatic procedure, unconsciously invoked dently closely related. The child may knowin interpreting human action. We see it as an what the other feels but care little or not at alloverlearned skill, which may be systemati- about this; alternatively this information, forcally misleading in ways much more difficult some youngsters, may be an issue of survival.to detect and correct than mistakes in con- The emotional significance of mental statesscious attributions would be. Reflective func- determines the evolution of the capacity ortion similarly lends a shape and coherence to structure available for processing, but this isself-organization which is outside awareness, not usually addressed. In current models ofin contrast to introspection, which has a clear theory of mind development the child tends toimpact on experience of oneself. be seen as an isolated processor of informa- Our central concern here is the acquisition tion, engaged in the construction of a theoryof reflective function and the light this might of mind using biological mechanisms whichcast on the development of self-organization. may fail if the child’s endowment is poor.Baron–Cohen and Swettenham (1996) appro- This, from the viewpoint of developmentalpriately ask “ . . . how on earth can young psychopathology and its psychosocial treat-children master such abstract concepts as be- ment, is a barren picture which ignores thelief (and false belief) with such ease, and central role of the child’s emotional relation-roughly at the same time the world over?” (p. ship with the parents or other caregivers in158). Their answer is that of modularity theo- fostering the capacity to understand interac-rists, along the lines of Chomsky’s solution to tions in terms of mental states. The develop-the problem of the acquisition of a knowledge ment of children’s understanding of mentalof syntax. They postulate an innate (learning) states is embedded within the social world ofmechanism with a specific location in the the family, with its interactive network ofbrain (see also Leslie, 1994; Segal, 1996). complex and at times intensely emotionallyOther current psychological theories stress the charged relationships, which, after all, consti-cognitive precursors of theory of mind. Some tute the primary content of early reflection.favor the folk psychology, theory–theory, ap- Therefore it should not surprise us that the na-proach assuming that the child evolves a sci- ture of family interactions, the quality of pa-entific theory-like network of interdependent rental control (Dunn, Brown, Somkowski,propositions about the mind on the basis of Telsa, & Youngblade, 1991b), parental talkexperience (e.g., Botterill, 1996; Gopnik, about emotions (Denham, Zoller, & Cou-1996). Others assume that theory of mind is choud, 1994), and the depth of parental dis-acquired via simulation of the mental state of cussion involving affect (Dunn, Brown, &the other, either through making inferences Beardsall, 1991a) are all strongly associatedfrom what we ourselves would do in the with the acquisition of the intentional stanceimagined circumstances (e.g., Goldman, 1993; in observational studies. The involvement ofHarris, 1992) or an even more radical assump- the family in the child’s acquisition of a the-tion of imagined transformation into the other ory of mind is further highlighted by the ro-which does not involve introspection or infer- bust finding that the presence of siblings inence (Gordon, 1995). the family appears to improve the child’s per- Both simulation and theory–theory models formance on a range of false-belief tasks (Jen-may appear to emphasize social learning as- kins & Astington, 1996; Perner, Ruffman, &pects of the development of mentalization but, Leekman, 1994; Ruffman, Perner, Naito, Par-upon closer scrutiny, their focus is at the level kin, & Clements, in press).of mechanism rather than content. They ques- Modular accounts of theory of mind devel-tion how and when the child acquires knowl- opment have some difficulty with such data.edge of other minds in an abstract sense and Both the theory–theory and the simulation ac-
  • 4. 682 P. Fonagy and M. Targetcounts also fall short of adequately addressing Jaffe (1997) have shown that interaction be-the social origins of this critical aspect of self- tween baby and mother shows both self-regu-organization. In the theory–theory account lation and sensitivity to the state of the other.mental concepts are thought to develop within Their facial expressions showed rapid fluctua-a network of interdependent concepts on the tions: affect, space, and degree of contact inbasis of data from the social world, but the each 1⁄ 12 s time period responded to the ex-social world does not generally “give” con- pression of the other in the previous period,cepts to the child—it provides him with data presumably on the basis of schemata of antici-for concept building. In the simulation model pated reactions. High coordination predictedmental state concepts are thought to arise later good cognitive performance, whereasfrom introspection, but this begs the question lower levels of coordination were optimal forof how children come to think of their own secure attachment and easy temperament. In-mental states in terms of feelings, beliefs, terestingly, security with the mother in thewishes, and so on. This paper attempts to ex- Strange Situation at 1 year was better pre-plore the role of parent–child relationships in dicted by coordination with a stranger thanthe transformation of prereflective experience with the mother at 4 months.of mental states into reflective understanding Interactions at this stage may be argued toof them. Within this social context both social be presymbolic, in the sense that they are non-models of mentalization may have their place; mentalistic; the infant is not required to repre-the predominance of one or other route to un- sent the thoughts or feelings of the caregiver.derstanding the mind may be a function of in- However, they involve reference to futuredividual differences between children and be- states such as goals as explanatory constructstween environments, but, in our view, a in the interpretation of the behavior of thesatisfactory model must have the child’s rela- other. Thus they can be used to predict behav-tionships with attachment figures as its start- ior although these structures would be limiteding point. in their capacity to modify behavior. Recent experimental work by Gergely and Csibra (e.g., Gergely, Nadasdy, Csibra, & Biro, 1995)Developmental Roots of Reflective suggests that the infant’s perception of socialFunction in Infancy contingencies by the second half of the 1st“Teleological” stance year is teleological in that they make refer- ence to future states (goals) as explanatoryThere is general agreement that self-organiza- entities in the interpretation of behavior basedtion initially entails the integration of body- on the principle of “rational action.” The tele-related experiences, defining the physical ological stance is applied by infants to humanboundaries of self and world (e.g., Brown- and nonhuman objects alike. Studies by Ger-ell & Kopp, 1991). Once the physical self is gely and Csibra (1997) demonstrated that in-established, social exchanges, the identifica- fants express surprise when nonhuman buttions of social boundaries and, somewhat moving objects (such as various sized discs inlater, the identification of social causality be- a computer-generated animated display) ap-come central self-functions. The caregiver’s pear to act “irrationally”—not choosing therecognition of the child’s intentional stance, optimal action given specific goals and realityhowever, is communicated nonverbally, be- constraints. The infant is assumed to extendginning at birth. Between birth and 5 months, teleological models beyond the prediction offace-to-face exchanges of affective signals be- human behavior. Teleological models, how-tween infant and caregiver (Beebe, Lach- ever, evolve into mentalizing ones in the re-mann, & Jaffe, 1997; Tronick, 1989) play a stricted domain of human action. They be-key role in the development of the child’s rep- come fully mentalizing once representationsresentation of affect. of goal states come to be thought of as desires, For example, using a microanalytic obser- and constraints come to be thought of in termsvational paradigm, Beebe, Lachmann and of the agent’s beliefs about physical reality.
  • 5. Attachment and reflective function 683 The infant’s behaviors in dyadic interac- contingent actions of others. Taking Stern’stions are underpinned by an evolving model (1985) and Neisser’s formulation of the inter-of rational action by the caregiver. We would personal self together, we can identify threeargue that the development from teleological aspects of the intersubjective development ofto mentalizing models will depend upon the the self, which Mundy and Hogan (1994) termquality of interpersonal interactions between instrumental action states, sensory or percep-the infant and the caregiving adult. It should tual action states, and affective action states.be noted that although such models may Rogers and Pennington (1991) offered amerely represent rational action, it is the per- model of the cognitive underpinnings for suchceived rather than actual rationality of an act an intersubjective process in their concept ofwhich defines the teleological model. Thus representational mapping (the process of co-misapprehension of reality constraints (e.g., ordinating representations of self and other)assumed dangerousness) will provide and cre- which is thought to underlie the sharing of af-ate a model where action which is clearly irra- fect, attention, and higher order aspects oftional from an external standpoint is neverthe- cognition such as beliefs. The existence of im-less seen as based on the principle of rational itation skills from the neonatal stage repre-action. The predictive significance of the in- sents strong evidence for the model (Meltzoff,fant’s response to a stranger in the Beebe 1993). The acquisition of an appreciation ofstudy suggests that representations (working mental states, however, goes beyond mir-models) of self–other relations even when not roring.yet mentalized begin to vary in quality in the The development of an understanding of1st year, and this quality is related to infant– affect in self and other may be a good illustra-caregiver interactions, as observed in the lab tion of the role of representational mapping insituation. If sufficiently coherent to be gener- the development of reflective abilities (Ger-alized to other relationships in characteristic gely & Watson, 1996; Target & Fonagy,ways, they may index processes crucial to the 1996). Anxiety, for example, is for the infantcreation of a secure mother–infant bond. a confusing mixture of physiological changes, ideas, and behaviors. When the mother re- flects, or mirrors, the child’s anxiety, this per-Representational mapping ception organizes the child’s experience, andRepresentational mapping is likely to under- he now “knows” what he is feeling. Thepin the gradual move in infancy from teleo- mother’s representation of the infant’s affectlogical to mentalizing models of mind. Be- is represented by the child and is mapped ontween 6 and 18 months the child becomes to the representation of his self-state. The dis-increasingly able to match his mental state crepancy between these is helpful insofar as it `with that of the caregiver vis-a-vis a third ob- provides organization for the self-state andject or person, as, for example, in requesting thus the caregiver’s mirroring can become theor joint attention (Bretherton, 1991). The higher order representation of the child’s ex-communication is evidently deliberate, since perience. Within this model mirroring wouldchildren at this phase try to repair failed com- be expected to fail if it is either too close tomunicative bids and thus show some recogni- the infant’s experience or too remote from it.tion of awareness and agency in self and other If the mirroring is too accurate, the perceptionincluding affective states, perceptions, and in- itself can become a source of fear, and it losestentions (Stern, 1985; Wellman, 1993). Neis- its symbolic potential. If it is unavailable, orser (1991) suggested that based on perceptual is contaminated with the mother’s own preoc-processes, two preconceptual aspects of the cupation, the process of self-development isself emerge: the ecological and the interper- profoundly compromised. We may presumesonal. While the former involves self-aware- that individuals for whom the symptoms ofness in reference to perception of nonsocial anxiety signify catastrophes (e.g., heart attack,surroundings, the latter is generated via the imminent death, etc.) have metarepresenta-coperception of actions of the self and related tions of their emotional responses which can-
  • 6. 684 P. Fonagy and M. Targetnot be limited in intensity through symboliza- plays in others as well as arriving at the regu-tion, perhaps because the original mirroring lation and control of his own emotions. Theby the primary caregiver exaggerated the in- representational mapping of emotion displaysfant’s emotions. and self-experience is seen here as a prototyp- Admittedly this is a speculative model, but ical instance of caregiver sensitivity, which,it is empirically testable. It might help answer as we shall attempt to demonstrate, is likelythe thorny question of why individuals with to be an important component of the develop-panic disorders attribute immense significance ment of mentalizing. The sensitivity of theto physiologically relatively mild levels of caregiver prompts the child to begin organiz-disequilibrium. The suggestion here is that the ing self-experience according to clusters of re-metarepresentation, or symbolic representa- sponses which will eventually come to be ver-tion, of affect in these cases contains too bally labeled as specific emotions (or desires).much of the primary experience; hence, in- The high contingent response is the means bystead of labeling the experience having the which this mapping can take place. Thepotential to attenuate it, it tends to stimulate child’s affective experiences are given furtherand exacerbate symptoms of the affect state, meaning by becoming associated with clusterswhich in turn accentuates the secondary ex- of reality constraints within the parent–infantpression, in a cycle of escalating panic.3 In interaction (leading to rudimentary beliefscollaboration with George Gergely, we are about the causes and consequences of hisdesigning a series of studies of the infant’s emotional state).emotional understanding which will more di-rectly test these ideas. In a recent study (Fo- Transmission of attachment securitynagy et al., 1995), we have confirmed thatmothers who soothe their distressed 8-month- The attachment system (Bowlby, 1969, 1973,olds most effectively following an injection 1980) is intimately connected with the pro-rapidly reflect the child’s emotion, but this cess of representational mapping and the de-mirroring is mixed with other affects (smiling, velopment of the reflective function of the self.questioning, mocking display, and the like). There is general agreement that, as the selfIn displaying such “complex affect” (Fo- ´ exists only in the context of the other, the de-nagy & Fonagy, 1987) they ensure that the ´ velopment of the self is tantamount to the ag-infant recognizes their emotion as analogous gregation of experiences of self in relation-to, but not isomorphic with, their experience ships (e.g., Crittenden, 1994; Sroufe, 1990).and thus the process of symbol formation may Psychoanalytic object relations (Kernberg,begin. In this way, the representational map- 1982; Winnicott, 1965) and attachment theo-ping between affect of self and emotions of rists (Bowlby, 1980) are in agreement thatothers, the exchange of affect between young repeated, invariant aspects of self–other rela-child and caregiver, provides a unique source tions are abstracted into internal representa-of information to the child about his own in- tional mental models and structured, to useternal states. Kernberg’s term, into self–other–affect triads, We suggest that the meaning or sense of or internal working models, according toaffect develops out of the integrated represen- Bowlby. Although in its original formulationtation of the affect in self and other. The com- the concept of internal working model lackedbination of the representation of self-experi- specificity (Dunn, 1996), more recent empiri-ence and the representation of the reaction of cal work by psychoanalysts has greatly im-the caregiver elaborates the child’s teleologi- proved this (Horowitz, 1995; Luborsky & Lu-cal model of the mind, and ultimately enables borsky, 1995).him to interpret and understand affective dis- At the same time, cognitive scientists have elaborated the notion of procedural memories3. In terms of linguistic theory, one may say that the sig- based on the nonconscious implicit use of past nifier is not sufficiently “demotivated”; in other words experience (e.g., Johnson & Multhaup, 1992; it resembles the signified too closely. Schacter, 1992). There is general agreement
  • 7. Attachment and reflective function 685that the memory system is at least of a dual Steele, & Fonagy, 1996). The small overlapnature with two relatively independent, neuro- between the two sets of classifications couldlogically and psychologically homogeneous, be equally well accounted for by assuming asystems underpinning it. In addition to the au- temperament factor or by the generalizationtobiographical memory, which is at least in of the child’s behavior with the mother (re-part accessible to awareness, an important flecting her attachment classification) to hiscomponent to memory is a nonvoluntary sys- behavior with the father. The results suggesttem which is implicit, principally perceptual, that the infant develops independent modelsnondeclarative, and nonreflective. It is possi- (self–other schemata) for his major attach-ble that it is, at least in certain respects, more ment relations based on his past history of in-dominated by emotional and impressionistic teractions with each of those individuals. Ininformation than its autobiographical counter- turn, these interaction experiences are indexedpart (e.g., van der Kolk, 1994). It stores the by the caregiver’s representation of her or his“how” of executing sequences of actions, mo- attachment history.tor skills being prototypical instances. The There has been considerable research onprocedural knowledge that it contains is ac- the manner in which representations of attach-cessible only through performance. It mani- ment might influence the caregiver’s behaviorfests itself only when the individual engages with the child. Van IJzendoorn’s (1995) com-in the skills and operations into which knowl- prehensive meta-analysis identifies a “trans-edge is embedded. Given these features, it mission gap,” to the extent that the variabilityseems likely that the schematic representa- which AAI narratives and SSn classificationstions postulated by attachment and object re- share is not accounted for by observationallations theorists are most usefully construed data concerning the sensitivity of caregiveras procedural memories, the function of behavior. Indeed, studies of the AAI-SSn as-which is to adapt social behavior to specific sociation, which concurrently measured theinterpersonal contexts. sensitivity of caregiver–infant interaction, have The classification of patterns of attachment yielded negative (Ward & Carlson, 1995) orin infancy (Ainsworth, Blehar, Waters, & inconclusive results (van IJzendoorn, Kranen-Wall, 1978) taps into procedural memory burg, Zwart–Woudstra, Van Busschbach, &(Crittenden, 1990; Fonagy, 1995). The strength Lambermon, 1991). Previously, we have sug-of the Strange Situation (SSn) as a method gested that the transmission gap may be aof psychological assessment is to provide a consequence of the limitations of measures ofpowerful analogue of past situational contexts sensitivity (Fonagy et al., 1995). Sensitivity iswithin which knowledge concerning the a generic construct covering a wide range of“how” of behavior with a specific caregiver is parental behaviors (Belsky, Rosenberger, &accrued. In this sense attachment is a skill, Crnic, 1995). Not all of these may be equallyone which is acquired in relation to a specific powerful in engendering secure attachment. Ifcaregiver encoded into a teleological model of secure attachment is conceived of as the ac-behavior. In the London Parent–Child Study, quisition of procedures of goal oriented ra-the Adult Attachment Interview (AAI), ad- tional action for the regulation of aversiveministered before the birth of the first child to states of arousal within relationships (Cas-100 predominantly middle class primiparous sidy, 1994; Sroufe, 1996), it is argued thatparents, was tested as a predictor of attach- these would be most consistently acquiredment classification at 1 year to mother and at and coherently represented when the child’s18 months to father (Fonagy, Steele, & Steele, acute affective state is accurately, but not1991b). There was only a marginally signifi- overwhelmingly, reflected back to the child.cant association between the attachment clas- The child who looks for a way of manag-sification with mother and that with father. ing his distress identifies in the response ofHowever, both SSn results were powerfully the caregiver a representation of his mentalpredicted by the attachment classification of state which he may internalize and use as partthe respective parent on the AAI (Steele, of a higher order strategy of affect regulation.
  • 8. 686 P. Fonagy and M. TargetThe secure caregiver soothes by combining a tenden (1988; Crittenden & DiLalla, 1988) re-“mirror” with a display incompatible with the ports that maltreated toddlers display falselychild’s affect (thus perhaps implying coping). positive affect which does not match their trueThis formulation of sensitivity has much in feelings. At an extreme, the internalization ofcommon with the British psychoanalyst, Wil- the caregiver’s defenses can not only lead tofred Bion’s (1962) notion of the role of the a failure to adequately represent and displaymother’s capacity to mentally “contain” the actual emotional experience, but also to theaffect state intolerable for the baby, and re- construction of an experience of self aroundspond in terms of physical care in a manner this false internalization (Winnicott, 1960).that acknowledges the child’s mental state yet While the experience of “putting on anserves to modulate unmanageable feelings. act” may be common, particularly in adoles-The finding that the clarity and coherence of cence (Harter, Marold, Whitesell, & Cobbs,the mother’s representation of the child medi- 1996), here we are referring to the highly dis-ates between her attachment status and her be- tressing experience of personality disorderedhavior is certainly consistent with this model children who feel a sense of alienation from(Slade, Belsky, Aber, & Phelps, in press). their core self (Bleiberg, 1994). A strategyRatings of the quality of the reflective func- many such children adopt later in develop-tion of each caregiver were found indepen- ment is to attempt to externalize this false partdently to predict the child’s security of attach- of their self-representation, and manipulatement in the London Parent–Child Project the behaviors of others around them so these(Fonagy et al., 1991a). match the incongruent self-representation. We If secure attachment is the outcome of suc- would argue that this explains the strangelycessful containment, insecure attachment may coercive behavior with the caregiver of pre-be seen as the infant’s identification with the school children whose attachment in infancycaregiver’s defensive behavior. Proximity to was classified as disorganized (Crittenden,the caregiver is maintained at the cost of a 1992; Main & Cassidy, 1988). In a desperatecompromise to reflective function. A dismiss- way they try, we suggest, to provoke behavioring (Ds) caregiver may altogether fail to mir- in another person which expresses part ofror the child’s distress because of the painful their self-representation experienced asexperiences this evokes for her or because she “alien,” they can then experience a more co-lacks the capacity to create a coherent image herent residual self (Fonagy & Target, 1995).of the child’s mental state. By contrast, thepreoccupied (E) caregiver may represent the Secure infant becomes mentalizing childinfant’s state with amplification and insuffi-cient marking, or complicated by responses to There is general agreement that the “harmoni-the parent’s ambivalent preoccupation with ousness of the mother–child relationship con-her own experience, so much so that the sym- tributes to the emergence of symbolicbolic potential of the exchange is lost. In both thought” (Bretherton, Bates, Benigni, Camai-cases the infant internalizes the caregiver’s at- oni, & Volterra, 1979, p. 224). Bowlby recog-titude and “this dysynchrony becomes the nized the significance of the emergence ofcontent of the experience of the self” (Critten- “the child’s capacity both to conceive of hisden, 1994, p. 89). mother as having her own goals and interests separate from his own and to take them into account” (1969, p. 368). Moss, Parent, andInfant attachment and developing self Gosselin (1995) reported that attachment se-We may speculate about the impact of this on curity with mother was a good concurrent pre-the development of the child’s sense of self. dictor of metacognitive capacity in the childWe know that avoidant infants respond to in the domains of memory, comprehensionseparation with minimal displays of distress and communication. The Separation Anxietywhile experiencing considerable physiological Test, a projective test of attachment security,arousal (Spangler & Grossman, 1993). Crit- has been shown to be a good predictor of be-
  • 9. Attachment and reflective function 687lief–desire reasoning capacity in 3- to 6-year- of secure attachment and false belief under-old children when age, verbal mental age, and standing was due to an as yet unknown andsocial maturity were all controlled for (Fo- unmeasured third factor, such as tempera-nagy, Redfern, & Charman, 1997). ment. More plausibly, it could be argued that We have recently completed a prospective the facilitative effect of secure attachment isstudy of the relationship of attachment secu- due to a more relaxed, task-oriented attitude,rity to mother (1 year) and father (18 months) a general facility to engage in a cognitivelyand children’s performance on three tests of demanding task, to relate to an adult experi-theory of mind at 5 years (Fonagy, Steele, menter in a playful, exploratory way, and soSteele, & Holder, submitted). Ninety-two of on: that it reflects performance, rather than96 children tested in the SSn at 12 and 18 competence. This suggestion could be testedmonths were seen. Eighty-two percent of using a false-belief task where implicit andthose classified as secure at 12 months with explicit knowledge of false belief is sepa-mother passed the belief–desire reasoning rately assessed. If attachment security relatestask, whereas 46% of those who had been to performance, then securely attached chil-classified as insecure failed. Infant–father at- dren would be expected to do better only ontachment (at 18 months) also predicted the the explicit (verbal/pointing) task. Implicit,child’s performance, with 77% of infants clas- procedural false belief reasoning would be ex-sified as secure passing the test compared to pected to be facilitated by secure attachment55% of children classified as insecure. There only if this was associated with superior re-was some indication of an additive relation- flective capacity. This study remains to beship, in that 87% of children with two secure performed, and is planned in our laboratory.relationships passed the belief–desire task, In what follows we shall, however hazard-63% of those with only one secure relation- ously, assume that the relationship betweenship and only 50% of those insecure with both false belief reasoning and security of attach-did so. A similar but somewhat weaker pat- ment is nontrivial.tern could be observed with the second-order We then envisage two alternative sets offalse-belief task. Thirty-six percent of those models to explain this relationship: (a) Secu-secure with both parents passed compared rity of attachment in infancy predisposes chil-with 23% who were secure with one and 9% dren to benefit from social processes directlywho were insecure with both. facilitating reflective abilities and social un- In a somewhat smaller but careful longitu- derstanding (mediational models), and (b) se-dinal study of mother–infant dyads, Meins curity of attachment is an indicator of thatand colleagues (Meins, Fernyhough, Russel, & quality of infant–caregiver relationship whichClark–Carter, in press) reported that 83% of generates psychological understanding. In thischildren who were securely attached in infancy second model, the social processes which ac-passed a false-belief task at age 4, in compari- celerate the mentalizing quality of self-organi-son with 33% of insecurely attached peers. At zation are the very same as those which en-age 5, 85% of securely attached children and sure security of attachment.50% of insecurely attached ones passed a task Mediational models would require thatrequiring an understanding of information ac- specific social processes are shown to be in-cess. Although, probably because of its small volved in this aspect of the development ofsample, the study was not able to replicate our self-organization, and such social processesresults on the false belief and emotion task, are enhanced in securely attached individuals.the general trend of the findings confirms that There are at least three candidates which meetsecurity of attachment is significantly linked these criteria.to symbolic abilities in general and precocious The first is pretense. There is evidence thatmentalizing in particular. children in their 3rd year who engage more There are both trivial and substantive ex- readily in cooperative interaction (Dunn et al.,planations which could account for these find- 1991b), and specifically in joint pretend playings. They would be trivial if the association (Astington & Jenkins, 1995; Youngblade &
  • 10. 688 P. Fonagy and M. TargetDunn, 1995), show superior mentalization and presumes a degree of trust, in so far as theemotion understanding performance. There is child relies on the other’s version or percep-a separate body of observations from longitu- tion of reality.dinal studies of attachment that preschool The second is talking. There is evidencechildren securely attached to their mother in that conversations about feelings and aboutinfancy engage more strongly in fantasy play the reasons behind people’s actions are linkedthan avoidant children, whose engagement is to the relatively early achievement of reflec-low and whose pretend play is impoverished tive function (Dunn & Brown, 1993). Three-(e.g., Belsky, Garduque, & Hrncir, 1984; year-olds whose mothers spontaneously ex-Bretherton et al., 1979; Main, Kaplan, & Cas- plained their emotions in a lab task showedsidy, 1985). There is also evidence that se- enhanced emotion understanding over thecurely attached young children can more eas- subsequent 15 months (Denham et al., 1994).ily use help from adults to elaborate their play Patterns of mother–child interaction char-(Meins et al., in press; Slade, 1987). acteristic of secure dyads—shared play, com- It is highly plausible that joint pretend play forting, or joking—are also contexts withinor playfulness fosters the understanding of which mothers’ explanations of mental statesmental states. Deliberate role-taking is seen as are particularly found to facilitate reflectiveintegral to the off-line simulation model of the function (Dunn, 1996). Secure attachment mayperformance of mentalization tasks (Gold- then engender patterns of verbal interaction be-man, 1989). Within other models pretend play tween child and caregiver which in turn sup-is an early manifestation of the theory of mind port thinking about feelings and intentions.mechanisms (Leslie, 1987). It is an important The central role of language in the acquisi-puzzle why 3-year-olds can understand that tion of mentalizing capacity was forcefullysomeone is entertaining a pretend representa- advanced by Smith (1996), using primate evi-tion but not a false belief (Harris, Kava- dence. Even more pertinent is Harris’s (1996)naugh, & Meredith, 1994), a pretend/real dis- proposal that the experience of engaging intinction but not an appearance/reality one conversations per se shows children that peo-(Flavell, Flavell, & Green, 1987). In the case ple are receivers and providers of information,of pretend, the representations, while they are whether or not the conversation refers to men-different from reality, are shared by those en- tal states. The structure of informative conver-gaged in the pretend game. As Astington sations (e.g., being told about an event one(1996) put it, “they are intermental, not intra- has not witnessed, dissent and denial, fillingmental” (p. 193). The sharing of representa- in information gaps) implies that partners intions different from reality may help in under- a conversation differ in what they know andstanding situations where representations are believe about a shared topic. Effective con-not only different from reality but are not versation requires that gaps in shared knowl-shared in a social pretend domain. In joint edge and belief are acknowledged and ad-pretend play or playfulness the adult adopts dressed. The measurement of attachment inthe child’s mental stance and re-presents it to adults (Main, Kaplan, & Cassidy, 1985) em-the child in relation to a third object which is phasizes that secure attachment involvessymbolically held in mind by both (Target & greater sensitivity to the rules of conversation.Fonagy, 1996). The scaffolding provided by The third potential mediator is peer groupthe child’s playmate in pretend play (Vygot- interaction. We have already noted that inter-sky, 1967) not only promotes earlier success action with siblings enhances theory of mindbut is also the mechanism whereby the devel- performance. There is an independent body ofopment of reflection comes about. Lillard evidence which supports a strong link be-(1993) argued that symbolic play may offer a tween secure attachment in infancy and rat-“zone of proximal development” for the skills ings of peer competence: social orientation,which subserve mentalization ability. Chil- reciprocity, popularity, and empathy (e.g.,dren with a secure attachment history may be Elicker, Englund, & Sroufe, 1992; Park &more likely to engage in an activity which Waters, 1989).
  • 11. Attachment and reflective function 689 Both simulation theory and theory–theory from Dunn’s work suggests that these differ-explanations of the development of mentaliza- ent contexts correlate poorly with one anothertion offer good explanations of the facilitative (Dunn, 1996). For example, observationaleffect of more intense peer group interaction data shows that individual differences found(Ruffman et al., in press). Peer group interac- in pretend play, management of conflict, andtion should increase the opportunities the talking about mental states are not correlatedchild has for simulation, imagining what he between social situations (mothers, siblings,would see, think, feel etc., if he were in an- close friend) although each correlates withother person’s situation. Equally, interaction sociocognitive assessments (e.g., Young-with peers or older sibs could be seen from a blade & Dunn, 1995). These findings couldtheory–theory perspective as a rich source of suggest that there are a number of indepen-ideas about how the mind works. An alterna- dent, simultaneous pathways between attach-tive view may be that enculturation is itself ment, social situations, and social cognition.the source of the child’s mental state concepts Alternatively, there is the second possibil-(Astington, 1996). Bruner (1983) proposed ity, that the suggested mediating variables arethat parents’ tendency to treat the infant’s not on the causal path at all, that their correla-spontaneous gestures as if they were inten- tion with the rate of acquisition of mentaliza-tional communications leads to infants seeing tion is spurious, that this facility is directlythemselves as having intentions and starting related to the child’s attachment status. Earlyto communicate intentionally. The social experience with the caregivers in the 1st yearworld (in the first instance, the parent) fosters of life may create a bedrock of theory of mindthe child’s sense of his mental self through competence, helping the child to move fromcomplex linguistic and interactional pro- a teleological to a mentalizing model of be-cesses, behaving towards the infant in a way havior. What evidence do we have to supportthat leads him eventually to share the assump- such a contention?tion that his own behavior and (by simulation First, recall that Fonagy, Steele, Steele, andor the observation of similar interactions be- Holder (1997) found that a mother’s attach-tween the caregiver and others) that of others ment classification before the birth of themay be best understood in terms of mental child was a powerful predictor of the child’sstates (Fonagy & Target, 1996; Target & Fo- theory of mind competence at 5 years. Al-nagy, 1996). Through participation in activi- though, on the face of it, this can be ac-ties of their culture they come to share their counted for by the mediational models, we be-culture’s way of understanding people’s ac- lieve that there is now evidence that thetions. If there is a process of “apprenticeship” caregiver brings something to the parent–in which peers and caregivers encourage the child relationship, evident even before thechild’s use of mentalizing concepts (Asting- birth, which may be critical in the child’s es-ton, 1996), then secure attachment may be a tablishment of both secure attachment andcatalyst to this learning process. The greater mentalization.readiness with which secure children are will- What is this capacity? It is well establisheding to explore and engage with the social that in infancy, mothers of securely attachedworld could then account for their mentalizing children are more sensitive to their children’sskill. needs (Ainsworth, Bell, & Stayton, 1971; Isa- There is nothing exclusive about these bella, 1993). We have already mentioned thatthree mediational models. Pretense often the parent’s capacity to envision the mentalinvolves the use of mental state language. In- states of her or his own parents is predictiveteraction with peers often involves both lan- of the infant’s security of attachment to eachguage and pretense. In general, social engage- parent (Fonagy et al., 1991a). In a follow-upment tends to enhance social understanding, of the same group, the same capacity also pre-and such engagement is more accessible to se- dicted superior performance on a false beliefcurely attached children. There is, however, a task at 5 years, controlling for verbal fluencyproblem with a singular model. Evidence in the child. (However, this result was not
  • 12. 690 P. Fonagy and M. Targetfound for all tasks which could be thought to ideas and feelings which determine his ac-index mentalization). tions, and the reactions of others to him, A path analysis of the above data showed which can then be generalized to other similarthat not all the variance predicted was medi- beings. The caregiver approaches the cryingated by mother–infant attachment status at 1 infant with a question in her mind: “Do youyear. Mother’s mentalizing ability seemed to want your nappy changed?” “Do you need ahave a direct as well as an indirect relation- cuddle?” The sensitive caregiver is unlikely toship with the child’s theory of mind. Thus, the address the situation without having the per-child’s attachment security was not the only son in mind, so is unlikely to say to herself,predictor; the mother’s tendency to envision “Are you wet around your bottom?” or “Havepeople (including the child) as mental entities you been standing alone too long?” The sensi-also seemed to be important. tive caregiver can bridge the focus on physi- The above data suggest that common cal reality and internally directed attention,mechanisms underpin attachment organiza- sufficiently for the child to identify contingen-tion in caregiver and infant, and the preco- cies between internal and external experience.cious emergence of mentalizing in the child. Ultimately, the child arrives at the conclusionIt should be remembered that no clear causal that the caregiver’s reaction to him may bepath was identified among mediational mod- understood as rational given the assumptionels. The relative importance of various po- of an internal state of belief or desire withintential mediational mechanisms for the at- himself. Unconsciously and pervasively, thetachment–theory of mind relationship varies caregiver ascribes a mental state to the childaccording to context but intergenerational with her behavior, treats the child as a mentaldata may be consistent with at least two of the agent, which is perceived by the child andmodels (pretense, language). Further experi- used in the elaboration of teleological models,mental research which manipulates parental and then in the development of a core sensebehavior and explores attachment and theory of mental selfhood. We assume that this, byof mind task performance (van IJzendoorn, and large, is a mundane process, happeningJuffer, & Duyvesteyn, 1995) will be necessary routinely throughout early life, not reflectedto show whether specific behaviors which en- on, and so rarely modified. Caregivers, how-gender secure attachment simultaneously en- ever, differ in their ways of carrying out thishance mentalizing. For such a study to be fea- natural human function. Some may be partic-sible, we need a model of how attachment ularly alert to the earliest indications of inten-may directly relate to theory of mind perfor- tionality; others may need stronger indicationsmance. Next we outline a tentative model of before perceiving the child’s mental state andhow such a mechanism may operate. modifying their behavior accordingly. Others, as we described in the context of early in- fancy, may systematically misperceive theReflective parenting and development child’s states of mind, with resulting deforma-of mentalization tion of the child’s sense of himself. The child’s development and perception ofWe take the view that the acquisition of the mental states in himself and others thus de-theory of mind is part of an intersubjective pends on his observation of the mental worldprocess between the infant and caregiver (see of his caregiver. He is able to perceive mentalGopnik, 1993, for a highly elegant elaboration states, to the extent that his caregiver’s behav-of such a model). In our view, the caregiver ior implied such states. This he does when thefacilitates the creation of mentalizing models caregiver is in a shared pretend mode of play-through complex linguistic and quasilinguistic ing with the child (hence the association be-processes, primarily through behaving to- tween pretend and early mentalization), andwards the child in such a way that leads him many ordinary interactions (such as physicaleventually to see that his own behavior may care and comforting, conversations withbe best understood by assuming that he has peers) will also involve such shared menta-
  • 13. Attachment and reflective function 691tion. This is what makes mental state concepts the mental state of the caregiver evokes in-such as thinking inherently intersubjective; tense anxiety through either frightening be-shared experience is part of the very logic of havior suggesting malevolence towards themental state concepts. child, or behavior suggesting fear, which may The parent’s capacity to observe the mo- include fear of the child himself; and (c) thement to moment changes in the child’s mental child needs to use disproportionate resourcesstate, then, lies at the root of sensitive care- to understand the parent’s behavior, at the ex-giving, which is viewed by attachment theo- pense of reflecting on self-states.rists as the cornerstone of secure attachment These factors combine, perhaps, to make(e.g., Ainsworth et al., 1978; Grossmann, disorganized infants become keen readers ofGrossmann, Spangler, Suess, & Unzner, 1985; the caregiver’s mind under certain circum-Isabella & Belsky, 1991). Secure attachment stances, but (we suggest) poor readers of theirin its turn provides the psychosocial basis for own mental states. Thus, in terms of the rivalacquiring an understanding of mind. The se- models of theory of mind development, suchcure infant feels safe in making attributions of children may acquire a theory–theory ofmental states to account for the behavior of mind, but cannot use simulation of mentaliz-the caregiver. By contrast the avoidant child ing with the same confidence as childrento some degree shuns the mental state of the whose attachment (albeit insecure) is orga-other, while the resistant child focuses on his nized. The alternative models may be moreown state of distress to the exclusion of close usefully thought of as alternative routes tointersubjective exchanges. Disorganized in- mentalization, the first (theory–theory) acces-fants may represent a special category; hyper- sible to all, the second (simulation) morevigilant of the caregiver’s behavior they use readily available to children whose early at-all cues available for prediction and may be tachment relationships made such a strategyacutely sensitized to intentional states, and safely possible.thus may be more ready to construct a mental-ized account of the caregiver’s behavior. We Theoretical model of developmentwould argue (see below) that in such children of mentalizationmentalization may be evident but it does nothave the central and effective role in self-or- In previous papers (Fonagy & Target, 1996;ganization which characterizes securely attached Target & Fonagy, 1996), we have attemptedchildren. to describe the normal development of reflec- We believe that most important for the de- tive function in the child of 2–5 years. Wevelopment of mentalizing self-organization is suggested that there is a transition from a dualthat exploration of the mental state of the sen- mode of experience to mentalization. Primar-sitive caregiver enables the child to find in ily from a clinical perspective, we advanced aher mind an image of himself as motivated by number of propositions concerning the devel-beliefs, feelings, and intentions, in other opment of the psychological part of the self.words, as mentalizing. There is considerable These wereevidence to support the view that secure at- 1. Until 3 or 4 years of age, reflective func-tachment enhances the development of inner tion is characterized by two modes of relatingsecurity, self-worth, and autonomy (e.g., Lon- internal experiences to the external situation:derville & Main, 1981). Disorganized infants, (a) In a serious frame of mind, the child ex-even if they acquire the skill of mentalization, pects the internal world in himself and othersfail to integrate this with their self-organiza- to correspond to external reality, and subjec-tion. There may be a number of linked rea- tive experience will often be distorted tosons for this: (a) The caregiver of the disorga- match information coming from outsidenized infant is less likely to be reliably (“psychic equivalence mode”), (e.g., Gop-contingent in responding to the infant’s self- nik & Astington, 1988; Perner, Leekam, &state, and further to show systematic biases in Wimmer, 1987); and (b) while involved inher perception and reflection of his state; (b) pretend play, the child knows that internal ex-
  • 14. 692 P. Fonagy and M. Targetperience does not reflect external reality (e.g., Reflective function and self-developmentBartsch & Wellman, 1989; Dias & Harris,1990), but then the internal state is thought While mentalization may not be an unequivo-to have no relationship to the outside world cally positive experience, Dunn’s work shows(“pretend mode”). us at any rate that the understanding of emo- 2. Normally, the child then integrates these tion at 3.5 years predicts a positive perceptionalternative modes to arrive at mentalization, of social relations, mature moral sensibility,or reflective mode, in which mental states can and the understanding of complex emotionsbe experienced as representations. Inner and (Dunn, 1996). Stern (1985) pointed out that aouter reality can then be seen as linked, yet sense of ownership of one’s actions, whetherthey are accepted as differing in important derived from the experience of forming plans,ways, and no longer have to be either equated proprioceptive feedback, or the objective con-or dissociated from each other (e.g., Gopnik, sequences of physical actions on the environ-1993). Mentalization comes about through the ment, contributes to the sense of self-agency.child’s experience of his mental states being In our view, such agency also crucially de-reflected on, for instance through secure play pends on the quality and reliability of reflec-with a parent or older child, which facilitates tive function, as ownership of action is inti-integration of the pretend and psychic equiva- mately tied to the mental state (belief orlence modes, through a process which may be desire) which initiated it. It is impossible toan elaboration of the complex mirroring of the conceive of self-agency as fully establishedinfant by the caregiver. In playfulness, the by the physical actions of the child, as such acaregiver gives the child’s ideas and feelings large proportion of these will fail to achieve(when he is “only pretending”) a link with re- their intended objective, because of theality, by indicating the existence of an alterna- child’s immature physical and cognitive ca-tive perspective, which exists outside the pacities. The recognition of the child’s inten-child’s mind. The parent or older child also tional stance by others must then be critical inshows that reality may be distorted by acting making the thought “real” for the child. Weupon it in playful ways, and through this play- believe that interaction which links percep-fulness a pretend but real mental experience tions, thoughts, and emotions as causes andmay be introduced. consequences of action, and the contempla- 3. In traumatized children, intense emotion tion of mental states without fear, contributeand conflict lead to a partial failure of this significantly to self-agency. The earliest foun-integration, so that aspects of the pretend dation is presumably the baby’s sense that hemode of functioning become part of a psychic brings about the caregiver’s mirroring behav-equivalence manner of experiencing reality. ior (Gergely & Watson, 1996).This may be because where maltreatment or Of course, the core of self-agency musttrauma has occurred within the family, the at- originally lie with the body, where the in-mosphere tends to be incompatible with the fant’s attempts to exercise control frequentlycaregiver “playing with” the most pressing as- succeed after early infancy. Higher level, morepects of the child’s thoughts; these are often complex actions, particularly those which in-disturbing and unacceptable to the adult, just volve others in the child’s life, often requireas they are to the child. The rigid, controlling the reflective caregiver to make sense of thebehavior of the preschool child with a history young child’s wishes and translate these intoof disorganized attachment is thus seen as action sequences for the links between mentalarising out of a partial failure on the part of states and action to be established. It is to bethe child to move beyond the mode of psychic expected then that individuals who have expe-equivalence in relation to specific ideas or rienced severe neglect or coercive, rigid,feelings, so that he experiences them with the frightening, and, at an extreme, abusive par-intensity that might be expected had they been enting will frequently experience their sensecurrent, external events. of self-agency as massively curtailed, and
  • 15. Attachment and reflective function 693limited to the more firmly established bodily adoxically drive them physically closer to a(physical) domain. potential abuser. Their ability to adapt to, modify, or avoid the perpetrator’s behavior is also constrained by limited mentalizing skills.Reflective function and pathological There are several reasons why the familyself-development environment of maltreatment is likely to un-The model of the development of mentalizing dermine the development of reflective func-capacity which we propose has considerable tion.clinical implications, a few of which we will First, in abusive families the public worldmention here. of school and community—where reflective function is common and desirable—is oftenImpact of maltreatment on reflective function. kept very separate from the world of home,Maltreated children, perhaps even more than where the inhumane behavior of an adultinsecure ones, are at risk of failing to find makes recognition of the mental state of thetheir own intentional being within the mind other dangerous to the developing self. Evenof the caregiver, and are thus at risk of poor where a maltreated child benefits from sensi-development of mentalization. There is accu- tivity and reflectiveness in his public world,mulating evidence that maltreatment does im- so developing an alternative model of relatingpair the child’s reflective capacities and sense and experiencing himself, the models derivedof self. Schneider–Rosen and Cicchetti (1984, from public and family experiences are likely1991) noted that abused toddlers showed neu- to be kept insulated from each other, and rigidtral or negative affect on recognizing them- in their application to the separate contexts.selves in the mirror, unlike their nonabused Second, the child may have specific prob-peers. Beeghly and Cicchetti (1994) showed lems in dealing with different experience. Inthat toddlers with a history of maltreatment abusive families the meaning of intentionalwere not retarded in receptive language but states may be denied or distorted. Abusivewere significantly behind in productive lan- parents may claim beliefs and feelings at oddsguage, reflecting a withdrawal from social in- with their behavior. Abuse, particularly withinteractions. Their specific deficit was in the the family, prevents the child testing andrelative absence of internal state words and modifying representations of mental states.the context-bound (concrete) nature of their Thus, the mental representation of ideas tendsinternal state language. They also showed less to become rigid, maladaptive, and inappropri-differentiation in attributions. Their internal ate, and consequently may be partially orstate language was particularly sparse in terms largely abandoned.of words pertaining to cognition and belief A third possibility is that the maltreatedstates, but was richer for perception and de- child is forced to construct a model of thesire. Cicchetti and Beeghly (1987) found that caregiver’s mind based on an awareness ofyoung school-age children who had been mal- analogous mental states in himself. It may betreated used proportionally fewer words about argued, on the basis of the simulation model,internal states, attributed their internal states that simulation is compromised by both theto fewer social agents, and were more context dissimilarity between the child’s mental expe-bound than their counterparts who were not rience and that of the abuser, and the threatmaltreated. They appeared to control their that such simulation inevitably brings with it.anxiety by modifying their language to ex- If understanding the behavior of his caregiv-clude certain aspects and contexts associated ers requires the maltreated child to try to gen-with maltreatment. This pattern of results sug- erate their probable thoughts and feelings,gests that maltreatment may cause children to then he will be confronted with attitudes to-withdraw from the mental world. For mal- wards himself which are extremely painful totreated children, physical experiences proba- recognize: hatred, cruelty, indifference. Abusebly become more important, and this may par- could destroy the child’s belief that one can
  • 16. 694 P. Fonagy and M. Targetunderstand others through one’s own feelings sionals and family members. These anomalies(Herman, 1992), and the child would be likely can be clarified by more sophisticated devel-to inhibit his capacity for simulation in in- opmental theory.tense attachment relationships. Our chosen framework is provided by “dy- A fourth possibility is that the difficulty is namic skills theory” (Fischer & Farrar, 1987;not a result of the maltreatment itself, but of Fischer, Kenny, & Pipp, 1990) which depictsthe family atmosphere surrounding it (which development as the elaboration of increas-may well also occur where maltreatment does ingly complex control systems (skills). Re-not). Social constructivist ideas concerning the flective function may be readily conceived ofdevelopment of mentalization (e.g., Asting- as one such control system, critical to the or-ton, 1996) are pertinent here. Authoritarian ganization of the self. Within dynamic skillspunishment of bad behavior and demanding theory, reflective function would be seen asof obedience is clearly less facilitating of the not simply a property of the person, but of thechild’s development of mentalization than are person and situation together, because allequivalent interactions with authoritative par- skills are composed of both the person’s ac-ents, who reason with the child and explain tivities and the contexts within which thesedecisions and rules with reference to people’s occur. Particular tasks, specific events, otherdifferent points of view (Baumrind, 1971). people, as well as culture are seen as part ofThere is some evidence that authoritarian par- the skill. Further, the development of a skill isenting is associated with delayed false belief not seen as progression along a singular path,task performance (Holmes, Roldan, & Miller, determined by maturation. Rather, reflective1994, cited in Astington, 1996). As, in a Vy- function, as a skill, evolves through variedgotskian framework, the individual’s compe- pathways, molded by many dynamically inter-tence originates in their social interactions and acting influences, such as the individual’sis then internalized, we would expect the ab- emotions, social interaction, family relation-normal patterns of parent–child relations in ships and environment, important socialthe families of maltreated children to lead to groups, the reactions of the wider social world,a distorted experience of minds. Alessandri etc. (Fischer, Knight, & Van Parys, 1993).(1991, 1992) noted that the incompetence of Reflective function is a strand within themaltreated youngsters in pretend symbolic developmental web, one of the many distinctplay was mirrored by their mothers’ difficulty control systems that are neither strongly con-in taking a playful stance with their child, nected with each other, nor coordinated ordirecting their attention, and engaging in posi- integrated (Fischer & Pipp, 1984). The “frac-tive interactions. This pattern of results is con- tionation” or splitting of all abilities as a func-sistent with the model that the lack of appro- tion of tasks and domains is well demon-priate social scaffolding may undermine the strated, and we might expect reflectivenormal development of mentalizing in mal- function to be subject to the same kind of de-treated children. ´ velopmental decalage (unevenness) which characterizes the rest of cognitive develop-Developmental framework for abnormal re- ment (Flavell, 1982). Fractionation refers toflective function. It is tempting to argue that the tendency for a person not to coordinatedisorders of conduct and borderline states can skills or experiences that are naturally sepa-be explained as dismissive and preoccupied rate, but may be thought of as belonging to-forms of nonmentalizing self-organizations gether by some external criterion (Fischer &respectively, but this would be simplistic. In Ayoub, 1994). Just as the understanding ofboth instances, there are often variations conservation of liquid does not generalize toacross situations, or types of relationship. The conservation of area, reflective capacity indelinquent adolescent is aware of the mental one domain of interpersonal interaction shouldstates of other gang members and the border- not be expected to generalize to others. Re-line individual is at times hypersensitive to flective function does not begin as a generalthe affective states of mental health profes- capacity, but is a particular skill tied to the
  • 17. Attachment and reflective function 695task and domain where it is learned, a specific naturally move toward integration. The familycategory of relationship. Reflective function might of course, as we mentioned, supportas a skill may be more or less present in situa- such splits with sharp dissociations betweentions as a function of contextual support and their public, proper world and their private,emotional state, which push an individual up tyrannical one. The split is context and affector down a developmental strand. We have dependent; within an attachment theorynoted above that the child’s observed use and framework we might say that the self is orga-experience of mental state language can differ nized so that certain internal working modelsmarkedly across social contexts. It is clearly include considerable reflective components—possible for task-based skills such as reflec- expectations incorporating the mental statestive function to come to be coordinated, but of self and other—while other working mod-this should not be seen as automatic. Uneven- els of relationships appear impoverished, indi-ness across situations is likely to remain prev- cating only minimal mentalizing skills. In thealent even in adults, especially when they are latter contexts the subject will offer only ster-emotional (Fischer & Ayoub, 1994). eotyped, concrete, low level descriptions. Normal development is from fractionation This does not imply developmental delay ortowards integration, which involves the coor- regression; rather it suggests a remarkablydination of previously separate skills and pro- complex ability to coordinate two distinct lev-vides the foundation for more complex, so- els of functioning. The abusive or emotionallyphisticated control systems (Bidell & Fischer, depriving world within which they developed1994). Abnormalities of reflective function, has engendered in them the sophisticatedthe continued use of a teleological rather than skills that were required for adaptation. Thusa mentalizing model for predicting behavior, to talk of deficit or absence of a capacity inshould not then be seen as either a conse- such individuals is an oversimplification.quence of arrest and fixation at an early stage, Measures of global abilities may not yield aor a regression to that stage. Pathologies in difference between these individuals andthe reflective function of the maltreated child other groups. Efforts at going beyond clinicalmay be expected to develop increased com- impression in terms of measurement have toplexity with age and time, in a manner similar take on board the situational specificity of theto other skills. The skill for limited reflective- failure of reflective function.ness developed by the child to anticipate and We will return to the example of conductforestall maltreatment and its painful physical disordered children, for whom we suggest thatand psychological impact would be adaptive nonreflective internal working models mayin their original world, but would be expected dominate behavior when an element of con-to produce sophisticated forms of difficulty flict is present within a relationship. Conflict,rather than straightforward adaptations in or rather its adaptive resolution, particularlyother contexts (Noam, 1990). The ability to calls for the perception both of the self and ofbe reflective in general, but to show only min- the other in relation to the self, requiring theimal reflectiveness in the context of one’s individual to reconcile his own legitimateown childhood and parents, or in specific rela- claims with concern for the other (Killen &tionships which reactivate the same schemata, Nucci, 1995). The abnormality of the earlycould be a result of natural fractionation. Un- family environment of individuals with severeevenness or splitting of reflective ability could problems of conduct has been clearest in thealso be the consequence of an active (pur- context of normal conflicts (Patterson, 1982;poseful, conscious, or unconscious) attempt Perry, Perry, & Kennedy, 1992). Here theon the part of the individual not to coordinate child with a vulnerable capacity for mentali-or generalize reflective function to specific re- zation finds no affirmation of his intentionallationship domains. Here the unevenness is a stance and fails to acquire the sense of owner-developmental achievement, in that the per- ship or inner endorsement of his actions es-son must create a coordination in order ac- sential for a sense of self-agency. Consequentlytively to keep separate contexts which would his sense of autonomy becomes vulnerable
  • 18. 696 P. Fonagy and M. Targetand the importance of his original intention predominant response to emotional situationsis exaggerated. The characteristics of opposi- will be a nonreflective one, readily disownedtional defiant disorder (e.g., negativity, dis- by the self. Naturally the absence of reflectiveobedience, aggression) may in part be seen as function in such situations will give the ap-attempts at reasserting self-agency in a rela- pearance of rigidity to the person’s behaviortionship where the connection between mental as if only a singular pattern of response werestate and action within the self has been un- accessible. Furthermore, the response maydermined by insensitive and coercive par- frequently be in conflict with social norms be-enting. cause the tendency to take the perspective of Abnormalities of parenting represent but others has been abandoned in that contextone route to limitations on reflective function. and, consequently, the moral emotions usedThe child’s biological vulnerabilities such to make judgments about the consequences ofas hyperactivity, attention problems, low im- actions and regulate behavior are absent. Thepulse control, are all likely to obstruct the absence of reflective function may further ex-opportunity the child has for evolving a men- aggerate an antisocial response by forcing thetalized reflective model of conflict-related in- individual to see the other not as another in-terpersonal situations. Within a dialectic or tentional agent, but in nonhuman terms, as atransactional model there is a bidirectional body, as representing a social position orcausality inherent to such biological vulnera- agency, or as a faceless member of a group.bilities: They both provoke situations of con- Maltreatment, or more broadly trauma, isflict and place grave limitations on the child’s seen as interacting with the domain- and situ-capacity to acquire the flexibility needed for ation-specific restrictions upon reflective func-their adaptive handling. This may bear on the tion at two levels. First, as we have argued,well demonstrated comorbidity between con- maltreatment presents the young child with aduct disorders and hyperactivity or attention powerful emotional disincentive for taking thedeficit disorder (Kazdin, 1995). Similarly, perspective of others, because of the actualfactors associated with early behavioral prob- hostility of the intentional stance of thelems, such as poor parental adjustment (ma- abuser, as well as the constraints upon the selfternal aggression, suspiciousness, and mood which an older person’s failure to understanddisorder) (Shaw, Owens, Vondra, Keenan, the child’s budding intentionality imposes.& Winslow, 1996; Zahn–Waxler, Ianotti, Second, the child misses a protective factor,Cummings, & Denham, 1990), and resources the capacity to understand traumatic interper-(marital dissatisfaction, parental conflict) sonal situations, which would be likely to(Block, Block, & Gjerde, 1986; Campbell, limit their impact (Fonagy, Steele, Steele,Pierce, Moore, Marakovitz, & Newby, 1996) Higgitt, & Target, 1994). Thus, individualsmay limit the parents’ capacity to respond to traumatized by their family environment arethe child in ways which promote a mentaliz- vulnerable both in terms of the long-term mal-ing model of self–other relationships. adaptive effect of their reaction to the trauma The separation of action from intention un- and in terms of their reduced resilience in thedermines the emotional reaction an individual face of it. The predominantly nonmentalizingmay have to the consequences of their actions stance adopted in such situations thereforesince, as Hart and Killen (1995) pointed out, handicaps the individual and, if the viciousthe acquisition of moral emotions requires circle is unbroken, may come to dominate allthat individuals are “active contributors to interpersonal relationships. We believe that attheir own development, interpreting their this stage severe developmental psychopathol-world and making judgments that determine ogy, in the adult entrenched personality disor-their actions in it” (p. 7). Subsequently, the der, is the likely consequence.ReferencesAinsworth, M. D. S., Bell, S. M., & Stayton, D. J. (1971). olds. In H. R. Schaffer (Ed.), The origins of human Attachment and exploratory behaviour of one year social relations. New York: Academy Press.
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