A Critical Analysis of the Use of Attachment Theory in Cases of Domestic Violence Critical Social Work 14(2) Fiona Buchanan1 1 University of South Australia

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Critical Social Work, 2013 Vol. 14, No. 2

19 Buchanan A Critical Analysis of the use of Attachment Theory in Cases of Domestic Violence Critical Social Work 14(2) Fiona Buchanan1 1 University of South Australia

Author Note

The author acknowledges the contributions of Professor Fiona Verity and Associate Professor Charmaine Power, Flinders University during early discussions of concepts described in this manuscript. The manuscript did not receive research support from any funding body.

Abstract

Social policies and social work practices are increasingly influenced by attachment theory. Women who have been subjected to domestic violence by male partners are being assessed within this discourse, which takes little account of societal perspectives, which sustain injustices and power differentials. Domestic violence is known to be a major social problem but when attachment theory is applied to women and their babies in domestic violence it negates knowledge based in lived experiences. Rather attachment theory is informed by non-gendered family violence perspectives and research instruments, which frame domestic violence within an individualised perspective. In this way, women and their babies are observed and classified without regard for the societal factors, which affect them. In view of this, there is a need for critical social workers to question attachment theory and the positivist research instruments, which are being used to inform theory and practice. Particularly with regard to domestic violence as a gendered, societal issue, a broad perspective, which promotes a social justice view and the need for social change is indispensable.

Keywords: domestic violence; attachment theory; research instruments

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This paper results from the authors experience as a critical social worker and latterly as a lecturer in social work. In both roles, she has become increasingly concerned about how some social workers and social work students are enthusiastically embracing attachment theory without considering applications of this theory through a critical lens. It is not repudiated that the relationships between women and their children are important. However, when women and their children are the sole focus of assessment and treatment based in attachment theory broader societal issues and a gendered analysis are eclipsed.

Practitioners who currently embrace attachment theory include social workers, as well as nurses, occupational therapists, psychologists, and speech pathologists (Prior & Glazer, 2006). Many are encouraged to do so by mainstream services, which simultaneously adopt a family violence perspective. This perspective excludes feminist knowledge of domestic violence as a gendered social problem by situating violence as an outcome of dysfunctional family relationships (Dobash & Dobash, 2004). It is of concern when family violence and attachment theory perspectives combine to disavow deep knowledge based on lived experiences, which have informed the field of domestic violence over the past decades.

Many feminists have taken issue with attachment theory, describing the attachment field’s prescriptive mothering role as unreasonable, the emphasis on mothering as politically motivated and the rational for focusing on mothering in isolation from context as patriarchal (Contratto, 2002; Morris, 2008). Similarly, feminists have criticised family violence approaches to domestic violence, which deny the gendered nature of abuse (Dobash & Dobash, 2004; Flood, 2006). Although, the application of attachment theories to domestic violence have been critiqued (Buchanan, 2008), the family violence and attachment instruments, which are used to assess women who endure domestic violence have not, until now, been the subject of enquiry. Following an exploration of domestic violence and family violence perspectives, attachment theory applications are described and critiqued and the use of popular survey and assessment tools, which are used by researchers and practitioners to code and classify relationships between women and their babies are problemitized. A seminal study (Zeanah et al., 1999), and a recently published case study (Levendosky, Bogat, & Huth-Bocks 2011), which both investigate mother/child attachment in domestic violence are critiqued. In conclusion, the author calls for critical social workers to question applications of attachment approaches with particular concern for women who endure violence from their partners.

Domestic Violence Defined as an Issue of Gender

Defined within feminist understandings domestic violence is identified as ongoing physical, emotional, social, financial, and/or sexual abuse used to exert control and power by one partner over another in an adult relationship. This approach recognises a “constellation of abuse” (Dobash & Dobash, 2004, p. 334) where abusive acts consolidate to frighten, coerce, and intimidate. Elsewhere this pattern has been named as ‘coercive control’, which is gendered because the unequal distribution of responses and resources in society make women more susceptible to coercion and men more likely to use coercive tactics to maintain dominance (McKinnon, 2008; Stark, 2007). Historically critical, feminist enquiry has informed knowledge, which includes deep understandings about the definition, nature, prevalence and effects of domestic violence (Harding, 2007). It is noted that “domestic violence cannot be adequately

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21 Buchanan understood unless gender and power are taken into account” (Yllo, 2005, p.19). Such understandings of domestic violence consider social structures, which support gendered inequity and they define domestic violence as one way that patriarchy maintains dominance of women and children (Danmant et al., 2008).

Participants in qualitative, feminist research who are encouraged to authentically locate real life struggles have informed these understandings. Research based in participants’ voices contests distortions, which can preside when knowledge is informed by scientific research (Hesse-Biber, 2007). Feminist understandings of domestic violence, informed by the lived experiences of women, continue to resonate with women today. Through access to feminist practitioners, including social workers who base their knowledge in feminist research findings, women who have been abused begin to understand that the violence was not their fault (Loseke & Kurz, 2005).

Global appreciation of the gendered nature of domestic violence has been informed by research, which embraces lived experience as well as by multiple, large-scale quantitative research studies. In light of such extensive and varied research, The United Nations and The World Health Organization recognise gendered violence as the greatest health risk to women in the world (World Health Organization [WHO], 2005). Gendered violence is known to occur in all countries and in all socio-economic strata of society with 25% of women experiencing domestic violence each year (WHO, 2005).

A Broad Scope of Violence in Interpersonal Relationships

Within feminist discourses, it is recognised that there are circumstances where women are violent to their male partners. Women’s use of violence in interpersonal relationships includes situations where women use violence to defend themselves and their children (Kelly & Johnston, 2008). Emotional responses to separation are also found to lead to acts of violence by either men or women (Kelly & Johnston, 2008). Elsewhere, in a review of multiple studies of women’s use of violence, it is found that a combined sense of being ignored, plus anger and powerlessness pre-empted violent outbursts (Bair-Merritt et al., 2010). In other situations, both partners resort to using violence in their relationships. However, when violence is mutual, fear is not generally an issue for either partner and violence acts tends to be less frequent and involve lesser forms of physical abuse (Johnson & Leone, 2005).

The incidences of violence where women perpetrate abuses are differentiated from violence where coercive control is a dynamic combination of strategies, which are enacted and repeated, often escalating over the length of the relationship (Dobash & Dobash, 2004; Stark, 2007). Further, it has been substantiated that women most often suffer persistent domestic violence and that children are harmed by living in situations where there is enduring abuse (Moe, 2009; Radford & Hester, 2006; The Benevolent Society, 2009; Walby & Allen, 2004). Findings concerning violence in other circumstances do not discount the existence of domestic violence as a gendered pattern of coercive control, which affects significant numbers of women and children.

It is also evident that violence occurs in same sex partnerships. From a feminist perspective, this is understood to include coercive control, which is present in same sex

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22 Buchanan partnerships because of the impact of dominant socio-political systems, which oppress minority populations (McClennen, 2005). However, for the purposes of this paper, the focus is on heterosexual relationships because it is the mothering role of women who identify as heterosexual that is most often scrutinised from an attachment approach (Prior & Glazer, 2006).

Family Violence Perspectives

While international institutions have adopted feminist definitions and findings, feminists have been turning inquiry to the proliferation of multiple oppressions (Chinn, 2003; Leung, 2011). Meanwhile, an alternative philosophical stance, which uses the term ‘family violence’, has gained favour. Some proponents of this discourse negate gender issues by situating domestic violence as a product of family conflict undifferentiated from child abuse, elder abuse and abuse of parents by their offspring across all parameters of culture and race (Ehrensaft, 2008).

Viewed from the family violence perspective domestic violence is seen to have multiple causes. These causes appertain to various stresses within the family and to individualised responses based in pathologies, or are viewed as justified responses to provocation (Dutton, 2007). Within a family violence perspective, violent behaviour by men towards their female partners is sometimes perceived as inherited through poor parenting. With the increased popularity of attachment theory, the cause of violent behaviour is now being situated as a product of the individual’s insecure early attachment relationships with the primary care giver (Ehrensaft, 2008). The term ‘primary care giver’ generally refers to women as mothers (Prior & Glazer, 2006).

Situating domestic violence as a problem inherent in dysfunctional families and/or caused by insecure early attachment fits neatly with a neoliberal perspective, which denies the need for structural changes to address social issues (McDonald, 2005). These views deny gender at the macro and micro levels (Hunnicutt, 2009). Thus, the impact of societal institutions on women and men and the inherent nature of gendered roles within the family are denied. The focus can then turn instead to perceiving deficits in individual women and men. Many women already feel responsible for the violence that is perpetrated against them and the family violence approach deflects them from seeing violence against them in a societal context. In addition, it encourages researchers to follow a line of enquiry, which furthers the status quo in an unjust society. As noted:

Gender is a slippery construct, that is, if it is not front and centre within an analysis, it tends to become invisible. Just because some practitioners and theorists ignore or minimise gender (and its related power imbalances) as a variable does not reduce its impact. (McPhail, Busch, Kulkarni, & Rice, 2007, p. 832).

Instruments that Support a Non-Gendered Perspective

A family violence analysis has been promoted through the use of survey questionnaires named “the Conflict Tactics Scale (CTS)” and the “Revised Conflict Tactics Scale (RCTS)” (Straus, 1979; Straus, Hamby, Boney-McCoy, & Sugarman, 1996). These instruments have become popular with large studies because they are simple, quick and easy to use and do not

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23 Buchanan require skill or sensitivity on the part of the researcher. The CTS and RCTS questionnaires are also favoured in attachment theory research into mother/child relationships affected by domestic violence (Bogat, Dejonghe, Levendosky, Davidson, &Von Eye, 2006; Levendosky & Graham- Bermann, 2001; Levendosky et al., 2006). This is despite, or perhaps because, they are the only instruments, which find gender symmetry when used to measure domestic violence (Loseke, 2005).

The use of the CTS and the RCTS has been widely criticised on many points, in particular it is noted that the context of violence is ignored and social, emotional, and psychological effects are not acknowledged (Dobash & Dobash, 2004; Flood, 2006). Instead these instruments create a simplistic, distorted view. This view contrasts with feminist qualitative research results conducted with methods which are labour intensive because they are designed to elicit deep and meaningful data in relationship with research participants (Devault & Gross, 2007). In effect, the CTS and RCTS are examples of how research can mislead and distort societal issues so that patriarchal power and control are deemed irrelevant (Dobash & Dobash, 2004; Flood, 2006; Loseke, 2005).

Concerns about the family violence perspectives and the use of the CTS and RCTS are well documented elsewhere (Dobash & Dobash, 2004; Flood, 2006, 2010; Reed, Raj, Miller, & Silverman, 2010). Here it is of note that the family violence analysis concurs with attachment theory in following a psychological perspective, which “disregards the gender-based framework at the root of our understanding and consideration of domestic violence” (Reed et al., 2010, p.348). Both family violence and attachment approaches do not look beyond the family for the origins of violence. Further, attachment theory firmly places women at the center of enquiry and applies a deficit model to the mothering role irrespective of the social contexts in which women mother. This paper now turns to attachment theory and popular instruments used by attachment theorists to assess mother/child relationships.

The Development of Attachment Theory

Adherents of attachment theory believe that proscribed standards of primary relationships, usually with the mother, are essential to maximize healthy development across the lifespan (Prior & Glaser, 2006). Although gender is assumed, a gendered analysis is not offered. It is perceived that the early relationship with their mothers affects babies’ brain development, wellbeing, relationships, and interactions throughout the life cycle (Main, Hesse, & Kaplan, 2005; Prior & Glaser, 2006). The premise is that babies achieve optimal secure attachment relationships when their mothers provide “a secure base and a safe haven,” through sensitive and responsive care giving (Marvin, Cooper, Hoffman, & Powell, 2002). When attachment is assessed as insecure, it is perceived as less than ideal and the focus may turn to treatment so that the relationship can be repaired. The main categories of insecure attachment are named as avoidant, ambivalent and disorganized (Prior & Glaser, 2006). The potential mental health problems for babies with disorganized attachment are seen as most concerning with predictions of borderline personality disorders in later life (Bateman & Fonagy, 2004; Liotti, 2005).

From a feminist perspective, attachment theory is seen as a discourse, which prescribes a narrow and conservative role for women as mothers and promotes beliefs, which extend the

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24 Buchanan objectification of women (Contratto, 2002). Within attachment theory, the societal pressures on women are not considered as problematic, nor is the proscribed role of women as mothers critiqued (Morris, 2005). In the application of attachment based, expert opinion, deep, rich, complex, and varied perceptions are missed and it becomes easy to objectify and pathologize women (Lapierre, 2010). Social identities of ethnicity, culture, class, and multiple oppressions are ignored as a narrow lens is applied to categorise the mother/baby relationship and situate potential problems within that relationship.

Assessing Attachment

Attachment theory researchers and practitioners traditionally assess attachment patterns in a procedure with set tasks, where women and babies interactions are observed and coded by clinicians (Prior & Glaser, 2006). In the second half of the twentieth century Ainsworth pioneered a twenty minute assessment tool for categorising attachment patterns, which is named “the strange situation procedure” (Ainsworth, Bichar, Waters, & Wall, 1978). Using this procedure, the baby is observed interacting with his or her mother in a clinical setting. The baby’s and mother’s responses and behaviours are critically examined throughout a process where the mother is directed to leave and re-enter the room. Ainsworth, as creator of the strange situation procedure, used this procedure as an adjunct to lengthy periods spent in the homes of women and babies (Ainsworth & Bowlby, 1991). Nonetheless, as Goldberg, Grusec, and Jenkins (1999) write, “the idea that a 20 minute laboratory session could replace hundreds of hours of home observations was naturally appealing” (p. 481). As a result, the strange situation is now frequently used as the sole instrument for applying attachment categories to women and their babies. Ainsworth was dismayed by this development, as she did not see the procedure as a thorough means of defining mother/baby relationships (Ainsworth & Bowlby, 1991).

The strange situation procedure focuses on individual women and their babies in isolation from the real world. While claiming that this method is child centred there is no indication of how the baby reacts to others in the family and factors of poverty and levels of support are disregarded. In addition, Anglo-centric, middleclass norms of childrearing are assumed (Contratto, 2002). Further, in applying the strange situation procedure the possible presence and impact of domestic violence on woman and baby are unidentified. The effects on babies of witnessing multiple abuses of their mother are overlooked. Instead unconscious behaviours displayed by women and babies are the object of enquiry. If the relationship is deemed insecure, the woman’s childhood experiences of attachment are then the subject of investigation (Hesse, 2008).

Adult Attachment Interview (AAI)

As well as the strange situation procedure, an instrument named the Adult Attachment Interview (AAI) (George, Kaplan, & Main, 1985) has gained popularity when assessing individuals with regards to their ability to attach. The AAI takes the form of a multiple question, semi-structured interview which focuses on adults subconscious perceptions about attachment in their family of origin to predict the quality of parent/child attachment in the present (Hesse, 2008). This instrument is quasi-clinical and has been validated by extensive research. However, the AAI focuses on childhood experiences and pays little regard to wider issues of adult lived

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25 Buchanan experiences, societal contexts and the social identities that form and reform over the lifespan in response to injustice (Campbell & Baikie, 2012).

A Restricted Focus

Finger, Hans, Bernstein, and Cox (2009) state that “Attachment research has much to gain from adopting a wider contextual and ecological approach to the study of parent-child relationships” (p. 302). With particular reference to the field of domestic violence, knowledge limited by focusing on the mother/child dyad precludes consideration of the compromising context of a controlling parental partnership and the social constructs which uphold power differentials within such relationships. Not only may domestic violence be missed in entirety but also, even if domestic violence is known to occur, the numerous constraints put on women who are enduring domestic violence are rendered invisible.

Interestingly, from the 1970s, when feminism put violence against women on the agenda, attachment theorists have acknowledged domestic violence. Bowlby (1988), known as the father of attachment theory, recognises that “all too many women are battered by husband or boyfriend” (p. 88). Bowlby does not differentiate between causal factors of child abuse and domestic violence. In accordance with a family violence approach, he chooses to situate violence as an expression of anger and to focus on intergenerational causal factors. Through the lens of attachment theory Bowlby surmises that the purpose of violent behaviour is to “protect a relationship that was of very special value to the angry person” (Bowlby, 1988 p.89). Consistent with a family violence perspective this view focuses exclusively on pathology in interpersonal relationships. Bowlby’s perceptions continue to inform research in the field of attachment theory and the practices which are informed by attachment. When perpetrators of domestic violence are scrutinised it is in the context of the primary relationships with their own mothers (Sonkin & Dutton, 2003).

Measuring Effects of Domestic Violence on Relationships between Women and Babies

The sentinel attachment study, which measures the effects of domestic violence on the formation of relationships between women and their babies by Zeanah et al., (1999) used the conflict tactics scale (Straus, 1979) and the strange situation procedure (Ainsworth, Bichar, Waters, & Wall, 1978) as measures in a study of seventy-two mother/baby dyads who had endured domestic violence while living in poverty. The effects of poverty on mother/baby relationships are not investigated. The focus of the study is on physical abuse without acknowledgement that emotional abuse, fear, and intimidation of their mothers may have direct effects on babies. The conflict tactics scale and the strange situation procedure were supported by home visits to research participants. During home visits interviewers read out questions “to control for possible differences in reading levels” (Zeanah et al., 1999, p.84). Home visits were videoed for coding purposes. It is deduced from the above that building trusting relationships between women and interviewers was not a priority. The objectification of participants, reminiscent of abusers attitudes, could lead to suppression rather than revelation of salient information that falls outside the dictates of this clinical approach to data collection. Further, Zeanah et al. (1999) mention “mother’s proclivity to become involved with violent relationships” (p. 84), suggesting that a feminist analysis is missing. From feminist research, it is not evidenced

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26 Buchanan that women choose violent partners, but there is evidence that violence often develops later in the relationship once the woman is committed to its continuation (Stark, 2007).

Studies which follow Zeanah et al. (1999) to investigate the developing relationships between women and their babies in domestic violence tend to follow the tenets of attachment theory without assessment of attachment patterns and without precise definition of the term attachment (Bogat et al., 2006; Levendosky & Graham-Bermann, 2001; Levendosky et al., 2006). Recently, however, in a published case study of a women and her child by Levendosky, Bogat, and Huth-Bocks (2011) traditional attachment theory methods of structured interview and the strange situation procedure are applied to define effects of domestic violence on a mother– child relationship. As with Zeanah et al.’s (1999) study, in this research the emphasis is on physical abuse within a family violence perspective. Because the woman states that she had not been hit since the birth of her child, the researchers assume that abuse has stopped. Based on two interviews the woman is coded as “a distorted mother” (Levendosky et al., 2011, p.6). In attachment theory terms, this indicates that the mother has unresolved childhood issues and sees the child as an extension of herself. There is no mention of the child’s relationship with her father, or of the father’s behaviour in the child’s presence.

Consequences

By framing mother/baby relationships without regard for micro and macro contexts, the life world outside the portrait of mother and baby is excluded. As with traditional portrait, painting the focus is on the subject and interpretations are the prerogative of the observer. If attachment theory approaches, underpinned by family violence dictates, are followed the ability of social workers, and social work students, to perceive people as influenced by multiple perspectives of the social world across the life course may be compromised. Because of this, social workers and social work students need to take a critical view of how attachment perspectives are shaped by research and the ways in which knowledge of the broader picture is excluded. Without this, social workers take a limited view, which distorts experiences of both women and their children. As well as having a detrimental effect on women, it is suggested here that the needs of children, and people who have grown up with domestic violence, are not served when mothers are classified and found responsible for their wellbeing across their lifespan. It is disempowering to perceive ones destiny as compromised by an early relationship deemed as deficit.

While attachment theory has increased in popularity over past decades, feminist researchers have been critical of attachment theory without offering alternative research into mother/baby relationships (Morris, 2008). This division means that knowledge based in women’s voices concerning the impact of domestic violence on the relationships between themselves and their babies is missing from theories which informs a diverse range of services. Encouragement to embrace attachment theory is found in social policy and the allocation of government resources to programs, which promise social wellbeing outcomes and fiscal savings in the future (Commonwealth of Australia, 2008; The Organisation for Economic Co-operation and Development (OECD), 2001; Sims, 2009). These resources are allocated to child mental health services, childcare services, child protection agencies, family law courts, family home visiting, and early intervention services (Prior & Glaser, 2006). While it is appropriate that policies

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27 Buchanan orientate services to prevention and early intervention, there is also a need to address the ways in which societal institutions maintain inequities.

Many social workers and social work students will be employed in services, which implement policies underpinned by attachment approaches. Given the high prevalence of gendered abuse, these social workers will provide services to women and their children who are enduring domestic violence. There is, therefore, a need for social workers to utilise knowledge of gender analysis and feminist understandings of domestic violence to critically analyse the attachment approaches they are encouraged to utilise. If this is not undertaken, women living with violent partners may well be further disempowered. When women are already experiencing the disempowering effects of domestic violence, viewing the relationships with their children within a narrow frame constructed by instruments, which categorise regardless of social justice can do harm. Without a social justice approach women who endure domestic violence are encouraged to see themselves as deficient in mothering abilities. Further, others, including men who perpetrate domestic violence, are absolved of responsibility for children’s wellbeing and society and its institutions are excluded from accountability.

As found in research conducted by Buchanan, Power, and Verity (2013), when feminist methods of qualitative research are employed a very different perspective of the relationships between women and their babies in domestic violence is revealed. As was found in this research, preferencing the building of trusting relationships and enabling participant empowerment can attain deep and rich knowledge, which enhances understanding instead of limiting and distorting comprehension. There is a need for critical social workers to undertake further research, which builds on feminist traditions and gives a broader, more holistic view of the formation of relationships between women and babies enduring domestic violence. By undertaking such research, the political as well as the personal can be exposed for critical evaluation (Campbell & Baikie, 2012). This approach not only counters the negative impacts of a deficit model applied to women and children who are already disempowered, but can also reinforce the need for societal change.

Conclusion

It is easy to see why time poor social workers and inexperienced social work students may be seduced by expert driven, individualized approaches, which offer prescriptive assessment and therapeutic solutions. However, in doing so women and their children may be disadvantaged rather than empowered. Further, the role of social workers to challenge systems, which undermine social justice, may be obscured if social workers take an uncritical view of attachment theory and the family violence perspective. When it is recognized that knowledge is narrowly constructed there are opportunities for critical social workers to problematize the theories and methods, which restrict vision. Hopefully, critical social workers will find time to dispute current applied theory and that some will undertake further research to widen the current view of mother/baby relationships in domestic violence and so challenge policies and practices which negate critical societal perspectives.

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