link on attunement

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2169321/

Long quote:

"While attachments develop throughout the lifespan, clinical and neurobiological evidence indicates the importance of early foundations, remaining, as in a wall, important whatever is added. Like any relationship, infant attachment is a two-way, mutually-reinforcing process, which depends on what each contributes, on opportunity for closeness, on the attitudes of others, and on wider social factors. It develops through sophisticated maternal attunement to the baby's overtures, involving tone, pitch and rhythm of voice, posture, facial expression, movement, and touch. In this way, the parent reflects back the baby's emotions, giving them meaning and regulating them, which moulds development of the right pre-frontal cortex. This requires the baby's ability to elicit a response, and the parent's to respond.

"Attachment allows emotional regulation before infants can self-regulate. Involuntary stress regulation, mediated by the hypothalamus–pituitary–adrenal (HPA) axis (indicated by salivary cortisol), is ‘set’ in infancy — and probably antenatally — at a level adaptive to the prevalent environment and reflecting the effectiveness of calming. Stress regulation is important for exploration, learning, independence, and effective relationships. While poorly regulated infant stress can produce persistently exaggerated stress responses, serious abuse can cause them to ‘switch off’, leading to fearlessness, and, for example, relative bradycardia. Altered HPA axis function relates to childhood behavioural difficulties, anxiety, depression, and post-traumatic stress disorder. Disturbed attachment may also affect immunity and healing, and predispose to ‘psychosomatic’ illness, mediated by physical manifestations of autonomic dysfunction. While neuronal plasticity, developing cognition, and experience modulate stress responses, they do so around a baseline influenced by the first relationship an infant experiences.

"Attuned parenting imparts meaning to the ‘inner world’ of body signals (for example, hunger, satiety, full bladder, thought, and emotions). It teaches children that others recognise their needs, and establishes foundations for trust, empathy, understanding relationships, and verbal and non-verbal communication. Preconceptions are established for subsequent relationships, close and otherwise.

"Anything that interrupts the cycle of attunement affects the quality of attachment. If substance abuse or depression, for example, intermittently disturb otherwise good attunement, children experience attention as valuable, but unreliable, and not necessarily easily achieved, causing anxiety. Maternal stress, anxiety, and fatigue have similar consequences, by affecting the reading of social cues and subtlety of response. These children learn strategies for achieving and holding attention — over-compliance, constant smiling, disruptiveness, soiling, or use of symptoms — whatever works. Any attention, positive or negative, may be better than none. Management involves focusing attention on desired behaviour. The emotional ‘separation’ of discipline is difficult to tolerate and fear of rejection colours relationships. Breaks in attunement are unreliably resolved and stress is poorly regulated.

"Sometimes attuned, sometimes antagonistic parenting conveys attention as valuable, but unreliable and frightening, causing children to be ambivalent about seeking or sustaining it. Hypervigilance to parental mood affects concentration and causes ‘over-reading’ of disapproval. These can be difficult and confusing children to parent. They may seem to push away those to whom they are closest, while also craving their attention.

"Consistently unattuned parenting (for example, because parents have poor foundations for attachment, or learning difficulties), fails to teach children the benefit of closeness, while aggression can make them fear it. These children become ‘avoidant’ loners, inept at understanding non-verbal cues and the subtleties of language, and often seeking control through ‘sameness’. The resulting picture resembles ‘innate’ autistic spectrum disorder.

Pervasively abusive parenting can leave children disorganised and ineffective both in self-sufficiency, and with relationships, and without empathy. Successful independence is improbable, and adult criminality likely.

"Throughout life, individuals fall on a continuum of attachment style, ranging from ‘loners’ to those craving attention and approval — some seeming wary of sustaining the relationships they seek. The pathology implied by the labels ‘avoidant’, ‘anxious’, or ‘ambivalent’ attachment styles respectively (collectively described as ‘insecure attachment’), has qualified justification when 40% of the population are so categorised. However, the greater the deviation from ‘secure’ attachment, the greater the likelihood of dysfunction. In the middle of the spectrum are the 60% who are classified as ‘securely attached’. They may find the more comfortable personal path through life, valuing relationships yet independently competent. Although moulded by subsequent experience, childhood attachment continues to be reflected in adult personal, social, and professional relationships, and in approach to parenting. Adult attachment style also relates to how trauma and loss are handled, and to career choice. For example, medical students with ‘secure’ attachments are more likely to opt for a career in primary care than those tending to avoidant or anxious patterns. Childhood attachment might also influence aging, which relates to HPA-axis function."