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By John Bowlby

The world-famous psychiatrist and writer of the vintage works Attachment, Separation, and Loss deals very important guidance for baby rearing in response to the the most important position of early intimate relationships.

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Holidays or other interruptions he welcomes as saving his time. Perhaps he finds the analysis an 'interesting exercise'; although he is not convinced it is much use. And in any case he could probably do a better job by analysing himself! There is, of course, a large literature discussing the psychopathology of these conditions and the therapeutic problems they present; but on whatever issues there may be agreement there is none on aetiology. To take two contrasting viewpoints: whereas Winnicott ( 1960, 1974) attributes the condition squarely to early environmental failure in the form of 'not good enough mothering', Kemberg ( 1975) in his systematic treatise gives no more than a couple of easily missed paragraphs to the possible role that mothering plays in influencing development, and only a few passing references to the inadequate mothering certain of his patients may have received.

In both professions, moreover, practitioners are permitted to intervene in specified ways and privileged to observe what the consequences of such interventions are. These are immense advantages and psychoanalysts have not been slow to exploit them. Yet no science can prosper for long without enlisting new methods to cross-check on observations made and on hypotheses born of older methods. Here the research scientist is likely to have the advantage. In the medical sciences, physiologists and pathologists have made immense advances by means of animal experiments, tissue culture, biochemical analyses, and a thousand other ingenious techniques.

It would also be especially valuable if we were to have a detailed account of the conditions in which a major therapeutic change occurs. If, perhaps in a collaborative programme, records could be kept on a number of such patients, it might be possible to discover whether a frank and detailed discussion of the painful experiences a patient recalls having had in his relationships with his parents and the effects these appear to have had and still to be having on the ways he treats other people, including of course ourselves, promotes therapeutic change, as I predict, or hinders it, as is believed by some analysts.

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