依恋模式的连续性和潜在变化

Continuity and potential for change in attachment patterns

这一章的最后一节，重点阐述依恋模式的连续性和潜在变化。这符合Bowlby的观点，虽然反映早期依恋经验的内部工作模型已经成立，但足够严重的人生逆境，可以推翻一个安全基地，同样的，如果在早期逆境之后获得一个足够积极的关系经验，一个早期不安全基地也可以变得更稳定和坚实。Bowlby多次指出，人生的任何时刻都有可能发生积极的变化。

This final section of the chapter highlights both continuity and change in attachment patterns. This is in line with Bowlby’s comments that just because an internal working model reflecting early attachment experiences has been set up, life’s adversities, if severe or cumulative enough, can topple a secure base. But, equally, an early insecure base can become more stable and hardy if a sufficiently positive set of relationship experiences follows early adversity. Bowlby repeatedly pointed out that at no time in life is positive change impossible.

我们在孩子和跨代的生活模式中观察到了依恋模式的连续性。在养育环境中给予合理的稳定性，陌生情境实验中的反应模式，随着时间的推移是相当稳定的(Lyons-Ruth et al. 1991; Waters 1979; Vaughn et al. 1979)。此外，四种主要的母婴依恋模式，并不直接地由孩子的某种属性，比如气质类型来决定(Crockenberg 1981; van den Boom 1994)。大多数的研究，已经将婴儿－母亲的依恋质量与婴儿－父亲的依恋质量进行了比较，报告指出每一个婴儿－父母的关系在统计上都是独立与其他的(e.g. Main and Weston 1981; Steele et al. 1996)。陌生情境实验中，孩子在与母亲团聚时的行为表现，很大程度上反映了孩子与母亲互动的独特历史：当孩子发出接触和安慰的需要，母亲是如何回应的，而孩子又是如何理解的。不同的互动历史可能会巩固孩子对父亲的依恋。因此，婴儿期的依恋品质，最能诠释在陌生情境实验中观察到的儿童－照顾者关系的特质。陌生人情境实验可以说提供了一个可靠的指标，来衡量压力－诱导环境下婴儿的行为反应，这也如同提供了一个窗口，来展示儿童与养育者关系的内部工作模型。通过AAI的评估，养育者独特的内部关系工作模型，是对亲子关系质量最有力的预测，进一步彰显了依恋结构的具体性质(see Steele et al. 1996; van Uzendoorn 1995)。

Continuity has been observed within the life of the child, and across generations. Given reasonable stability in the caregiving environment, these patterns of response to the Strange Situation are reasonably stable over time (Lyons-Ruth et al. 1991; Waters 1979; Vaughn et al. 1979). Additionally, these four main patterns of infant-parent attachment are unlikely be directly determined to any significant extent by a property of the child such as temperament (Crockenberg 1981; van den Boom 1994). The majority of studies which have compared infant—mother attachment quality with infant-father attachment quality report that each infant-parent relationship is statistically independent of the other (e.g. Main and Weston 1981; Steele et al. 1996). The child’s behaviour upon reunion in the Strange Situation with the mother largely reflects the unique history of interactions with the mother, how she responded to her infant’s bids for contact and comfort and how these were interpreted by the infant. A different history of interactions is likely to underpin the child’s attachment to the father. Thus, attachment quality during infancy is best understood as a characteristic of the child-caregiver relationship most readily observable in the Strange Situation procedure. The Strange Situation may thus be said to provide a reliable index of infant behaviour in response to stress-inducing circumstances, and in doing so provides a window upon young children’s internal working models of their relationships to caregivers. That caregivers’ own unique internal working models of relationships, assessed via the AAI, is the most powerful predictor of the infant-caregiver relationship quality further underlines the relationship-specific nature of the attachment construct (see Steele et al. 1996; van Uzendoorn 1995).

已经有大量的研究，通过陌生人情境实验的评估，描绘出了一个人的后续发展，从婴儿期到童年，幼儿园期，潜伏期，青少年期，和成人期的社会认知发展。接下来提供一个从大量的文献中选定的概述，来看依恋需求，实际经验产生，心理表征（或内部工作模型）形成，并相应的影响后续的经验。

There have been an enormous number of studies charting the developmental sequelae from Strange Situation assessments in infancy to a variety of social and cognitive developments in toddlerhood, in the nursery years, in latency, in adolescence and most recently into adulthood. The following provides a selected overview of this vast literature on how attachment needs, and resulting actual experience, lead to mental representations (or internal working models) that, in turn, influence subsequent experiences.

Klaus和Karin Grossmann在德国的纵向研究工作已经发现，早期母婴依恋的长期影响。他们有许多令人印象深刻的研究，其中一个表明，三岁的安全依恋的孩子，玩游戏输的时候，能够面对成年考官公开地表达自己的悲伤（看着竞争对手的脸）。相比之下，那些有着不安全－回避型依恋历史的孩子，失败时不开心，却不能直接给出难过的表情，而假装一个“社会性微笑”。这些发现对他们的独立观察非常有意义，1岁的回避型依恋孩子会隐藏他们的负面情绪，此时内部指标由生理反应测定，唾液皮质醇测量显示出强烈而长期的紧张性兴奋(Spangler and Grossmann 1993)。不要错误地认为，这些发现是天然出现在孩子身上的，有证据表明，当这些回避型依恋孩子表现出积极的情绪时，他们的母亲非常愿意给出回应。而他们表现出的负面情绪往往被忽视和拒绝，因此这样的孩子才1岁就学会了掩饰自己的感情(Grossmann et al. 1986)。

The longitudinal work of Klaus and Karin Grossmann in Germany has identified long-term implications of early attachment to the mother. One of their many impressive studies showed that securely attached 3-year-old children were able to openly communicate their sadness (looking into the face of their competitor) upon losing a competitive game with an adult examiner. In contrast, those children with an insecure-avoidant history revealed distress when losing but were unable to directly show their sad faces and instead presented a ‘social smile’. These findings map meaningfully onto their independent observation that avoidantly attached 1-year-olds hide their negative feelings while internal indicators as measured by physiological responses in the form of salivary cortisol measurements show intense and prolonged stressful arousal (Spangler and Grossmann 1993). It would be a mistake to think of these findings as residing in the child alone, as there is evidence that mothers of the avoidantly attached children have powerfully conveyed to them a willingness to respond favourably, but only when they display positive affect. Their display of negative affect is likely to be ignored or rejected, and thus such children learn by 1 year of age to disguise their feelings (Grossmann et al. 1986).

Mary Main和她的同事们在对6岁儿童的一系列评估中，发现了令人印象深刻的连续性，这些儿童在5年前参加了陌生人情境实验评估。这项纵向研究使用了一系列不同的具有创新性的任务来评估这些6岁孩子现在的依恋关系，包括仔细观察分离1个小时后他们与父母之间的重聚行为，以及评估孩子对依恋主题的叙事能力。例如，问孩子们：‘在跟父母分开的2周内，孩子会做些什么？’现在已经6岁，在1岁时评估为安全依恋的孩子，可能会尝试着想办法解决分离的难题，比如要求父母不要离开，表达失望和愤怒，寻找保持联系的方法。那些在1岁时评估为不安全依恋的孩子，6岁时倾向于不知道该做点什么，或者让自己远离依恋对象，把自己锁起来，甚至自杀(Main et al. 1985)。这些研究结果对以下概念提供了支持，即内部工作模型是拒绝变化的，这可以帮助我们追踪到早期的内部工作版本，1岁时的行为评估可以跟童年后期的叙事指数强烈相关(r = 0.59)。

Mary Main and her colleagues found impressive continuity in a range of assessments of 6-year-olds who had participated in earlier Strange Situation assessments collected 5 years previously. This longitudinal study used a range of distinct and innovative tasks to assess the current attachment relationship of the 6-year-olds which included careful observations of reunion behaviour between parent and child following an hour-long separation, as well as narrative assessments provided by the child in response to attachment-themed prompts. For example, when the children were asked, ‘What would the child do during a 2-week separation from parents?’ the children who had been securely attached at age 1 year were now at age 6 more likely to imagine ways of dealing with the separation, i.e. asking the parents not to go, expressing disappointment or anger, finding ways of keeping in touch. The children who had been assessed at age 12 months to be insecurely attached, at age 6 had a tendency not to know what the child could do, or to remove themselves further from the attachment figures by locking themselves away or even killing themselves (Main et al. 1985). These findings provide support for the notion that the internal working model is resistant to change and that it is possible to track the way in which early versions evolve as development progresses so that an assessment of behaviour at one age can be strongly correlated (r = 0.59) to narrative indices later in childhood.

在对跨代依恋模式的纵向研究中，我们发现，在12个月大时评估为不安全依恋的孩子，他们母亲的AAI评估要么是拒绝的要么是心事重重的，但他们对情感的认知和理解上是领先的，包括6岁时的矛盾与复杂的感情(Steele et al. 1999)。进一步跟进这些孩子，到他们成长到青春期早期，发现他们的社会认知能力，可以通过10年前的依恋分类再次被预测到。从母亲那里获得的早期安全感，关系到11岁时应对情绪超载的困境和需要反复思考做出决定时，面对压力的能力。(Steele et al. 2002)。“将感受言语化”是一个人的情感素养，也经常被引作心理干预的目标。作为心理健康的基础，这一讲法很容易被概念化。

In our own longitudinal research into patterns of attachment across generations, we have found that children who were rated as insecurely attached to mother at 12 months, and whose mothers’ AAIs were either dismissing or preoccupied, were advanced in their recognition and understanding of emotion, including ambivalent or mixed feelings at 6 years of age (Steele et al. 1999). Further follow-ups of these children as they reach early adolescence has revealed social cognitive capacities that have again been predicted from attachment classifications collected 10 years previously. Early security with the mother is linked to the capacity at 11 years to acknowledge distress in response to cartoon depiction of affect-laden dilemmas and to elaborate thoughtful resolutions (Steele et al. 2002). Emotional literacy and the often-cited goal of most psychotherapeutic interventions to put ‘feelings into words’ can easily be conceptualised as the important underpinning to mental health.

AAI研究涉及的非临床样本， 对17岁或18岁的青少年进行报告，监测和评估，如果不出意外的话，他们已经发展出良好的自我功能，他们与母亲、父亲和他人之间发展出可能不同类型的早期依恋类型(e.g. Kobak and Sceery 1988)。进一步的，Main（1991）提出，10岁的儿童得益于早期与母亲的安全依恋关系，他们在提问探索心灵与知识的本质时，更多地展现出元认知意识。但是早期母婴依恋模式的连续性还可以在未来多久被观察到呢？

AAI research involving non-clinical samples suggests that by 17 or 18 years of age, if not sooner, individuals have developed a well-functioning capacity to report, monitor and evaluate their possibly very different types of early attachment experiences, i.e. with mother, father and others (e.g. Kobak and Sceery 1988). Further, Main (1991) has suggested that by 10 years of age children who have benefited from a secure early attachment to mother are more likely to demonstrate metacognitive awareness in response to probing questions exploring the nature of mind and knowledge. But how far into the future has continuity from early infant-mother patterns of attachment been observed?

值得注意的是，2000年3个纵向研究从AAI取得了20年前，12个月大的孩子在陌生人情境实验中母婴依恋的评估报告，进行了比较(Waters et al. 2000; Hamilton 2000; Weinfeld et al. 2000)。这三项研究揭示，连续性背后的经验确实是连续的，而显著的不连续性背后发生了严重的生活事件和困难，弱到中度的连续性背后，在过去几年里有普通家庭生活的起伏。有人可能会说，这并不令人惊讶，其他的研究应当去发现，什么从最早的经验中，被带到了以后的生活，什么是最有可能被修改的，更新的或可改变为以后的经验功能。显然，我们使用的语言，我们讲的故事，以及我们从我们的生活中获得的意义，必须为修改生命周期而开放。但同时，我们也会保持着对这个世界的自发反应模式，对情绪性和社会性刺激的自动解释，即使我们可能会学着不去相信这些“第一印象”或偏见。

Notably, the year 2000 saw the appearance of three longitudinal studies comparing the assessment of infant-mother attachment in the Strange Situation at 12 months with AAIs obtained circa 20 years later (Waters et al. 2000; Hamilton 2000; Weinfeld et al. 2000). The three studies revealed continuity where there was continuity of experience, marked discontinuity where there were indications of severe life events and difficulties, and weak to moderate continuity where there were the usual ups and downs of family life over the intervening years. Hardly surprising, one might say. Other research is needed to reveal what from earliest experience is carried over into later life, and what is most likely to be reworked, updated or otherwise changed as a function of later experiences. Clearly, the language we use, the story we tell, and the meaning we derive from our lives must 0 open to revision across the life cycle. At the same time, there may be spontaneous modes of responding to the world, and automatic interpretations of emotional and social stimuli that remain, even as we may learn not to trust these ‘first impressions’ or prejudices.

当一位被访者呈现出的状态表明过去的创伤已经解决了，这肯定是一个充满希望和积极的迹象。事实上，非临床人群中，有一些被访者的童年的经历与创伤是非同寻常的，他们却传递出一种超越恐惧的状态，而这种恐惧是作为孩子常常感受到的。此外，这样的被访者可以理解那些曾在童年虐待他们的照顾者，虽然并不一定宽容他们。这样的被访者的AAI评估结果显示出强大的自我意识，人际交往意识和依恋的重要价值，我们可以说这样的曾在童年被虐待过的成年人，不会再成为一个虐待者。而如此的弹性，可能源于虐待关系之外，当事人往往还有多个安全基地和避难所，如大家庭成员，配偶或治疗师所提供给他们的。在这方面，AAI提供了一个独特而强大的临床法律工具，可以被看作是一个可信赖的指标，来检测被虐待过的成年人是否有可能对他们的孩子重复自己的模式。

It is certainly a hopeful and positive sign when a speaker demonstrates that past trauma has been resolved. Indeed, in the non-clinical population, where childhood experiences have involved trauma it is not uncommonly the case that the speaker conveys a sense of moving beyond the fear they felt so often as a child. Additionally, such speakers are capable of going some way toward understanding, though not necessarily forgiving, caregiving figure (s) who perpetrated abuse against them as children. In these circumstances, the AAI often reveals a robust sense of self, interpersonal awareness and valuing of attachment so that one can say the adult who was abused is not likely to become an abuser. Such resilience invariably emerges out of the individual discovering one or more secure bases or refuges beyond the abusive relationship, such as may be provided by an extended family member, spouse or therapist. In this respect, the AAI offers a uniquely powerful clinical and legal tool insofar as it may be seen to provide a reliable indication as to whether or not abused adults are likely to repeat the pattern with their children.

在安娜佛洛伊德中心，出于对反思功能的三维概念研究，我们探索了伦敦AAI研究和临床过程的一个重叠部分。通过评估孕妇的这项能力(Steele et al. 1996)，发现反思功能比起其他任何AAI量表，可以更为有力的预测出母婴依恋的安全性(see Fonagy et al. 1995)。反思自己内心世界，体会到另一个人看问题的角度的能力，是临床医生在评估一个病人的“治疗可能性”时，脑海中需要考虑的关键问题。资源常常是有限的，心理治疗服务应当提供给有需要并可以从中获益的人。无论是公共诊所还是私人开业，对临床医生而言，如何去评估一个人是否可以得益于治疗，是一个关键问题。熟悉反思功能概念，在具有挑战性的临床执业领域，是非常重要的。这里有一个典型的例子，说明在痛苦的境遇中，具有反思功能，可以预期一个良好的治疗结果。一个青春期的男孩Steven到安娜佛洛伊德中心寻求帮助，在他16岁时，遭受了来自同学的严重欺凌。他被锁在学校的更衣室整整一个小时，一个打火机一直点在他的脸颊旁。他陷于一种自伤行为，并与他的父亲每天都处在一种施虐－受虐的战斗关系中。然而，他能够在潜在治疗的诊断阶段评论说：“我的父亲永远都不会满意……即使我成为令他高兴的那种男孩，他仍然不会喜欢我。”事实上，在接下来的密集治疗过程中，Steven能够探索他自己在与父亲的困难关系中扮演的角色，也能够看到他父亲在这样的病理情况中所起到的作用。

We have explored one area of overlap between AAI research and the clinical process in London, at the Anna Freud Centre, stemming from our work on the dimensional concept of reflective functioning. Notably, ratings of this capacity in the AAIs from pregnant women we have studied in London (Steele et al. 1996) have revealed that reflective functioning is a more powerful predictor of infant-mother attachment security than any other single AAI rating scale (see Fonagy et al. 1995). The capacity to reflect on one’s own internal world and to appreciate the perspective of another individual is a crucial question in the mind of the clinician when they are assessing a patient for ‘treatability’. Often there are limited resources with which to offer psychotherapy services to those that seek it and could benefit from it. The question of how to assess whether an individual might make use of treatment is a critical one for the clinician, whether in public or private practice. A familiarity with the concept of reflective functioning might have a very important role to play in this challenging area of clinical practice. An example of an adolescent boy who sought help at the Anna Freud Centre exemplifies a situation in which a capacity to reflect upon his painful situation was predictive of a good therapeutic outcome. Steven, at age 16 years, suffered from intense bullying by his schoolmates. This included being locked in a locker at school for a full hour, and having a cigarette lighter held to his cheek. He was engaging in some self-harming behaviour and was involved in a sado-masochistic relationship with his father, with whom he battled on a daily basis. However, he was also able to comment at the diagnostic stage of potential treatment, ‘My father will never be satisfied...even if I was the type of boy my father thinks he’d be happy with, he still wouldn’t be happy with me.’ Indeed, over the course of intensive psychotherapy that followed, Steven was able to explore both his own role in the difficult relationship with his father but also to see his father’s contribution to the pathological situation.

文献中一些关于连续性，非连续性，基于自己及别人的反思能力重要性的结果令人兴奋，在对临床人群的研究中，某种程度上有点反直觉结果地出现。Marian Radke-Yarrow对主要照顾者患有精神疾病的家庭进行的研究工作，也与依恋关系中的连续性和非连续性相关。Radke-Yarrow这项具有开创性的工作，是具有前瞻性的纵向研究之一，他把重点放在精神病理从父母到孩子的发展传递，以及同化上(Radke-Yarrow 1998)。这项精心设计的研究，对比了患有抑郁症的母亲的孩子，患有燥郁症母亲的孩子，没有任何精神病理诊断母亲的孩子，在一个连续性的发展阶段来看他们的精神和心理状态。这项研究已经取得了许多有趣的发现。从依恋理论的观点看，那些被分类为安全依恋，但他们的母亲有精神病理症状的孩子，相比较于有精神病理症状母亲，但是不安全依恋的孩子，发展出更多的问题。这对预测性的依恋理论研究当然是一个反直觉式的结论。然而，如果我们多思考一下，对一个有精神症状的母亲发展安全依恋的孩子，这可能意味着什么，我们就不会感到如此惊讶了。如果安全感是与互动联系在一起的，其特征在于调协，并映射别人的心智，思想，感情和意图，对孩子而言，一个可以快速探查到的风险，就是与有精神障碍的父母“太过接近”了。如果父母的头脑有时是混乱的，或者一会儿反应一会儿不反应，那么安全依恋可能比弹性依恋具有更多风险。在这种情况中，被心理失常的父母照顾的孩子，如果可以从精神上甚至是身体上都远离他们自己，才有可能自由地去探索别的关系，从而获得更好的资源。

Some of the most provocative findings in the literature around continuities, discontinuities and the importance of being able to reflect, upon oneself and others, have arisen in studies of clinical populations where somewhat counter-intuitive results have emerged. The work of Marian Radke-Yarrow on families where the primary caregiver suffers from psychopathology is relevant to a discussion on continuities and discontinuities in attachment. Radke-Yarrow’s pioneering study is one of the only prospective longitudinal studies with a strong emphasis on the developmental processes and the transmission of psychopathology and adaptation from parent to child (Radke-Yarrow 1998). This carefully designed study compared children of mothers who were clinically depressed, those with bipolar illness and those without any psychiatric diagnosis at successive stages of development, in terms of their psychiatric and psychosocial development. This study has yielded many interesting findings. However, from an attachment point of view the discovery that the children who were classified as securely attached to their mothers with psychiatric symptoms more often developed later problems than did the children who were insecurely attached to symptomatic mothers. This of course is counter-intuitive to what attachment theory and research might have predicted. However, if we think for a moment what it might mean for a child to be securely attached to a mother with psychiatric illness this finding might not be so very surprising. If security is linked to interactions characterized by being in tune with, and reflecting on the mind, thoughts, feelings and intentions of the other, one can quickly detect the risks for the child of being ‘too close’ to the mentally disturbed parent. For if the mind of the parent is at times chaotic, or non-responsive alternating with islands of appropriateness, security may become more of a risk than a resilient factor. In this situation of being cared for by a disturbed parent, children who are able to distance themselves, both psychically and even physically, might be free to explore other relationships and thus be better off.

另一组研究也出现了乍一看似乎是反直觉的结果，是对收养严重残疾儿童的养父母的研究(Steele et al. 2000)。这些被特别从收养机构挑选出来的家庭，是成功收养的榜样，被这些家庭收养的孩子，无论从哪个方面来看都很好。我们给予AAI一组30对这样的父母，我们感兴趣的是，是否通过他们的依恋历史和他们曾经所做的，能预测出成功的结果。这项研究一个有趣的特点是，96%的样本报告说，当事人遭受的严峻逆境，都是丧失了重要的依附对象。这些家庭特别要寻找一个残疾孩子，如一对父母所说：我想要一个有孩子的生活。但令人惊讶的是，大多数的采访对象被评估分类为不安全－忽视型。首先，我们对这个结果感到困惑不解。然而，我们很快就开始明白，成年人可能使用了一个类似的策略，来思考和感受他们的孩子。正如他们用理想化的方式来评价他们自己的依恋历史，其中负面的或有害的方面被防御在意识之外，不再能回忆起来，当他们想到跟收养的残疾孩子的关系时，也成功地使用了相似的策略。这些父母都致力于给孩子照顾与养育，但却对感受和反思不是非常感兴趣。从孩子的角度看来，这也许也是他们所需要的，就是让家长把他们理想化，把每一个发展中的小变化看作巨大的进步。在某种程度上，似乎这些父母意识到他们自己的童年历史在亲密关系中没有得到足够的爱，所以他们也许是用一种矫枉过正的方式走进一个新的关系。

Another set of findings that at first glance seem counter-intuitive arises out of study of adoptive parents who chose to adopt children with severe disabilities (Steele et al. 2000). These families were especially selected by the adoption agency as examples of successful placements where the children were considered to be doing very well by all those concerned. We administered the AAI to a group of 30 of these parents, as we were interested in whether their attachment histories and what they made of them, might have predicted the successful outcomes. One of the interesting features of the study was that 96% of the sample reported having faced severe adversity in the form of having endured the loss of an important attachment figure. The families also reported to especially seeking out a child who was disabled because, as one parent put it, ‘I wanted to have a child for life.’ Surprisingly, the majority of the interviews were classified as insecure-dismissing. To begin with we were puzzled by this result. However, we soon began to understand that the adults were probably using a similar strategy in thinking and feeling about their children. Just as they evaluated their own attachment histories in an idealising way, where the negative or deleterious aspects were defensively kept out of consciousness by failing to recall them, they could successfully use a similar strategy when thinking about their relationship with their adopted disabled child. These were parents who were devoted to the care and nurturance of the children, but were not particularly interested in thinking about feelings or being reflective. From the children’s point of view it seemed this is perhaps just what they needed, that is, a parent who would idealise them and see every small increment of development as a huge step forward. At some level, it seems that these parents were aware that their own childhood histories were not optimal in providing a loving relationship, and so they could embark on a new relationship perhaps as a way of redressing the balance.

这些研究(Radke-Yarrow 1998; Steele et al. 2000)，突出了一些有趣的反直觉结果，警示我们开放地面对新证据非常重要，需要完善和扩展我们的思维，这是John Bowlby精神分析工作中一个核心和持久的特点。这是一种在方法论上比较可靠的途径，以描绘和理解发展研究与精神分析交汇之处的轨迹。

These studies (Radke-Yarrow 1998; Steele et al. 2000), which highlight some interesting counter-intuitive findings, alert one to the importance of being open to new evidence, and being prepared to refine and extend our thinking, a central and enduring characteristic of John Bowlby’s approach to psychoanalytic work. It was an approach devoted to charting and understanding developmental trajectories in methodologically robust ways at the crossroads of developmental research and psychoanalytic interests.

结论

Conclusion

Bowlby把他自己放到了这样一个治疗路径，50多年来，这条路径指导他致力于理解依恋关系，在大学里推动研究和临床工作。依恋理论－和它的精神分析内核－已经发展为一个领先的理论。但这是为什么呢？我想这里有两个主要的原因：首先，由于可获得的，创造性的，使用友好的，科学合理的方法不断增加，依恋关系的生物、社会和心理基础，以及它们的破坏和重建，被广泛地研究。其次，这些理论和研究，实际上都明显地，直接地，针对了我们所面临的一些最突出的社会议题。这些紧迫的社会议题包括各种急迫的内容：我们如何才能最好地理解，衡量，并最终提高亲子关系的质量？我们如何提高儿童保育的质量和有效性？我们如何在收养和寄养领域促进“正确”的选择？

Bowlby set himself upon a therapeutic path which led him, over some 50 years, to direct his efforts at understanding attachment relationships and facilitating research and clinical work universally. Attachment theory—with its psychoanalytic core—has established itself as a leading theory. But why? I think there are two main reasons. Firstly, the biological, social and psychological foundation of attachment relationships, and the violation as well as restoration of them, has been extensively studied by an increasing available, creative, user-friendly and scientifically sound set of methods. Secondly, the theory and research do actually speak, plainly and directly, to some of the most salient social issues facing us. These pressing social issues include a variety of urgent questions, including the following. How can we best understand, measure, and ultimately improve the quality of parent-child relationships? How can we deliver successful and cost-effective parent-infant and child psychotherapy? How can we improve the quality and availability of childcare? How can we facilitate the making of ‘right’ choices in the fields of adoption and foster care?

我想John Bowlby一定会很开心地惊讶于，他半个世纪前的理论著作已经引发了依恋运动。他的“安全基地” (Bowlby 1988)理论，具有高度的阅读价值，事实上是基于他在1970年代晚期1980年代早期发表的一场演讲，他惊愕于临床医生如此长时间地忽视他的工作。“我觉得有点意外，依恋理论是由临床医生建立，诊断和治疗情绪障碍的病人和家庭，而现在却主要用于推动发展心理学的研究。” (Bowlby 1988:xii)。这段话很耐人寻味，其中一点是Bowlby把自己定义为临床医生，而不仅仅是个研究者。他常常在治疗工作中定期休假，谈论自己对依恋理论的兴趣。他还提醒，我们应多考虑家庭，而不仅是“情绪障碍病人”，他可以被认为是第一批家庭治疗师之一(see Bowlby, 1947)。现在应用的一项Bowlby的开创性贡献，是他在1951年提出的对情绪的重新回应，这经常包含在他后来的著作中：如果一个社会重视他的孩子们，那必须珍视他们的父母。

I think John Bowlby would be pleasantly surprised to learn of the way in which his theoretical writings from some half-century ago have given rise to the attachment industry. In fact in his highly readable A Secure Base (Bowlby 1988), based on lectures he delivered in the late 1970s and early 1980s, he showed his consternation with the way that clinicians so long ignored his work. ‘I find it somewhat unexpected that whereas attachment theory was formulated by a clinician for use in the diagnosis and treatment of emotionally disturbed patients and families, its usage has been mainly to promote research in Developmental Psychology’ (Bowlby 1988:xii). This quote is of interest for several reasons. One is that Bowlby defined himself as a clinician, not just a researcher. He often commented on his interest in attachment theory to rest firmly on therapeutic work. He also mentions not just ‘disturbed patients’ but also points us to think of families and can be credited with being one of the first family therapists (see Bowlby, 1947). The current applications of his seminal contribution re-echo a sentiment Bowlby expressed in 1951, and frequently included in his later writings: ‘if a society values its children, it must cherish their parents’.