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The paper traces the relationship between attachment processes and the development of the capacity to envision mental states in self and others. We suggest that the ability to mentalize, to represent behavior in terms of mental states, or to have "a theory of mind" is a key determinant of self-organization which is acquired in the context of the child's early social relationships. Evidence for an association between the quality of attachment relationship and reflective function in the parent and the child is reviewed and interpreted in the context of current models of theory of mind development. A model of the development of self-organization is proposed which has at its core the caregiver's ability to communicate understanding of the child's intentional stance. The implications of the model for pathological self-development are explored, with specific reference to the consequences of maltreatment.
Development and Psychopathology, 9 (1997), 679–700
Copyright 1997 Cambridge University Press
Printed in the United States of America
Attachment and reflective function:
Their role in self-organization
Sub-Department of Clinical Health Psychology, University College London
The paper traces the relationship between attachment processes and the development of the capacity to envision
mental states in self and others. We suggest that the ability to mentalize, to represent behavior in terms of mental
states, or to have “a theory of mind” is a key determinant of self-organization which is acquired in the context of
the child’s early social relationships. Evidence for an association between the quality of attachment relationship and
reflective function in the parent and the child is reviewed and interpreted in the context of current models of theory
of mind development. A model of the development of self-organization is proposed which has at its core the
caregiver’s ability to communicate understanding of the child’s intentional stance. The implications of the model for
pathological 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 of
freedom or initiative, and generates the expe-rently experiencing a considerable revival of
interest from social scientists and develop- riences leading to the distinctness of oneself
as a person. Modern developmental psychol-mentalists (e.g., Bracken, 1996; Cicchetti &
Beeghly, 1990; Cicchetti & Toth, 1994). Psy- ogy has brought us closer to a full understand-
ing of the mental processes which combine tochological interest in the self is usually traced
to 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 Function
the active agent responsible for construct-
ing the self-concept of Me. To paraphrase in Developmentalists over the past 10 years have
drawn attention to the remarkable capacity ofthe terms of current cognitive neuroscience,
the Me is the mental representation, while the young children to interpret their own and
other people’s behavior in terms of mentalI embodies the mental processes or functions
which underpin representations of the self states. Reflective function is the develop-
mental acquisition that permits the child to re-(Mandler, 1985). The I organizes and inter-
prets experience, ensures the experience of spond not only to other people’s behavior, but
to his
conception of their beliefs, feelings,
hopes, pretense, plans, and so on. Reflective
We gratefully acknowledge the support of the Gatsby
function or mentalization enables children to
Foundation and the Ludowyk Trust. We would also like
“read” people’s minds (e.g., Baron–Cohen,
to acknowledge the long-term collaboration with Miriam
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 to
Gyorgy 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: Peter
Fonagy, Sub-Department of Clinical Health Psychology, 1. For economy of expression only, we will generally use
“he” to refer to a child and “she” to refer to a parentUniversity College London, Gower Street, London
WC1E 6BT, UK; E-mail: or other caregiver.
P. Fonagy and M. Target680
ingful and predictable. As children learn to has great generalizability and explanatory
value. Recent philosophers of mind (Hopkins,understand people’s behavior, they can flexi-
bly activate, from multiple sets of self–other 1992; Wollheim, 1995) have extended Den-
nett’s approach to unconscious processes.representations organized on the basis of prior
experience, the one(s) best suited to respond They illustrated that one of Freud’s most sub-
stantive contributions was to extend folk psy-adaptively to particular interpersonal transac-
tions. chology to unconscious mental states, a the-
ory of unconscious mind, thus making thoseThe interdependence of reflective function
as it applies to others and to the self was high- aspects of behavior meaningful which—using
the ordinary constructs of intentionality—lighted by the second pioneer of psychologi-
cal self theory, Cooley (1902/1964): “The make little sense (e.g., dreams, neurotic symp-
toms, humor). These behaviors may be under-thing that moves us to pride and shame is not
the mechanical reflection of ourselves, but an stood if we add unconscious beliefs, thoughts,
and feelings to our everyday model of theimputed sentiment, the imagined effect of this
reflection upon another’s mind” (p. 153). De- mind.
Extending these ideas, we consider reflec-velopmentally, this may be thought to imply
that a mental operation is required in early tive function to be the mental function which
organizes the experience of one’s own andchildhood, to derive the self-state from the ap-
perception of the mental state of the other. others’ behavior in terms of mental state con-
structs. Reflective function concerns knowl-Exploring the meaning of others’ actions is
then a precursor of children’s ability to label edge of the nature of experiences which give
rise to certain beliefs and emotions, of likelyand find meaningful their own psychological
experiences. This ability arguably underlies behaviors given knowledge of beliefs and de-
sires, of the expectable transactional relation-the capacities for affect regulation, impulse
control, self monitoring, and the experience of ships between beliefs and emotions, and of
feelings and beliefs characteristic of particularself-agency, the building blocks of the organi-
zation of the self. In previous papers (e.g., Fo- developmental phases or relationships. Its es-
sence is not that the individual should be ablenagy, Steele, Moran, Steele, & Higgitt, 1991a)
we have labeled the predisposition to under- to articulate this theoretically, and this is clear
in our operationalization (Fonagy, Steele,stand behavior in mental state terms reflective
self-function, or more simply reflective func- Steele, & Target, 1997). Individuals differ in
the extent to which they go beyond observ-tion.
The notion of reflective function is rooted able phenomena to explain their own or oth-
ers’ actions in terms of beliefs, desires, plans,in Dennett’s (1978, 1987) proposal that three
stances are available in the prediction of be- and so on. This undoubtedly high level cogni-
tive capacity is, we believe, an important de-havior: the physical stance, the design stance,
and the intentional stance. Dennett’s thesis is terminant of individual differences in self-or-
ganization, intimately involved with manythat explanation in terms of beliefs and de-
sires, so-called intentional states, provides defining features of selfhood such as self-con-
sciousness, autonomy, freedom, and responsi-good grounds for predicting human behav-
ior—the only grounds accessible to all of us; bility (Bolton & Hill, 1996; Cassam, 1994).
Intentional stance, in the broad sense consid-this knowledge is embodied in the theory of
mind of folk psychology (see Churchland, ered here (i.e., including apparently irrational
unconscious motives), explains one’s own be-1986; Mele, 1992).
Theory of mind is an interconnected set of havior and therefore creates the continuity of
self-experience which is the underpinning ofbeliefs and desires, attributed to explain a per-
son’s behavior. The theory of mind concept a coherent self-structure.
It is important that reflective function is
not conflated with introspection. Bolton and
2. Dennett’s formulation is unnecessarily restrictive (Bol-
Hill (1996) note that the weakness of intro-
ton & Hill, 1996). It does not address predicting the
behavior of systems which do not function rationally.
spection is to define mental states in terms of
Attachment and reflective function 681
conscious motivation rather than, as here, in do not ask what the child feels about the men-
tal states he encounters in others. Yet, in thisterms of their capacity to regulate behavior.
Introspection or self-reflection is quite differ- context at least, the question of knowledge
and that of emotional investment are evi-ent from reflective function as the latter is an
automatic procedure, unconsciously invoked dently closely related. The child may know
what the other feels but care little or not at allin interpreting human action. We see it as an
overlearned skill, which may be systemati- about this; alternatively this information, for
some youngsters, may be an issue of survival.cally misleading in ways much more difficult
to detect and correct than mistakes in con- The emotional significance of mental states
determines the evolution of the capacity orscious attributions would be. Reflective func-
tion similarly lends a shape and coherence to structure available for processing, but this is
not usually addressed. In current models ofself-organization which is outside awareness,
in contrast to introspection, which has a clear theory of mind development the child tends to
be seen as an isolated processor of informa-impact on experience of oneself.
Our central concern here is the acquisition tion, engaged in the construction of a theory
of mind using biological mechanisms whichof reflective function and the light this might
cast on the development of self-organization. may fail if the child’s endowment is poor.
This, from the viewpoint of developmentalBaron–Cohen and Swettenham (1996) appro-
priately ask “ . . . how on earth can young psychopathology and its psychosocial treat-
ment, is a barren picture which ignores thechildren master such abstract concepts as be-
lief (and false belief) with such ease, and central role of the child’s emotional relation-
ship with the parents or other caregivers inroughly at the same time the world over?” (p.
158). Their answer is that of modularity theo- fostering the capacity to understand interac-
tions in terms of mental states. The develop-rists, along the lines of Chomsky’s solution to
the problem of the acquisition of a knowledge ment of children’s understanding of mental
states is embedded within the social world ofof syntax. They postulate an innate (learning)
mechanism with a specific location in the the family, with its interactive network of
complex and at times intensely emotionallybrain (see also Leslie, 1994; Segal, 1996).
Other current psychological theories stress the charged relationships, which, after all, consti-
tute the primary content of early reflection.cognitive precursors of theory of mind. Some
favor the folk psychology, theory–theory, ap- Therefore it should not surprise us that the na-
ture of family interactions, the quality of pa-proach assuming that the child evolves a sci-
entific theory-like network of interdependent rental control (Dunn, Brown, Somkowski,
Telsa, & Youngblade, 1991b), parental talkpropositions about the mind on the basis of
experience (e.g., Botterill, 1996; Gopnik, about emotions (Denham, Zoller, & Cou-
choud, 1994), and the depth of parental dis-1996). Others assume that theory of mind is
acquired via simulation of the mental state of cussion involving affect (Dunn, Brown, &
Beardsall, 1991a) are all strongly associatedthe other, either through making inferences
from what we ourselves would do in the with the acquisition of the intentional stance
in observational studies. The involvement ofimagined circumstances (e.g., Goldman, 1993;
Harris, 1992) or an even more radical assump- the family in the child’s acquisition of a the-
ory of mind is further highlighted by the ro-tion of imagined transformation into the other
which does not involve introspection or infer- bust finding that the presence of siblings in
the family appears to improve the child’s per-ence (Gordon, 1995).
Both simulation and theory–theory models formance on a range of false-belief tasks (Jen-
kins & Astington, 1996; Perner, Ruffman, &may appear to emphasize social learning as-
pects of the development of mentalization but, Leekman, 1994; Ruffman, Perner, Naito, Par-
kin, & Clements, in press).upon closer scrutiny, their focus is at the level
of mechanism rather than content. They ques- Modular accounts of theory of mind devel-
opment have some difficulty with such data.tion how and when the child acquires knowl-
edge of other minds in an abstract sense and Both the theory–theory and the simulation ac-
P. Fonagy and M. Target682
counts also fall short of adequately addressing Jaffe (1997) have shown that interaction be-
tween baby and mother shows both self-regu-the social origins of this critical aspect of self-
organization. In the theory–theory account lation and sensitivity to the state of the other.
Their facial expressions showed rapid fluctua-mental concepts are thought to develop within
a network of interdependent concepts on the tions: affect, space, and degree of contact in
s time period responded to the ex-basis of data from the social world, but the
social world does not generally “give” con- pression of the other in the previous period,
presumably on the basis of schemata of antici-cepts to the child—it provides him with data
for concept building. In the simulation model pated reactions. High coordination predicted
later good cognitive performance, whereasmental state concepts are thought to arise
from introspection, but this begs the question lower levels of coordination were optimal for
secure attachment and easy temperament. In-of how children come to think of their own
mental states in terms of feelings, beliefs, terestingly, security with the mother in the
Strange Situation at 1 year was better pre-wishes, and so on. This paper attempts to ex-
plore the role of parent–child relationships in dicted by coordination with a stranger than
with the mother at 4 months.the transformation of prereflective experience
of mental states into reflective understanding Interactions at this stage may be argued to
be presymbolic, in the sense that they are non-of them. Within this social context both social
models of mentalization may have their place; mentalistic; the infant is not required to repre-
sent the thoughts or feelings of the caregiver.the predominance of one or other route to un-
derstanding the mind may be a function of in- However, they involve reference to future
states such as goals as explanatory constructsdividual differences between children and be-
tween environments, but, in our view, a in the interpretation of the behavior of the
other. Thus they can be used to predict behav-satisfactory model must have the child’s rela-
tionships with attachment figures as its start- ior although these structures would be limited
in their capacity to modify behavior. Recenting point.
experimental work by Gergely and Csibra
(e.g., Gergely, Nadasdy, Csibra, & Biro, 1995)
Developmental Roots of Reflective
suggests that the infant’s perception of social
Function in Infancy
contingencies by the second half of the 1st
year is teleological in that they make refer-
“Teleological” stance
ence to future states (goals) as explanatory
entities in the interpretation of behavior basedThere is general agreement that self-organiza-
tion initially entails the integration of body- on the principle of “rational action.” The tele-
ological stance is applied by infants to humanrelated experiences, defining the physical
boundaries of self and world (e.g., Brown- and nonhuman objects alike. Studies by Ger-
gely and Csibra (1997) demonstrated that in-ell & Kopp, 1991). Once the physical self is
established, social exchanges, the identifica- fants express surprise when nonhuman but
moving objects (such as various sized discs intions of social boundaries and, somewhat
later, the identification of social causality be- a computer-generated animated display) ap-
pear to act “irrationally”—not choosing thecome central self-functions. The caregiver’s
recognition of the child’s intentional stance, optimal action given specific goals and reality
constraints. The infant is assumed to extendhowever, is communicated nonverbally, be-
ginning at birth. Between birth and 5 months, teleological models beyond the prediction of
human behavior. Teleological models, how-face-to-face exchanges of affective signals be-
tween infant and caregiver (Beebe, Lach- ever, evolve into mentalizing ones in the re-
stricted domain of human action. They be-mann, & Jaffe, 1997; Tronick, 1989) play a
key role in the development of the child’s rep- come fully mentalizing once representations
of goal states come to be thought of as desires,resentation of affect.
For example, using a microanalytic obser- and constraints come to be thought of in terms
of the agent’s beliefs about physical reality.vational paradigm, Beebe, Lachmann and
Attachment and reflective function 683
The infant’s behaviors in dyadic interac- contingent actions of others. Taking Stern’s
(1985) and Neisser’s formulation of the inter-tions are underpinned by an evolving model
of rational action by the caregiver. We would personal self together, we can identify three
aspects of the intersubjective development ofargue that the development from teleological
to mentalizing models will depend upon the the self, which Mundy and Hogan (1994) term
instrumental action states, sensory or percep-quality of interpersonal interactions between
the infant and the caregiving adult. It should tual action states, and affective action states.
Rogers and Pennington (1991) offered abe noted that although such models may
merely represent rational action, it is the per- model of the cognitive underpinnings for such
an intersubjective process in their concept ofceived rather than actual rationality of an act
which defines the teleological model. Thus representational mapping (the process of co-
ordinating representations of self and other)misapprehension of reality constraints (e.g.,
assumed dangerousness) will provide and cre- which is thought to underlie the sharing of af-
fect, attention, and higher order aspects ofate a model where action which is clearly irra-
tional from an external standpoint is neverthe- cognition such as beliefs. The existence of im-
itation skills from the neonatal stage repre-less seen as based on the principle of rational
action. The predictive significance of the in- sents strong evidence for the model (Meltzoff,
1993). The acquisition of an appreciation offant’s response to a stranger in the Beebe
study suggests that representations (working mental states, however, goes beyond mir-
roring.models) of self–other relations even when not
yet mentalized begin to vary in quality in the The development of an understanding of
affect in self and other may be a good illustra-1st year, and this quality is related to infant–
caregiver interactions, as observed in the lab tion of the role of representational mapping in
the development of reflective abilities (Ger-situation. If sufficiently coherent to be gener-
alized to other relationships in characteristic gely & Watson, 1996; Target & Fonagy,
1996). Anxiety, for example, is for the infantways, they may index processes crucial to the
creation 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, and
he now “knows” what he is feeling. TheRepresentational mapping is likely to under-
pin the gradual move in infancy from teleo- mother’s representation of the infant’s affect
is represented by the child and is mapped onlogical to mentalizing models of mind. Be-
tween 6 and 18 months the child becomes to the representation of his self-state. The dis-
crepancy between these is helpful insofar as itincreasingly able to match his mental state
with that of the caregiver vis-a
-vis a third ob- provides organization for the self-state and
thus the caregiver’s mirroring can become theject or person, as, for example, in requesting
or joint attention (Bretherton, 1991). The higher order representation of the child’s ex-
perience. Within this model mirroring wouldcommunication is evidently deliberate, since
children at this phase try to repair failed com- be expected to fail if it is either too close to
the infant’s experience or too remote from it.municative bids and thus show some recogni-
tion of awareness and agency in self and other If the mirroring is too accurate, the perception
itself can become a source of fear, and it losesincluding affective states, perceptions, and in-
tentions (Stern, 1985; Wellman, 1993). Neis- its symbolic potential. If it is unavailable, or
is contaminated with the mother’s own preoc-ser (1991) suggested that based on perceptual
processes, two preconceptual aspects of the cupation, the process of self-development is
profoundly compromised. We may presumeself emerge: the ecological and the interper-
sonal. While the former involves self-aware- that individuals for whom the symptoms of
anxiety signify catastrophes (e.g., heart attack,ness in reference to perception of nonsocial
surroundings, the latter is generated via the imminent death, etc.) have metarepresenta-
tions of their emotional responses which can-coperception of actions of the self and related
P. Fonagy and M. Target684
not be limited in intensity through symboliza- plays in others as well as arriving at the regu-
lation and control of his own emotions. Thetion, perhaps because the original mirroring
by the primary caregiver exaggerated the in- representational mapping of emotion displays
and self-experience is seen here as a prototyp-fant’s emotions.
Admittedly this is a speculative model, but ical instance of caregiver sensitivity, which,
as we shall attempt to demonstrate, is likelyit is empirically testable. It might help answer
the thorny question of why individuals with to be an important component of the develop-
ment of mentalizing. The sensitivity of thepanic disorders attribute immense significance
to physiologically relatively mild levels of caregiver prompts the child to begin organiz-
ing self-experience according to clusters of re-disequilibrium. The suggestion here is that the
metarepresentation, or symbolic representa- sponses which will eventually come to be ver-
bally labeled as specific emotions (or desires).tion, of affect in these cases contains too
much of the primary experience; hence, in- The high contingent response is the means by
which this mapping can take place. Thestead of labeling the experience having the
potential to attenuate it, it tends to stimulate child’s affective experiences are given further
meaning by becoming associated with clustersand exacerbate symptoms of the affect state,
which in turn accentuates the secondary ex- of reality constraints within the parent–infant
interaction (leading to rudimentary beliefspression, in a cycle of escalating panic.
collaboration with George Gergely, we are about the causes and consequences of his
emotional state).designing a series of studies of the infant’s
emotional understanding which will more di-
rectly test these ideas. In a recent study (Fo-
Transmission of attachment security
nagy et al., 1995), we have confirmed that
mothers who soothe their distressed 8-month- The attachment system (Bowlby, 1969, 1973,
1980) is intimately connected with the pro-olds most effectively following an injection
rapidly reflect the child’s emotion, but this cess of representational mapping and the de-
velopment of the reflective function of the self.mirroring is mixed with other affects (smiling,
questioning, mocking display, and the like). There is general agreement that, as the self
exists only in the context of the other, the de-In displaying such “complex affect” (Fo
nagy & Fo
nagy, 1987) they ensure that the velopment of the self is tantamount to the ag-
gregation of experiences of self in relation-infant recognizes their emotion as analogous
to, but not isomorphic with, their experience ships (e.g., Crittenden, 1994; Sroufe, 1990).
Psychoanalytic object relations (Kernberg,and thus the process of symbol formation may
begin. In this way, the representational map- 1982; Winnicott, 1965) and attachment theo-
rists (Bowlby, 1980) are in agreement thatping between affect of self and emotions of
others, the exchange of affect between young repeated, invariant aspects of self–other rela-
tions are abstracted into internal representa-child and caregiver, provides a unique source
of information to the child about his own in- tional mental models and structured, to use
Kernberg’s term, into self–other–affect triads,ternal states.
We suggest that the meaning or sense of or internal working models, according to
Bowlby. Although in its original formulationaffect develops out of the integrated represen-
tation of the affect in self and other. The com- the concept of internal working model lacked
specificity (Dunn, 1996), more recent empiri-bination of the representation of self-experi-
ence and the representation of the reaction of cal work by psychoanalysts has greatly im-
proved this (Horowitz, 1995; Luborsky & Lu-the caregiver elaborates the child’s teleologi-
cal model of the mind, and ultimately enables borsky, 1995).
At the same time, cognitive scientists havehim to interpret and understand affective dis-
elaborated the notion of procedural memories
based on the nonconscious implicit use of past
3. In terms of linguistic theory, one may say that the sig-
experience (e.g., Johnson & Multhaup, 1992;
nifier is not sufficiently “demotivated”; in other words
it resembles the signified too closely.
Schacter, 1992). There is general agreement
Attachment and reflective function 685
that the memory system is at least of a dual Steele, & Fonagy, 1996). The small overlap
between the two sets of classifications couldnature with two relatively independent, neuro-
logically and psychologically homogeneous, be equally well accounted for by assuming a
temperament factor or by the generalizationsystems underpinning it. In addition to the au-
tobiographical memory, which is at least in of the child’s behavior with the mother (re-
flecting her attachment classification) to hispart accessible to awareness, an important
component to memory is a nonvoluntary sys- behavior with the father. The results suggest
that the infant develops independent modelstem which is implicit, principally perceptual,
nondeclarative, and nonreflective. It is possi- (self–other schemata) for his major attach-
ment relations based on his past history of in-ble that it is, at least in certain respects, more
dominated by emotional and impressionistic teractions with each of those individuals. In
turn, these interaction experiences are indexedinformation than its autobiographical counter-
part (e.g., van der Kolk, 1994). It stores the by the caregiver’s representation of her or his
attachment history.“how” of executing sequences of actions, mo-
tor skills being prototypical instances. The There has been considerable research on
the manner in which representations of attach-procedural knowledge that it contains is ac-
cessible only through performance. It mani- ment might influence the caregiver’s behavior
with the child. Van IJzendoorn’s (1995) com-fests itself only when the individual engages
in the skills and operations into which knowl- prehensive meta-analysis identifies a “trans-
mission gap,” to the extent that the variabilityedge is embedded. Given these features, it
seems likely that the schematic representa- which AAI narratives and SSn classifications
share is not accounted for by observationaltions postulated by attachment and object re-
lations theorists are most usefully construed data concerning the sensitivity of caregiver
behavior. Indeed, studies of the AAI-SSn as-as procedural memories, the function of
which is to adapt social behavior to specific sociation, which concurrently measured the
sensitivity of caregiver–infant interaction, haveinterpersonal contexts.
The classification of patterns of attachment yielded negative (Ward & Carlson, 1995) or
inconclusive results (van IJzendoorn, Kranen-in infancy (Ainsworth, Blehar, Waters, &
Wall, 1978) taps into procedural memory burg, Zwart–Woudstra, Van Busschbach, &
Lambermon, 1991). Previously, we have sug-(Crittenden, 1990; Fonagy, 1995). The strength
of the Strange Situation (SSn) as a method gested that the transmission gap may be a
consequence of the limitations of measures ofof psychological assessment is to provide a
powerful analogue of past situational contexts sensitivity (Fonagy et al., 1995). Sensitivity is
a generic construct covering a wide range ofwithin which knowledge concerning the
“how” of behavior with a specific caregiver is parental behaviors (Belsky, Rosenberger, &
Crnic, 1995). Not all of these may be equallyaccrued. In this sense attachment is a skill,
one which is acquired in relation to a specific powerful in engendering secure attachment. If
secure attachment is conceived of as the ac-caregiver encoded into a teleological model of
behavior. In the London Parent–Child Study, quisition of procedures of goal oriented ra-
tional action for the regulation of aversivethe Adult Attachment Interview (AAI), ad-
ministered before the birth of the first child to states of arousal within relationships (Cas-
sidy, 1994; Sroufe, 1996), it is argued that100 predominantly middle class primiparous
parents, was tested as a predictor of attach- these would be most consistently acquired
and coherently represented when the child’sment classification at 1 year to mother and at
18 months to father (Fonagy, Steele, & Steele, acute affective state is accurately, but not
overwhelmingly, reflected back to the child.1991b). There was only a marginally signifi-
cant association between the attachment clas- The child who looks for a way of manag-
ing his distress identifies in the response ofsification with mother and that with father.
However, both SSn results were powerfully the caregiver a representation of his mental
state which he may internalize and use as partpredicted by the attachment classification of
the respective parent on the AAI (Steele, of a higher order strategy of affect regulation.
P. Fonagy and M. Target686
The secure caregiver soothes by combining a tenden (1988; Crittenden & DiLalla, 1988) re-
ports that maltreated toddlers display falsely“mirror” with a display incompatible with the
child’s affect (thus perhaps implying coping). positive affect which does not match their true
feelings. At an extreme, the internalization ofThis formulation of sensitivity has much in
common with the British psychoanalyst, Wil- the caregiver’s defenses can not only lead to
a failure to adequately represent and displayfred Bion’s (1962) notion of the role of the
mother’s capacity to mentally “contain” the actual emotional experience, but also to the
construction of an experience of self aroundaffect state intolerable for the baby, and re-
spond in terms of physical care in a manner this false internalization (Winnicott, 1960).
While the experience of “putting on anthat acknowledges the child’s mental state yet
serves to modulate unmanageable feelings. act” may be common, particularly in adoles-
cence (Harter, Marold, Whitesell, & Cobbs,The finding that the clarity and coherence of
the mother’s representation of the child medi- 1996), here we are referring to the highly dis-
tressing experience of personality disorderedates between her attachment status and her be-
havior is certainly consistent with this model children who feel a sense of alienation from
their core self (Bleiberg, 1994). A strategy(Slade, Belsky, Aber, & Phelps, in press).
Ratings of the quality of the reflective func- many such children adopt later in develop-
ment is to attempt to externalize this false parttion of each caregiver were found indepen-
dently to predict the child’s security of attach- of their self-representation, and manipulate
the behaviors of others around them so thesement in the London Parent–Child Project
(Fonagy et al., 1991a). match the incongruent self-representation. We
would argue that this explains the strangelyIf secure attachment is the outcome of suc-
cessful containment, insecure attachment may coercive behavior with the caregiver of pre-
school children whose attachment in infancybe seen as the infant’s identification with the
caregiver’s defensive behavior. Proximity to was classified as disorganized (Crittenden,
1992; Main & Cassidy, 1988). In a desperatethe caregiver is maintained at the cost of a
compromise to reflective function. A dismiss- way they try, we suggest, to provoke behavior
in another person which expresses part ofing (Ds) caregiver may altogether fail to mir-
ror the child’s distress because of the painful their self-representation experienced as
“alien,” they can then experience a more co-experiences this evokes for her or because she
lacks the capacity to create a coherent image herent residual self (Fonagy & Target, 1995).
of the child’s mental state. By contrast, the
preoccupied (E) caregiver may represent the
Secure infant becomes mentalizing child
infant’s state with amplification and insuffi-
cient marking, or complicated by responses to There is general agreement that the “harmoni-
ousness of the mother–child relationship con-the parent’s ambivalent preoccupation with
her own experience, so much so that the sym- tributes to the emergence of symbolic
thought” (Bretherton, Bates, Benigni, Camai-bolic potential of the exchange is lost. In both
cases the infant internalizes the caregiver’s at- oni, & Volterra, 1979, p. 224). Bowlby recog-
nized the significance of the emergence oftitude and “this dysynchrony becomes the
content of the experience of the self” (Critten- “the child’s capacity both to conceive of his
mother as having her own goals and interestsden, 1994, p. 89).
separate from his own and to take them into
account” (1969, p. 368). Moss, Parent, and
Infant attachment and developing self
Gosselin (1995) reported that attachment se-
curity with mother was a good concurrent pre-We may speculate about the impact of this on
the development of the child’s sense of self. dictor of metacognitive capacity in the child
in the domains of memory, comprehensionWe know that avoidant infants respond to
separation with minimal displays of distress and communication. The Separation Anxiety
Test, a projective test of attachment security,while experiencing considerable physiological
arousal (Spangler & Grossman, 1993). Crit- has been shown to be a good predictor of be-
Attachment and reflective function 687
lief–desire reasoning capacity in 3- to 6-year- of secure attachment and false belief under-
standing was due to an as yet unknown andold children when age, verbal mental age, and
social maturity were all controlled for (Fo- unmeasured third factor, such as tempera-
ment. More plausibly, it could be argued thatnagy, Redfern, & Charman, 1997).
We have recently completed a prospective the facilitative effect of secure attachment is
due to a more relaxed, task-oriented attitude,study of the relationship of attachment secu-
rity to mother (1 year) and father (18 months) a general facility to engage in a cognitively
demanding task, to relate to an adult experi-and children’s performance on three tests of
theory of mind at 5 years (Fonagy, Steele, menter in a playful, exploratory way, and so
on: that it reflects performance, rather thanSteele, & Holder, submitted). Ninety-two of
96 children tested in the SSn at 12 and 18 competence. This suggestion could be tested
using a false-belief task where implicit andmonths were seen. Eighty-two percent of
those classified as secure at 12 months with explicit knowledge of false belief is sepa-
rately assessed. If attachment security relatesmother passed the belief–desire reasoning
task, whereas 46% of those who had been to performance, then securely attached chil-
dren would be expected to do better only onclassified as insecure failed. Infant–father at-
tachment (at 18 months) also predicted the the explicit (verbal/pointing) task. Implicit,
procedural false belief reasoning would be ex-child’s performance, with 77% of infants clas-
sified as secure passing the test compared to pected to be facilitated by secure attachment
only if this was associated with superior re-55% of children classified as insecure. There
was some indication of an additive relation- flective capacity. This study remains to be
performed, and is planned in our laboratory.ship, in that 87% of children with two secure
relationships passed the belief–desire task, In what follows we shall, however hazard-
ously, assume that the relationship between63% of those with only one secure relation-
ship and only 50% of those insecure with both false belief reasoning and security of attach-
ment is nontrivial.did so. A similar but somewhat weaker pat-
tern could be observed with the second-order We then envisage two alternative sets of
models to explain this relationship: (a) Secu-false-belief task. Thirty-six percent of those
secure with both parents passed compared rity of attachment in infancy predisposes chil-
dren to benefit from social processes directlywith 23% who were secure with one and 9%
who were insecure with both. facilitating reflective abilities and social un-
derstanding (mediational models), and (b) se-In a somewhat smaller but careful longitu-
dinal study of mother–infant dyads, Meins curity of attachment is an indicator of that
quality of infant–caregiver relationship whichand colleagues (Meins, Fernyhough, Russel, &
Clark–Carter, in press) reported that 83% of generates psychological understanding. In this
second model, the social processes which ac-children who were securely attached in infancy
passed a false-belief task at age 4, in compari- celerate the mentalizing quality of self-organi-
zation are the very same as those which en-son with 33% of insecurely attached peers. At
age 5, 85% of securely attached children and sure security of attachment.
Mediational models would require that50% of insecurely attached ones passed a task
requiring an understanding of information ac- specific social processes are shown to be in-
volved in this aspect of the development ofcess. Although, probably because of its small
sample, the study was not able to replicate our self-organization, and such social processes
are enhanced in securely attached individuals.results on the false belief and emotion task,
the general trend of the findings confirms that There are at least three candidates which meet
these of attachment is significantly linked
to symbolic abilities in general and precocious The first is pretense. There is evidence that
children in their 3rd year who engage morementalizing in particular.
There are both trivial and substantive ex- readily in cooperative interaction (Dunn et al.,
1991b), and specifically in joint pretend playplanations which could account for these find-
ings. They would be trivial if the association (Astington & Jenkins, 1995; Youngblade &
P. Fonagy and M. Target688
Dunn, 1995), show superior mentalization and presumes a degree of trust, in so far as the
child relies on the other’s version or percep-emotion understanding performance. There is
a separate body of observations from longitu- tion of reality.
The second is talking. There is evidencedinal studies of attachment that preschool
children securely attached to their mother in that conversations about feelings and about
the reasons behind people’s actions are linkedinfancy engage more strongly in fantasy play
than avoidant children, whose engagement is to the relatively early achievement of reflec-
tive function (Dunn & Brown, 1993). Three-low and whose pretend play is impoverished
(e.g., Belsky, Garduque, & Hrncir, 1984; year-olds whose mothers spontaneously ex-
plained their emotions in a lab task showedBretherton et al., 1979; Main, Kaplan, & Cas-
sidy, 1985). There is also evidence that se- enhanced emotion understanding over the
subsequent 15 months (Denham et al., 1994).curely attached young children can more eas-
ily use help from adults to elaborate their play Patterns of mother–child interaction char-
acteristic of secure dyads—shared play, com-(Meins et al., in press; Slade, 1987).
It is highly plausible that joint pretend play forting, or joking—are also contexts within
which mothers’ explanations of mental statesor playfulness fosters the understanding of
mental states. Deliberate role-taking is seen as are particularly found to facilitate reflective
function (Dunn, 1996). Secure attachment mayintegral to the off-line simulation model of the
performance of mentalization tasks (Gold- then engender patterns of verbal interaction be-
tweenchildandcaregiverwhichinturnsup-man, 1989). Within other models pretend play
is an early manifestation of the theory of mind port thinking about feelings and intentions.
The central role of language in the acquisi-mechanisms (Leslie, 1987). It is an important
puzzle why 3-year-olds can understand that tion of mentalizing capacity was forcefully
advanced by Smith (1996), using primate evi-someone is entertaining a pretend representa-
tion but not a false belief (Harris, Kava- dence. Even more pertinent is Harris’s (1996)
proposal that the experience of engaging innaugh, & Meredith, 1994), a pretend/real dis-
tinction but not an appearance/reality one conversations per se shows children that peo-
ple are receivers and providers of information,(Flavell, Flavell, & Green, 1987). In the case
of pretend, the representations, while they are whether or not the conversation refers to men-
tal states. The structure of informative conver-different from reality, are shared by those en-
gaged in the pretend game. As Astington sations (e.g., being told about an event one
has not witnessed, dissent and denial, filling(1996) put it, “they are intermental, not intra-
mental” (p. 193). The sharing of representa- in information gaps) implies that partners in
a conversation differ in what they know andtions different from reality may help in under-
standing situations where representations are believe about a shared topic. Effective con-
versation requires that gaps in shared knowl-not only different from reality but are not
shared in a social pretend domain. In joint edge and belief are acknowledged and ad-
dressed. The measurement of attachment inpretend play or playfulness the adult adopts
the child’s mental stance and re-presents it to adults (Main, Kaplan, & Cassidy, 1985) em-
phasizes that secure attachment involvesthe child in relation to a third object which is
symbolically held in mind by both (Target & greater sensitivity to the rules of conversation.
The third potential mediator is peer groupFonagy, 1996). The scaffolding provided by
the child’s playmate in pretend play (Vygot- interaction. We have already noted that inter-
action with siblings enhances theory of mindsky, 1967) not only promotes earlier success
but is also the mechanism whereby the devel- performance. There is an independent body of
evidence which supports a strong link be-opment of reflection comes about. Lillard
(1993) argued that symbolic play may offer a tween secure attachment in infancy and rat-
ings of peer competence: social orientation,“zone of proximal development” for the skills
which subserve mentalization ability. Chil- reciprocity, popularity, and empathy (e.g.,
Elicker, Englund, & Sroufe, 1992; Park &dren with a secure attachment history may be
more likely to engage in an activity which Waters, 1989).
Attachment and reflective function 689
Both simulation theory and theory–theory from Dunn’s work suggests that these differ-
ent contexts correlate poorly with one anotherexplanations of the development of mentaliza-
tion offer good explanations of the facilitative (Dunn, 1996). For example, observational
data shows that individual differences foundeffect of more intense peer group interaction
(Ruffman et al., in press). Peer group interac- in pretend play, management of conflict, and
talking about mental states are not correlatedtion should increase the opportunities the
child has for simulation, imagining what he between social situations (mothers, siblings,
close friend) although each correlates withwould see, think, feel etc., if he were in an-
other person’s situation. Equally, interaction sociocognitive assessments (e.g., Young-
blade & Dunn, 1995). These findings couldwith peers or older sibs could be seen from a
theory–theory perspective as a rich source of suggest that there are a number of indepen-
dent, simultaneous pathways between attach-ideas about how the mind works. An alterna-
tive view may be that enculturation is itself ment, social situations, and social cognition.
Alternatively, there is the second possibil-the source of the child’s mental state concepts
(Astington, 1996). Bruner (1983) proposed ity, that the suggested mediating variables are
not on the causal path at all, that their correla-that parents’ tendency to treat the infant’s
spontaneous gestures as if they were inten- tion with the rate of acquisition of mentaliza-
tion is spurious, that this facility is directlytional communications leads to infants seeing
themselves as having intentions and starting related to the child’s attachment status. Early
experience with the caregivers in the 1st yearto communicate intentionally. The social
world (in the first instance, the parent) fosters of life may create a bedrock of theory of mind
competence, helping the child to move fromthe child’s sense of his mental self through
complex linguistic and interactional pro- a teleological to a mentalizing model of be-
havior. What evidence do we have to supportcesses, behaving towards the infant in a way
that leads him eventually to share the assump- such a contention?
First, recall that Fonagy, Steele, Steele, andtion that his own behavior and (by simulation
or the observation of similar interactions be- Holder (1997) found that a mother’s attach-
ment classification before the birth of thetween the caregiver and others) that of others
may be best understood in terms of mental child was a powerful predictor of the child’s
theory of mind competence at 5 years. Al-states (Fonagy & Target, 1996; Target & Fo-
nagy, 1996). Through participation in activi- though, on the face of it, this can be ac-
counted for by the mediational models, we be-ties of their culture they come to share their
culture’s way of understanding people’s ac- lieve that there is now evidence that the
caregiver brings something to the parent–tions. If there is a process of “apprenticeship”
in which peers and caregivers encourage the child relationship, evident even before the
birth, which may be critical in the child’s es-child’s use of mentalizing concepts (Asting-
ton, 1996), then secure attachment may be a tablishment of both secure attachment and
mentalization.catalyst to this learning process. The greater
readiness with which secure children are will- What is this capacity? It is well established
that in infancy, mothers of securely attacheding to explore and engage with the social
world could then account for their mentalizing children are more sensitive to their children’s
needs (Ainsworth, Bell, & Stayton, 1971; Isa-skill.
There is nothing exclusive about these bella, 1993). We have already mentioned that
the parent’s capacity to envision the mentalthree mediational models. Pretense often
involves the use of mental state language. In- states of her or his own parents is predictive
of the infant’s security of attachment to eachteraction with peers often involves both lan-
guage and pretense. In general, social engage- parent (Fonagy et al., 1991a). In a follow-up
of the same group, the same capacity also pre-ment tends to enhance social understanding,
and such engagement is more accessible to se- dicted superior performance on a false belief
task at 5 years, controlling for verbal fluencycurely attached children. There is, however, a
problem with a singular model. Evidence in the child. (However, this result was not
P. Fonagy and M. Target690
found for all tasks which could be thought to ideas and feelings which determine his ac-
tions, and the reactions of others to him,index mentalization).
A path analysis of the above data showed which can then be generalized to other similar
beings. The caregiver approaches the cryingthat not all the variance predicted was medi-
ated by mother–infant attachment status at 1 infant with a question in her mind: “Do you
want your nappy changed?” “Do you need ayear. Mother’s mentalizing ability seemed to
have a direct as well as an indirect relation- cuddle?” The sensitive caregiver is unlikely to
address the situation without having the per-ship with the child’s theory of mind. Thus, the
child’s attachment security was not the only son in mind, so is unlikely to say to herself,
“Are you wet around your bottom?” or “Havepredictor; the mother’s tendency to envision
people (including the child) as mental entities you been standing alone too long?” The sensi-
tive caregiver can bridge the focus on physi-also seemed to be important.
The above data suggest that common cal reality and internally directed attention,
sufficiently for the child to identify contingen-mechanisms underpin attachment organiza-
tion in caregiver and infant, and the preco- cies between internal and external experience.
Ultimately, the child arrives at the conclusioncious emergence of mentalizing in the child.
It should be remembered that no clear causal that the caregiver’s reaction to him may be
understood as rational given the assumptionpath was identified among mediational mod-
els. The relative importance of various po- of an internal state of belief or desire within
himself. Unconsciously and pervasively, thetential mediational mechanisms for the at-
tachment–theory of mind relationship varies caregiver ascribes a mental state to the child
with her behavior, treats the child as a mentalaccording to context but intergenerational
data may be consistent with at least two of the agent, which is perceived by the child and
used in the elaboration of teleological models,models (pretense, language). Further experi-
mental research which manipulates parental and then in the development of a core sense
of mental selfhood. We assume that this, bybehavior and explores attachment and theory
of mind task performance (van IJzendoorn, and large, is a mundane process, happening
routinely throughout early life, not reflectedJuffer, & Duyvesteyn, 1995) will be necessary
to show whether specific behaviors which en- on, and so rarely modified. Caregivers, how-
ever, differ in their ways of carrying out thisgender secure attachment simultaneously en-
hance mentalizing. For such a study to be fea- natural human function. Some may be partic-
ularly alert to the earliest indications of inten-sible, we need a model of how attachment
may directly relate to theory of mind perfor- tionality; others may need stronger indications
before perceiving the child’s mental state andmance. Next we outline a tentative model of
how such a mechanism may operate. modifying their behavior accordingly. Others,
as we described in the context of early in-
fancy, may systematically misperceive the
child’s states of mind, with resulting deforma-
Reflective parenting and development
tion of the child’s sense of himself.
of mentalization
The child’s development and perception of
mental states in himself and others thus de-We take the view that the acquisition of the
theory of mind is part of an intersubjective pends on his observation of the mental world
of his caregiver. He is able to perceive mentalprocess between the infant and caregiver (see
Gopnik, 1993, for a highly elegant elaboration states, to the extent that his caregiver’s behav-
ior implied such states. This he does when theof such a model). In our view, the caregiver
facilitates the creation of mentalizing models caregiver is in a shared pretend mode of play-
ing with the child (hence the association be-through complex linguistic and quasilinguistic
processes, primarily through behaving to- tween pretend and early mentalization), and
many ordinary interactions (such as physicalwards the child in such a way that leads him
eventually to see that his own behavior may care and comforting, conversations with
peers) will also involve such shared menta-be best understood by assuming that he has
Attachment and reflective function 691
tion. This is what makes mental state concepts the mental state of the caregiver evokes in-
tense anxiety through either frightening be-such as thinking inherently intersubjective;
shared experience is part of the very logic of havior suggesting malevolence towards the
child, or behavior suggesting fear, which maymental state concepts.
The parent’s capacity to observe the mo- include fear of the child himself; and (c) the
child needs to use disproportionate resourcesment to moment changes in the child’s mental
state, then, lies at the root of sensitive care- to understand the parent’s behavior, at the ex-
pense of reflecting on, which is viewed by attachment theo-
rists as the cornerstone of secure attachment These factors combine, perhaps, to make
disorganized infants become keen readers of(e.g., Ainsworth et al., 1978; Grossmann,
Grossmann, Spangler, Suess, & Unzner, 1985; the caregiver’s mind under certain circum-
stances, but (we suggest) poor readers of theirIsabella & Belsky, 1991). Secure attachment
in its turn provides the psychosocial basis for own mental states. Thus, in terms of the rival
models of theory of mind development, suchacquiring an understanding of mind. The se-
cure infant feels safe in making attributions of children may acquire a theory–theory of
mind, but cannot use simulation of mentaliz-mental states to account for the behavior of
the caregiver. By contrast the avoidant child ing with the same confidence as children
whose attachment (albeit insecure) is orga-to some degree shuns the mental state of the
other, while the resistant child focuses on his nized. The alternative models may be more
usefully thought of as alternative routes toown state of distress to the exclusion of close
intersubjective exchanges. Disorganized in- mentalization, the first (theory–theory) acces-
sible to all, the second (simulation) morefants may represent a special category; hyper-
vigilant of the caregiver’s behavior they use readily available to children whose early at-
tachment relationships made such a strategyall cues available for prediction and may be
acutely 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 development
would argue (see below) that in such children
of mentalization
mentalization may be evident but it does not
have the central and effective role in self-or- In previous papers (Fonagy & Target, 1996;
Target & Fonagy, 1996), we have attemptedganization which characterizes securely attached
children. to describe the normal development of reflec-
tive function in the child of 2–5 years. WeWe believe that most important for the de-
velopment of mentalizing self-organization is suggested that there is a transition from a dual
mode of experience to mentalization. Primar-that exploration of the mental state of the sen-
sitive caregiver enables the child to find in ily from a clinical perspective, we advanced a
number of propositions concerning the devel-her mind an image of himself as motivated by
beliefs, feelings, and intentions, in other opment of the psychological part of the self.
These werewords, as mentalizing. There is considerable
evidence to support the view that secure at- 1. Until 3 or 4 years of age, reflective func-
tion is characterized by two modes of relatingtachment enhances the development of inner
security, self-worth, and autonomy (e.g., Lon- internal experiences to the external situation:
(a) In a serious frame of mind, the child ex-derville & Main, 1981). Disorganized infants,
even if they acquire the skill of mentalization, pects the internal world in himself and others
to correspond to external reality, and subjec-fail to integrate this with their self-organiza-
tion. There may be a number of linked rea- tive experience will often be distorted to
match information coming from outsidesons for this: (a) The caregiver of the disorga-
nized infant is less likely to be reliably (“psychic equivalence mode”), (e.g., Gop-
nik & Astington, 1988; Perner, Leekam, &contingent in responding to the infant’s self-
state, and further to show systematic biases in Wimmer, 1987); and (b) while involved in
pretend play, the child knows that internal ex-her perception and reflection of his state; (b)
P. Fonagy and M. Target692
perience does not reflect external reality (e.g., Reflective function and self-development
Bartsch & Wellman, 1989; Dias & Harris,
1990), but then the internal state is thought While mentalization may not be an unequivo-
cally positive experience, Dunn’s work showsto have no relationship to the outside world
(“pretend mode”). us at any rate that the understanding of emo-
tion at 3.5 years predicts a positive perception2. Normally, the child then integrates these
alternative modes to arrive at mentalization, of social relations, mature moral sensibility,
and the understanding of complex emotionsor reflective mode, in which mental states can
be experienced as representations. Inner and (Dunn, 1996). Stern (1985) pointed out that a
sense of ownership of one’s actions, whetherouter reality can then be seen as linked, yet
they are accepted as differing in important derived from the experience of forming plans,
proprioceptive feedback, or the objective con-ways, and no longer have to be either equated
or dissociated from each other (e.g., Gopnik, sequences of physical actions on the environ-
ment, contributes to the sense of self-agency.1993). Mentalization comes about through the
child’s experience of his mental states being In our view, such agency also crucially de-
pends on the quality and reliability of reflec-reflected on, for instance through secure play
with a parent or older child, which facilitates tive function, as ownership of action is inti-
mately tied to the mental state (belief orintegration of the pretend and psychic equiva-
lence modes, through a process which may be desire) which initiated it. It is impossible to
conceive of self-agency as fully establishedan elaboration of the complex mirroring of the
infant by the caregiver. In playfulness, the by the physical actions of the child, as such a
large proportion of these will fail to achievecaregiver gives the child’s ideas and feelings
(when he is “only pretending”) a link with re- their intended objective, because of the
child’s immature physical and cognitive ca-ality, by indicating the existence of an alterna-
tive perspective, which exists outside the pacities. The recognition of the child’s inten-
tional stance by others must then be critical inchild’s mind. The parent or older child also
shows that reality may be distorted by acting making the thought “real” for the child. We
believe that interaction which links percep-upon it in playful ways, and through this play-
fulness a pretend but real mental experience tions, thoughts, and emotions as causes and
consequences of action, and the contempla-may be introduced.
3. In traumatized children, intense emotion tion of mental states without fear, contribute
significantly to self-agency. The earliest foun-and conflict lead to a partial failure of this
integration, so that aspects of the pretend dation is presumably the baby’s sense that he
brings about the caregiver’s mirroring behav-mode of functioning become part of a psychic
equivalence manner of experiencing reality. ior (Gergely & Watson, 1996).
Of course, the core of self-agency mustThis may be because where maltreatment or
trauma has occurred within the family, the at- originally lie with the body, where the in-
fant’s attempts to exercise control frequentlymosphere tends to be incompatible with the
caregiver “playing with” the most pressing as- succeed after early infancy. Higher level, more
complex actions, particularly those which in-pects of the child’s thoughts; these are often
disturbing and unacceptable to the adult, just volve others in the child’s life, often require
the reflective caregiver to make sense of theas they are to the child. The rigid, controlling
behavior of the preschool child with a history young child’s wishes and translate these into
action sequences for the links between mentalof disorganized attachment is thus seen as
arising out of a partial failure on the part of states and action to be established. It is to be
expected then that individuals who have expe-the child to move beyond the mode of psychic
equivalence in relation to specific ideas or rienced severe neglect or coercive, rigid,
frightening, and, at an extreme, abusive par-feelings, so that he experiences them with the
intensity that might be expected had they been enting will frequently experience their sense
of self-agency as massively curtailed, andcurrent, external events.
Attachment and reflective function 693
limited to the more firmly established bodily adoxically drive them physically closer to a
potential abuser. Their ability to adapt to,(physical) domain.
modify, or avoid the perpetrator’s behavior is
also constrained by limited mentalizing skills.
Reflective function and pathological
There are several reasons why the family
environment of maltreatment is likely to un-
dermine the development of reflective func-The model of the development of mentalizing
capacity which we propose has considerable tion.
First, in abusive families the public worldclinical implications, a few of which we will
mention here. of school and community—where reflective
function is common and desirable—is often
kept very separate from the world of home,Impact of maltreatment on reflective function.
Maltreated children, perhaps even more than where the inhumane behavior of an adult
makes recognition of the mental state of theinsecure ones, are at risk of failing to find
their own intentional being within the mind other dangerous to the developing self. Even
where a maltreated child benefits from sensi-of the caregiver, and are thus at risk of poor
development of mentalization. There is accu- tivity and reflectiveness in his public world,
so developing an alternative model of relatingmulating evidence that maltreatment does im-
pair the child’s reflective capacities and sense and experiencing himself, the models derived
from public and family experiences are likelyof self. Schneider–Rosen and Cicchetti (1984,
1991) noted that abused toddlers showed neu- to be kept insulated from each other, and rigid
in their application to the separate contexts.tral or negative affect on recognizing them-
selves in the mirror, unlike their nonabused Second, the child may have specific prob-
lems in dealing with different experience. Inpeers. Beeghly and Cicchetti (1994) showed
that toddlers with a history of maltreatment abusive families the meaning of intentional
states may be denied or distorted. Abusivewere not retarded in receptive language but
were significantly behind in productive lan- parents may claim beliefs and feelings at odds
with their behavior. Abuse, particularly withinguage, reflecting a withdrawal from social in-
teractions. Their specific deficit was in the the family, prevents the child testing and
modifying representations of mental states.relative absence of internal state words and
the context-bound (concrete) nature of their Thus, the mental representation of ideas tends
to become rigid, maladaptive, and inappropri-internal state language. They also showed less
differentiation in attributions. Their internal ate, and consequently may be partially or
largely abandoned.state language was particularly sparse in terms
of words pertaining to cognition and belief A third possibility is that the maltreated
child is forced to construct a model of thestates, but was richer for perception and de-
sire. Cicchetti and Beeghly (1987) found that caregiver’s mind based on an awareness of
analogous mental states in himself. It may beyoung school-age children who had been mal-
treated used proportionally fewer words about argued, on the basis of the simulation model,
that simulation is compromised by both theinternal states, attributed their internal states
to fewer social agents, and were more context dissimilarity between the child’s mental expe-
rience and that of the abuser, and the threatbound than their counterparts who were not
maltreated. They appeared to control their that such simulation inevitably brings with it.
If understanding the behavior of his caregiv-anxiety by modifying their language to ex-
clude certain aspects and contexts associated ers requires the maltreated child to try to gen-
erate their probable thoughts and feelings,with maltreatment. This pattern of results sug-
gests that maltreatment may cause children to then he will be confronted with attitudes to-
wards himself which are extremely painful towithdraw from the mental world. For mal-
treated children, physical experiences proba- recognize: hatred, cruelty, indifference. Abuse
could destroy the child’s belief that one canbly become more important, and this may par-
P. Fonagy and M. Target694
understand others through one’s own feelings sionals and family members. These anomalies
can be clarified by more sophisticated devel-(Herman, 1992), and the child would be likely
to inhibit his capacity for simulation in in- opmental theory.
Our chosen framework is provided by “dy-tense attachment relationships.
A fourth possibility is that the difficulty is namic skills theory” (Fischer & Farrar, 1987;
Fischer, Kenny, & Pipp, 1990) which depictsnot a result of the maltreatment itself, but of
the family atmosphere surrounding it (which development as the elaboration of increas-
ingly complex control systems (skills). Re-may well also occur where maltreatment does
not). Social constructivist ideas concerning the flective function may be readily conceived of
as one such control system, critical to the or-development of mentalization (e.g., Asting-
ton, 1996) are pertinent here. Authoritarian ganization of the self. Within dynamic skills
theory, reflective function would be seen aspunishment of bad behavior and demanding
of obedience is clearly less facilitating of the not simply a property of the person, but of the
person and situation together, because allchild’s development of mentalization than are
equivalent interactions with authoritative par- skills are composed of both the person’s ac-
tivities and the contexts within which theseents, who reason with the child and explain
decisions and rules with reference to people’s occur. Particular tasks, specific events, other
people, as well as culture are seen as part ofdifferent points of view (Baumrind, 1971).
There is some evidence that authoritarian par- the skill. Further, the development of a skill is
not seen as progression along a singular path,enting is associated with delayed false belief
task performance (Holmes, Roldan, & Miller, determined by maturation. Rather, reflective
function, as a skill, evolves through varied1994, cited in Astington, 1996). As, in a Vy-
gotskian framework, the individual’s compe- pathways, molded by many dynamically inter-
acting influences, such as the individual’stence originates in their social interactions and
is then internalized, we would expect the ab- emotions, social interaction, family relation-
ships and environment, important socialnormal patterns of parent–child relations in
the families of maltreated children to lead to groups, the reactions of the wider social world,
etc. (Fischer, Knight, & Van Parys, 1993).a distorted experience of minds. Alessandri
(1991, 1992) noted that the incompetence of Reflective function is a strand within the
developmental web, one of the many distinctmaltreated youngsters in pretend symbolic
play was mirrored by their mothers’ difficulty control systems that are neither strongly con-
nected with each other, nor coordinated orin taking a playful stance with their child,
directing their attention, and engaging in posi- integrated (Fischer & Pipp, 1984). The “frac-
tionation” or splitting of all abilities as a func-tive interactions. This pattern of results is con-
sistent with the model that the lack of appro- tion of tasks and domains is well demon-
strated, and we might expect reflectivepriate social scaffolding may undermine the
normal development of mentalizing in mal- function to be subject to the same kind of de-
velopmental de
calage (unevenness) whichtreated children.
characterizes the rest of cognitive develop-
ment (Flavell, 1982). Fractionation refers toDevelopmental framework for abnormal re-
flective function. It is tempting to argue that the tendency for a person not to coordinate
skills or experiences that are naturally sepa-disorders of conduct and borderline states can
be explained as dismissive and preoccupied rate, but may be thought of as belonging to-
gether by some external criterion (Fischer &forms of nonmentalizing self-organizations
respectively, but this would be simplistic. In Ayoub, 1994). Just as the understanding of
conservation of liquid does not generalize toboth instances, there are often variations
across situations, or types of relationship. The conservation of area, reflective capacity in
one domain of interpersonal interaction shoulddelinquent adolescent is aware of the mental
states of other gang members and the border- not be expected to generalize to others. Re-
flective function does not begin as a generalline individual is at times hypersensitive to
the affective states of mental health profes- capacity, but is a particular skill tied to the
Attachment and reflective function 695
task and domain where it is learned, a specific naturally move toward integration. The family
might of course, as we mentioned, supportcategory of relationship. Reflective function
as a skill may be more or less present in situa- such splits with sharp dissociations between
their public, proper world and their private,tions as a function of contextual support and
emotional state, which push an individual up tyrannical one. The split is context and affect
dependent; within an attachment theoryor down a developmental strand. We have
noted above that the child’s observed use and framework we might say that the self is orga-
nized so that certain internal working modelsexperience of mental state language can differ
markedly across social contexts. It is clearly include considerable reflective components—
expectations incorporating the mental statespossible for task-based skills such as reflec-
tive function to come to be coordinated, but of self and other—while other working mod-
els of relationships appear impoverished, indi-this should not be seen as automatic. Uneven-
ness across situations is likely to remain prev- cating only minimal mentalizing skills. In the
latter contexts the subject will offer only ster-alent even in adults, especially when they are
emotional (Fischer & Ayoub, 1994). eotyped, concrete, low level descriptions.
This does not imply developmental delay orNormal development is from fractionation
towards integration, which involves the coor- regression; rather it suggests a remarkably
complex ability to coordinate two distinct lev-dination of previously separate skills and pro-
vides the foundation for more complex, so- els of functioning. The abusive or emotionally
depriving world within which they developedphisticated control systems (Bidell & Fischer,
1994). Abnormalities of reflective function, has engendered in them the sophisticated
skills that were required for adaptation. Thusthe continued use of a teleological rather than
a mentalizing model for predicting behavior, to talk of deficit or absence of a capacity in
such individuals is an oversimplification.should not then be seen as either a conse-
quence of arrest and fixation at an early stage, Measures of global abilities may not yield a
difference between these individuals andor a regression to that stage. Pathologies in
the reflective function of the maltreated child other groups. Efforts at going beyond clinical
impression in terms of measurement have tomay be expected to develop increased com-
plexity with age and time, in a manner similar take on board the situational specificity of the
failure of reflective other skills. The skill for limited reflective-
ness developed by the child to anticipate and We will return to the example of conduct
disordered children, for whom we suggest thatforestall maltreatment and its painful physical
and psychological impact would be adaptive nonreflective internal working models may
dominate behavior when an element of con-in their original world, but would be expected
to produce sophisticated forms of difficulty flict is present within a relationship. Conflict,
or rather its adaptive resolution, particularlyrather than straightforward adaptations in
other contexts (Noam, 1990). The ability to calls for the perception both of the self and of
the other in relation to the self, requiring thebe reflective in general, but to show only min-
imal reflectiveness in the context of one’s individual to reconcile his own legitimate
claims with concern for the other (Killen &own childhood and parents, or in specific rela-
tionships which reactivate the same schemata, Nucci, 1995). The abnormality of the early
family environment of individuals with severecould be a result of natural fractionation. Un-
evenness or splitting of reflective ability could problems of conduct has been clearest in the
context of normal conflicts (Patterson, 1982;also be the consequence of an active (pur-
poseful, conscious, or unconscious) attempt Perry, Perry, & Kennedy, 1992). Here the
child with a vulnerable capacity for mentali-on the part of the individual not to coordinate
or generalize reflective function to specific re- zation finds no affirmation of his intentional
stance and fails to acquire the sense of owner-lationship domains. Here the unevenness is a
developmental achievement, in that the per- ship or inner endorsement of his actions es-
sential for a sense of self-agency. Consequentlyson must create a coordination in order ac-
tively to keep separate contexts which would his sense of autonomy becomes vulnerable
P. Fonagy and M. Target696
and the importance of his original intention predominant response to emotional situations
will be a nonreflective one, readily disownedis exaggerated. The characteristics of opposi-
tional defiant disorder (e.g., negativity, dis- by the self. Naturally the absence of reflective
function in such situations will give the ap-obedience, aggression) may in part be seen as
attempts at reasserting self-agency in a rela- pearance of rigidity to the person’s behavior
as if only a singular pattern of response weretionship where the connection between mental
state and action within the self has been un- accessible. Furthermore, the response may
frequently be in conflict with social norms be-dermined by insensitive and coercive par-
enting. cause the tendency to take the perspective of
others has been abandoned in that contextAbnormalities of parenting represent but
one route to limitations on reflective function. and, consequently, the moral emotions used
to make judgments about the consequences ofThe child’s biological vulnerabilities such
as hyperactivity, attention problems, low im- actions and regulate behavior are absent. The
absence of reflective function may further ex-pulse control, are all likely to obstruct the
opportunity the child has for evolving a men- aggerate an antisocial response by forcing the
individual to see the other not as another in-talized reflective model of conflict-related in-
terpersonal situations. Within a dialectic or tentional agent, but in nonhuman terms, as a
body, as representing a social position ortransactional model there is a bidirectional
causality inherent to such biological vulnera- agency, or as a faceless member of a group.
Maltreatment, or more broadly trauma, isbilities: They both provoke situations of con-
flict and place grave limitations on the child’s seen as interacting with the domain- and situ-
ation-specific restrictions upon reflective func-capacity to acquire the flexibility needed for
their adaptive handling. This may bear on the tion at two levels. First, as we have argued,
maltreatment presents the young child with awell demonstrated comorbidity between con-
duct disorders and hyperactivity or attention powerful emotional disincentive for taking the
perspective of others, because of the actualdeficit disorder (Kazdin, 1995). Similarly,
factors associated with early behavioral prob- hostility of the intentional stance of the
abuser, as well as the constraints upon the selflems, such as poor parental adjustment (ma-
ternal aggression, suspiciousness, and mood which an older person’s failure to understand
the child’s budding intentionality imposes.disorder) (Shaw, Owens, Vondra, Keenan,
& Winslow, 1996; Zahn–Waxler, Ianotti, Second, the child misses a protective factor,
the capacity to understand traumatic interper-Cummings, & Denham, 1990), and resources
(marital dissatisfaction, parental conflict) sonal situations, which would be likely to
limit their impact (Fonagy, Steele, Steele,(Block, Block, & Gjerde, 1986; Campbell,
Pierce, Moore, Marakovitz, & Newby, 1996) Higgitt, & Target, 1994). Thus, individuals
traumatized by their family environment aremay limit the parents’ capacity to respond to
the child in ways which promote a mentaliz- vulnerable both in terms of the long-term mal-
adaptive effect of their reaction to the traumaing model of self–other relationships.
The separation of action from intention un- and in terms of their reduced resilience in the
face of it. The predominantly nonmentalizingdermines the emotional reaction an individual
may have to the consequences of their actions stance adopted in such situations therefore
handicaps the individual and, if the vicioussince, as Hart and Killen (1995) pointed out,
the acquisition of moral emotions requires circle is unbroken, may come to dominate all
interpersonal relationships. We believe that atthat individuals are “active contributors to
their own development, interpreting their this stage severe developmental psychopathol-
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... Отож, згідно з психоаналітичною теорією, менталізація та уявлення про інших тісно пов'язані з уявленням про себе (Luyten & Fonagy, 2015). Високо розвинена менталізація, яка найчастіше опосередкована рефлексивною функцією реалізується завдяки здатності створювати уявний образ себе та образ іншого у своєму внутрішньому суб'єктивному світі, з подальшим вмінням витримувати відмінності між образом себе та образом іншого в уяві (Fonagy & Target, 1997;Knox, 2011). J. Knox у зв'язку з цим наголошує, що знання про свої вчинкивідкриття їх значення та їх осмислення, так само як і осмислення вчинків інших, є основою відчуття власної суб'єктності. ...
... Таким чином, менталізація та суб'єктність є тісно зв'язаними психічними явищами, формування яких є ціллю психологічного впливу у процесі психотерапії чи психологічного консультування. Суб'єктність є тісно пов'язаною з активністю особистості та зі спроможністю прийняття рішень (Дітюк, 2021; Мещеряков, 2017) Менталізація є не лише пов'язаною із суб'єктністю особистості, але й із структурними її особливостями, про що неодноразово наголошують психоаналітики (Fonagy & Target, 1997;Semkiv & Turetska & Kryvenko & Kechur, 2022). ...
... Саме через надійну прив'язаність, яка виступає запорукою довіри між дитиною та її опікуном, опікун може передати свою менталізуючу компетентність дитині. Вміння опікуна осмислювати, рефлексувати психічні стани дитини і передавати їй свій спосіб осмислення цих станів і є основою розвитку менталізації у майбутньому (Fonagy & Redfern & Charman, 1997;Knox, 2011;Fonagy & Target, 1997). Подібний механізм лежить в ядрі психотерапевтичного впливу та, зокрема, в основі психотерапії, що базується на менталізації. ...
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Developing reliable and valid tools for measuring the effectiveness of psychological and psychotherapeutic interventions is a critical task of modern psychological science and practice in Ukraine. The article presents a description of approbation of the psychological questionnaire (scale) for measuring self-assessment of development mentalization and self-agency in the process of mentalization-based psychological counseling (therapy) (SAMS). SAMS was developed within the theoretical psychoanalytic paradigm based on the psychodynamic tradition of empirical studies of the effectiveness of psychological interventions. The theory of mentalization by P. Fonagy and the theory of self-agency by J. Knox became the theoretical foundation of the SAMS. The purpose of the empirical study is to develop the body of SAMS and to check it for reliability and validity. Psychometric strengths of the SAMS were checked on a sample of clients of the project “Poradnya” (psychological counseling center) of psychology and psychotherapy Department of the Ukrainian Catholic University. 86 people were studied in the initial research and 32 in the re-test research. The study examined the SAMS methodology for internal, constitutional, and re-test reliability and its structural and constitutional convergent validity. According to the results of the conducted empirical research, it can be stated that the SAMS technique has high reliability and validity. Therefore, it can be used in further scientific studies of the effectiveness of psychological interventions in the same way as in psychological practice in Ukraine.
... Parental reflective function (RF), is the ability to "mentalize" or envision mental states in oneself and one's child (e.g., thoughts, feelings, desires, and intentions) and verbalize them (Fonagy et al., 2002, p. 363;Fonagy, 2006;Sharp, 2006;Midgely and Vrouva, 2012). It is a modifiable trait (Byrne et al., 2020;Letourneau et al., 2020;Slade et al., 2020) that is theorized to improve children's developmental attainment, including cognitive abilities (Steele et al., 1996;Fonagy and Target, 1997;Fonagy et al., 2002;Allen et al., 2008;Sharp and Fonagy, 2008). Interventions designed to improve parental RF have demonstrated improvements in infants' speech development (Bain, 2014), reductions in school-aged children's externalizing (e.g., aggressiveness) behaviors (Londono Tobon et al., 2020), and improvements in preschool-aged children's developmental outcomes (Anis et al., 2020a). ...
... The construct of RF is the operationalization of mentalization (i.e., ability to understand others and oneself in terms of mental states) in the context of attachment relationships and is frequently used synonymously with mentalizing (Fonagy et al., 1998;Sharp and Fonagy, 2008). RF is distinguishable from many related terms including "mindblindedness, " "mindreading, " "theory of mind, " "metacognition, " "mindfulness, " "empathy, " and "emotional intelligence" (Fonagy and Target, 1997;Fonagy et al., 2002;Sharp et al., 2006;Allen et al., 2008). The related concept of "mind mindedness, " defined as the "proclivity to treat one's child as an individual with a mind" (Meins and Fernyhough, 1999, p. 364), is a commonly used construct. ...
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Children’s cognitive abilities (e.g., working memory) are associated with mental health, adaptive behaviors, and academic achievement, and may be enhanced by parental reflective function (i.e., capacity to reflect on mental states, feelings, thoughts, and intentions in one’s child and oneself). We evaluated associations between maternal reflective function and children’s cognitive abilities alone and while controlling for parent-child attachment and interaction quality, and psychosocial (i.e., maternal depressive symptoms, adverse childhood experiences) and sociodemographic (e.g., socioeconomic status) factors. Our sample, recruited in Canada, was primarily white and included 73 mothers and their 4–5 year old preschool children. Maternal reflective function was measured with the Reflective Functioning Scale applied to the Parent Development Interview and the Parental Reflective Functioning Questionnaire. Multiple regression analyses revealed that maternal reflective function was associated with children’s cognitive abilities. The Parent Development Interview rated child-reflective function was associated with children’s higher verbal comprehension alone and while adjusting for covariates (e.g., parent-child interaction quality, socioeconomic status), and the Parental Reflective Functioning Questionnaire Interest and Curiosity with higher verbal comprehension while adjusting for parent-child interactions and attachment pattern. The Parental Reflective Functioning Questionnaire Certainty in Mental States was associated with higher working memory scores for children while adjusting for covariates. Full Scale IQ and Visual Spatial Index were not significantly associated with maternal reflective function. Associations were found between secure and disorganized attachment with higher verbal comprehension and lower working memory, respectively. These findings highlight the importance of high maternal reflective function to cognitive abilities in early childhood.
... Over the years, the attachment theory has interacted with the construct of reflective function by deepening how attachment allows the development of mentalization (Bateman & Fonagy, 2012;Fonagy, 2001Fonagy, , 2003Fonagy & Target, 1997;Freda et al., 2019;Slade, 2007;Steele, 2003). Also, research on attachment styles has explored the different stages of the individual's life cycle, expanding into adolescence (Cacioppo et al., 2019;Schimmenti et al., 2012) and adulthood (Bennet & Nelson, 2010;Wallin, 2007), and in the field of romantic relationships (Feeney & Monin, 2008;Mikulincer & Goodman, 2006;Rholes & Simpson, 2004;Velotti et al., 2018;Zavattini, 2010), and social and labor relations (Lanciano & Zammuner, 2014). ...
The Adult Attachment Scale-Revised (Collins and Read in J Person Soc Psychol 58(4):644, 1990. measures the dimensions of the attachment style of adults through the degree to which the individual feels comfortable in intimacy and closeness with the partner (Close), with dependence on the partner (Depend) and worrying about being rejected or unloved (Anxiety). Dimensions measured by the AAS can capture the core of the structure that determines adults' differences in attachment styles. This study aimed to evaluate the factorial structure of the AAS-R among a sample of Italian adults. The Italian translation of AAS-R was administered to the sample of 1546 Italian adults (M = 27.4; SD 9.35). Exploratory factor analysis and confirmatory factor analysis were performed to examine the validity of the Italian version of the AAS-R measure. The present study showed that the Italian version of the AAS-R has a clear factorial structure and good psychometric properties. Clinical and research implications were discussed.
... Notably, one's level of RF originates within early attachment relationships. Ideally, infants are thought to learn about the minds of others by being held in mind by their caregivers (Fonagy and Target, 1997;Slade, 2005). However, caregiving contexts in which this process is disrupted may impede the development of RF capacities. ...
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Parental reflective functioning (RF) is often cited as an important domain in which mothers with addictions struggle in their roles as parents, though the links between addiction and RF remain unclear. Exposure to attachment trauma associated with parental mental illness and substance use is commonly associated with both addiction and lower RF. We thus examined how family history of parental mental illness and substance use may relate to the RF of mothers with addictions. One hundred ninety-four mothers in outpatient substance use treatment completed the Parent Development Interview and provided information about whether their mothers and fathers experienced mental illness or problems with substance use. Univariate ANOVAs revealed an interaction between family history of maternal mental illness and maternal substance use. Among mothers with a history of maternal substance use, those with a history of maternal mental illness had higher RF than those who had no history of maternal mental illness. Among mothers who did not report a family history of maternal mental illness, mothers who had a family history of maternal substance use exhibited significantly lower RF than mothers with no family history of maternal substance use. Exposure to paternal mental illness or substance use was not associated with mothers’ RF. These findings highlight the importance of disentangling the contributions of attachment trauma to mothers’ RF and utilizing interventions that support mothers’ capacity to reflect about how their early experiences of being cared for by a mother with a mental illness or addiction may impact their current caregiving behaviors.
... It has been estimated that 75% to 80% of the attachment style in infant can be predicted by the attachment style in the caregiver (Benoit & Parker, 1994;Fonagy et al., 1996;Fonagy, Steele, & Steele, 1991;Ward & Carlson, 1995). Nevertheless, the score of the reflexive function is a better predictor of the attachment style in the infant (Fonagy & Target, 1997). ...
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Introduction. The mother and child attachment could have an important and long-lasting impact. An insecure attachment could lead to emotional development difficulties. It has been suggested that maternal care in infants is associated with personality. However, more studies in adults are needed. Objective. To determine if attachment styles in subjects with affective or anxiety disorders are associated with the expression of personality traits, and if this effect can be modulated by the presence of the short allele of the 5-HTTLPR polymorphism. Method. Our sample included 87 patients with mood or anxiety disorders. The NEO-PI-R questionnaire and the Adult Attachment questionnaire by Melero were used. Results. Insecure attachment styles were associated with a higher expression of neuroticism, and a lower expression of extraversion, conscientiousness, and agreeableness, especially in individuals with the most insecure attachment. An interaction was identified between the attachment style and the 5-HTTLPR genotype on the expression of agreeableness. Higher neuroticism, and lower extraversion and conscientiousness tended to be present in carriers of the S allele. Discussion and conclusion. There was a significant association between the attachment styles and the expression of neuroticism, extraversion, agreeableness, and conscientiousness-responsibility according to the Big Five Model. The short allele may be associated with the modulation of certain aspects of personality. Prevention strategies should be established to promote adequate attachments between infants and caregivers to avoid a possible risk factor for future maladaptive personality traits.
... La interpretación socioemocional permite procesar la información social y emocional, otorgando significado a las claves sociales y facilitando comprender y resonar con las emociones, intenciones y estados mentales propios y de los demás, así como atribuirles significado cultural en el marco más amplio de un contexto determinado. Nuestro concepto de interpretación socioemocional integra dos capacidades relacionadas: la mentalización propuesta por Fonagy (Fonagy & Target, 1997;Fonagy, 2006;Fonagy et al., 2018); y la empatía (Decety & Meyer, 2008;Decety, 2015;Decety et al., 2018;Heyes, 2018;Stern & Cassidy, 2018). ...
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Currently there is no consensus on what is the socio-emotional development, what are its components and path of progress, hindering the progress of transdisciplinary research and the development of evaluation and intervention methods in public policies. The literature about socio-emotional development is extensively reviewed, offering a theoretical model that identified three principal socio-emotional competencies: (a) socio-emotional cognition: composed by the attention and interpretation of social situations; (b) emotion regulation: composed by the emotion modulation and impulse control; (c) socio-emotional communication: composed by verbal and no verbal communication with others.
There is now ample evidence from the preclinical and clinical fields that early life trauma has both dramatic and long-lasting effects on neurobiological systems and functions that are involved in different forms of psychopathology as well as on health in general. To date, a comprehensive review of the recent research on the effects of early and later life trauma is lacking. This book fills an obvious gap in academic and clinical literature by providing reviews which summarize and synthesize these findings. Topics considered and discussed include the possible biological and neuropsychological effects of trauma at different epochs and their effect on health. This book will be essential reading for psychiatrists, clinical psychologists, mental health professionals, social workers, pediatricians and specialists in child development.
Parental Psychiatric Disorder presents an innovative approach to thinking about and working with families where a parent has a mental illness. With 30 new chapters from an internationally renowned author team, this new edition presents the current state of knowledge in this critically important field. Issues around prevalence, stigma and systems theory provide a foundation for the book, which offers new paradigms for understanding mental illness in families. The impact of various parental psychiatric disorders on children and family relationships are summarized, including coverage of schizophrenia, depression, anxiety, substance abuse disorders, eating disorders, personality disorders and trauma. Multiple innovative interventions are outlined, targeting children, parents and families, as well as strategies that foster workforce and organisational development. Incorporating different theoretical frameworks, the book enhances understanding of the dimensions of psychiatric disorders from a multigenerational perspective, making this an invaluable text for students, researchers and clinicians from many mental health disciplines.
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This chapter presents findings related to two hypotheses regarding 9-12 month old infants: 1. Infants who can feel assured of their mother's av availability and responsiveness, especially in situations of stress, can devote themselves more fully and enthusiastically with the physical environment. In other words, because these infants can use the mother as a secure base from which to launch out into the world, they can learn more about their environment and about propensities of objects by teaching themselves (the attachment-exploration hypothesis). 2. If infant and mother can achieve an interactive style in which harmony and affective synchrony predominate, the infant has increased opportunity to acquire cognitive and communicative skills through interaction with the mother (the attachment-teaching hypothesis).
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In a longitudinal study, the personalities of children from intact families at ages 3, 4, and 7 were reliably assessed by independent sets of raters using Q-items reflecting important psychological characteristics of children. A number of these families subsequently experienced divorce. The behavior of boys was found, as early as 11 years prior to parental separation or formal dissolution of marriage, to be consistently affected by what can be presumed to be predivorce familial stress. The behavior of boys from subsequently divorcing families was characterized by undercontrol of impulse, aggression, and excessive energy prior to parental divorce. The behavior of girls from subsequently divorcing families was found to be notably less affected by the stresses in families prior to parental divorce. The prospective relations afforded by the longitudinal analyses suggest that the behavior of conflicting, inaccessible parents during the preseparation period may have serious consequences for personality development, especially for boys. Hence, some characteristics of children commonly seen to be a consequence of divorce may be present prior to marital dissolution.
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Bowlby's notion of internal representational models is explored with the purpose of clarifying the nature of such models. Distinctions are made among the concepts of (a) focus, (b) memory systems, (c) content, (d) cognitive function, (e) meta-structure, (f) quality of attachment, (g) behavioral strategies, and (h) attitude toward attachment. New terms are offered for familiar concepts, such as defended insecure quality of attachment. New meanings are given for familiar terms, such as working model and balanced attitude toward attachment. In addition, new concepts are introduced including procedural models and meta-models. Areas for further research are discussed in terms of other aspects of relationships and nonattachment relationships. Throughout, the emphasis is on specification of meaning and integration of aspects and levels of models. Finally, issues about assessing attachment and intervening clinically are discussed.
Epidemiologists and psychoanalysts have been equally concerned about the intergenera‐tional concordance of disturbed patterns of attachment. Mary Main's introduction of the Adult Attachment Interview (AAI) has provided the field with an empirical tool for examining the concordance of parental and infant attachment patterns. In the context of a prospective study of the influence of parental patterns of attachment assessed before the birth of the first child upon the child's pattern of attachment to that parent at 1 year and at 18 months, the Anna Freud Centre—University College London Parent‐Child Project reported a significant level of concordance between parental security and the infant's security with that parent. In the context of this study, a new measure, aiming to assess the parent's capacity for understanding mental states, was developed and is reported on in this paper. The rating of Reflective‐Self Function, based upon AAI transcripts, correlated significantly with infant security classification based on Strange Situation assessments. The philosophical background and clinical importance of the measure are discussed.
Theories of Theories of Mind brings together contributions by a distinguished international team of philosophers, psychologists, and primatologists, who between them address such questions as: what is it to understand the thoughts, feelings, and intentions of other people? How does such an understanding develop in the normal child? Why, unusually, does it fail to develop? And is any such mentalistic understanding shared by members of other species? The volume's four parts together offer a state of the art survey of the major topics in the theory-theory/simulationism debate within philosophy of mind, developmental psychology, the aetiology of autism and primatology. The volume will be of great interest to researchers and students in all areas interested in the 'theory of mind' debate.
In 3 experiments, children's comprehension of successive pretend actions was examined. In Experiment 1, children (25-38 months) watched 2 linked actions (e.g., a puppet poured pretend cereal or powder into a bowl, and then pretended to feed the contents of the bowl to a toy animal). Children realized that the pretend substance was incorporated into the second action. In Experiment 2, children (24-39 months) again watched 2 linked actions (e.g., a puppet poured pretend milk or powder into a container, and then pretended to tip the contents of the container over a toy animal). They realized that the animal would become ''milky'' or ''powdery.'' In Experiment 3, children (25-36 months) drew similar conclusions regarding a substitute rather than an imaginary entity. The results are discussed with reference to children's causal understanding, their capacity for talking about objects and events in terms of their make-believe and real status, and the processes underlying pretense comprehension.
A cross-sectional, correlational study of 30 children, 3 to 5 years old, investigated relations between their theory of mind development and social interaction, controlling for age and general language ability. Children's overall performance on 4 standard false belief tasks was associated with their production of joint proposals and explicit role assignments during a 10 minute session of pretend play, False belief task performance was not associated with the child's total amount of pretend play or with a measure of empathic concern. We discuss the significance of an association between a laboratory measure of theory of mind development and children's behaviour observed in a naturalistic setting. We argue that the description and explanation of children's theory of mind and social understanding is best pursued through the combined efforts of experimenters and ethologists.