By Dr Elaine Arnold

This article has been adapted from Dr. Elaine Arnold’s introductory presentation to 17th Annual Conference of Supporting Relationships and Families, formerly the Separation and Reunion Forum. More can be found out about SRF at its website at http://www.serefo.org.uk/index.html.

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SRF’s  decision, this year, to focus our conference on the health challenges for older people, has been influenced by wide media coverage of the rise in dementia amongst the ageing population. While considerable attention is being paid by scientists and medical practitioners to the onset and medical treatment of Dementia, rather less regard is given to the issues of emotional health and well being – not just for those with Dementia but for all adults as we age.

In societies such as ours in which public discourse still struggles to recognise the attachment needs of children, and which continues to undervalue older people, this comes as little surprise. Furthermore, within the field of Attachment research, the primary focus until recently has been on infants, children and their interactions with parents. And yet, as Bowlby made so clear, attachments matter to human beings of all ages, from the Cradle to the Grave.

Many of the key principles of Attachment theory apply across the life cycle. For example,

• Throughout life, we need proximity to those we trust and help us feel secure. For infants and children, especially, our psychological survival and brain development depend on the availability and responsiveness of others. But as we mature, we still seek the proximity of others for our sense of self, value and security.

• Unwanted separation and loss of our Attachment figures is a source of great pain and sorrow. (And reunion – a potential source of great joy!) Then, too, how we manage our experiences and feelings of separation and loss can vary by age, the quality of our social networks, and our emotional resources. Certainly, early Attachment security is one essential resource, whilst early and enduring Attachment anxieties can prolong our suffering.

• Unresolved Attachment anxieties in childhood and adolescence can generate ways of thinking and behaving, that give us an illusion of security BUT practically undermine our ability to get our Attachment needs met. These are our childhood survival strategies – our ‘neurotic solutions’, as Joan Woodward describes them – which we create to cope with anxious attachments (Woodward, 1988). As we mature, however, these strategies can hinder our lifelong ability to feel good about ourselves and to trust in the ‘thereness’ of others.

For older adults, these principles still apply – and perhaps more acutely so. For one thing, ageing necessarily entails many forms of loss. We might lose work (redundancy, retirement), housing, and community resources and relationships. In short – loss of social networks. These networks are so important, because they enable those intimate, meaningful interactions on which our sense of self and value often rely.

Ageing also entails unwanted separation from, and disruption of, social and emotional bonds – as family structures weaken, children move away, colleagues take jobs elsewhere. We may come to live our lives in growing isolation, especially in urban environments.

Of course, ageing necessary brings loss – through illness and death – of parents, partners, friends, colleagues, siblings and children. In this, we grieve the loss of loved ones – their physical and emotional presence. But, we must also mourn the collapse of those meanings through which we made sense of ourselves in the world. As Marris so richly described it, permanent loss challenges us to make sense of life in new ways – a painful process which, itself, depends on our connections with others (Marris, 1996).

As we age, we might also lose our sense of security – not just in our connections with others, but with our own bodies and minds. The emergence of chronic or acute illness, including Dementia, leaves us feeling vulnerable and insecure, as we may come to doubt our own capacity for selfhood and resilience. We may withdraw into ourselves, or demand the constant emotional care of others in order to feel safe. Or both.

Unfortunately, if we have carried unresolved Attachment anxieties throughout our lives, they might both heighten our need for others and undermine our conviction that our needs will be met. Such conflicts can be a torment to ourselves, and seem bizarre to those we rely on for help – family, friends, doctors, careworkers. We might wander corridors seeking parents long deceased, shout our rage against early childhood abuse, refuse nourishment and resist support. But what seems strange behaviour to others can make absolute sense to us, in light of those psychological strategies we developed to survive.

Early attachment security, however, can provide resources with which to cope. A good enough sense of self, an ability to trust, a positive attitude toward and engagement with others, and the steady cultivation of affectional bonds over a lifetime, can provide important protection against the traumas of loss.

As Bowlby argued,

Intimate attachments to other human beings are the hub around which a person’s   life revolves.  Not only when he is an infant, a toddler or a schoolchild but throughout his adolescence and his years of maturity as well and on unto old age.

(J. Bowlby, Attachment and Loss,1980, p.442).