Views & Reviews Medical Classics

The Making and Breaking of Affectional Bonds

BMJ 2009; 338 doi: (Published 04 February 2009) Cite this as: BMJ 2009;338:a3133
  1. Kate Robertson, staff grade psychiatrist, Ardenleigh Centre, Birmingham
  1. kate.robertson{at}

    Consisting of seven lectures that John Bowlby gave between 1956 and 1977, this book introduces and explores subjects that are still at the forefront of child and adolescent psychiatry today. It is impossible to overestimate Bowlby’s influence on subsequent psychiatric research and practice. The acknowledged “father of attachment theory,” he focused on child development, though his interests were far wider.

    A clear thinker with a dislike of jargon, he could quote Oscar Wilde (“Each man kills the thing he loves”), Shakespeare (“Give sorrow words”), or (rather alarmingly) George Bernard Shaw (“Never hit a child except in hot blood”). Bowlby had a mean turn of phrase himself and a surprisingly unblinkered view of childhood. Babies and young children are “selfish, jealous, sexy, dirty, and given to tempers, obstinacy, and greed,” although there is no doubt that he liked them anyway. His opinions were strong and direct: all research “is a gamble, and we have to put our money on the horses we happen to fancy”; “that punishment is efficient as a means of control I believe to be one of the great illusions of western civilization.” For his special field of study he chose the removal of children from their homes to residential nurseries or hospitals, believing that such action could have serious ill effects and that “preventive measures might be possible.”

    The first lecture lays out themes that are expanded in the following five and revisited and explored again in the last. Bowlby comes out as an early feminist (“Let us hope that as time goes on our society, still largely organised to suit men and fathers, will adjust itself to the needs of women and mothers”) and admits to a “cautiously optimistic view of human nature.” He considers the crucial roles of ambivalence and conflict and how humans regulate these, considers conflicting emotions as a normal state of affairs, and recognises the limitations of theory: “To the clinician the learning theorist seems always to be struggling to cram a gallon of obstreperous human nature into a pint pot of prim theory.”

    Through the lectures the seeds of future research can be seen sprouting from his reflections: lifespan and intergenerational approaches, ethology, loss and mourning, maternal separation, disturbed personality development, the secure base, exploration, trust, resilience, and the effects of anoxia at birth are all touched on as well as attachment itself. Bowlby wasn’t satisfied with food and sex as the conventional rationales for the development of affection, which he saw as an essential human need. In the last lecture he looks at therapy, both family and individual, and the role of the therapist: “Finally he must never forget that, plausible, even convincing, though his own surmises may seem to him . . . in the long term it is what the patient honestly believes thats must be accepted as final.”

    This book is a great introduction to a genuinely questioning thinker and theorist.


    Cite this as: BMJ 2009;338:a3133


    • The Making and Breaking of Affectional Bonds

    • By John Bowlby

    • First published 1979

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