The American contribution to attachment theory: John Bowlby’s WHO trip to the USA in 1950 and the development of his ideas on separation and attachment

ABSTRACT

This paper explores John Bowlby’s foundational contributions to attachment theory, particularly his fascination with ‘separation’ and its impact on child development. Tracing the origins of Bowlby’s interest to his personal experiences and his exposure to ideas of mental hygiene and child guidance in the 1930s, it underscores the alignment of his ideas with key figures in the English school of psychoanalysis. The central narrative of this paper unfolds during Bowlby’s 1950 WHO research trip, investigating orphaned and separated children in Europe and the USA. Utilizing archival materials from the Wellcome Library in London, the authors offer unique insights into Bowlby’s journey, highlighting his evolving views on mother-child separation through interactions with his American colleagues. This comprehensive exploration sheds light on Bowlby’s pioneering work, emphasizing the American influence on his ideas, and the evolving theoretical framework that continues to shape our understanding of child development and attachment today.

KEYWORDS:

• Separation
• attachment theory
• WHO
• maternal deprivation
• mental hygiene
• child guidance

Introduction

Attachment theory, developed by British child psychiatrist and psychoanalyst John Bowlby (1907–1990) and Canadian-American psychologist Mary Ainsworth (1913–1999), has revolutionized current day understanding of the bond between children and their primary caregivers. Central to attachment theory is the notion that a continuous, affectionate relationship is essential for healthy child development. One significant aspect of Bowlby’s work focused on the effects of “separation” from primary caregivers on children’s emotional and psychological well-being. Bowlby (1952) argued that the quality of parental care has a significant impact on mental development: “essential for mental health is that the infant and young child should experience a warm, intimate, and continuous relationship with his mother (or permanent mother-substitute) in which both find satisfaction and enjoyment” (p. 11). If this was not the case, it would result in (partial) maternal deprivation. Complete deprivation, in particular, had “even more far-reaching effects on character development and may entirely cripple the capacity to make relationships” (p. 12). Bowlby first elaborated on the developmental effects of separation in his report for the World Health Organization (WHO), from which the above quotes originate. Separation had by then been on his mind for decades and he himself confessed to having “a rather one-track, one-problem mind” (Tanner & Inhelder, 1971; cf., p. 27; Van der Horst & Van der Veer, 2010). Separation would later become part of the core of attachment theory (Diamond & Keefe, 2024).

Bowlby’s fascination with “separation” has been traced back to his own childhood, which was marked by painful separations (Van der Horst, 2011; Van Dijken, 1998), and to his professional interactions in interwar psychiatry in Britain in the 1930s (Polat, 2021). Elsewhere, we have also shown that Bowlby’s basic notion that separation from caregivers early in life may jeopardize child development was much in line with ideas of leading members within the English school of psychoanalysis, such as Ronald Fairbairn (1889-1964), Donald Winnicott (1896–1971), Henry Dicks (1900–1977), and Ian Suttie (1889-1935) (Van der Horst & Van der Veer, 2010). Contrary to prevailing ideas in orthodox psychoanalysis and behaviorism, Bowlby and others believed that the “need for love” may actually be primal, anticipating Bowlby’s later emphasis on the evolutionary basis of the mother-child relationship.

In this paper, we aim to describe how Bowlby spread his ideas on the alleged pathological effects of parent-child separation in the New World and at the same time tried to buttress them with new research findings during his research trip for the WHO in 1950. For this WHO assignment Bowlby first travelled through Europe (for a detailed report, see Van der Horst et al., 2020) and then to the USA to study the needs of children who were orphaned, or separated from their families for other reasons, and needed care in foster homes or institutions. The resulting report (Bowlby, 1951, 1952) is generally considered a landmark publication in psychology, although it subsequently met with methodological criticism (M. D. Ainsworth et al., 1962; Rutter, 1972). By partially reconstructing Bowlby’s visit to the USA, and critically analyzing the WHO report, we will shed light on Bowlby’s encounter with the American psychiatry and psychology of that time and get a clearer understanding of the origins of the WHO report and of the part American research played in the development of Bowlby’s ideas on separation and attachment. In doing so, we highlight the underestimated American contribution to what was initially considered a “British theory” (Newcombe & Lerner, 1982).

Our reconstruction is in part based on archival materials from the Wellcome Library in London, where Bowlby’s personal papers are kept. We make use of Bowlby’s notebooks (AMWL: PP/BOW/D.4/8), which contain careful notes about the people he met during his trip, their studies of potential interest, and short sections on their personal opinions and impressions. Additionally, we use the more detailed reports, dictated by Bowlby and subsequently sent to Noel Hunnybun, a senior psychiatric social worker at the Tavistock Clinic in London, for further distribution (AMWL: PP/BOW/B.1/12). Finally, we draw on Bowlby’s personal correspondence with his wife Ursula Bowlby, who showed a strong involvement in his work (cf. Kahr, 2016). But before we turn to the analysis of the USA part of Bowlby’s WHO trip and the subsequent report, we will pay attention to some important developments in interwar psychiatry and describe how Bowlby became increasingly focused on “separation,” which subsequently developed into an all-encompassing theme in attachment theory.

Interwar psychiatry in Britain: mental hygiene, child guidance, psychoanalysis

At the end of the 19th century, Europe and the United States witnessed significant improvements in public health and a rapid decline in infant and child mortality rates, thanks in part to increasing medical knowledge, better (public) hygiene, and the advent of well-baby clinics. This led to the belief that similar progress might be possible for the development of mind. The new emphasis on mental sanity led to the Mental Hygiene Movement, started in 1908 in Connecticut, expanded to Canada in 1918 (Pols, 2001, 2002; Richardson, 1989), and spreading through Europe in the 1920s. This movement brought forward the idea that inadequate emotional adjustment during infancy and childhood could affect (later) mental health and aimed at promoting adequate child socialization. It sought to achieve this by starting prevention efforts as early as possible, preferably in infancy (Bridges, 1928). The movement thrived in the Interwar period and the inaugural International Congress in Washington D.C. in 1930 attracted representatives from over 50 countries (Richardson, 1989).

One of the results of the emphasis laid on children’s healthy mental development by the Mental Hygiene Movement was the establishment of so-called Child Guidance Clinics. These clinics, originally an American phenomenon introduced to Britain by Sir Cyril Burt (1883-1971) (Hearnshaw, 1979), provided treatment for “difficult” children through multidisciplinary teams comprising a psychiatrist, psychologist, and social worker. The prevailing belief at these clinics, particularly among social workers, was that children’s issues could stem from inadequate parental relationships, with unresolved parental conflicts from childhood potentially contributing to or perpetuating their children’s problems (Stewart, 2011). Like the Mental Hygiene Movement, the Child Guidance Clinics spread from the United States to the United Kingdom in the 1920s.Bowlby later acknowledged that he gained invaluable insights from working with these social workers, surpassing what he learned from his psychiatric colleagues (Senn, 1977; Smuts, 1977).

In the opposite direction, psychoanalysis emerged in Europe in the early 20th century and gradually conquered Canadian and American psychiatry and psychology, with Sigmund Freud attributing adult psychological problems to real or imagined events that had taken place during childhood (Freud, 1920). Newcombe and Lerner (1982) argue that Freud’s work was received in scientific circles in Britain by two distinct currents: the “eclectics” and the “orthodox.” The eclectics embraced Freudian concepts like unconscious motivation and repression but rejected the notion of infantile sexual trauma, evolving into a school centered around the Tavistock Clinic. They diverged from orthodox Freudians on the basis of their experience with the treatment of war trauma, which suggested that the phenomenon of “shell shock” couldn’t always be linked to unresolved childhood conflicts. This led to alternative explanations, such as W. H. R. Rivers’ (1862–1922) theory of self-preservation conflicting with duty. The orthodox Freudians, including Freud himself, also struggled to explain shell shock, leading to concepts like “repetition compulsion” and the “death instinct.” Interestingly, Bowlby initially aligned with the orthodox group but later shifted towards the eclectic approach of the Tavistock Clinic (Van der Horst & Van der Veer, 2010).

The combined influence of clinical work done at the Child Guidance Clinics, various brands of psychoanalytic theory and also American behaviorism (with its idea that “good habits” can be conditioned in any child regardless of his or her penchants or abilities) (Watson, 1928), led to a strong belief in the formative and lasting influence of early upbringing (Kagan, 1998). Perhaps more than ever before, it was believed that parents are responsible for their children’s mental development. Given the fact that mothers were seen as the ones who should shoulder the burden of children’s upbringing (Bird, 1997), mothers were often being seen as the cause of how children would turn out later in life (e.g. Friedlander, 1947; Hulbert, 2003; Thom, 1927). It was against this background that Bowlby developed his ideas on mother-child separation as a causative factor in maladaptation, a theme that also resonated with his own personal experience.

Separation as a theme in Bowlby’s early life and work

John Bowlby was the fourth of six children in an affluent upper middle class Victorian family. As was customary in the upper echelons of English society at the time, the Bowlby children were raised by a governess and had only limited contact with their parents. The daily care of young John was entrusted to his favorite nanny Minnie, who left the family when John was only four years old (Van Dijken, 1998). When Bowlby (1958) later stated that “for a child to be looked after entirely by a loving nanny and then for her to leave when he is two or three, or even four or five, can be almost as tragic as the loss of a mother” (p. 7), he may have well had his own separation from Minnie in mind. Furthermore, the Bowlby children initially received private lessons at home, but at the age of ten John was sent to boarding school (Hunter, 1991), a place he later described as one “he would not send a dog to … at that age” (Van Dijken, 1998, p. 34). These painful events, which Bowlby later said had “sufficiently hurt but not sufficiently damaged” (p. 11) him may have paved the way for Bowlby’s later adoption of the idea of maternal deprivation and separation as causative factors in child development, an idea that he also came across during his formative years at university and while working at the London Child Guidance Clinic.

From 1925, Bowlby studied medicine and psychology at Cambridge and London. During his studies, he volunteered for a year at two so-called “progressive schools,” institutions strongly influenced by the psychoanalytic ideas which at the time dominated psychological theory. At one of these progressive schools, Bowlby encountered several “affectionless characters” among difficult-to-manage and behaviorally maladjusted children – children who seemed unable to form emotional bonds with others. Bowlby’s colleagues pointed out that quite a few of these children began displaying deviant behavior after they had been abandoned by their primary caregivers. This episode, combined with his own childhood experiences, convinced Bowlby of the potential detrimental effects of mother-child separation and it became a significant theme in his subsequent professional career. Moreover, it had a profound impact on his decision to combine his medical studies with psychoanalytic training.

In the societal context of his time, Bowlby delved into psychoanalysis while maintaining his medical career. Between 1933 and 1935, he served as a clinical assistant at the Maudsley Hospital under Australian-born psychiatrist Aubrey Lewis (1900–1975), a firm critic of psychoanalytic methods. From 1934 to 1938, Bowlby worked part-time at the Institute for the Scientific Treatment of Delinquency, where the emphasis was on addressing mental issues as the cause of juvenile delinquency. He also joined the London Child Guidance Clinic, where he encountered cases of children with psychopathic traits linked to early separations from their mothers. Bowlby pursued doctoral studies at University College London under Sir Cyril Burt’s formal supervision (Van der Horst, 2011). Although he did not complete his PhD, his association with Burt was notable, as Burt was central to the dissemination of the child guidance perspective in Britain (see above). Bowlby shared Burt’s belief that “nearly every tragedy of crime is in its origin a drama of domestic life” (Van der Horst & Van der Veer, 2010). All in all, at these different treatment institutions, Bowlby became familiar with the institutional innovation set to prevent juvenile delinquency and promote mental hygiene (Polat, 2021). More importantly, his clinical understanding of the significance of early life experiences was shaped by the child guidance practices of the time.

Bowlby’s work at these institutions, which embraced psychoanalytic therapy, but not its orthodox form (see Newcombe & Lerner, 1982; Polat, 2021; Van der Horst & Van der Veer, 2010), ran parallel to his more traditional psychoanalytic training within the British Psycho-Analytical Society. Between 1929 and 1937, Bowlby underwent psychoanalytic training at the Institute of Psychoanalysis. During his training, Bowlby received supervision from Melanie Klein (1882–1960), a very prominent figure in the psychoanalytic world at that time. However, Klein and Bowlby held distinctly different views on the cause of “mental disorders” presented by children. Klein believed these disorders were the result of unconscious fantasies from childhood, while Bowlby argued that emotional disturbances were clearly linked to actual events in a child’s life. He was convinced that real-life experiences, rather than solely the imaginings of the childish mind, were crucial in understanding and treating psychological issues. In his inaugural address to the British Psycho-Analytical Society, Bowlby (1940) drew attention to these early experiences, suggesting that separation from the mother during the first three years could lead to emotionally withdrawn and affectionless behavior in later life. Bowlby’s dissenting opinion brought him into conflict with leading figures in British psychoanalysis, including Klein and Anna Freud (1895–1982). Nonetheless, Bowlby maintained an independent course while remaining an active member of the psychoanalytic community. His line of thought concerning the value of real-life experiences evolved in the “English school” of object relations. This school within the larger psychoanalytic movement emphasized the importance of a primitive need for security and professed the belief “that a child begins life completely helpless and dependent, and that it responds with every expression of terror to … loss of mother” (Dicks, 1939, p. 20) and therefore has “a tendency to seek love and security as such” (p. 90). From 1940, Bowlby worked as a psychiatrist in the British army, and after the war, he joined the London Tavistock Clinic, where the ideology of the English school predominated, and where he remained for the rest of his professional life.

As Bowlby sought to explain the strong relation between young children and their mothers or primary caregivers, separation became a recurring theme in his work. From the 1930s onward, he conducted research on the consequences of separation and maternal loss on the development of young children. Interestingly, his involvement went beyond pure research; Bowlby was socially engaged as well. He protested, for example, against the evacuation of young children at the beginning of World War II (Bowlby et al., 1939). Due to ongoing German bombings in the London area, nearly 750,000 children were evacuated to the countryside without their parents, resulting in various emotional problems. Bowlby also advocated, along with others, for a drastic change in the then very limited opportunities for parents to visit their hospitalized children (Van der Horst & Van der Veer, 2009).

Bowlby (1944) published the initial findings of a retrospective study on the deviant behavior of 44 “thieves” treated by him and his colleagues at the London Child Guidance Clinic between 1936 and 1939. He compared these 44 delinquent youths with a control group of 44 children treated in the same clinic for emotional problems but not exhibiting criminal behavior. He found that more than half of the delinquent youths had experienced temporary separation from their mothers at a young age. Bowlby hypothesized that as a result, these children failed to develop emotional or “libidinal ties” (p. 158) with others and suffered from “affectionless” behavior (i.e. stealing).

In 1950, Bowlby’s study on the consequences of separation and deprivation led to his WHO assignment to investigate the “mental health of homeless children,” a significantly large group in the post-war era. Bowlby first consulted the available literature and subsequently visited prominent figures in child and adolescent psychiatry in Switzerland, France, the Netherlands, Sweden, and the United States. Not surprisingly, in his final report he concluded that “there is now sufficient evidence for the damaging and far-reaching effects of prolonged separation of young children from maternal care on their character formation and thus on their future life” (Bowlby, 1952, p. 46). This statement was completely in line with ideas about maternal deprivation that belonged to an “epistemological trend in interwar psychiatry” (Polat, 2021). The WHO report itself was a milestone, not only for psychiatry and psychology as scientific disciplines which extensively documented the detrimental effects of separation experiences for the first time, but also for Bowlby personally. He had been making a huge effort since the 1930s to describe and understand the phenomena he observed in clinical practice, yet he still lacked what he considered an adequate theoretical explanation. Bowlby would later testify that “those five months [he] worked for World Health were very crucial ones for [him],” as he now had the opportunity to “g[e]t to know a lot of people … a chance to read up the literature which [he] had not been able to do before and … to put [his] ideas together on paper” (Senn, 1977, p. 18). His encounter with American psychiatry during the second part of his WHO trip turned out to be of great value in shaping these ideas.

Bowlby meets American psychiatry

Bowlby, having developed his ideas against the background of psychoanalysis, mental hygiene and child guidance for twenty years, was rather disappointed with what he found during his meetings with European experts in the field of child development during the first part of his WHO trip in 1950, the story of which we related in a previous study (Van der Horst et al., 2020). He started his European trip at the WHO headquarters in Geneva, and then followed on to France, The Netherlands, and Sweden. In France, he spoke with orthodox psychoanalysts whose work he opted to neglect in his final report. In The Netherlands, he met with people who shared his views but couldn’t provide him with scientific research data. In Sweden, he was confronted with a much broader social view on the origin of and remedy for homeless children, which he chose to ignore. From the start, Bowlby had seemed somewhat skeptical about the possible results of his European research trip and he feared he might end up wasting his time with “pretty stupid” colleagues. In fact, we questioned whether Bowlby’s trip was an open-minded search for new scientific data regarding homeless children and suggested he might simply have been looking for confirmation of his firm conviction that the child’s separation from his mother was the cause of all problems. For Bowlby, the European part of the WHO trip seemed first and foremost an excellent opportunity to find research data that confirmed his views and to spread his ideas. However, at that time the majority of research on homeless children, separation, adoption, etc., was being done on the other side of the Atlantic. So, it must have been with some anticipation that Bowlby boarded a Boeing 377 Stratocruiser at Heathrow Airport on Sunday 5 March 1950, to start his transatlantic trip.

Bowlby’s itinerary

When Bowlby landed at New York International airport on 6 March 1950, he knew that a very busy period lay ahead of him. It was a cramped schedule, indeed: in slightly more than a month he would visit eight cities, have dozens of meetings, and discuss research and policy with more than 75 people. During these meetings he took minutes in his notebooks and during what remained of his time he read scientific papers, dictated summaries of his findings into a dictaphone, and wrote letters to his wife. Bowlby travelled well prepared. Although he still had to phone and write people to make appointments, he knew most of the relevant researchers and their specialties and had read part of their writings in advance. In fact, he took pride in having a thorough knowledge of American research and wrote in a letter to his wife Ursula:

I know almost as much about what is going on in the States as any informants over here. They are all pretty impressed by my familiarity with research activities and continue to confirm that I am seeing all the right people. (Bowlby in a letter to Ursula, March 10, 1950)

Travelling by plane, train, bus, and taxi, Bowlby remained primarily in the eastern part of the US and visited Washington, Philadelphia, New York, New Haven, Boston, Chicago, Ann Arbor, and Ithaca (see Figure 1).

Figure 1. Bowlby’s itinerary from March 5 to April 7, 1950.

It is not entirely clear how the selection of the researchers Bowlby met was made but it is certain that he received help from colleagues in both Geneva and London. In his preface to the WHO report Bowlby (1952, p. 7) mentions, among others, Ronald Hargreaves “for his help in planning the visits and discovering the literature,” his research assistant Philippe Kocher “for abstracting many papers and books,” and Eric Trist of the Tavistock Institute of Human Relations “who has also taken part in the planning of this project” (cf. Van der Horst et al., 2020). Naturally, not all of Bowlby’s meetings were organized in advance; he also ran into people whom he hadn’t planned to meet. Moreover, he also met colleagues whose relevance for his purpose (i.e. finding evidence for his maternal deprivation hypothesis) wasn’t always immediately apparent. But in retrospect, some of these more accidental meetings were quite remarkable and we will discuss a few of them before turning to the research that was more pertinent to Bowlby’s central hypothesis and found its way into the WHO report.

On March 21, for example, travelling by train from New York to Boston, Bowlby visited Yale University in New Haven and met with Arnold Gesell (1880–1961), the former director of the Yale Clinic of Child Development, and famous for his developmental schedules and childrearing guides. Bowlby noted that Gesell was “nowhere loved,” which he considered “a pity since he has done valuable work” (Bowlby in a letter to Noel Hunnybun, 29 March 1950). The two men agreed that maternal deprivation was harmful in general but contrary to Bowlby’s conviction Gesell drew “attention to the fact that a few children do not succumb” (AMWL: PP/BOW/D.4/8, Bowlby’s notebook “USA 1”). Later that day, in New Haven, Bowlby met Neil Miller (1909–2002), an expert on learning theory interested in Freudian theory (see below), whom he would meet again one week later in Chicago. Present during their second meeting was also “a young man called Gewirtz” (Bowlby in a letter to Noel Hunnybun, 29 March 1950). Bowlby wasn’t very pleased with Gewirtz’ rigorous behavioral modification approach:

Once again, I ran into the anti-clinical attitude … If only we could combine our own clinical insights with their research skills, we should be pretty hot! (Bowlby in a letter to Noel Hunnybun, March 29, 1950)

Little did Bowlby expect, of course, that the same Jack Gewirtz (1924–2021) would become engaged in a fierce methodological debate with Bowlby’s later close ally Mary Ainsworth more than 25 years later (M. D. S. Ainsworth & Bell, 1977; Bell & Ainsworth, 1972; Gewirtz & Boyd, 1977a, 1977b; cf.; Van Rosmalen et al., 2024).

The next day, on March 22, while visiting the Department of Social Relations at Harvard University in Boston, Bowlby spoke with the sociologist Talcott Parsons (1902-1979), who co-founded and chaired the Department and had a strong interest in Freudian theory, and the child psychologist Robert Sears (1908–1989). Sears and his colleagues John Dollard (1900–1980), Clark Hull (1884–1952), and Neil Miller tried to translate Freudian concepts into stimulus-response formulations. Sears was especially interested in the way children internalize values and attitudes of their parents (i.e. Freud’s super-ego) and how they learn to identify with and imitate their mothers (i.e. develop dependency) using concepts like “drive reduction” and “secondary reinforcement” (Grusec, 1992). Bowlby noted that he was impressed by the empirical work done by Sears and his wife Pauline.

The Sears have just completed the collection of data on a sample of 45 nursery school children (done at Iowa) and are beginning its analysis. It is concerned with the children’s parental relations, their school behaviour and projection material obtained in play. There is a great deal of interesting material regarding identification, overt and repressed hostility and so on, which I believe to be crucial for an understanding of personality development. Since it is carried out with a high degree of competence it will be most valuable. We have much to learn from this party and it would be a good thing if Mary Flanders and Jimmy [Robertson] were to spend some time there. (Bowlby in a letter to Jock Sutherland, March 25, 1950)

That same day Bowlby had dinner with Henry Murray (1893–1988), co-developer of the Thematic Apperception Test, the behaviorist Edward Tolman (1886–1959), who coined such concepts as “latent learning” and the “cognitive map,” and Jerome Bruner (1915–2016) on his way to become cognitive psychologist. It was, in his view …

as enjoyable an evening as I’ve ever spent. Tolman … is wholly delightful—modest, amusing, and kindly: he is universally admired and loved. Bruner is also a most likable chap and most stimulating. He is working on personality distortions of perception which is highly relevant to our separation studies. (Bowlby in a letter to Jock Sutherland, March 25, 1950)

On March 25, Bowlby again met Bruner and enjoyed an hour’s talk with him. He was impressed by his study on perception and its distortion by emotion and personality factors.

The programme seemed to me well-designed and relevant. The last two numbers of the Journal of Personality (Bruner & Postman, 1949b, 1949b) with which they furnished me are of the greatest interest in this connection. In studying this stuff and in my discussions with Bruner I feel on the track of a number of things which may help us to understand the psychological effects of separation. (Bowlby in a letter to Jock Sutherland, March 25, 1950)

Finally, in Ithaca, on April 4 and 5, Bowlby had two meetings with Urie Bronfenbrenner (1917-2005), the later author of ecological systems theory, and his research team. At the time Bronfenbrenner was assistant professor at Cornell University studying the social forces on child development. Unfortunately, we do not know what they discussed.

But Bowlby didn’t just talk with fellow researchers. He also managed to see several people of funding agencies (the Milbank Memorial Fund, the Commonwealth Fund, the Rockefeller Foundation, and the Josiah Macey Foundation), he met a few personal acquaintances, and, finally, he did a tiny bit of sightseeing, primarily by strolling around in the cities he visited. On just two occasions he found the time for a touristic activity: in New York he visited the Empire State Building and in Boston he attended a skating show.

This brief overview of Bowlby’s trip shows that Bowlby met with a wide variety of people: not just researchers who could provide him with direct evidence of the supposed effects of maternal deprivation but also learning theorists and other people with an interest in dynamic theory (e.g. Miller, Parsons, Sears), authorities on child development (e.g. Gesell), young rising stars (Bronfenbrenner, Bruner, Gewirtz), people from funding agencies, and acquaintances. In what follows, we will discuss Bowlby’s meetings with researchers who more directly influenced the WHO report and its central hypothesis that it is primarily maternal deprivation that wreaks havoc in child development.

Meeting the American researchers who contributed to the WHO report

As described in the WHO report itself, Bowlby’s (1952) argumentation in Maternal Care and Mental Health is best divided into two separate parts. In the first part, titled “Adverse effects of maternal deprivation,” Bowlby aims to elucidate the causes or etiology of child psychopathological behavior and delineates the consequences and repercussions of deprivation. In the second part, titled “Prevention of maternal deprivation,” Bowlby provides an overview of potential remedies to prevent and treat maternal deprivation. The American researchers and clinicians, psychologists, psychiatrists, social workers, and policy makers with whom Bowlby met in March and April of 1950, have all contributed to various conclusions drawn in the report that was widely distributed and discussed in the years that followed. It became an international success, receiving many favorable reviews, and was translated into 12 languages (see Van der Horst et al., 2020). Also, the abridged paperback version Child care and the growth of love (Bowlby, 1953) sold nearly half a million copies (Holmes, 1993; Karen, 1994).

Adverse effects of maternal deprivation

One of the principal American pediatricians of that period was Harry Bakwin (1894–1973), who had published one of the most renowned papers on “loneliness in infants” (Bakwin, 1942) in the previous decade. Yet, from Bowlby’s personal notes it becomes clear that he did not share Bakwin’s conservative political views¹ and resisted his baiting and provocative approach (cf. Isenberg, 2010). Therefore, it was with some hesitation that Bowlby accepted an invitation to attend a “large dinner party” on March 17 at Bakwin’s home² in New York. Despite his reservations Bowlby “accepted with all the outward signs of eagerness, but made a stern resolve to avoid politics [and] all things controversial. Mercifully it was quite a large dinner party at which [he] met some nice [and] intelligent people, some of whom [also] regarded Bakwin as being reactionary.” Although meeting Bakwin did not offer any new insights, in the WHO report Bowlby made ample use of Bakwin’s earlier findings.

In his landmark publication on deprivation, Bakwin (1942) had described the care of small children in New York’s Bellevue Hospital. To reduce the high mortality rate, attributed to malnutrition and infection, “the open ward (…) ha[d] been replaced by small, cubicled rooms in which masked, hooded and scrubbed nurses and physicians move[d] about cautiously so as to not stir up bacteria” (p. 31). To everyone’s astonishment, the high mortality persisted, and the children only began to gain weight after their return home, despite being on a high-caloric diet. Bakwin presumed that the “psychologic neglect” (p. 32) they endured, the total lack of emotional warmth, and the sterile environment in the wards were damaging to the children. After a change in hospital protocols at Bellevue, nurses were actively encouraged to mother and cuddle the children, embracing opportunities to hold and engage in playful interactions with them. Moreover, parents were invited to visit their infants, which was not a very common practice in children’s wards at the time (see Van der Horst & Van der Veer, 2009). The outcomes of this policy adjustment were striking. Despite the heightened risk of infection, the mortality rate among infants below one year of age showed a substantial decline, plummeting from 30–35% to less than 10%. For Bakwin, as for Bowlby, this was clear evidence for the adverse effects of deprivation on physical health. Similar findings, which Bowlby referred to as “studies by direct observation,” had also been documented by psychoanalyst Margaret Ribble (1890–1971) and psychiatrist David Levy (1892–1977), but Bowlby failed to get in touch with them personally when he was in New York. Bowlby reported to his colleagues in London that after failing to get in touch with Ribble at the start of his trip, he made no further attempts, since her “reputation [in New York] is low and I’m afraid we shall have to revise our views.” Apparently, it was “widely recognised that [Ribble] ha[d] no data and never had any but casual clinical impressions.” Given Bowlby’s interest in scientific data to support clinical work, it is no surprise he was disappointed. With regard to Levy, Bowlby thought “he move[d] too quickly from one item to another ever to want to work anything out.” A meeting with Levy, too, never materialized. Bowlby nevertheless used the work of both Ribble and Levy to support his claims of the ill-effects of deprivation in the final report.

Another “big fish” Bowlby probably wanted to catch during his stay was psychoanalyst and psychiatrist René Spitz (1887–1974). Spitz had worked with Katherine Wolff on the issue of sterile children’s wards in Austria before he fled to the USA. There, Spitz documented the effects of continuous institutional care of infants under one year of age by comparing children in a nursery to children in a foundling home, in both motion pictures (Spitz, 1947, 1952) and scientific studies. Based on observations in these settings, Spitz (1945, 1946) concluded that infants need affective interactions with a mother (or mother substitute) for a healthy physical and behavioral development to take place and that their absence may result in serious consequences for the development of the personality of the child. Spitz’s was the first to coin the term “hospitalism” which he described as “a vitiated condition of the body to long confinement in a hospital, or the morbid condition of the atmosphere of a hospital” (Spitz, 1945, p. 53). On March 13, Bowlby met with Spitz in New York over dinner and mentioned in his notebook that “Spitz ceased his observations a year ago and is busy writing his stuff up. He seems to have a lot of papers on hand but is evidently not going to do any further observation.” A few weeks later, after visiting Yale, New Haven, where Spitz’s former co-worker and child psychologist Katherine Wolf (1907–1957) was now located, Bowlby expressed his reservations about Spitz: “Wolf has been very largely responsible for all Spitz’s work, but her modesty combined with his showmanship has led him to get all the credit.” Although Bowlby was critical of Spitz (see also Van der Horst et al., 2019), stating that he felt he (Bowlby) and his colleagues might “have to be a little careful about giving [Spitz] a preview of [their] ideas,” he referred to Spitz’s work in the WHO report on several occasions. In particular, Spitz’s (or Wolf’s) direct observations were important evidence for the effects of deprivation on emotional and cognitive development.

In this part of the report, Bowlby also referred to the work of Gesell and Amatruda, who had documented the order of appearance of the adverse reactions in institution infants (such as diminished interest and activity, excessive preoccupation with strange persons, and blandness of facial expressions). Bowlby also reported on the work of Harriet Rheingold (1908–2000), although he did not personally meet her during his stay. Rheingold had studied children awaiting adoption and being cared for by foster-mothers, with and without other young children. The children receiving “all the foster-mother’s attention were on the average accelerated in development” (Bowlby, 1952, p. 18).

Another source of evidence Bowlby presented to support his claims regarding adverse effects of maternal deprivation were so-called “retrospective studies.” In this context, Bowlby mentioned the work of child neuropsychiatrist Lauretta Bender (1897–1987), who at the time was head of the children’s psychiatric service at Bellevue Hospital. In his notes, Bowlby characterized her as “a dogmatic bossy little woman” with a “lack of insight.” On March 15, Bowlby joined her at a case conference in which “diagnosis tended to follow her interest” in “childhood schizophrenia,” a diagnosis that would nowadays be called autism. Bowlby was clearly not impressed by Bender, but he did cite her work in the WHO report insofar as it confirmed his own findings. Bender had reported on a syndrome that she termed “psychopathic behavior disorder in childhood.” Children with this syndrome had “an inability to love or feel guilty” and were very similar to the affectionless thieves that Bowlby (1944) had described in his own work. Like Bowlby, Bender concluded that there was “a specific connexion between prolonged deprivation in the early years and the development of an affectionless psychopathic character” (pp. 34–35).

More retrospective evidence came from Bowlby’s visit to the Jewish Board of Guardians, where he spent a whole day on March 13 and had several conversations, one of them with director Hershell Alt (1897–1981) and another with superintendent and psychiatric social worker Norman V. Lourie (1912–2003) of the Hawthorne-Cedar Knolls school. This residential school provided care for “nearly 200 boys and girls between 8–18 years old, many of them exceedingly difficult cases – affectionless thieves by the dozen” who lived in “12 cottages with up to 16+ children.” At Hawthorne, social workers investigated “child histories and childhood histories of their parents.” Although the institution was “too big,” Bowlby was “very favourably impressed.” He considered Lourie to be Bruno “Bettelheim’s counterpart,” who at the time worked at the Orthogenic School for the training of social workers (Pollak, 1997; Van Rosmalen et al., 2020).

Although Bowlby valued the evidence from these direct observations and retrospective studies, he was also critical about their conclusiveness: “conclusions [of direct studies] must for the present be regarded as tentative” (Bowlby, 1952, p. 29) and an “objection to … retrospective studies is … that they are concerned only with children who have developed adversely, and fail to take account of those who may have had the same experience but have developed normally” (pp. 32–33). For Bowlby, “of special value” were “follow-up studies,” studies that “take a group of children institutionalized in infancy and seek to determine how they have developed” (p. 36), which he strategically presented after the direct observations and retrospective studies. This section on “follow-up studies” almost exclusively relied on William Goldfarb’s (1915–1995) work of “outstanding quality” (p. 36).

Bowlby had two meetings with Goldfarb, one with him and his wife at their house on Riverside Drive in Upper Manhattan on March 11 and one on March 14. The meetings were particularly fruitful and his impression of Goldfarb positive:

Goldfarb is the real bright spot here, though for the past four years he has been in “retirement” studying medicine. He is a delightful young man of 35, modest, sensitive and intelligent, married to a P[sychiatric] S[ocial] W[orker] and with a boy of nine and a brand-new baby daughter. I had coffee with them a week ago and entertained him to dinner on Tuesday. His work is not widely known, but he is highly regarded in discriminating quarters. Personally, he seems to be liked and respected. His studies seem to have been carried out between 1940–46 off his own bat, and in his spare time, whilst acting as psychologist to an Agency. He has done nothing for the past four years, though he has a great deal of interesting material, including case histories, still unpublished. I raised with him the possibility of his coming over to the Tavi for 12 months on a Fulbright, to work with us and write his stuff up into a coherent monograph. He was greatly attracted by the idea and is thinking it over seriously. October 1951 is the earliest he could make as he has to complete a medical internship. He wants to become a psychiatrist and is already in training in psychoanalysis. Though it is impossible to judge his ultimate ceiling, there is no doubt about his quality. I was amused to find that none of the Foundation[s] know about Goldfarb, and I had considerable pleasure in drawing to their attention a fellow New Yorker, of whom they took due note. (Bowlby in a letter to Noel Hunnybun, 19 March 1950)

In nine publications on the care of children in foster homes in New York, Goldfarb (1943d, 1943a, 1943c, 1943d, 1944, 1945a, 1945b, 1947, 1949) compared the prevalence of “aggressive behavior disorders” (Goldfarb, 1943d, p. 250) in foster children with experience in institutions in the first three years of life to the behavior of foster children without such experiences. Goldfarb hypothesized that in the “institution group” these behavior disorders were more likely to be found than in the “foster home group.” The conditions in the institutions were like those described by Bakwin:

The children (…) had (…) been cared for in an institution with (…) an outstanding programme of medical prevention. Babies (…) were each kept in their own little cubicles to prevent the spread of epidemic infection. Their only contacts with adults occurred during those few hurried moments when they were dressed, changed, or fed by the nurses. These nurses had neither training nor time and resources to offer love and attention to a large group of babies. (…) [A]lmost complete social isolation during th[e] first year of life, (…) and [an] only slight enrichment of experiences that followed in the next two years. (Goldfarb, 1947, p. 456)

Goldfarb (1943a, p. 127) noted that the institutionalized children had “an exceedingly impoverished, meagre, undifferentiated personality with related deficiency in inhibition and control” and a “passivity or apathy of personality.” In the explanation of his findings, Goldfarb laid special emphasis on three main features in the institutions: 1) absence of stimulation, 2) absence of psychological interaction and reciprocal relation with adults, and 3) absence of normal identifications. The sterile climate in which the children lived, apparently had major consequences for later social interaction and Goldfarb concluded that a healthy interaction between children and their caregivers was of the utmost importance.

In the WHO report, Bowlby extensively quoted Goldfarb to bring home his message of the negative and permanent consequences of deprivation for future personality development, a message that “will by now be familiar to the reader” (p. 39). He underlined Goldfarb’s (1949, p. 625) conclusion that “the institution children present a history of aggressive distractible, uncontrolled behavior. Normal patterns of anxiety and self-inhibition are not developed. Human identifications are limited, and relationships are weak and easily broken … ” and Goldfarb’s (1943b, p. 128) statement that “the fact that the personality distortions caused by the earlier deprivation are not overcome by later community and family experience must be stressed. There is a continuity of essential traits as late as adolescence. If anything, there is a growing inaccessibility of change.”

The “direct observations” of Bakwin, Ribble, Levy, Spitz and Wolff, and Rheingold, the “retrospective evidence” of Bender, and Lourie at the Hawthorne-Cedar Knolls School, and the “follow-up studies” by Goldfarb, together with the evidence Bowlby had collected in Europe (see Van der Horst et al., 2020), make up the argument in the first part of Bowlby’s monograph. Bowlby concluded “that the prolonged deprivation of the young child of maternal care may have grave and far-reaching effects on his character and so on the whole of his future life” (p. 46). Bowlby acknowledged that “relatively few studies taken by themselves are more than suggestive. But when all the evidence is fitted together it is seen to be remarkably consistent and this, taken with the considered opinions of experienced child-guidance workers in many different countries, leaves no doubt that the main proposition is true” (p. 46). Bowlby himself was convinced of the impact of deprivation for the development of “affectionless and psychopathic character” and identified three significant experiences based on the mentioned studies that can lead to an “affectionless and psychopathic character” (p. 51): “lack of any opportunity for forming an attachment to the mother figure during the first three years;” “deprivation for a limited period – at least three months and probably more than six – during the first three or four years;” “changes from one mother-figure to another during the same period.” Instead of providing expensive care after the damage had been done, Bowlby thought it “far more practicable, and in the long run far cheaper, to arrange methods of care for infants and toddlers which will prevent these conditions developing” (p. 51). Hence, in the second part of the WHO report, Bowlby turned to the possible “prevention of deprivation.”

Prevention of maternal deprivation

This part of the WHO report consisted of several chapters that addressed “the purpose of the family,” the “causes of family failure” and how to prevent it, and reported on the influence of different alternatives and substitutes for family life on child development, such as adoption, boarding-homes, and group care. Bowlby presented the results of his exchange with child care practitioners and policy makers in the different countries he visited, and, compared to the first part of the report, relied much less on findings from scientific studies, and more on findings from policy and practice.

Bowlby, first of all, emphasized the importance of the quality of the mother-child relationship, not just the quantity of maternal care. Children and their mothers should experience “the enjoyment of each other’s company” in a continuous relationship, as “continuity is necessary for the growth of a mother” (p. 67). Bowlby stated that “the bad parent who neglects her child is none the less providing much for him” and concluded that “children thrive better in bad homes than in good institutions” (p. 68), a nowadays often-quoted statement. To support this, Bowlby presented findings from a study by Sophie van Senden Theis (1885–1957), who was the first adoption professional and researcher in the USA and is best known for her pioneering work How foster children turn out (Theis, 1924). Her results showed that children growing up in “bad homes” showed more social adjustment in adult life than children who had spent five years or more of their childhood in institutions. Bowlby clearly valued family life over institutional care yet stressed the intergenerational aspect of “poor parenting:” “That vicious circle is the most serious aspect of the problem and one to which this report will constantly revert” (p. 69). The relationship with parents, already referred to by Bowlby in the early 1950s as “attachment of children” (p. 69), remained important, because children are loyal to their parents. Often, after out-of-home placements, many new separations follow: “Even for good foster-home agencies, the rate of replacement is deplorably high; even in good institutions, the turnover of staff is a constant problem” (p. 69). In Bowlby’s view, “on occasion children have to be cared for outside their homes, but let such arrangements be regarded as a last resort to be undertaken only when it is absolutely impossible for the home to be made fit for the child” (pp. 70–71). This view clearly differed from what had been practiced up to that point, but for Bowlby it was evident that the family was the best place for a child to develop and “discussions with social workers prominent in child care in the USA have again and again emphasized … the extent to which deprivation and unhappiness in the parents’ own childhoods have been the cause of their present problems” (p. 78). So, once again, Bowlby had reason to point to the intergenerational transmission of parenting: “deprived and unhappy children grow up to make bad parents” (p. 81).

Given the intergenerational effects of “bad parenting,” Bowlby argued, prevention was of utmost importance: “If a community values its children it must cherish their parents” (p. 84). Bowlby saw several solutions, starting with supporting parents, to effectively restore familial life. This was crucial for Bowlby because “evidence accumulates pointing to the child’s experience in his family in his early years as being of central importance for his healthy emotional development” (p. 91). Too often, children’s problems – such as bedwetting, theft, or aggression – are the reason for intervention, but this only addresses the symptoms, not the core issue, namely the socio-economic, socio-medical, or marital problems of the parents. A child of his time, Bowlby was no advocate for women in the workforce: “There is little net gain in womanpower, since for every 100 mothers employed 50 workers are necessary to care for the babies and, as every industrialist knows, mothers of young children are unsatisfactory employees and often absent on account of minor illnesses at home” (p. 86). Hence, in his report, Bowlby made a case for supporting parents to provide stable homes, more specifically, to help mothers enter into a warm and continuous relationship with their children, which would help the children to develop into healthy adults. Social workers in the USA had already started changing their policy to “mending the home instead of disrupting it” (p. 88). Only if “sustaining family relations” (p. 91) was not possible, solutions outside the natural home group should be considered (see for criticism of Bowlby’s views, Vicedo, 2013).

The first choice for placement outside the family was adoption. In his encounters with American policy makers³ Bowlby noticed the “progressive policy in the USA … has changed abruptly in the last ten years and far more adoptions are being arranged” (p. 99). Bowlby valued adoption over all other forms of substitute care, “for it is a very serious thing to condemn a child to be parked in an endless succession of foster-homes or to be brought up in an institution when there are long waiting lists of suitable parents wishing to adopt children” (p. 100). When only temporary care was needed, Bowlby thought a solution lay in “mobilizing relatives and neighbours” (p. 110) to facilitate a swift return home, because for various reasons institutional care often lasted longer than necessary and there was a “vital need of a child for a continuous intimate relationship” (p. 111). Foster care in boarding-homes was to be considered a short-term solution for situations of crisis only and for young children temporary placement in boarding homes or in institutions should be prevented at all cost: “For [children under the age of six] it may be recommended that the plan adopted by several American agencies should become general – the maintenance of a register of foster-mothers who are qualified and willing to take a couple of infants or toddlers for brief periods, and who are paid a retaining fee so that vacancies are always available at short notice” (p. 110). This type of care should only provide short stays with a quick return home and agencies have a task to “help the parents recognize the origins of the problem and make a realistic plan for the future” (p. 115).

Thus, Bowlby was strongly opposed to group care for children under the age of six. For older children, there were circumstances where Bowlby thought group care provisions could be necessary, for example, in the case of seriously maladjusted children not (yet) able to make an effective relationship with foster-parents; for adolescents who are independent and do not readily accept strangers in a parental role; for children over the age of six who are in need of short-term care; for children whose parents feel threatened by foster-parents and need an interval before deciding over their future placement; and for large groups of siblings otherwise split up among several foster-homes.

In making the case against group care, Bowlby presented the work and experience of the colleagues he met at various American agencies, mostly private charitable organizations devoted to helping homeless and dependent children. Bowlby had conversations with Howard Hopkirk (1894–1963), executive director of the Child Welfare League of America in New York; psychiatrist Florence Clothier (1903–1987) at the New England Home for Little Wanderers in Boston; Mary Lawrence (1898–1990), executive director of the Jewish Children’s Bureau in Chicago; and executive director Lois Wildly and child psychiatrist Margaret Gerard (1894–1954) of the Illinois Children’s Home and Aid Society in Chicago. Bowlby’s evaluation of his meetings at these agencies varied widely: Hopkirk “monopolised [his] time” and Bowlby was “not very enthusiastic” about Clothier, whereas Lawrence “gave a most interesting and vivid account of [her] activities” and his discussion with Wildy and Gerard was “most productive.” During his trip, Bowlby wrote to his colleagues back home that he had “been much impressed by the best social work for children being done in this country and ha[d] learnt a great deal relevant to report.” Bowlby thought “it is encouraging to find a high degree of agreement on principles and practi[c]e – all very much in line with Tavi[stock] thinking.” His conclusion was “that group residential care is always to be avoided for those under about 6 years, that it is suitable for short-stay children between 6 and 12, and for both short-stay and some long-stay adolescents” (pp. 137–138). If necessary, group care should be provided in small “villages” (such as at the Hawthorne-Cedar Knolls School in Westchester County, New York) or should be “merged into the surroundings” (like at the Jewish Children’s Bureau in Chicago). Bowlby concluded that group care is clearly unsuitable for children between ages three and six and “the provision of clusters of small homes where skilled professional foster-mothers can care for them in tiny families of one or two while they receive treatment is probably the answer” (p. 145). Here he may have thought of an arrangement like the one practiced in Skå, Sweden, where children received therapy while living with a “house father” and a “house mother” in small cottages (see Van der Horst et al., 2020).

In the final conclusion of his report, Bowlby stated that “the proper care of children deprived of a normal home life can now be seen to be not merely an act of common humanity, but to be essential for the mental health and social welfare of a community” and that if nothing happened, “they grow up to reproduce themselves” (p. 157). Bowlby emphatically concluded that the problem was twofold: first, “there is still a woeful scarcity of social workers skilled in the ability to diagnose the presence of psychiatric factors and to deal with them effectively” and, secondly, “a lack of conviction on the part of governments, social agencies, and the public that mother-love in infancy and childhood is as important for mental health as are vitamins and proteins for physical health” (p. 158).

Conclusion

The WHO report was a milestone in John Bowlby’s career and in our understanding of maladjusted and deprived children. Bowlby did his utmost to find evidence for the hypothesis that early separation from the mother figure is at the root of many of children’s developmental problems and may lead to lasting personality problems. This hypothesis was in line with the thinking of many of his British and American contemporaries. Both psychoanalysts and behaviorists believed in what Kagan (1998) has coined “childhood determinism,” e.g. the idea that childhood experiences determine adult outcome. Moreover, like Bowlby, many psychiatrists and clinical psychologists shared the conviction that such phenomena as playing truant and pilfering found their origin in some malfunctioning of the nuclear family, and that some form of “treatment” could resolve the problems. The focus was on proximal factors such as mother deprivation and marital discord and less on more distal factors such as parental unemployment, bad housing, and poverty. In this the British and American clinicians, with their interest in proximal factors, differed from their colleagues in Sweden, who emphasized distal factors (Van der Horst et al., 2020; Zetterqvist Nelson et al., 2017). The clinical evidence Bowlby gathered at the Institute for the Scientific Treatment of Delinquency and the London Child Guidance Clinic seemed to confirm this approach. Bowlby’s focus on the nuclear family also led him to reject group residential care for children without parents. He preferred children to be adopted in a new family or otherwise to be cared for in a home with a family-like arrangement, i.e. with a foster “father” and a foster “mother.” Communal arrangements, such as practiced in the early kibbutzim in Israel, Bowlby (1952) suspected to be less optimal.

Hence, Bowlby’s WHO assignment to study the situation and needs of homeless children all over the post-war world evolved into a study of mother-child separation and its detrimental effects. In collecting evidence for his view, Bowlby was not the proverbial impartial researcher who “lets the data speak for themselves,” but a passionate scholar who cherished his own favorite hypothesis. He did not hide his subjective impressions of his colleagues’ characters and abilities in his private correspondence. Studies that provided counterevidence for Bowlby’s hypothesis were easily dismissed by implying they were flawed: “Work with so many shortcomings cannot be accepted as calling in question the almost unanimous findings of the workers already quoted” (p. 42).

Bowlby’s trip to the USA was of great importance to him. His view on the fundamental effect of mother-child deprivation was strengthened by his meetings with his American colleagues, and in his WHO report he made ample use of the American research by Bakwin, Ribble, Levy, Spitz and Wolff, Rheingold, Bender, Lourie, and most notably the work done by Goldfarb, whom he considered the absolute star of American psychiatry. His many meetings with researchers, clinicians, and policy makers in the USA informed him about the causes and consequences of maternal deprivation and possibilities for its prevention and treatment. No wonder he was exhausted after the five weeks he spent in Washington, Philadelphia, New York, New Haven, Boston, Chicago, Ann Arbor, and Ithaca. As Bowlby wrote, completely in line with the subject of his study, he was “beginning to feel rather like a child who has been moved too often from one foster home to another.”

The WHO report was a milestone but the theory presented was, of course, still some steps removed from full-fledged attachment theory. Bowlby’s understanding of the evidence he gathered in America was still phrased in psychoanalytic terms. In his view, a continuous relationship with a nurturing figure in the early years was crucial for personality development, because we learn how to free ourselves from the bondage of our instincts through the development of the ego and superego. Initially, the mother serves as an extension of the developing ego and superego (cf. object relations theory). Thus, Bowlby thought it necessary for the “undifferentiated psyche” to be exposed to the influence of the mother as a “psychic organizer.” It was only later that Bowlby acquainted himself with the ethological framework that he subsequently used to describe the phenomena of deprivation, separation, and the mother-child relationship (Van der Horst, 2011).

In the WHO report, Bowlby also sketched the direction of future work. He considered it unnecessary to spend time demonstrating the validity of the general proposition regarding the adverse effects of deprivation. Instead, researchers should be encouraged to move on to the study of basic processes and the identification and unraveling of the effects of the many variables at play. Bowlby emphasized the importance of research quality (as is seen in his notebooks, where he mercilessly evaluated the work of the people he met). And, interestingly, Bowlby stressed the importance of observation, in line with the work being done by James Robertson at the Separation Research Unit, but before he came across the work of ethologists, and before he had met with Ainsworth, who would later advocate observation as a premise in attachment theory. Finally, Bowlby deplored the tendency for experimentalists to despise the clinician’s lack of precision and for clinicians to blame the experimentalists for a lack of insight into human nature, seemingly referring to his encounter with Gewirtz as the wording in the WHO report is very similar to the remarks about this meeting in his personal correspondence. Instead, Bowlby strongly suggested that a combination of clinical and experimental techniques, where the work of each complements and promotes the work of the other, is the way to future progress – indicating a foresight into what attachment theory would become in the years that followed: a theory with both empirical and clinical implications that are wonderfully intertwined.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was made possible by grants awarded to the first and second author by the Köhler-Stiftung [S112/10210/16] and the Dr. J. L. Dobberke Stichting voor Vergelijkende Psychologie [no. 3819].

Notes

1. Bakwin’s conservative and “reactionary” political views were not in line with Bowlby’s progressive and social thinking (see Durbin & Bowlby, 1939; cf.; Mayhew, 2006; Thomson, 2013).

2. Bowlby commented that the Bakwin’s had “an attractive old house, hung … with a number of very good pictures.” Bakwin and his wife Ruth Morris Bakwin (1898–1985) collected art by famous painters such as Van Gogh, Matisse, Cézanne, Gauguin, Modigliani and Picasso – known as the Bakwin Collection.

3. On March 7, for example, with Maud Morlock (1889-1980) of the Children’s Bureau of the U.S. Federal Security Agency, who gave him “some account of the position of the illegitimates” (cf. Morlock & Campbell, 1946).