1. Introduction 1.1 Starting-point
My diploma thesis is based on personal day-to-day observations that common treatment of mothers and infants positively affects attachment capacity.
This is, on the one hand, reflected by more spontaneous and/or intensive contacts such as the infant’s proximity-seeking to the mother and often also to the father. On the other hand, the infant becomes visibly more autonomous in daily life. The infant may, for example, show more interest in playing, be more perseverant and be better capable of coping with separation episodes either at home or in institutions such as playgroups or kindergarten.
For mothers, this type of treatment is usually a very positive experience which they do not want to miss, and they also explicitly say so. The way the mother sees the infant also changes. The needs of the infant are better understood, and tolerance towards the infant increases.
1.2 Attachment and attachment theory
In developmental psychology, bonding or attachment is described as an affective relationship between mother and infant which unites them in space and time (Ainsworth, M., 1973). For 50 years (Bowlby, Spitz, Ainsworth et al), attachment research, especially modern research, has emphasized the importance of early mother-infant interaction for the infant’s personality development (Spangler & Grossmann et al). Attachment theory has been proved and classified by many empirical longitudinal studies. Take the following example: the development of regulatory disorders in infants such as excessive crying, sleep disorders and feeding problems are thought to be mainly related to the mother-infant relationship (or parent-infant relationship) (Sarimski, Popousek).
1.3 Attachment in osteopathy
There has not yet been any osteopathic study to see if and to what extent osteopathic treatment might positively affect the quality of the mother-infant attachment. However, a few osteopaths, especially Catherine Henderson, a qualified US osteopath, have confirmed to me that they have made the same experiences and observations as I. In view of my observations laid down at 1.1 (starting-point), I consider it worthwhile performing a clinical study to provide answers to all the questions. In my diploma thesis, I will focus on mother and infant as a (system) unit. I would like to show that paediatric osteopathy is capable of bringing about changes in the quality of the mother-infant attachment. I have a sufficient number of suitable subjects.
The main objective of my diploma thesis consists in showing if and how common mother-infant treatment positively affects the quality of the attachment. In addition, I would like to analyze if and how the clinical symptom parameters (regulatory disorders) in infants are indirectly positively affected by this type of treatment.
3. Method 3.1 Treatment
The method will be based on distributing same questionnaires, drafted by myself, to mothers of the examination-and control group and observing the infants during the first consultation. I will not only observe the infant’s motivation to explore the consulting room while I talk with the mother, but I will also observe the infant while the mother receives treatment and reverse. The set of questionnes and the observationes will above all follow the standardized attachment classification of Ainsworth’s “strange situation” .
Group to be examined (mother-child):
Ten mothers with their children will receive a treatment course of three osteopathic sessions; the time intervals between the sessions will be three weeks each. The details will be as follows:
When the family has fixed an appointment by telephone, the first questionnaire and a covering letter will be sent to them. The mother will be requested to fill in the questionnaire and take it with her when the first consultation takes place.
The history will be taken, and the first treatment will carried out. The mother will be treated. The infant will be present in the consulting room and may touch the mother whenever he/she wishes. The mother will be given the second questionnaire and will be asked to fill it in shortly before the second treatment and take it with her.
The second treatment will be carried out; again the mother with the child present in the consulting room seeking contact or not.
The third treatment will be carried out; in the same way as in the two treatments before. She will then receive the third questionnaire, which she will be asked to fill in week after the third treatment and send back.
During all three treatments, I will never treat the infant directly.
Control group (child-mother):
Ten children with their mother from the control group will be treated under similar circumstances. However, they will be treated three times alone. Mother will sit beside the treatment table and will together with the infant for example look at a book or just be present in the room. Again the time intervals between the treatment course will be three weeks each.
Twenty infants, different ages. The age bracket will be from 9 months to 6 years, and they will have a variety of complaints (anxiety, sleep disorders, agressiveness, difficulty in getting on well with other infants of the same age, etc.).
3.3 Criteria of assessment
By means of three questionnaires and observations, the symptom parameters will be assessed on a qualitative and quantitative level.
4. Expected results
I expect that after three common mother-infant treatments (examination group) there will be a considerable increase in the mother-infant interaction and that the infant will in particular show a balance between attachment and exploration. Positive effects on secondary regulatory disorders of the infant cannot be excluded (Popousek, 1999). In my diploma thesis, I will assess, summarize and discuss the results.
5. Supervising osteopath and exchange of ideas/interviews
Nicholas Marcer, a qualified osteopath from Fribourg, Switzerland, is the supervisor of my diploma thesis.
Contacts with the Osteopathic Centre for Children in London and the Osteopathic Centre for Children in Vienna,
Dr. V. Frymann, Frymann’s Osteopathic Center for Children in San Diego/California, USA,
Centre for Children in Munich, Social Paediatric Centre and Clinic for Social Paediatrics and Developmental Rehabilitation, 81377 Munich, Germany, Catherine Henderson, qualified osteopath, USA
Petermann, F., Niebank, K., Scheithauer, H. (Hrsg.), (2000), Risiken in der frühkindlichen Entwicklung
Sarimski, K., (1986), Interaktion mit behinderten Kleinkindern
Kissgen, R., (Diss), (2000), Bindungsqualität einjähriger motorisch entwicklungsverzögerter Kinder unter Berücksichtigung verschiedener Einflussfaktoren
Spitz, René A., (1965), Vom Säugling zum Kleinkind (orig.: The first year of life)
Winnicott, D.W., (1990), Das Baby und seine Mutter (orig.: Babies and their mothers)
Renggli, F., (1977), Angst und Geborgenheit
Klaus Marhall H., Kennell John H., (1987) Mutter-Kind-Bindung (orig.: Maternal-Infant-Bonding)
Rosenblith Judy F.,(1992), In the Beginning
Keller, H., (Hrsg),(1997), Handbuch der Kleinkindforschung
Bowlby, J., (1969), Bindung (orig.: Attachment and loss)
Ainsworth, Mary D. Salter, Blehar, Mary C., Waters, E., Wall, S., (1978), Patterns of Attachment
Garmezy, N., Rutter, M., (1988), Stress, Coping, and Development in Children et.al.
Bern, 04.08.2002 Marta Kreutz The draft of my diploma thesis was looked up by my supervisor Nicholas Marcer.