Erikson's Theory and Knowledge of Attachment Principles

The first eighteen months of life is filled with rapid changes for parents and infants across every aspect of human development. At the stage of infancy the influence of a positive attachment can enrich an infant's behavioural development (Peterson 2010, pp.140-150). Erikson (1968, cited in Peterson 2010, p.51) theorises that to mould a positive attachment an infant must achieve a balance of the psychosocial stage of 'trust versus mistrust'. The achievement of this stage combined with the infant's environment, social arena, and how infants see themselves as individuals is dependent on a positive attachment. With an understanding of Erikson's theory and knowledge of attachment principles a nurse can help parents achieve this stage of infancy. This essay will concentrate on how having an understanding of Erikson's theory can help nurses when advising positive attachment strategies to parents, such as soothing an unsettled infant and help prevention of negative behaviours.

Erikson assembled eight stages of human development that 'remain within the proper rate and proper sequence which govern the growth of personality' (Erikson 1959, p. 52). In other words, a person cannot advance to the next stage of development without achieving a resolution of conflict with the one before. The first stage of 'trust

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versus mistrust' is between birth to eighteen months and is described as a time of potential 'crisis' for an infant (Erikson 1959, p. 50). During this stage an infant battles with inner conflict which is slowly developed into a balance between sense of self and trust in others. Caregivers have the responsibility to guide infants toward a successful resolution of conflict so they are competent to advance to Erikson's next stage of 'Autonomy versus shame and doubt' (Peterson 2010, p. 51).

It is important to also define positive attachment; as the trusting relationship that forms during infancy, usually with the primary caregiver. It is a time when an infant develops a secure attachment with a caregiver that prepares the infant for positive relationships on an intimate and social level that is carried on throughout the stages of life (Peterson 2010, p. 141).

After birth an infant is dependent on others to fulfil his/her every need. The focus is on the 'quality of the maternal relationship' as suggested by Erikson (1965, cited in Candlin 2008, p. 131). This significant stage is the maternal bond, usually between the primary caregiver and infant, that grows through a sense of connection. The primary

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caregiver develops an internal sense of what the infants needs are, and the infant can sense the mother is confident and secure in her actions knowing that all his/her needs will be met (Erikson 1963, p. 76). The infant is reliant on this emotional security to help guide him/her on the right path to establish trust, in preparation for a positive attachment. If the infant has inability to grow through attachment and develops mistrust he/she may display signs of constant crying, inability to self soothe and withdrawal, possibly due to the caregiver struggling to connect and understand the infant's needs (Children, Youth and Women's Health Service 2011).

By aiming to support the primary caregiver and encourage positive attachment a nurse could recommend the Maskan approach of learning to 'interpret and respond' to soothe the infant as suggested by Cianco (2001, p. 6). Also, using Eriksons (1963, p. 237) observation and theory of the Sioux Indians to swaddle and restrict the limbs of an infant to calm him/her may be useful to alleviate the negative behaviour.

The relationship of attachment is developed over time, but an infant's environment is also vital for their psychosocial growth. The primary

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caregiver needs to provide a kind, warm and stimulating environment that is safe and secure (Peterson 2010, p. 124). The infant needs to trust that this is a good place to be and have the desire to develop emotionally and explore his/her surroundings. Having a desire to develop his/her 'mental vitality' in this environment as described by Erikson (1968, p. 95) is one gain of mastering positive growth. However, an unattached infant could develop an imbalance of trust showing anger and bad tempered behaviour that could lead to 'rage' (Erikson 1968, p. 82).

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