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John Bowlby Interview with Milton Senn, M.D.
Editor’s Note: This interview with John Bowlby was conducted by Milton Senn, M.D. on October 19, 1977 in London, England as part of an oral history project he conducted that is archived at the National Library of Medicine in Bethesda, Maryland (“American Child Guidance Clinic and Child Psychiatry Movement Interview Collection, 1975-1978”). Dr. Senn, a psychoanalytically-trained pediatrician, had been Chairman of the Department of Pediatrics at Yale and the Director of Yale’s renowned Child Study Center from 1948 to 1966. A visionary, Senn authored a seminal 1948 article “The Psychotherapeutic Role of the Pediatrician” in the journal Pediatrics.
Interviewer: Dr. Milton J.E. Senn
Dr Senn’s Introduction: Dr. Bowlby is being interviewed because of his long connection with the Tavistock Clinic in London from which he is now retired as director of the Department for Children and Parents. He is also well-known for his research in ethology. His books on separation anxiety, that is maternal infant, separation, are very well-known around the world. His first publication was entitled Forty-Four Juvenile Thieves and brought him recognition.
Senn: Dr. Bowlby, I appreciate very much your giving me this chance to interview you. I wonder if you would begin by talking about how you came into the field of child guidance work and child psychiatry. When did you do that and what was your early experience?
Bowlby: Well, I actually came in in 1936 and I will tell you how. I went to Cambridge and read medicine. I was not particularly enthusiastic about reading medicine. My father was a surgeon, he was quite a leading London surgeon, and he encouraged me to read medicine on the grounds that there are many different things you can do if you read medicine, and I took that. At Cambridge, I did natural sciences and the pre-clinical anatomy and physiology; but during that time I got interested in psychology, especially in what would now be called developmental psychology. Just why that was so I really don't know - but it did lead me, in my third year at Cambridge, to read psychology and to give up medicine.
In fact, I gave up medicine for one solid year and I spent that year in progressive schools, one of which was what we would now call a school for maladjusted children. I was six months there, and one reason I went there was because there was a member on the staff, a highly intelligent man, who later became professor of art in Toronto, with whom I had a long talk before going. I really felt he knew a lot more than anyone else I had met. John Alford was his name. He was a man of 40 then—45 maybe. He had been knocked up in the first war and he'd had some psychotherapy with an American called Homer Lane. During the early '20s, Homer Lane ran a small home for disturbed children in this country. He was analytically oriented and my friend, John Alford, had had some therapy with him. Lane's establishment broke up about 1925 or '26. I had gone up to Cambridge in 1925 and I left in 1928. It was 1928-29 that I spent in this school.
Senn: What did you do there?
Bowlby: I'll tell you: there were 22 children varying in age about three to eighteen, both sexes. I was put in charge of those under eight or nine , I think the under tens. Anyway, it was a handful of children, about 7 or 8 of them, and I was in charge. Well, you may well ask what I did. I don't think I would like to describe what I did. I did my best.
Senn: Were you a teacher?
Bowlby: I was on the staff. I was a teacher, yes. They were very short of staff. They had no money and as I had a little private money, I was there without pay - there was no pay either way - they gave me my keep and I didn't get anything else. It suited me very well because I found it interesting. And when I was there, I learned everything that I have known; it was the most valuable six months in my life, really. It was analytically oriented. The man who ran it, a man called Theodore Faithfull, was by profession a veterinary surgeon, a rather mercurial character, very intelligent, very unstable really, but with an analytic orientation. John Alford also was there, really he was there more in the guise of a parent than as staff. Again he was unpaid.
Senn: When you say “analytically oriented", what does that mean? Freudian psychoanalytically oriented?
Bowlby: Yes Freudian oriented using it in a rather loose way. Now I will give you an example of some of the things that I learned there. I learned that the problems of today are to be understood developmentally. And as I put it now—in terms of the child’s family experiences or lack of these.
One boy who had been expelled from one of the big schools, a boy of sixteen, he had been expelled for stealing, was a very isolated, remote boy who made very little contact with anyone and was in the habit of pilfering. His history was that he was illegitimate. He had not been brought up by his mother; he had been brought up by a trained nurse and then she had left and he had rather disturbed early years. The notion was that his present condition was the result of that experience--you can see how important that was to me. It was a rather broad type of theory; it was a point of view, shall we say.
I recall also another small boy of seven who spent his whole time trailing me around, he was always with me, he was known as my "shadow". Well, that was a very important experience too.
Now after being there from Christmas until July, John Alford said to me, "Look, this is no place for you to stay, what you ought o do is to complete your medical training and train in psychiatry and psychotherapy." At that moment that was very unwelcome advice: I had no desire to spend three years doing clinical training.
However, I had the good sense to accept his advice. I got accepted at one of the London Medical Schools, University College Hospital--very much at the last minute--but I think that the fact that my father was a leading surgeon and I had got a first class honor's degree at Cambridge, that probably eased me in. Anyway, I was very lucky because it is an extremely good hospital and I was with some first-class people. And I simply ground through three years of clinical training in order to get a medical qualification. I found the science of medicine, physiology and pathology--I found that interesting. I have always found it interesting - but I never wanted to practice as ordinary doctor - nor have I.
In addition to doing my medical training, I started an analysis. John Alford had told me that there were two places in London where some training could be obtained: one was the Tavistock Clinic and the other was the British Psycho-Analytic Society, and he and I debated which of those two places it should be. Now I must explain that the Tavistock, pre-war, was eclectic. It was analytically oriented, as we would say, but there were no qualified analysts on the staff. This was because it was the policy of Ernest Jones, who was the leader of the British Psychoanalytic Group, to be very exclusive. For instance, I am told he forbade any qualified analyst even to give lectures at the Tavistock - certainly not without his approval.
Well, to cut a long; story short, I settled for the Psycho-Analytic Society on the grounds that, as John told me, it was a rather more professional group. But it was very much touch and go - which I went to. I was 22 at the time, in 1929. I applied to Ernest Jones and Edward Glover to be taken on as a student-candidate; they accepted provisional way and I was allocated to Joan Riviere as analyst. (Riviere - it is a French name - her husband was a lawyer--they were English people--she was a straight English lady.) She was subsequently much influenced by Melanie Klein. I had finished my medical training and I had had three years of analysis.
The day after I qualified in medicine I started work at the Maudsley Hospital as a clinical assistant. I never did any general medicine or pediatrics--I went straight into psychiatry. At that point, too, I was accepted for further training in analysis, so I began seeing two patients under supervision at the clinic. I spent three quarters of my day at the Maudsley and late afternoon and evening doing analysis. That went on through 1933, 1934 1935 and 1936 with having the intention of specializing in child psychiatry, Actually, in 1935 I applied to start child psychiatry. I was not successful, but I was in 1936.
Senn: Applied where?
Bowlby: I'll tell you... this is where the American influence came in again. (Homer Lane, you see was an American. I can tell you where to find out more about him but I don't know much about him myself. He was obviously a gifted man.) The Commonwealth Fund, as you know, had been invited over here in the middle 1920s. Margaret Scovill came over as their representative--and in the end they gave a very substantial grant both for training purposes and to start the London Guidance Clinic.
The London Child Guidance Clinic was set up in a part of Islington called Canonbury. That clinic, I think, was founded in 1929. It trained educational psychologists, social workers and child psychiatrists. Each year three fellowships in child psychiatry were advertised--they were half-time fellowships for one year--and in 1936 I was successful in being appointed to one of them. I used to spend every morning at Canonbury and a bit of the afternoon usually as well, and then I went on and did analysis later in the day. I should say that I always had a few hundred pounds of private money--very important--which meant to say that I was not pressed for bread and butter. I was at the time also much influenced by two close friends who were academic economists, one of whom is my brother-in-law and one of whom was a very close personal friend with whom I shared a flat, and they represented a strong academic interest.
Senn: They were economists?
Bowlby: Economists, yes - perhaps I should go a bit further. Both were very able people, both have gone a long way though unfortunately, one, Evan Durbin, died in a very tragic accident in 1948. They were first-class people which was very important, really, because I was espousing a very novel and peculiar outlook as an analytically oriented child psychiatrist as we might call it. That was what I was aspiring to be. The whole field was still very controversial and needed a lot of academic justification. Well, to cut a long story short --first of all I had had a good scientific training at Cambridge, and secondly, my academic friends were very powerful debaters and any position which I took up I had to justify up to the hilt by argument and evidence. This was an invaluable discipline I think.
Well, I have got to 1936. I was reaching the end of my analytic training, which I did in 1937 at the age of 30. I had spent my half-time year doing child guidance work at Canonbury and I was fortunate in being retained on the staff after my fellowship. I was employed there as half-time child psychiatrist from 1937 to 1940, really for only two years 1937-39 because the war started then and made things very different. I completed half a book plus an M.D. thesis at Cambridge. The half book was with one of my economist friends, Even Durbin, called Personal Aggressiveness and War; at that time war was very much in the wind, in the air. Durbin joined me in writing 150 pates on the relationship between personal aggression and war. I think it is one of the first exercises of its sort.
Senn: How was that received?
Bowlby: It created a great deal of interest. The joint piece had appeared initially as roughly half of a book of essays entitled War and Democracy, published in 1938. As it was the essay that was most appreciated, it was subsequently republished separately. I was also working on an M.D. thesis which was later published as Personality and Mental Illness based on what I had done at the Maudsley. As you know, in this country an M.D. is a higher degree, and I got that in 1939. I was also working on what was subsequently published as Forty-Four Juvenile Thieves which I had more or less completed on the outbreak of war. I worked on it also during the first winter of the war—during the phony war, but it was not published until 1944.
Senn: What were those subjects? Where did you study them?
Bowlby: At the Canonbury Clinic. It was a study done on the basis of my clinical experience at Canonbury in which I compared the histories and behavior, personality patters, or 44 children who stole, with those of 44 other children who did not steal. Most of these cases were my own, but a number were those of immediate colleagues with whom I was working. And this when the notion of separation and deprivation became of importance to me. Having been alerted to those ideas while I was at the school in 1929, when I met these children in 1936 and 1937, I was much struck by the types of experience they had had.
Senn: That was all basic to your later career.
Bowlby: Entirely, that’s where I started in 1929. By 1939 I was then 32. I had completed my higher medical degree, I had completed such training as I was going to do in adult psychiatry, I had completed my training in psychoanalysis, and all that was very fortunate because when the war struck everything changed. During the first six months of the war nothing much happened. I had offered my services here and there but there was no response. Then in May and June 1940, I was in the so-called Emergency Medical Service in which I was dealing with cases of war neurosis, cases from Norway and Dunkirk; but that was not a very happy experience for reasons I won't attempt to go into now.
Anyway, in August that year Jack R. Rees invited me to join Army Psychiatry. Now J. R. Rees had been Medical Director of the Tavistock before the war, and he had been appointed consultant in psychiatry to the British Army. When he had the chance to recruit a few civilian psychiatrists, which he did first in the Spring of 1940, he had appointed some Tavistock psychiatrists, a number of whom later became well-known: Henry Dicks, Ronald Hargreaves of the World Health Organization, Wilfred Bion, and so on. These were pre-war Tavistock people appointed to the Army in the spring of 1940. I came in with the second wave of recruits in August and September 1940, during the Battle of Britain when things were very exciting. I was more than happy to be in uniform, you know, I wanted to get going. Until then, during the first six months of the war, I had continued work in child psychiatry at the Canonbury Clinic which had been evacuated to Cambridge. I used to go down to Cambridge for three days a week and then saw private patients in London for the other two.
Senn: Were many of the children's problems related to the war at that time?
Bowlby: Mostly not. but a number of these children we saw in Cambridge had been evacuated from London. Also there were various people in Cambridge who were interested in the social and psychological problems of evacuated children, for instance Susan Isaacs and Sybil Clement Brown, two leading people. I participated in the planning of a survey of evacuated children which was subsequently published under the editorship of Susan Isaacs.
However, by September 1940, I was in uniform and for five years I was an Army Psychiatrist. Now, for most of that time I was doing officer selection. I happened to do an experimental venture in officer selection during 1941 so that when the War Office Selection Boards were set up--initially in Edinburgh in early 1942--and were later used for selecting officers throughout the British Army, I was one of the first psychiatrists to be appointed.
And after being in it for six months on an operational selection board I was posted to the Research and Training Centre where my job was to try to follow up the men selected in order to validate the procedure. It was a large-scale research survey type of exercise. Apart from a basic scientific interest in the problem I had no qualifications for it. However, this was a very important time in my life because I then became one of a group of psychiatrists and psychologists who, as it turned out, subsequently developed the Tavistock Clinic and Tavistock Institute. We started together in 1942 in the Army.
Senn: Was that research, would you say, sort of social research?
Bowlby: Well, it was an attempt to find out whether those who were selected by the Selection Boards for training and commissions were any good and also whether they were as good as was predicted. It meant following them up to find out what their career was at training unit and subsequently in an active service regiment. The group of people with whom I was working--I think I had better go back and say a little more about Army psychiatry.
J.R. Rees had not only recruited Tavistock people, but he had also recruited a great number of other people, like myself, who, while not being Tavistock, were dynamically oriented, socially and psychologically oriented, so that this Army Psychiatry Group bridged all those frightful chasms that had been present before the war. For example, as a psychoanalyst I had not talked with Tavistock people before the war because that was verboten more or less, and I had not met many other people in psychiatry either. In the Army we were all on the same job, we all got to know each other personally and there developed an integrated outlook. We were perhaps half a dozen analysts, including John Rickman and Adrian Stephen who were senior people and a number of juniors like myself, a whole bunch of Tavistock people of different degrees of seniority and a number
of others.
Amongst the others were Jock Sutherland who had taught psychology in Edinburgh before he took up medicine and psychiatry. He became the senior psychiatrist in this unit and Eric Trist was the senior psychologist, a very very brilliant person. It was as a member of this team that I undertook this follow-up study, the validation study. Really it was the equivalent of my doing a PhD thesis under Eric Trist’s supervision. Eric Trist--I am very deeply indebted to him. My training in psychology at Cambridge had been confined to one year and not all of that either. In the army I received what was really a post graduate training in psychology under Eric Trist and Jock Sutherland, and at least one other psychologist, Ben Morris. So here again I was extremely fortunate. I was in this Research and Training Unit for three years from the end of 1942 to the end of 1945 when I left the Army at the end of the war. Also I made time to re-write Forty-Four Juvenile Thieves in a good deal better form than it had been before; it was published in 1944.
Then we come on to the post-war scene. There was a group of us in the Army; some being particularly engaged in officer selection, others in the rehabilitation of returned prisoners of war, others again had been engaged on problems of morale in units, war neurosis, and so on. So there was a wide spectrum of interest in social psychiatry with an emphasis on preventive psychiatry, and our dream was that, in some way, we should all continue this in civil life.
Now, I had had no dealings with the Tavistock before the war, nor had Sutherland, but as you can see, in the Army we were a group for which the Tavistock acted as a kind of anchor. So the notion was that some of the pre-war Tavistock people, together with some of the rest of us who were not Tavistock but who were in the party, should develop something or other as a post-war enterprise around the Tavistock.
Tommy Wilson, as he was always known, A.T.M. Wilson, who was at the War Office as an Army psychiatrist--he enlisted the interests of Alan Gregg at the Rockefeller in this idea and the upshot was that the Tavistock group was given what in those days was a substantial grant. I won't attempt to name the figure because I forget exactly what it was. Anyway, it was a lot of money for us. This enabled the Tavistock to recruit about half a dozen of us as full-time staff after the war: Wilson. Trist, Sutherland, Ben Morris and myself--that's five--and one or two others, I think. At any rate, that was the nucleus.
And I was invited to take over the Children's Department of the Tavistock. There was nothing I wanted more. This fitted like a glove, you see. So I started here actually in February of 1946--a couple of months after leaving the Army--started full-time on fifteen hundred a year, which at that time was quite good pay, adequate anyway. Of course, during the war the Tavistock had been running on a very tight shoe-string; it was just a very limited exercise in other people’s premises. However, some savings were available which before the war had been intended for certain residential purposes and those were used to acquire the building in Beaumont Street which had formerly been a nursing home. So we set up shop there in 1946.
Now at that time it was foreseen that there would be a National Health Service and, although there was some debate as to whether the Clinic should or should not be in the Health Service, I am thankful to say it was agreed it should. I was certainly one of those who was most insistent that we should go into the Health Service. However, that meant that, whilst the clinical service went into the Health Service, those social psychiatry activities--some of which were in industry--plainly could not do so, and that led to the setting up of the Tavistock Institute of Human Relations as a separate but sister body and that is how the two have existed ever since--as twins.
The Clinic has been in the Health Service--government money, stable, rigid, limiting; the Institute has been private, poor, unstable but it could do what it liked. The combination of these two sources of support was very valuable and I think for 25 years we exploited the opportunities which they gave us to advantage.
Senn: When you say you headed the Children's Unit, what was that, what did that consist of at the Tavistock when you took over?
Bowlby: Well, it consisted of about half a dozen staff. It is quite difficult for me to say. Most of them were part time unpaid people. There might have been four or five psychiatrists who were each doing perhaps anything from three or four half days downwards. I was the only full timer.
Senn: Was this a service clinic?
Bowlby: A service clinic.
Senn: Providing services for what kind of children?
Bowlby: Every sort of child throughout Great Britain.
Senn: Every sort of child economically as well as with a variety of disorders?
Bowlby: Economically as well. Yes.
Senn: And what was the theoretical background? How was therapy conceptualized?
Bowlby: I had better think back a bit. I am going to go back pre-war again. There were several clinics in London before the war, perhaps half a dozen. There was Dr. Emanuel Miller at the East London Clinic. There was the unit at the Tavistock. There was the Canonbury Clinic set up on Commonwealth money which was the biggest. Those three each had a staff of the three disciplines: psychiatry, psychology and social work. It is very difficult to say just what the theoretical views were; they were very mixed.
Senn: But it was a sort of a team approach?
Bowlby: A team approach.
Senn: With the social worker doing some of the diagnostic intake?
Bowlby: Well, the parents tended to be allocated to the social worker, all the children had psychological tests, practically all, and the psychiatrist was also supposed to see and treat the children. Frankly, it wasn't a good set up. The interdisciplinary side was good but the fragmentation of the family was extremely bad. At that time, too, fathers were very rarely seen.
We tended to get children not only from relatively close areas but also from very far afield. In fact, I remember one of my early experiences at the Tavistock was that I saw one child from Cornwall and another from Scotland in the same week. Well, plainly, what you could do in such circumstances was terribly limited; it was quite impractical, really.
Now, it is difficult for me to distinguish between the theoretical view that I brought with ne and those of others, so I really have to be rather egocentric here because, for good or ill, I brought my ideas with me, although I certainly learned a lot as well. I brought a psychoanalytic viewpoint but the great shortcoming, in my judgment, of the psychoanalytic approach to children has always been that it has been willfully uninterested and inept in regard to the environmental situation of the child. The child is thought of almost as a closed system, and treatment is directed at this psychological system within the child.
Now I never shared that view. I have always been clear that the family patterns were vital to understanding any child psychiatry case. In that regard I have really had a running debate with my psychoanalytic colleagues all my life--I still do. I think they still give totally inadequate attention to these things; I think the real life experiences of a child, both of the past and the present, are crucial to understanding the problem. I brought that point of view with me from this school I was in in 1929 and I never changed.
Now, one of the things that happened to me at Canonbury was that I worked with two social workers who were analytically oriented and who were interested to understand the problems of the parents in terms of their own psychological histories. Well, that is what is widely recognized now but at that time it was new. They were excellent people, they were doing excellent work and I learned a hell of a lot from them. I learned far more from those two social workers than I learned from my psychiatric colleagues because I don't think they had a great deal to offer. I will say that if they had much to teach me, I didn't learn it. I went my own way from the start to quite honest. My concern was with family interaction and the extent to which a child’s personality is changed by the family pattern in which he grows up.
That was the background of my Forty-four Thieves paper and also the very first paper I ever wrote. It was read to the British Psychoanalytical Society and was called The Influence of Early Environment on the Development of Neurosis and Neurotic Character, a theme which I have always regarded as immensely important and which has never been popular amongst my psychoanalytic colleagues.
So, as I say, I went my own way. Others in the Canonbury Clinic, I would say, shared this point of view more or less. And something similar was going on at the Tavistock. Theory was not in any sense formulated coherently, I think. And when I got to Tavistock in 1946 there was a group of people, mostly part time people who shared this point of view, again more or less.
Senn: How then did you get from that into your more extensive work in the field of maternal-child separation?
Bowlby: I'll tell you. You see, my initial study had been forty-four juvenile thieves. When I reached here in 1946, I was concerned to do three things: to run a service clinic, to teach within the service clinic and to develop a research enterprise.
Senn: Teach whom?
Bowlby: Psychiatrists, social workers, psychologists. In 1944, during the war, there was an Education Act passed and amongst many very far reaching changes which were enacted during the war, there was a provision that there should be child guidance clinics throughout Britain. That was a very remarkable decision to be reach reason it was reached in 1944. The reason it was reached was this; that those who had trained in child guidance during the war--very many of them social workers on Commonwealth Fund money--had earned such golden reputations during the war, particularly in reference to evacuated children, that the merits of this service had become nationally recognized, hence this policy.
Therefore, when I reached the Tavistock in 1946 the national policy was to have clinics all through the country although in practice there were only enough trained people to man perhaps 10 or 20 percent of them. So it seemed to me that top priority was training. Since you can't train unless you are running a decent service, we had to run a decent service first and to train second. Those were the two priorities, and my notion was that research would follow as soon as possible. At that time we were training something like four psychiatrists, half a dozen educational psychologists and, I would say, six social workers; it was of that order. We had a staff of about a dozen, roughly three of each profession. I inherited a very able educational psychologist who was a very senior woman and I inherited also a senior child psychotherapist and two social workers. I must say there was a lot of difficulty and friction between what you might call the old staff and the new brooms. Now, fortunately for me, the Children's Department at that time was very small, very few people involved, so I had an easy route.
In the Adult Department, the position was much more difficult; 1 won't go into it but it was more difficult; you can see the problem. One of the first things I did was to appoint a senior social work tutor, Noel Hunnybun, who was one of the original social workers from the early days, and also another social work tutor. We had an excellent educational psychologist already, and we soon had a second one appointed. One of my main problems was to find another staff psychiatrist who was up to scratch academically as well as professionally. It was really run as a one man band for a time.
Now, coming to research. In 1948, 1 sought some research support and my concern was to work on maternal deprivation having got on to this track before the war. I decided that this was a central issue and also researchable and some of the experiences I had had doing research during the war I wanted to bring into this field. So I managed to get a very small grant of a few hundred pounds from a small British foundation called the Sir Halley Stewart Trust. That body had given some support to the Tavistock before the war and that is why I approached them and, partly no doubt, why they gave me some support. I had attempted to get bigger money from the Nuffield Foundation but without success.
With this small grant from the Sir Halley Stewart Trust I wanted to engage a psychiatric social worker, and I appointed a very remarkable man, Robertson, who had grown up in the Glasgow slums---come up the hard way, self educated very largely--who had been a Quaker and during the war had been allocated to portering work at a charitable foundation in London, which happened to be Anna Freud's nursery! Having worked at Anna Freud’s nursery in this capacity for four years during the war—and in fact they recognized and appreciated his qualities—he trained in psychiatric social work just after the war. So he was available and as he had got a lot of experience with problems I was interested in and he also seemed to me to have other great merits, I appointed him. So he came, I think in early 1949 and westarted our work on maternal deprivation… (It’s a long story but if you would like me to continue I will do so).
Senn: Let’s come back to the clinic here, the Child Guidance Clinic. Have the notions about these children changed or, at least, were they until you retired from the directorship here? Are they still the same as those you held earlier?
Bowlby: My own views?
Senn: Yes. Did they remain constant or did they change as you were the director here?
Bowlby: I think I would saythat my views have developed and amplified and evolved but I don't think they have changed very much. They have certainly evolved very greatly but in regard to the usual clinical problems of diagnosis, prognosis and so on I don't think I have changed much.
Senn: You have used the word "social psychiatry”. Would you say that your more recent work here at the Tavistock Clinic was in the realm of social psychiatry or community psychiatry?
Bowlby: Yes, I will tell you why. I changed the name of the Department to Children and Parents early on.
Senn: From a child guidance clinic?
Bowlby: It was called The Children's Department. I said it is the Department for Children and Parents - you can see why I said that. The work of the department, although I was the director and chairman, has in my judgment remained very conservative in many respects. There has been a very strong psychoanalytic influence, particularly a Kleinian influence in which, I think much too little attention is given to environment. As a result my research became somewhat - I won't say "divorced"--that is too strong a word--but it was certainly distinct from the clinical enterprise. There were always members of the staff in the department who were keenly interested in my research work and keenly supportive and appreciative, although there have been an awful lot of others who have been none of these things.
Senn: In your department?
Bowlby: Yes. Our personal relations have always been excellent but many of them have been very much under the influence of Melanie Klein and have really regarded my work as not very relevant to the problems of children. So in certain respects I have been a stranger in my own department.
Senn: Why would the Melanie Klein influence be so strong here? Because in other has been closely identified with Melanie Klein and one of which has been closely identified with myself. Now because of this strong Kleinian influence it proved departments of the Tavistock Center they are not strong?
Bowlby: Yes, very strong.
Senn: That is where the overlap came?
Bowlby: Yes. Within the department there have been two strands of clinical thinking and practice, one of which impossible to do much research on clinical cases and, for that and other reasons, most of our research was done on children in residential nurseries, in hospital settings, in various settings where children are separated from their parents and so on. And Robertson pioneered all that work.
In the Autumn of 1950, which is about a year or 18 months after Robertson had joined me, Ronald Hargreaves invited me to do an ad hoc job for the World Health Organization. Ronald Hargreaves had been a pre-war Tavistock person, a psychiatrist, an Army psychiatrist; we got to know each other well then. He was appointed Chief of the Mental Health Section of WHO right at the outset in 1948 and because he knew, of my Forty-four Juvenile Thieves publication, when the problem of the mental health of homeless children came up in United Nations circles, he thought of me as a person who might contribute. He wrote to me asking “Would you undertake a short term consultancy on behalf of the Organization and write some sort of a report for us?" Well, I accepted that, as you can see, and I started on New Year's Day 1950. I worked for World Health for a total of five months during 1950. During that time, I spent six weeks on the continent of Europe and five weeks in the United 'States--that was my first visit to the States.
Senn: That was when we met; you came to New Haven?
Bowlby: We certainly met then - it was 1950 - it must have been.
Senn: …when we talked about Kate Wolf's work on separation and Rene Spitz.
Bowlby: That's right, it was 1950, yes. This was my first visit, you see, and my concern was to meet child psychiatrists and social workers and psychologists, anyone who was concerned with children in general and what you might call deprived children, children out of their own homes in particular. I was very struck by what seemed to me to be a very considerable degree of agreement amongst professional people that this was an important and interesting area. At that time some professional people had thought about it, perhaps written about it and had conceptualized it. Others had not done so but when one raised this topic it wasfamiliar to them.
I think in some cases, you know, they said, "Yes, come to think of it, this is very important" and so on. So I was struck really by what seemed to me, both on the continent of Europe and in America and Britain, a very high degree of professional consensus. Now, you may say, perhaps I was reading that into it, but those five months I worked for World Health were very crucial ones for me because I got to know a lot of people. Secondly, I had a read up the literature which I had not been able and thirdly, to put my ideas together on paper. I worked very hard, very hard indeed that year.
Senn: Your work and your writing in the field of separation, of course, have become famous writings, very popular in the United States. You have had an influence in the U.S. I speak, for example, about my own group at Yale. You influenced them when they were concerned about institutionalization of children, particularly young children. How do you evaluate your contributions, and the contributions of other British psychiatrists to the thinking of American child psychiatrists and child guidance people?
Bowlby: I find that very difficult to judge, I do really. You see, I think each country is very insular. I would say, for example, in this country maternal deprivation is very much identified with my name. In America, I was under the impression it is identified with Rene Spitz’s name and a few others. Erik Erikson's work has much better known over there than it has been here and I have always felt that my influence has been much great in the States. We--when I say "we" I am thinking of my group--we have been very proud of the influence we have in this country, both in regard to the care of children in hospitals and in regard to the whole child care field.
Our impression is that, whilst in this country it has developed on a national scale, in America it has been spotty and patchy. Now this may be wrong - I don't know. But I mean, to take an example, there is no doubt that this book Maternal Care and Mental Health is known very much better here than in the United States and the popular version, the Penguin version, which has been selling something like 20,000 copies for 25 years, has never sold more than 1000 or 2000 a year in the States. Whereas for good or ill Great Britain is saturated with our ideas, it is quite different.
Senn: Have you had professional meetings, seminars and this kind ofthing with Erikson or Spitz over the years where you could discuss your ideas.
Bowlby: I have never had regular meetings. I have met them many times and we have had very serious discussions, yes. Of course they are a bit older than me and Rene Spitz is…
Senn: He is dead…
Bowlby: Yes.
Senn: Erikson is several years older than you.
Bowlby: Yes.
Senn: Did they ever give credit to you, for your work in their writing?
Bowlby: I am trying to recall now.
Senn: I don't recall ever seeing much in the way of Spitz’s…
Bowlby: I don't think either of them did. It they didn't, neither of them. did.
Senn: Did you feel there was resistance by the Americans to your ideas, or that press agents were not active in America on your behalf.
Bowlby: Well, you see, there was great resistance—let me paint the British picture first. Maternal Care and Mental Health published in the Spring of 1951. It became a bestseller from the word go in this country. There were certain groups who took to it with great enthusiasm, other groups were distinctly lukewarm and others hostile, each profession reacted differently. The social workers took to it with enthusiasm; the psychoanalysts treated it with caution, curiously and for me infuriatingly, pediatricians were initially hostile but subsequently many of them became very supporting; adult psychiatrists totally uninterested, totally ignorant, totally uninterested.
Senn: Psychologists?
Bowlby: Many of them pro, many of the clinical psychologists pro but, of course, many of the academic psychologists bitterly hostile. So it was a complete range of reactions.
Senn: What about the child psychiatrist in Britain?
Bowlby: Child psychiatrists pro--anything from strongly pro to moderately pro, but no hostility.
Senn: But there has been an application, quite a widespread application of
ideas in the care of children in Britain?
Bowlby: Yes. Now, the reason for that is this: Set up at the end of the war there was a Government Committee on the Care of Children out of their own homes, known as the Curtis Committee, named after the chairman, Dame Myra Curtis. That reported in 1946. Some child guidance people were on it--Susan Isaacs was a member, I think. Sybil Clement Brown was certainly a member. I was among dozens who gave evidence. It was a far-reaching report which recommended among that there should be a child care service set up under the local authorities. That was implemented in 1948. So every authority in Britain had a children's officer and had responsibility for caring for children out of their own home. My report to WHO came at a psychological moment because it gave theoretical background to guide policy. Insofar as my views were influential it was because the social workers took them up and implemented them in the children's field.
There were other influences, I need hardly tell you. A person who played a very big part in all this was one whose approach was very different from mine, although in the same direction--Donald Winnicott. Winnicott was a pediatrician who became a child psychiatrist. His wife is a senior social worker. They worked together in this field during the war and were very influential in the care of evacuated and difficult children. Winnicott has had a very big influence in the social work field, but it has always been at a more individual, clinical level than mine, which has been more at the policy making and scientific level. In fact, we converged. In this country, I think that he and I between us have had a very big influence on the social work profession in child care.
The other thing which happened was in regard to the care of children in hospital. In 1951, the great majority of hospitals either forbade visiting by parents altogether or restricted it to, say, once a week. Now Robertson played a very very big part in changing that. In the first place he made this film A Two Year Old Goes to Hospital. He made that in 1952 and I'll tell you the circumstances he made it in. He was making what I would now call naturalistic, natural history observations of children, first at home, then going into hospital, what happened in hospital, what happens after they get home. He is a naturalist --that is his métier.
By 1951, he had become absolutely exasperated in so far as he gave reports to psychoanalytic audiences, pediatric audiences, psychiatric audiences about his observations and he met with endless resistance. "It isn't true, it doesn't happen," He was so exasperated by these reactions that he came to me--I remember in April 1952--and said, "I am going to make a film to show them." I may say, he had never used a cine camera before in his life.
We rustled up a little money to buy him a camera and we discussed how the film should be made. I suggested the time sample part of it and so on. He did some practicing on his own children with the camera. We had very little film, we had very little money and he made this film in late July, early August of 1952. Of course it was a winner. He ran out of film just as the child was leaving hospital. Now that film was immensely important--I think it has been immensely influential all around the world. It has been immensely influential in this country. I remember seeing it for the first time and being immensely moved.
We followed a strategy with that film and I want to emphasize this. We followed a strategy. First of all, the participants in the film had to see it, the matron of the hospital, the pediatrician the nurses, the parents so they all saw it. There were little bits of criticism, mainly for trivial reasons really. They wanted a few cuts and we cut them out because they were of no scientific importance.
Now we realized that this film was dynamite and we were very cautious. First of all it had to be edited; there wasn't much cut out actually because there was not much film. There was also the problem of what sort of sound commentary should we put on as it is a silent film.
Originally what happened was that Robertson drafted a commentary which he spoke whilst the film was being shown. We tried that out two or three times. This never worked because what was a perfect commentary for one audience was totally inappropriate for another. Either it was banal or madly controversial. We realized that in commenting on the film, the commentary had to be directed to each particular audience at that particular moment. So we agreed that the sound track should be restricted to giving only such information as was necessary to make the film intelligible. What was already on the film needed no comment.
The commentary says that this child is two years and four months old, she is an only child, and so on and so on. There were various things which you had to fill in in order to follow the film. But it was strictly factual. This was a very very key policy decision. The second thing was that the film was never allowed to be shown without an informed person from the Tavistock showing it. Thirdly it had to be shown first to two key groups of people--pediatricians and sick children's nurses. The only concern at that point was to have it accepted as a valid document.
What it signified, what it meant, what to do about it was quite another story, but first, it had to be accepted by the relevant professions as a valid statement. Now all that took a year or more. After that we could show it to other professional groups, but for a period of perhaps five years we refrained from showing it more publicly because we felt that it was vital that the professional groups should have an opportunity of seeing it, digesting it and, if necessary, acting on it. So this was a quite deliberate policy decision.
Senn: What were the criticisms against your work? Why did people disbelieve your thesis on separation? It did not fit into psychoanalytic theory enough?
Bowlby: Well, it didn't fit in to psychoanalytic theory enough. It put too much emphasis on the environment. One of the reasons that I selected separation, I concentrated on separation, was not because I felt it was necessarily the most important event, certainly not the most frequent pathogenic experience, but because it was unquestionable--it had either happened or it had not happened. Insofar as I thought that parental attitudes and all the rest of it were extremely important, this was something that at that time was much more difficult to deal with scientifically. We had no tape recorders and certainly no audio-visual aids.
Consequently I concentrated on separation, because my whole concern--really most of my life—has been to bring home to people that the environmental situation and the interaction of child and environment really matters. It was the environmental factor that was totally left out, in my view, of Melanie Klein's views, of Anna Freud's views, the psychoanalytic movement in general, and the psychiatric world in general.
Senn: Did the psychiatric world in general think that you were too specific, that you were pinpointing separation too exactly as being that meaningful?
Bowlby: Yes, they did.
Senn: In other words they thought, “Well, separation is in some instances very traumatic”…?
Bowlby: No, they didn’t think that. I am not exaggerating when I say that, with exceptions, most of them thought it was irrelevant. I remember a senior psychoanalyst saying that this child’s response was entirely determined by the fact that her mother was going to have a new baby--that's an example. And every other factor in the case was brought up as the reason that this child was distressed--it couldn't be separation. I think separation had been totally left out of preceding theory. And, of course, in terms of pediatricians it was distressing and disturbing because one was drawing attention to something which implied that some of their practices were very harmful. Again, it had been totally left out of their thinking. There was, you see, a widespread assumption that no children in 'my' ward cry. Robertson was frequently told “We have no crying children here,” whereas earlier he had heard children screaming down the corridor. An extraordinary blindness, you see. These were all reasons that people were resistant. I think the people who irked me most were the psychoanalytic groups because I felt was one of them and that my ideas were really highly to a psychoanalytic viewpoint.
Senn: Along the way you became interested in ethology? Where did that fit in to all that?
Bowlby: Well, I will tell you. You see, in 1950 I wrote the report. It’s in two parts, the first part…
Senn: For the U.N.?
Bowlby: For the World Health, yes.. The first part gives the evidence that deprivation experiences have adverse effects and therefore are to be taken seriously. Part two, really, policy. What do you do about it, how do you handle these problems? What was missing in that monograph was how comes that those experiences can possibly have those effects. Those experiences can't have those effects was the reaction of many people, you see. It is impossible for those experiences to have any effects. Working for the world Health Organization for a few months I had been totally unable to cope with that part of the problem. Some reviewers pointed out that this was a sad lack.
Consequently, in the summer of 1951--just after the monograph was published--one of the things in my mind was how to account for the bond the rupture of which causes all this distress. What is this bond? It was then the conventional wisdom to suppose that it was entirely derived from feeding. I knew it wasn't that, it didn't fit with any of my clinical experiences.
It was then that a friend called my attention to Lorenz's work on imprinting and the following response—that was July of 1951. I got hold of the English translation of his pre-war paper on The Companion in the Bird’s World. It was published in the American ornithological journal Ibis in 1935 I think. Anyway, I got hold of a copy and read that. Of course, it was a totally unknown world for me at that time but it happens--this was again a bit of luck--that Julian Huxley, the biologist., was a friend of my wife’s family and knew her father well. That summer, the Huxley’s were staying up with my father-in-law in the Western Highlands and we were holidaying nearby. So I took the opportunity of asking Julian whether he knew anything about ethology and was it any use.
Well, it happens that he had done some of the early work. He knew Lorenz well; he was a tremendous enthusiast He was writing the forward to the translation of. Lorenz's King Solomon Ring and he sent me the page proofs. He also drew my attention to Niko Tinbergen’s work and was, generally speaking, enthusiastic. So I thought, okay, this is scientifically alright. So I spent the next six months mugging up ethology. I just read everything I could get my hands on and I stuck my neck out.
In the Spring of 1952 there was a conference in this country of a new charitable foundation called The Mental Health Research Fund. It had called a small conference in Oxford on Prospects in Psychiatric Research to which I was invited. I thought that the programme, as drawn up, was rather inadequate, and I volunteered a paper on Critical Phases in Development of Man and Other Animals which was a manifesto suggesting that ethology has a lot to offer us. I volunteered this with fear and trepidation as to how it would be received but, in fact, it created a great stir, partly because it was one of the few novel things that had been offered. It was a very brief paper, a lightweight paper. Anyway it caused a stir because it represented a new angle.
This is where Hargreaves comes in again. Ronald Hargreaves was invited to attend this conference and he was taken by this paper and by another paper by a neurophysiologist called Greg Walter, on electroencephalography. He thought World Health should convene a study group on the development of children and he invited me to join a little working party to decide who should be invited.
Well, the upshot was that we had four meetings under WHO auspices--one was in London and the other three in Geneva. Piaget and Barbel Inhelder were there, and about a dozen others. Subsequently a number of other people joined, like Julian Huxley, Erik Erikson and von Bertalanffy. We had settled for four meetings at yearly intervals and for four days at a time. This was of course enormously exciting, very arduous, an interdisciplinary event. It was set up in the same style as the Macy conferences pioneered by Frank Fremont-Smith. Ronald invited Frank to conferences--Frank accepted and he did brilliantly. They were edited and published under the names of Tanner and Inhelder. They were very well received--in this country, certainly.
Senn: Were they published as Macy Foundation publications?
Bowlby: No, they weren't published by WHO either; published by Tavistock Publications, a private arrangement.
Now, coming back to my own affairs, I told you about a small grant from the Sir Halley Stewart Trust. The next small grant we got, I think, was from the World Health Organization. Then we got a small grant from the International Children’s Centre in Paris and then, having met Frank at this conference, we got a small Macy grant. He also supported Lorenz in quite a big way, I believe. So we were building up our group on some additional money. At that time, in addition to Robertson, we added Mary Ainsworth. She joined me in 1950 for four years--until 1954. Mary Salter Ainsworth, a Canadian citizen, about five years my junior who has worked in the United States most of her life. She was was over here with her husband at that time, that was why she was in London. Subsequently she has been at Johns Hopkins and recently moved to the University of Virginia. Another psychologist we recruited as a junior was Rudolph Schaffer; he got a chair in developmental psychology at Strathclyde subsequently.
So we had a little group of very good people--I was lucky really--and what happened was that my role became increasingly that of theoretical interpreter. Robertson was making observations. Mary Ainsworth was making observations. We were collecting information but the theory was a mess; there was no suitable theory really. There was psychoanalytic theory and there was learning theory but they did not fit.
Consequently I plunged for ethology. So I found myself eventually in the role of the theoretician introducing ethological ideas to try to explain data which we were busy collecting. In a way it was a strange role for me. I had wanted to contribute to the scientific development of psychoanalysis. I thought psychoanalysis was scientifically a mess and that a lot of work needed doing. I had always wanted to do that, its true. At any rate, I tumbled into this particular'work, examining the deprivation and separation data in the light of ethological ideas.
For some years I was the only person in the unit who was enthusiastic about ethology and who understood it. Subsequently, Mary Ainsworth became a very formidable ally. Going back to ethology--of course--I met Lorenz in Geneva and I got to know him and visited his place. I also got to know a very able young ethologist called Robert Hinde. Now,Robert Hinde is the leading man in the world at present. I think no one would dispute that. He had been trained as a zoologist at Cambridge and with Tinbergen. In 1954 when I first met him he was a bright young man in Cambridge. Well, that was a very valuable link. He came to our seminars at the Tavistock and was impressed--so he told me-- by the sort of observations we were making and by the interdisciplinary outlook we cultivated.
Senn: You were making observations on humans?
Bowlby: We were strictly on humans.
Senn: And he on birds?
Bowlby: That's right. However, his father was a doctor and he always had a medical outlook. In 1957, or 1956 maybe, he decided to study monkeys. He was in touch with Harry Harlow and I helped him get some research money. I told Frank Fremont-Smith about his work and commended it to him and he was very impressed. So I was glad to do that and help him a bit in one or two other ways as well. I am very proud to have done that. He started working on monkeys, I suppose in the Spring of 1958 and he built up his work. He still got a monkey colony at Cambridge. But he himself, having done 15 years hard labor on monkeys--more like 20--he has moved on to studying children now. I. will say, we know each other very well…
Coming back to 1955, at that time the Ford Foundation was supporting behavioral science on a very big scale, which means that they were giving what were then very large grants to a limited number of places. We applied for their support and we were one of the places that was given it. So having got useful but not large amounts of research support from other quarters, the Ford money came in in a big way. Now, as it happens, although we were informed in 1957 that this money was available, we did not need it until 1958 because we already had enough. So it was agreed we could carry it forward and we used it during the years 1958 to 1963. My association with Robert Hinde was very close from that time onwards.
Senn: How is he doing his work with children, and where?
Bowlby: Well, you see, I am still working on the same old problem. What happened is this. In 1957 I started tackling theory and I wrote a paper, which was published the year after, called The Nature of the Child’s Tie to his Mother which presented a different way of looking at it to the traditional one. It was published in the International Journal of Psycho-Analysis. That had quite an effect--not so much on psychoanalysts—but on a lot of other people in child psychology.
And then I wrote a paper called Separation Anxiety., and then one on Grief and Mourning in Early Childhood, linking up the responses of children to loss with the responses of adults to loss. I published five papers at that time; they were thought of as chapters of a book and I had to start again. But by 1964 I decided that they would not do as chapters in a book and I had to start again. Then I spent the next five years writing a volume which was called Attachment. I started writing one volume and then I found it was two volumes. So having published Attachment I had a second one to write. But in the middle of the second one I decided it wasn't two volumes--it had to be three. The second volume, Separation, came out in 1973. So that leaves Loss and I am working on Loss, hoping to finish it in the coming year.
Senn: As I told you earlier this noon, I live in a small town in Connecticut and that has a small library and that has a small library. It has your books on attachment, both volumes.
Bowlby: Well, that is very nice. These books, they were published of course in America. In this country it is Hogarth Press; in New York, Basic Books. With an American publisher you get much better publicity and circulation in the States.
Senn: Just to end this--and you have been very cordial and very helpful--I wonder if you could sort of say what is presently going on in British psychiatry? Do you see any trends in the care of emotionally disturbed and retarded children in Great Britain, new developments? Where are you going in terms of these children and their problems and in doing something to help them?
Bowlby: Well., I think many of these ideas now have become part of the intellectual climate of Great Britain, that is very important. That means to say that policy makers, children's officers, social workers, pediatricians, child psychiatrists, who advocate certain courses have widespread support from intelligent public opinion. To take an example, whereas the judges used to make some really dreadful errors in custody cases, many judges now are well informed and take a lot of trouble, and within their jurisdiction make very wise decisions. So all these ideas are no longer new-fangled, peculiar. They have ceased to be controversial--that I think is the big thing. At least they have almost ceased to be. Anyway, they are largely accepted now, recognized now. This I think has had a very widespread effect.
To take an example, almost all children’s hospitals allow unlimited visiting and a large number not only allow but encourage mothers to stay in hospital if they want to. Another instance is battered babies, which is something that has become of public concern in recent years, thanks largely to the work of Kempe. Although a punitive attitude still exists there is a very widespread understanding now that these parents are disturbed people with very poor backgrounds, and that they do these things for reasons which can be understood after a fashion and that punishment is not really the answer. These are the things in which I think we really have seen a radical change.
Also, as regards delinquency, there was a time when people really believed that punishment worked with chronic delinquents. Now they know it doesn't. They are aware that most of them are psychological cripples and that some other way of tackling the problem has to be thought up.
Senn: In America we have swung back to strong belief in punishment.
Bowlby: Yes.
Senn: You have not swung around?
Bowlby: No. Of course, the field of delinquency is enormously complex. There is everything from terrorists to drunkenness--you can't generalize. But there is much better understanding and information about some of these problems and what doesn't work and what might work. Although, God knows, we are miles away from having solved the problems, I think at least we are tackling them in a sensible way--I do think that.
Senn: Would you say that there has been a change in the education of children, in general education? Has your work influenced general education?
Bowlby: I don't think so, no. I would almost say, I don't expect it to.
Senn: What about foster care, leaving children in their own homes, that kind of thing?
Bowlby: You see, right back before 1950 it was recognized that institutions were not a very good thing and that foster care was the method of choice. Since that monograph in 1951, in this country, there has been very strong support for foster care, and also very considerable efforts to support a home rather than taking children away from it. All that has been going forward now for 20 years. I need hardly say sometimes it is done more efficiently and effectively than at others; but this is the national policy. It has been so now for a long time.
Senn: Is there anything else you would like to add to this wonderful interview?
Bowlby: No, I don’t think so.
Senn: I do appreciate it very much, and I am very thankful not only for this, but for many things you have done for children and for other people.
Bowlby: Well, I must say, one thing which I did recognize fairly early was that in selecting separation as a field of study, it had certain great merits. First of all, it is a limited area which has great practical importance and it provides also a starting point for a scientific endeavour. So these characteristics and,, speaking for myself, I have done my best to exploit both; but increasingly on the scientific side and decreasingly on the practical side. And the reason for that is this, the practical side has been very largely done in this country--that is to say…
Senn: Not finished but....
Bowlby: It's been started and the professional groups resp,onsible for these services are now well and truly educated. I get a lot of invitations to speak--I am very selective. A lot of social work groups invite me. I do not accept; they already know it all, so it’s unnecessary. Occasionally pediatricians invite me and I do my best to accept. Psychiatrists--I always accept if I can because adult psychiatrists, until recently, have been totally ignorant. One thing which I do think has happened in this country over the last ten, fifteen years--ten years maybe--has been that psychiatry as a whole in Britain is much less organic and genetic and continental in outlook and much more aware of the psycho-social aspects. This is new because there was a time when everything in the psycho-social world was regarded at the Maudsley and other places as being outside the bounds of science.
Senn: Even at the Maudsley?
Bowlby: The Maudsley has changed radically.
Senn: Was the Maudsley, in the early days more organically oriented?
Bowlby: Oh, yes, very.
Senn: Neurologically oriented?
Bowlby: Sure, very.
Senn: Under Sir Aubrey Lewis? Did he begin bringing a change in terms of social ... ?
Bowlby: He brought a change in terms of what you might call community social but not in terms of family social. He was very critical of psychoanalysis-- hostile to psychoanalysis. It was not until he retired ten years ago and he was succeeded by Denis Hill that things began to change. Denis Hill is not a psychoanalyst but he is married to a psychoanalyst. He is much more broadminded, much more catholic in his interests and much more prepared to sponsor research in the field of dynamic psychiatry. Aubrey Lewis always claimed to stand for diverse viewpoints but in practice the psycho-dynamic, psycho-social side had a very thin time of it. The atmosphere in the Maudsley has changed greatly.
Senn: Thank you very much.
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