The Earliest Relationship; Parents, Infants and Early Attachment

Excerpted from
The Earliest Relationship; Parents, Infants and Early Attachment
By T. Berry Brazelton, M.D., Bertrand G. Cramer

The Prehistory of Attachment

Each woman's pregnancy reflects her whole life prior to conception. Her experiences with her own mother and father, her subsequent experiences with the oedipal triangle, and the forces that led her to adapt to it more or less successfully and finally to separate from her parents, all influence her adjustment to this new role. Unmet needs from childhood and adolescence are part of the desire to become pregnant and, then, to adapt to the condition of pregnancy. After examining how these early experiences and needs are reflected in the desire for a child, we will look at the transformations brought about by pregnancy itself, and at the further reshuffling of emotions and fantasies as a woman develops her new identity as a mother.

Gender Identity

Many forces act together to bring about a sense of identity for each gender. Most people have a mixture of these feelings, but a core identity predominates. This "core gender identity" (the subjective sense of belonging to one sex) appears to develop from the beginning of life, under the influence of both biological and environmental forces.

1. Hormonal Influences. Sex chromosomes determine the differentiation of the ovary and the testes in the developing fetus. Then, at "critical" moments of fetal development, high levels of circulating androgens determine the formation of typical male external genitalia. A dominant level of androgens will give a genetically female fetus male external genitalia. The clitoris will be enlarged at birth and appear to be a penis. The testicular sac is developed, and the baby's physique is masculinized.

John Money and Anke Ehrhardt (1972) have also demonstrated that behavioral and emotional sex differentiation may be influenced in the uterus in the same way. Sex hormones have a direct influence on the brain, affecting the formation of important neurotransmitters as well as fostering the growth of nerve cells. Sex hormones affect the hypothalamus, an area of the brain closely related to behavior regulation. Both male and female animals exposed to high levels of prenatal androgens exhibit mating and other behavior characteristic of the male. In human beings, however, while hormones play a role in the development of external genitalia and, possibly, in brain development, it is the interplay between such biological forces and environmental factors that determines behavior.

2. Assigned Sex. At birth, a sex is assigned to the baby on the basis of the appearance of the external genitalia. This assignment plays a determinant role in developing gender identity. Money and Ehrhardt have shown this dramatically in their study of children born with external genitalia that differ from their chromosomal sex orientation. This is the case with the female fetuses mentioned above, who were exposed to androgenic hormonal influences and who demonstrated "male" genitalia at birth. These children are raised as boys, and the perceptions and behavior of those around them determine their subjective conviction of being boys. Money and Ehrhardt showed that by age two, gender identity is fixed in the child's mind.

Similarly, a genetically male fetus that is insensitive to the influence of androgens during fetal life will look female at birth, with a vagina and the external characteristics of a female. Such children will be raised as girls. From the first, parents will treat them as female, and they will grow up thinking of themselves as female.

A father is more likely to toss a boy baby into the air; a mother is likely to protect her daughter from such play. Our vocal behavior is also set by past experiences of our own. We are likely to talk softly and soothingly to a girl, to attempt to excite and stimulate a boy with the same words. The rhythm of interaction between parent and child is likely to be low-keyed and slow for a girl, with more dramatic ups and downs and shorter intervals for boys. There is increasing evidence that mothers tend to talk to and to handle girls more than they do their boy babies. These labeled behaviors are so deeply ingrained in all of us by our own parents' handling that we are unlikely to be able to change them by conscious determination. How parents feel about maleness and femaleness will have a powerful influence on gender identity, and will be transmitted to the infant in subtle ways through every interaction. Identification with her mother's behavior toward her and a father's participation in a little girl's nurturant behavior may reinforce her wish to become a mother in later life.

5. Bodily Sensations And Imagery. The developing infant's sensations—especially around the genitals—may influence the psychic concept of the self belonging to one sex or the other. Since boys' genitals are more exposed and more available to self-handling as well as to handling by the caregiver, the early experiences of exploration, masturbation, and of valuing one's genitalia can lead to more exhibitionism and externalizing of sexuality in the male. In the female, privacy, wonder at her genitalia and its meaning and value, and internalizing of sensation are more likely. These differences in sensual experience based on differences in the sexual characteristics of the body will deepen and grow throughout life and continue to influence gender identity. A girl's questions about what her genitalia and breasts are expected to do will recur often as she grows up. When she reaches the age of menstruation, these questions become heightened all over again. Her unseen and untested reproductive organs will be woven into her fantasies of pregnancy. Robert Stoller has described these fantasies as vital to a female's development of her identity and argues for the concept of primary femininity. In his view, a girl develops a feminine identity from early infancy.