Attachment and the loss of fertility: the attachment strategies of prospective adoptive parents
| Published date | 06 June 2019 |
| Pages | 78-96 |
| DOI | https://doi.org/10.1108/JCS-11-2017-0049 |
| Date | 06 June 2019 |
| Author | Steve Farnfield |
| Subject Matter | Health & social care |
Attachment and the loss of fertility: the
attachment strategies of prospective
adoptive parents
Steve Farnfield
Abstract
Purpose –The purpose of this pape r was to determine the atta chment strategies of prospective
adoptive parents and an y correlation between a ttachment and the defen sive strategies they use d when
talking about loss of ferti lity. The study also examined wheth er attachment strategy of the applica nts had a
bearing on the decision by the local authority to place a child.
Design/methodology/approach –The samplewas comprised of 48 respondents(21 couples) representing
84 per cent of all peoplewho applied to one UK Social Services Departmentin a 12-month period. Placement
of a child was reviewedtwo years following the assessment. The study used thedynamic maturational model
versionof the adult attachment interview(DMM-AAI), together withadded questions on loss of fertilityto assess
the applicants’attachment strategiestogether with unresolved loss and traumaand the DMM modifiers.
Findings –Unlike adoption studies using the Main and Goldwyn system, this study rated very few of the
applicants’AAIs as secure (13 per cent), 48 per cent were in the normative low-risk range and 52 per cent of
the AAIs were coded in the more complex DMM insecure strategies. There was a significant bias towards
marriages where the partners deployed opposite low-risk/DMM strategies (13 (62 per cent) of couples).
Compared with data on non-clinical populations the AAIs showed a high level of unresolved loss or trauma
(58 per cent). Using a six-way distribution (A1-2, C1-2, B, A3-4, C3-6 and A/C) there was an 87 per cent
correspondence between discourse about loss of fertility and that about attachment, thereby supporting the
established proposition that reproduction is part of the attachment system. Twenty one per cent of the AAIs
were coded as “disorientated”and this is discussed in terms of conflict for adoptive of parents concerning the
raising of a child who carries their own genes or those of strangers. A case is made to conceptualisenegative
impact of infertility in terms of unresolved trauma rather than loss.
Research - limitations/implications –Thisstudy adds to research showingthat the DMM approach is more
finely calibrated than the ABC+disorganised model with the latter likely over coding for security. The results
emphasise thatfertility and reproductionare legitimate subjects for attachmentstudies and that AAI discourse
analysis is a valid methodology for future research. However coder agreement as to whether or not loss of
fertility was resolved was only fair (64per cent) κ. 0.25 (po0.33). More work is required in orderto determine
what constitutesunresolved loss of fertility and whatimpact, if any, this has on parentingan adopted child.
Practical implications –The practice implications are considered in a separate paper.
Social implications –The findings are contenti ous in that they suggest a sign ificant number
(48 per cent) of adoptive parents have needs not dissimilar to other clients of psychological services.
Originality/value –This is the firstDMM-AAI study with prospectiveadoptive parents and the findingsshow
significantdifferences when comparedwith previous studies using theMain and Goldwyn AAI. It is also the first
study to establishfertility as a legitimate area for attachment studies by usingAAI discourse analysis.
Keywords Attachment, Assessment, Adoption, Infertility, Adult attachment interview,
Dynamic maturational model
Paper type Research paper
Introduction
Adoption in the UK is an integral if numerically small part of the child welfare system. Over the last
few decades the profile of adopted children has changed from that of infants relinquished by their
birth parents to older children who have been taken into local authority care for reasons of abuse
Received 10 November 2017
Revised 4 November 2018
Accepted 15 March 2019
Steve Farnfield is based
at the Department of
Psychology, University of
Roehampton −Whitelands
College, London, UK.
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VOL. 14 NO. 2 2019, pp. 78-96, © Emerald Publishing Limited, ISSN 1746-6660 DOI 10.1108/JCS-11-2017-0049
or neglect. Many of these children are traumatised (Rees and Selwyn, 2009) and so present
considerable challenges to their adoptive families. Until recently adoptive parents were typically
heterosexual couples but there is now an increase in adoption by single parents and same-sex
couples (New Family Social, 2018).
While more is known about maltreating than typical parenting there is no standard
approach to the assessment of parenting in social work practice and there have been
ongoing criticisms concerning the lack of analysis in parenting assessments (Woodcock,
2013; Selwyn, 2015). The assessment of adoptive parents is conducted by local authority
social services or voluntary organisations using a standard report format, but chiming
with practice in child protection, the means of gathering and evaluating information varies
(Selwyn, 2015).
Despite the variations in assessment practice there is a consensus regarding certain attributes
that are reasonable predictors of successful (i.e. good enough) parenting, whether the context is
child protection or family placement. Two of these are the focus of this study: the parents’state of
mind regarding their childhood attachment and unresolved loss and trauma (Fonagy, Steele and
Steele, 1991; Dozier et al., 2001; Madigan et al., 2006; Farnfield, 2008; Stacks et al., 2014;
van Ee et al., 2016; Reijman et al., 2017).
The majority of heterosexual couples applying to adopt do so because they cannot conceive a
child of their own but s urprisingly litt le is known about the im pact that loss of fert ility has on
parenting an adopted child (see Crawshaw and Balen, 2010). Infertility is not easy to diagnose
with any degree of certainty and many couples are what the literature refers to as “sub-fertile”;
that is the reasons for their lack of fertility are unclear and for some there is still a chance that
they might conceive a child sometime in the future (Crawshaw and Balen, 2010). The choice of
adoption as a solution to childlessness appears to be one made by a minority of people. One
large Danish stud y following women s tarting fertility treatment, foun d 75 per cent of
respondents had gi ven birth 5 years late r, 19 per cent remained c hildless and only 6 pe r cent
had adopted a child (Pinborg et al., 2009). However, this self-report study was likely biased
towards women who had conceived.
This paper reports on the attachment strategies of prospective adoptive parents. The dynamic
maturational model version of the adult attachment interview (DMM-AAI) was used to assess
48 adults representing 84 per cent of all the people who applied to one UK social services
department to adopt a child in a 12-month period. This exploratory study builds on a
discussion chapter by Farnfield (2012) and is the first major study to use the DMM-AAI with
adoptive parents. As well as attachment, trauma and loss it also investigated the degree to
which information processing (see below) regarding loss of fertility corresponded with
attachment strategy.
Adult attachment
Attachment in adults refers to a behavioural system that has developed out of childhood
relationships with our own parents or carers and now functions in a more generalised way to
process information about safety, danger and sexual opportunity (Bowlby, 1980: Chapter 4).
After puberty the protective function of attachment is integrated with the reproductive function
(Del Guidice, 2009) so that what began as attachment to parents is now focused on attachment
to a sexual partner (Crittenden, 2005).
All attachment behaviour, whether secure or insecure, is strategic in that its goal is to regulate
social encounters in terms of intimacy, potential harm and rejection. Humans are social animals
and a crucial concept for using attachment in assessments is that of information processing: how
we determine whether other people are safe to approach or are a threat. This goes on all of the
time, mostly at an unconscious level (Porges, 2011).
Bowlby discussed information processing in terms of defensive exclusion (Bowlby, 1980):
distortions or omission of information, in the body (feelings) and the mind (thoughts), which
function to avoid the suffering that is caused by giving this information conscious expression.
Thus Type A and C attachment (see below) are different forms of defensive exclusion that pose
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