184:...the child may go on to the stage known as "despair". He's very quiet, withdrawn, miserable and apathetic. He stops playing – seems to lose interest in everything'. The child gives up hope of his or her mother returning and may appear to be "settling down", to the satisfaction of unenlightened staff. In fact, 'when he gets home, he'll take much longer to get over the experience. He'll cling to his mother more', and before recovering will 'usually then have to go through the protest phase on the way'.
346:" to the feelings children have for their parents...they run in parallel'. They distinguished the two on the grounds that 'Bonding is a mature form of loving. But the attachment of child to parent is an immature form of loving – unstable in the early months and years'. They considered that 'bonding progresses down the generations to promote the well-being of each new batch of babies...where the parents are not bonded to the children, the children are put at risk'.
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Robertsons found of the fostered children that, 'in varying degree, reflecting their different levels of object constancy and ego maturity, all made a relationship to the substitute mother...The relationship with the foster-mother gave comfort and an emotional anchor which prevented them from deteriorating and held them safely until they were reunited with the mother'.
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mothering at all; but, 'in fact, he only seems to have recovered, and at the cost of killing his love for his mother'. When eventually reunited with the family, 'the child can seem quite changed and now appears superficial, emotionally distant'. His relationships with others are shallow and untrusting. 'This is the most difficult stage to undo'.
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They also explored the reverse situation, when a mother was hospitalised and the children thereby separated from her – themselves 'fostering children while their mothers were in hospital' and so demonstrating that 'planning for the situation and arranging proper care can make a difference'. The
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In recent years there have been great changes in children's wards, partly brought about by this film. But many young children still go to hospital without the mother and, despite the play ladies and volunteers, the depth of their distress and the risks to later mental health remain an insufficiently
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In the protest phase, the child is visibly distressed, cries and calls for his mother ' – distress, angry crying, searching, trying to find the mother and get her back'. The child reunited at this stage will 'usually be quite difficult for a time. It's as though he is punishing the mother for going
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In the denial/detachment phase, the child shows more interest in his surroundings and interacts with others, but seems hardly to know the mother when she visits or care when she leaves, which is why 'the third stage – "detachment" – is the most serious'. Apparently, the child seems not to need any
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When James
Robertson first entered the children's ward to make observations, he was shocked by the unhappiness he saw among the youngest children, in particular those aged under 3. The competent, efficient doctors and nurses gave good medical care but seemed unaware of the suffering around them.
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Robertson's research was met with hostility by the medical profession. Even his colleagues at the
Tavistock Clinic – although accepting 'that anything that breaks up the child's life into fragments is harmful. Mothers know this' – did not feel the same sense of urgency. They had not seen the
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Laura, aged 2, is in hospital for 8 days to have a minor operation. She is too young to understand her mother's absence. Because her mother is not there and the nurses change frequently, she has to face the fears, frights and hurts with no familiar person to cling to. She is extremely upset by a
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James decided to make a film record of a young child's stay in hospital. It would allow the evidence to be examined and re-examined. He hoped it would pierce defences that the spoken word could not. With a grant of £150 he purchased a cine camera and 80 minutes of black-and-white film. He had
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said of him, "(He) was a remarkable person who achieved great things. His sensitive observations and brilliant observations made history, and the courage with which he disseminated – often in the face of ignorant and prejudiced criticism – what were then very unpopular findings, was
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Decades later, 'now that we understand the process, hospitals are making it much easier for parents to visit more or live in the hospital with younger children so that the two later stages are reached much less often'; but it required shock tactics from
Robertson to achieve that end.
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This caused great distress to the young patients, and it was well known in the community that a child could be 'changed' by a stay in hospital. However, little of this disquiet reached the hospitals, and later commentators would speak of 'an emotional
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Wartime
Nurseries. Joyce was a student caring for the infants who had lost family life due to the war. James began by organising the maintenance and firewatching, but later became the social worker. Both James and Joyce benefited from teaching by
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Based on several years of observations in long and short stay wards, James
Robertson formed a theory of phases of response of the under 3's to a stay in hospital without the mother: Protest, Despair and Denial/Detachment (James Robertson, 1953a).
296:"The restraint and objectivity of the film may at first reassure, for the child is unusually composed for her age, but few nurses will doubt the degree of her distress, the signs of which they have so often felt powerless to relieve."—
308:". . . convincing and brilliant demonstration ad oculos of the outward manifestations of the inner processes that occur in infants who find themselves unexpectedly and traumatically without their families."—Anna Freud, LL.D.,
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This film study of typical emotional deterioration in an unaccompanied young patient, and of the subtle ways in which she shows or conceals deep feelings of distress, remains as vivid and relevant as when it was made.
314:"...a connected and credible demonstration of stress, separation anxiety, early defensive manoeuvres, and topics akin. .also a social document of honest power. Without preaching, it bears a message of reform. . ."—
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at the
Tavistock Clinic in 1948, to make observations on separated young children. As a convenient way to do so, he was sent to the short stay children's ward at the Central Middlesex Hospital in London.
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legendary. He will always be remembered as the man who revolutionised children's hospitals, though he accomplished much else besides. I am personally deeply grateful for all that he did."
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Alsop-Shields, Linda; Mohay, Heather (July 2001). "John Bowlby and James
Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital".
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They saw that children initially protested at separation from the parents, but then settled, becoming quiet and compliant. However, Robertson saw this as a danger signal.
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The
Robertsons went on to make 'a series of harrowing films that revealed the true nature and extent of distress shown by separated young children' in hospital.
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At the time, visiting of children in hospitals was severely restricted. In a survey of London
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to the awareness of children's emotional needs and distress. The strength of this resistance is vividly illustrated by the work of James
Robertson'.
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The resulting film is regarded as a classic. It has been designated "of national and historic importance" and a copy is being preserved in the
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rectal anaesthetic. Then she becomes quiet and "settles". But at the end of her stay she is withdrawn from her mother, shaken in her trust.
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London Hospital, under 3 years old, no visits, but parents could see children through partitions. Over 3 years old, twice weekly.
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for parent-to-infant attachment'. For the Robertsons, '"bonding" refers to the feelings parents have for their children and "
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Robertson and Bowlby saw breaks in a child's attachment bonds as responded to by 'phases of protest despair and detachment'.
509:"John Bowlby and James Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital"
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St Thomas's Hospital, first month no visits, parents could see children asleep 7–8 pm;
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304:. Though the standard of care in the hospital was high she undoubtedly fretted." -
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Munro-Davies, H.G. (1949) 'Visits to Children in Hospital', Spectator, 18 March.
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away. When he's got those feelings off his chest, he returns to normality'.
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After the war, James trained as a Psychiatric Social Worker and joined
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300:. ". . . explodes the belief that a 'good' child is well-adjusted."—
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The emotional needs of young children and their families
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Robertson contributed evidence from his research to the
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Westminster Hospital, Wednesdays 2–3 pm, Sundays 2–3 pm
507:Alsop-Shields, Linda; Mohay, Heather (July 2001).
555:Psychology for Nurses and the Caring Professions
199:regarding the welfare of children in hospitals.
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495:The Child, the Family, and the Outside World
414:The Making and Breaking of Affectional Bonds
41:and Institute, London from 1948 until 1976.
261:Learn how and when to remove this message
180:If however 'the separation continued for
137:Charing Cross Hospital, Sundays, 3–4 pm;
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311:International Journal of Psychoanalysis
121:St Bartholomew's, Wednesdays 2–3:30 pm;
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243:adding citations to reliable sources
683:20th-century British psychologists
134:West London Hospital, no visiting;
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653:Health professionals from Glasgow
274:never used a cine camera before.
566:Christine Brain/Penny Mukherji,
525:10.1046/j.1365-2648.2001.01821.x
435:Families and How to Survive Them
379:10.1046/j.1365-2648.2001.01821.x
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118:Guy's Hospital, Sundays, 2–4 pm;
673:British conscientious objectors
668:Scottish documentary filmmakers
322:Further developments: fostering
230:needs additional citations for
209:A Two-year-old Goes to Hospital
583:(London 1989) p. 97 and p. 140
568:Understanding Child Psychology
76:. In 1941 James and his wife
68:in his late teens, and in the
29:(1911–1988) was a psychiatric
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581:Separation and the Very Young
399:Judith Trowell/Marion Bower,
678:Scottish Christian pacifists
169:Protest, despair, detachment
56:James Robertson was born in
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592:J. and J. Robertson, p. 203
579:James and Joyce Robertson,
513:Journal of Advanced Nursing
367:Journal of Advanced Nursing
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447:Skynner/Cleese, p. 110-111
192:same things he had seen.
105:Young children in hospital
663:Attachment psychologists
316:Contemporary Psychology
306:British Medical Journal
658:British psychoanalysts
497:(Penguin 1973 ) p. 223
484:Skynner/Cleese, p. 112
463:Skynner/Cleese, p. 111
334:Bonding and attachment
74:conscientious objector
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472:Skynner/Cleese, p. 11
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438:(London 1994) p. 110
289:recognised problem.
239:improve this article
416:(London 1979) p. 48
72:he registered as a
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493:D. W. Winnicott,
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82:Anna Freud
58:Rutherglen
52:Background
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