In his publication titled Grief, Separation, and Loss (1960), Bowlby revised Freud’s theory of signal anxiety and presented a modern application of Freud’s motivational theories (Bowlby, 2005). Bowlby’s contribution focused on the infant’s need for an unbroken and secure attachment to the mother. He thought that children who do not have such provision were likely to experience emotional reactions of separation consisting of protest, despair, and detachment (Bowlby, 2005). According to Bowlby (1960), when a healthy child over the age of 6 months is separated from their biological mother to whom they are securely attached and placed with strangers, the child’s initial reaction is to cry and attempt to regain the mother. “He will often cry loudly, shake his cot, throw himself about, and look eagerly towards any sight or sound which might prove to be the missing mother” (p. 13).
Protest begins with the child’s perception of a threat of separation (Bowlby, 1958). Such protest is marked by crying, anger, physical attempts of escaping, and searching for the parent (Bowlby, 1960). According to Bowlby (1960), the period of protest might have ups and downs and could last for as long as a week or more. During this time, the child might seem preoccupied with his or her efforts in the hope and expectation that the mother will soon return. Despair follows protest, whereby physical movement begins to diminish (Bowlby, 1960). Crying becomes sporadic, and the child may appear despondent and might withdraw from contact, and is more likely to be aggressive toward other children or a favorite object brought from home (Bowlby, 1960). The child might also appear to enter a phase of mourning the loss of the attachment figure. The desire for the mother does not end, but the continued hope of her return begins to fade (Bowlby, 1960). Bowlby (1960) further reported that “ultimately, the restless noisy demands begin to cease; the child becomes apathetic and withdrawn, a despair broken only perhaps by an intermittent and monotonous wail. He or she is in a state of unutterable misery” (p. 13). The final phase of detachment consists of an attempted return to sociability (Bowlby, 1960). Offers by other adults to provide care are no longer rebuffed by the child, yet the child might behave in an abnormal way upon reunion with a caregiver (Bowlby, 1960).
Bowlby traced the use of the term grief in the work of Robertson, a social worker and psychoanalyst who was a strong influence on Bowlby (Metcalf, 2010). Robertson and Bowlby worked together in creating a 1952 documentary film titled A Two-Year-Old Goes to the Hospital (Metcalf, 2010). The film was based on children between the ages of 18 and 48 months, and focused on the impact that separation from parents have on children during admission to a hospital or residential nursery (Bowlby, 1960). This film was also instrumental in altering hospital policy visitation restrictions on parents (Zepf, 2011).
Robertson’s study enhanced Bowlby’s theory on the traumatic effects of separation in which appropriate attention had been bestowed on the child from an unfamiliar surrogate (Metcalf, 2010). Robertson explained, as cited in Bowlby (1960), that if an infant is extricated from the care the biological mother at the age of 18 to 48 months, when the child is so possessively and securely attached to her, it is as if the child’s world has been shattered. The profound need for the mother is left unsatisfied; and the frustration and desire for her might result in tremendous grief for the child. Robertson described the intensity of this grief as extremely overwhelming and characteristic of the same kind of grief and loss an adult might experience when mourning the death of a close loved one (Metcalf, 2010).