Miriam Steele: Breaking Cycles of Neglect Using Attachment Research
“I never get to see myself from the outside, I’m always judging myself from the inside,” reports a parent participating in a New School-Albert Einstein Medical Center clinical research collaboration directed by New School for Social Research psychologist Miriam Steele and her colleagues. Steele suggests that stepping outside of the interaction prompts reflective functioning, a theoretical framework she developed with her collaborator and husband Howard Steele over a decades-long examination of parent-child attachment. They have used the lens of attachment research to examine everything from the intergenerational links in parent-child relationships, intervention approaches to address child maltreatment, adoption, and the development of body image. She describes her work as bridging “the world of psychoanalytic thinking and clinical practice with contemporary research in child development.” In the course of our recent conversation it became clear that, for Steele, to research is to learn, to teach, and to help people – and to discover the next big question.
Group Attachment-Based Intervention
Steele’s focus is a psychological intervention called Group Attachment-Based Intervention (GABI), and she assesses its impact in a randomly controlled trial, federally funded by the Human Resources Services Administration. The research team – comprised of faculty and graduate students at NSSR, as well as clinicians and researchers from Albert Einstein College of Medicine – brings together parents and young children from the Bronx for a thrice-weekly session of a group-based clinical treatment. As described in her co-authored article, Looking from the outside in: the use of video in attachment-based interventions (Attachment & Human Development, 2014), GABI is designed “to reach parents with histories of multiple adverse childhood experiences and ongoing exposure to poverty, domestic and neighborhood violence and risk of child maltreatment.” This intervention grew out of a community-based intervention, setting it apart from interventions conceptualized in an academic setting and then delivered to patients.
The project started with one fundamental assertion, said Steele: “We know from neurobiology that well-nurtured brains look different from those that are not. That’s been well documented. The question is, how can we bring about change ?” Steele thinks that such a transformation in a parent could be brought on in part by an important aspect of the intervention: a parent watching video footage of her interactions with her child and being asked to reflect on what she sees while also hearing the reflections from her peers in the group.
The use of video footage in clinical interventions is not new. Nor is the group therapeutic treatment setting. What is unusual is to do both simultaneously. Steele and colleagues are already seeing that the unique combination – analyzing video footage of parent-child interactions and processing among peers – can catalyze change in the early years of parenting. In a case study detailed in the article, the clinician reviews a video with a mother who is dismissing her child’s fears, in a wish to believe that the child has not experienced the trauma that is ongoing in his home. With the clinician’s and group’s feedback, the mother is able to imagine alternative modes of interaction with the child. One observing parent comments, “We always hope [our children] don’t see or hear what is really going on when we fight, but what happens when they do?”
Neuroimaging studies have established that the physiological impact of watching oneself in interaction with a loved one is different from the effect of watching unrelated others in interaction. Steele remarks that “different parts of the brain light up, when it’s you and your baby versus someone else and their baby.” Steele notes that the video clip does not even have to demonstrate a heavily emotional experience; it can be just 30 seconds of an interaction. “There is something very immediate and very powerful about seeing yourself, as you interact with your child, which includes catching sight of yourself, in the role of parent.”
As Steele says, her aim with this intervention is to break the cycle of trauma that impacts impoverished communities and that has built up over several generations. Most parents participating in the GABI trial were born in the context of trauma – at every level-within the family and their community, and are now having children of their own. Although the program is unique in attracting both mothers and fathers, many referrals to the program are single mothers raising multiple children. While Steele hopes this work improves the lives of vulnerable parents and children, she also sees imbalances in the clinical setting that need to be addressed. In this trial, the families are mainly African-American and Latina, and hail from one of the country’s most underserved areas, the Bronx. One mother commented that the only white people she ever saw were teachers or judges, or those on television, and “not actually people who would want to pick up her children and engage with them.” A significant strength of this type of intervention is its ability to tackle detrimental social isolation, Steele notes, so the families stay engaged not only because of their commitment to their children’s well-being, but because of the strength of social ties they develop in the process.
Steele has seen a positive impact from the project even before its completion. The New School/Albert Einstein College of Medicine team have collected over 300 hours of footage and, with funding from the Robin Hood Foundation, have turned this documentation into an online training program. Steele recently secured funding from the New York State Health Foundation to establish this intervention in ten different sites across New York State. Steele notes that “because [the intervention is] delivered in a group, we have the possibility of engaging many families at one time. The intervention is deemed cost-effective as compared to individual treatment, where the number of missed appointments for vulnerable families can be substantial.”
This upcoming fall semester, Steele will teach an interdisciplinary course called “Trauma, Children and Politics” with fellow psychologist Bill Harris. Harris, regularly advocates for federal legislation to improve the lives of children in poverty. In this course, students from across The New School will “explore the challenges of translating research into policies capable of supporting the goal of breaking the cycle of abuse across generations.” The course is a new initiative for Steele, bridging the world of intervention with vulnerable families and social policy.
Attachment and the Body
In a related research project, Steele is finding connections between attachment, self-regulation, and body representation. Before arriving at NSSR ten years ago, Steele was approached by psychotherapist and writer Susie Orbach (‘Fat is a Feminist Issue’) with a hunch – that as Steele puts it, “there is an attachment dimension to how mothers transmit ideas and thoughts and feelings about their bodies, almost with their mother’s milk, to their young infants.” Orbach asked Steele to join forces with a New York based group of psychoanalysts who focus on the body and to design a study that would examine these connections.
One of Steele’s doctoral students, Tiffany Haick, introduced a method called the mirror interview, in which a researcher asks people standing in front a mirror a series of questions about body image and relationships, while observing both verbal and non-verbal behaviors. Using this measure, Steele and her team were able to test this hypothesis of the relation between body representation and attachment. Steele pointed out prior research on media-based messages confirming that “those with more secure relationships [to one’s parents] are less likely to internalize the pernicious messages received from outside sources.” She and her team posited that the mirror interview would help them capture a connection between a mother’s representation of her childhood experiences and the transmission of her own body representation to her daughter.
After conducting and rating over 50 Adult Attachment Interviews and mirror interviews (the latter including both mothers and toddlers), Steele and then clinical doctoral student Tiffany Haick found clear relationships between the way mothers speak about their own childhood and about their bodies. The researchers established that secure attachment states of mind led to coherent narratives about the body. Another graduate student Kristin Tosi found that the babies of securely attached mothers also engaged with their own image in what Steele calls a mid-range or “Goldilocks model” – not too much, not too little. They look, then they look away, then they look back. By contrast, babies whose mothers were classified as dismissive of their own experiences with their mother, had a harder time engaging with their own image and tended to look away. Lastly, mothers who showed anger towards their own mothers had babies who seemed to engage at length with their own image, sometimes almost longingly or with aggression.
Wearables: The Intersection of Psychology and Psychophysiology
During the mirror interviews, Steele and her graduate students were struck by non-verbal impulses of mothers “tucking in their shirts, tugging, pulling, having seemingly self soothing behavior as they talked about what their fathers might think about their bodies.” Steele’s instinct was to explore the interface between clothing design and body representation. In trying to make sense of the literature, she realized that the better approach would be to collaborate with fashion experts at Parsons School of Design. Steele connected to Sabine Seymour, an Assistant Professor who studies the intersection of design and technology.
The outreach quickly turned into mutually beneficial and necessary collaboration, the results of which Steele and her graduate student Hannah Knafo presented at the Eyebeam Art and Technology Center’s Conference on Computational Technology. Seymour studies the phenomenon of “wearables,” shorthand for clothing embedded with data-collecting technology. Steele has been able to provide a theoretical and methodological basis for exploring the psychological implications of wearable technology. While Seymour fabricates low-impact and washable clothing that collects data from mothers and babies while they interact, Steele is now looking beyond the behavioral aspects of the subjects to measure psychophysiological impact.
A Selection of Publications by Miriam Steele
Steele, M., Steele, H., Bate, J., Knafo, H., Kinsey, M. Bonuck, K., Meisner, P. & Murphy, A. (2014) Looking From the Outside In: The Use of Video in Attachment-Based Interventions. (.PDF) Attachment & Human Development, 16, 402–415.
Murphy, A., Steele, M., Dube, S.R., Bonuck, K., Meissner, P., Bate, J., Goldman, H., Steele, H. (2013) Adverse Childhood Experiences (ACE) Questionnaire and Adult Attachment Interview (AAI): Implications for Parent Child Relationships. (.PDF) Child Abuse and Neglect, 38, 224-233.