James Robertson (1911–1988) was a psychiatric social worker, psychoanalyst and filmmaker who worked at the Tavistock Clinic and the Tavistock Institute of Human Relations, London from 1948 until 1976.
In a 1959 review of Robertsons film, "A Two-Year-Old Goes to Hospital", paediatrician Donald Winnicott declared that "One seldom meets a nurse or a social worker who has not had an opportunity to see it, and its influence has been very great".
John Bowlby 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 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".
Life James Robertson was born in Rutherglen, Scotland in 22 March 1911, and grew up in a working-class, close-knit loving family where children were cuddled, loved and protected. He intrinsically understood that children needed their mother and was sensitive to pain due to separation. He became a Quaker in his late teens, and in the Second World War he registered as a conscientious objector.
In 1939, Robertson met his future wife Joyce Robertson (nee User) in Birmingham, while he was studying the humanities at the Fircroft College of Adult Education and she was studying at the Hillcroft College for working women. The couple had both been working at the Bournville chocolate factory at the time they met. The couple had had two daughters, Katherine McGilly (born in 1944) and Jean Clelland (born in 1950). Later they had two grandchildren and three great grandchildren.
Career
When World War II broke out, Robertson registered as a conscientious objector. At the start of the work he began working at a Pacifist Service Unit in East London, helping the victims of the bombing and helping to evacuate children who were at risk of bombing to other parts of the uk.
Hampstead Wartime Nurseries In January 1941 the couple began working with Anna Freud in the Hampstead War Nurseries and remained there for the rest of the war. Joyce was a student caring for the infants who had lost family life due to the war, while James began by organising the firewatching at the nursery and as a general maintenance man. Freud had a particular reliance on the couple as they were English and from a working-class background, unlike many of the émigrés who arrived to work at nurseries. Freud used them to translate both cultural and linguistic differences that were unknown to Freud as an emigre herself. Robertson also acted in the role of a father figure to many of the children without fathers.
Both James and Joyce benefited from teaching by Anna Freud and Dorothy Burlingham in child psychiatry. They also learned more prosaic subjects like common children's diseases, first aid and anatomy as well as subjects like the Montessori education method. Freud required that all her staff to maintain records of observations of children's behaviour that were recorded on small cards that were then discussed during weekly meetings and then indexed. This led to Robertson receiving meticulous training in naturalistic observation. The collaboration with Freud in discussing the psychological development of children, led Robertson to consider taking further training. During the war he completed a diploma qualification in social science.
In 1945, the couples thirteen-month-old baby, Katherine had to go into hospital for a week for treatment. The couple were appalled to discover that they could not visit their child. Indeed, this was considered normal practice. The reason given was the prevention of infection. This was illustrated in January 1940 when Ayr County Hospital decided to not to admit visitors to children that resulted in an editorial in The Lancet. This was widely practiced in UK hospitals. Robertson decided from that point onwards to only research mother/child separation due to hospital admission.
At the end of the war when the wartime nursery was shutting down, Robertson had the task of either returning the children to their families, or seeking families who would adopt the child. Out of the 191 children remaining at the nursery at the end of the war, Robertson returned 101 children to their parents. After the war, Robertson won a scholarship to the London School of Economics after the war to study psychiatry, graduating in 1947 as a psychiatric social worker. After his graduation he began training in psychoanalysis with the help of Freud.
Tavistock clinic In February 1948, Robertson was a co-founder along with John Bowlby's of the Tavistock Child Development Research Unit at the Tavistock Clinic. Bowlby had received a small grant from the Sir Halley Stewart Trust in 1948 to start researching the effects of separation and maternal deprivation of small children aged between 1 and 3 years that Bowlby called his sanatorium study. Robertson had been employed by Bowlby to make observations on separated young children and report the findings to Bowlby. Robertson had been trained in a strictly Freudian view of psychoanalysis that was not shared with Bowlby's. Bowlby at the time believed in what became known as the object relations theory of psychoanalysis that was developed in the early 1930s and 1940s by Melanie Klein and Donald Winnicott and formalised in 1952 by Scottish psychiatrist Ronald Fairbairn. Although for most practical purposes he was in agreement with Freud, when it came to discussing theory they had widely differing views. The German-American child psychologist Christoph Heinicke who specialised in mother/child separation (and would later join Bowlby's team) also disagreed with Bowlby's theoretical conclusions but agreed with the empirical data, but again for practical purposes agreed with Bowlby on everything else. This perhaps reflects in Robertson and Bowlby's relationship and how each viewed different theoretical aspects of mother/child separation. Certainly they complemented each other work, Bowlby as theorist who would use Robertson material that he compiled from observation. Also at Tavistock was psychoanalyst Isobel Menzies, who studied how the stress of working in hospital causes anxieties in nurses and how they dealt with it. Robertson used Menzies insights in his research.
Young children in hospital Beginning in February 1948, Robertson began observing young children at Central Middlesex and Harefield hospitals and made similar visits to local short and long-stay hospitals as well as residential nurseries. At the time, visiting of children in hospitals was still severely restricted. This was again illustrated by a 1949 letter to The Spectator by H.G. Monroe Davies who published a survey of visiting times to London Hospitals for parents. Some allowed no visiting, some no visiting for under three year olds, others only 1 or 1.5 hours visiting a week, others - twice a week, but it all cases it was extremely restrictive. 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 resistance to the awareness of children's emotional needs and distress. The strength of this resistance is vividly illustrated by the work of James Robertson'.
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 three years old. The competent, efficient doctors and nurses gave good medical care but seemed unaware of the suffering around them. Robertson described his experience:
Naturalistic observations During this project, Robertson observed more than 50 children in both long and short stay wards, although not all of them were intensively observed. When Robertson and Bowlby analysed the observations they concluded that when the child lost their mother and their efforts to regain that contact failed, they responded by inhibiting their feelings. Bowlby assigned the term "Detachment" to this phase. In 1950, developmental psychologist Mary Ainsworth joined the clinic in 1950. She was assigned to analyse Robertson's observations and tried to persuade Bowlby that the term was misleading as she believed an inhibition was present that blocked intense feelings of attachment, i.e those intense feelings were still present but inhibited, whereas detachment indicated separation from the care-giver. Robertson and Bowlby believed this inhibition was responsible for the tic-like movements and avoidant behaviour and it was Robertson qualitative assessment that the longer it went on for the child who received less comfort from hospital staff, the more psychological disturbance the child would experience at home. The child became more aggressive and anxious, would seek less affection, which would likely to occur at odd moments and without explanation. An example was "Bobby" who would punch his father for a particular reason, but would smile and severely punch his mother, randomly and seemingly for no reason.
When Robertson completed the study, Bowlby uses a quantitative metric on Robertson's data, based on IQ and teachers ratings of the children, to form a hypothesis that could prove the children would suffer consequences in later life due to separation, but was unable to do so. The results were withheld from publication. However, the qualitative results of the naturalistic observations by Robertson were considered by Ainsworth to be "entrancing’ and ‘deeply impressive". She stated:
One of the most influential observations Robertson made concerned "ambivalent anxiety/preoccupation" and avoidant behaviour that manifested as being withdrawn. After the child was separated from his mother, followed by protest, the behaviours were seen over an extended period of time that decreased as time went on. This led to a preoccupation of the child with the caregiver. Upon reunion, the child would display avoidant behaviour that could lead to withdrawal when the child returned home.
Other behaviours As well as ambivalent and avoidant behaviours, Robertson observed a number of other behaviours that was later important for the formation of attachment theory. These were behaviours associated with separation but also reunion. For over a decade, between the mid-1950s and the mid-1960s, Bowlby would record these observations in a book, writing and rewriting them as the context changed and new knowledge emerged. The core of these behaviours that Robertson observed was one of disorientation. Both Bowlby and Robertson suggested they indicated some form disruption of the attachment response, but weren't sure what it signified. The lack of clarity by Bowlby, led him to prevent the book being published, which resulted in a gradual separation by Robertson from the Tavistock Clinic in the early 1960's. Ainsworth saw the lack of publication as a major loss to development psychology.
Disorientation Robertson noted that children could change between ambivalent and avoidant behaviour without an external input. An example patient, Jacqueline, after five months at home, would seek "baby cuddles" from her mother in the evening and daytime, but between the two extremes of behaviour, of being a baby and being detached and independent, she would exhibit little evidence of a moderate behaviour expected of a young child. Essentially she would swing between the two behaviours.
Robertson also observed disorientation during a reunion between mother and child. During a visit by Laura's mother Robertson described the disorientation: