Enuresis is wetting the bed involuntarily and repeatedly during sleep after the age of five, when most children achieve full control. Diurnal enuresis as a name for the problem has been avoided lately and involuntary urinating during the day is named daytime incontinence. Nocturnal enuresis is diagnosed if involuntary bed wetting appears two or more times per week during a longer period of time, i.e. at least for several months.
During the past two decades the role of the father in the child’s life has been discussed again, as if the father had been put “aside”. Although older scientific literature mentions mother as the first object for the child, it is often not emphasised that the father is not exempt from the child’s life and that the child builds his/her relationship with the father from birth, separate from the relationship with the mother.
Two separate attachments
One interesting interview with Sir Richard Bowlby, son of John Bowlby known for his theory of attachment, is worth mentioning here. The interview was conducted in February 2009, in London. Sir Richard answered questions about the role of the father as an attachment figure. He said that researchers had found that children who were shining in social situations as young adults, had so-called double attachment, i.e. they were attached to their mothers who provided continual safe base and positive model for close relationships in the family, and they were attached to their fathers who provided exciting play and interactive challenges.
It seems that there are two separate, but equally important attachment roles – one providing love and safety, and the other providing involvement in exciting and challenging experience. Both are present in each parent, sometimes equally, and sometimes one is more present than the other. Consequently, father is not a figure of secondary attachment, but one more figure of primary attachment. Secondary attachment figures may be grandparents, siblings, kindergarten teachers, aunts, relatives, teachers.
Children learn by comparing their father with their mother
Some authors emphasise that the father introduces diversity, separation and the outside world into the child’s world on one hand, and on the other hand, he is a symbol of safety and protection. Father is there as a real person who establishes an active relationship with his child, and the child recognises the difference and limitations of the relationship with each parent. Early relationship of the child with his/her father includes much of what exists in the child’s relationship with his/her mother, but it is different from that relationship because the father is different. In this dyadic relationship, the child takes in the manner in which the father relates to the child. Differences between parents, including their sex, separation, interaction of styles, stimulate development of thinking and symbolic thinking processes, symbolic representations in the child. Reality forces the child into the process of differentiating between his/her mother and father, their different relationships, imperfections and needs. The child learns to compare.
Back to the interview with Sir Richard Bowlby, we conclude that the theory of attachment is focused on the quality of relationships which the child needs to achieve a sense of safety in dangerous circumstances. This author believes that we have to analyse the instinctive human needs for discovery, pleasure and a feeling of accomplishment and that we have to take care of the emotional and social implications of the needs on child development even when these needs are not present.
Two parent families
In the families where two parents participate in child care, one is usually an attachment figure providing stable safe base and shelter of safety when the child is alarmed, while the other provides safe base for exploration and excitement when the child is not alarmed – different, but equally important roles. There are also overlaps in these two attachment roles, in both parents, but each parent will emphasise one or the other attachment relationship.
It is important to point out why father’s sensitive and appropriate involvement in the relationship with his child has such a positive influence on the child’s adult life, which is equally important as mother’s influence. It can be seen why father’s emotional unavailability, separation or loss can have an impact which is equally negative as mother’s emotional unavailability, separation or loss, but in different ways and for different reasons. For the children to be successful in their later life, they need two different systems: one to know where their safe base is so they can return when the activity is finished and when they are alarmed by something, the other to have a reliable companion who will show the way. Sometimes both parents provide both of these systems, sometimes they have different separate roles.
Cultural influence on the model of double attachment
So, fathers have decisive influence on their child’s long-term social development, they play the role of reliable companions. Harmony between parents seems to be a very significant prerequisite for their child’s emotional outcomes. We need to mention that family conflicts are related to a wide range of negative outcomes for children and that parents in conflict are less capable of providing good parenting. Besides, if the child is exposed to a parental conflict resulting in separation or divorce, his/her healthy emotional life is threatened. If there is no marital discord and the parents separate or divorce, results are even worse.
Cultural issues are very important and John Bowlby believes that the model of double attachment is generally related to western cultures. In eastern cultures, the emphasis is on collectivism, and more rarely on individualism. Different cultural values will result in different social practices.
Written by: Marija Bogadi, MD, psychiatrist